17. Case Design Workshop Pt. I Flashcards
Surveying
➢____
an analysis and comparison of the prominence of intraoral contours associated with the fabrication of a prosthesis
➢____
a paralleling instrument used in the construction of a prosthesis to locate and delineate the contours and relative positions of abutment teeth and associated structures
➢____
the specific direction in which a prosthesis is placed upon the abutment teeth
surveying
dental surveyor
path of insertion
Surveying ➢Purposes ▪ Determine the path of \_\_\_\_ ▪ Identify \_\_\_\_ planes ▪ Locate \_\_\_\_ area ▪ Evaluate \_\_\_\_ undercuts
insertion
guiding
undercut
soft tissue
Surveying ➢Purposes ▪ Evaluate esthetics ▪ Determine \_\_\_\_ procedure/ tooth modification ▪ Delineate the \_\_\_\_ of contour ▪ \_\_\_\_ the cast
restorative
height
tripoding
Determining Factors
➢Guiding planes
▪ ____ proximal surfaces to one another
➢Retentive areas or undercut
▪ only with a given path of ____
▪ minimum retention against reasonable ____ forces
▪ changing the path of insertion
▪ altering the ____ of the clasp by changing its design, size & length, or material
parallel
insertion
dislodging
flexibility
Determining Factors
➢ Interference
▪ may be eliminated by ____, extraction, modifying tooth surfaces, or restoration
▪ selecting a different path of insertion at expense of existing ____ and undercut
▪ modified with ____ with the path of insertion dictated by the interference
surgery
guiding plane
restorations
Determining Factors ➢ Esthetics ▪ less \_\_\_\_ display ▪ missing anterior teeth - more \_\_\_\_ tilting ▪ fixed \_\_\_\_ denture
metal
posterior
partial
Surveying Procedures
1. Place and tighten the cast on the table.
Adjustable table should be allowed only in two directions, ____ or ____.
➢ Zero-Tilting: the occlusal ____ and the ____ should be parallel
A-P
lateral
plane
platform
Surveying Procedures 2. Surveying for guiding planes ▪ proximal surfaces: \_\_\_\_ tilting ▪ principal \_\_\_\_ first ▪ within a range that tooth modification is \_\_\_\_
A-P
abutment
possible
Then we would go to the opposite side so this is a class 2 modification 1. So we have a premolar here, we have three teeth that are abutment teeth so we found the ____ plane here and we carry that onto our surveryor.
ideal
Surveying Procedures
➢ bisect the ____ angle
3. Tilt the cast to the ____ line
maximum
bisecting
Surveying Procedures
4. Mark the established ____ tilt on the other side of the cast.
A-P
Surveying Procedures
5. Surveying for retentive undercuts
▪ ____ tilting along the established A-P tilt
▪ ____ retention
▪ ____ retention
▪ within a range that tooth modification is ____
lateral
minimum
uniform
possible
Surveying Procedures
➢ repeat the same procedure as for ____ tilt: bisecting the maximum angle created by ____ tilting
6. Mark the established ____ tilt on the front or rear of the cast
A-P
lateral
lateral
Surveying Procedures
7. Evaluate tissue ____
▪ severe tooth undercut
▪ soft tissue
interferences
Surveying Procedures
8. Esthetics
▪ ____ of denture base (A)
▪ ____ between abutment tooth and artificial tooth (B)
extension
black triangle
Surveying Procedures
9. Determining and ____ the final path of insertion
tripoding
Surveying Procedures
10. Carbon marking the ____ and tissue ____
survey line
undercut
Requirements for PRDP Design
____
Stability
____
Occlusion
> > >
____
Comfort
____
support
retention
esthetics
function
Guidelines of PRDP Design ➢Support: ▪ rests next to \_\_\_\_ areas except for RPI design ▪ \_\_\_\_ rests next to distal extension areas ▪ add rests as needed for \_\_\_\_ support ▪ make sure there will be no \_\_\_\_ of rests with opposing occlusion ▪ \_\_\_\_ connector expanded as needed ▪ altered cast impression as required
edentulous two pericemental interference major
Guidelines of PRDP Design ➢Stability: ▪ \_\_\_\_ connectors touching vertical surfaces of teeth wherever possible ▪ indirect retainers placed ▪ clasp assembly (rests, minor connectors, retentive and bracing arms) not \_\_\_\_ with occlusion ▪ extension of bases ▪ \_\_\_\_ major connector
minor
interfering
rigid
Guidelines of PRDP Design
Retention:
survey for ____” undercut
create guiding planes to assure path of insertion that allows the retentive tip to be in ____” undercut
Circumferential clasp in Class ____ or modification areas
Wrought wire ____ or ____ next to distal extension areas
0.01
0.01
III
circumferential
I bars
Guidelines of PRDP Design
➢Esthetics:
▪ ____ when possible
▪ whenever possible, keep retentive tips in ____ and ____ portions (shoulders) of circumferential clasps on distals of anterior abutment teeth
➢Occlusion:
▪ Rests, minor connectors, and retentive arms planned to avoid ____ in centric or lateral movements
I bars
mesial
proximal
interference
Guidelines of PRDP Design ➢Comfort: ▪ \_\_\_\_ connectors kept away from speech areas whenever possible; use \_\_\_\_ behind rugae, use \_\_\_\_ rather than linguoplates.
