FIXED

PROSTHESI
S
PLANNING TREATMENT OF UNITARY
RESTORATIONS
TEACHER: Dr. DORKA GONZALES CALDERON
YEAR : 5th - X CYCLE
CLUSTER : 8
PLANNING TREATMENT OF UNITARY
RESTORATIONS

It is performed using cast metal, ceramic

and metal-ceramic restorations, and it is possible to replace
large
areas of missing coronal tooth structure.

The choice of
restorative
material

In the design, adapting to

the patient's
needs
What is a stump?
The stump is the dental preparation that constitutes the
support
element for a PFU or PFP.

Vital stump

Reconstructed vital stump

Reconstructed non-vital stump

Post-stump system
 TYPES OF MATERIALS
□ Dual-polymerization, radiopaque, fiberglass-
reinforced composite material.

PARACORE □ This resin comes in 5 ml syringes and 25 ml

(COLTÉNE / cartridges.
WHALEDENT)
□ It is found in three shades:
□ White to differentiate it from the tooth
structure, dentin shade for aesthetic restorations
and translucent for the restoration of anterior
teeth.
□ ParaBond provides an adhesion surface and
enables sealing. It consists of a conditioner
(Non-Rinse) for enamel and dentin and a
chemical polymerization adhesive system
(Adhesive A and B).
 TYPES OF
MATERIALS
Composite resins have become the dental material of
choice for reconstructing cores and fractured dental

structures prior to the placement of an extra coronal

reconstruction.
 TYPES OF MATERIALS
GLASS IONOMER
Core rebuilder/restorative, is a resin modified glass
ionomer system.
Vitremer This material offers polymerization in three ways: An
acid-base reaction;
Photopolymerization; Autopolymerization
 TYPES OF
MATERIALS
GLASS High-density
IONOMER glass ionomer used in a minimally
invasive
KETAC MOLAR technique or for atraumatic
restorative treatments.

Conventional
self-curing glass ionomer cement that is
RIVA – SELF characterized by being a resistant dentin
CURE replacement
, does not shrink and does not contain
bisphenol A in its composition.
Light-curing resin-coded glass ionomer cement used
for restoration of caries
RIVA – LIGHT
, fissures, lines and others
CURE
in permanent teeth.
 TYPES OF MATERIALS
GLASS IONOMER
( (
RIVA – SELF CURE
-------------------------------- --------------------------------------
________________________
X X
KETAC MOLAR RIVA – LIGHT CURE _____
_______________________>
_J
 METAL FREE INLAY AND ONLAY AND THEIR
CONSIDERATIONS

CERAMICS INLAY

This technique used to This crown is the most suitable

restore teeth when it comes to combining full
with coverage and maximum
injuries small aesthetics.
either
CERAMICS ONLAYS
 METAL FREE INLAY AND ONLAY AND THEIR
CONSIDERATIONS
X-

(-------------------------------------
VENEERS
It has emerged as a means of
producing a highly esthetic result
in intact anterior teeth,
albeit disfigured by severe staining
or developmental defects
limited to the buccal surface of
the tooth, all without the removal of
large amounts of tooth structure
.
 POINTS FOR
CHOOSING
MATERIAL IN A
RESTORATION

Aestheti
cs
 TREATMENT PLANNING
FOR MISSING TEETH
( ( ..
Fixed partial denture ------- -------.
PPR
partial removable prosthesis tooth-supported PPF
_________________ _____________________/
_ ________ ___________- Fixed-adhesive partial
It uses an abutment tooth at With resin, (
Edentulous spaces greater than two conservative restoration)
posterior teeth each end of the edentulous for situations where
Anterior spaces larger than four space to support it. the abutments have no
incisors or spaces that include the defects and
canine and two adjacent teeth. Periodontally healthy a single tooth is missing,
Insufficient number of pillars. abutments, well-designed
retainers whether incisor or
premolar.
Requires one pillar
will be successful this time.
 TREATMENT PLANNING
FOR MISSING TEETH

