Abutment

PULF L
em no
O4 Abutment
Qnst. Define abutment. [DU-Aug'13,
Ans: RU-Aug'18, 17|
Abutment:
Tt is defined
as, "A tooth, a
portion of a tooth or that portion of an implant used for the support of a
or removable prosthesis." fixed

Ref-Deepak]
Qns-2 Mention the criteria of an ideal abutment tooth for Fixed Partial denture.
Or, Write a short note on abutment selection criteria. [DU-Feb'17, 151
Ans: [RU-Feb'17]
Ideal criteria of abutment:
An ideal abutment should have
the following characteristics
Ideal crown root ratio
Adequate thickness of enamel and dentine
Adequate bone support
Absence of periodontal disease
Proper gingival contour
(S.N. use little description with figures in case of short note-See question no. 4]
Ref-Deepak]
Qns3. What are the types of abutment? [DU-Aug'16, RU-Aug'18, 17]
Ans:
Types of abutment:
1. Cantilever abutments
2. Pier abutments
3 Tilted abutments
4. Extensively
damaged abutments
5. Implant abutments

[Ref-Deepak]
butmant

PULP I 253

peseribe
pescribe the eriteria
crit for cantilever
abutment.
A n s

criteria ofcantilever abutment:

[DU-Aug'16)
More than average bone support should
cient mount of tooth structure
Sufficient amo be present
retentive
should be available because the final retainer should be more
.The abutment
he abutment should be
occlusal scheme
selected such that its position favours the development of an ideal
Replacement of lateral incisor with
canine support
Replacement of first
premolar with second premolar and first molar
.Ifstrong abutments are not support
available, adjacent to the edentulous space,
can be incorporated spring cantilever desg
Ref-Deepak]
Oa-5Write a short note on pier abutment. [RU-Feb'16]
Q
Ans
Pler abutment:
Apier abutment is a single tooth with two adjacent edentulous spaces on either side.
lhthis case, the single tooth will have to act as an abutment for both the edentulous spaces.

Figure-Pier abutment

edentulous spaces, it will be subjected to unbalanced forces, which

ince a single abutment supports two The forces acting on one end of
the prosthesis will tend to lit
an lead to trauma of the periodontium. In such condition, the lifespan of the retainer
as a fulcrum.
Other end like a lever using the abutment
sdramatically reduced. should be provided near the pier abutment.
order to prevent trauma to the abutment, a tress breaker
in a keyway.
with a key
The stress breaker is a non-rigi connector
Ref-Deepak]
 be considered for abutment selection? [DU-Aug'12] -200
Qns- What are the points tothat need to be considered during abutment
selection tor fixed partial
or,
Or, What are the factors
denture? [DU-Aug'15, Feb'11, 101
Or, Crown-Root ratio is a vital factor for an abutment selection. Why? [DU-Feb'13
Or,
Ans:
Factors that need to be considered during abutment selection:
The factors influencing the choice of an abutment
1. Location, position and condition of the tooth:
Teeth with the following characteristics are preferred abutments-
Teeth adjacent to edentulous spaces
T e e t h with grossly decayed crowns that can be restored with a full veneer crown.
Modifications like dowel core and pin retained amalgam restorations may be needed to
restore crown morphology in grossly destructed teeth
Vital teeth are preferred, though endodontically treated teeth can also be used
Pulp capped teeth should not be used as abutments because they are always under the risk
of requiring root canal treatment

2. Root configuration:
The forces acting on a tooth transferred to the supporting bone through the root. The shape of the
root determines the ability of the abutment to transfer the masticatory load to the supporting
bone. Some factors for root configuration are
Roots with greater labiolingual widths are preferred

.Roots with irregularcurvatures are preferred

Teeth with longer roots serve as better abutments
Teeth with conical roots can be used for short span fixed partial dentures
Crown-Roo ratio PULP 255
The ratio between the
than one. length of the
gn ot the crown and
and the length of
of the
The length of the rootsshould always
the root should always be
oc less
crown in this
instead it indicates the case does
length of the structurenot indicate the clinical or
above the crest of the anatoone
alveo12

Fig: The true 'crown

length' indicates clinical crown height and
not anatomical crown height

for the tooth to act as a good abutment.

ig: Ideally the root should belonger than the crown (3:2) abutment
for a tooth to act as an
Ratios upto 1:1 is acceptable

considered to have very long crowns

Teeth with alveolar defects
are
be 2:3 (0.66)
Ideally the root ratio should
crown
Ratios up to 1:1 (1.0) are acceptable crown is longer than the root) are unacceptable
(i.e. the length of the
Ratios above one
4. Root support: that aid to evaluate an abutment.
of the most important factors
ne alveolar bone is one
be healthy
alveolar bone should
The supporting architecture and
show no signs of bone defects or ho
bone
trabecular
It should have good
loss the bone architecture
to evaluate
should be used
Intra-oral radiographs
Abutment PULP I| 25

5. Periodontal ligament area:

l t depends upon the size and length of the root. The bone support increases with an
increase in the periodontal ligament area

