Midterm Review Flashcards
what percent of adults (age 20-64) have missing teeth (excluding 3rd molars)?
52%
what is associated with increasing the probability of tooth loss?
The CDC reports that tooth loss increases directly with diabetes, indirectly with dental visits, indirectly with education, indirectly with income, varies by ethnicity, and is unaffected by gender
what behaviors decrease tooth loss predictability?
-in general, people who brush and floss regularly have fewer missing teeth than those who don’t brush or floss regularly -I honestly don’t understand how this answers the question, but this was what was in the review ppt…
what is masticatory ability?
a subjective assessment that is focused on the patients reported psychological assessments
what are the problems noted by partially edentulous patients regarding their teeth?
uncomfortable, uptight, embarrassed, and self conscious
what does NOT bother partially edentulous patients about their teeth?
interrupting meals, pain/aching, poor diet, speech, and function
what is masticatory efficiency?
an objective assessment that is focused on chewing efficiency measured by the size of particles sieved after patients chew their food
What macro nutrient do PE patients struggle acquiring?
-folate mostly -also fiber, magnesium, and iron
What vitamin or mineral do PE patients have a deficiency in?
-fiber, magnesium, and iron are deficient -vitamin C, vitamin K, and sodium are low, but are still sufficient for a healthy diet
What foods do PE patients routinely not eat?
dark green vegetables, orange vegetables, legumes, and whole grains
What number of missing teeth is cited as “problematic” in chewing?
-20 Teeth or less is usually considered the baseline of disease -so, 8 missing teeth, excluding 3rd molars
Does PE increase the fraction size of the food boli, and therefore does PE with 10 or more missing teeth impact patients’ “masticatory efficiency?”
-It is probable that self-assessment of chewing ability is, in general, too optimistic when compared with the results of objective tests -missing functional tooth units leads to 50% of the reason why food isn’t getting fractioned down in partially edentulous patients
What are the contemporary common solutions to PE?
As far as solutions go for missing teeth dentists currently offer four to six solutions: 1) Removable Partial Denture, 2A) Fixed-Partial Denture (bridge), 2B) Fixed-Partial Denture (cantilever), 2B) Fixed Partial Denture (Maryland bridge), 5A) Single-Unit dental implant, 5B) Multiple-Unit dental Implant
What are the SPECIFIC and GENERAL problems with the current solutions to PE?
1) Intervention does not fix patients’ ability to speak or taste (functional limitations) and sometimes our intervention makes these things worse 2) Interventions are not going to improve their food selections (physical limitation) 3) Interventions won’t help people feel more satisfied with life or more able to function (incapacity)
Describe the state of the literature regarding, the quality of evidence in determining the value of one prosthetic over another.
-there is insufficient evidence to recommend one prosthetic intervention versus another for patients with partial edentulism -Due to the low scientific evidence of the included studies, it was not possible to compare various treatment methods used for rehabilitation of single tooth loss of partial edentulism
Describe the state of the literature regarding, the quality of evidence in determining the value of one prosthetic over another.
-there is insufficient evidence to recommend one prosthetic intervention versus another for patients with partial edentulism -Due to the low scientific evidence of the included studies, it was not possible to compare various treatment methods used for rehabilitation of single tooth loss of partial edentulism
what are the positive reactions to current solutions to PE?
1) Intervention does relieve patients’ psychological discomfort/pain during eating (physical pain) 2) Intervention does reduce self-consciousness and feelings of tension about the teeth (psychological discomfort) 3) Interventions will make people more relaxed and less embarrassed (psychological limitation); 4) Interventions will help FPD wearers and middle agers feel less irritable with others and more able to do their jobs (social limitations)
what is meant by a “heuristic”?
enabling a person to discover or learn something for themselves
what would a common heuristic outline of prosthetics would look like for no treatment, RPD, 3-unit FPD, single implant, and multiple implants? include cost, function, longevity, satisfaction, and oral health risk
How do removable partial dentures effect those on the island of disease, and how should dentists best help those with PE who are receiving removable partial dentures, specifically with respect to periodontal disease?
Removable partial dentures do not cause any adverse periodontal reactions, provided that pre-prosthetic periodontal health has been established and maintained with meticulous oral hygiene. Frequent hygiene recalls and prosthetic maintenance are essential tools to achieve a good long-term prognosis.