Implant-supported fixed
partial denture

Ideal in cases with an

insufficient number of abutment teeth.
Replaces teeth when there is no
distal abutment.
Crest should be flat and wide
to allow placement of the implantSingle
implant.
Long-standing edentulous space presents
little or no inclination or prolongation in
ABSTENTION FROM adjacent or antagonist teeth and the
PROSTHETIC TREATMENT possibility of replacing it is left to choice.
“As long as there is no perceived functional,
occlusal or aesthetic deterioration, the
placement of a prosthesis will be a service of
dubious effectiveness”
 EVALUATION OF THE
PILLARS
□ Every restoration must withstand constant occlusal forces.
□ Time is important in the design when fabricating a FPD, since the
forces absorbed by the missing tooth are transmitted to the abutment
teeth through the pontic, connectors and retainers.
□ It is preferable that the abutment be built on a vital tooth
□ Endodontically treated teeth with radiographic evidence of a
good apical seal and complete canal obturation.
FIXED PROSTHESIS............................2
What is a stump?.................................6
TYPES OF MATERIALS...................8
TYPES OF MATERIALS...................9
TYPES OF MATERIALS.............11
GLASS IONOMER...................11
TYPES OF MATERIALS.............12
GLASS IONOMER...................12
TYPES OF MATERIALS.............13
GLASS IONOMER...................13
TREATMENT PLANNING. .17
FOR MISSING TEETH.........17
TREATMENT PLANNING. .19
FOR MISSING TEETH.........19
EVALUATION OF THE PILLARS20
AXIAL REDUCTION...........41

It refers to the length of It is preferable The dental

the tooth from the occlusal to the alveolar that they are area where the
crest as wider periodontal ligament is
opposed to the length of inserted into
the root within the the
alveolar bone. bone is evaluated.
A larger tooth has a
 vestibulolingually. separated roots offer
better periodontal support than
Multi-rooted posterior teeth with if they are convergent.
 BIOMECHANICAL
CONSIDERATIONS
■ Longer pontics are less rigid
■ Failure of PPF with long pontic in lower teeth. Long pontic produces
greater torque force on the prosthesis in case of weak abutment. A
pontic with a greater occlusal-
gingival dimension is chosen.
<■N
Double
secondary
pillars\/

■ It should not be adjacent to the

edentulous space
■ Have the same root surface and
crown-root ratio as the primary
pillar
 (-------------------------------------------------------------\
(--------------.
Intermediate Pillars Abutments on
_______________________J inclined molars
■ Edentulous space on either side ■ If the
of a tooth thus creating an invasion is slight,
intermediate abutment it is remedied by
■ Rigid connectors between pontics restoring or re-
and retainers for PPF provide strength contouring the
and stability while minimizing mesial surface of
stresses the third molar and
associated with thinning the
the restoration. second molar
further.

■ It can be resolved with orthodontics. Which also helps to eliminate bone

defects along the mesial surface of the root.
 <>
Fixed Fixed partial dentures Partial Dentures
In Cantilever
that replace a canine
__________________________________________/

■ Difficult to perform because teeth is

the canine most successfully restored
is outside the axis that joins by means of a PPR.
the pillars ■ It is one that has a pillar
■ An edentulous space created or pillars supported
by exclusively on one end of
the loss of a canine or two the pontic, while the other

to both abutment teeth PFP or the abutment

tooth
adjacent has none.
 ■ This is a potentially
destructive design.
■ When a cantilever pontic is
used to replace a missing tooth,
the forces applied to the pontic
have a different effect on an
abutment tooth.
 1. Preservation of dental structure
2. Retention and resistance
BEGINNING 3. structural durability
OF CARVING 4. Marginal integrity
5. Preservation of the periodontium

(-----------------------------'YO
Preservation of
(-----------------------------\
the structure
\/ Retention and Resistance
A restoration must preserve the remaining tooth YO)
structure.
Patient acceptance. Retention: Prevents the
Retention requirements permit. restoration from leaving along the
path of
insertion or longitudinal
axis.

Resistance: Prevents
the
restoration from being
dislodged by force
and avoids any
movement of the
 restoration
under occlusal forces.
 The axial walls of this preparation must have a slight
consistency that allows its placement. Two opposing
Acquaintance external walls that gradually converge

The + retentive preparation is the one FREEDOM OF

that MOVEMENT:
has parallel walls
The larger the surface area of the The number of paths along
preparation, which a restoration can exit a
the greater the retention. tooth preparation is
geometrically limited.

MAXIMUM RETENTION -
SINGLE WAY
Preparation with long, parallel
walls
and grooves = Retention
 LENGTH
Occlusogingival length
Longer preparations will have more surface area = + retentive

P. with long walls it interferes with

the inclination displacement of
the restoration better than the short preparation
.
Preparation on short walls
can be improved with grooves in the axial
walls.
 Replacing internal components:
The basic retention unit of a restoration is the two opposing
axial walls with minimal taper.
Internal components:
Groove, box shape and pin well.

