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Bridge DesignBridge Design
Out Lines:Out Lines:
Introduction.Introduction.
Def. Of Bridge.Def. Of Bridge.
Fixed Partial Denture Designs.Fixed Partial Denture Designs.
New designs of fixed partial New designs of fixed partial
denture.denture.
Bridge DesignBridge Design
•Replacement of missing teeth or Replacement of missing teeth or
tooth is essential to patient, not only tooth is essential to patient, not only
for esthetic & function but also for the for esthetic & function but also for the
longevity of his dentition. The longevity of his dentition. The
continuity of dental arch is important continuity of dental arch is important
for teeth support & preserve its static for teeth support & preserve its static
condition. condition.
IntroductionIntroduction
• Before replacement of any missing Before replacement of any missing
tooth, realignment of the abutment tooth, realignment of the abutment
teeth to the normal position is a teeth to the normal position is a
must if possible I.e (bodily drift, must if possible I.e (bodily drift,
tilting & over eruption of the tilting & over eruption of the
opposing) treated with orthodontic opposing) treated with orthodontic
means, grinding or even means, grinding or even
devitalization to correct the plane of devitalization to correct the plane of
occlusion. occlusion.
Missing teethMissing teeth may be replaced by may be replaced by one of the three prosthesis optionsone of the three prosthesis options::
A tooth supported fixed partial denture (FPD) A tooth supported fixed partial denture (FPD) which include conventional tooth supported FPD which include conventional tooth supported FPD & resin-bonded tooth supported FPD& resin-bonded tooth supported FPD..
A removable prosthesis (partial, complete)A removable prosthesis (partial, complete)..
OR an implant supported prosthesisOR an implant supported prosthesis..
connector
pontic
retainer
Abutment tooth
Bridge ComponentsBridge Components
Def. Of Bridge.Def. Of Bridge.What are Dental Crowns and Tooth What are Dental Crowns and Tooth
Bridges?Bridges?
Both crowns and bridges are fixed Both crowns and bridges are fixed prosthetic devices. Unlike prosthetic devices. Unlike removable devices such as removable devices such as denturesdentures, which can be take out and , which can be take out and cleaned daily, crowns and bridges cleaned daily, crowns and bridges are cemented onto existing teeth are cemented onto existing teeth or implants, and can only be or implants, and can only be removed by a dentist.removed by a dentist.
• . . HOW Do Bridges Work?HOW Do Bridges Work?
• bridge may be recommended if you're bridge may be recommended if you're
missing one or more teeth. Gaps left by missing one or more teeth. Gaps left by
missing teeth eventually cause the missing teeth eventually cause the
remaining teeth to rotate or shift into remaining teeth to rotate or shift into
the empty spaces, resulting in a bad the empty spaces, resulting in a bad
bite. The imbalance caused by missing bite. The imbalance caused by missing
teeth can also lead to gum disease and teeth can also lead to gum disease and
temporomandibular joint (temporomandibular joint (TMJTMJ)disorders.)disorders.
Bridges are cemented to the natural Bridges are cemented to the natural teeth or implants surrounding the teeth or implants surrounding the empty space. These teeth, called empty space. These teeth, called abutments, serve as anchors for the abutments, serve as anchors for the bridge. A replacement tooth, called bridge. A replacement tooth, called a pontic, is attached to the crowns a pontic, is attached to the crowns that cover the abutmentsthat cover the abutments . .
Fixed Partial Denture Designs.Fixed Partial Denture Designs.There are three types of dental bridges:There are three types of dental bridges:
Conventional tooth supported fixed partial Conventional tooth supported fixed partial denture (FPD)denture (FPD)
Resin Bonded tooth supported fixed partial Resin Bonded tooth supported fixed partial denture (FPD) denture (FPD)
Implant supported (FPD)Implant supported (FPD)
A posterior resin-bonded fixed partial denture using the occlusal surface for bonding.
Resin Bonded tooth supported Resin Bonded tooth supported fixed partial denture (FPD) fixed partial denture (FPD)
.Fixed-fixed Fixed-fixed Resin Bonded Resin Bonded BridgeBridge
ConventionalConventional Fixed Bridges Fixed Bridges::
The false tooth is attached by the bridge The false tooth is attached by the bridge to the other teeth around the space - to the other teeth around the space - bridging them together. Unlike partial bridging them together. Unlike partial dentures, fixed bridges are set in place dentures, fixed bridges are set in place permanently and cannot be removed. permanently and cannot be removed. This procedure is used to replace one or This procedure is used to replace one or more missing teethmore missing teeth..
