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Replacing Missing Teeth PDF
Replacing Missing Teeth PDF
Resin-bonded Bridge
Ken Hemmings, BDS, MSc, DRD RCS, MRD
RCS, FDS RCS, Consultant in Restorative Dentistry With improvements in the field of
and Zoe Harrington, BDS, MFGDP(UK), MSc, adhesive dentistry, resin-bonded
MFDS RCS, Specialist Registrar in Restorative bridgework has become a viable option for
Dentistry, Eastman Dental Hospital & Institute, the long-term replacement of missing
256 Gray’s Inn Road, London WC1X 8LD.
teeth. One study reported a median Figure 1. Shortened dental arch.
R E S T O R AT I V E D E N T I S T RY
neighbouring teeth.
Where there is insufficient bone for
implant placement, grafting procedures
may be required. The appearance of
implant-retained prostheses may be
unpredictable and is rarely better than
conventional crown and bridgework. Soft
tissue loss can be difficult to restore and
loss of the interdental papilla is common,
Figure 8. The use of pink porcelain to mask resulting in a long contact area rather than Figure 10. Implants used to replace
tissue loss. a contact point. Ridge augmentation congenitally absent 3/3.
techniques can be considered to enhance
the final appearance but increase the
complexity and length of treatment (Figure
9).
Replacement of a single tooth, multiple
teeth or the whole arch is now possible
with implants. They can be considered the
tooth replacement of choice for most
clinical situations but are particularly
Figure 9. Localized ridge defect following the useful when dealing with unrestored,
Figure 11. Implant-retained crowns 3/3.
traumatic loss of 21/1. heavily restored and spaced dentitions.
Certain medical conditions, such as
should be taken to locate incisive and haematological disorders, metabolic bone contra-indications to implant treatment.
inferior dental canals, nasal cavity, disease, psychological illness, alcoholism Smoking7 and active periodontal disease
maxillary sinuses and the roots of and poorly controlled diabetes, are relative lower success rates. Similarly, implants are
DU 140-141 WITH ADS 13/4/04 11:11 AM Page 2
R E S T O R AT I V E D E N T I S T RY
not immune to the damaging occlusal popularity. This involves fitting a his/her patient for such care.
forces generated by bruxist patients. provisional restoration immediately after
Ideally, 7 mm of interproximal and implant placement in order to restore
interocclusal space is required for implant function and appearance, as well as
placement, though many components are improving the final soft tissue contour by REFERENCES
1. Kayser AF. Shortened dental arches and oral
now available to help with problem allowing the gingivae to heal around a function. J Oral Rehab 1981; 8: 457–462.
situations. Age does not influence the restoration with similar contours to the 2. Love WD, Adams RL. Tooth movement into
likelihood of success of implants.8 final prosthesis (Figures 10, 11). edentulous areas. J Prosth Dent 1971; 25: 271–277.
3. Djemal S, Setchell D, King P, Wickens J. Long-term
However, some elderly patients find the survival characteristics of 832 resin-retained bridges
procedures difficult to cope with. It is not and splints provided in a post-graduate teaching
advisable to place implants before growth CONCLUSIONS hospital between 1978 and 1993. J Oral Rehab 1999;
is completed as they behave in a similar Case selection is crucial to success when 26: 302–320.
4. Creugers NH, Kayser AF, van‘t Hof MA. A meta-
way to an ankylosed tooth. considering any form of tooth analysis of durability data on conventional fixed
Developments in the field of replacement. Whichever treatment bridges. Community Dent Oral Epidemiol 1994; 22:
implantology include the use of immediate modality is finally selected, it should suit 448–452.
implants that are placed into a prepared the needs of the patient, be carefully 5. Reuter JE, Brose MO. Failures in full crown retained
dental bridges. Br Dent J 1984; 157: 61–63.
extraction socket following tooth removal.9 planned and skilfully executed. The 6. Standlee JP, Caputo AA. Load transfer by fixed partial
They have the advantages that the success and limitations of removable dentures with three abutments. Quintessence Int
number of surgical sessions is reduced, partial dentures and conventional 1988; 19: 403–410.
the waiting period for socket healing is bridgework are well known to the 7 Bain CA, Moy PK.The association between the
failure of dental implants and cigarette smoking. Int J
eliminated, the alveolar ridge height and profession. Resin-bonded bridges and Oral Maxillofac Implants 1993; 8: 609–615.
width is preserved and overall costs are dental implants now have proven track 8. Jemt T. Implant treatment in elderly patients. Int J
reduced. The main disadvantages of this records and should be offered to patients Prosthodont 1993; 6: 456–461.
9. Wöhrle P. Single-tooth replacement in the aesthetic
technique are that it is more demanding as predictable alternatives. It is the
zone with immediate provisionalization: fourteen
both surgically and prosthetically. practitioner’s choice whether to undertake consecutive case reports. Pract Periodont Aesthet Dent
Immediate loading is also increasing in these relatively newer techniques or refer 1998; 10: 1107–1114.