lec 1 Flashcards
Prosthetic
- any missing part of the body that is being replaced
Device
serves a special function, intended for short term
- Splints
- Orthodontic applicance
- Space maintainers
***NOTE: RPD and night guard are two different types prothetics
Interim or provisional denture:
- Only used for a short time
- For esthetics, function, occlusional support, we don’t make mandibular denture if patient is completely edentionlous
Transitional removable partial denture:
- Used for loss of additional teeth over time is anticipated, but the immediate extraction of teeth is not warranted
- **ONLY use this when extraction of the teeth is not warranted
- gprosthesis
- IF patient has a lot of bone loss but no active disease, then may consider transitional removalble denture
- *** DO NOT USE THIS DURING ACTIVE DISEASE
Treatment removable complete denture:
- Used as a carrier for treatment material
- Patient that has an existing denture and causing irritation to their soft tissue,
- Tends to shrink the tissue and get them healthy before we take impression for final protheses.
- Cover as protective layer for patient site
o Realigning these immediate dentures as tissue is resorbed
o Denture does not fit as well and could potentially irritate the tissues underneath the protheses
Prosthodontics:
- Branch of dentistry pertaining to the restoration and maintenec of oral function, comfort, appearance, and health of the patient by restoration of natural teeth or replacement of missing teeth and oral and maxillofacial tissues with artificial body parts
- prothetics more prone to head and neck area
What are the three branches of prosthodontics?
o broken into fixed, removable, and maxillofacial prosthodontics
o fixed dental prothesis
replacement and restoration by artificial substitute that cannot be removed , screwed in into the implants
o fixed partial denture
screwed mechanically
o Removable
replacement of teeth and tissue structures for edentulous or partially edentuolous patients with artificial parts that are removable by the patient
SOOO difference between fixed and removable is whether the patient can remove it or not ( the protheses)
TRUE
What does the removable prothesis include?
removable protheise is not just an RPD, + INCLUDE CATegory of C.D.
**RPD+CD **(Category)
REmovale partial denture:
Partially edentulous patient that is an artificial replacement : RPD
-PATIENT CAN REMOVE PROTHESIS
-RPD
Removal is divided into two groups:
1- Extension base RPD or tooth- tissue supported RPD
Supported and retained by natural teeth only at one end of the denture base, and the occlusal load is carried by both the remaining teeth and the edentulous ridge
- Also called TOOTH+TISSUE supported RPD support for prothesis from teeth and soft tissue= “composite support”
Examples: bilateral distal extension RPD (kennedy I), and unilateral distal extension RPD (k:class2), anterior extension RPD (class 4)
Residual ridge or edentulous ridge/ edentuolous ridge
the residual bone with its soft tissue convering that remains after the extraction of the teeth
Basal seat:
- The oral tissue and structures of the residual ridge supporting the denture, base are referred to as the basal seat or denture foundation area
OT + RR
Composite support:
support derieved from both the basal seat and the remaining teeth (K 1 and 2, and some 4)
2- Tooth supported RPD
- Entirely supported by the remaining teeth at each end of the edentulous area
Abutment a tooth
that part of the dental implant which served to support and/ or retain the prosthesis
- Anytime something is used as an abutment to support and retain prothesis= considered abutment
example: implant
Retainer:
- The portion of a fixed or removable partial denture that attaches the prothesis to an abutment
DENTAL SURVEYOR:
used to design an RPD: determine the relative of parreleism of two or more axial surfaces of a cast of the dental arch
- Locate and delineate the contours and relative positions of abutment teeth and associated structures
HEIGHT OF CONTOUR:
- **On any given abutement tooth is depednant upon what the selected axial postion is **= in RPD= path of insertion
Undercut:
- Portion of tooth is below the heigh of contour and above the gingiva
- Other names: infrabulge or retentive area
- Used in reference to an abutment tooth
Support area:
- Area of the tooth which is occlusal or incial to the HOC as shown by surbey line
- CONVERGES to the occlusoal/ incisal
- Other names: nonretentive area or supravulge
- NOT USED FOR RENTION, HOWEVER++++USED FOR SUPPORTTT
Angle of cervical convergence
- Located apical to the HOC on an abutment tooth
- IMPPP bc can tell you how quickly you will get to the size of undercut that you would like to use for that particular abutment tooth
- Can use the analyzing rod or undercut gauge
Retention
- Quality of a denture that resists the vertical forces attempting to dislodge it
Stability:
- Quality of prothesis to be firm+ stead+ constant+ to resist displacement by functional, horizontal or rotational forces
ComponentsL
1Major components,
2Minor components
3Direct retainer
4Stabilizing or reciprocal componinsent
5Rest
6Base- at least one- with teeth
7Indirect retainer
Major connector
goes from one side of the tooth to the other, must use BOTH SIDES, else will damage soft tissue and teeth
Lingual bar:
- Major connector- must be rigid
- Superior border must be a minimum of 3 mm
- Want to get as inferior in the floor of the mouth without irritating the tissue
- Major connectors connect one side of the arch to the other side and provides cross stability – must be rigid
- Must have 8mm from most inferior part of major connector to the gingival margin
o How to measure?