•The usual The usual configuration for configuration for Conventional fixed Conventional fixed partial denture (FPD) partial denture (FPD) utilize an abutment utilize an abutment tooth on each end of tooth on each end of edentulous space to edentulous space to support the support the prosthesis. The prosthesis. The abutment teeth abutment teeth should be should be periodontally soundperiodontally sound . .
-- The maximum number of posterior The maximum number of posterior
teeth that can be replaced with teeth that can be replaced with conventional FPD is three, while conventional FPD is three, while four adjacent anterior teeth can be four adjacent anterior teeth can be safely replaced with conventional safely replaced with conventional FPD. The connector between the FPD. The connector between the FPD components may be rigid, non FPD components may be rigid, non rigid or loop connector. The rigid or loop connector. The materials are either metal onlymaterials are either metal only
((limited due to estheticlimited due to esthetic ,) ,)metal-ceramicmetal-ceramic ((most commonly usedmost commonly used ) )or ceramic only or ceramic only
) limited due to its poor strength() limited due to its poor strength(..
Basic Designs of Basic Designs of Conventional tooth Conventional tooth
Supported fixed partial denture (FPDSupported fixed partial denture (FPD): ):
There are several different types of dental There are several different types of dental
bridges: bridges:
Fixed-fixed dental bridgeFixed-fixed dental bridge
Fixed-movable bridge designFixed-movable bridge design
Cantilever dental bridgeCantilever dental bridge
Spring cantilever dental bridgeSpring cantilever dental bridge•compound and hybrid bridgecompound and hybrid bridge
Fixed Partial Denture Designs.Fixed Partial Denture Designs.
Conventional tooth supported Conventional tooth supported fixed partial denture (FPD)fixed partial denture (FPD)
Resin Bonded tooth supported Resin Bonded tooth supported fixed partial denture (FPD)fixed partial denture (FPD)
Implant supported (FPD)Implant supported (FPD)
1.1. Fixed-fixed dental bridge, Fixed-fixed dental bridge,
which consists of a filler tooth which consists of a filler tooth
(a pontic) that is attached to (a pontic) that is attached to
two dental crowns. The two dental crowns. The
dental crowns fit over the dental crowns fit over the
existing teeth to hold the existing teeth to hold the
dental bridge in place. The dental bridge in place. The
fixed dental bridge is the fixed dental bridge is the
most popular bridge. most popular bridge.
Conventional tooth supported Conventional tooth supported fixed partial denture (FPD)fixed partial denture (FPD)
1.1. Fixed-fixed dental Fixed-fixed dental bridgebridge
2.2. Fixed-movable bridge Fixed-movable bridge designdesign
3.3. Cantilever dental Cantilever dental bridgebridge
4.4. Spring cantilever Spring cantilever dental bridgedental bridge
55.. compound and hybridcompound and hybrid
bridgebridge
fixed-fixed dental fixed-fixed dental bridgebridge
fixed-fixed dental bridge restoring fixed-fixed dental bridge restoring missing upper caninemissing upper canine . .
fixed-fixed dental bridge restoring fixed-fixed dental bridge restoring missing lower second premolarmissing lower second premolar . .
22-- Fixed-movable bridge Fixed-movable bridge designdesign,,
It has a rigid connector at the It has a rigid connector at the
distal end of the pontic distal end of the pontic
where it joins the major where it joins the major
retainer & a movable retainer & a movable
connector (semirigid joint) connector (semirigid joint)
that allows some vertical that allows some vertical
movement of the mesial movement of the mesial
abutment tooth which abutment tooth which
receives the minor retainerreceives the minor retainer..
Conventional tooth supported Conventional tooth supported fixed partial denture (FPD)fixed partial denture (FPD)
1.1. Fixed-fixed dental Fixed-fixed dental bridgebridge
2.2. Fixed-movable bridge Fixed-movable bridge designdesign
3.3. Cantilever dental Cantilever dental bridgebridge
4.4. Spring cantilever Spring cantilever dental bridgedental bridge
55.. compound and hybridcompound and hybrid
bridgebridge
Fixed-movable bridge designFixed-movable bridge design
Fixed-movable bridge design restoring Fixed-movable bridge design restoring missing upper right second premolarmissing upper right second premolar..
