Fundamentals of Fixed Prosthodontics
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
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
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
Editor: Leah Huffman
Design: Ted Pereda
Production: Patrick Penney
Printed in the USA
Dedication
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