TOPIC: DIAGNOSIS AND TREATMENT PLANNING IN FIXED PARTIAL DENTURE
🎯 KEY POINTS:
🔹Xerostomia is common to autoimmune disorders such as Sjogren syndrome, Rheumatoid Arthritis, Lupus Erythematosus and Scleroderma.
🔹Ante’s law is the abutment teeth should have total pericemental area equal to or greater than the pericemental area of the tooth/teeth to be replaced.
🔹Ideal crown:root ratio is 1:2, optimum or recommended is 2:3 and minimum ratio is 1:1.
🔹If edentulous space exists on either side of the abutment tooth, such tooth is called pier abutment.
🔹The space located below the contact area between teeth is called the embrasure space.
🔹Tilted molar is best uprighted by orthodontic means.
🔹Root amputation is removal of root without touching the crown.
🔹Hemisection is a procedure in which tooth is separated through crown and furcations.
🔹Radectomy is a process of resection of root.
🔹Ratio of 1.618:1.0 is called golden proportion and is a constant.
🔹Andrews’ bridge is indicated when there is large anterior ridge defect. It is a rectangular bar which is connected to the fixed retainers and follows the curve of the arch.
🔹Mandibular first molar is most frequently replaced by FPD.
📌 DIAGNOSIS:
✳️ DEFINITION: A determination of the nature of disease. (GPT 8thEd)
💡The essential elements which are necessary for proper diagnosis in fixed prosthodontics are:
- Medical and dental history
- Extraoral examination including TMJ and occlusal evaluation
- Intraoral examination
- Diagnostic casts
- Diagnostic wax-up
- Radiographs
🔷 Common Medical Conditions Which Influence The Treatment Of FPD
🔸Diabetes
🔸Cardiovascular Diseases
🔸Neurological Disorders
🔸Disease Of The Skin
🔸Disease Of Joints
🔸Radiation Therapy Patient
🔎 DIAGNOSTIC AIDS USED IN FIXED PROSTHODONTICS
💡Some of the diagnostic aids commonly used are:
🔸Diagnostic casts
🔸Diagnostic wax-up
🔸Photographs
🔸Radiographs
🔸Vitality testing with thermal or electrical stimulation
📌 ABUTMENT
✳️ DEFINITION: A tooth, a portion of the tooth or that portion of an implant used for the support of a fixed or removable prosthesis. (GPT 8th Ed)
🔷 Factors Influencing Abutment Selection
🔸Crown-to-root ratio
🔸Root configuration
🔸Location, angulation and condition of the abutment
🔸Root surface area
🔸Rigidity of FPD
🔷 Different Types Of Abutments Used In FPD
🔸Unrestored or ideal abutment
🔸Pier abutment
🔸Cantilevered abutment
🔸Tilted molar abutment
🔸Endodontically treated abutment
🔸Implant abutment
🔷 Residual Ridge Defects And Their Management
♦️ J.S. Siebert (1983) Classified the Residual Ridge Defects into the Following Three Categories:
(i) Class I: Has a normal ridge height with loss of faciolingual ridge width.
(ii) Class II: Has a normal faciolingual ridge width with loss of ridge height.
(iii) Class III: Loss of both ridge height and width.
(iv) Class N: No loss or minimal deformity of the ridge; this category was later added and was not a part of the original Siebert’s classification
♦️Techniques Used to Correct Ridge Defects
(i) Soft tissue ridge augmentation
(ii) Interpositional graft
(iii) Siebert’s onlay graft or thick free gingival graft
(iv) Gingival porcelain
(v) Ridge augmentation
(vi) Andrews’ bridge
🔷 Periodontal Factors Which Influence Treatment Planning In Fixed Prosthodontics
(i) Periodontitis
(ii) Trauma From Occlusion
(iii) Embrasure Spaces
(iv) Margin Placement
(v) Biologic Width