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Removable prosthodontics II > Re-introduction to Removable Partial Dentures > Flashcards

Re-introduction to Removable Partial Dentures Flashcards

1
Q

Partial Denture-Definition:

A

A prosthesis that replaces one or more, but not all of the natural teeth and supporting Structures. It is supported by the teeth and or the mucosa. It may be fixed (i.e. a bridge) or a removable

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2
Q

Clinical indications for RPDs:

A
  1. Missing large number of teeth on both sides of the arch
  2. Remaining teeth are not suitable abutments for fixed bridge
  3. Implants are contraindicated
  4. Patient preference
  5. Financial limitations
  6. Need for an immediate or temporary prosthesis
  7. Failed fixed bridgework
  8. Need to replace existing RPD
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3
Q

Clinical contraindications for RPDs:

A
  1. Missing small number of teeth on one side of the arch
  2. Remaining teeth are not suitable as abutments for RPD
  3. Implant placement may be possible with careful planning
  4. Patient expectations are not realistic
  5. Non-compliant patient / poor oral hygiene
  6. Aesthetic demands impossible to satisfy
  7. Several unsuccessful previous attempts to provide satisfactory RPD
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4
Q

Treatment planning sequence:

A
  1. Listen to the patient
  2. Examine the patient
  3. Collect data from special tests
  4. Evaluate all information
  5. Discuss treatment options with the patient
  6. Reach agreement on treatment plan of choice
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5
Q

Treatment provision sequence:

A
  1. Pain relief / acute conditions / urgent extractions of hopeless teeth
  2. Periodontal treatment & urgent endodontic treatment
  3. Stabilization / temporization
  4. Direct/indirect restorations & non urgent endodontic treatment
  5. Prosthodontic treatment
  6. Maintenance
  7. Prosthodontic treat
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6
Q

Clinical examination-Sequence:

A
  • Extra oral
  • Intra oral: soft tissues
  • Intra oral: dentition & periodontal condition
  • Intra oral: occlusion
  • Intra oral: denture bearing tissues
  • Extra oral & intra oral: previous RPDs
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7
Q

What should be our No 1 priority when examining a new patient for the first time?

A

SCREENING FOR ORAL CANCER AND HEAD & NECK CANCER!

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8
Q

Special tests:

A
  • Radiographic examination: periapical, bite-wing, panoramic
  • Pulp vitality tests
  • Full periodontal charting if indicated
  • Articulated study casts
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9
Q

Patient evaluation-Considerations:

A
  • Information from patient interview
  • Clinical findings
  • Special tests findings
  • Available treatment options
  • Risks and benefits
  • Associated costs and time to completion
  • Needs for maintenance
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10
Q

Anatomical features of the partially dentate maxilla:

A
  • Maxilla
  • Labial / buccal sulci
  • Labial / buccal frena
  • Incisive papilla
  • Rugae
  • Residual alveolar ridge
  • Palatine raphe
  • (Palatine torus)
  • Palatal gingival remnant
  • Vibrating line / soft & hard palate junction Fovea palatini
  • Maxillary tuberosity
  • Hamular notch
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11
Q

Anatomical features of the partially dentate mandible:

A
  • Labial / buccal / lingual sulci Labial / buccal / lingual frena
  • Genial tubercles (Mandibular tori)
  • Residual alveolar ridge
  • Buccal shelf
  • Mylohyoid ridge
  • Retromylohyoid fossa
  • Retromolar pad
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12
Q

Why is it so important to know all the anatomical features of the partially dentate arch?

A
  • Anatomical landmarks that will guide us to setting up the artificial teeth
  • Anatomical structures that determine / limit denture extension
  • Anatomical features to avoid!
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13
Q

The Kennedy classification system of partially edentulous arches:

A
  • Class I: bilateral edentulous areas located posterior to the remaining teeth
  • Class II: unilateral edentulous area located posterior to the remaining teeth
  • Class III: unilateral edentulous area bounded by remaining teeth
  • Class IV: single, bilateral edentulous area located anterior to the remaining teeth
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14
Q

Biomechanics of RPDs-Considerations in regards to RPDs:

A
  • Forces applied by the RPD to the tissues
  • Forces applied to the RPD in function
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15
Q

Biomechanics of RPDs-Sequelae of using RPDs:

A
  • Damage to the remaining teeth
  • Damage to the periodontium
  • Damage to the residual alveolar ridge
  • Fulcrums and levers, wedges and inclined planes!
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16
Q

RPD design-A proven method for success:

A
  • Formulate the theoretically ideal design for the specific case
  • Adapt to the patient’s needs
  • Adjust according to the clinical presentation
  • Revise and finalise the design
  • Demonstrate and explain the design to the patient
  • Revise again if needed
  • Communicate the design to the dental technician
  • Ensure the execution is correct
17
Q

RPD design step by step:

A
  1. Select path of insertion and survey cast
  2. Mark teeth to be replaced
  3. Indicate positions and depth of undercuts
  4. Plan support (rests / saddles)
  5. Plan retention (direct retainers)
  6. Plan stability (bracing arms)
  7. Join all components with the simplest major connector possible
  8. Assess the design for indirect retention
  9. Verify undercuts and modify the direct retainers if needed
  10. Review overall design and modify if needed
18
Q

Top 5 hazards in the Dental Laboratory:

A
  • Cross infection
  • Fire
  • Dust / fumes / liquids
  • Sharps & rotary instruments
  • Eye injuries
19
Q

Aims of the preliminary jaw relationship registration:

A

To mount the primary casts on the articulator, in order to:

  • study the occlusion for diagnosis and treatment planning
  • ensure there is adequate space for the artificial denture teeth
  • ensure there is adequate space for other components of the RPD
20
Q

Clinically significant positions of the mandible:

A
  • Maximal intercuspal position (ICP): the complete intercuspation of the opposing teeth independent of condylar position, sometimes
    referred to as the best fit of the teeth regardless of the condylar position
  • Retruded contact position (RCP):
    Guided occlusal relationship occurring at the most retruded position of the condyles in the joint cavities. A position that may be more retruded than the centric relation position.
  • Retruded position (RP): same as RCP when there are no tooth contacts (edentulous cases or partially dentate with no occluding pairs of teeth)
21
Q

Surveying of primary casts for RPD design-Step by step:

A
  1. Preliminary assessment
  2. Initial survey: horizontal > in some cases that is all that is needed!
  3. Tilting the cast: usually anteriorly or posteriorly. - improve the appearance (reduce black triangles) - avoid interferences - maximize retention
  4. Final survey at the selected tilt: ensure undercuts present both at tilted and horizontal positions
  5. Don’t forget to mark the selected tilt!

Removable prosthodontics II (13 decks)

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