PDI Lecture Part II Flashcards
1
Q
what are the 3 classifications for PDI
A
- edentulous
- partially edentulous
- dentate
2
Q
what are the 4 categories for each classification
A
class I - class IV
3
Q
what are the 4 considerations in class 1 partial edentulism
A
- location and extent of edentulous area
- abutment condition
- occlusion
- residual ridge morphology
4
Q
describe the location and extent of edentulous areas in class I partial edentulism
A
- edentulous area confined to a single arch and may include:
- anterior maxillary span that does not exceed 2 incisors
- anterior mandibular span that does not exceed 4 missing incisors or
- posterior span that does not exceed 2 premolars or 1 premolar and 1 molar
5
Q
describe the abutment condition in class I partially edentulous patient
A
no need for pre prosthetic surgery
6
Q
describe the occlusion in class I partially edentulous patient
A
- no need for pre prosthetic therapy
- class I molar and jaw relationships
7
Q
what are the biomechanical considerations for partial fixed denture prosthesis
A
- number of abutment teeth and number of missing teeth - simple vs complex
- splinted or pier abutment
- non-parallel abutments
- combined anterior and posterior FDP
8
Q
describe class I partial edentulism partially edentulous patient
A
- ideal or minimally compromised edentulous area, abutment condition, and occlusion
- there is a single edentulous area in 1 sextant
- the residual ridge is considered type A
9
Q
describe the location and extent of the edentulous area in class II partially edentulous patient
A
- moderately compromised
- both arches have edentulous spaces and 1 of the following
- anterior maxillary span that does not exceed 2 incisors
- anterior mandibular span that does not exceed 4 missing incisors
- posterior span that does not exceed 2 premolars or 1 premolar and 1 molar
- any missing canine (maxillary or mandibular)
10
Q
describe the abutment condition in class II partially edentulous patient
A
- moderately compromised
- insufficient tooth structure to retain or support intracoronal or extracoronal restorations - 1 or 2 sextants
- abutments in 1-2 sextants require localized adjunctive therapy
11
Q
describe the occlusion in class II partially edentulous patient
A
- moderately compromised
- occlusion requires localized adjunctive therapy - enameloplasty- prematurities
- class I molar and jaw relationships are seen
12
Q
what is the most common FDP to replace more than two teeth with success
A
mandibular anterior FPD replacing 4 incisors
13
Q
why does the mandibular anterior FPD replacing 4 incisors have a better prognosis than maxillary
A
direction of forces inward towards arch
14
Q
what are the weakest potential abutments in a mandibular anterior FPD
A
lateral incisors and adjacent premolar
15
Q
what is the optimal abutment in a mandibular anterior FPD
A
canines
16
Q
what is the prognosis for maxillary FPDs supported by canines and why
A
decreased prognosis and higher stresses/forces
17
Q
what is the PDI for replacing a missing canine
A
class II or higher
18
Q
what are the considerations for replacing a canine
A
- adjacent premolar and lateral incisor are weakest potential abutments
- maxillary replacement- forces outside inter abutment axis and directed outward
19
Q
what is the best option for replacing a missing canine
A
implant supported single crown
20
Q
when are occlusal interferences produced
A
when FDP made to over erupted opposing dentition
21
Q
what is done to correct an occlusal plane
A
- opposing tooth/teeth restored to correct occlusal plane
- may require RCT; periodontal surgery; orthodontics; extraction
- prevents occlusal interferences in restored dentition
22
Q
are tilted molars good abutments
A
no
23
Q
how are tilted molars prepared to be an abutment
A
- mesial wall must be over reduced/overtapered
- results in decreased resistance
24
Q
what may intrude on the path of insertion of a tilted molar
A
- distal adjacent tooth may intrude on the path of insertion
- mesial surface may need re-contouring or restoration or extraction or orthodontic uprighting
25
what is the purpose of molar uprighting
- places abutment in better position for preparation
- distributes forced under loading through long axis of tooth - helps prevent/eliminate mesial bony defects
- enables replacement of optimum occlusion
26
what is the purpose of non rigid attachments for tilted molar abutments and and how is it prepared
- allows slight movement - short span
- keyway in distal of premolar to avoid intrusion of molar (mesial seating action)
- must prepare box in distal of premolar preparation (to accomodate the female/keyway)
27
what are the non-rigid connectors indications
- pier abutment FPD
- long span FPD with multiple abutments
- non parallel abutments- tipped molar
28
what does the custom incisal guide table do
- provides a record of the incisal guidance that has been established with provisional restorations or a diagnostic wax-up
- provides a record for the lab to create the desired anterior guidance in the produced prostheses
