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PubMed1979

Reactive force distributions for teeth when loaded singly and when used as fixed partial denture abutments.

1. A finite element model was devised to examine mechanical responses of the periodontium to loads applied to the model in vertical, oblique, and horizontal directions for an individual tooth having varied alveolar levels, splinted teeth, and a cantilever type of fixed partial denture. 2. Forces applied to the teeth are balanced by stresses generated within the periodontal membrane and alveolar bone. 3. It was substantiated that the teeth were evolved to carry axial types of loads, since stresses on the periodontium were smaller than those obtained for oblique or horizontal types of loads. Axial types of loads produce compressive stresses on the periodontium; oblique or horizontal types of loads produce zones of compressive and tensile stresses. 4. Mechanically, splinting teeth is a desirable procedure. 5. A cantilever type of fixed partial denture should have at least two abutments. It should not be used to replace more than one tooth.

Alveolar Process↗
PubMed1998

In vitro study of fracture strength and marginal adaptation of fibre-reinforced-composite versus all ceramic fixed partial dentures.

In this in vitro study fracture strength and marginal adaptation of adhesive-fixed three-unit posterior fixed partial dentures made with two different fabrication modifications--with and without the retainer material "Single"--of the new fibreglass system Vectris/Targis and from the metal-free Al2O3-ceramic In-Ceram were examined. The quality of the marginal adaptation was characterised using SEM evaluation and dye penetration techniques. In-Ceram and Vectris/Targis with "Single" showed good marginal adaptation, both statistically significantly better than the modification without "Single". After thermal cycling and mechanical loading the fibreglass reinforced systems showed a significantly higher fracture strength than the In-Ceram.

Aluminum Oxide↗
PubMed1983

A screw-connected fixed partial denture.

This technique provides one solution to the problem of using tilted abutment teeth for a fixed partial denture. It provides good retention without excessive tooth destruction and without excessive contour in the completed restoration.

Dental Pins↗
PubMed1992

Periodontal effects of fixed partial denture retainer margins: configuration and location.

Our purpose was to study the periodontal response to posterior fixed partial denture (FPD) retainers with different marginal configurations and locations. One posterior proximal site restored with a clinically acceptable FPD and one matched, unrestored posterior proximal site were examined in 60 subjects. Assessments were made of the FPD retainers and the periodontal responses to both the long-term and short-term use of these retainers. Periodontal examination included assessment of probing depth and bleeding on probing and determination of plaque index and the gingival index scores. Statistical analysis showed that "clinically acceptable" FPDs, which had clinically detectable deviations from an ideal (flat) retainer/tooth configuration, were not associated with increased probing depth or bleeding on probing when compared to the matched, unrestored teeth at both examinations. As a group, sites adjacent to subgingival retainer margins were not associated with greater probing depths than sites adjacent to supragingival retainer margins. These findings suggest that long-term exposure to variations of FPD margin configuration and location, within clinically acceptable but less than ideal parameters, are not associated with the destruction of the supporting periodontal tissues.

Adult↗
PubMed2006

Numerical modeling of the fracture process in a three-unit all-ceramic fixed partial denture.

OBJECTIVES: The main objectives were to examine the fracture mechanism and process of a ceramic fixed partial denture (FPD) framework under simulated mechanical loading using a recently developed numerical modeling code, the R-T(2D) code, and also to evaluate the suitability of R-T(2D) code as a tool for this purpose. METHODS: Using the recently developed R-T(2D) code the fracture mechanism and process of a 3U yttria-tetragonal zirconia polycrystal ceramic (Y-TZP) FPD framework was simulated under static loading. In addition, the fracture pattern obtained using the numerical simulation was compared with the fracture pattern obtained in a previous laboratory test. RESULTS: The result revealed that the framework fracture pattern obtained using the numerical simulation agreed with that observed in a previous laboratory test. Quasi-photoelastic stress fringe pattern and acoustic emission showed that the fracture mechanism was tensile failure and that the crack started at the lower boundary of the framework. The fracture process could be followed both in step-by-step and step-in-step. SIGNIFICANCE: Based on the findings in the current study, the R-T(2D) code seems suitable for use as a complement to other tests and clinical observations in studying stress distribution, fracture mechanism and fracture processes in ceramic FPD frameworks.

