Not really-You need cross arch stabilization and bracing when restoring a complete arch. The clinician must be able to control the vertical, horizontal, and sagittal axes of rotation. Theses rotational axes are present whether a fixed prosthesis or a combination fixed and removable prosthesis is used.
Thank you very much Dr. Ira Zinner and Dr. Eli Raviv. for your informative answers.
I wounder if the problem of stabilization still exists or not if we use implant-supported FPD in this type of edentulous span?!
Generally one of the limited indication of FPD is the long span edentulous space and i will prefer implant in cases of long span area.
Thank you.
An interesting question about a historic approach . However,in my view,cross arch stabilisation is very much yesterday's game.
There can be very little ,if any, justification now for removing 62-73% of sound tooth tissue (Edelhof and sorenson 2002) for multiple preparations to provide one path of insertion for such prostheses.
The concept was founded on the now discredited idea that distributing occlusal load across multiple teeth to provide rigidity stopped periodontal disease.
Most of have not believed that for over forty years (Axelsson and Lindhe). Double abutting as a concept can contain the seeds of later failure due to pulpal or structural problems .Splinting teeth for cross arch stabilisation also makes it more difficult for the average person to keep things clean -hence later failure.
Just ask yourself-"would I have that destruction done to your own remaining sound teeth if you were missing those teeth"
in the late seventies and early eighties Nyman, Lindhe, Ericsson, Lundgren etc. have shown that after treatment of severe periodontal disease and only a few teeth left in one arch (e.g. fiv teeth) that a cross arch connecting- one piece bridge (often with shortened dental arches ) can be placed. Liundgren has performed a lot of force measurements on the load patterns in such restorations. According to our current perception of esthetics (and probably also function) of such reconstructipons would no more being accepted by our patients. Lundgren et al. discussed some of these cases they followed over 20 years. Se: Lundgren et al 2008, (Periodontology 2000)
However, with implants available nowadays these are a good indication for long span gaps. Whenever possible, short segnments or restorations are preferred and if possible teeth do not have to be prepared for crowning.
Sorry to be joining in on this late.
I think there are 2 different concepts that are being intertwined here and perhaps muddying the water.
When we are doing a removable partial denture, especially one with a distal extension, cross-arch stabilization, enhanced with a rigid major connector, is the design of choice. It is predicated on distributing the unavoidable forces to as many components of the RPD as possible. To my knowledge there are no compelling clinical studies to refute this technique.
In the perio-prosthesis, cross-arch stabilization was extremely popular for the reasons stated by Drs. Mericske-Stern and Kelleher and I agree that given the research and the introduction of implants this is “old school”.
Problem as I see it is that the original question was not answered.
So, can you do a fixed partial denture instead of a removable partial denture to restore the Kennedy Class IV scenario?
First response is why not do implants?
If implants are not possible the following factors need to be established:
The width of the edentulous space and the occlusal-gingival height – see Law of Beams.
The length of the anterior cantilever, if it exists.
The quality of the abutment teeth.
The opposing occlusion.
The decision to double abut or not , can then be determined.
While Ante’s Law is based on expert opinion, it does seem to work, especially in the non-ideal scenarios.
Thank you very much Dr. Gary Goldstein
That's all what we need to know. :)
Just to throw this into the mix :-)
Clin Oral Implants Res. 2007 Jun;18 Suppl 3:63-72.
Ante's (1926) law revisited: a systematic review on survival rates and complications of fixed dental prostheses (FDPs) on severely reduced periodontal tissue support.
Very informative explaination given by Gary Goldstein. I agree with it
- Badges
- Science topic
- Similar topics
- Correction