Detail description of diagnosis and treatment planning in fpd

1. Company Logo

2. Company LogoDiagnosis and Treatment
Planning in Fixed Partial
Dentures
Presented by
Dr.Abbasi Begum .M
P.G Department of Prosthodontics
Narayana Dental College

3. ContentsContents
1. Introduction
2. Definitions and terminologies
3.Diagnostic aids
– Personal information
– Patient evaluation
– Medical history
– Past dental history
 Clinical examinationClinical examination
• General examination
• Extra oral examination
• Intraoral examination
– Radiographic examination
- Vitality testing 102

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 4.Treatment plan
 Treatment planning for single – tooth restorations
 Treatment planning for the replacement of missing teeth
- Selection of the type of prosthesis
- Abutment evaluation
- Biomechanical considerations
- Special problems
 5.Conclusion
 6.References
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5. Company LogoSequelae of tooth loss
Migration
Unilateral chewing
Alveolar bone loss
Occlusal interference
Loss of proximal contact
Overloading of anteriors
Loss of VD
TMD
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6. The traditional restorative
approach in prosthetic
dentistry

7. Treatment options for missing teeth

8. Company LogoINTRODUCTIONINTRODUCTION
Fixed prosthodontics :
The art and science of restoring damaged teeth
with cast metal, metal-ceramic,or all-ceramic
restorations, and of replacing missing teeth with
fixed prostheses.

9. Successful
fixed
prosth-
odontic
treat- ment

10. Company LogoDefinitions and terminologies
 Fixed partial denture:
A dental prosthesis that is luted,screwed or mechanically
attached or otherwise securely retained to the natural teeth,
tooth roots, and /or dental implant abutments that furnish
primary support for the dental prosthesis.
 Commonly referred to as BRIDGES
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11. DiagnosisDiagnosis
DIAGNOSIS
 The determination of the
nature of a disease.
Glossary of Prosthodontic terms 8Glossary of Prosthodontic terms 8
TREATMENT PLAN
 The sequence of procedures
planned for the treatment
of a patient after diagnosis.
Glossary of Prosthodontic terms 8Glossary of Prosthodontic terms 8

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“Nothing is more critical to
success than beginning with all
the necessary data.”
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13. Company Logo5 elements to a good
diagnostic workup
1. History
2. TMJ/occlusal evaluation
3. Intraoral examination
4. Diagnostic casts
5. Full mouth radiographs
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14. 90

15. Company LogoMEDICAL HISTORY-outline
Accurate and current general medical history should
include
 Medication.
 As well as relevant medical conditions.
 If necessary the patients physician(s) can be
contacted for clarification.
 Conditions affecting the treatment methods
 Conditions affecting treatment plan
 Systemic conditions with oral manifestations
 Possible risk factors for the dental surgeon and

16. Company LogoHistoryHistory
 Any special precautions are necessary ??????
 To premedicate some patients for certain conditions
or to avoid medication for others
 History of infectious diseases
Serum Hepatitis
AIDS
 previous reaction to a drug:
 an allergic reaction
 or syncope resulting from anxiety in the dental chair

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 A reaction to a dental material : nickel-containing alloys
 Patients who present with a history of cardiovascular
problems may require special treatment
 Patient with uncontrolled hypertension should
not be treated
 A systolic reading 160 mm of mercury or a
diastolic reading 95 preempts dental treatment
 Refer the patient to his or her physician for evaluation
and treatment

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 Hypertension or Coronary artery disease……………..
epinephrme X since this drug has a tendency
heart rate
elevate blood pressure
PREMEDICATION
BASED
ON 1991 GUIDELINES
(AHA)
Amoxicillin in case of allergy Prosthetic heart valve
Erythromycin OR History of previous
bacterial endocarditis,
Clindamycin Congenital heart
malformations,
or mitral valve prolapse

