LECTURE 4. DIAGNOSIS IN FIXED PROSTHESIS

Consequences of tooth loss

Inclination of the adjacent teeth
Loss of proximal contact
Occlusal alterations:
prematurities and interferences
Alterations of the supporting tissue
Supraeruption of the antagonist tooth

Requirements for a bridge

1. Good distribution of abutment teeth

2. Periodontal health (abuntments)

3. Balanced occlusion

Fixed pros contradictions

1.- Patients with poor hygiene
2.- Adolescents
3.- Untreated periodontal problems
4.- Lack of appropriate abutment teeth
5.- Excessive edentulous space for the resistance of the abutment teeth.
6.- Non-compliance with Ante's Law

Ante’s law

"The root surface of the abutment teeth must be equal to or larger than that of the teeth to be replaced with pontic”

Non-compliance with ante’s law

EDENTULOUS SPACE VS ANTE’S LAW

DIAGNOSIS: CHARACTERISTICS

1º. GENERAL AND ORAL CLINICAL HISTORY

2º. INTRAORAL EXAMINATION

3º. ATM AND OCCLUSION EVALUATION

4º. DIAGNOSTIC MODELS

5º. SERIAL INTRAORAL RADIOGRAPHS

Clinical history

Intraoral exploration

TMJ and occlusion evaluation

Any headache? Neck pain? Shoulder pain?

Assessment of joints
• Mouth opening
• Desviations
• Clics
• Crackle

BIG ALTERATIONS
• Wax-up diagnostic
• Determine wether the restorations can correct the occlusal problem

LITTLE ALTERATIONS
• Occlusal adjustment
• Improve occlusal aspects

Diagnostic model