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PRDP, Final > 2. Diagnosis and Treatment Planning > Flashcards

2. Diagnosis and Treatment Planning Flashcards

1
Q

Indications for PRDP
 Length of ____ contradicts use of FDP
 No abutment tooth ____ to edentulous space
(Kennedy Class I and II)
 Reduced ____ support of remaining teeth
 Need for ____-PRDP may act as a periodontal splint
 Excessive ____ loss of residual ridge
 Patient desire
 ____ considerations
 After recent extractions-interim until site heals
 Esthetics in ____ region

A 
edentulous span
posterior
periodontal
cross-arch stabilization
bone
economic
anterior
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2
Q 
Advantages of PRDP
 Not \_\_\_\_
 \_\_\_\_ tooth structure removed 
 No \_\_\_\_
 Can always go to fixed
A

irreversible
limited
pulpal necrosis

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3
Q

The first appointment is the standard appointment where you gather the ____ (radiographs, photographs….and reads rest of list).

You can hand articulate or you can articulate the case definitively, then you can get the study cast articulated.

Then you can get a plan and then you can go to the ____ appointment, assuming all the ____ treatment has been done, and begin getting ready to prepare the teeth.

In the second appointment, you are gonna do mouth ____ and obtain ____ (again, this is assuming all Phase 1 treatment and all period has been done).
The ideal case is someone successfully wearing a removable partial and nothing has changed, they just need a new set and you can more easily move into the second appointment.

If patient is missing enough teeth then you need rims. If you need rims to mount the case, even diagnostically, you need rims made from the ____ cast, bring them back and get the record, and then you can mount the case. So this delayed moving into the second appointment.

A 
information
second
Phase I
preparation
impressions
diagnostic
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4
Q

In the second appointment you prepare the ____, you obtain the ____, write a ____ to have a framework made up, and then you go onto appointment 3.

A

mouth
impression
laboratory authorization

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5
Q

Diagnostic casts

 During the treatment-planning, diagnostic casts are ____
 Proposed designs are drawn directly on the ____ cast.
 Individual casts then serve as blueprints for the placement of restorations, the recontouring of teeth, and the preparation of rest seats
 These casts also may be helpful during treatment-planning presentations
 Patients are more likely to approve a treatment plan if they can visualize existing problems than they are if they must rely upon a verbal description

A

surveyed

diagnostic

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6
Q

On the third appointment you are gonna get the framework back from the lab and you are gonna ____ the framework in their mouth to make sure it sits or it doesn’t affect the occlusion. And then you are going to use that to get the record. Remember the framework was made on a ____ cast, which you have not mounted yet. So you are gonna either use the framework by using registration material or adding wax. You are gonna do a ____ and you are also gonna pick the teeth.

If you are gonna do there alternative impression, the altered cast impression, then you are gonna take the impression with the ____. Then this gets sent to the lab for a ____ pour. Now you have a master cast that is cut-out and the edentulous area is the new impression. It is very accurate but not always necessary. This alternative impression gives you a good impression of the ____ areas.

Then you are gonna mount teeth on these frameworks.

A

fit
master
facebow

framework
second
edentulous

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7
Q

Either you do it or the lab but teeth are set in wax and you are gonna bring that back to the patient and do a try in.

This is a difference between a complete denture where you are going from the record base to the trial denture, we have that ____ step where we are getting the framework back, fitting the framework, and then having the teeth put on the framework. So that is this visit, which is similar to the denture try-in visit, so we are looking at how the teeth are placed, aesthetics, and occlusion.

You can make changes chairside, and if things are really off then you are gonna send it back to the lab.

A

intermediate

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8
Q

And then we ____ them, so there is a whole process for inserting them. Each time you are giving some patient education, kinda gearing them up to the concept of what they are gonna be getting. Then you are gonna have them bring them back in ____ hours and if you see sore spots then you adjust it.

A

insert

24

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9
Q

Tell them to leave them out at night if they haven’t worn them before. So take out the prosthesis at night and let the tissues rest and then you are looking for additional adjustments appointments to get them comfortable: adjusting ____, checking for sore spots, checking____

A

occlusion

sore spots

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10
Q

If you see ____ spots then bring bring them back again but if things are going well and they are having any problems tell them to call.

