lecture 1 doc pastor

Question 1

The branch of dental arts and science that deals with the replacement of missing teeth and oral tissues to restore and maintain oral form, appearance, function, and health.

Answer 1

PROSTHODONTICS

Question 2

The branch of dentistry pertaining to the restoration and maintenance of oral function, comfort, appearance, and health of the patient by replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitution.

Answer 2

PROSTHODONTICS

Question 3

The specialty of dentistry that replaces missing teeth with a removable prosthesis.

Answer 3

REMOVABLE PROSTHODONTICS

Question 4

Replacement of missing teeth and contiguous tissues with prosthesis design to be removed by the wearer.

Answer 4

REMOVABLE PROSTHODONTICS

Question 5

2 DISCIPLINES OF REMOVABLE PROSTHODONTICS

Answer 5

Removable Partial Denture
Removable Complete Denture

Question 6

• Referred to as a partial, replaces one or more teeth in the same arch.
• Partial denture that can be removed and replaced in the mouth by a patient.

Answer 6

Removable Partial Denture

Question 7

• Provisional, Temporary
• A denture used for a short interval of time to provide:
  *Esthetics, mastication, occlusal support, and convenience.
  *Conditioning of the patients to accept the final prosthesis.

Answer 7

Interim Denture

Question 8

Made out of plastic all throughout (partial denture)

Answer 8

temporary provisional denture

Question 9

• Plan/fabricate your prosthesis before the extraction.
• Ready for installation
  Just have to adjust if it doesn’t fit
  Have to educate the px of its consequences

Answer 9

Immediate denture

Question 9

it has metal framework

Answer 9

final or permanent prosthesis

Question 10

Consequences of immediate fabrication of denture

Answer 10

(1) aggressive bone resorption – needs to heal before you can put pressure
(2) loosening of the denture
(3) after few months, px needs to come back because it’s already loose / easy to be dislodged.

Question 11

CONSEQUENCES OF TOOTH LOSS
(5)

Answer 11

• Residual ridge resorption.
• Teeth over-eruption, drifting, and shifting.
• Alteration in the oral mucosa.
• Decrease in the masticatory function.
• Esthetics

Question 12

Direction of bone resorption:

Answer 12

• Mandible = Downward
• Maxilla = Upward & backward
  That’s why the chin/mandible would look like it drooped downward.

Question 13

what is the Passive movement of the tooth?

Answer 13

the tooth actually erupts until it contacts its opposing tooth; if no opposing tooth = it will continue to erupt = supra-eruption.

Question 14

how long before they can put the final restoration/crown?

Answer 14

3-6 months

Question 15

EXTRAORAL FACTORS THAT INFLUENCE THE CHOICE OF A REMOVABLE PROSTHESIS
(7)

Answer 15

Physical health
Mental health
Motivation
Age
Dietary habits
Socioeconomic factors
Occupation

Question 16

INTRAORAL FACTORS THAT INFLUENCE THE CHOICE OF A REMOVABLE PROSTHESIS
(6)

Answer 16

Musculature
Salivary flow
Residual alveolar ridge
Oral mucosa
Oral habits
Tori

Question 16

INDICATIONS FOR A REMOVABLE PARTIAL DENTURE
(9)

Answer 16

Length of edentulous
Abutment tooth
Periodontal support of remaining teeth
Cross arch stabilization
Excessive bone loss
Aesthetics
Immediate tooth replacement after extraction
Emotional problem
Patient desires

Question 17

Maximum edentulous space for FPD

Answer 17

2 teeth

Question 18

Longer material, the longer the span of FPD, the more the material will become _______; can cause gaps on the margins of the abutment tooth = can cause recurrent caries and failure of restoration.

Answer 18

flexible

Question 19

the pericemental area (area covered by the alveolar bone) of the abutment teeth should be equal or surpass the pericemental area of the missing tooth to be removed.

Answer 19

Ante’s law

Question 20

DO NOT fabricate ______ on POSTERIOR (limited on lateral incisor).

Answer 20

cantilever

Question 20

RPD IS GENERALLY PREFERRED IN THE FOLLOWING CONDITIONS:
(10)

Answer 20

1. When more than 2 posterior teeth or 4 anterior teeth are missing;
2. If canine and two of its adjacent teeth are missing;
3. When there is no distal abutment tooth;
4. Presence of multiple edentulous spaces;
5. If the teeth adjacent to edentulous spaces are tipped, they cannot be used as an abutment for a fixed prosthesis;
6. If periodontally weakened teeth are present near the edentulous spaces;
7. Teeth with short clinical crowns;
8. Insufficient number of abutments;
9. Severe loss of tissue on the edentulous space
10. Old patients.

Question 21

PHASES OF TREATMENT:
(3)

Answer 21

Periodontal phase: Oral prophy, oral hygiene instruction, make sure no gingivitis.
Resto/surgical phase: Do either restoration of carious teeth and/or surgical extraction of badly broken-down tooth (INTERCHANGEABLE but recommended to extract first) NEVER place prosthesis with an adjacent that have caries.
Wait for 2-3 months.
Final phase: Prosthodontic rehabilitation.

Question 21

CONTRAINDICATIONS FOR A REMOVABLE PARTIAL DENTURE (4)

Answer 21

Lack of suitable teeth in the arch to support, stabilize and retain the removable prosthesis. Rampant cares or sever periodontal conditions that threaten the remaining teeth in the arch. A lack of patient acceptance for esthetic reasons. Chronic poor oral hygiene.