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 Previous radiation therapy, hemorrhagic disorders,
extremes of age, and terminal illness
 Expected to modify thepatient's responsethepatient's responseto dental
treatment
affect the prognosisprognosis
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 Systemic conditions with oral
manifestations
 Eg periodontitis modified by
diabetes, menopause, pregnancy, or the use of
anticonvulsant drugs

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 Epilepsy
 Diabetic patients
 Dental treatment for the diabetic should
interfere as little as possible with the patient's
dietary
routine, and the patient's stress level should be
reduced
Xe ro sto m ia: conductive to greater carious activity
extremely hostile to the margins of
cast metal or ceramic restorations

22. DENTADENTA
LL
HISTOHISTO
RYRY

23. Company LogoPeriodontal HistoryPeriodontal History
 The patients oral hygiene is assessed, current
plaque control measures are discussed, as are
previously received oral hygiene
instructions.
 The frequency of any previous debridement
should be recorded
 Nature of any previous periodontal surgery
should be noted.

24. Company LogoRestorative HistoryRestorative History
 Simple composite resin or dental amalgam fillings,
or it may involve crowns and extensive fixed partial
dentures
 Prognosis and probable longevity of any future
fixed prostheses
Endodontic HistoryEndodontic History
 Monitoring periapical health and
 Detecting recurring lesions promptly
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25. Company LogoOrthodontic HistoryOrthodontic History
Apical root resorption subsequent to
orthodontic
treatment.
As the crown/root ratio is affected, future
prosthodontic treatment and its prognosis
may also be affected
RemovableRemovable
Prosthodontic HistoryProsthodontic History
Helpful in assessing whether future treatment will
be more successful

26. Company LogoOral Surgical HistoryOral Surgical History
 Missing teeth and any
complications that may have
occurred during tooth removal is
obtained
 Before any treatment is
undertaken,
the prosthodontic component of
the proposal treatment should
be fully co-ordinated with
surgical component

27. Company LogoRadiographic HistoryRadiographic History
 Judging the progress of dental disease
 A current diagnostic radiographic series is
essential and should be obtained as part of the
examination.

28. Company LogoTMJ Dysfunction HistoryTMJ Dysfunction History
 A history of pain or clicking in theTMJor neuromuscular
systems, such astendernessto palpation, may bedueto
TMJDYSFUNCTION, which should benormally be
treated and resolved beforefixed prosthodontic treatment
begins

29. Company LogoEXAMINATION
 General Examination
 Extraoral Examination
 TemporomandibularJoints
 Muscles of Mastication
 Lips
 Intraoral Examination
 Periodontal Examination
 Gingiva
 Periodontium
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 OcclusalExamination
 Initial Tooth Contact
 Lateral and Protrusive Contacts
 Jaw Maneuverability
 Radiographic Examination
 Vitality Testing

31. Company LogoEXAMINATIONEXAMINATION
 Clinician's use of
 Sight,
 Touch, And
 Hearing to detect conditions outside the normal
range
 It is critical to record what is actually observed
rather than to make diagnostic comments
about the condition.
 EX:- Gingival inflammation - swelling, redness,
and bleeding on probing…

32. Company LogoGENERAL EXAMINATIONGENERAL EXAMINATION
General appearance, gait, and weight
Skin color-signs of anemia or jaundice
Vital signs-respiration, pulse, temperature,
and blood pressure
 vital signs outside normal ranges should
be referred for a comprehensive
medical evaluation

33. Company LogoEXTRAORAL EXAMINATION
1. Facial symmetry: Special attention
2. Cervical lymph nodes are palpate
3. TMJ
This permits a
comparison between
relative timing of left
and right condylar
movements.
Asynchronous movement
– anterior disk
displacement.

