The ABUTMENT
By Dr. Motaz Sayed 1
What the Abutment?
Abutment
Tooth:
Is the natural tooth
which supports and
retains the bridge at one
or both side.
Selection of abutment teeth
■ Oral examinations
■ Radiographs
■ Diagnostic cast
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Abutment Evaluation
•Retention
•Vitality
•Periodontal Health
•Crown-Root Ratio
•Root Configuration
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Abutment Evaluation
Retention
• Each abutment must have adequate
individual retention
• Obtained by proper tooth reduction.
• Inadequate retention may develop
recurrent caries.
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Abutment Evaluation
Vitality
• Vital abutment (Best) /Or ,,,,,,,,,
• Asymptomatic or Questionable vitality
• Symptomatic (Endodontic Therapy)
• Canal available for post
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Abutment Evaluation
•Periodontal Health
• Periodontal Status:
• Inflamed gingiva bleed and
make preparation and impression
making more difficult.
• Treat Pockets (First)
• Bone Support (Crown root
ratio)
• Mobility:
• Mobile teeth may not be able to
support any span under occlusal
stress for very long.
•
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Abutment Evaluation
Crown-root Ratio
• Ideally, a clinical crown-to-root ratio 2:3.
• Minimally1:1 crown-to-root ratio. (Must be carefully evaluated)
• Ratio less than 1:1 (Not Advisable)
• Bone Support necessary to resist lateral forces of fixed partial
denture
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Abutment Evaluation
Ante’s Law
Abutment support is
evaluated by Ante’s law
• The root surface area of
the abutment teeth
should equal or surpass
that of the teeth being
replaced with pontics”
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Abutment Evaluation
Root Configuration
• Irregular shaped roots
provide more support
than round Roots
• Multi-rooted teeth with
roots that are widely
separated Provide
more support than ones
with roots that are
convergent
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Abutment Evaluation
The Ideal Abutment
Is the tooth with :
•Sound tooth with sufficient clinical crown
•In a suitable position and angulation and
•Reasonable alignment
•Good root configuration
•Without gingival or bone recession
•No periodontal involvement
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Bio-mechanical Considerations
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Bio-mechanical Considerations
• Management of Destructive Forces
• The design of the bridge should allow for occlusal forces
and dislodging forces, like torque, flexure, and tension to
be handled.
• Occlusion should be designed to optimize the distribution
of occlusal forces evenly throughout the envelope of
motion over the entire mouth.
Example:
• Span Length.
• Pier abutment
• Non rigid connector
• Cantilevered Bridges
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Bio-mechanical Considerations
• Management of Destructive Forces:
• The design of the bridge should allow for occlusal forces
and dislodging forces, like torque, flexure, and tension to
be handled.
• Occlusion should be designed to optimize the distribution
of occlusal forces evenly throughout the envelope of
motion over the entire mouth.
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Deflection of a fixed partial denture varies directly with
the cube of the length
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Deflection of a fixed partial denture varies inversely with the cube of
the occlusogingival thickness
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Bio-mechanical Considerations
If there is one unit of
deflection for span length X
that deflection will be eight
times as great if the length is
doubled 2X and twenty
times as great for span
length that is tripled 3X .
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A bridge of shorten length will flex less
compared to longer bar with same dimension
Increase in length of the bar to twice its
original value increase its flexibility by
eight(8) times
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Bio-mechanical Considerations
Pier Abutments
Pier Abutment An isolated tooth between two edentulous spans .
It acts as a fulcrum in rigid connector design.
A non rigid connector prevents it from acting as a fulcrum.
If a non rigid connector is placed on the distal side of the retainer
movement in a mesial direction will seat the key in to the key way ,
but if placed mesially this movement will unseat the key.
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Bio-mechanical Considerations
Pier Abutments
• Pier Abutments
• Are abutment teeth where an
edentulous space lies on each side.
Because they lie in the middle of the
span, they can act as a fulcrum for
destructive forces.
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Bio-mechanical Considerations
Non-rigid Connectors
• Non-rigid connectors placed on the distal aspect of both canines to
defuse force.
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Bio-mechanical Considerations
Cantilevered Bridges
• A bridge have one abutment teeth on each end of the bridge (ie: the pontic is
the end of the bridge,
• Used in certainly situations where the stress can be distributed nicely and not
put undo stress on the abutment teeth.
• Occlusion is always minimized and/or ignored on the pontic.
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Selection of abutment teeth
Factors influencing design:
• Crown length, span length
• Crown form, arch form, alveolar ridge form.
• Root length and form, axial alignment,
• Crown-root ratio,
• Pulpal health, periodontal health, mobility.
• Occlusion, and opposing dentition.
• Age of the patient,
• Esthetics
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Factors affecting the success or failure of fixed restoration
There are many factors related to the teeth and to the adjacet
oral structures ,that have direct influence on the success or
failure of fixed restorations
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Factors affecting the success or failure of fixed restoration
Crown Length and form
• Teeth must have adequate occluso-cervical crown to achieve
sufficient retention.
• Teeth with short clinical crown often dosen`t provide
satisfactory retention.
• Additional length achieved through periodontal surgery or by
orthodontic treatment .
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Factors affecting the success or failure of fixed restoration
3- Root Length And Form
Abutment teeth must retain stability of prosthesis during function
abutment resist the occlusal force that will be transmitted to roots
then to bone (as anchorage – stability require anchorage).
Roots with invert-taper form better than curved or malformed
roots ,
multi-rooted teeth provide greater stability (anchorage) than
single-rooted teeth.
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Factors affecting the success or failure of fixed restoration
Root Length And Form
Teeth with long roots act as a good
abutment
Teeth with invert-taper form of root are
better abutment than curved or malformed
roots
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Factors affecting the success or failure of fixed restoration
2:3ratio has generally been considered to be satisfactory ,
whereas a 1:1 is considered minimal.
(requires condition of other factors such as number of teeth
being replaced , tooth mobility and overall periodontal health)
{Crown root Ratio can be determined by X-Ray panoramic or
pre-apical }
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Factors affecting the success or failure of fixed restoration
6- Occlusion
The occlusal forces on the prosthesis are related to:
- the degree of muscular activity
- the patient`s habits such as bruxism
- the number of teeth being replaced
- the leverage on the bridge
- the bone support
- Opposing teeth
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Factors affecting the success or failure of fixed restoration
There are three types of force can be directed against a prosthesis
during function ( tipping force – twist {rotational} force – path of
insertion force) .
1-Tipping force can occur in buccolingual or mesiodistal direction
depending on point of force application.
2-Twist force may cause a restoration to move circumferentionally
around the prepared teeth
3- Path of insertion force can be apically or occlusally directed
1 2 3
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Factors affecting the success or failure of fixed restoration
Arch Form
A-B fulcrum line , straight line
drawn between the teeth immediately
adjacent to the edentulous area
C-D lever arm
E-F counterbalancing retention
offered by including premolars
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