Kayser AF, Witter DJ, Spanauf AJ. Overtreatment with removable partial dentures in shortened dental arches. Aust Dent J. 1987; 32:178-182
Craddock HL, Youngson CC, Manogue M, Blance A. Occlusal changes following posterior tooth loss in adults. Part 2. Clinical parameters associated with movement of teeth adjacent to the site of posterior tooth loss. J Prosthodont. 2007; 16:495-501
Tonetti MS, Cortellini P, Graziani F, Cairo F, Lang NP, Abundo R Immediate versus delayed implant placement after anterior single tooth extraction: the timing randomized controlled clinical trial. J Clin Periodontol. 2017; 44:215-224 https://doi.org/10.1111/jcpe.12666
Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res. 2007; 18:97-113
Salinas TJ, Eckert SE. In patients requiring single-tooth replacement, what are the outcomes of implant- as compared to tooth-supported restorations?. Int J Oral Maxillofac Implants. 2007; 22:71-95
Ante IH. The fundamental principles of abutments. Michigan State Dent Soc Bull. 1926; 8:14-23
Nyman S, Lindhe J. Prosthetic rehabilitation of patients with advanced periodontal disease. J Clin Periodontol. 1976; 3:135-147
Laurell L, Lundgren D. Influence of occlusion on posterior cantilevers. J Prosthet Dent. 1992; 67:645-652
Laurell L, Lundgren D. Periodontal ligament areas and occlusal forces in dentitions restored with cross-arch bilateral end abutment bridges. J Clin Periodontol. 1985; 12:850-860
Laurell L, Lundgren D. A standardized programme for studying the occlusal force pattern during chewing and biting in prosthetically restored dentitions. J Oral Rehabil. 1984; 11:39-44
Brumfield RC. Fundamental mechanics of dental bridges, 5th edn. In: Tylman SD, Tylman SG (eds). St Louis: The CV Mosby Company; 1965
Shillingburg HT, Sather DA, Wilson EL, Cain JR, Mitchell DL, Blanco LJ, Kessler JC, 4th edn. (authors/eds). Boston: Quintessence Int; 2012
Smyd ES. The mechanics of dental structures. J Am Dent Assoc. 1952; 44:187-193
Smyd ES. Dental engineering as applied to inlay and bridge fabrication. N Y J Dent. 1951; 21:161-163
Biancu SI, Ericsson I, Lindhe J. The periodontal ligament of teeth connected to osseointegrated implants. An experimental study in the beagle dog. J Clin Periodontol. 1995; 22:362-370
Shillingburg HT, Fisher DW. Nonrigid connectors for fixed partial dentures. J Am Dent Assoc. 1973; 87:1195-1199
Djemal S, Setchell D, King P, Wickens J. Long-term survival characteristics of 832 resin-retained bridges and splints provided in a post-graduate teaching hospital between 1978 and 1993. J Oral Rehabil. 1999; 26:302-320
King PA, Foster LV, Yates RJ, Newcombe RG, Garrett MJ. Survival characteristics of 771 resin-retained bridges provided at a UK dental teaching hospital. Br Dent J. 2015; 218:423-428 https://doi.org/10.1038/sj.bdj.2015.250
Thoma DS, Sailer I, Ioannidis A, Zwahlen M, Makarov N, Pjetursson BE. A systematic review of the survival and complication rates of resin-bonded fixed dental prostheses after a mean observation period of at least 5 years. Clin Oral Implants Res. 2017; 28:(11)1421-1432 https://doi.org/10.1111/clr.13007
Schweitzer RD, Schweitzer J. Free-end pontics used on fixed partial dentures. J Prosthet Dent. 1968; 20:120-138
Briggs P, Ray-Chaudhuri A, Shah K. Avoiding and managing the failure of conventional crowns and bridges. Dent Update. 2012; 39:78-84
Walton TR. An up-to-15-year comparison of the survival and complication burden of three-unit tooth-supported fixed dental prostheses and implant-supported single crowns. Int J Oral Maxillofac Implants. 2015; 30:851-861 https://doi.org/10.11607/jomi.4220
Walton TR. Changes in the outcome of metal-ceramic tooth-supported single crowns and FDPs following the introduction of osseointegrated implant dentistry into a prosthodontic practice. Int J Prosthodont. 2009; 22:260-267
Walton TR. Changes in patient and FDP profiles following the introduction of osseointegrated implant dentistry in a prosthodontic practice. Int J Prosthodont. 2009; 22:127-133
Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications in fixed prosthodontics. J Prosthet Dent. 2003; 90:31-41
Asbia S, Ibbetson R, Reuben RL. Occlusal convergence and strain distribution on the axial surface of cemented gold crowns. Stud Health Technol Inform. 2008; 133:21-32
A Contemporary Approach to the Provision of Tooth-Supported Fixed Prostheses Part 1: Indications for Tooth Replacement and the Use of Fixed Bridges Retained by Crowns
A Contemporary Approach to the Provision of Tooth-Supported Fixed Prostheses Part 1: Indications for Tooth Replacement and the Use of Fixed Bridges Retained by Crowns Richard Ibbetson Dental Update 2024 45:1, 707-709.
Fixed tooth replacement is a central part of prosthodontic care for patients. The approach and options for treatment have changed due to the decrease in dental disease in the population and the impact of the osseo-integrated implant. Despite the impact of the dental implant, there remain indications for the use of tooth-supported fixed prostheses. Improving oral health, the continued developments in resin-retained bridgework and the dental implant have reduced the indications for fixed prostheses retained by crowns. The last 30 years have seen a simplification in the design of fixed bridgework and this article describes the contemporary approach to this treatment modality. The first of this two part series discusses appropriate designs and the use of fixed bridges retained by crowns and the second part discusses fixed bridges where the abutment teeth require minimal or no preparation.
CPD/Clinical Relevance: To assist in the appreciation of the principles of design for fixed bridgework, whether supported by crowns or resin retainers.
Article
Changes in the pattern of dental disease with the reduction in tooth loss and an improved understanding of what constitutes a stable functioning dentition have altered the indications for tooth replacement.
When fixed tooth replacement is required, the need for tooth-supported fixed prostheses has decreased as a consequence of the impact of implants. Their increasing and generally beneficial use necessitates a re-evaluation of the advice that patients are given. In a recent informal survey, young dentists were asked how they would choose to have their own missing maxillary central incisor replaced, and well over 90% of respondents opted for an implant-supported prosthesis. This was not surprising, nor was their second choice, which was overwhelmingly a resin-retained bridge rather than a tooth-supported fixed bridge where the retainers were crowns.
There are four indications:
The aesthetic requirements of patients are a clear indication for some form of tooth replacement. It is likely that the majority of patients would prefer a fixed replacement for their missing teeth, however, it may not always offer the best aesthetic outcome. Deficiencies of hard and soft tissues are more easily managed with removable prostheses than fixed.
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