Fig: According to Ante's law the total pericemental surface area ofthe abutments (1+2)
should be equal to or greater than that of the missing teeth ()

Periodontally diseases teeth are unsuitable to be used as abutments

The pericemental area of the abutment should be calculated and if it is not sufficient then
an additional tooth should be used as a secondary abutment

6. Assessment of pulpal health:

Usually unrestored abutments are preferred
If caries is present, regular preparation can be done. If large carious lesions are present
they should be scooped out and can be used for additional retention
I f large carious lesions are present they should be scooped out and can be used for
additional retention
. I f the abutment tooth has a carious lesion with pulpal involvement then root canal
treatment is advised. Root canal is not advised for abutments with periapical lesions.
p [Ref-Deepak]
O MA

etient has come to you with a

p a t d e n e
PULP 1257
atment options (which typecomplaint of missing
explanation. [DU-Feb'141 of bridge and issing right
right upper
upper lateral incisor. Mention
pontic designyou
girl
A younggin aged about 15 you will pree
prefer) with

Ato years old come to

we to
Odue congenital missing of
congenital
to congenital
of upper you with the complain
upper lateral toyou comy of aesthetic problem
incisor. Writeyour
your treatmen
treatment plan.
Treatmentoptions:
AS

oth-Maxillary lateral incisor

Missng
t o o t h - M a

nUpper central incisor and

and canine canins
R
R e
e b
a alln
neerrs
s--R
Rees
sin-bonded

retainers
tment-pont root ratio-2.6
peda onsiderations:
oCaries
.Caries and/or
and/o restorations on the
abutments
If canine is would require metal-ceramic retainers.
equire metal-ceramic
. If the
the canine long, well-supported
ill not contact in centnic or lateral periodontally, and in restoration, and if
need of restoration, if the pontic
the ponu
can be used. excursions, a single-abutment cantilever fixed partial dentu
In that case, a metal-ceramic crown also
should be used as a retainer
.An untouched
central
incisor and a first
cantilevered from metal ceramic crowns onpremolar
in need of restoration could call for a
pontic
the canine and first
premolar.
[Ref-Shillingburg]
-A patient having lost of Right maxillary canine with 2ad premolar. Mention the treatment
plan. [DU-Feb'15]
AS
Treatment plan:
Wissing teeth-Maxillary canine and second premolar
utments-Central and lateral incisors, first premolar, and first molar
etainers-Metal-ceramic on incisors and premolar, and seven-eighths crown on molar
Pontics-Metal-ceramic
Abutment-Pontic root ratio-2.1
Design considerations:
Non-rigid connector between first premolar retainer and second premolar pontic.
The corresponding mandibular situation would be handled identically with the substitution of a
full gold crown on the first molar, if the patient does not object.
A metal-ceramic crown could be substituted
[Ref-Shillingburg]
Write down the treatment options for a missing lower first permanent molar in a healthy
mouth.
ARS:

Iratment options:
ng tooth-Mandibular first molar
butments-S-Second premolar and second molar
hetalner Metal-ceranmic crown on premolar and gold crown on molar
full veneer

ontic-All-metal hygienic
ent-pontic root ratio-1.5
 Abutment
PULP258
Considerations: R usiteq A
the second premolar if the clinical
A three-quarter crown is technically feasible on crown is
c.

longer than average and the patient is agreeable

A tilted molar may require orthodontic uprighting, a proximal half crown, or
itenalqzs
wn
Ref-Shillingburg
Qns-1e. What is Ante's Law? [DU- Feb'15, Aug'15, RU-Aug'18]
Write down its values for each tooth. [RU-Feb'17]
Or, Define Ante's Law. [DU-Feb'171
Or, Describe Ante's law.
Or, Write a short note on Ante's law. [RU-Feb'161
Ans:
Ante's Law:
Johnston et al proposed the famous Ante's Law. According to this law, "The sum of the pericemental
ental
areas of abutment teeth should be equal to or surpass that of the teeth being Teplaced."

The Ante's law has been stated in the glossary as follows, "In fixed partial denture prosthodontics for
the observation that the combined pericemental area of all the abutment teeth supporting a fixed partial
denture should be equal to or greater in pericemental area than the tooth or teeth being replaced; as
formulated for removable partial prosthodontics, the combined pericemental area of the abutment teeth
plus the mucous area of the denture base should be equal to or greater than the pericemental area of the
missing teeth." obnot loms
de Ref-Deepak]
Values for each tooth:
Root surfacearea of Abutment:
| Maxillary:
Root surface area (mm) Percentage root surface area in
quadrant
Central incisor_ 204 10
Lateral incisor 79 9
Canine 273 14
First premolar 234 12
Second premolar 220
First molar 433 22
Second molar 431 22

Mandibular: 8tms
Central incisor 154
Lateral incisor 168
Canine 268 15
180 | 10
First premolar
207
Second premolar_
First molar 431 24

Second molar 426 23 [Ref-Fujimoto