A

sore

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11
Q 
First appointment
 Give health \_\_\_\_
 \_\_\_\_ patient
 Establish \_\_\_\_ with patient
 Dr Boucher said :“The first five minutes spent with a patient represent the most important period of dentist- patient interaction. Patients should feel that the dentist is genuinely interested in them and in helping to solve their dental problems.”
A

questionnaire
interview
rapport

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12
Q 
First appointment
 Gain insight into a patient's psychological makeup
 House classification 
 \_\_\_\_
 \_\_\_\_
 \_\_\_\_ 
 \_\_\_\_
 Evaluate the effects of patient’s \_\_\_\_ problems on dental treatment (diabetes, arthritis, etc)
A

philosophical
exacting
hysterical
indifferent

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13
Q

Patient treatment (or Management) includes four processes
 Ascertaining a patients dental ____
 Relating the patient’s ____ or wants to needs
 ____ a treatment plan to address the needs
 ____ the treatment plan

A

needs
desires
developing
executing

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14
Q

Importance of the Diagnostic Phase of Treatment

 The formulation of an appropriate treatment plan requires careful evaluation of all pertinent ____
 Information must be obtained from patient ____, radiographic evaluation, oral examination, diagnostic mounting of casts, preliminary survey and design procedures, and appropriate consultations with medical and dental specialists

A

diagnostic data

interviews

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15
Q

Examination of the Partially Dentate Patient
Previous Denture Experience

Question the patient about experience with past removable partial dentures. Has there been an inability to adjust to ____ an PRDP? Why?

Have previous PRDP ____ due to caries or periodontal disease?

What ____ of PRDP has the patient worn in the past?

Speech problems?

A

wearing
failed
kind

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16
Q

Examination of the Partially Dentate Patient

Evaluation of Current Prostheses

Determine if patient report problems with existing PRDP and/or criticisms of present PRDP are justified. This judgment may help you decide if you can help the patient.

Pay special attention to:

  1. Complaints concerning ____
  2. Complaints concerning specific ____ aspects such as the type of major connector
  3. Any evidence of ____ such as excessively worn natural or prosthetic teeth
A

esthetics
design
parafunction

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17
Q 
Examination of the Partially Dentate Patient
Radiographic Examination
1. \_\_\_\_ Ratio 
2. \_\_\_\_ Teeth
3. Remaining \_\_\_\_ 
4. \_\_\_\_ Teeth
5. Teeth with prior \_\_\_\_ treatment 
6. \_\_\_\_
A 
crown/root
impacted
bone
extruded
endodontic
caries
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18
Q

Examination of the Partially Dentate Patient
Diagnostic casts
1. Diagnostic casts
a. Permit analysis of ____ tissues
b. Permit analysis of tooth ____
c. Permit analysis of ____ space
d. Permit analysis of the ____ (tooth contacts)
e. Valuable aids in patient ____ and presentation of ____ to the patient.

A 
hard & soft
contours
inter-arch
occlusion
education
treatment options
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19
Q 
Occluded Diagnostic Casts
Adequate \_\_\_\_ space?
Evaluate \_\_\_\_
Adequate inter-occlusal space for \_\_\_\_?
Check for things you did not note when performing \_\_\_\_ examination
A

inter-ridge
occlusal plane
rest seats
intra-oral

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20
Q

Examination of the Partially Dentate Patient

Intra-oral Examination

  1. Arch size - If maxillary and mandibular arches differ significantly in size problems may occur with:
    a. ____
    b. Arrangement of ____ Teeth
    c. Alveolar atrophy due to:
  2. ) Excessive force delivered to small ____ by prosthesis supported by a large ridge
  3. ) Excessive force delivered by teeth in the ____.
A

esthetics
posterior
edentulous ridge
opposing ridge

21
Q

Examination of the Partially Dentate Patient

Intra-oral Examination

  1. Cross Sectional Contour of Ridge
    a. Bulbous Ridge or Any Ridge with Large Undercuts
    1.) Problem with placement and removal of PRDP due to precise path of ____ or
    removal.
    2.) Excessive relief can cause an unaesthetic ____ and problems with food collection.
    3). ____ correction may be advisable.
A

placement
lip contour
surgical

22
Q

Examination of the Partially Dentate Patient

Intra-oral Examination

  1. Torus Palatinus
    a. May create problems with placement of the ____ connector
  2. ) Surgical removal is sometimes done.
  3. ) Often an ____ major connector may be used
A