•The main uses of this design areThe main uses of this design are::
- - mesially tilted molar to avoid its mesially tilted molar to avoid its
over cutting & pulp exposureover cutting & pulp exposure..
• - -in case with pier abutment to in case with pier abutment to
reduce the stress transmitted to the reduce the stress transmitted to the
terminal retainers as a result of the terminal retainers as a result of the
middle abutment acting as a fulcrum middle abutment acting as a fulcrum
causing failure of weaker retainercausing failure of weaker retainer..
cantilever dental bridgecantilever dental bridge33-- Is often used when there are
teeth on only one side of the
span. A typical 3 unit cantilever
dental bridge consists of two
abutment dental crowns that are
positioned next to each other on
the same side of the missing
tooth space. The pontic is then
connected to the two dental
crowns, which extend into the
missing tooth space.
Conventional tooth supported Conventional tooth supported fixed partial denture (FPD)fixed partial denture (FPD)
1.1. Fixed-fixed dental Fixed-fixed dental bridgebridge
2.2. Fixed-movable bridge Fixed-movable bridge designdesign
3.3. Cantilever dental Cantilever dental bridgebridge
4.4. Spring cantilever Spring cantilever dental bridgedental bridge
55.. compound and hybridcompound and hybrid
bridgebridge
Cantilever dental bridge Cantilever dental bridge restoring missing upper lateral restoring missing upper lateral incisorincisor..
Cantilever dental bridge Cantilever dental bridge restoring missing upper right restoring missing upper right
central incisorcentral incisor..
Color Atlas of clinical operative Color Atlas of clinical operative dentistry, Crown & Bridgedentistry, Crown & Bridge
bridge: bridge: cantilever dental cantilever dental 4-4-SpringSpring
The pontic is away from the abutment The pontic is away from the abutment
and is connected to the retainer by and is connected to the retainer by
long flexible bar running high into long flexible bar running high into
the palate. The abutments are the palate. The abutments are
usually the two premolars splinted usually the two premolars splinted
together or a single premolar or together or a single premolar or
molarmolar..
Conventional tooth supported Conventional tooth supported fixed partial denture fixed partial denture (FPD)(FPD)
1.1. Fixed-fixed dental bridgeFixed-fixed dental bridge
2.2. Fixed-movable bridge Fixed-movable bridge designdesign
3.3. Cantilever dental bridgeCantilever dental bridge
4.4. Spring cantilever dental Spring cantilever dental bridgebridge
55.. compound and hybridcompound and hybrid
bridgebridge
bridge bridge cantilever dental cantilever dental SpringSpring
Close-up view of spring cantilever Close-up view of spring cantilever bridgebridge . .
•55 - -compound and hybrid bridgecompound and hybrid bridge Conventional tooth supported Conventional tooth supported
fixed partial denture (FPD)fixed partial denture (FPD)
1.1. Fixed-fixed dental Fixed-fixed dental bridgebridge
2.2. Fixed-movable bridge Fixed-movable bridge designdesign
3.3. Cantilever dental Cantilever dental bridgebridge
4.4. Spring cantilever Spring cantilever dental bridgedental bridge
55.. compound and hybridcompound and hybrid
bridgebridge
Color Atlas of clinical operative Color Atlas of clinical operative dentistry, Crown & Bridgedentistry, Crown & Bridge
New designs in conventional tooth supported FPDNew designs in conventional tooth supported FPD::
11 ) )Sleeve design FPDSleeve design FPD
22 ) )Andrews bridge designAndrews bridge design
33 ) )Split pontic bridge designSplit pontic bridge design4) Cross - pin and wing design4) Cross - pin and wing design
5) Metal free FPD5) Metal free FPD
11 ) )Sleeve design FPDSleeve design FPD
As the retention of any As the retention of any restoration is directly proportional restoration is directly proportional to the lengthto the length of the axial wallsof the axial walls of of the preparation.the preparation. Abutment with Abutment with short crowns have always a short crowns have always a challenge for dentist because challenge for dentist because these abutments are considered these abutments are considered the major cause for FPD failure the major cause for FPD failure specially in young patients where specially in young patients where the addition of extra-means of the addition of extra-means of retention (grooves, boxes, slots, retention (grooves, boxes, slots, pins) may violate pulpal integrity. pins) may violate pulpal integrity.
