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RPD - Su15 > lec 1 > Flashcards

lec 1 Flashcards

1
Q

what is an RPD

A

A biomechanical prothesis that replaces teeth or tooth in a partially dentate arch. Removable from the mouth and replaced at patient’s will.

biomechanical - incorportates clinical and xray findings into the design

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2
Q

4 treatment options for replacing teeth

A
  1. No treatment
  2. implant supported restoration
  3. fixed partial denture = BRIDGE
  4. removable partial denture
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3
Q

Why is a fixed option usually the treatment of choice?

A

fixed:

  1. implant supported restoration
  2. fixed partial denture = bridge

b/c it feels more like their own teeth and functions better

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4
Q

waht are the 10 indications for RPD?

A
  1. long edentulous span
  2. abscence or inadequate periodotnal support
  3. cross arch stabilization
  4. distal extension
  5. structually and anatomically comprised abuntment
  6. need to restore hard and soft tissue contours
  7. age and health
  8. anterior esthetics
  9. attitude and desire of pt
  10. ease of plaque removal
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5
Q

waht is the #1 indication of RPD?

A

distal extension

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6
Q

if a pt has HIGH caries risk, why is RPD a good option?

A

ease of plaque removal

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7
Q

future of RPD is good bc?

A
  1. aging population 65+ yo
    - now: 13%
    - future: double to 26%

[however edentulous pt are LOWERING]

  1. osteointegrated implants
  2. inexperienced dentists
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8
Q

Ossteointegrated implants

A
  1. implant supported restoratios - need for interim removable prothesis
  2. implant removable prothesis [same biomechanics principles but improved RPD versions using implants
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9
Q

why are implants not likely to replace implants?

A
  • high cost
  • other factors
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10
Q

For edentulous pts –> complete dentures

waht is the ONE source taht completely supports the teeth?

A

oral mucosa

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11
Q

for edentulous pts –> complete dentures

we have TOTAL CONTROL over the setup of their teeth bc we are _________ them

A

rehabilitating them

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12
Q

why are RPD pt more difficult to treat than complete edentulous pts?

A

presence of remaining teeth:

  • caries
  • severe occlusal wear
  • malpositioned teeth
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13
Q

2 sources of support for RPD

A
  1. oral mucosa
  2. abuntment teeth
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14
Q

Remaining teeth pose a problem for RPD pts bc:

A
  1. reduced VDO
  2. occlusal plane discrepancy
  3. unstable centric occlusal contacts –> loss of posterior support
  4. compromised esthetics
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15
Q

treatment goals or objectives with RPD

A
  1. stablize individual arch and protect remaining structure
  2. organize interach function:
    - VDO
    - occlusal plane
    - centric
    - esthetics
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16
Q

3 things for well designed RPD

A
  1. cross arch stabilization, crossing the midline
  2. unite remaining teeth
  3. restores function and controls the direction of the force over the remaining teeth and tissue
17
Q

Controlling the direction of the forces over the remaining teeth and tissue for:

A

VDO

occlusal plane

centric

18
Q

5 parts to a well designed RPD

A
  1. Rests - main support for vertical forces
  2. major connectors - has to be very rigid and stiff to provide cross arch stabilization and connect all arches into one
  3. minor connectors/ proximal plates - anything that connects the rests to the major connectors
  4. denture base connectors - provides mechanical retention
  5. retainers - aka clasp or ibar
19
Q

3 requirements to successful RPD r

A
  1. retention - resistance vertical dislodging forces
  2. stability - resistance to horizontal or torsional forces

3 . support - resistance to occlusal or vertical seating forces

20
Q

which of the 5 design parts of an RPD is most important

A

rest

why?

supports the vertical forces

21
Q

why is support the most important

A

bc support protects the remaining structrures:

  • overlying bone
  • teeth
  • mucosa
22
Q

what are the main/primary support of RPD

what are 2ndary suport

A

-primary is RESTS - controls the direction of the force over the vertical axis of the teeth

[when rest are placed on the tooth = primary support]

-secondary support: major connectors and denture base connectors

23
Q

stability is?