maxillary major

anterior-posterior palatal

23
Q

Examination of the Partially Dentate Patient
Intra-oral Examination

  1. Torus Palatinus
    3). A torus palatinus which extends to the ____ can cause special problems.
    4.) Incorporating a ____ major connector in a maxillary distal extension PRDP is a poor choice due to lack of ____ stabilization of
    the distal extension segment.
A

vibrating line
U shaped
cross arch

24
Q

U Shaped Major Connector

Not a good choice unless the major connector is ____

A

broad

25
Q

Examination of the Partially Dentate Patient

Intra-oral Examination
4. Torus Mandibularis
a. Creates \_\_\_\_.
b. Covered by \_\_\_\_ tissue
1.) Often results in \_\_\_\_
a.) impingement of major connector 
b.) impingement of denture base
2.) \_\_\_\_ removal is preferred
3.) \_\_\_\_ is to modify \_\_\_\_
a.) Keep inferior border above torus
b.) Place extra relief under connector to
allow for settling
A 
undercut
thin
soreness
surgical
option
major connector
26
Q

Examination of the Partially Dentate Patient
Intra-oral Examination

  1. Appearance of mucosa
    a. Dentate areas
    1.) Appearance may indicate level of ____
    and periodontal health status
    2.) ____ of gingiva could affect clasp design
    and placement
A

periodontal health status

recession

27
Q 
Examination of the Partially Dentate Patient
Intra-oral Examination
5. Appearance of mucosa
b. Inflamed edentulous areas 1.) Indication of \_\_\_\_
of mucosa to
previous PRDP
2.) Can also indicate \_\_\_\_
hour wearing of the PRDP
A

reaction

24

28
Q

Examination of the Partially Dentate Patient
Intra-oral Examination
6. Depth of vestibule
a. Mandibular anterior lingual area
1.) Space available determines choice of ____ design - lingual plate or lingual bar
2.) Choice is critical because adjustment of major
connector is ____ due to material (metal) and limited dimensions
a.) ____ of PRDP may be affected adversely by adjustment of major
connector

A

major connector
difficult
strength and rigidity

29
Q

Examination of the Partially Dentate Patient

Intra-oral Examination
6. Depth of vestibule
a. Mandibular anterior lingual area 3.) Evaluation procedure
a.) Position mouth mirror between tongue and vestibular region
b.) Ask patient to elevate ____ to determine functional level of vestibule
and lingual frenum
c.) Periodontal probe may be used to measure distance from gingival margin to depth of vestibule to transfer to diagnostic cast

Also instruct patient to rest tip of tongue on ____ during mandibular diagnostic impression

A

tongue

lower lip

30
Q

Examination of the Partially Dentate Patient

Intra-oral Examination

  1. Depth of vestibule
    b. Mandibular anterior labial area
    1.) In situations with advanced alveolar atrophy
    ____ vestibule may be ____ enough to contraindicate bar clasp designs.
A

labial

shallow

31
Q

Examination of the Partially Dentate Patient

Intra-oral Examination

  1. Depth of vestibule
  2. ) Shallow vestibule depth in the area may limit ____ of the labial bar of a ____ type of PRDP
A

placement

swing-lock

32
Q

Examination of the Partially Dentate Patient
Intra-oral Examination
6. Depth of vestibule
c. Maxillary and mandibular posterior areas
1.) Limited depth may limit clasp design
a.) contraindicate ____

A

bar clasps

33
Q

Examination of the Partially Dentate Patient

Intra-oral Examination

  1. Inter-arch space - factors to evaluate
    a. Low tuberosity
    1.) Methods to evaluate space in tuberosity area
    a.) Remove dentures, stand at arms length and ____ the cheeks
    b.) Have patient allow mandible assume a ____ position, gently separate the lips and observe
    space in tuberosity region
    c.) Observe that present PRDP is ____ extended in
    the posterior region
    d.) Mounted ____ casts
A

retract
rest
under
diagnostic

34
Q

Examination of the Partially Dentate Patient
Intra-oral Examination

2.) Correction of low tuberosity
a.) Usually corrected ____
b.) Evaluate radiographs for position of the ____
c.) Soft tissue enlargement easy to correct by
removing a ____.
d.) Bony enlargement harder to ____ and slower
healing.

A

surgically
sinus
wedge
remove

35
Q

Examination of the Partially Dentate Patient
Intra-oral Examination
7. Inter-arch space - factors to evaluate
b. Extruded teeth
1.) ____
2.) ____ and/or restore
a.) May require ____

A

extract
recontour
endodontics

36
Q

Examination of the Partially Dentate Patient
Intra-oral Examination
7. Inter-arch space - factors to evaluate

c. Overclosure

1.) May occur due to lack of a ____
2.) Evaluate ____ with facial
measurements and speech to evaluate rest space
and closest speaking space.