New designs in conventionalNew designs in conventional
tooth supported FPDtooth supported FPD::
11 ) )Sleeve design FPDSleeve design FPD
22 ) )Andrews bridge designAndrews bridge design3) Split pontic bridge design3) Split pontic bridge design
4) Cross - pin and wing design4) Cross - pin and wing design
5) Metal free FPD5) Metal free FPD
A new sleeve design retainer for posterior A new sleeve design retainer for posterior
fixedfixed partial denture have been introducedpartial denture have been introduced..This design solved the problem of short This design solved the problem of short abutments as it saved the occlusal surface abutments as it saved the occlusal surface front reduction and established a natural front reduction and established a natural retention by avoiding shortening the axial retention by avoiding shortening the axial walls of the abutments . walls of the abutments .
Also intact occlusal surface of the abutments Also intact occlusal surface of the abutments aid establishment of natural occlusal aid establishment of natural occlusal relationship.relationship.
The preparation consists of axial reduction of
the facial , lingual & proximal surfaces,
chamfer finish line cervically (supragingivally
) and the occlusoaxial finish line terminates
approximately 0.5 mm gingival to the
occluding area of the functional cusps.
Precious or non precious porcelain fused-to
metal alloys can be used for its fabrication.
This type of bridge can be cemented with This type of bridge can be cemented with
any type of cement (zinc phosphate, any type of cement (zinc phosphate,
polycarboxylate, Glass-ionomer or resin polycarboxylate, Glass-ionomer or resin
cement) .cement) .
2) Andrews bridge design2) Andrews bridge design
One solution used in the One solution used in the
restoration of large ridge restoration of large ridge
defects in thedefects in the anterior region anterior region
when ridge augmentation can when ridge augmentation can
not be performed for anynot be performed for any
reason. reason.
Andrews bridge system utilizes Andrews bridge system utilizes
fixed retainers that are fixed retainers that are
connected by a rectangular bar connected by a rectangular bar
that follows the curve of the that follows the curve of the
ridge under itridge under it
New designs in conventionalNew designs in conventional
tooth supported FPDtooth supported FPD::
11 ) )Sleeve design FPDSleeve design FPD
22 ) )Andrews bridge designAndrews bridge design3) Split pontic bridge design3) Split pontic bridge design
4) Cross - pin and wing design4) Cross - pin and wing design
5) Metal free FPD5) Metal free FPD
• The prosthesis consists of teeth set in a removable flange The prosthesis consists of teeth set in a removable flange
of gingiva- colored acrylic resin that clips over and is of gingiva- colored acrylic resin that clips over and is
stabilized by the rectangular bar .stabilized by the rectangular bar .
• 3) Split pontic bridge 3) Split pontic bridge designdesign
The obvious problem with non parallel The obvious problem with non parallel
abutment ( tilted molar or pier abutment ( tilted molar or pier
abutment ) is the establishment of a abutment ) is the establishment of a
common draw .common draw .
The optimal treatment is considered The optimal treatment is considered
to be orthodontic molar uprighting, to be orthodontic molar uprighting,
but often the dentist have to deal but often the dentist have to deal
with the paralleling problem in a with the paralleling problem in a
purely restorative manner.purely restorative manner.
New designs in conventionalNew designs in conventional
tooth supported FPDtooth supported FPD::
11 ) )Sleeve design FPDSleeve design FPD
22 ) )Andrews bridge designAndrews bridge design3) Split pontic bridge design3) Split pontic bridge design
4) Cross - pin and wing design4) Cross - pin and wing design
5) Metal free FPD5) Metal free FPD
• This design include an attachment that is This design include an attachment that is
placed entirely withinplaced entirely within the ponticthe pontic . . It is It is
particularly useful in tilted and pier abutment particularly useful in tilted and pier abutment
case.case.
• The wax pattern of the anterior segment is fabricated with a The wax pattern of the anterior segment is fabricated with a distal arm attached to the anterior retainer (or the distal of the distal arm attached to the anterior retainer (or the distal of the pier abutment). The underside of this arm is shaped like the pier abutment). The underside of this arm is shaped like the tissue - contacting area of the pontic . tissue - contacting area of the pontic .
