Introduction Flashcards
Prosthodontics is that body of knowledge and skills pertaining to:
(2)
• The restoration and replacement of the natural dentition with
artificial substitutes.
• The restoration of the dental arches with fixed or removable
dental prostheses.
Prosthodonticsis
the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation, and maintenance of the oral function, comfort, appearance, and health of patients with clinical conditions associated with missing or deficient teeth and/or maxillofacial tissues by using biocompatible substitutes.
Fixed Prosthodontics:
the branch of prosthodontics concerned with the replacement and/or restoration of teeth by artificial substitutes that cannot be removed from the mouth by the patient.
Branches of Prosthodontics (4)
- Fixed Prosthodontics
- Removable Prosthodontics
a) Complete Denture Prosthodontics
b) Partial Denture Prosthodontics - Implant Prosthodontics
- Maxillofacial prosthetics
Scope of Fixed Prosthodontics
“Restoration of a single tooth to rehabilitation of the entire occlusion”
Scope of Fixed Prosthodontics
fxn (5)
- Restore function and esthetics of single teeth
- Replacement of missing teeth
- Improve comfort and mastication
- Complete / maintain the integrity of dental arches
- Self image
Reasons for Tooth Destruction and Loss (5)
- Caries
- Periodontal disease
- Trauma
- Erosion (GERD) (Bulimia)
- Worn Dentition (Attrition) (Bruxism)
Reasons for Tooth Destruction and Loss
6
- Cysts, malignancies and tumors
- Radiation therapy for tumors
- Grossly mal-aligned teeth
- Iatrogenic extraction
- Congenitally missing teeth
- Failure to erupt (impacted teeth)
Sequelae of tooth loss (4)
resorption
tilting
drifting
occlusal disharmony
Resorption:
The socket remodels until it assumes the shape of the rounded edentulous ridge.
Occlusal disharmony:
leads to discomfort,
pain or damage to
TMJ
•Crown:
a cemented extracoronalrestoration covering the
outer surface of a prepared tooth.
Extracoronal Cemented Restorations
•Crown (3)
- “Sleeve” retention
- Slight convergence of opposing walls
- “Path of insertion”
Partial veneer crown:
an extracoronal restoration
covering a portion of the clinical crown.
Extracoronal Cemented Restorations
•Partial veneer crown (2)
• “Sleeve” retention with additional
internal retentive features
• Grooves
•Inlay:
a cemented intracoronalrestoration is fabricated indirectly and cemented into the prepared cavity of the tooth.
“Wedge” retention:
slight divergence of
opposing internals walls.
Onlay:
an inlay modified with an
occlusal veneer (replacing 1 or more
cusps).
Fixed Dental Prosthesis (FDP or FPD)
•Dental prosthesis replacing one or more missing teeth which is
cemented/ rigidly attached to remaining teeth (or implants).
implant Restorations
•Single Crown or FDP attached to an osseointegrated implant(s)
Elements of Fixed Prosthodontics Diagnosis
(Fixed Prosthodontics Work-up)
(6)
- Patient History
- TMJ and Occlusal Evaluation
- Intraoral Examination
- Diagnostic Casts
- Radiographic Evaluation
- (Esthetic Analysis)
• Diagnostic Casts (2)
- Diagnostic Waxing
* Custom Trays, Matrix for Interim Restorations
Patient History
3
- Medical History
- Dental History
- Chief Complaint
Hodgkins disease / radiation therapy →
2
Xerostomia
Radiation induced caries
Intraoral Examination: Periodontal Condition
5
•Plaque – where and how much •Attached gingiva •(3mm - abutments) •Inflammation •BoP / Pockets •Gingival architecture •Mobility
TMJ / Occlusal Evaluation (3)
- Joints
- Muscles of mastication
- Assessment of pain
• Joints
• Sounds; opening limitations / deviations
• Muscles of mastication
• Palpation of extraoral and intraoral muscles of mastication
• Assessment of pain
•Type and origin of pain
Determination of the presence or absence of physiologic health.
(2)
- Normal (treatment to maintain occlusion)
* Dysfunctional (improvement / restorations?)
Intraoral Exam: Evaluation of Occlusion
11
• Presence and location of caries • Previous restorations and prostheses • Evaluation of the occlusion • Relationship of spaces, if more than one • Bony defects • Health of tissues • Wear facets • Occlusal prematurities; interferences; buttressing bone • Difference between CRCP (CO) and MIP • Existence and amount of anterior guidance • Occlusal Scheme
• Occlusal Scheme
3
- Canine Guidance
- Group Function
- Bilateral Balance
Accurate representation of dental arches
Diagnostic Casts
Diagnostic Casts
• Mounted on a
semi-adjustable articulator with a
facebow transfer
Diagnostic casts provide information for
diagnosing
problems and arriving at a treatment plan
Patient communication:
Determine —
and expected —.
compromises
results
Make duplicate
mandibular and maxillary casts
Custom Tray / Vacuum Matrix
Full Mouth Radiographs
Correlate facts collected from
intraoral
exam and diagnostic casts