Acoustics↗
PubMed1995

Replacement of congenitally missing lateral incisors with ceramic resin-bonded fixed partial dentures.

Congenital absence of teeth may accompany palatal clefts; various replacements are available and include conventional fixed partial dentures (FPDs), implant-supported artificial crowns, and resin-bonded FDPs. Orthodontic and restorative dentistry consultations are essential for appropriate treatment. The recent introduction of an all-ceramic resin-bonded FPD provides an esthetic prosthesis.

Adult↗
PubMed1996

Analysis of load transfer and stress distribution by an implant-supported fixed partial denture.

This study simultaneously examined the load transfer and stress distribution by an implant-supported fixed partial denture. A mandibular implant framework with implants connected to the abutments was embedded in a three-dimensional photoelastic model of a mandible. Strain gauges were attached on the superior surface of the framework, and a vertical load of 7.5 kg was applied to seven points on the framework. The measurements derived from this simulation revealed that (1) there was a direct proportion between the stress distribution in the metal framework and stresses created in the supporting structure around the implants; (2) the mode of load transfer and stress distribution was directly proportional to the distance of the components from the loading point; and (3) when the cantilever was loaded, the major part of the stress was distributed within the cantilever in the connection to the distal abutment. In this simulation, stress was distributed over the two, or maximum three, closest implants with the distal implant the most stressed.

Birefringence↗
PubMed1989

[A photoelastic study of the stress distributions in the surrounding tissues of the abutments of a fixed partial denture with secondary abutments].

The purpose of this study was to evaluate the stress distributions of fixed partial dentures with secondary abutments. In the case where the lower first premolar and the second premolar were missing, four 2-dimensional photoelastic models with the canine and the first molar as primary abutments with secondary abutments were prepared as follows; Model I: primary abutments only. Model II: primary abutments with the lateral incisor as the secondary abutment. Model III: primary abutments with the second molar as the secondary abutment. Model IV: primary abutments with the lateral incisor and the second molar as secondary abutments. Two-dimensional photoelastic stress analysis was used with the stress areas recorded photographically. A vertical load was applied to the pontic in each case. After the stress patterns in surrounding tissues of the abutments were observed and recorded, the conclusions were as follows: 1. In model I, applied force was distributed to the long axis of the abutments. 2. In model II, III, IV, all the secondary abutments showed compressive stresses. No tensile stresses were developed. 3. The mesial aspect of the lateral incisor and the distal aspect of the second molar as the secondary abutment showed no compressive stresses.

Dental Abutments↗
PubMed1990

[Fixed partial denture on osseointegrated screw implants].

There are many differences between full dentures on Brånemark implants and fixed partial dentures built on the same type of implants: due to some more critical anatomical conditions, the choice of number, position and length of the implants is more delicate; the need of an harmonious crown-gingival tissue relationship; higher occlusal forces than in edentalous cases; difficulty in satisfying aesthetic requirements and ease of hygiene. The surgical treatment plan, a pre-requesite to any surgery, permits to determine the length of implants, their number, their position, their long axis direction and the design of the surgical guide, which will indicate to the surgeon the location and the axis for drilling. If this axis is nearly parallel to the sagittal plane for mandibular implants, it will be angulated to that same plane for maxillary implants. In the latter cases, it is often necessary to use angulated transepithelial abutments in order to prevent the abutment screw from having an occlusal access. In order to perform the prosthetis, an impression should be taken with the transepithelial abutments. The final reconstruction can be preceded by a temporary prosthesis, then (or) transitory to await gingival stabilization and not overload the implant immediately after it has been connected with the abutment. The fixed partial denture can be secured with screws or cemented when it is of small size and it must satisfy the functional and aesthetic requirements of the patient. The choice of the material used on the occlusal surface is very important and varies depending on the case. Aesthetics should not be prevent an in easy hygiene. These objectives are not reached at the time the prosthesis is made but during the course of the surgical and prosthetic treatment. Single restorations are subjected to the rules pertaining to any fixed partial denture on implants, but have particular characteristics, such as the almost systematic elimination of the abutment and the absolute necessity of the correct placement of the implant. The single units are more easily subject to unscrewing for mechanical reasons. Although the use of implants is a valuable aid in cases of partial fixed restoration, it requires particular attention with regard to precision.

