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      Fundamentals of Fixed Prosthodontics

Fourth Edition

      Cover design based on a photograph of Monument Valley on the Navajo Reservation in northern Arizona taken at sunrise by Dr Herbert T. Shillingburg, Jr.

      FUNDAMENTALS OF FIXED PROSTHODONTICS

      FOURTH EDITION

      Herbert T. Shillingburg, Jr, DDS

      David Ross Boyd Professor Emeritus

       Department of Fixed Prosthodontics

       University of Oklahoma College of Dentistry

       Oklahoma City, Oklahoma

      with

      David A. Sather, DDS

      Edwin L. Wilson, Jr, DDS, MEd

      Joseph R. Cain, DDS, MS

      Donald L. Mitchell, DDS, MS

      Luis J. Blanco, DMD, MS

      James C. Kessler, DDS

      Illustrations by

      Suzan E. Stone

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      Quintessence Publishing Co, Inc

       Chicago, Berlin, Tokyo, London, Paris, Milan, Barcelona, Istanbul, Moscow, New Delhi, Prague, São Paulo, and Warsaw

      Library of Congress Cataloging-in-Publication Data

      Fundamentals of fixed prosthodontics / Herbert T. Shillingburg Jr. ... [et al.]. -- 4th ed.

       p. ; cm.

       Includes bibliographical references and index.

       ISBN 978-0-86715-475-7

       I. Shillingburg, Herbert T.

       [DNLM: 1. Denture, Partial, Fixed. 2. Crowns. 3. Dental Prosthesis Design. 4. Prosthodontics--methods. WU 515]

      617.6'9--dc23

       2011041249

      5 4 3 2 1

      inline equation © 2012 Quintessence Publishing Co, Inc

      All rights reserved. This book or any part thereof may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, or otherwise, without prior written permission of the publisher.

      Quintessence Publishing Co, Inc

       4350 Chandler Drive

       Hanover Park, IL 60133

       www.quintpub.com

      Editor: Leah Huffman

       Design: Ted Pereda

       Production: Patrick Penney

      Printed in the USA

      Dedication

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      In Memoriam

      Constance Murphy Shillingburg

      1938–2008

      This book is dedicated to the loving memory of Constance Murphy Shillingburg. We met at the University of New Mexico at the beginning of her freshman year in 1956. We were married 4 years later, 1 week after she graduated. During my first 2 years in dental school, I made 13 trips, totaling over 22,000 miles, from Los Angeles to Albuquerque. She shared all of the triumphs and disappointments of my last 2 years in dental school. It was not my career; it was our career. She supported me in all that I did. She didn’t question my leaving practice to start a career in academics or our moving from California to Oklahoma. We had three daughters along the way. Although she had three open-heart surgeries in her teens because of rheumatic fever and then two cancer surgeries later in life, she was the most optimistic person I ever met.

      She accompanied me on 29 trips outside the United States. At first she came along because she loved to travel, and I didn’t enjoy the trips nearly as much without her. However, I very quickly learned that my hosts and audiences were enchanted by her. They enjoyed her as much or more than they did me, and she used what she learned on those trips in her teaching. She died 3 weeks after we celebrated our 48th wedding anniversary. There is a song on the most recent Glen Campbell album, Ghost on the Canvas, that sums it up perfectly: “There’s no me…without you.”

      Authors

      Luis J. Blanco, DMD, MS

      Professor and Chair

      Department of Fixed Prosthodontics

      University of Oklahoma College of Dentistry

      Oklahoma City, Oklahoma

      Joseph R. Cain, DDS, MS

      Professor Emeritus

      Department of Removable Prosthodontics

      University of Oklahoma College of Dentistry

      Oklahoma City, Oklahoma

      James C. Kessler, DDS

      Director of Education

      L. D. Pankey Institute

      Key Biscayne, Florida

      Donald L. Mitchell, DDS, MS

      Professor Emeritus

      Department of Oral Implantology

      University of Oklahoma College of Dentistry

      Oklahoma City, Oklahoma

      David A. Sather, DDS

      Associate Professor

      Department of Fixed Prosthodontics

      University of Oklahoma College of Dentistry

      Oklahoma City, Oklahoma

      Herbert T. Shillingburg, Jr, DDS

      David Ross Boyd Professor Emeritus

      Department of Fixed Prosthodontics

      University of Oklahoma College of Dentistry

      Oklahoma City, Oklahoma

      Edwin L. Wilson, Jr, DDS, MEd

      Professor Emeritus

      Department of Occlusion

      University of Oklahoma College of Dentistry

      Oklahoma City, Oklahoma

      Preface

      Fixed prosthodontics is the art and science of restoring damaged teeth with cast metal, metal-ceramic, or all-ceramic restorations and of replacing missing teeth with fixed prostheses using metal-ceramic artificial teeth (pontics) or metal-ceramic crowns over implants. Successfully treating a patient by means of fixed prosthodontics requires a thoughtful combination of many aspects of dental treatment: patient education and the prevention of further dental disease, sound diagnosis, periodontal therapy, operative skills, occlusal considerations, and, sometimes, placement of removable complete or partial prostheses and endodontic treatment.

      Restorations in this field of dentistry can be the finest service rendered for dental patients or the worst disservice perpetrated upon them. The path taken depends upon one’s knowledge of sound biologic and mechanical principles, the growth of manipulative skills to implement the treatment plan, and the development of a critical eye