2. Introduction to Partial Dentures Flashcards
Reasons patients lose teeth (6)
Caries Periodontal disease Endodontic infection Trauma Cancer Hypodontia
Consequences of missing teeth (4)
Anatomical (extra-oral, intra-oral)
Aesthetics (loss of hard and soft tissues which support the face)
Functional (mastication, speech)
Psychological
Features of SDA (4)
20 teeth - minimum number to function correctly
Most posterior teeth are missing
Satisfactory oral function without the use of an RPD
Priority given to maintaining an anterior and premolar dentition in one/both jaws
When does the SDA occur
When there is sufficient capacity in subjects when there is sufficient adaptive capacity in subjects when 3-5 occlusal units (OU) are left
Indications for retaining SDA (5)
Missing posterior teeth with 3-5ou remaining
Sufficient occlusal contacts to provide a large enough occlusal table
Favourable prognosis for remaining anterior and premolar teeth
Patient not motivated to pursue complex restorative plan
There are limited financial resources on dental care
Contraindications for retaining SDA (5)
If there is a poor prognosis for remaining dentition
Untreated or advanced periodontal disease
Pre-existing TMJ dysfunction
Signs of pathological tooth wear
Significant malocclusion (severe class II or III)
Methods of extension of SDA (3)
Resin-bonded bridges
RPDs
Implant-supported prostheses
Reasons for resin-bonded bridges extension of SDA (4)
Max of one unit on each side of arch
Light contact on pontics in ICP
Minimal contact in excursion
Heavy contacts may lead to failure
Reasons for RPD extension of SDA (2)
Bilateral free-end saddle
RPI design
Reasons for implant-supported prostheses extension of SDA (2)
Single tooth
Cantilever/fixed bridge
Types of RPD support (3)
Tooth borne
Mucosa borne
Tooth and mucosa borne
(Made from CoCr or PMMA)
Indications for RPD (6)
Multiple missing teeth No suitable bridge abutments Implants contraindicated Immediate after extraction Provisional during implant treatment Transitional to complete denture
Contraindications for RPD (5)
Untreated dental disease Chronic poor oral hygiene Patient acceptance SDA that patient can function with Mobile teeth (unless transitional denture)
Advantages of RPDs (4)
Simple
Restore function
Restore appearance
Cost effective
Disadvantages of RPDs (4)
Plaque retention
Aesthetics (clasps and flanges)
Denture stomatitis
Compromise abutment teeth
Types of extra-oral exam (6)
Lower facial height Naso-labial angle Limited opening Any abnormalities Smile line Aesthetics of existing dentures
Types of intra-oral exam (10)
Periodontal status (BPE)
Endodontic status
Caries
Tooth wear (active)
Indirect restorations (crowns, bridges; dismantle)
Potential abutments
Freeway space
Edentulous spaces (number, position, length, ridge form, displaceable tissue)
Health of denture-bearing area Occlusion (inter maxillary space, occlusal contacts)
Types of Kennedy classifications (4)
Kennedy class I Kennedy class II Kennedy class III Kennedy class IV
Definition of Kennedy class I
Bilateral free-end saddle
Bilateral edentulous areas located posterior to the remaining natural teeth. Denture saddles that restore such edentulous areas are described as ‘distal extension saddles’
Definition of Kennedy class II
Unilateral free-end saddle
A unilateral edentulous area located posterior to the remaining natural teeth
Definition of Kennedy class III
Posterior unilateral bounded saddle
A unilateral edentulous area with natural teeth remaining both anterior and posterior to it. Denture saddles that restore this type of edentulous area are said to be ‘bounded saddles’
Definition of Kennedy class IV
Anterior bounded saddle that crosses the midline
A single edentulous area located anterior to the remaining natural teeth
Types of Craddock classifications (3)
Craddock class I Craddock class II Craddock class III
Definition of Craddock class I
Tooth borne support
Saddles supported on both sides by substantial abutments
Definition of Craddock class II
Mucosa borne support
Vertical biting forces resisted entirely by soft tissues
Definition of Craddock class III
Tooth and mucosa borne support
Tooth supported at only one end of the saddle
Components of denture examinations (10)
Aesthetics Support Retention Stability Extension Occlusion Material Design Condition of teeth (healthy tooth required for abutments) Condition of base
Definition of support
The resistance to vertical movement of the denture towards the tissue
Definition of retention
The resistance to displacement of the denture away from the tissue
Definition of stability
The resistance to horizontal (lateral) movement of the denture
