Communication between dentist and laboratory:

Question 1

Q: How would you classify a Removable Partial Denture?

Answer 1

A: Class IIb Medical Devices

Here, we can include medical devices such as long-term corrective contact lenses, removable partial dentures, complete dentures, implants, surgical lasers, defibrillators, and others. They are medium to high-risk devices, and patients may use them for a period longer than 30 days.

Question 2

Custom-made devices:

Answer 2

Constructed specifically in accordance with a written prescription of a registered dental practitioner, or other person authorised to write such a prescription by virtue of his professional qualification, which gives under his responsibility, specific characteristics as to its design;

• Intended for the sole use of a particular patient

NOTE: A written prescription may take the form of a letter from a qualified person or a moulded impression of the shape of the required device together with the order specifying customer details, and a request to ‘make as pattern’. It is the qualified person who is responsible for specifying the particular design characteristics of the product

Question 3

Custom-made devices:

Conformity assessment requirements:

Answer 3

• Chemical, physical and biological properties of the device
• Infection and microbial contamination
• Construction and environmental properties
• Protection against radiation
• Requirements for medical devices connected to or equipped with an energy source;
• Information supplied by the manufacturer, including labels.

Question 4

Custom-made devices:

Required Information:

Answer 4

As a minimum requirement the labels on a custom-made device must include:

• Data allowing identification of the device in question, i.e. description, serial number, order number, generic name
• The particular features of the device as specified in the relevant prescription, i.e. the written prescription with its special features extracted to define the particular device
• A statement that the device is intended for exclusive use by a particular patient, together with the name of the patient or patient identifier

Question 5

Communication between dental clinic and laboratory:

Answer 5

• All clinical and technical stages involve risk of inherent errors
• These are due to limitations in the materials, techniques, skill, patient acceptance of procedures etc.
• To minimize errors, each part should aim to perform to their maximum ability
• Even when they do, effective communication is key to avoiding errors
• Each part must accept their responsibilities

Question 6

Communication between dental clinic and laboratory

COMMUNICATION AIDS:

Answer 6

1. Study models
2. Impressions
3. Intra and extra oral photographs
4. Mock preps and / or wax up
5. Shade guides
6. Bite registration
7. Prescriptions with diagrams and proper instructions
8. Provisional restoration model

Question 7

Study models:

Answer 7

1. They are necessary both to the dentist and the dental technician for planning and executing the treatment
2. They assist and record the dental anatomy
3. They assist and record arch form
4. They assist and record the curves of occlusion
5. They assist in calculating the edentulous space
6. They assist in detecting abnormalities, enlargements
7. distortion of arch form etc
8. They provide record before, immediately, after and several years after treatment

Question 8

Quality Assurance:

Answer 8

• One area where problems have arisen relates to atechnician’s willingness to accept an impression, or perhaps a bite registration, or a dentist’s willingness to accept (and subsequently fit) work supplied by a technician, that is not of an appropriate standard.
• It is helpful to establish mutually agreed ‘terms of engagement’ where from the very outset, the responsibilities of each party are clearly set out and understood.

Question 9

Deadlines:

Answer 9

• Problems can arise from the date set for the return of the work from the technician to the dentist. This must be realistic and agreed mutually. Missed deadlines can lead to patient dissatisfaction, especially when it prevents treatment being completed as promised for an important occasion in the patient’s life such as a holiday, wedding, business commitment, etc. On the other hand, asking technicians to meet impossible deadlines makes it more likely that the work will be carried out under pressure, causing or the possibility that attention to detail might suffer.

Question 10

Laboratory Prescriptions:

Answer 10

With few exceptions, laboratory work authorizations do not request enough information from the dentist. This could be because there is not enough space on the prescription to record it. It is, therefore, important to use a laboratory that fully understands the need for shade matching. Each laboratory prescription should contain enough space to record clinical information about each ceramic component of the restoration- for example, different shades of porcelain and opaque, and where to place them on the tooth .

Question 11

Electronic prescription card:

Answer 11

For computerized practices it is extremely simple to scan these documents and hold them in electronic format along with the rest of the patient’s records. Where paper- based records are kept, financial records such as invoices may be stored separately (and perhaps kept for a shorter period of time).

Question 12

Q: If you only provide a design sheet, what important information will you fail to convey?

Answer 12

• Path of insertion
• Location of undercuts for finishing clasps
• Exact outline of major connector
• Flange extension