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BDS2 Prosthodontics (removable) > Intro to RPD and patient assessment > Flashcards

Intro to RPD and patient assessment Flashcards

1
Q

Why do patients have missing teeth?

A
  • caries
  • periodontal disease
  • endondontic infection
  • trauma
  • cancer
  • congenitally absent
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2
Q

What are the consequences of missing teeth

A
  • anatomical
  • aesthetic
  • functional
  • psychological
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3
Q

Anatomical consequneces of missing teeth

A

Extra-oral

  • change in facial appearance
  • TMJ problems

Intra-oral

  • alveolar resorption
  • tooth movement
  • toothwear

unwanted tooth movements

  • over-erupted teeth
  • drifting and tilting
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4
Q

aesthetic consequences of missing teeth

A

loss of hard and soft tissues which support face

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5
Q

functional consequences of missing teeth

A

mastication

speech

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6
Q

psychological effects of missing teeth

A

emotional

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7
Q

how can we replace missing teeth

A
  • resin bonded bridgework
  • conventional bridgework
  • implant crowns
  • implant bridgework
  • RPDs
  • complete dentures
  • implant retained dentures
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8
Q

what are the different types of resin bonded bridgework (and conventional bridgework)

A
  • mesial cantilever

- fixed-fixed

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9
Q

how are implants fitted

A

screw retained

dental implant, implant abutment, implant crown

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10
Q

how are implant bridges fitted

A

two implant abutments, a pontic in the middle

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11
Q

how can complete dentures be held in the mouth

A
  • removable (no attachments or stability)
  • implant retained (snaps in place)
  • implant supported (screw retained and non-removable)
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12
Q

what is a saddle?

what are the different types of them

A

area with no teeth

free-end and bounded

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13
Q

Do we need to replace all missing teeth?

A

no, according to WHO you need min of 20

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14
Q

What is a shortened dental arch

A

a dentition where most posterior teeth are missing

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15
Q

do you need to fix a shortened dental arch?

A

depends, in the right circumstances, non replacement of posterior missing teeth can provide a stable and acceptable dentition

priority given to maintaining an anterior and premolar dentition in one or both jaws

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16
Q

how many occlusal units (teeth) should be left for sufficient adaptive capacity

A

3-5
(a pair of occluding premolars = 1 unit)
(a pair of occluding molars = 2 units)

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17
Q

how can we extend a shortened dental arch with bridgework

A
  • max one unit on each side of the arch
  • minimal contact in excursion
  • heavy contacts may lead to failure
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18
Q

how can we extend a shortened dental arch with implants

A
  • single tooth

- cantilever/ fixed bridge

19
Q

how can we extend a shortened dental arch with RPDs

A
  • bilateral free end saddle
20
Q

How can you describe RPDs

A

By support

  • tooth borne
  • mucosa borne
  • tooth and mucosa borne

By material

  • acrylic
  • cobalt chrome
21
Q

What are the components of patient assessment for dentures

A
  • history
  • examination
  • special investigations
  • diagnosis
  • treatment plan
22
Q

How do you take a full denture history

A
  • 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?)
23
Q

How do you take a medical history for a denture patient

A
  • routine medical history
  • identify problems which could affect treatment (arthritis, neuromuscular disease, xerostomia, osteoporosis/biphosphonates, insertion and removal)
24
Q

How do you take a social history for a denture patient

A
  • distance travelled/ ability to attent
  • accompanying person?
  • hobbies - musical instruments
  • smoking
  • alcohol
  • diet
25
Q

what are the two arms of an examination for dentures

A

patient and denture

26
Q

Describe the patient examination for dentures (extra oral)

A

Extra-oral

  • lower facial height
  • nasio-labial angle
  • limited opening
  • any abnormalities
  • smile line
  • aesthetics of existing dentures
27
Q

Describe the patient examination for dentures (intra oral)

A

General examination

  • periodontal status
  • endodontic status
  • caries
  • tooth wear
  • indirect restorations

Edentulous spaces

  • number
  • position
  • length
  • ridge form
  • displaceable tissue

Occlusion

  • occlusal vertical dimension
  • occlusal contacts
  • freeway space
28
Q

Kennedy class 1

A

bilateral free end saddle

29
Q

Kennedy class 2

A

unilateral free end saddle

30
Q

kennedy class 3

A

posterior bounded saddle

31
Q

kennedy class 4

A

anterior bounded saddle

32
Q

craddock class 1

A

tooth borne

“saddles supported on both sides by substantial abutments”

33
Q

craddock class 2

A

mucosa borne

“vertical biting forces resisted entirely by soft tissues”

34
Q

craddock class 3

A

tooth and mucosa borne

“tooth supported at only one end of the saddle”

35
Q

definition of denture support

A

the resistance to vertical movement of the denture towards the tissue

36
Q

definition of denture retention

A

the resistance to displacement of the denture away from the tissue

37
Q

definition of denture stability

A

the resistance to horizontal (lateral) movement of the denture

38
Q

what do you examine in a denture

A
  • aesthetics
  • extension
  • occlusion
  • material
  • design
  • condition of teeth and base
39
Q

What are the characteristics of teeth that you can use as abutments

A
  • teeth structurally sound, with satisfactory appearance
  • teeth in good alignment and position
  • the previous restorations and endodontic treatments are satisfactory
  • the abutment tooth roots and supporting alveolar bone are adequate
  • the soft tissue of the edentulous ridge is satisfactor in quantity and quality
40
Q

what special investigations can you do on abutment teeth

A
  • periapical radiographs
  • sensibility testing (EPT, ethyl chloride)
  • surveyed study models
  • clinical photographs
41
Q

What can be diagnosed relating to the patient

A
  • partial edentulism
  • endodontic
  • periodontal
  • caries
  • toothwear
  • shortened dental arch
  • combination syndrome
42
Q

what can be diagnosed relating to the denture

A
  • over/under extension
  • reduced (support, retention, stability)
  • fractured clasps/ baseplate
  • No RWS
  • poor aesthetics
  • worn teeth
43
Q

how are things diagnosed

A

structured, logical and discussed with the patient

BDS2 Prosthodontics (removable) (9 decks)

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