29
what is the location and extent of the edentulous area in class III partially edentulous patient
- substantially compromised
- 1 or both arches; compromised support of abutment teeth
- posterior maxillary or mandibular edentulous area more than 3 teeth or 2 molars
- any edentulous area including anterior and posterior areas of 3 or more teeth
29
what is the abutment condition in class III partially edentulous patient
- substantially compromised/ fair prognosis
- insufficient tooth structure or support intracoronal or extracoronal restorations - 3 sextants
- more substantially localized adjunctive therapy - 3 sextants
30
describe the occlusion on class III partially edentulous patient
- substantially compromised
- entire occlusion must be re-established but without any change in the occlusal vertical dimension
- class II molar and jaw relationships are present
31
what missing teeth would qualify a patient as class III partially edentulous patient
- any edentulous areas including anterior and posterior areas of 3 or more teeth
- maxillary canine and 2 contiguous teeth
32
what is the location and extent of the edentulous area in class IV partially edentulous patient
- severely compromised
- any edentulous area or combination of edentulous areas requiring a high level of patient compliance
33
what is the abutment condition of class IV partially edentulous patient
- severely compromised
- abutments in 4 or more sextants have insufficient tooth structure to retain or support intracoronal or extracoronal restorations
- abutments in 4. or more sextants require extensive adjunctive therapy
- abutments have guarded prognosis
34
describe the occlusion in class IV partially edentulous patient
- severely compromised
- entire occlusion must be reestablished, including changes in the occlusal vertical dimension
- class II division 2 or class III molar and jaw relationships are seen
35
what the tooth condition for a class I dentate patient
- no localized adjunctive therapy required
- pathology that affects the coronal morphology of 3 or less teeth, one sextant
36
what the occlusal scheme for a class I dentate patient
- no pre prosthetic therapy required
- contiguous, intact dental arches
- class I molar and jaw relationships
37
what is the tooth condition for class II dentate patient
- insufficient tooth structure to retain or support intracoronal or extracoronal restorations - one sextant (pin retained core/post core)
- pathology that affects the coronal morphology of.4 or more teeth in a sextant
- pathology can be in 2 sextants and can be in opposing arches
- teeth require localized adjunctive therapy for a single tooth or in a single sextant
38
what is the occlusal scheme for a class II dentate patient
- moderately compromised
- occlusal scheme requires localized adjunctive therapy
- enameloplasty on premature occlusal contacts
- anterior guidance is intact
- class I molar and jaw relationships
39
what features make a dentate patient class II
- 1 sextant exhibits 3 defective restorations with an esthetic component
- additional variables of gingival architecture and individual tooth proportions increase the complexity of the clinical conditions
40
describe the tooth condition for class III completely dentate patients
- substantially compromised
- insufficient tooth structure to retain or support intracoronal or extracoronal restoration - 2 sextants
- pathology that affects the coronal morphology of 4 or more teeth in 3 or more sextants
- pathology can be in 3 sextants in the same arch and/or in opposing arches
- teeth require more substantial localized adjunctive therapy for teeth in 2 sextants
41
describe the occlusal scheme for class III completely dentate patients
- substantially compromised
- requires major therapy to maintain the entire occlusal scheme without any change in the occlusal vertical dimension
42
describe the tooth condition for class IV completely dentate patient
- insufficient tooth structure to retain or support intracoronal or extracoronal restorations - 3 or more sextants
- pathology affects coronal morphology of more than or 4 teeth in all sextants
- teeth in more than or 4 sextants require extensive adjunctive therapy
43
describe the occlusal scheme for class IV dentate pt
- severely compromised
- occlusal scheme requires major therapy to re establish the entire occlusal scheme including any changes in the occlusal vertical dimension
- class II division 2 malocclusion
- class III molar and jaw relationships
44
what are the modifiers for all PDI classifications
- esthetic concerns/challenges
- presence of TMD symptoms
- oral manifestations of systemic disease
- psychosocial factors
- maxillofacial defects
- ataxia
- refractory patient
45
the higher classification has a direct impact on:
the difficulty of the provided treatment and the prognosis of the treatment
46
comprehensive evaluation and assessment of all necessary parameters to help in:
diagnosis, treatment and prognosis
47