Dental Implantation, Endosseous↗
PubMed2004

Fixed partial denture or single-tooth implant restoration? Statistical considerations for sequencing and treatment.

The choice to replace a single missing tooth can be based on the primary decision that the restorability of the tooth is in doubt. Many teeth are decimated by incipient or recurrent caries, trauma, endodontic complications, or periodontal disease which requires extraction. It is our objective to familiarize the participant with literature comparing success rates of fixed partial dentures and single-tooth implant restorations and a repertoire of prosthodontic techniques used in replacement of single missing teeth with osseointegrated dental implants. The fixed partial denture (FPD) has been regarded as the standard of care for some time in replacement of single and multiple missing teeth. Many studies surveying long term survival have been compiled and analyzed to arrive at a generalized outcome. Most of these studies arrive at common conclusions. Studies surveying success of single-tooth implant-supported restorations are not comparably abundant nor survey for comparable time as those for FPDs. Although, many of the outcomes are statistical survival estimates such as Kaplan-Meier survival tables, implant restorations in partially dentate patients are a predictable means of tooth replacement. There are certain factors which make FPD more appropriate and conversely factors which make an implant restoration more appropriate. Indications and contraindications for each treatment scenario will also be reviewed based on the literature and clinical experience. It is hoped that the practitioner will be able to appropriately identify those cases in which either an FPD or an implant restoration is the appropriate treatment option.

Contraindications↗
PubMed1987

Endodontic and restorative management of a resorbed eight-unit fixed partial denture abutment tooth: report of case.

Treating internal resorption is one of dentistry's most difficult challenges. This pathological process is difficult to manage in an advanced stage. The usual treatment involves surgery or, in many cases, extraction of the resorbed tooth. It is often difficult for the patient to understand and accept such a radical treatment approach. This report of case illustrates severe internal resorption that destroyed a major portion of a key abutment tooth supporting an eight-unit fixed partial denture. The resorptive pathosis was treated by a nonsurgical endodontic approach. The severely damaged abutment was reinforced and restored so that the existing eight-unit fixed partial denture could be preserved. The patient was pleased with the method of treatment and was commended for seeking regular recall professional care. It would have been easy to postpone treatment as the problem was asymptomatic. However, to do so probably would have resulted in loss of the resorbed abutment tooth, thus creating a complex restorative situation. The original prosthesis is currently 14 years old, functioning well, and showing no apparent evidence of pathosis. Costly and time-consuming remake procedures were avoided and patient satisfaction was maintained.

Dental Abutments↗
PubMed1991

A comparison of impression materials for complete-arch fixed partial dentures.

This study compared the marginal fit of complete-arch fixed prostheses under simulated clinical conditions. Prostheses were made on casts constructed from three commonly used impression materials; polyether, polyvinyl siloxane (medium-viscosity and putty-wash), and reversible hydrocolloid. A maxillary dentoform with four abutment teeth was used as the master cast and six impressions were made with each material. Individual castings for each abutment were made on the stone casts. The abutment castings were luted together on the casts to provide a complete-arch fixed partial denture using a ticonium framework and acrylic resin. The marginal fit of the abutment castings was measured on the master cast before and after the prostheses were luted together. The polyether and both addition silicone impression materials were significantly more accurate than the reversible hydrocolloid in both situations. All of the single castings were clinically acceptable, but the luted restorations made from reversible hydrocolloids were not.

Analysis of Variance↗
PubMed2005

Color stability of provisional crown and fixed partial denture resins.