o Measure with a perio probe - PLEASE NOTE: the amount of room you think you have on your cast is not always the amount of room you actually have in the patient’s mouth
Lingual plate:
Similar, except is that it extends on the lingual of anterior teeth
- Used for High lingual frenum or
- space available less than 8mm
- NOTE: lingual bar would be preferred because its more hygienic and patient is less likely to get caries
- Another option: sublingual bar (not used as much)- turns 90 degrees on itself and more horizontal, problem? More irritation and get in the way of the tongue
- Kennedy class 1 where the residual ridges have undergone extreme resorption
- Can be used to stabilize periodontally involved teeth
- Useful when future loss of the incisor is anticipated
- Major connector position onto the tooth, on the lingual of tooth (3 mm away), never at gingival margin
- SOOOO EITHER ON THE TOOTH OR 3mm away (mandibular)
Labial bar (not often)
- Extreme lingual tilting (inclination) of the remaining lower incisor teeth and lower premolars, molars= can’t put a lingual bar= flip it= put it on labial= cannot get any type of major connector on the lingual without it hanging out in space
- May have inoperable lingual tori!!! LIKE ME SO I’D NEED A LABIAL BAR
- Severe and abrupt lingual tissue undercuts make it impractical to use a lingual bar or plate
Palatal plate:
- Must be: anterior borders are placed at a minimum of 6mm away (MAJOR DIFFERENCE BETWEEN MAXILLARY AND MANDIBULALR) from gingival margins or it can cover the cingulum of all the teeth (NEVER ON GINGIVAL MARGIN)
- If we would extend the posterior border to the vibrating line= food and debris might get into the connector and you don’t want that
- Posterior borders are extended to the junction of the hard and soft palate on an extension base RPD or anterior to the vibrating line
Single palatal strap:
- Strap is minimum of 8mm in width
- Bilateral tooth-supported rpd, especially with short edentualous spans
- Want to keep the palatal strap within the borders of the 4 supporting rests and cross perpendicular to midline
- JUST MAKE SURE you ha ve enough width so it doesn’t flap
- Should NOT be used to connect anterior edentulous areas with distal extension bases
Single palatal bar:
similar to single palatal STRAP
- A connector that is less than 8mm in width is called a bar- thicker so it doesn’t have flexure
- Must have have adequate thickness for rigidity to provide cross arch stabilization
Anterior posterior palatal strap (MOST COMMON IN MAXXILLARY ARCH)
- Want to get the anterior border of the anterior strap should be located as far posteriorly as possible
- Anterior border falls on the posterior slope to avoid making a bulk by avoiding convex surfaces
- The posterior border of the anterior strap ends on the anterior slope of the rugae if present avoiding adding bulk by avoiding convex surfaces
The anterior has to be 8-10 mm
The posterior has to be 8mm in width= to prevent flexor
The posterior strap is never on the movable tissue= bc the patient will get food and debris will be stuck there
Anterior-posterior palatal bar requirements
(SIMILAR TO the anterior-posterior palatal strap EXCEPT IS THAT we are not getting the width that we get with the strep= must make it thicker and get a bar in the anterior and a bar in the posterior
- Stay away from patients that don’t have this already
- The posterior is ½ ovoid to make it comfortable for the patient if the tongue rubs against the area
- Can be used when abutments are widely spaced, can be used to avoid palatal torus
- We don’t have enough room anterior/posterior/both to place a strap
U-shaped palatal connector:
Also called horseshoe
- Band of metal running along the lingual of the teeth and must be at least 7-9mm wide
- Used when large torus palatal exists
- Used when several anterior teeth are to be replaced on a kennedy class 3 or 4
- Most commonly misued major connecetor
SUMMARY OF MAX CONNECTORS
- anterior-posterior major connector may be used with any kennedy classification most frequently used with class 2 and
- A single wide palatal strap mist used in the kennedy class 3
- Palatal plate used with kennedy class 1 (when pt has a lot of missing teeth, maybe just 6 anterior teeth left)
- Avoid u-shape major connector when a class 1 or 2 design except when inoperable palatal torus is present
MINOR CONNECTOR:
- Componenet of rpd that connect to the major connector
o Rests
o Indirect retainers
o Direct retainers
o Base
DR. BI
o ANYTHING ATTACHED TO MAJOR CONEECTOR IS A MINOR CONNECTOR
TRUE
DIRECT RETAINER:
- Rpd that engages in the occasional direction, when eating it falls out, or fall when talking
- Flexes into an undercut, the only part of the denture that goes into an undercut
- Examples: intracoronal retainer (internal attachment)- is attached totally within the confines of the cusps and normal proximal/axial contours of an abutment tooth
- Examples: extracoronoal retainer (external attachment) is one which outside or external to the crown portion of a natural tooth, restoration, partial, or complete crown
