Bridge Design

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

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• 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.

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• . . 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.

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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.


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..







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.







bridgebridge

Cantilever dental bridge Cantilever dental bridge restoring missing upper lateral restoring missing upper lateral incisorincisor..

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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


3.3. Cantilever dental bridgeCantilever dental bridge

4.4. Spring cantilever dental Spring cantilever dental bridgebridge


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)






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


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::


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


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







• 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.







• 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 .







• 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



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


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)

Bridge Design

Documents

clinical operative

themissing

metal free

tooth supported

movable bridge

fixed prosthodontic

fixed dental

implant supported