Bridges Compared to Teeth
04/18/2005 |
Question:
How do implants compare to two missing teeth. The last upper molar is a solid capped tooth, then two missing teeth and then another capped tooth. I previously had a removable one tooth bridge in this spot, and liked it better than the fixed bridge on the other side. It was easier to clean and felt better chewing.
Answer:
Contraindications to Implant Placement (NIH Consensus Conference
- Acute illness
- Terminal illness
- Pregnancy
- Uncontrolled metabolic disease
- Tumoricidal radiation to implant site
- Unrealistic patient expectation
- Improper patient motivation
- Lack of operator experience
- Inability to restore the prosthesis
Treatment Planning
- mounted study casts
- radiographs (corrected for magnification)
- evaluation of edentulous space (mesiodistal dimension); orthodontics may be necessary to gain space
- evaluation of soft tissue contours; soft tissue management may be needed to gain ideal contours
- evaluation of adjacent teeth; caries control may be necessary, periapical pathology may need to be addressed
Interarch space must provide enough room for prosthetic components
Fabrication of an Interim or Transitional Partial Denture
Step 1 (Clinical):
- Alginate impressions to generate casts
- Jaw relation records as needed
- Shade selection for acrylic denture teeth and resin
Step 2 (Laboratory):
- Bend and add wire clasps if needed
- Set denture teeth into position with wax
- Lubricate (alcote) teeth and labial surface of cast
- Plaster matrix of teeth and labial surface of cast
- Remove all wax used to set teeth
- Readapt teeth to position with plaster matrix
- Drill retentive holes in bottom of plastic teeth; teeth may also need be made shorter to allow room for acrylic resin
- Add rope wax as a finishing line for the acrylic resin
- Add powder and liquid repair resin
- Place rubber band around matirx and cast
- Place in pressure pot for 15 minutes
- Finish and Polish
Step 3 (Clinical):
- Try-in of transitional
- PIP
- Adjust occlusion and clasps
Step 4 (Clinical):
- Homecare instructions
- Remove at night; place in water; clean with tooth brush; etc.
Related Resources:
removable vs fixed bridge – Part 1
For more information:
Go to the Crowns, Bridges, Dentures, Implants health topic.