34. Company LogoAuricular palpationAuricular palpation
 Light anterior pressure
-Identify potential disorders
in the posterior
attachment of the disk
 Tenderness, or pain on
movement- Inflammatory
changes in the
Retrodiscal tissues
 Palpation at Angles of the
mandible- Identify even
a minimal click
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35. Company Logo4. Maximum mandibular opening4. Maximum mandibular opening
Normal values to maximum opening range
from 45 to 55 mm
< 35mm– restricted – intra capsular
changes.
Midline deviation on opening and/or
closing is recorded
The maximum lateral movements of the
patient can be measured
(normal is about 12 mm)EXAMINATION OF TEMPOROMANDIBULARDISORDERS
IN THE ORTHODONTIC PATIENT: A CLINICAL GUIDE, JAppl Oral Sci.

36. Company LogoMuscles of Mastication.
 Palpated for signs of tenderness.
 Palpation is best accomplished bilaterally and
simultaneously.
 This allows the patient to compare and report
any
differences between the left and right sides.

37. Temporalis
Masseter muscle Palpation Medial pterygoid
Lateral pterygoid

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Trapezius muscle is felt
at the base of the skull,
high on the neck
The sternocleidomastoid muscle is
grasped
between the thumb and forefingers on the
side
of the neck.
The muscle will be accentuated by a
slight
turn of the patient's head

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A brief palpation of masseter, temporalis,
medial pterygoid, lateral pteregoid, trapezius
and
sternocleido mastoid muscles may reveal
tenderness.
Any difference – classify the discomfort as mild,
moderate , severe.
Each palpation site is given a numerical score..
Treatment initiated – asses the response to
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40. Company Logo5. LIPS :-5. LIPS :-
 Next, the patient is observed for tooth exposure
during normal and exaggerated smiling.
 This may be critical in treatment planning and
particularly for margin placement of metal-
ceramic crowns.
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41. Company LogoINTRA ORAL EXAMINATIONINTRA ORAL EXAMINATION
 Evaluate the condition of the soft
tissues, teeth, and supporting
structures.
A) SOFT TISSUE EXAMINATION:-
 Lips, tongue, floor of the mouth,
gingiva, vestibule, cheeks, hard and
soft palate…
 Any abnormalities of the soft tissues
should be noted and the patient
informed

42. Company LogoClassification of Ridge Defects:Classification of Ridge Defects:
 Seibert 1983 classified the
various types of ridge loss
into 3 classes [1]:
 Class I: Buccolingual loss ofBuccolingual loss of
tissue with normal ridgetissue with normal ridge
height in apicocoronalheight in apicocoronal
dimensiondimension
 Class II: Apicocoronal lossApicocoronal loss
of tissue with normal ridgeof tissue with normal ridge
width in a Buccolingualwidth in a Buccolingual
dimensiondimension
 Class III: Combination
Bucco - lingual and apico-

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 Later, Allen et al (1985) introduced severity as a
classification criterion in the evaluation of alveolar
deformities.
 Severity is classified as-
 Mild deformity < 3mm
 Moderate deformity 3 - 6mm
 Severe deformity > 6mm
Periodontal Plastic Surgery ForAlveolarRidge Augmentation: A Case Report,
Ashish Agarwal et al, Indian Journal of Dental Sciences.
June 2012 Issue:2, Vol.:4
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44. Company LogoGingiva :-
 Lightly dried before examination so that moisture
does not obscure subtle changes.
 Color, texture, size, contour, consistency and
position are noted
 carefully palpated to express any exudate or pus
that may be present in the sulcular area

45. Company LogoPERIODONTAL EXAMINATION :
Should include ;
 Assessment of the quality and quantity Of
Attached Gingiva
 Depth of Periodontal Pockets measured with a
periodontal probe
 Degree of tooth mobility
 Degree of recession

46. Company LogoPeriodontal Pockets And Attachment
Levels
 In this examination the probe is inserted
essentially parallel to the tooth and is
“walked” circumferentially through the sulcus in
firm but gentle steps, determining the
measurement when the probe is in contact with
the apical portion of the sulcus .
 Thus any sudden change in the attachment level
can be detected.

