Ask an Expert: Bridges Compared to Teeth

Crowns, Bridges, Dentures, Implants

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

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Response by:

Nancy L Clelland, DMD, MSD
Professor of Restorative & Prosthetic Dentistry
College of Dentistry
The Ohio State University