Intro to RPD Flashcards
Why do patient’s have missing teeth? (6 points)
- Caries
- Periodontal disease
- Endodontic infection
- Trauma
- Cancer
- Congenitally absent (hypodontia)
What are the 4 main categories of the consequences of missing teeth?
- Anatomical
- Aesthetic
- functional
- Psychological
What are the extra-oral anatomical consequences of missing teeth? (2 points)
- Change in facial appearance
- TMJ problems
What are the intra-oral anatomical consequences of missing teeth? (3 points)
- Alveolar resorption
- Tooth movement
- Tooth wear
What is the aesthetic consequence of missing teeth?
- Loss of hard and soft tissues which support the face
What are the functional consequences of missing teeth? (2 points)
- Makes mastication and speech more difficult
What is the psychological consequence of missing teeth?
- Depression
- Some people cannot cope with the denture despite how well it is made as they cannot get over the emotional aspect of loosing teeth
How can we replace missing teeth? (7 points)
- resin bonded bridgework
- Conventional bridgework
- Implant crowns
- Implant bridgework
- Removable partial dentures
- Complete dentures
- Implant retained dentures
Resin bonded bridgework has many different designs? Name 2 of them?
- Mesial Cantilever
- Fixed-fixed
What is a mesial cantilever resin bonded bridgework?
- A dental bridge that is designed when abutment teeth are prepared on only one side of the missing toothless gap. In such cases, the pontic is located outside the abutment teeth
- Only anchored to one end of a support to which it is protruding
What is a fixed-fixed bonded bridgework?
- Bridge cemented to natural teeth
What is a pontic?
- A fake tooth on bridgework
What is a retainer in bridgework?
- What you attach to the abutment tooth to secure the retainer
What is the name for the tooth the retainer goes onto?
The abutment tooth
What are the 2 types of conventional bridgework?
- Cantilever
- Fixed-fixed
What is the name for a complete denture that has no attachments for stability?
- Removable
What is the name for a complete denture that ‘snaps into place’?
- An implant retained denture
What is the name for a complete denture that is screw retained and non-removable?
- Implant supported denture
What are the advantages of
fixed partial dentures? (5 points)
- More natural appearing tooth substitutes
- Feel more natural
- Superior stability with chewing hard foods
- Minimal soft tissue coverage
- Not easily removed
What are the disadvantages of fixed partial dentures? (4 points)
- More expensive
- More suitable for short spans
- Extensive tooth preparation is usual
- Abutments must be in good alignment and functionally adequate
What are the advantages of removable partial dentures? (5 points)
- Generally less expensive
- Minimal tooth preparation
- Longer edentulous spans can be restored
- Replacement of missing alveolar ridge tissues is possible
- Can be removed for cleaning and adjustments of repairs
What are the disadvantages of removable partial dentures? (4 points)
- Clasps may be unattractive
- Designs may be bulky, complicated and plaque -retentive
- May cause gagging
- Retention and stability may be problematic
What is meant by a saddle?
- An area with no teeth
What are the 2 types of saddle?
- Free-end saddle
- Bounded saddle
What are the 2 types of free-end saddle?
- Bilateral
- Unilateral
What are the 2 types of bounded saddle?
- Anterior
- Unilateral bounded
Do you need to replace all of the missing teeth with the partial denture?
- No you don’t have to replace them all the time
- It depends on the teeth that are needing to be replaced
Do we need to have 32 teeth in our mouth for normal function?
- No, in 1992, the world health organisation stated:
- The retention, throughout life, of a functional, esthetic, natural dentition of not less than 20 teeth and not requiring recourse to prostheses should be the treatment goal for oral health
What is the name for a dentition where most posterior teeth are missing?
Shortened dental arch
Do you get satisfactory oral function without the use of a RPD in a patient with a shortened dental arch?
Yes
What teeth are given priority to maintaining in one or both jaws when some teeth are missing?
- Anterior and premolar dentition
In a shortened dental arch there is sufficient adaptive capacity in subjects with 3-5 occlusal units left? What are 1&2 units given for?
- 1 unit = a pair of occluding premolars
- 2 units = a pair of occluding molars
What are the considerations when using bridgework to extend the SDA? (3 points)
- Max one unit on each side of the arch
- Minimal contact in excursion (a movement of the mandible, from the centric po sition and back)
- Heavy contacts may lead to fialure
How can you extend the shortened dental arch using a RPD?
- By creating a bilateral free end saddle RPD
What is a ‘tooth borne’ RPD?
- Everything rests on the teeth
What is a mucosa borne RPD?
