Case Selection and Treatment Planning
When a single tooth requires a crown, the prosthetic crown will in most instances rest upon whatever tooth structure was originally supporting the crown of the natural tooth. However, when restoring an edentulous (without teeth) area with a bridge, the bridge is almost always restoring more teeth than there are root structures to support. For instance, in the photo at right, the 5-unit bridge will only be supported on three abutment teeth. To determine whether or not the abutment teeth can support a bridge without failure from lack of support from remaining root structures, the dentist employs Ante's rule—which states that the roots of abutment teeth must have a combined surface area in three dimensions that is more than that of the missing root structures of the teeth replaced with a bridge. When the situation yields a poor prognosis for proper support, double abutments may be required to properly conform to Ante's rule.
When a posterior tooth intended for an abutment tooth already possesses an intracoronal restoration, it might be better to make that bridge abutment into an inlay or an onlay, instead of a crown. However, this may concentrate the torque of the masticatory forces onto a less enveloping restoration, thus making the bridge more prone to failure.
In some situations, a cantilever bridge may be constructed to restore an edentulous area that only has adequate teeth for abutments either mesially or distally. This must also conform to Ante's rule but, because there are only abutments on one side, a modification to the rule must be applied, and these bridges possess double abutments in the majority of cases, and the occlusal surface area of the pontic is generally decreased by making the pontic smaller than the original tooth.
Read more about this topic: Bridge (dentistry)
Famous quotes containing the words case, selection, treatment and/or planning:
“Socialists make the mistake of confusing individual worth with success. They believe you cannot allow people to succeed in case those who fail feel worthless.”
—Kenneth Baker (b. 1934)
“It is the highest and most legitimate pride of an Englishman to have the letters M.P. written after his name. No selection from the alphabet, no doctorship, no fellowship, be it of ever so learned or royal a society, no knightship,—not though it be of the Garter,—confers so fair an honour.”
—Anthony Trollope (1815–1882)
“To me, nothing can be more important than giving children books, It’s better to be giving books to children than drug treatment to them when they’re 15 years old. Did it ever occur to anyone that if you put nice libraries in public schools you wouldn’t have to put them in prisons?”
—Fran Lebowitz (20th century)
“For the people in government, rather than the people who pester it, Washington is an early-rising, hard-working city. It is a popular delusion that the government wastes vast amounts of money through inefficiency and sloth. Enormous effort and elaborate planning are required to waste this much money.”
—P.J. (Patrick Jake)