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Examination of tooth structure:
Carious lesions:-
-determine Rate and Extent of carious lesions.
 The amount and location of caries, coupled
with an evaluation of plaque retention, can offer
some
prognosis for new restorations that will be placed.
 It will also help to determine the preparation
designs to be used.
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48. Company LogoOcclusal Examination
 Special attention is given to
 initial contact,
 tooth alignment,
 eccentric contacts,
 and jaw maneuverability.
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49. Company LogoGeneral Alignment :-
 Crowding, rotation, supra-eruption, spacing,
malocclusion, and vertical and horizontal
overlap.
 Teeth adjacent to edentulous spaces often have
shifted position slightly.
 Small amounts of tooth movement can significantly
affect fixed prosthodontic treatment.

50. Company LogoAnalysis of occlusion
 Any TMJ Pain, muscle spasm.
 Ease or Difficulty with which the various
excursions can be made voluntarily by the
patient.
 Any occlusal interferences.
 Over erupted or tilted teeth interfering with the
occlusion.

51. Company LogoRADIOGRAPHIC EXAMINATION
 Can help to evaluate the following areas:
- Degree of bone loss
- Impacted teeth, residual roots
- Root morphology, crown-root ratio
- Presence of apical disease
- Caries
- calculus
- pulp chambers & canals
- Periodontal ligament and surrounding bone
- existing restorations (marginal fit, contour)

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 PANO RO MIC RADIO GRAPHS
Presence or absence of teeth
Assessing third molars impactions,
Evaluating the bone before implant placement.
Screening edentulous arches for buried root tips

53. Company LogoSpecial Radiograph’s For TMJ
Disorders
 Transcranial exposure-reveal the lateral third of
the mandibular condyle and can be used to
detect structural and positional
changes
 More information can be obtained fromTomography
Arthrography
C T scanning
Magnetic resonance
imaging
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Vitality Testing
Pulpal health must be measured before
restorative treatment to
 PERCUSSION and
 THERMAL STIMULATION
 TEST CAVITY-nonvitality without L.A
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VITALITY TEST asses only afferent Nerve
supply.
MISDIAGNOSIS occurs if N S is damaged and
blood supply intact .
Careful inspection of radiographs therefore
provide an essential aid in the
examination.

56. Company LogoDIAGNOSTIC CASTS
 Articulated diagnostic
casts are essential in
planning fixed
Prosthodontic treatment.
 They must be accurate reproductions of the
maxillary and mandibular arches made from
distortion free alginate impressions.
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57. Company LogoAdvantages of Diagnostic Casts:-
1) Allow an unobstructed view of the edentulous
spaces and an accurate assessment of the span
length, as well as occlusogingival dimension.
2) Length of the abutment teeth can be accurately
gauged to determine which preparation designs
will provide adequate retention and
resistance.
3) The true inclination of the abutment teeth will
also became evident, so that the problems in
a common path of insertion can be anticipated.48

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4) Mesiodistal drifting, rotation and faciolingual
displacement of prospective abutment teeth can
be
clearly seen.
5) A thorough evaluation of wear facets – their
number, size and location is possible.
6) Diagnostic wax-up can be carried out in
situations calling for the use of pontics which
are wider or narrower than the teeth that would
normally occupy the edentulous space
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7) Teeth that have supraerupted into the opposing
edentulous spaces are easily spotted and the amount
of correction needed can be determined.
8) Occlusal discrepancies can be evaluated and the
presence of centric prematurities or excursive
interferences can be determined.
9) Discrepancies in the occlusal plane become very
apparent on the articulated casts.
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60. Company Logo
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61. The selection of the material and design of the
restoration is based on several factors:
1 Destruction of tooth structure
2. Esthetics
3. Plaque control
4. Financial considerations
5. Retention
Treatment Planning for Single-Tooth
Restorations
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62. Company LogoDestructionof toothstructure:
 If the amount of destruction is such that the
remaining tooth structure must gain strength and
protection from the restoration, cast metal or
ceramic is indicated over amalgam or composite
resin.
Esthetics
 All-ceramic crowns-incisors
 Metal-ceramic crowns can be used for
 Single-unit anterior or posterior crowns
 Fixed partial dentures. 43

