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Prostho II > 2. Assessment of the partialy edentulous patient > Flashcards

2. Assessment of the partialy edentulous patient Flashcards

1
Q

Edentulous patient has ____ & _____ disorders

A

functional and esthetic

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2
Q

What are the three hippocratic questions?

A
  • What happened to you
  • since when?
  • What do you think the cause is?
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3
Q

What do you ask when assessing the patients oral hygiene?

A
  • How many times a day they brush
  • How many oral checkups in a year
  • What the patient uses
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4
Q

What do we examine in the physical exam extraorally? (5)

A
  • Postural habits
  • Paralysis / asymmetries
  • OVD
  • Pain upon touch
  • Opening=closing path deviation
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5
Q

What do we examine in the physical exam extraorally with postural habits? (2)

A
  • Spinal column deviation

- Postural tension/relaxation

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6
Q

What do we examine in the physical exam extraorally with OVD? (3)

A
  • musculature
  • muscular coordination
  • hypertrophy
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7
Q

What do we examine in the physical exam extraorally with opening-closing of the mandible? (2)

A
  • Opening range limittion

- Opening-closing path deviation

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8
Q

What do we examine in the physical exam intraorally? (5)

A
  • Oral hygiene
  • Shape and color of oral structures
  • Mobility of oral structures
  • Inspection
  • Palpation
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9
Q

What do we examine in the physical exam intraorally with oral hygiene? (2)

A
  • Dental Plaque

- Dental calculus

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10
Q

What do we examine in the physical exam intraorally with shape and color of oral structures?

A
  • If theres a suspicious lesion we biopsy it
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11
Q

What do we examine in the physical exam intraorally with mobility of oral structures?

A

Frenuli

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12
Q

What do we inspect in the intraoral physical exam? (4)

A
  • Bone tissue - Torus
  • Number of remaining teeth
  • Position and condition of remaining teeth to see if needs restorative treatment is
  • Edentulous space morphology
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13
Q

What do we palpate in the intraoral physical exam palpation? (4)

A
  • Painful points
  • Assess supporting mucosa
  • Tooth mobility
  • Periodontal probing
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14
Q

What do we palpate for painful points? (2)

A
  • Supporting tissues

- Muscular insertions

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15
Q

What do we palpate to asses the supporting mucosa? (2)

A
  • Hypertrophic

- Resilient

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16
Q

What is the significance of palpating for tooth mobility?

A

Determines the kind of support for the denture

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17
Q

What is the significance of palpating for periodontal probing

A

Very important in assessing abutment teeth

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18
Q

What destabilizes dental arches?

A

tooth loss

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19
Q

What happens to the arch after tooth loss? (2)

A
  • arch interuption

- arch shortening

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20
Q

What is arch interruption? (4)

A
  • tooth movement
  • loss of interproximal contacts = food impaction
  • arches rearrange to close the gap
  • stability comes after a long time
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21
Q

What happens with arch shortening? (3)

A
  • Happens because of mesialization of teeth
  • Tooth may have to be extracted if it extrudes
  • if only the 2nd molars are lost, arches may remain stable
22
Q

What complementary tests are used? (3)

A
  • orthopantomography
  • full mouth series
  • occlusal analysis
23
Q

What do we see with orthopantomopgraphy? (4)

A
  • cysts
  • remaining roots
  • malign and benign tumors (ex. odontomas)
  • location of inferior alveolar nerve and mental foramen relative to edentulous space
24
Q

Orthopantomography is used for …?

A

general view of the mouth

25
Q

Full mouth series is used for…?

A

assesment of teeth and periodontium

26
Q

What do we see with full mouth series? (11)

A
  • Remaining teeth
  • Caries
  • Previous dental resorations
  • Number, shape and size of roots
  • Previous endodontic therapies
  • Root resoption
  • root fracture
  • periapical granuloma
  • apicoectomy (i.e. root end surgery)
  • Cementoma
  • Occlusal trauma
27
Q

What is the ideal/good/minimum crown to root ratio? (3)

A
  • Ideally: 1/2
  • Good: 2/3
  • Minimum 1/1
28
Q

How do we analyze occlusion?