Question 22

COMPONENTS OF A PARTIAL DENTURE (5)

Answer 22

Framework Connectors Retainer Rest Artificial teeth

Question 23

The cast metal skeleton that provides support for the remaining components of the prosthesis.

Answer 23

Framework

Question 23

Joins various parts of the partial together. -Major connector -Minor connector

Answer 23

Connectors

Question 24

- Known as a clasp, it supports and provides stability to the partial denture by partially circling an abutment tooth. - Main function: Retention (but also gives support and resistance).

Answer 24

Retainer

Question 25

- A metal projection designed to control the seating of the prosthesis. - Provides support – resistance to vertical forces along the long axis of the tooth towards the tissue.

Answer 25

Rest

Question 26

- Denture teeth - Constructed from either acrylic or porcelain.

Answer 26

Artificial Teeth

Question 27

SIX PHASES OF PARTIAL DENTURE SERVICE

Answer 27

1. Education of Patient 2. Diagnosis, Treatment Planning, Design, Treatment, Sequencing, and Mouth Preparation 3. Support for Distal Extension Denture Bases 4. Establishment and Verification of Occlusal Relations and Tooth Arrangements 5. Initial Placement Procedures 6. Periodic Recall

Question 28

Systematic investigation of an unnatural condition, the identification of this condition and the determination of its cause.

Answer 28

DIAGNOSIS

Question 29

The number of restored teeth, signs of recurrent decay. and evidence of decalcification should be noted before decision is made on the unrestored teeth as potential abutment selections. Evident periodontal diseases and mobility of teeth (further noted and investigated through radiographic examination). Palatal and mandibular tori and other conditions which may require surgical interventions to prepare the mouth.

Answer 29

VISUAL EXAMINATION

Question 30

The data derived from these procedures enable the operator to formulate a total treatment plan which will provide the appropriate foundation for the replacement of missing teeth with a removable partial denture.

Answer 30

Oral prophylaxis Excavation of carious lesions Placement of treatment restorations Pocket depth placement and mobility ORAL EXAMINATION

Question 31

To measure the quality of bone support for the potential abutment teeth whereas it will withstand increased forces upon movements of the partial prosthesis.

Answer 31

ROENTGENOGRAPHIC ANALYSIS

Question 32

Serious Illness that needs prophylactic medications Allergies, current medications, family history. tobacco, and alcohol habits Night grinding possibilities Treatment Prosthesis

Answer 32

MEDICAL AND DENTAL HISTORIES

Question 33

1. the amount of clinical crown versus the amount of root embedded to the bone. 2. ratio ideal 3. minimum

Answer 33

1. crown root ratio 2. 2:3 3. 1:1

Question 34

FACTORS AFFECTING TREATMENT PLAN (7)

Answer 34

Number of teeth to be replaced Residual Dentition Condition Patients Health Patients Expectations Dentist Competence Laboratory Competence Time

Question 35

ALTERNATIVES to Removable Partial Denture (Treatment Options) (4)

Answer 35

No treatment (shortened dental arch) Fixed partial denture Implant supported prosthesis Complete denture

Question 36

The classification of a partially edentulous arch should satisfy the ff. requirements: (3)

Answer 36

It should prevent immediate visualization of the type of partially edentulous arch that is being considered. It should permit immediate differentiation between the tooth supported and tissue supported removable partial denture. It should be universally accepted

Question 37

By Edward Kennedy (1925) the most widely accepted classification of partially edentulous arches. In an attempt to simplify the problem and encourage more universal use of a classification, and in the interest of adequate communication. Classified edentulous areas into four. Any other edentulous spaces are designated as modification spaces. Based on the relationship of the edentulous spaces to the abutment teeth.

Answer 37

Classification (Kennedy Classification)

Question 38

Bilateral free-end / distal extension Bilateral edentulous areas located posterior to the remaining natural teeth.

Answer 38

Class I

Question 39

Unilateral free-end / distal extension Unilateral edentulous area located posterior to the remaining natural teeth.

Answer 39

Class II

Question 40

Unilateral edentulous area with natural teeth remaining both anterior and posterior to it (bounded). Not crossing the midline.

Answer 40

Class III

Question 41

Single, but bilateral (crossing the midline) edentulous area located anterior to the remaining natural teeth.

Answer 41

Class IV

Question 42

It is a modification of Kennedy’s System. It is based less on the number and location of the remaining teeth and edentulous spaces. It takes into consideration the capabilities of the teeth, which bound the spaces to serve as abutments for prosthesis.

Answer 42

Applegate-Kennedy’s System

Question 43

8 rules of Applegate-Kennedy’s System

Answer 43

Rule 1 Classification should follow rather than precede any extractions of teeth that might alter the original classification. Rule 2 If a third molar is missing and is not to be replaced, it is not considered in the classification. Rule 3 If a third molar is present and is to be used as an abutment, it is considered in the classification. Rule 4 If a second molar is missing and is not to be replaced, it is not considered in the classification (e.g., if the opposing second molar is likewise missing and is not to be replaced). Rule 5 The most posterior edentulous area (or areas) always determines the classification. Rule 6 Edentulous areas other than those that determine the classification are referred to as modifications and are designated by their number. Rule 7 The extent of the modification is not considered, only the number of additional edentulous areas. Rule 8 No modification areas can be included in Class IV arches. (Other edentulous areas that lie posterior to the single bilateral areas crossing the midline would instead determine the classification; see Rule 5.)