GOOD MORNING

PROSTHODONTICS
definition
Prosthodontics is the dental specialty pertaining to the diagnosis,
treatment planning, rehabilitation and maintenance of the
oral function, comfort, appearance and health of patients with clinical
conditions associated with missing or deficient teeth and/or
maxillofacial tissues using biocompatible substitutes

BRANCHES

FIXED

: Fixed
: Movable
: Removable

REMOVABLE

COMPLETE

MAXILLOFACIAL

PARTIAL

: Extracoronal.
: Intracoronal

INTRODUCTION TO
FIXED PARTIAL DENTURE

JINISHNATH
(Final Year ,Part I )

FIXED PARTIAL DENTURE

Definition
A partial denture that is luted or otherwise
securely retained to natural teeth, tooth roots
and/or dental implant abutments that furnish
the primary support to the prosthesis- GPT

FIXED PROSTHODONTICS.
Fixed prosthodontics pertains to the restoration or

replacement of teeth with artificial substitutes that

are attached to natural teeth, roots or implants and
that are not readily removable.

FOR SUCESSFUL TREATMENT

Meticulous attention to every details
patient interview diagnosis and education
prevention of dental disease
periodont. Therapy (if indicated)
occl. Consideration
Appropriate treatment plan
operative skills and treatment
follow up care

Usually belongs following categories following categories

comfort

social
function
appearance

Personal details
Medical history
Medical condition affecting treatment method, treatment plan and
systemic condition

Dental history
Periodontal history
Restorative history
Endodontic history

Surgical history
Tmj dysfunction history

Examination
General examination
Extra oral examination
Tmj
Muscles
Lips

Intraoral examination
Periodontal
Occusal

Radiographic examination

INDICATIONS OF FIXED PROSTHESIS.

One or two adjacent teeth are missing in the same arch or

short span edentulous arches.

The supportive tissues are healthy.
Suitable abutment teeth are present.
The patient is in good health and wants to have the
prosthesis placed.
The patient has the skills and motivation to maintain
good oral hygiene.
Patients preference

Contraindications for a Fixed Prosthesis

o Necessary supportive tissues are diseased or missing.
o Suitable abutment teeth are not present.
o The patient is in poor health.

o The patient is not motivated to have the prosthesis

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

Common Terms
CROWN
Laminate Veneers/Facial Veneers

INLAY
ONLAY

ABUTMENT
PONTIC
CONNECTORS
RETAINER

CROWN
It is a cemented extracoronal restoration that covers or

veneers the outer surface of the clinical crown.

Primary function is to protect the underlying tooth structure
& restore the function, form and esthetics.
TYPES
1) Full veneer crown.
2) Partial veneer crown.
:-three quarter crowns
:-reverse three-quarter crowns
:-seven-eight crowns
:-pinledges
:-inlay
:-onlay

Full Veneer Crown (cast metal)

If it covers all of the crown, the restoration is a full or

complete veneer crown

It may be fabricated entirely of a gold alloy or some
other untarnishable metal, a ceramic veneer fused to
metal.

INDICATIONS
Teeth that have extensive coronal destructions by caries or trauma
Restoration of choice whenever maximum retention is needed
Indicated on endodontically treated teeth
Correction of occlusal plane
CONTRAINDICATIONS
If less than maximum retention and resistance is needed
Wherever intact buccal or lingual wall exists
Enameloplasty
For high esthetic needed exists like anterior teeth

Advantages
Strong
High retentive qualities
Can be modify form and occlusion
Easy to obtain adequate resistance form

Disadvantages
Removal of large amount of tooth structure

Display of metal

METAL CERAMIC CROWNS

The restorations consists of a complete coverage cast metal crown that is

veneered with a fused porcelain to mimic the appearance of a natural tooth

Indications
Esthetics
Gingival involvement
If porcelian jacket crowns is contraindicated

Contraindications
Large pulp chamber
Intact buccal wall

Advantages
Superior esthetics
Retentive qualities are excellent

Disadvantages
Removal of substantial tooth structure
Fracture can occur
Difficult to obtain accurate occlusion in glazed porcelain
expensive

Partial Veneer Crown

An extracoronal metal restorations that covers only part of the clinical
crown is considered to be a partial veneer crown

Partial Veneer
Crown
MOD Gold Onlay

Indications
Clinical crown of average length or longer
Intact buccal/labial surface
Well supported by sound tooth structure