They promote the retention and overall resistance of an axial wall.

 INSERTION ROUTE:
It is an imaginary line along which the restoration will be placed or removed from the preparation.

The preparations are examined in the mouth with the aid of a mirror using only one eye.
The insertion path of a preparation must be parallel to the adjacent proximal contacts,
otherwise this will prevent its placement.

STRUCTURAL DURABILITY
•A restoration must contain a mass of material that can withstand the forces of occlusion.
•This mass must be confined to the space created by the dental preparation.
 OCCLUSAL REDUCTION

To provide adequate metal mass and strength to the restoration, occlusal reduction is required.

Inadequate occlusal reduction does not provide the space necessary for a restoration of
adequate thickness.

Gold alloys
1.5 mm in functional cusps.
1 .0 mm in non-functional cusps
। Metal ceramic crowns:
1.5 to 2.0 mm at cusp. Functional
1 .0 to 1.5 mm in non-functional
Ceramic crowns
2 .0 mm
 • The basic inclined plane pattern of the occlusal surface must be duplicated in order to
produce adequate space without having to excessively shorten the preparation.

FUNCTIONAL CUSPID BEZEL

•An integral part of occlusal reduction is the functional cusp bevel.
 Provides space for adequate metal
mass in a large occlusal contact area.
 AXIAL REDUCTION
•It is also important when ensuring space to obtain adequate thickness of the
restorative material.

•Without adequate axial reduction = thin walls subject to distortion.

They provide space to the metal and improve the rigidity and durability of the
restoration.

The occlusal grooveOcclusal

shoulderIsthmusProximal

grooveThe box
 MARGINAL INTEGRITY
•The restoration can survive in the biological environment of the oral cavity only
if the margins are closely adapted to the cavo-surface finishing line of the
preparation.
Setting up finishing lines
•The preferred gingival finish line for veneering metal restorations is: Chamfer.
 Gingival bevel
Chamfer marginal integrity
Marginal integrity Vestibular axial reduction
Structural duration Retention and resistance
Structural duration
Lingual axial reduction
Retention and resistance
Structural duration

Fin
Preservation of dental structure
Retention and resistance

Functional cusp bevel

Structural duration

Shoulder
Marginal integrity
Occlusal reduction by planes
Structural duration
 DESIGN ADVANTAGES DISADVANTAGES INDICATIONS
Knife Edge Preserves dental Does not provide Not recommended
structure enough volume
Chisel Edge Preserves dental Difficult to control Occasional on indented
structure location teeth
Removes polish without Extends furrow
Bezel support. Allows metal preparation. Vestibular face partial
finish coverage crowns.
Differentiated margin, Lingual surface, in cast
Chamfer adequate volume, easy Caution to avoid lip metal and metal ceramic
to control without enamel support crowns.
Volume of Restorative Less conservative of Vestibular face metal
Material dental structure ceramic and all-ceramic
Shoulder
crowns

Volume of material. Less conservative,

Beveled shoulder Advantages of the bezel extend the preparation
towards the apical Vestibular face posterior
metal ceramic crowns
with supragingival margin
 Shoulder
Chamfer
Marginal integrity
Marginal integrity
Structural duration

Fin
Retention and resistance axial reduction
Tooth preservation Retention and resistance
Structural duration

Incisal depression
Structural duration
 DEEP CHAMFER:

Provides better support for a ceramic

crown than a conventional chamfer.

SHOULDER:
•It is chosen for
all-ceramic crowns since the wide edge
provides resistance to
occlusal forces.
•It requires the destruction of more tooth
structure than any other finishing line
.
 RADIAL SHOULDER:
•Its stress concentration is lower since it has a gingivoaxial angle.

BEVELED SHOULDER:
•Gingival finish line in the proximal box of inlays and onlays, for the occlusal
shoulder of onlays and three-quarter mandibular crowns.
 KNIFE EDGE

Finishing line that allows a sharp

metal
margin

The execution of finishing lines has a

PERIODONTAL direct effect on the ease of manufacturing

PRESERVATION restorations and their ultimate success.

Subgingival restorations are an important etiological factor in periodontitis.

THANK YOU FOR
YOUR TIME