A

resistance to horizontal and torsional forces

comes from:

  1. proximal plates <<< Main
  2. lingual plates
  3. rests
  4. denture base connectors
  5. bracing clasp arms
24
Q

retention?

A

resistance to vertical dislodgment forces

from:

  1. retainers <<< mostly
  2. parallel guiding planes
  3. indirect retainers [for extension base RPDs only]
25
Q

Diagnosis includes

A
  1. patient evaluation - CC, expectation, attitude
  2. History - dental [had they have RPD b4] and medical [any systemic diseases taht will affect our prognosis and tx plan
  3. oral exam - hard tissue [lingual and palatal tori, teeth [malpositioned, caries, periodotnal status], maxillo-mandibular relationship - class III is the most difficult to treat]

soft tissue - frenum location, denture bearing surfaces, attached gingiva, ht of soft tissue contour

  1. habits - like tongue thrust
  2. radiographs - pathology and abuntments
  3. mounted diagnostic casts - with CR in proper VDO
26
Q

When making the mounted casts what are the steps?

A
  1. prelimanary impressions
  2. study casts
  3. RPD design on paper and on study casts
    - survey
    - MAP [most advantageous position] - path of insertion and withdrawl for RPD
    - prep study casts
  4. prep typodont [pt]
  5. final impression
  6. master casts
27
Q

goals of alginate impression for study casts

A
  1. capture all remaining teeth and soft tissue surfaces
  2. surfaces taht will be in contact with the future RPD
  3. occluding tooth surfaces
  4. critical landmarks:
    - retromolar pad
    - hamular notch
    - vestibular debths and edentulous regions
    - lingual frenum attachment
28
Q

waht are the criterias for stock tray selection for alginate impression

A
  1. have even thickness of 3 -4 mm of alginate
  2. test the stock tray in the mouth - should not be impinging anywhere and captures all the structures
  3. check the length of the tray using a mouth mirror
  4. tray alternations:
    - high palatal vault : rope wax or compound to have 3 -4 even thickeness
    - periphery wax for tray extension
29
Q

Alginante impression directions

A
  1. dispense entire pouch content into mixing bowl
  2. add 1 full water (3 parts) with 73 degrees into mixing bowl
  3. mix 1 min for creamy consistency
  4. have the pt rinse with warm water
  5. fill tray, insert into the mouth using a mouth mirror, hold for 1 min till the stickiness is gone
  6. break seal with one snap motion
  7. rinse debris and blood from impression
  8. pour up cast immediately

past 10 min is no longer accurate

30
Q

mixing time ____

total working time _____

initial setting time ____

A

mixing time 1 min

total working time 2 min and 15 sec

intial setting time 2 min and 30 sec

31
Q

setting time is waht?

A

time you beginning mixing to the time the impression hardens

3 min and 30 sec

32
Q

pour up the impression

A
  1. measure the proper water to power ratio
  2. mix into vaccum power mix for even thickness
  3. gentle vibration, flow the stone into indentations of impression
  4. avoid air bubbles
  5. bottom surface of the base should be rough to facilitate adding of base
  6. suspend poured impression by tray holder
  7. once stone fully set invert the cast and add base

base 10 -15 mm thickness

  1. afte 1 hour separate the cast from the impression
33
Q

trimming directions

A
  1. begin trim only AFTER 24 HOURS
  2. soak cast in slurry water for 5 min
34
Q

why should you soak the stone in slurry water for 5 min before trimming?

A
  1. prevent damage to the cast
  2. prevent sludge from adhereing
35
Q

why should the cast NEVER be soaked in water or rinsed?

A

dental stone is water solubel

36
Q

trim base to be ____ mm

land should be ___ mm

A

10 - 15 mm base

4 mm land

37
Q

why do we ask the patient to stick their tongue out and stay on top of the tray when pouring impressions for MAN?

A
  1. to capture the lingual frenum at its full extension
  2. related to the choice of major connector
38
Q
A

RPD - Su15 (1 decks)

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