Clinical RPD Treatment/Clinical Forms

Question 1

Prior to removable prosthetic clinical treatment, students complete:

Answer 1

• Comprehensive exam and oral diagnosis
• All necessary consults (medical and dental)
• Develop comprehensive treatment plan
• Survey articulated diagnostic casts
• Draw RPD design on diagnostic casts and have faculty approval

Question 2

What do you do during the patient’s first appointment?

Answer 2

• Medical & Dental History
• Panoramic & periapical radiographs of potential abutment teeth- must be within previous year.
• Complete periodontal & restorative charting
• Diagnostic Casts
• Pulpal evaluations of potential abutment teeth

Question 3

What do you do during the patient’s second appointment?

Answer 3

• Review radiographs
• Any additional radiographs taken
• Identify any additional teeth requiring extraction
• Pulp test potential abutments, if not previously done
• Identify teeth requiring endodontic treatment
• Need for periodontic therapy already determined
• Diagnose necessary restorations
• Soft tissue, residual ridge support
• Vertical space

Question 4

How do you decide to do endo to save a tooth or extract?

Answer 4

• Presence of ferrule
  —2mm circumferentially is ideal
• Length of crown
  —Abutment height
  —At least 4mm of abutment height
• Crown to root ratio
  —Less than 1:1

Question 5

How do you decide to do perio treatment to save a tooth or extract?

Answer 5

• > 3mm pocket: Treat before prosthetic work
• Crown to root ratio : Less than 1:1

Question 6

What are the different restorations what you will diagnose during a patient’s second appointment?

Answer 6

– Some identified at first visit
– Amalgams, composites
– Single crowns, FPDs, RPDs, complete denture
– Surveyed crowns: abutment
* Large amalgam
* Extensive caries
* Inappropriate contours: not determined until diagnostic cast surveyed

Question 7

What do you need to check before choosing a survey crown (abutment)?

Answer 7

• Large amalgam
• Extensive caries
• Inappropriate contours: not determined until diagnostic cast surveyed

Question 8

What do you need to consider about vertical space for an RPD patient?

Answer 8

• Patient in occlusion, Diagnostic cast
• Bony interference: tuberosity
• Supra-erupted teeth

Question 9

What is a pier abutment?

Answer 9

• Stand alone tooth with edentulous spaces on either side
• should not be clasped

Question 10

Pier abutments should or should not be clasped?

Answer 10

Should NOT

Question 11

What are the steps to RPD treatment plan?

Answer 11

1. Consultation with Prosthodontics Faculty
2. Survey Diagnostic Cast
   3.Quality Assurance Worksheet

Question 12

What do you do during the consultation with prosthodontics faculty phase of RPD treatment planning?

Answer 12

• Preparation prior to Consultation
  – Mounted preliminary cast

Question 13

What do you do during the survey diagnostic cast phase of RPD treatment planning?

Answer 13

–Determine potential path of insertion
* Potential guide planes, retentive undercut of indicated abutments
–Mark Survey line of abutments: Measure & mark retentive undercut
–Tripod sides of the cast
–Indicate modification area

Question 14

What needs to be entered into Axium for the RPD treatment plan?

Answer 14

– Indicate types and order of necessary treatment by appointment
– Begin with disease control procedures first
– Periodontic, Surgical, Endodontic treatment
– Restorative prior to RPD tx:
* Amalgams, composites, FPD
* Surveyed crowns: RPD Guide plane preparations may precede the crown preparation

Question 15

What is included in a complete clinical RPD treatment form?

Answer 15

– RPD Mouth preparation
– Impression for Master cast
– Framework try-in
– Occlusal Record appointment
– Denture tooth try-in
– Final wax-up
– Delivery
– 24 and 72 hour adjustment

Question 16

What are the clinical versus laboratory steps for a traditional RPD workflow?

Answer 16