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Fixed Prosth 3rd year > 11/7 > Flashcards

11/7 Flashcards

1
Q

prosthesis is a____

general

A

SUBSITUTION for the lost dentition

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2
Q

characteristics of fixed and removable patients

A

missing teeth
may have or had RPD

teeth decay, or period

OCCLUSAL DISHARMONY

insufficient teeth to eat

aestehtic issues

  • risk associated with that
  • reclusive
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3
Q

what to do if more young

A

hang on to teeth PRESERVE BONE – generally adapt well

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4
Q

if patient more old

A

need to keep strategic eeth

so not as important to keep nonstrategic / all teeth

less adaptive than the young

xerostomia is a problem

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5
Q

physiologic shock?

A

YES – all patients - loss of teeth

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6
Q

assessment considerations -general 3

A

anatomical

dentition

design

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7
Q

anatomical considerations

A

ridge relationship
- mandible to maxilla? excessive appropriate or deficient

inter ridge space - can it even fit

plane of occlusion violation - supraeruption often against edentuous area

tori, undercuts, ridge prominence, frenum

ridge quality and height

tissue quality

tongue position and size

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8
Q

in fixed / or removable you need a prognosis of the abutment teeth?

A

YES – a single tooth can alter treatment plan

the end therapy- goal is predictable dentistry – we do NOT want to have to treat this tooth / area again

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9
Q

diagnostic mounted models for what?

longer list

A
  1. determine the PLANE OF OCCLUSION
  2. look for supra erupted teeth / infra-erupted teeth
  3. intra arch space
  4. strategic teeth for the support of the prosthesis / support of the OCCLUSION
  5. number and location of the occlusal untis
  6. analysis of the occlusion
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10
Q

if patient has current RPDS? how get mounted models? what if edentulous?

A

take impression with the prosthesis in it – then remove RPD from impression and make casts and mount

make daignositc moles of edentulouos ridge and make wax rim and mount case

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11
Q

mount in CR or MIP?

A

default is CR for most distal extension cases - use CR more often than not

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12
Q

when is MIP mount acceptable

specificaly when?

A

when there is an adequate number of teeth to provide good tripodization of tooth contacts / support AFTER tooth prep

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13
Q

what do majority of tissue borne RPDs require for mounting?

A

require occlusion rims for mounting the cases so an additional visit must be planned

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14
Q

when determine the need for occlusal support?

A

during FIXED THERAPY

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15
Q

prepare rest seats and guide planes when?

A

on the CASTS to see if we will have problems

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16
Q

survey and design on?

A

best done on the second model

select abutment teeth

prep and make guide planes on the cast

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17
Q

therapeutic costs assessed consist of? look at ___ for these

A
  1. financial
  2. biologic
  3. esthetics
  4. therapeutic
  5. temporal
  6. physchological

look as Risk vs Reward abd Cost / benefit analyses

18
Q

A/P relationship ridge

A

need to see if parallel to occlusal plane

  • often if try and hand articulate this we have an A-P rock
19
Q

steps for assessment

A

models duplicated and both mounted

selection of teeth that need fixed therapy

evaluate what worked and what did not work

consultation

patient desires

develop a plan

20
Q

what do duplicates allow for?

A

allow you to do a wax up of the proposed therap and execute the design to verify that it will work
- rest seats, guide planes, retention apparatus

21
Q

rest seat next to an edentulous area? causes

A

hrizontal forces – class I leveer

22
Q

what do indirect retainers do

A

create class 2 levers

23
Q

which class lever do we want

A

class 2

24
Q

think ahead - steps

A

plan tx
execute on models first
bring the designs and models chair side
take impressions to check your work

25
Q

during assessment of dentition look at?

occlusal support and stability implication

A

number of teeth

  • occclusal support and stability
  • BEFORE TOOTH MODIFICATION
  • DURING TOOTH MODIFICATION

location
need for restorative therapy
perio health?

26
Q

interim prosthesis usually come into play when

A

after extractions

27
Q

when do extractions what must be available and why

A

interim partial denture – maintain support and occlusion

28
Q

if patient wears RPD may require what in tx plan

unique to this?

A

diagnostic models with wax rims

two sets of modelfs if patient wears RPD!

unique is that need two models - with and without the RPD

29
Q

A-P rock

A

bad

30
Q

determine need for occlusal support when

A

during fixed therapy

- prepare rest seats and guide planes on the CAST to see if you will have a problem

31
Q

assessment steps

A
  1. models duplicated and both mounted

selection of teeth that need fixed therapy

evaluate what worked and what did not

consultatin

patient desires

plan

32
Q

duplicated models allow for

A

to do a wax up of the proposed therapy and exeute the design to verify that it will work - rest seats, guide planes and retention apparatus

33
Q

after assessment then?

A

stablize and confirm on survery

34
Q

when can you commence therapy

A

after stabilization

35
Q

major thing included in stabalization

A

interim RPD

36
Q

definitive therapy includes

A

completion of restorative needs – like survey crowns and new master model for fabriation of metal frame

wax rim try in and mounting of master casts

toth set up try in

deliery of RPD and education on the care of mouth and prosthesis

37
Q

case he presented with general steps

A
  1. clinical and radiographic exam
  2. smile analysis
  3. diagnostis casts
    - look at static occlusion, ridges (parallelism / lack there of)
  4. diagnostic cast with RPD in

COME UP WITH DIAGNOSIS / PROBLEM LIST

DIAGNOSTIC WAX - UP

  • freeway, length width - golden proportion
  • look at new static occlusion giving ptd dynamic . an
38
Q

treatment sequence

A
  1. assessment - work up - consent for a plan
  2. stabilzation
    - perio
    - pre-prosthteic - interim RPD and provisional corwns
    - surgical
  3. definitive
    - prosthetic tx
  4. maintenance / re-eval - follow up and maintenance
39
Q

crown and RPD sequence

A 
perio tx 
interim RPD and provisional crown 
extractin 
PFM crowns 
PFM survey crowns 
RPD
40
Q

crowns are delivered when

A

with an interim partial denture – then can create a master cast

Fixed Prosth 3rd year (17 decks)

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