Contraindications
Short teeth
High caries index
Extensive destruction
Not used in endodontically treated teeth
Poor alignment
Bulbous teeth
Thin teeth

Advantages

Conservative of tooth structure

Easy access to margins
Less gingival involvement
Verification of seating simple

Disadvantages
Less retentive than full crown
Limited adjustment of path of withdrawal
Not indicated on vital teeth

Three-quarter crowns

This type of crowns restore the occlusal surfaces and

the three of the four axial surfaces but not
including the facial surfaces

Pinledge

A partial veneer retainer preparation incorporating

pins holes to provide retention

Indications
High esthetic requirement
Undamaged anterior teeth
When proximal grooves are impossible to prepare
To alter lingual contour of maxillary anterior teeth

Contraindications
Large pulp
Non vital teeth
Thin teeth
carious involvement

Advantages
Minimal tooth reduction
Minimal marginal length
Minimal gingival involvement
Adequate retention
Excellent esthetics

Disadvantages
Less retentive
Techanically demanding

INLAY
A fixed intracoronal restoration; a dental
restoration made outside of a tooth to correspond to the form of
the prepared cavity, which is then luted into the tooth
Inlay may be used as a single tooth restorations for proximo-occlusal or
gingival lesions with minimal to moderate extensions.
They may be made up of gold alloy or ceramic material.
Inlays are similar to fillings but the entire work lies within the cusps on the
chewing surface of the tooth.

Indications
Small carious lesion
Adequate dentinal support
Low caries rate
Patient request for gold restorations

Contraindications
high caries index
Poor plaque control
MODs
Poor dentinal support require
wide preparation

ONLAY
A restoration that restores one or more cusps and
adjoining occlusal surfaces or the entire occlusal surface and is retained
by mechanical or adhesive mean
It is used for restoring more extensively damaged posterior teeth needing wide
mesio-occluso-distal restorations.

Indications
Worn or carious teeth with intact buccal and lingual cusps
MOD amalgam requiring replacements
Low caries rate

Contraindications
High caries risk
poor plaque control
Short clinical crown/extruded tooth
bruxism

Laminate Veneers/Facial Veneers

It consists of a thin layer of dental

porcelain or cast ceramic that is bonded

to the facial surfaces of the tooth with
an appropriate resin
It is used in situations requiring an
improved cosmetic appearance on the
anterior tooth.

PARTS OF FIXED PARTIAL DENTURE

RETAINER
ABUTMENT
PONTIC
CONNECTOR

RETAINER
Any type of device used for the stabilization
or retention of a prosthesis
Positioned at margin - less susceptible to caries or
recurrence of caries
Rigidity withstand the requisite load
Functional adaptation and protect the tooth against
its fracture
Least destroys the cervical marginal ridge

Types of retainer
Full veneer crowns
Partial veneer crowns
Conservative retainers
All metal retainers
Metal ceramic retainers
All ceramic retainers
All acrylic retainers

Pontics
An artificial tooth on a fixed dental prosthesis that
replaces a missing natural tooth, restores its function, and usually
fills the space previously occupied by the clinical crown

Pontics

Requirements of pontics
-restore function
-provide esthetics and comfort
-be biologically acceptable
-permit effective oral hygeine
-preserve underlying residual mucosa
Material used
Metal-ceramic pontics
Resin veneered
All metal
Facings

ABUTMENT
A tooth, a portion of a tooth, or that portion of a dental implant that serves to
support and/or retain a prosthesis

Connectors
Fixed dental prosthodontics, the portion of a fixed dental
prosthesis that unites the retainer(s) and pontics

Types-Rigid connectors
-Non rigid connectors
-tenon mortise connectors
-loop connectors
-split pontic connectors
-cross pin and wing connectors

Nonrigid connectors

Loop connectors
Loop connectors are used for when existing diastema is to be
maintained in the planned fixed prosthesis
T he connector consists of a loop on the lingual aspect of the prosthesis that
connects adjacent retainers and /or pontics

FUNCTIONS OF FIXED PARTIAL DENTURE

Provide proper occlusal function.
Maintain arch integrity/tooth position.
Maintain occlusal relationships.
Protect and preserve the remaining structures.

REFERENCE
Fundamentals of Fixed Prosthodontics Third edition.
Herbert.T.Shillingburg.
Theory and practice of Fixed Prosthodontics. Tylmans
Contemporary Fixed Prosthodontics.stephen F Rosenstiel

Have a nice day

Keep smiling