IntroductionIntroduction to to

Fixed ProsthodonticsFixed Prosthodontics

Dr. Feras Aalam

ProsthodonticsProsthodontics

The dental specialty concerned withThe dental specialty concerned with the making of the making of artificial replacements for missing parts of the artificial replacements for missing parts of the mouth and jaw. Also called prosthetic dentistry or mouth and jaw. Also called prosthetic dentistry or prosthodontia.prosthodontia.

Fixed prosthodontics is the specialized Fixed prosthodontics is the specialized area of dentistry involved in the area of dentistry involved in the replacement of missing teeth with a replacement of missing teeth with a cast prosthesis permanently cast prosthesis permanently cemented in place. cemented in place.

Indications for Fixed Indications for Fixed

ProsthodonticsProsthodontics One or two adjacent teeth are missing in One or two adjacent teeth are missing in

the same arch.the same arch. The supportive tissues are healthy.The supportive tissues are healthy. Suitable abutment teeth are present.Suitable abutment teeth are present. The patient is in good health and wants The patient is in good health and wants

to have the prosthesis placed.to have the prosthesis placed. The patient has the skills and motivation The patient has the skills and motivation

to maintain good oral hygiene.to maintain good oral hygiene.

Contraindications for Fixed Contraindications for Fixed ProsthodonticsProsthodontics

Necessary supportive tissues are Necessary supportive tissues are diseased or missing.diseased or missing.

Suitable abutment teeth are not present.Suitable abutment teeth are not present. The patient is in poor health. The patient is in poor health. The patient is not motivated to have the The patient is not motivated to have the

prosthesis placed.prosthesis placed. The patient has poor oral hygiene habits.The patient has poor oral hygiene habits. The patient cannot afford the treatment.The patient cannot afford the treatment.

Types of Cast RestorationsTypes of Cast Restorations

InlayInlay Indirect restoration Covers a portion of the Indirect restoration Covers a portion of the

occlusal and proximal surface. (dose not occlusal and proximal surface. (dose not cover the cusps)cover the cusps)

OnlayOnlay Indirect restoration Covers the proximal Indirect restoration Covers the proximal

surfaces and most or all of the occlusal surfaces and most or all of the occlusal surface. (covers the cusps) surface. (covers the cusps)

Porcelain VeneersPorcelain Veneers Thin shell-like covering placed to improve the Thin shell-like covering placed to improve the

appearance of anterior teeth.appearance of anterior teeth.

Full metal crownFull metal crown Completely covers the anatomic crown of Completely covers the anatomic crown of

an individual tooth.an individual tooth. Three‑quarter crown Three‑quarter crown

Covers the anatomic crown of a tooth Covers the anatomic crown of a tooth except for the facial portion.except for the facial portion.

Porcelain‑fused‑to‑metalPorcelain‑fused‑to‑metal crown crown (PFM)(PFM) Full metal crown with outer surfaces Full metal crown with outer surfaces

covered with a veneer of porcelain.covered with a veneer of porcelain.

Types of Cast RestorationsTypes of Cast Restorations cont’dcont’d

Types of Cast RestorationsTypes of Cast Restorations cont’dcont’d

Fixed bridgeFixed bridge A prosthesis for or more missing A prosthesis for or more missing

teeth within the same arch.teeth within the same arch.

Types of Cast RestorationsTypes of Cast Restorations cont’dcont’d

Types of Cast RestorationsTypes of Cast Restorations cont’dcont’d

Full ceramic crownFull ceramic crownCompletely covers the anatomic Completely covers the anatomic crown of an individual tooth.crown of an individual tooth.

Crown FabricationCrown Fabrication

1. Tooth Preparation, Including Build-Up1. Tooth Preparation, Including Build-Up 2. Impression2. Impression 3. Temporization3. Temporization 4. Model (Cast) and Die Fabrication4. Model (Cast) and Die Fabrication 5. Wax-Up5. Wax-Up 6. Investing and Casting6. Investing and Casting 7. Crown Adjusting and Polishing7. Crown Adjusting and Polishing 8. Clinical Try-In and Cementation8. Clinical Try-In and Cementation

RestorationsRestorations

Tooth PreparationsTooth Preparations

The tooth is prepared so the cast The tooth is prepared so the cast restoration can slide into place and restoration can slide into place and be able to withstand the forces of be able to withstand the forces of occlusion.occlusion.

Rotary instruments are used to reduce the Rotary instruments are used to reduce the height and contour of the tooth.height and contour of the tooth.

Hand cutting and rotary instruments Hand cutting and rotary instruments prepare the gingival margins.prepare the gingival margins.

Tooth PreparationTooth Preparation

Build-UpsBuild-Ups

Pin RetainedPin Retained

Preformed PostsPreformed Posts

Custom Cast Post and Custom Cast Post and CoreCore

Build-UpsBuild-Ups

Pin RetainedPin Retained

Build-UpsBuild-Ups

Preformed PostsPreformed Posts

Build-UpsBuild-Ups

Custom Cast Post Custom Cast Post and Coreand Core

ImpressionsImpressions

Cord temporarily displaces the Cord temporarily displaces the gingival tissue and widens the gingival tissue and widens the gingival sulcus so impression gingival sulcus so impression material can flow around all material can flow around all parts of the preparation. parts of the preparation.

NonimpregnatedNonimpregnated ImpregnatedImpregnated

Gingival Retraction and Tissue Gingival Retraction and Tissue ManagementManagement

Elastomeric impression Elastomeric impression materials are used to materials are used to create these extremely create these extremely accurate impressions.accurate impressions.

Final ImpressionFinal Impression

TemporariesTemporaries

Custom made acrylicCustom made acrylic Relined polycarbonate Relined polycarbonate

crownscrowns Preformed metal crownsPreformed metal crowns

TemporariesTemporaries

Custom made Custom made acrylicacrylic

TemporariesTemporaries

Relined polycarbonate Relined polycarbonate crownscrowns

TemporariesTemporaries

Preformed metal Preformed metal crownscrowns

Model (Cast) andModel (Cast) andDie FabricationDie Fabrication

SeriesSeries