17. Case Design Workshop Pt. I Flashcards by J L

Surveying

➢____
an analysis and comparison of the prominence of intraoral contours associated with the fabrication of a prosthesis
➢____
a paralleling instrument used in the construction of a prosthesis to locate and delineate the contours and relative positions of abutment teeth and associated structures
➢____
the specific direction in which a prosthesis is placed upon the abutment teeth

surveying
dental surveyor
path of insertion

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Surveying
➢Purposes
▪ Determine the path of \_\_\_\_ 
▪ Identify \_\_\_\_ planes
▪ Locate \_\_\_\_ area
▪ Evaluate \_\_\_\_ undercuts

insertion
guiding
undercut
soft tissue

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Surveying
➢Purposes
▪ Evaluate esthetics
▪ Determine \_\_\_\_ procedure/ tooth modification
▪ Delineate the \_\_\_\_ of contour 
▪ \_\_\_\_ the cast

restorative
height
tripoding

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Determining Factors
➢Guiding planes
▪ ____ proximal surfaces to one another

➢Retentive areas or undercut
▪ only with a given path of ____
▪ minimum retention against reasonable ____ forces
▪ changing the path of insertion
▪ altering the ____ of the clasp by changing its design, size & length, or material

parallel
insertion
dislodging
flexibility

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Determining Factors
➢ Interference
▪ may be eliminated by ____, extraction, modifying tooth surfaces, or restoration
▪ selecting a different path of insertion at expense of existing ____ and undercut
▪ modified with ____ with the path of insertion dictated by the interference

surgery
guiding plane
restorations

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Determining Factors
➢ Esthetics
▪ less \_\_\_\_ display
▪ missing anterior teeth - more \_\_\_\_ tilting
▪ fixed \_\_\_\_ denture

metal
posterior
partial

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Surveying Procedures
1. Place and tighten the cast on the table.
Adjustable table should be allowed only in two directions, ____ or ____.
➢ Zero-Tilting: the occlusal ____ and the ____ should be parallel

A-P
lateral
plane
platform

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Surveying Procedures
2. Surveying for guiding planes 
▪ proximal surfaces: \_\_\_\_ tilting
▪ principal \_\_\_\_ first
▪ within a range that tooth modification is \_\_\_\_

A-P
abutment
possible

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Then we would go to the opposite side so this is a class 2 modification 1. So we have a premolar here, we have three teeth that are abutment teeth so we found the ____ plane here and we carry that onto our surveryor.

ideal

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Surveying Procedures
➢ bisect the ____ angle
3. Tilt the cast to the ____ line

maximum

bisecting

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Surveying Procedures

4. Mark the established ____ tilt on the other side of the cast.

A-P

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Surveying Procedures
5. Surveying for retentive undercuts
▪ ____ tilting along the established A-P tilt
▪ ____ retention
▪ ____ retention
▪ within a range that tooth modification is ____

lateral
minimum
uniform
possible

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Surveying Procedures
➢ repeat the same procedure as for ____ tilt: bisecting the maximum angle created by ____ tilting
6. Mark the established ____ tilt on the front or rear of the cast

A-P
lateral
lateral

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Surveying Procedures
7. Evaluate tissue ____
▪ severe tooth undercut
▪ soft tissue

interferences

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Surveying Procedures
8. Esthetics
▪ ____ of denture base (A)
▪ ____ between abutment tooth and artificial tooth (B)

extension

black triangle

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Surveying Procedures

9. Determining and ____ the final path of insertion

tripoding

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Surveying Procedures

10. Carbon marking the ____ and tissue ____

survey line

undercut

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Requirements for PRDP Design

____
Stability
____
Occlusion

> > >

____
Comfort
____

support
retention
esthetics
function

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Guidelines of PRDP Design
➢Support:
▪ rests next to \_\_\_\_ areas
except for RPI design
▪ \_\_\_\_ rests next to distal extension areas
▪ add rests as needed for \_\_\_\_ support
▪ make sure there will be no \_\_\_\_ of rests with opposing occlusion
▪ \_\_\_\_ connector expanded as needed
▪ altered cast impression as required

edentulous
two
pericemental
interference
major

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Guidelines of PRDP Design
➢Stability:
▪ \_\_\_\_ connectors touching vertical surfaces of teeth wherever possible
▪ indirect retainers placed
▪ clasp assembly (rests, minor connectors, retentive and bracing arms)
not \_\_\_\_ with occlusion
▪ extension of bases
▪ \_\_\_\_ major connector

minor
interfering
rigid

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Guidelines of PRDP Design
Retention:
 survey for ____” undercut
 create guiding planes to assure path of insertion that allows the retentive tip to be in ____” undercut
 Circumferential clasp in Class ____ or modification areas
 Wrought wire ____ or ____ next to distal extension areas

