20. Case Presentation

Question 1

Initial (Phase I) Treatment
____ periodontal debridement
 ____ control instructions
 Assess ____ & discuss options

Answer 1

phase I
plaque
oral hygiene

Question 2

Diagnostic information after Phase I treatment
 Tooth brushing instruction ____
 ____ study casts
 ____ information
for PRDP design
 ____ & ____ findings along with mounted ____ to help determine which teeth to use for PRDP abutments

Answer 2

reinforced
mount
diagnostic
radiogrpahs
clinical
casts

Question 3

Mounted study (diagnostic) casts
Using \_\_\_\_ and \_\_\_\_ because “hand articulation” of casts not possible as too few teeth in contact

Answer 3

record bases

wax rims

Question 4

Evaluate mounted casts
 Plane of occlusion
 Occlusal contacts for
\_\_\_\_ placement
 Evaluate teeth & tissues on casts for possible:
 Support = \_\_\_\_, edentulous tissues
 Retention = \_\_\_\_, guide planes
 Stability =\_\_\_\_ elements
 Comfort = \_\_\_\_ connectors

Answer 4

rest
rests
undercuts
bracing
major

Question 5

Design means determining:
 Support
 Stability
 Retention  Esthetics  Occlusion  Comfort  Function

All in the context of biomaterials and the biologic problem
Objective: maintain or enhance
____

Answer 5

quality of life

Question 6

Treatment
 ____ surgery for pocket elimination
 Remove decay and place amalgam restorations
 Mandibular laterals (#23 & 26) hopeless and ____
 #27 crown ____, endodontics, post/core & crown

Answer 6

periodontal
extracted
lengthening

Question 7

Kennedy class in maxilla : \_\_\_\_
Mandible: \_\_\_\_

Answer 7

class I mod II
class I mod I

Question 8

____ connector in max : just replacing 1 premolar/molars on the right side, premolars still intact in left side —> if we determine that there is enough support of the teeth, consider ____ so that we don’t have to cover the whole palate.

In this case, have enough abutment teeth to NOT cover the entire palate in metal
≇ Mandible: ____ - diagnostic cast to determine depth of lingual? —> we have ____mm in this case, so we can do lingual bar
Lingual bar is the most comfortable especially for people getting prosthesis for the 1st time
If we wanted to splint the teeth —> consider ____
Survery crown on the ____

Answer 8

ajor
A-P palatal strap

lingual bar
7
lingual blanket
canine

Question 9

Which teeth should be clasped?

Maxillary? ____
Mandibular? ____

Answer 9

#5 and #13
#21 and #28

Question 10

Clasps?

Maxillary #5 & #13?
____ combination clasp Mandibular #21 & #28?
____combination clasp

Answer 10

RPI, RPA or wrought wire

RPI, RPA or wrought wire

Question 11

If we do C clasp —> as the partial want to the toward the tissue, it torques the tooth to the ____ because the retentive tip picks up more undercut and rocks the tooth.

If RPI/RPA —> the forces are mostly by moving the rest to the mesial —> forces go down to the tooth — > guide plate is engaged on the tooth —> the clasp now goes into more undercut
Does not torque the tooth because the force is now mostly down the ____ of the tooth
RPA is similar: the rest is ____ and no distal occlusal portion to the clasp
as the chewing forces go down, the retentive tip goes into more ____ (no ____
movement to the distal)
≇
Wrought wire works like the C clasp but it’s a more ____ clasp
Does not grab the tooth with as much force

Answer 11

distal
long axis
mesial
undercut
torque
flexible

Question 12

Indirect retention?

Maxillary?
#6, #8, #11 \_\_\_\_ rests Mandibular?
#22, #27 \_\_\_\_ rests

Indirect retention on maxilla:
Doing indirect retention and support to help with stability of the prosthesis
≇
Want to do the canines and the #8 tooth ≇
‣ ≇ ≇ ≇
‣
Allows for good support because of presence of edentulous areas in ____

Mandible : Rests are going to be on ____ side
Fulcrum line
Want to rest on the ____ (cingulum rests of #22/27).
On #27(canine) - did survey crown and put a ledge (planned this ahead)
No clasp on this tooth but ledge present

Answer 12

cingulum
cingulum

between
mesial
canines

Question 13

Look at the edentulous area of tooth #10
What framework design will increase the retention of the denture tooth to the framework?
____ or ____

Ideal for \_\_\_\_ tooth edentulous area
large edentulous area
Want to cover it up with \_\_\_\_
To help with retention, can do the tube tooth (post) or Steele’s facing
≇ Smaller edentulous area
≇
‣

Answer 13

tube tooth
steele’s facing

single
mesh

Question 14

Completed Treatment
 Maxillary and mandibular PRDP achieve QOL objectives
 Plaque control excellent 
 Recall every \_\_\_\_ months
 In function for over 20 years

Answer 14

4 to 6