How do removable partial dentures effect those on the island of disease, and how should dentists best help those with PE who are receiving removable partial dentures, specifically with respect to caries?
multiple studies…
- 2 years after restoration of lower shortened arches, there was a significantly greater incidence of new and recurrent caries lesions in subjects restored with RPDs compared with cantilever RBBs
- caries was observed 6x more frequently in the RPD group than in the group with fixed restoration. occlusal and functional conditions deteriorated in the RPD group only
How do removable partial dentures effect those on the island of disease, and how should dentists best help those with PE who are receiving removable partial dentures, specifically with respect to survival rates of teeth adjacent to treated edentulous spaces?
spaces restored with an FPD had longer 10-year survival estimates than those that remained untreated. spaces restored with an RPD had the poorest 10-year survival rate
which kennedy classification is bilateral edentulous areas located posterior to the natural teeth?
class I
which kennedy classification is a unilateral edentulous area located posterior to the remaining natural teeth?
class II
which kennedy classification is a unilateral edentulous area with natural teeth remaining both anterior and posterior to it
class III
which kennedy classification is a single, but bilateral (crossing the midline), edentulous area located anterior to the remaining natural teeth?
class IV
T or F:
regarding kennedy classification, classification should follow rather than preced any extractions of teeth that might alter the original classification
true
regarding kennedy classifications, if a third molar is missing and is not to be replaced, is it considered in the classification?
no
regarding kennedy classifications, if a third molar is present and is to be used as an abutment, is it considered in the classification?
yes
regarding kennedy classifications, if a second molar is missing and is not to be replaced, is it considered in the classification?
no
regarding kennedy classifications, the most ___ edentulous area always determines the classification
posterior
regarding kennedy classifications, edentulous areas other than those that determine the classification are referred to as ___ and are designated by their ___
modifications, number
- what is the kennedy classification?
- what is the classification if you remove the centrals?
- what is the classification if you restore 1st molars with implants?
- what is the kennedy classification? Class 1
- what is the classification if you remove the centrals? Class 1 mod 1
- what is the classification if you restore 1st molars with implants? Class 3
- what is the kennedy classification?
- what if you are going to remove #20?
- what if you are going to restore 1st molars with implants?
- what is the kennedy classification? Class 1 mod 1
- what if you are going to remove #20? Class 2
- what if you are going to restore 1st molars with implants? Class 3
- What is the classification?
- What is the classification if you are going to remove # 16 and you don’t plan to replace it?
- What is the classification if you are going to remove # 15 & 16 and you don’t plan to replace them?
- What is the classification? Class 2
- What is the classification if you are going to remove # 16 and you don’t plan to replace it? Class 2
- What is the classification if you are going to remove # 15 & 16 and you don’t plan to replace them? Class 2
- What is the classification?
- What is the classification if you are going to remove # 18 and you don’t plan to replace it?
- What is the classification? Class 2 mod 2
- What is the classification if you are going to remove # 18 and you don’t plan to replace it? CLass 1 mod 1
- What is the classification?
- What is the classification if you lose 7-10?
- What is the classification if you lose 7 – 10 and bridge 14 – 16?
- What is the classification? Class 3
- What is the classification if you lose 7-10? Class 3 mod 1
- What is the classification if you lose 7 – 10 and bridge 14 – 16? Class 4
- What is the classification?
- What is the classification if you are going to remove place implant bridges on both sides from 1st PM to 1st molars?
- What is the classification? Class 3
- What is the classification if you are going to remove place implant bridges on both sides from 1st PM to 1st molars? Trick question! Not partially edentulous
- What is the classification?
- What is the classification if you place implants in 8 and 9 for single crowns to improve the hold?
- What is the classification if you place implants in 7 and 10 for an implant bridge?
- What is the classification? Class 4
- What is the classification if you place implants in 8 and 9 for single crowns to improve the hold? Class 3 mod 1
- What is the classification if you place implants in 7 and 10 for an implant bridge? Class 3 mod 1
- What is the classification?
- What is the classification if you lose #25?
- What is the classification if you lose 2nd premolars?
- What is the classification if you lose second premolars and first molars?
- What is the classification? Class 3 mod 1
- What is the classification if you lose #25? Class 4
- What is the classification if you lose 2nd premolars and keep #25? Class 3 mod 3
- What is the classification if you lose second premolars and first molars and keep #25? Class 3 mod 3
what lever classification is this?
class 1
what lever classification is this?
class 2
what lever classification is this?
