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Fix appliances, types of crown and bridges Dr. Peter Hermann Fix appliance Fix appliance replacing one or more teeth that cannot be removed by the patient. Substantial tooth preparation is necessary for a conventional restoration. The appliance usually occupies no more space than the original dentition. General indication for crowns Badly broken down teeth Primary trauma Tooth wear Hypoplastic conditions To alter the shape or size or inclination of teeth To alter the occlusion As part of another restoration Root-filled teeth Combined indications Consideration of crown Physical properties, material Clinical consideration Odontotechnology (Cost) Complete crown Partial crown Metal Metal-ceramic platinum-bonded porcelain cast-metal with cemented porcelain facing Metal-acrylic Ceramic Acrylic Circonium Glass-fiber reinforced polymer Ceramic reinforced composite Advantage of replacing missing teeth Appearance Ability to eat Speech Periodontal splinting A feeling of completeness Orthodontic retention Restoring occlusal vertical dimension Disadvantage of replacing missing teeth Damage to tooth and pulp Secondary caries Failures Effects on the periodontium Cost and discomfort When teeth are missing the first decision is whether replacing them will do more good than harm. If the decision is for replacement, the second consideration is whether the prosthesis should be fixed or removable or implant. The patient’s attitude, general health, occupation, age and sex should all be taken into consideration. The state of the teeth and the oral hygiene will affect the final decision as to whether a bridge will be succesful. An abutment is a tooth or implant to which a bridge is attached. A retainer is a crown or other restoration that is cemented (screwed) to the abutment. A pontic is an artificial tooth as a part of a bridge. The saddle is the area of the edentulous ridge over which the pontic will lie. A unit, when applied to bridgework, means either a retainer or a pontic. A connector connects a pontic to a retainer or two retainers to each other. Types of bridge Fixed-fixed bridge ( Rigid connector at both end of the pontic.) Fixed-movable bridge ( Rigid connector at one end, a movable connector at the other end which allows some vertical movements of the abutment tooth.) Types of bridge Cantilever bridge ( Provides support for the pontic at one end only.) Removable bridge ( They can be removed by the dentist without being destroy.) Minimal preparation bridge ( Direct, chemically retentive ) Principles of design pontics To improve appearance To stabilize the occlusion To improve masticatory function To improve the phonetical function Cleansability Appearance Strength Designs of pontic Hygienic (wash-through) Dome-shaped Ridge-lap Saddle Thank you for your attention!