Diagnosis and tt planning in FDP-III Dr Jitendra Rao Dept of Prosthodontics

Consideration before FDP tt planning Deep bite Supraeruption of teeth Short clinical crown Para functional habits Severe loss of tissues in the edentulous ridge (Ridge defect)

Deep Bite/Traumatic bite Overbite more than 3mm of anterior teeth often results in problems in the design and fitting of F.P.Ds Sign of posterior occlusal collapse, with its accompanying loss of inter-arch space

Supra-erupted teeth Overlooked clinically but will often complicate fixed partial denture design and fabrication Inter-arch space obliteration Short axial height of crown/prosthesis How to counter this problem? Coronoplasty of enamel Extraction of tooth Intrusion of crown Intentional endodontic tt followed by crown

Parafunction habit Any parafunctional habit like bruxism, clenching of teeth,nail biting,object biting If a parafunctional habit is verified or even strongly suspected, the patient must be counseled regarding the effects of the habit and if necessary Treatment for the adverse habit should be instituted

Tilted Molar Abutments The over-all objective in molar uprighting is ideal positioning of the molar which will eventually become an abutment tooth for a fixed prosthesis. The ideal position will provide an optimal periodontal environment for the molar Removable partial denture with molar uprighting springe – an appliance for uprighting the severely tilted bilateral molar abutment. This design is very cheap and can be planned at any age without hampering masticatory function during the course of treatment. Dr Rao et al-J Prosthodontic Research – 57(1):57-61

Cantilever FPDs A cantilever FPD is one that has an abutment or abutments at one end only, with the other end of the pontic remaining unattached. This is a potentially destructive design with the lever arm created by the pontic Abutment teeth for cantilever FPDs should be evaluated for lengthy roots with a favorable configuration, good crown root ratios and long clinical crowns.

Canine Replacement FPD/ Canine Rule

MCQ

1.Contraindication of FDP a.Diabetes mellitis b.Hypertension c.Age below 18 yrs d.Xerostomia 2.Indication for FDP a. Crowding of tooth b. Crown lengthening c .Rotated tooth d. Endodontically treated teeth 3.Symptoms are considered to be suffering from a TMJ disorder except a. Facial disfigurement b.Restricted Jaw movements c.Clicking d. Pain& tenderness

4.Health of the attached gingiva can be best assessed by a. Measurement on a radiograph b.Application of force on tooth c.Periodontal probe examination on buccal and lingual surface d.Bleeding on examinations 5. An Intra-oral radiographic examination reveals all EXCEPT a. Remaining bone support b. Width of Periodontal ligament and trauma from occlusion c. Quality of supporting bone, trabecular patterns and reactions to functional changes, proximity to lamina dura d. Bird eye view of the associated tooth and structure 6.Consideration for tt in FDP can be possible in Edentulous space with no distal abutment Multiple edentulous spaces Tipped teeth adjoining edentulous space Tooth having long and divergent root

7.The major biomechanical factors which affect the design of an FPD are: Length of edentulous Ridge Pontic design Connector design The direction of the forces acting on the FPD 8.Ideal crown-root ratio for a tooth to be utilized as a fixed partial denture abutment is 2:3 1:1 2:3 1:1.75 1:1.5

9. Non rigid connector, keyway on -distal contours of a abutment and key on mesial side of the distal pontic are the features of a. Pier abutments b. Tilted molar abutments c.Cantilever abutment d. Double abutments 10.Arcon articulator  Condylar housing is in lower member Condylar housing is in upper member Have no Condylar housing Is fully adjustable articulator 11. Hinge axis is   Transverse axis Vertical axis Saggital axis Coronal axis

12.Jepsen’s rule is applicable for Pontic selection Abutment selection Crown root ratio for FPD Root surface area of abutment 13.Tilted molar abutment is contraindicated for FPD > 150 < 200 200 - 250 >250

14.Reason for not replacing the maxillary canine through FPD is all EXCEPT Canine is outside the inter-abutment axis Longest root in the arch LI is weakest in ant and Ist PM is weakest in post region Prone for pulp exposure   15. Tooth having minimum root surface area Maxillary CI Mandibular CI Mandibular LI Maxillary LI

Books Rosensteil Shillingburg thank you..

Key for MCQ 1.c 2.d 3.a 4.c 5.d 6.d 7.d 8.b 9.a 10.b 11.a 12.b 13.d