63. Company LogoPlaquecontrolPlaquecontrol
 Use of a cemented restoration-
“A Good Plaque control program”
 If extensive plaque, decalcification, and caries are present
in a mouth, the use of crowns of any kind should be
carefully weighed
 Motivated to follow a regime of brushing, flossing and
dietary regulation to control or eliminate the disease
process responsible for destruction of tooth structure.
 If these measures prove to be successful
cast metal, ceramic or metal ceramic restorations can be
42

64. Company LogoFINANCIALCONSIDERATIONS
“SOME
ONE” ?????????????????
Government agency
A branch of military
Insurance company
Selection should not be less than optimum just
because the patient cannot afford
 Sound alternative to theSound alternative to the preferred treatment
plan
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65. Company LogoRetention
 Full veneer crowns are unquestionably the most
retentive
 Special concern for ;
 Short teeth
 Removable partial denture abutment.
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66. Company LogoTWELVE RESTORATION TYPES
 "plastic restoration" or a "cemented
restoration ?????????
INTRA CORONAL RESTORATION
 When sufficient coronal tooth structure exist to retain and
protect a restoration under the anticipated stresses of
mastication an intracoronal restoration can be
employed.
 In this circumstance , the crown of the tooth and the
restoration itself are dependent upon the strength of
remaining tooth structure to provide structural integrity.
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67. Company LogoGLASS IONOMER
 Where extensions can be kept minimal.
 Class V lesions
 Incipient lesions
 Root caries in geriatric patients & periodontal
patients
 Interim treatment restoration to assist in the
control of a mouth with rampant caries
further enhanced by the release of
fluoride by the material.
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68. Company LogoCOMPOSITE
 Restoration of incisal angles assisted by acid
etching, a tooth that has received a class 4 resin
restoration ultimately will require a crown.
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69. Company LogoSILVER AMALGAM
Minor to moderate sized lesions in
esthetically non critical areas.
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70. Company LogoCOMPLEX AMALGAM
 Moderate to severe lesions - amalgam
augmented by pins.
 As a final restoration when a crown is
contraindicated .
 Missing cusps or endodontically treated
premolars and molars.
 Teeth that ordinarily would be restored with
mesio-occulso-distal (MOD)onlays or other
extracoronal
restorations.
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71. Company LogoMETAL INLAY
 Minor to moderate lesions where esthetic
requirements are low .
 Usually made of softer gold alloys
 Etchable base metal alloys- if a bonding effect is
desired.
 Restoration of MOD on molars.
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72. Company LogoCERAMIC INLAY
 Minor to moderate sized lesion where esthetic demand is
high.
 B’coz this type of restoration can be etched to enhance
bonding the structural
integrity of tooth cusps may be
stabilized by bonding
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73. Company LogoMODONLAY
 Moderately large lesions on premolars and molars with
intact facial and lingual surfaces.
 It will accomodate a wide isthmus and upto one
missing cusp on molar.
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74. Company LogoEXTRACORONALRESTORATION
 Insufficient coronal tooth.
 Deflective axial tooth structure.
 Modify contours to refine occlusion or improve
esthetics.
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75. Company LogoPARTIALVENEERCROWN
 To restore a tooth with one or more intact axial
surfaces with half or more of the coronal tooth
structure remaining.
 For short span fixed partial dentures.
 If tooth destruction is not extensive.
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76. Company LogoFULLMETAL
 Restore teeth with multiple defective axial
surfaces.
 Restricted to situation where there are no
esthetic
expectations.