A
  • impression + casting
  • facebow trasnfer
  • upper moutning
  • intermaxillary transfer
  • lower mounting
  • usually magnetic split cast to be able to carry casts to the surveyor
29
Q

What do we analyze with static occlusion assessment? (5)

A
  • dental arches morphology
  • intermaxillary relationships
  • Overbite/over jet
  • Occlusal plane
  • teeth
30
Q

What do we analyze with dynamic occlusal assessment? (3)

A
  • Prematurities
  • Interferencies
  • Type of disocclusion
31
Q

Static occlusion assessment: Arch morphology? (3)

A
  • triangular
  • oval
  • parabolic
32
Q

Static occlusion assessment: intermaxillary relationships? (3)

A
  • Angle’s class
  • Open bite
  • Cross bite
33
Q

Static occlusion assessment: Overbite/overjet of partially edentulous patients? (2)

A
  • Increased overbite

- Decreased OVD

34
Q

Static occlusion assessment: occlusal plane? (4)

A
  • unevenness
  • curve of spee
  • curve of wilson
  • location and span of edentulous areas
35
Q

Static occlusion assessment: teeth? (4)

A
  • migrations
  • inclinations
  • rotations
  • wear
36
Q

Last step of preprosthetic procedure?

A

Rehabilitation by means of RPD

37
Q

What are the preprosthetic procedures? (6)

A
  • periodtonal treatment
  • surgical treatment
  • restorative treatment
  • fixed partial denture
  • orthodontic treatment
  • final assessment
38
Q

What is the preprosthetic surgical treatments? (5)

A
  • extractions
  • osteotomy
  • soft tissue surgery (vestibuloplasty, lesion exersis)
39
Q

What is the preprosthetic restorative treatments? (2)

A
  • restorations

- endodontic therapy

40
Q

What is the purpose of preprosthetic orthodontic treatments? (3)

A

Improves:

  • occlusion
  • occlusal load over abutment teeth
  • path of insertion for RPD
41
Q

What is the final assessment in pre prosthetic procedures? (2)

A
  • new occlusal analysis / contacts
  • radiographs / probing fives info about where is the better location of occlusal rests (so they dont interfere with occlusion), etc
  • tooth preps for rest seats
42
Q

What is a surveryor?

A
  • paralleling instrument used in contruction of prosthesis to locate and delineate contours and relative positions of abutment teeth and associated structures
43
Q

What does the surveyor help with?

A
  • to locate path of insertion
  • to prepare guiding planes
  • to prepare rest seats
  • all with minimum interference with occlusion
  • stability and retention of denture
44
Q

Surveryor and the path of insertion?

A

-certain paths have tooth surfaces in a certain inclination relative to that path

45
Q

Surveyor and guiding planes? (2)

A
  • can be prepared at vertical tooth surfaces

- will improve path of insertion facilitating a single favorable path

46
Q

Surveryor and retention?

A

retention distributed evenly so no abutment tooth is overloaded

47
Q

To record path of insertion at the surveryor we need to…

A

draw three lines or point over the cast

48
Q

What do we do after tooth preparation? (4)

A
  • new impressions to record changes
  • custom trays with spacer
  • best with impression silicones
  • assess casts again in surveyor
49
Q

Objective of tooth preparation? (3)

A
  • Achieve appropriate path of insertion
  • Achieve appropriate retention
  • Avoid interferences with occlusion or tissues (ex torus)
50
Q

How is the guiding plane made? (2)

A

with the blade of the surveyor

*only a simulation

51
Q

What can we prepare in the surveyor?

A
  • rest seats
  • every prp ahs to be written down
  • later preps in the cast have to be made into pateints mouth according to the notes

Prostho II (12 decks)

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