Prosthodontics Final Flashcards
(11 cards)
two major types of removable prosthetics-
-A removable partial denture, also referred to as a partial; replaces one or more teeth in the same arch
-A removable full denture, also referred to as a denture; replaces all the teeth in one arch
Extraoral Factors that influence the choice of a removable prosthesis
Physical Health: Chronic conditions like diabetes and medications influence tissue tolerance to prosthetic pressure.
Mental Health: Poor mental health affects the patient’s comfort and ability to maintain the prosthesis.
Patient Motivation: Understanding patient motives, particularly if solely aesthetic, and exploring alternatives is essential.
Age: Design considerations differ for young patients (growth accommodation) and older patients (perception of aging).
Dietary Habits: Nutritional status influences tissue health and, subsequently, prosthesis tolerance.
Social and Economic Factors: Patient attitudes, affordability, and accessibility of treatment impact decision-making.
Occupation: Concerns about appearance changes during treatment and scheduling appointments without disruption are vital.
Intraoral Factors that influence the choice of a removable prosthesis
Musculature: Muscle tone and tongue activity affect prosthesis retention and adaptation.
Salivary Flow: Normal or excessive saliva production and conditions like dry mouth influence comfort.
Residual Alveolar Ridge: Ridge resorption affects prosthesis fit and requires periodic evaluation.
Oral Mucosa: Tissue alterations and poor prosthesis fit cause friction and sore spots.
Oral Habits: Clenching, grinding, and mouth breathing affect stress on remaining structures.
Tori: Overgrowths like mandibular or maxillary tori impact prosthesis fit and may require surgical intervention.
Indications for prescribing a removable partial denture
Replacing multiple teeth in the same quadrant or arch: When a patient is missing several teeth in one area, a removable partial denture can restore function and aesthetics effectively.
Temporary replacement for missing teeth in children: In cases where children have missing teeth, especially during growth phases, a removable partial denture can serve as a temporary solution until more permanent options become viable.
Preservation of tooth structure: Removable partial dentures can be beneficial in situations where preserving natural tooth structure is important, particularly in children and adolescents. This can help avoid further reduction of tooth structure, especially in cases where fixed bridges or implants are not suitable.
Suitable for patients with time constraints: Patients who cannot undergo lengthy dental procedures or who have difficulty tolerating extensive dental work may benefit from removable partial dentures as they typically require fewer appointments and less preparation compared to fixed bridges or implants.
Facilitating good oral hygiene: Removable partial dentures allow for easy removal, enabling patients to maintain good oral hygiene practices by cleaning both the denture and the remaining natural teeth effectively.
Providing support for periodontally compromised teeth: In cases where teeth are affected by periodontal disease, a removable partial denture can serve as a supportive splint, helping to stabilize and distribute forces evenly across the remaining teeth
Contraindications to prescribing a removable partial denture include
Inadequate support from remaining teeth: If there are not enough suitable teeth in the arch to provide adequate support, stability, and retention for the partial denture, it may not be a viable treatment option.
Severe dental conditions: Conditions such as rampant caries or advanced periodontal disease that pose a significant risk to the remaining teeth in the arch may make a removable partial denture unsuitable.
Patient dissatisfaction with aesthetics: Some patients may reject removable partial dentures due to concerns about their appearance, particularly if they are visible when smiling or speaking.
Chronic poor oral hygiene: Patients who struggle with maintaining good oral hygiene may not be suitable candidates for removable partial dentures, as inadequate cleaning can lead to complications such as plaque buildup, gum disease, and bad breath
Major indications for prescribing a full denture
Complete edentulism: When a patient has lost all of their natural teeth in either or both arches, a full denture is often the primary treatment option to restore their oral function and appearance.
Irreparable condition of remaining teeth: If the remaining natural teeth are severely compromised and cannot be salvaged through restorative treatments, extraction may be necessary. In such cases, a full denture provides a comprehensive solution for tooth replacement.
Incompatibility with partial dentures: Some patients may not have enough remaining natural teeth to support a removable partial denture effectively. In these situations, a full denture becomes the preferred treatment option.
Patient preference: In cases where alternative treatment options are available but the patient refuses or is unwilling to pursue them, a full denture may be the most suitable choice based on their preferences and circumstances
Contraindications to prescribing a full denture
Availability of alternative treatments: If other viable treatment options offer comparable or superior outcomes to a full denture, those alternatives should be considered first.
Patient’s physical or mental health: Patients who have physical or mental illnesses that may impair their ability to cooperate during the fabrication process or to accept and wear the denture properly may not be suitable candidates for full dentures.
Hypersensitivity to denture materials: Some individuals may have allergies or sensitivities to certain denture materials. In such cases, hypoallergenic materials may be indicated, or alternative treatment options should be explored.
Lack of interest in tooth replacement: If a patient is not interested in replacing missing teeth or does not prioritize dental treatment, it may not be appropriate to prescribe a full denture unless there are compelling reasons to do so for the patient’s overall health and well-being.
Acrylic Partial Dentures
Appropriate for short-term replacement of one or two teeth
Base made from tissue-coloured acrylic with artificial teeth attached
A wire reinforcement may connect the base to acrylic artificial teeth. Thin wire clasps partially encircle the teeth necessary to hold the acrylic partial in place
Cast Partial Dentures
considerably stronger than acrylic because of the metal framework under and around the artificial teeth
The metal framework has the following components
Retainers (clasps): Surround the natural teeth to hold the partial denture in place
Connectors: Bars that connect the left and right sides of the partial denture
Lingual Connector: Located on the mandible, inferior and lingual to the anterior teeth
Palatal Connector: On the maxilla; may cross the palate
Saddle or Denture Base Connector: Metal framework that supports the artificial teeth and denture base acrylic
Minor Connector: Links major connectors to other areas of the metal framework
Rests: The part of the framework that extends from the retainers or connectors and limits the seating of the partial denture. The rests sit on the occlusal or lingual surface of the teeth and help distribute the force of occlusion to the teeth, rather than the alveolar ridge
