Module 2 Flashcards
The art of identifying a disease from its signs and
symptoms
DIAGNOSIS
Requires the careful evaluation of all pertinent
diagnostic data.
TREATMENT PLAN
A mandatory first step in the treatment of any patient.
DIAGNOSIS AND TREATMENT PLANNING
THREE PHASES OF PLANNING PROCESS
- Examination
a. History
b. Oral examination (visual-digital
examination)
c. Radiography survey
d. Study cast analysis - Selection of the prosthetic service to be
prescribed - Formulation of the treatment plan
Comprehensive understanding of the individual who is
wearing the prosthesis is essential in the selection of the
most appropriate prosthetic service and formulation of
a through treatment plan
EXAMINATION
The examination is divided into
a. Preliminary examination
b. Definitive examination
The medical history may be obtained by using the
“vending machine method”
MEDICAL HISTORY
the anemic patient may have a:
● Pale mucosa
● Reduced salivary output
● Sore red tongue
● Infrequently bleeding gums
ANEMIA
patients with uncontrolled diabetes are:
● Poor risk for prosthodontic therapy
● Dehydrated; diminution in salivary flow
● Macroglossia; tongue is red & sore
● Teeth frequently loosen due to alveolar
breakdown
● Generalized osteoporosis
● Bruises easily & heals slowly
DIABETES
the patient suffers:
● Rapid destruction of the alveolar bone
● Generalized osteoporosis
HYPERPARATHYROIDISM
patient:
● Shows no oral symptoms
● Early loss of deciduous teeth followed
by an accelerated eruption of
permanent teeth
HYPERTHYROIDISM
patients:
● Usually take phenytoin (dilantin,
sodium), a drug that usually produces
hypertrophy of oral mucosa.
● Gingival surgery is usually indicated
before construction of a removable
prosthesis
EPILEPSY
treatment of patients with arthritis
usually raises the question whether the
disease has affected the TMJ.
ARTHRITIS
➝ Easy to treat
➝ Well adjusted and easy going
➝ Accept their share of responsibilities and
recognizes the need for replacement of the
missing teeth
➝ They have the role in maintaining their dental
health
➝ Easily adjust to any properly constructed
denture
➝ Does not present problems for the dentist
PHILOSOPHICAL PATIENT
➝ Precise in everything they do
➝ Can only be satisfied by perfection
➝ Many demands, the dentist need to explain the
treatment step by step in detail
➝ Additional appointment is needed, due to the
dentist’s extreme care, effort & patience
➝ High expectation, difficult to treat
EXACTING PATIENT
➝ Emotionally unstable
➝ Excessively apprehensive to dental treatment
➝ Complaint without justification
➝ They are never going to wear the prosthesis
➝ Cannot accept responsibilities for any of their
dental problems
➝ With chronic or debilitating disorder which are
depressed
HYSTERIC PATIENT
➝ Lack of motivation and care to the oral health
➝ Uncooperative, ignores any instruction given for
the success of the treatment
➝ No concern in their appearance even numerous
anterior and posterior teeth are missing
➝ Prognosis of RPD treatment is poor
INDIFFERENT PATIENT
Putting the initial contact with the patient in its proper
perspective. The few minutes spent with the patient are
the most important period the dentist spends with the
patient.
COVERT EXAMINATION
- Clinical Examination
- Radiographic interpretation of caries
- Underlying bone support
- Condition of existing restoration
- Questionable abutments
- Periodontal support
- Tooth mobility
ORAL EXAMINATION
A vital and valuable contribution to ascertain how the
patient arrived at his/her present state of
semi-edentulousness
DENTAL HISTORY
- Good lighting
- Clear mouth mirror
- Sharp explorer
- Calibrated dental probe
VISUAL AND DIGITAL EXAMINATION
Types of food impaction:
forceful wedging of food against gingival tissues and into
the interproximal spaces through occlusal pressure.
VERTICAL FOOD IMPACTION
● Scale: excellent, fair, poor
● Poor oral hygiene - presence food particles, bacterial
plaque or calculus
● When an RPD is inserted it is important that the
patient’s remaining natural teeth and tissues receive
consistent and meticulous cleaning in order for an
acceptable degree of health is maintained.
ORAL HYGIENE STATUS
● Check for areas of erosion and abrasions, extent of
carious activity and degree of carious susceptibility
● If dental caries is significant problem, basic decision will
depend on the potential ability of the patient to control
the disease
● All carious lesion should be restored before
prosthodontic treatment begins
CARIOUS LESION AND MISSING TEETH
Types of food impaction:
forceful wedging of food between the teeth by the tongue,
lips and cheeks
HORIZONTAL FOOD IMPACTION
● Coral pink in color
● Dull translucent
● Orange peel appearance (stippling)
NORMAL GINGIVA
● Red
● Smooth and shiny gingiva
● Blunting and thickening of the gingiva
GINGIVITIS
CLASSIFICATION OF TOOTH MOBILITY
greater than normal; less than 1mm. movement in any
direction
CLASS I
CLASSIFICATION OF TOOTH MOBILITY
tooth moves 1mm. From normal in any direction
CLASS II
CLASSIFICATION OF TOOTH MOBILITY
tooth moves more than 2.0mm. In any direction including
rotation and depression
● Physiologic movement is barely discernable
● Change in normal physiologic movement may
indicate traumatic occlusion or presence of
periodontal disease, in class III mobility, this
exhibits poor prognosis which necessitate
extraction
CLASS III
Location and appearance of any ulcerations, areas of
inflammation or suspicious lesion should be noted
ORAL MUCOSA
This should be visually inspected and palpated with the
aid of the finger tip
RESIDUAL RIDGE
Whether palatal or lingual torus, the location should be
recorded and if surgical intervention is necessary, it
should be noted
TORUS
● Teeth
● Supporting tissues
● Jaw bone
PANORAMIC RADIOGRAPH
Patients are requested to touch the teeth lightly
together slowly until first contact is felt and then to
close all the way, presence of slide between the initial
contact and maximum intercuspation indicates a
discrepancy in jaw closure between centric relation
and centric occlusion.
OCCLUSION
It is important to measure radiographically the quality
of the alveolar support of potential abutments.
Consideration must be made regarding the ff:
a. Support offered to the abutment teeth adjacent
to the distal free end edentulous areas
b. Need for splinting to the adjacent tooth
c. Selection of clasp assembly design
d. Selection of impression materials and techniques
PERIAPICAL RADIOGRAPH
MOUNTED DIAGNOSTIC CAST
Evaluation of the following areas:
● Occlusal relationship
● Plane of occlusion
● Abutment teeth contour
● Rest seat areas
● Interarch space
● Ridge relationship
● Soft tissue
the way the px walks
Gait
1-2mmm
Sulcus depth
poor oral hygiene
White lesion
plaque or calculator deposits
Gingivitis cause
cancerous
Red lesion
is used to monitor the bone
development
Cephalometric x ray
How to measure length of crown and root:
Crown: incisal to crest of the bone
Root: crest of the bone to tip of root
the area covered by the abutment
teeth must be equal or greater compared to the
total teeth being replaced.
Ante’s Law
horizontal relation
Plane of occlusion