- Everything rests on the mucosa
What is a tooth and mucosa borne RPD?
- Mixture: resting both on the teeth and mucosa
What are the 2 materials that can be used as a base in a RPD?
- Acrylic
- Cobalt Chrome
What are the 5 main things you have to include in a patient assessment for a RPD?
- History
- Examination
- Special investigations
- Diagnosis
- Treatment plan
For patient assessment you have to take a full denture history from the patient. What should you ask about? (6 points)
- 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?
For patient assessment, a routine medical history needs to be taken to identify problems which could affect the treatment. What are some of these problems? (6 points)
- Arthritis
- Neuromuscular
- Mucosal disease
- Xerostomia
- Osteoporosis/bisphosphonates
- Insertion and removal
In the patient assessment for a RPD a social history has to be taken, what should be included in this? (6 points)
- Distance travelled/ability to attend
- Accompanying person?
- Hobbies - musical instruments
- Smoking
- Alcohol
- Diet
During patient assessment, they have to have an extra-oral assessment, What do you need to look for in this?
- Lower facial height
- Nasio-labial angle
- Limited opening
- Any abnormalities
- Smile line
- Aesthetics of existing dentures
A patient assessment had to be taken for RPD’s. What has to be included in the general intra-oral examination? (5 points)
- Periodontal status
- Endodontic status
- Caries
- Tooth wear
- Indirect restorations
A patient assessment has to be done prior to making RPD’s. What is included in the edentulous spaces aspect of the intra oral exam? (5 points)
- Number
- Position
- Length
- Ridge form
- Displaceable tissue
A patient assessment has to be taken prior to making a RPD. What has to be included in the occlusion part of an intra-oral examination? (3 points)
- Occlusal vertical dimension
- Occlusal contacts
- Freeway space (the space between the occluding surfaces of the maxillary and mandibular teeth when the mandible is in physiological resting position)
What is freeway space?
- The space between the occluding surfaces of the maxillary and mandibular teeth when the mandible is in physiological resting position
What does the Kennedy classification system classify?
- Classification of edentulous jaw conditions and partial dentures, based in the distribution of edentulous spaces
What is the Kennedy class I?
- Bilateral free end saddle
What is the Kennedy class II?
- Unilateral free-end saddle
What is the Kennedy class III?
- Unilateral single-bounded saddle
What is the Kennedy class IV?
- Single bilateral anterior bounded saddle
What is a Craddock class I?
- Saddles supported on both sides by substantial abutments
What is a Craddock class II?
- Vertical biting forces resisted entirely by soft tissues
What is a Craddock class III?
- Tooth supported at only one end of the saddle
During denture examination what does ‘support’ mean?
- The resistance to vertical of the denture towards the tissue
During denture examination what does ‘retention’ mean?
- The resistance to displacement of the denture away from the tissue
During denture examination what does ‘stability’ mean?
- The resistance to horizontal (lateral) movement of the denture
During denture examination there are 6 things we are particularly interested about. What are these?
- Aesthetics
- Extension (what the bite is like)
- Occlusion
- Material
- Design
- Condition of teeth and base
A patient may get stomatitis because they fail to take out their denture. What is stomatitis?
- Inflammation of the mucous lining of any of the structures of the mouth.
- The word stomatitis literally means inflammation of the mouth
When considering the teeth required to be abutments for a RPD, what factors do we need to consider? (5 points)
- Are the teeth structurally sound, with satisfactory appearance?
- Are the teeth in good alignment and position?
- Are the previous restorations and endodontic treatments satisfactory?
- Are the abutment tooth roots and supporting alveolar bone conditions adequate?
- Is the soft tissue of the edentulous ridge satisfactory in quantity and quality?
What special investigations can we do to check the quality of abutment teeth (and how good the bone support is) for RPD’s? (4 points)
- Periapical radiographs
- Sensibility tests (EPT - pulp testing, ethyl chloride)
- Surveyed study models
- Clinical photographs
What is meant by ‘combination system’?
- A term used to describe the situation where only 6-8 lower anterior teeth remain functioning against a complete upper denture
When diagnosing a patient with a partial denture, what problems are you looking for in the patient? (7 points)
- Partial edentulism
- Endodontic (tooth pulp)
- Periodontal (gum/soft tissues)
- Caries
- Toothwear
- Shortened dental arch
- Combination syndrome
When diagnosing a patient with a partial denture, what problems are you looking for in the denture? (8 points)
- Over/under extension
- Reduced support, retention or stability
- Fractured clasps/baseplates
- No free way space
- Poor aesthetics
- Worn teeth