➢Function:
▪ chewing;
recheck placement of all framework elements for occlusal interference,
▪ speaking;
recheck placement of framework elements to avoid interference with speaking.
major
palatal straps
lingual bars
Periodontal Considerations ➢ Major connectors ▪ Maxillary major connectors \_\_\_\_ mm from the gingival margin <6 mm: \_\_\_\_ (A)
6
linguoplate
Periodontal Considerations
Major connectors
Maxillary major connectors
beading at the periphery: ____ mm deep and wide, round (B)
no relief except for ____ (C)
metal highly polished (D)
tissue surface should ____ be highly polished except where it crosses the ____ (E)
0.5-1
gingival margin
not
gingival margin
Periodontal Considerations ▪ Mandibular major connectors • \_\_\_\_ mm from the gingival margin • <3 mm: \_\_\_\_ (A) • metal highly polished A
3
linguoplate
Periodontal Considerations
▪ Mandibular major connectors
• ____ to prevent soft tissue impingement (B)
• ____ gauge (____ mm) sheet wax
relief
32
0.2
Periodontal Considerations
▪ Mandibular major connectors
• tissue surface should be highly ____. (C)
polished
Periodontal Considerations Minor Connectors junction of rest and minor connector: at least \_\_\_\_ mm \_\_\_\_ mm between minor connectors minimal gingival coverage: \_\_\_\_° \_\_\_\_ of gingival tissues
1.5
5
90
relief
Periodontal Considerations
➢ Clasps
▪ ____ tooth and gingival coverage to reduce plague accumulation
▪ bar clasp
never ____ soft tissues
horizontal approaching arm: ____ mm from the
gingival margin
superior border of the bar: at least ____ mm from the
gingival margin
____ (C)
minimal impinge 3-5 3 90
Periodontal Considerations ▪ circumferential clasp at the junction of \_\_\_\_ and \_\_\_\_ should not contact free \_\_\_\_ located in the occlusal 1/3 may increase \_\_\_\_
middle 1/3
cervical 1/3
gingival margins
forces
Periodontal Considerations ➢ Rests ▪ direct forces along the \_\_\_\_ of the tooth (A) ▪ \_\_\_\_ rest seat (B) ▪ at least \_\_\_\_ mm at the junction
long axis
positive
1.5
Periodontal Considerations ➢ Bases ▪ optimal extension maximize the tissue support and stability ▪ adjacent to abutment teeth expose \_\_\_\_ tissue (A)
▪ internal finish line
____ polished metal B contact (B): finishing index
tissue stop
gingival
highly
Biomechanical Considerations for PRDP Design
Direct Retention
____ clasp retention
adhesion and cohesion – maximum coverage and intimate ____
frictional retention – ____
neuromuscular control – lip, cheek, tongue
minimum
contact
guiding plane
Biomechanical Considerations for PRDP Design
➢ Clasp position
▪ quadrangular configuration Kennedy class III
one as far as ____; the other as far ____ as esthetics and space permit
posteirorly
anteriorly
Biomechanical Considerations for PRDP Design
➢ Clasp position
▪ triangular configuration
Kennedy class II
one as far as ____; the other as far ____ as esthetics and tooth contour permit
posteriorly
anteriorly
Biomechanical Considerations for PRDP Design ➢ Clasp position ▪ linear configuration Kennedy class I the most \_\_\_\_ teeth \_\_\_\_ retainer
posterior
indirect
Biomechanical Considerations for PRDP Design
➢ Clasp design
▪ basic cast ____ vs. ____
▪ wrought wire ____ clasp
circumferential
RPI
combination
Biomechanical Considerations for PRDP Design ➢ Splinting of abutment teeth ▪ increase \_\_\_\_ area A ▪ \_\_\_\_ or short root (A) ▪ \_\_\_\_ or lone standing abutment (B) ▪ \_\_\_\_ stabilization with partial denture (C)
periodontal
tapered
intermediary
cross-arch
Biomechanical Considerations for PRDP Design ➢ Indirect retention ▪ Kennedy class \_\_\_\_ ▪ Kennedy class \_\_\_\_ ➢ Auxiliary rests ▪ \_\_\_\_
I and II
IV
lingual plate
Biomechanical Considerations for PRDP Design
➢ Occlusion
▪ MD ____ and the number of teeth to be replaced
▪ ____ cutting surface for chewing efficiency
▪ no ____ cusp incline
width
sharp
steep
Biomechanical Considerations for PRDP Design
➢ Denture bases
▪ maximum ____
▪ accurate ____ to residual ridge
coverage
adaptation
Biomechanical Considerations for PRDP Design ➢ Major connectors ▪ \_\_\_\_ ▪ \_\_\_\_ at each side of lingual plate ▪ \_\_\_\_ support from rests
rigid
rests
vertical
Biomechanical Considerations for PRDP Design
➢ Minor connectors
▪ ____
▪ intimate contact between ____ and minor connector
distinct path of ____ to help retention
improved ____
rigid
guiding plane
insertion
stability
Biomechanical Considerations for PRDP Design
Rests and rest seats
90
ball-and-socket
stress
PRDP Design Procedure
1. Selection of Abutment Teeth
▪ Teeth adjacent to the ____ ridges in general
▪ Teeth for ____ retainer (s)
edentulous
indirect
PRDP Design Procedure
- Check the occlusal contact on the abutment tooth.
