Intro to Partial Dentures Flashcards
Name reasons why patients may have missing teeth? (6)
- Caries
- Periodontal disease
- Endodontic infection
- Trauma
- Cancer
- Congenitally absent
What are the extra oral problems with losing teeth (2)
- Changes in facial appearance
2. TMJ problems
List the intraoral problems with losing teeth (3)
- Alveolar resorption
- Tooth movement
- Toothwear
What can loss of functionality affect? (2)
- Mastication
2. Speech
How can we replace missing teeth? (7)
- Resin bonded bridgework
- Conventional bridgework
- Implant crowns
- Implant bridgework
- RPD’s
- Complete dentures
- Implant retained dentures
What is a bridge pontic?
The missing tooth
What is a bridge abutment tooth
The tooth next to the missing tooth
- Where the retainer goes on
What are the types of bridgework? (2)
- Conventional
2. Resin bonded
What are the different types of complete dentures (3)
- Denture: Removable
- No attachment for stability - Denture: Implant retained
- Snaps in place - Denture: Implant supported
- Screw retained + non removable
What is the exception for NOT needing to replace all missing teeth?
If the patient has a satisfactory SDA
Define the Shortened Dental Arch
A dentition where MOST posterior teeth are missing
How is an extension of the SDA achieved? (3)
- Resin bonded bridgework
- Implants
- Single tooth
- Cantilever/fixed bridge - RPD
- Bilateral free end saddle
What are the different types of support for an RPD? (3)
- Tooth borne
- Everything rests on the teeth - Mucosa borne
- Everything rests on the mucosa - Tooth + mucosa borne
- Mixture
What are the material (base) options for RPDS? (2)
- Acrylic
2. Cobalt chrome
What does a patient assessment for RPDS involve? (5)
- History
- Examination
- Special investigations
- Diagnosis
- Treatment plan
What kind of questions can a full denture history involve? (6)
- Why were teeth lost?
- How long have they worn dentures for?
- How many dentures have they had?
- Have they got a favourite denture?
- Have they got a preferred design?
- Which do they prefer, metal or acrylic resin denture?
List some health problems that may be noted in a MH, that affect RPD tx (6)
- Arthritis
- Neuromuscular
- Mucosal disease
- Xerostomia
- Osteoporosis/ bisphosphonates
- Insertion + removal
Questions to ask for the social history (4)
- Hobbies
- Musical instruments - Smoking
- Alcohol
- Diet
List extra-oral factors that may affect RPD planning (6)
- Lower facial height
- Nasio-labial angle
- Limited opening
- Any abnormalities
- Smile line
- Aesthetics of existing dentures
List intra-oral factors that may affect RPD planning (5)
- Periodontal status
- Endodontic status
- Caries
- Tooth wear
- Indirect restorations
How to examine :
> Edentulous spaces (5)
> Occlusion (3)
On an intra-oral examination
EDENTULOUS SPACES
- Number
- Position
- Length
- Ridge form
- Displaceable tissue
OCCLUSION
- Occlusal vertical dimension
- Occlusal contacts
- Freeway space
Define the term support
The dentures resistance to vertical movement towards the tissue
Define the term retention
The dentures resistance to displacement away from the tissue
Define the term stability
The dentures resistance to horizontal (lateral) movement
List the features of dentures that should be examined (6)
- Aesthetics
- Extension
- Occlusion
- Material
- Design
- Condition of teeth and base
What are examples of special investigations that can be done for abutments? (4)
- Periapical radiographs
- Sensibility testing
- EPT
- Ethyl chloride - Surveyed study models
- Clinical photographs
Are RPD’s always necessary for an SDA?
No as can have satisfactory oral function without the use of an RPD
How is priority given when a patient with a shortened dental arch decides not to use removable partial dentures?
Priority given to maintaining an anterior and premolar dentition in one or both jaws
How many occlusal units allows sufficient adaptive capacity in a shortened dental arch?
3 to 5
How many units does a pair of occluding premolars give?
1
How many units does a pair of occluding molars give?
2
List some indications of a SDA (4)
- Missing posterior teeth with 3-5 occluding units remaining
- Sufficient occlusal contacts for a large enough occlusal table
- Patient not motivated to pursue complex prescription plan
- Limited financial resources on dental care
List some contraindications of an SDA (5)
- If there is a poor prognosis for the remaining dentition
- Untreated or advanced periodontal disease
- Pre-existing TMJ dysfunction
- Signs of pathological toothwear
- The patient has significant malocclusion (severe Class II or Class III)
List different DESIGNS for a bridge (3)
- Fixed-fixed
- Cantilever
- Hybrid
List the different types of bridge pontic (3)
- Ridge lap
- Ovate
- Hygienic
Give the different types of retainer used in a bridge (2)
- Wing
2. Crown on abutment tooth
Name advantages of fixed partial dentures (4)
- More natural appearance
- Superior stability with chewing hard foods
- Minimal soft tissue coverage
- Not easily dislodged
Name disadvantages of fixed partial dentures (3)
- More expensive
- More suitable for short spans
- Extensive tooth prep
Name advantages of RPD’s (4)
- Less expensive
- Minimal tooth prep
- Longer edentulous spans can be restored
- Can be removed for cleaning, adjustments or repairs
Name disadvantages of RPD’s (4)
- Clasps may be unattractive
- Designs may be bulky, complicated and plaque retentive
- May cause gagging
- Retention and stability may be problematic
What is the maximum unit of bridgework on each side of the arch?
1
What are the contact points like on pontics in the intercuspal position?
Light contact points
Describe the contact of bridgework in excursion
Minimal contact in excursion
Why are there minimal and light contacts in bridgework?
As heavy contacts may lead to failure
What kind of bridge may be used in an implant?
Cantilever/fixed bridge
List the indications for RPD’s (4)
- Multiple missing teeth
- No suitable bridge abutments
- Implants contraindicated
- Transitional to complete denture
List the contraindications for RPD’s (4)
- Untreated dental disease
- Chronic poor oral hygiene
- Patient acceptance
- SDA that patient can function with
What are the features of abutments used for bridgework?(5)
- Teeth structurally sound, with satisfactory appearance and crown forms
2 Teeth in good alignment and position, no orthos or complex RPD design required
- The previous restorations and endo txs are satisfactory
- The abutment tooth roots and supporting alveolar bone are functionally adequate
- The alveolar bone of the edentulous ridge between or distal to the abutment teeth is adequate in quantity and quality