class 3
name 3 ways you can weaken the force exerted onto the resistance in a class 1 lever system
- move the resistance farther from the fulcrum, and resistance on the force overpowers the force
- move the fulcrum closer to the force, and force on the resistance is weaker
- move the force closer to the fulcrum, and the force exerted on the resistance is weaker
name 3 ways you can weaken the force exerted onto the resistance in a class 2 lever system
- move the resistance farther from the fulcrum, and resistance on the force overpowers the force
- move the fulcrum closer to the force, and force on the resistance is weaker
- move the force closer to the fulcrum, and the force exerted on the resistance is weaker
name 3 ways you can weaken the force exerted onto the resistance in a class 3 lever system
- move the resistance farther from the fulcrum, and resistance on the force overpowers the force
- move the fulcrum closer to the force, and force on the resistance is weaker
- move the force closer to the fulcrum, and the force exerted on the resistance is weaker
what lever classification is this? (blue arrows point to resistance)
class 1
what lever classification is this? (blue arrows point to resistance)
class 2
what lever classification is this? (blue arrows point to resistance)
class 3
how do you identify the path of insertion using a surveyor?
- The Path of Insertion is the direct line the removable partial denture will take on insertion into the dentition.
- This picture illustrates how the surveyor can be useful in helping coordinate the many planes that need to be parallel in order to maintain just on path of insertion.
- Though it isn’t the only way, generally it is best to plan on the path of insertion being perpendicular to the plane of occlusion since patients tend to bite their partials into place.
how do you identify the height of contour line using a surveyor?
how do you identify undercuts using a surveyor?
The undercut is below the height of contour, but only the position where the undercut disc touches should the retentitive clasp touch. Were it to touch below the disc, it would be too hard to get in and out; higher than the disc, and its too easy to get the partial in and out.
how do retentive arms and reciprocal arms contribute to stability?
- Note that the “reciprocal arm” sits against the height of contour, and can resist horizontal forces by transferring those forces to the wall of tooth which is perpendicular to those said destabilizing forces.
- It is good to point out that the retentive arm touches above, on, and below the height of contour –and is therefore useful in destabilizing horizontal forces as well –even though not all the stabilizing walls are perpendicular to the forces.
how do major connectors contribute to stability?
- Rigid major connectors allow destabilizing forces to be spread across many teeth which push back on the destabilizing forces to increase stability.
- Major connectors transfer forces through their rigidity to other elements of the mouth, which increases the number teeth pushing back on the destabilizing forces, which greatly increases stability.
how do rests contribute to stability?
Metal “rests” sit in “rest seats” in teeth. Because “rest seats” are round on the contacting surface (to lessen the stress on enamel crystal structure) they have only a minor horizontal component that will resist destabilizing forces. Since the walls of the rest seats look like simple machine wedges, the horizontal forces tend to lift the rest from the rest seat and destabilize the partial.
what are 6 types of maxillary major connectors we need to know for this class?
A. single palatal strap
B. anterior-posterior palatal strap
C. palatal plate
D. U-shaped
E. single palatal bar
F. anterior-posterior palatal bars
what are the 2 types of mandibular major connectors we need to know for this class?
A. lingual bar
B. lingual plate
how do retentive arms, reciprocal arms, and guide planes synergistically stabilize partials to increase retention?
- consider the principle of “encirclement” which means that more than 180 degrees in the greatest circumference of the tooth, passing from diverging axial surfaces to converging axial surfaces, must be engaged by the clasp assembly
- When the guide plane the reciprocal arm and the retentive arm work to encircle the tooth, stability increases, which leads to increased retention.
how does changing the path of insertion change undercuts?
This picture is borrowed from McCracken’s text. Note that picture B shows a fundamental change in the height of contour from picture A because the table the egg sits on has had its plane changed. Note how by changing the plane of the table, the path of insertion changes, and when the path of insertion changes so do the undercuts. Can you engage an undercut in picture B below the letter A on the left side of the egg –how about in picture A, can you engage the undercut on the line below the arrow?
what is the difference between a tooth-supported partial and a tissue-supported partial?
- In this picture, you can see the difference between the R and L sides, which are tooth borne and tissue borne respectively. Tooth borne partials are far easier to construct, the real challenge in making partials is managing the distal extension partial denture cases.
- In a distal extension partial denture, denture bases that are not in tooth-supported modifications must contribute to the support of the denture. Such support is critical to the goal of minimizing functional movement and improving stability of the prosthesis. Although the abutment teeth provide support for the distal extension base, as the distance from the abutment increases, support from the underlying ridge tissues becomes increasingly important. Maximum support from the residual ridge may be obtained by using broad, accurate denture bases, which spread the occlusal load equitably over the entire area available for such support. The space available for a denture base is determined by the structures surrounding the space and by their movement during function.
what are the depth cuts for rest seats that provide fundamental support for anterior teeth?
what are the depth cuts for rest seats that provide fundamental support for posterior teeth?