▪ Check out the available space for the rest and minor connector.
▪The rest seats on the upper anterior teeth should be placed ____ below the occlusal contacts to avoid the occlusal interferences.
YES:
Place a normal ____ seat
accompanied with the proposed clasp system.
NO:
▪ Relocating the rest seat, for instance, mesial to distal or crescent cingulum rest seat to lug (ball) rest seat on anterior teeth
▪ Preparing ____ rest seat, if allowed.
▪ Doing enameloplasty on the opposing tooth
▪ Fabricating ____ crown
gingivally
rest
deeper
survey
PRDP Design Procedure
- Survey the cast for a desired path of insertion
▪ Start with ____ – Place the occlusal plane parallel to the surveying platform
▪ Find out the parallel ____ on the proximal and lingual surfaces as well as tooth surfaces that the metal framework, minor connector, will contact. -> Use ‘____ rod’.
▪ Find out the retentive undercut for the proposed clasp system on each abutment, most often ____”, at the mesio or disto-facial line angle area
▪ at the cervical 1/3. -> Use ‘____ gauge’.
▪ Indicate any soft tissue ____ that may
interfere with placing the PRDP
▪ Take esthetic consideration for anterior edentulous area.
YES:
Lock the surveying table and ____ the path of insertion.
NO:
▪ Different clasp system with a different ____
▪ Different path of ____ for the proposed clasp system
▪ Lingual undercut – retentive arms should be equilaterally or ____ opposed.
▪ ____ crown
▪ Preparation of undercut – dimple or depression
zero tilt guiding planes analyzing 0.01 undercut undercuts
tripod undercut insertion diagonally survey
PRDP Design Procedure
- Scribing the survey lines
▪ Replace the surveying tool with ‘____ marker’.
▪ Scribe them on the areas that the ____ components may contact. In other words, on the facial, lingual and proximal surfaces as well as soft tissue.
carbon
metal
PRDP Design Procedure
- Outline the PRDP components in ____
▪ Denture base and denture base minor connector
▪ Major connector
▪ Rest seats
▪ Clasp assembly – retentive and reciprocating arms
▪ Minor connectors that connect all metal components
red
PRDP Design Procedure
- Indicate the areas that interfere with placing the PRDP
▪ Mark them on teeth in ____ with solid line circle and spaced diagonal lines or blue arrows.
▪ These areas are where ____ has to be considered. This procedure will be done by ____ clinically (tooth modification on survey & design form).
▪ If the amount of enameloplasty should be more than 0.03” or there is post-operative sensitivity you may need a ____ crown.
blue
reshaping
enameloplasty
survey
Tooth Supported vs. Tissue Supported ➢Tooth supported: Kennedy Class III and IV ▪ Support: \_\_\_\_ ▪ Direct retainer: \_\_\_\_ clasp ▪ Indirect retainer: no \_\_\_\_ ▪ Stability: \_\_\_\_ connector and rigid portion of clasp ▪ Impression: \_\_\_\_ form ▪ Denture base: \_\_\_\_ or acrylic
teeth cast circumferential need minor anatomical metal
Tooth Supported vs. Tissue Supported
➢ Tissue supported: Kennedy Class I and II
▪ Support: teeth and ____
▪ Direct retainer: ____ clasp, I-bar
▪ Indirect retainer: ____
▪ Stability: ____ connector, rigid portion of clasp, and denture base
▪ Impression: ____ form, ____ cast impression
▪ Denture base: ____
edentulous ridge wrought wire yes minor supporting altered resin
Best Clasp Design
Longitudinal studies indicate there is no “____” clasp design
All act the same for the ____ of the abutment over time
best
same