0.01
0.01
III
circumferential
I bars

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Guidelines of PRDP Design
➢Esthetics:
▪ ____ when possible
▪ whenever possible, keep retentive tips in ____ and ____ portions (shoulders) of circumferential clasps on distals of anterior abutment teeth

➢Occlusion:
▪ Rests, minor connectors, and retentive arms planned to avoid ____ in centric or lateral movements

I bars
mesial
proximal

interference

Guidelines of PRDP Design
➢Comfort:
▪ \_\_\_\_ connectors kept away from speech areas
whenever possible;
 use \_\_\_\_ behind rugae,
 use \_\_\_\_ rather than linguoplates.

➢Function:
▪ chewing;
 recheck placement of all framework elements for occlusal interference,
▪ speaking;
 recheck placement of framework elements to avoid interference with speaking.

major
palatal straps
lingual bars

Periodontal Considerations
➢ Major connectors
▪ Maxillary major connectors
 \_\_\_\_ mm from the gingival margin 
 <6 mm: \_\_\_\_ (A)

linguoplate

Periodontal Considerations  Major connectors  Maxillary major connectors  beading at the periphery: ____ mm deep and wide, round (B)  no relief except for ____ (C)  metal highly polished (D) tissue surface should ____ be highly polished except where it crosses the ____ (E)

0.5-1 gingival margin not gingival margin

``` Periodontal Considerations ▪ Mandibular major connectors • ____ mm from the gingival margin • <3 mm: ____ (A) • metal highly polished A ```

3 | linguoplate

Periodontal Considerations ▪ Mandibular major connectors • ____ to prevent soft tissue impingement (B) • ____ gauge (____ mm) sheet wax

relief 32 0.2

Periodontal Considerations ▪ Mandibular major connectors • tissue surface should be highly ____. (C)

polished

``` Periodontal Considerations Minor Connectors  junction of rest and minor connector: at least ____ mm  ____ mm between minor connectors  minimal gingival coverage: ____° ____ of gingival tissues ```

1.5 5 90 relief

Periodontal Considerations ➢ Clasps ▪ ____ tooth and gingival coverage to reduce plague accumulation ▪ bar clasp  never ____ soft tissues  horizontal approaching arm: ____ mm from the gingival margin  superior border of the bar: at least ____ mm from the gingival margin  ____ (C)

``` minimal impinge 3-5 3 90 ```

``` Periodontal Considerations ▪ circumferential clasp  at the junction of ____ and ____  should not contact free ____  located in the occlusal 1/3 may increase ____ ```

middle 1/3 cervical 1/3 gingival margins forces

``` Periodontal Considerations ➢ Rests ▪ direct forces along the ____ of the tooth (A) ▪ ____ rest seat (B) ▪ at least ____ mm at the junction ```

long axis positive 1.5

``` Periodontal Considerations ➢ Bases ▪ optimal extension  maximize the tissue support and stability ▪ adjacent to abutment teeth  expose ____ tissue (A) ``` ▪ internal finish line  ____ polished metal B contact (B): finishing index tissue stop

gingival | highly

Biomechanical Considerations for PRDP Design  Direct Retention  ____ clasp retention  adhesion and cohesion – maximum coverage and intimate ____  frictional retention – ____  neuromuscular control – lip, cheek, tongue

minimum contact guiding plane

Biomechanical Considerations for PRDP Design ➢ Clasp position ▪ quadrangular configuration  Kennedy class III  one as far as ____; the other as far ____ as esthetics and space permit

posteirorly | anteriorly

Biomechanical Considerations for PRDP Design ➢ Clasp position ▪ triangular configuration  Kennedy class II  one as far as ____; the other as far ____ as esthetics and tooth contour permit

posteriorly | anteriorly

``` Biomechanical Considerations for PRDP Design ➢ Clasp position ▪ linear configuration  Kennedy class I  the most ____ teeth  ____ retainer ```

posterior | indirect

Biomechanical Considerations for PRDP Design ➢ Clasp design ▪ basic cast ____ vs. ____ ▪ wrought wire ____ clasp

circumferential RPI combination

``` Biomechanical Considerations for PRDP Design ➢ Splinting of abutment teeth ▪ increase ____ area A ▪ ____ or short root (A) ▪ ____ or lone standing abutment (B) ▪ ____ stabilization with partial denture (C) ```

periodontal tapered intermediary cross-arch

``` Biomechanical Considerations for PRDP Design ➢ Indirect retention ▪ Kennedy class ____ ▪ Kennedy class ____ ➢ Auxiliary rests ▪ ____ ```

I and II IV lingual plate

Biomechanical Considerations for PRDP Design ➢ Occlusion ▪ MD ____ and the number of teeth to be replaced ▪ ____ cutting surface for chewing efficiency ▪ no ____ cusp incline

width sharp steep

Biomechanical Considerations for PRDP Design ➢ Denture bases ▪ maximum ____ ▪ accurate ____ to residual ridge

coverage | adaptation