77. Company LogoMETALCERAMIC CROWN
Multiple defective axial surfaces
Fixed partial dentures retainer where
full coverage and good cosmetic
results must be obtained.

78. Company LogoALLCERAMIC CROWN
Full coverage and maximum esthetics.
Restricted to situation likely to produce low
moderate stress .
Usually used on incisors.

79. Company LogoCERAMIC VEENERS
Intact anterior tooth that are marred by
severe staining or developmental defects
restricted to facial surface of the tooth.
Moderate incisal clipping and proximal
lesions.
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80. Company Logo
TREATMENTPLANNINGFORTHEREPLACEMENTOF
MISSINGTEETH
 A REMOVAL PARTIAL DENTURE.
 A TOOTH SUPPORTED FIXED PARTIAL DENTURE
OR
 AN IMPLANT SUPPORTED FIXED PARTIAL
DENTURE
SELECTION OF THE TYPE OF THE
POSTHESIS
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81. Company LogoFACTORS CONSIDERED
 BIOMECHANICAL
 PERIODONTAL
 ESTHETIC
 FINANCIAL and
 PATIENTS WISHES.
It is not uncommon to combine two types in the
same arch.
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82. Company LogoREMOVABLE PARTIAL DENTURE
 Edentulous spaces greater than two posterior
teeth.
 Anterior space greater than four lncisors.
 Edentulous space with no distal abutment.
 Multiple edentulous spaces.
 Tipped teeth adjoining edentulous spaces and
prospect-ive abutments with divergent
alignment. 23

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 Periodontally weakened.
 Teeth with short clinical crowns.
 Insufficient number of abutments.
 If there has been a severe loss of tissues
in the edentulous ridge.
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84. Company LogoCONVENTIONAL TOOTH
SUPPORTED FIXED
PARTIAL DENTURE
 Abutment teeth are periodontally sound.
 Edentulous span is short and straight.
 Expected to provide a longlife of function for the
patient.
 No gross soft tissue defect in the edentulous ridge.
 Reserved for patients who are both highly motivated
and able to afford.
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85. Company LogoRESIN BONDED TOOTH
SUPPORTED
FIXED PARTIAL DENTURE
 Defect free abutments where single missing
tooth.
 A single molar (muscles are not well developed).
 Mesial and distal abutment are present.
 Moderate resorption and no gross soft tissue
defects on edentulous ridges.
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86. Company Logo
 Younger patients whose immature teeth with
large pulps are poor risks for endodontic free
abutment preparation.
 Tilted tooth can be accommodated only if there
is enough tooth structure to allow a change
in the normal alligment of axial reduction.
 Periodontal splints.
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87. Company LogoIMPLANTSUPPORTEDFIXED PARTIAL
DENTURE
Insufficient number of abutments.
Patient’s attitude and or a combination of
intra oral factors make a removable partial
denture or FPD a poor choice.
No distal abutment.
Alveolar bone with satisfactory density and
thickness in a broad, flat ridges.

88. Company Logo
Configuration that permit implant
placement.
Single tooth where defect free adjacent
teeth.
A span length of two or six teeth can be
replaced by multiple implants.
Pier in an edentulous span (three or more
teeth long).
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89. Company LogoNO PROSTHETIC TREATMENT
Long standing edentulous space into which
there has been little or no drifting or
elongation of the adjacent teeth.
If the patients percieves no functional ,
occlusal or esthetic impairement.
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90. Company LogoCASEPRESENTATION
In cases where the choice between a fixed
partial denture and a removable partial
denture is not clear cut, two or more
treatment options should be presented to
the patients along with their
advantages and disadvantages.

