The role of occlusion for the stability of fixed bridges in patients with reduced periodontal tissue support.

The present investigation reports how occlusion may be utilized to establish and maintain stability of fixed bridges in patients with markedly reduced periodontal tissue support. The material consisted of 20 adult patients, aged 27-69, with advanced periodontal breakdown, often in combination with extensive loss of teeth. After periodontal treatment, the patients were rehabilitated with fixed bridges, whose stability was evaluated once a year for 2 to 6 years. The results show that permanent stability of bridgework can be obtained in patients where there is a minimum of remaining periodontal tissue support, even in combination with marked hypermobility of individual abutment teeth. The stability was achieved by proper treatment of the diseased periodontal tissues, and by establishment of stable occlusion in the intercuspal position. When there was a risk of bridge mobility on excursive movements of the mandible, balancing contacts were established for the prevention of migration, tilting and increasing mobility. The study also shows that cantilever pontics can be used to achieve and maintain the stability of fixed bridgework.