1. Partially Edentulous patient Flashcards
Who is considered partially edentulous?
Patient has at least one permanent tooth missing
Prosthodontically a patient is not considered partially edentulous if… (3)
- Anodontia
- Eruption disorders
- Lack of 3rd molars
Indications for RPDs? (6)
- wire bounded edentulous areas
- Severe bone loss preventing implants
- Recent extractions/traumatisms
- waiting period after preprostetic surgery
- periodontal disease
- economic reasons
Why do we use RPDs for wide bounded edentulous areas?
-porcelain and abutment teeth would suffer
What Kennedy classes do we use RPDs for severe bone loss preventing implants? (2)
Class I & II
What do the physiopathological disorders depend on? (3)
- Number of lost teeth
- Location of edentulous areas
- condition of remaining teeth
Which teeth have great strategic importance? (2)
Canines and first molars
What physiopathological disorders can occur from posterior teeth loss?
- Mastication disorders
- Deglutition disorders
What physiopathological disorders can occur from anterior teeth loss?
- Esthetic disorders
- Phonation disorders
Tooth loss that leads to partial edentulism is generally due to: (2)
- Caries in patients younger than 40 years old
- Periodontal disease in patients older than 40 years old
True or false partial edentualism is highly prevalent?
True
Partial edentualism is associated with pateints who…
have bad oral hygiene
More than half the population over this age is partially edentulous
40 years old
The initial consequence of tooth loss? not true for…? (3)
- Destablization of dental arches
- Not true for 3rd molars OR if there is 2nd molar loss with no 3rd molars
When a tooth is missing the surrounding teeth do what?
move to the remaining place
Which teeth move when there is tooth loss? (2)
- Antagonist teeth
- Teeth in same arch
Where do teeth migrate? (3)
- Distal teeth mesialize
- Mesial teeth distalize
- Antagonist teeth extrude
Teeth moving when there is tooth loss has consequences for… (2)
Teeth and TMJ
Tooth migrations and rotations produce… (2)
- Prematurities
- Interferencies: in protrusion, WS and NWS
What occlusal position occurs due to tooth loss? (2)
Greater MIOP and LIOP
What happens to the curve of spee with tooth loss? why? (2)
- Greater curve of spee
- b/c of extrusions, hinders posterior disocclusion
What is septum syndrome? Why does it occur? (2)
- Food impaction between teeth
- tooth loss
What happens with tooth loss and centric relation?
-Prematurities and displacement from centric relation
What happens with tooth loss and the occlusal plane?
alters occlusal plane
What happens with tooth loss and vertical dimension?
Loss of VD
Spread of front teeth after tooth loss?
labially
When does spread of teeth occur with tooth loss? (2)
- when there is reduced/lack of posterior occlusal support
- periodontal disease or bruxism
What can become dysfunctional in the stomatognatic system after tooth loss? (4)
- Teeth
- Periodontium
- Muscles
- TMJ
What can become dysfunctional with teeth after tooth loss? (5)
- Wear facets
- Cervical abfractions
- Tooth mobility
- Tooth migrations
- Pulp pain (b/c occlusal trauma)
What can become dysfunctional with periodontium after tooth loss? (4)
- periodontal pockets
- gingival recession
- vertical bone loss
- increased tooth mobility
What can become dysfunctional with muscles after tooth loss? (4)
Myositis Myalgia:
- Spontaneous
- Upon contact
What can become dysfunctional with TMJ after tooth loss? (4)
- Joint pain
- Joint sounds
- Mobility limitation
- Opening-closing path deviation
Most used classification for partially edentulous patient?
Kennedy 1923
Kennedy’s classification is goverened by…
the most posterior edentulous area being restored
How many Kennedy’s classes are there?
4 classes
Who added more classes to Kennedy’s classification? how many?
Applegate 2 more
What do the modifications mean in Kennedy’s class?
Represents the number of additional edentulous areas apart from the main one
Kennedy’s Class I? (3)
- Bilateral free-ended edentulism
- Front teeth preserved
- RPD will be tooth-tissue supported
Kennedy’s Class II? (2)
- Unilateral free-ended edentulism
- RPD will be tooth tissue supported
Kennedys class III (2)
- Bilaterally bounded partial edentulism
- RPD will be tooth-supported or tooth - tissue -supported
Kennedy’s Class IV (3)
- Bilaterally bounded anterior partial edentulism
- Crosses mid-line
- RPD will be tooth-supported
What do we do if there are 2 molars on the same side but no other teeth? (4)
- Difficult
- Best option: extract teeth and make CD
- RPD should be tissue-supported
- Transitory solution towards CD
What do we do if only both central incisors remain?
- difficult
- Best option: extract teeth and make CD
- RPD should be tissue-supported
- Transitory solution towards CD
When do we use the kennedy classification?
AFTER tooth extractions
What is not taken into consideration for kennedys classification? exception? (2)
- Third molars EXCEPT when needed for an abutment
- Absent second molar that will NOT be replaced by the denture
- Extension of edentulous areas (only number)
Which Kennedy class does not have modifications? why? (2)
Class IV
- if the arch has more edentulous areas than the anterior one it wont be a class IV
Class II
Class I
Class III
Class IV
Class I mod 2
Class I mod 1
Class I mod 3
Class I mod 4
Class II mod 1
Class II mod 2
Class II mod 3
Class II mod 4
Class III Mod 1
Class III Mod 2
Class III mod 3
Class III mod 4
Which class doesnt have modifications?
Class IV