91. Company Logo
The prosthodontist is the best person to
evaluate the physical and biological
factors present , while the patients
feelings should carry
considerable weight on matters of
esthetics & finances .
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92. Company LogoABUTMENT EVALUATION
The roots and their supporting tissues
should be evaluated for three factors
Crown root ratio
Root configuration
Periodontal ligament area
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93. Company LogoCROWN ROOTRATIO
Optimum -2:3
Minimum -1:1 (acceptable)

94. Company LogoROOTCONFIGERATION
 Broader Labiolingullay than Mesiodistally.
 Multirooted posterior teeth with widely separated
roots.
 Conical roots can be used -for short span.
 A single rooted tooth with evidence of irregular
configu- ration or with some curvature in the tooth
–is preferable than that which has a nearly
taper.

95. Company LogoPERIODONTAL LIGAMENT
AREA
 Larger teeth have a greater surface area
and better able to bear added stress.
 “ ANTE’S LAW” the root surface area of
the abutment teeth had to equal or
surpassed that of the teeth being
replaced with pontics.
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96. Company LogoBIOMECHANICAL
CONSIDERATIONS
 In addition to the increased load placed on the
pdl by a long span FPD.
 Longer spans are less rigid.
 Bending or deflection varies directly with the
cube of the length and inversely with cube of
the occlusogingival thickness of the pontic .
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97. Company Logo
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98. Company Logo
 Greater occlusogingival dimension
 Nickel chromium
 Double abutment
 Multiple grooves
TO MINIMIZE –
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99. Company Logo
Special Situations
 Non rigid connector
 Restrict to short span FPD
 key way -distal contours of pier a abutment
 key - mesial side of the distal pontic
PIER ABUTMENTS
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100. Company Logo
A Nonrigid connector on the
middle abutment isolates
force to that segment of the
fixed partial denture to which
it is applied

101. Company LogoTHIRD MOLAR ABUTMENTS
 Mild encroaching- restoring and recontouring
 Tilting is severe –corrective measures
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102. Company Logo
 Orthodontic appliance for
uprighting a tilted molar
 Proximal half crown as a retainer
Non rigid connector on distal aspect of premolar
retainer

103. Company LogoCANINE – REPLACEMENT FIXED
PARTIAL DENTURE
 Fixed partial dentures replacing canines can be difficult
because the canine often lies outside the interabutment
axis.
 FPD replacing a maxillary canine is subjected to more
stresses than that replacing a mandibular canine
 Edentulous spaces created by the loss of canine and any contiguous
teeth is best restored with Implants.
4

104. Company LogoCANTILEVER FIXED PARTIAL
DENTURES
 Lengthy roots with favourable
configuration.
 Long clinical crowns.
 Good crown root ratios and healthy
periodontium.
 Should replace only one tooth and have
atleast two abutments.
 Pontic should posses maximum
occlusogingival height to ensure a rigid 3

105. Company Logo
Forces on the pontic of a cantilever fixed
partial denture tend to tip the fixed partial
denture or the abutment tooth
Cantilever fixed partial denture replacing
maxillary lateral incisor, using the canine as
the abutment
Cantilever pontics can be used to replace
a 1st
premolar, if full veneers are used on
2nd
PM,and 1st molar

106. Company LogoCONCLUSION
The history and clinical examination must provide sufficient
data for the practioner to formulate a successful treatment
plan.
The overall prognosis is influenced by general and local
factors
1

107. Company LogoReferences
1. Fundamentals of fixed prosthodontics-3rd
edition,
Shillingburg
2. Contemporary Fixed Prosthodontics-Rosenstiel-
3rd
edition
3. Examination Of Temporomandibular Disorders .
A Clinical Guide, J Appl Oral Sci.
20 0 7 ; 1 5(1 ): 7 7 -8 2, Ana Claúdia de Castro
Ferreira et al
4. Pocket Dentistry-Fastest Clinical Dentistry
Insight Engine

108. Company Logo
5.History of and Examination for
Temporomandibular Disorders
6.Supplement the Base to Complement the Crown:
Localized Ridge Augmentation using
Connective Tissue Graft-
7. Hemini Shah et al, IJSS Case Reports &
Reviews | April 2015 | Vol 1 | Issue 11

109. Thank You
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