STATEMENT OF PROBLEM: Provisional resins are used extensively during fixed prosthodontic treatment and exhibit varying degrees of color change/discoloration over time. Data are needed to help predict color stability of provisional resins. PURPOSE: The purpose of this in vitro study was to measure the color change of 12 provisional prosthodontic materials after immersion in artificial saliva and artificial saliva-coffee solutions for 1, 2, and 4 weeks. MATERIAL AND METHODS: Twelve provisional materials were studied. Methacrylates consisted of Alike, Jet, Temporary Bridge Resin, Unifast, and Zeta CC. Bis-acryl resins included Instatemp, Integrity, Luxatemp, Protemp Garant, Provipont, Provitec, and Temphase. Ten specimens (25.4 mm x 25.4 mm x 2.4 mm) of each material were fabricated. Five specimens were stored at 37 degrees C in artificial saliva and 5 were stored in a solution of artificial saliva (400 cc) and coffee (800 cc). Baseline color was measured using a colorimeter. Further color measurements were made after 1, 2, and 4 weeks of immersion. CIE L *a *b * values were recorded and color differences (DeltaE) between baseline and each storage interval were calculated using a 2-way ANOVA with Bonferroni adjustment for multiple comparisons in conjunction with an overall alpha=.05. RESULTS: Results indicated the presence of strong interaction between material and storage solution regardless of the aspect of color considered (P<.0001 for DeltaE, DeltaL *, Deltaa *, and Deltab *). Coffee solution relative to saliva solution had the most significant impact on color change for Luxatemp, Protemp, and Temphase materials at 4 weeks, but the greatest overall color change for both coffee and saliva solutions was found for Provipont (DeltaE=9.40 coffee; 8.51 saliva) and the least overall color change for both solutions was found for Zeta CC (DeltaE=0.31 coffee; 0.23 saliva). CONCLUSIONS: Under the conditions of this study, 12 provisional crown and fixed partial denture resins demonstrated varying tendency to discolor over a range of time periods when immersed in artificial saliva and artificial saliva-coffee solutions.

Acrylic Resins↗
PubMed2005

Achieving optimal esthetics in a patient with severe trauma: using a multidisciplinary approach and an all-ceramic fixed partial denture.

UNLABELLED: The treatment of traumatic injuries can be difficult, especially when the patient's expectations are too high or unreasonable. Such cases require extremely clear communication with the patient before beginning the case, including an explanation of the final results, based on the patient's goals. Taking over a case from another colleague adds more complications and requires that close attention is paid to the reason for the original dissatisfaction between the former dentist and patient to avoid repeating the same mistakes. Clinically, patients with thin, fragile gingiva are extremely challenging if they require a fixed partial denture in the esthetic zone since the most common material, a ceramometal bridge, requires infragingival margins; if any recession occurs, a catastrophic esthetic failure will result. The case presented here underscores all these special issues. Proper multidisciplinary management, good patient communication, and the use of an all-ceramic fixed partial denture system can provide an excellent final result. CLINICAL SIGNIFICANCE: Replacing teeth in the esthetic zone is complicated, especially when trauma has caused severe damage to the surrounding bone and gingiva. Satisfying a demanding patient requires a multidisciplinary approach and psychological management, as are exemplified in this article.

Adult↗
PubMed1975

The provisional fixed partial denture.

A discussion of the rationale and requirements of the provisional restoration in fixed prosthetic dentistry has been presented. The imporatnce of this phase of restorative densitry and a survey of techniques for making interim restorations were gleaned from a review of the literature. A method for the fabrication of a provisional fixed partial denture using an acrylic resin interocclusal record was described and illustrated.

Dental Restoration, Temporary↗
PubMed2006

Retrospective evaluation of temporary cemented, tooth and implant supported fixed partial dentures.

INTRODUCTION: The aim of this study was to examine the clinical performance of this method, and determine which temporary cement was the most appropriate. METHODS: Dental fixtures (Tiolox implants GmbH, Germany) were implanted and crown and bridgework applied in a private practice between 1998 and 2003. Copings made of pure gold or titanium were permanently cemented onto the prepared teeth. The bridges were attached with either conventional temporary cements (Zinc oxide/ calcium hydroxide based) or acrylic/urethane cement (IMProv) both to the copings and to the implant abutments. Complications were evaluated by a retrospective review in January 2006. RESULTS: A total of 47 patients (response: 81%) with 65 fixed partial dentures could be evaluated. Removal and re-attaching without damage of the dentures was undertaken for the following reasons: for follow-up examinations (n = 31), colour corrections (n = 15), cleaning of the dentures (n = 12), treatment of peri-implantitis (n = 2), repair following ceramic fractures (n = 5), implant failure (n = 1), tooth extractions (n = 2), root canal treatments (n = 2), occlusal corrections (n = 2), or in the case of abutment loosening (n = 4). Accidental detachments with conventional temporary cements occurred more frequently and more rapidly than with IMProv (15% versus 88.7% survival rate after four years). CONCLUSIONS: This method for dental implant supported fixed partial dentures is successful and efficient.

Adult↗