``` Biomechanical Considerations for PRDP Design ➢ Major connectors ▪ ____ ▪ ____ at each side of lingual plate ▪ ____ support from rests ```

rigid rests vertical

Biomechanical Considerations for PRDP Design ➢ Minor connectors ▪ ____ ▪ intimate contact between ____ and minor connector  distinct path of ____ to help retention  improved ____

rigid guiding plane insertion stability

Biomechanical Considerations for PRDP Design  Rests and rest seats 

90 ball-and-socket stress

PRDP Design Procedure 1. Selection of Abutment Teeth ▪ Teeth adjacent to the ____ ridges in general ▪ Teeth for ____ retainer (s)

edentulous | indirect

PRDP Design Procedure 2. Check the occlusal contact on the abutment tooth. ▪ Check out the available space for the rest and minor connector. ▪The rest seats on the upper anterior teeth should be placed ____ below the occlusal contacts to avoid the occlusal interferences. YES: Place a normal ____ seat accompanied with the proposed clasp system. NO: ▪ Relocating the rest seat, for instance, mesial to distal or crescent cingulum rest seat to lug (ball) rest seat on anterior teeth ▪ Preparing ____ rest seat, if allowed. ▪ Doing enameloplasty on the opposing tooth ▪ Fabricating ____ crown

gingivally rest deeper survey

PRDP Design Procedure 3. Survey the cast for a desired path of insertion ▪ Start with ____ – Place the occlusal plane parallel to the surveying platform ▪ Find out the parallel ____ on the proximal and lingual surfaces as well as tooth surfaces that the metal framework, minor connector, will contact. -> Use ‘____ rod’. ▪ Find out the retentive undercut for the proposed clasp system on each abutment, most often ____”, at the mesio or disto-facial line angle area ▪ at the cervical 1/3. -> Use ‘____ gauge’. ▪ Indicate any soft tissue ____ that may interfere with placing the PRDP ▪ Take esthetic consideration for anterior edentulous area. YES: Lock the surveying table and ____ the path of insertion. NO: ▪ Different clasp system with a different ____ ▪ Different path of ____ for the proposed clasp system ▪ Lingual undercut – retentive arms should be equilaterally or ____ opposed. ▪ ____ crown ▪ Preparation of undercut – dimple or depression

``` zero tilt guiding planes analyzing 0.01 undercut undercuts ``` ``` tripod undercut insertion diagonally survey ```

PRDP Design Procedure 4. Scribing the survey lines ▪ Replace the surveying tool with ‘____ marker’. ▪ Scribe them on the areas that the ____ components may contact. In other words, on the facial, lingual and proximal surfaces as well as soft tissue.

carbon | metal

PRDP Design Procedure 5. Outline the PRDP components in ____ ▪ Denture base and denture base minor connector ▪ Major connector ▪ Rest seats ▪ Clasp assembly – retentive and reciprocating arms ▪ Minor connectors that connect all metal components

red

PRDP Design Procedure 6. Indicate the areas that interfere with placing the PRDP ▪ Mark them on teeth in ____ with solid line circle and spaced diagonal lines or blue arrows. ▪ These areas are where ____ has to be considered. This procedure will be done by ____ clinically (tooth modification on survey & design form). ▪ If the amount of enameloplasty should be more than 0.03” or there is post-operative sensitivity you may need a ____ crown.

blue reshaping enameloplasty survey

``` Tooth Supported vs. Tissue Supported ➢Tooth supported: Kennedy Class III and IV ▪ Support: ____ ▪ Direct retainer: ____ clasp ▪ Indirect retainer: no ____ ▪ Stability: ____ connector and rigid portion of clasp ▪ Impression: ____ form ▪ Denture base: ____ or acrylic ```

``` teeth cast circumferential need minor anatomical metal ```

Tooth Supported vs. Tissue Supported ➢ Tissue supported: Kennedy Class I and II ▪ Support: teeth and ____ ▪ Direct retainer: ____ clasp, I-bar ▪ Indirect retainer: ____ ▪ Stability: ____ connector, rigid portion of clasp, and denture base ▪ Impression: ____ form, ____ cast impression ▪ Denture base: ____

``` edentulous ridge wrought wire yes minor supporting altered resin ```

Best Clasp Design  Longitudinal studies indicate there is no “____” clasp design  All act the same for the ____ of the abutment over time

best | same