A

vertical stop

OVD

37
Q

Examination of the Partially Dentate Patient
Intra-oral Examination
7. Inter-arch space - factors to evaluate

Deep ____ Overlap

Patients that have a deep vertical overlap are difficult because we don’t have a lot of ____.

A

vertical

room

38
Q

Examination of the Partially Dentate Patient

  1. Maxillo-mandibular Relation - antero-posterior relation of the mandible to the maxillae in centric relation.

a. Retrognathic
1.) Occlusal balance difficult to achieve due to a deep
anterior ____ overlap
a.) Need anterior-posterior ____ curve
(curve of Spee) to achieve protrusive balance
2.) Patient may function ____ to centric relation or in
an area between centric relation and an anterior position

A

vertical
compensating
anterior

39
Q

Maxillomandibular Relationships

Prognathic

Retrognathic

In the rethrognathic cases, we have a large amount of ____. In the prognathic cases, the arches tend to be ____ in the maxillary.

A

overjet

narrow

40
Q

Examination of the Partially Dentate Patient
Intra-oral Examination

  1. Maxillo-mandibular Relation - ____ relation of the mandible to the maxillae in centric relation.

b. Prognathic
1.) Usually results in ____
2.) Stability of PRDP/ may be poor if maxillary anterior teeth
are positioned ____ of the ridge.

A

antero-posterior
posterior crossbite
forward

41
Q

Examination of the Partially Dentate Patient

  1. Maxillo-mandibular Relation - antero-posterior relation of the mandible to the maxillae in centric relation.
    c. Normal
  2. ) Patient will usually function at or near ____
A

centric relation

42
Q 
Tongue Position
 Wright
• Class I – \_\_\_\_ (favorable)
• Class II - \_\_\_\_ (less favorable)
• Class III - \_\_\_\_ (unfavorable)
A

neutral
slightly retruded
fully retruded

43
Q

Examination of the Partially Dentate Patient

Intra-oral Examination

  1. Evaluation of abutment teeth
    a. Routine examination of the teeth including caries status, ____, condition of existing restorations, periodontal condition, wear and presence and severity of abfraction lesions is performed.
    It is usually contraindicated to clasp a tooth with more than a ____+ mobility
A

tooth mobility

1

44
Q

Examination of the Partially Dentate Patient
Intra-oral Examination

  1. Evaluation of abutment teeth
    b. Evaluation of abutment teeth from radiographs
  2. ) ____ ratio
  3. ) Root ____
  4. ) ____
  5. ) Existing ____
A

crown-root
root
mobility
restorations

45
Q

Examination of the Partially Dentate Patient
Intra-oral Examination
11. Relation of teeth to desirable occlusal plane
a. ____
b. ____

A

lateral

antero-posterior

46
Q

Getting the centric relation and centric occlusion depends on the case. If it is dentate enough you can just ____ the case. It depends on how many teeth are missing and the occlusion relationships.

A

hand articulate

47
Q

Examination of the Partially Dentate Patient
Intra-oral Examination
13. Contraindications to an PRDP

If these teeth are ____ involved, the teeth are extracted and heal and then you make the denture. But maybe they have a couple of teeth that are still ok, maybe they still some canines that don’t have bone loss, maybe they just need periodontal treatment but you can work with the teeth, so don’t drill(?) the teeth until you have seen all possibilities.

A

periodontal

48
Q

Examination of the Partially Dentate Patient
14. Instructions to patient

So you can try these resources with your patient. The ADA has a Healthy Mouth section with reading materials and good information. They now have videos too.

Tells a story about a patient not going to him with bad dentures and he re-did the dentures for the person. Make sure you tell patients that dentures are not gonna ____ their teeth, because their teeth are ____. So they are replacing no teeth. The point is that the patient was misinformed.

A

replace

gone

49
Q

Examination of the Partially Dentate Patient
Intra-oral Examination
15. Prognosis
a. Realistic prognosis must be determined and presented to
the patient.
b. Some factors in prognosis
1.) Past dental ____
2.) Patient ____
3.) Oral ____
c. Prognosis must be discussed with patient ____ to beginning treatment.

A

history
expectations
hygiene

PRDP, Final (21 decks)

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