The pontic can be metal - ceramic but The pontic can be metal - ceramic but
No cement should be placed between No cement should be placed between
the two segments of the pontic.the two segments of the pontic.
• 4) Cross - pin and wing 4) Cross - pin and wing designdesign
It is a type of two -piece It is a type of two -piece
bridge system introduced bridge system introduced
1994 it allows preparing 1994 it allows preparing
the abutments in different the abutments in different
directionsdirections
( not parallel abutments) . In ( not parallel abutments) . In
this design the two bridge this design the two bridge
segments are rigidly fixed segments are rigidly fixed
after the retainers have after the retainers have
been cemented . been cemented .
New designs in conventionalNew designs in conventional
tooth supported FPDtooth supported FPD::
11 ) )Sleeve design FPDSleeve design FPD
22 ) )Andrews bridge designAndrews bridge design3) Split pontic bridge design3) Split pontic bridge design
4) Cross - pin and wing design4) Cross - pin and wing design
5) Metal free FPD5) Metal free FPD
• It is used in cases of tiltedIt is used in cases of tilted molar and pier molar and pier
abutment to avoid over cutting of the abutment to avoid over cutting of the
abutment whenabutment when semirigidsemirigid jointjoint isis usedused. . A A
vertical wingvertical wing isis attachedattached toto thethe mesialmesial
surfacesurface of the distal retainer wax pattern. of the distal retainer wax pattern.
This wing should be parallel to the path of This wing should be parallel to the path of
insertion of the mesial abutment insertion of the mesial abutment
preparationpreparation
•5) Metal free FPD5) Metal free FPD
Metal free framework system has Metal free framework system has
been recently introduced , which been recently introduced , which
has the potential for replacing has the potential for replacing
conventional ceramic fused to conventional ceramic fused to
metal restorations . This metal restorations . This
restoration is the most restoration is the most
esthetically pleasing prosthetic esthetically pleasing prosthetic
restoration , because there is no restoration , because there is no
metal to block light metal to block light
transmissions , they can resemble transmissions , they can resemble
natural tooth structure better in natural tooth structure better in
term of color and translucency .term of color and translucency .
New designs in New designs in conventionalconventional
tooth supported FPDtooth supported FPD::
11 ) )Sleeve design FPDSleeve design FPD
22 ) )Andrews bridge designAndrews bridge design3) Split pontic bridge 3) Split pontic bridge designdesign
4) Cross - pin and wing 4) Cross - pin and wing designdesign
5) Metal free FPD5) Metal free FPD
Labial view of ceramic bridge on master model..
Intra-oral view of cemented bridge
•FIXED PROSTHODONTIC DESIGNSFIXED PROSTHODONTIC DESIGNS
Simple fixed partial Simple fixed partial denture denture
(missing one tooth)(missing one tooth)
FIXED PROSTHODONTIC DESIGNSFIXED PROSTHODONTIC DESIGNS
•Simple fixed partial denture Simple fixed partial denture (missing one tooth) (missing one tooth)•Simple fixed partial denture Simple fixed partial denture (missing two teeth) (missing two teeth)•complex fixed-fixed bridge complex fixed-fixed bridge (more than two teeth) (more than two teeth)
Simple fixed partial Simple fixed partial denture denture (missing two teeth)(missing two teeth)
FIXED PROSTHODONTIC FIXED PROSTHODONTIC DESIGNSDESIGNS•Simple fixed partial denture Simple fixed partial denture (missing one tooth) (missing one tooth)•Simple fixed partial denture Simple fixed partial denture (missing two teeth) (missing two teeth)•complex fixed-fixed bridge complex fixed-fixed bridge (more than two teeth) (more than two teeth)
complex fixed-fixed complex fixed-fixed bridge bridge (more than two (more than two teeth)teeth)
FIXED PROSTHODONTIC DESIGNSFIXED PROSTHODONTIC DESIGNS
•Simple fixed partial denture Simple fixed partial denture (missing one tooth) (missing one tooth)•Simple fixed partial denture Simple fixed partial denture (missing two teeth) (missing two teeth)•complex fixed-fixed bridge complex fixed-fixed bridge (more than two teeth) (more than two teeth)