Par 2 - RPD Delivery

Question 1

what are the areas to watch out for when evaluating tissue adaptation?

Answer 1

1. bony prominences
2. frenal attachments
3. tissue undercuts (mylohyoid area, lateral surfaces of tuberosities)

Question 2

What is the purpose of phoenix?

Answer 2

to identify overextension

- more imp. for DE’s bc they require max extension

Question 3

When would you do an intraoral occlusal adjustment of an RPD? An extraoral occlusal adjustment?

Answer 3

Intraoral: ex. Kennedy class 3; stable contacts & supported

Extraoral: requires clinical remount due to poor support; ex. distal extension

Question 4

What are indications for extraoral correction of an RPD?

Answer 4

1. RPD w/ long extension base
2. extension base RPD w/ mobile soft tissue
3. RPD opposed by complete denture

Question 5

What are the steps for a clinical remount?

Answer 5

1. Acquire accurate interocclusal record
2. Remove RPD & bite registration from mouth
3. Make alginate “pick up” impression w/ RPD fully seated in mouth (block out undercuts & pour w/ RPD in impression)
4. Mount RPD against opposing cast or denture

Question 6

What are the advantages of clinical remount?

Answer 6

1. consistent, repeated closure
2. static - no tissue compression
3. better visibility

Question 7

If you had more than 1 rpd, which one would you adjust first?

Answer 7

• If one RPD is tooth-supported & the other is DE, adjust the tooth supported RPD’s occlusion first.
  OR
• (if you have 2 tooth-supported or 2 DE RPD’s) Adjust the one that occludes with the most natural teeth first.

Question 8

Describe the #139 plier.

Answer 8

“bird-beak”; has one rounded beak & one flat beak; place rounded end inside the clasp toward the tooth & apply pressure w/ oppos hand; use this plier most often
- bend in a plane perpendicular to flat surface of clasp

Question 9

Describe the #200 plier.

Answer 9

“three-pronged”; only time you will use this in clinic is if you are adjusting retentive portion of a T-clasp

Question 10

What would cause tongue biting?

Answer 10

If you have the posterior teeth set to lingual

Question 11

What could resolve cheek biting from RPD?

Answer 11

make sure you have some horizontal overlap in the posterior teeth to help protect against cheek biting

Question 12

What would cause gagging from an RPD?

Answer 12

MX major connector not being properly adapted to the palate (usu due to poor impression)

Question 13

What would cause a sore tooth from an RPD?

Answer 13

retentive clasp being too tight OR a rest that is interfering w/ occlusion (may be too high)

Question 14

Rests & clasps must be at least ___ mm thick.

Answer 14

1 mm

Question 15

What does PDI stand for and what does it determine?

Answer 15

PDI = Prosthodontic DIagnostic Index; determines complexity of case

Question 16

What are the PDI Classifications?

Answer 16

Class I: ideal or minimally compromised
Class II: moderately compromised
Class III: substantially compromised
Class IV: severely compromised

Question 17

What are the 4 diagnostic categories for PDI?

Answer 17

1. location & extent of edentulous area(s)
2. condition of abutment teeth
3. occlusal scheme
4. residual ridge

Question 18

What is important/special about PDI Class IV?

Answer 18

If you don’t have enough inter-arch space & have to increase VDO, you will lose natural teeth contact. This is ALWAYS a PDI Class IV situation.

Question 19

Missing teeth in only one arch is what PDI Class?

Answer 19

Class I

1) Location and extent of edentulous areas: confined to single arch
2) Abutment condition: ideal or minimally compromised
3) Occlusion: ideal or minimally compromised (CLASS I OCCLUSION)
4) Residual ridge morphology: conforms to Class I complete edentulism – radiographic mandibular ridge height 21 mm

Question 20

What is the radiographic MD ridge height for a PDI Class I?

Answer 20

21 mm

Question 21

Missing teeth in both arches is what PDI Class?

Answer 21

Class II

1) Location & extent: Edentulous areas in both arches
2) Condition of abutments: Abutments in 1 or 2 sextants have insufficient tooth structure to retain intracoronal or extracoronal restorations.
3) Occlusion: Require localized adjunctive therapy.
4) Residual ridge morphology: Class II complete edentulism (16-20 mm)

Question 22

What is the radiographic MD ridge height for a PDI Class II?

Answer 22

16-20mm

Question 23

Describe PDI Class III.

Answer 23

1) Location & extent: confined to one or both arches.
- any posterior maxillary or mandibular edentulous areas greater than 3 teeth or 2 molars, or any edentulous areas of 3 or more teeth.
2) Condition of abutments: Abutments in 3 sextants have insufficient tooth structure to retain intracoronal or extracoronal restorations.
3) Occlusion: Reestablishment of entire occlusal scheme (without change in VDO)
4) Residual ridge morphology: Class III complete edentulism (11-15 mm)

Question 24

What is the radiographic MD ridge height for a PDI Class II?

Answer 24

11-15mm

Question 25

Describe PDI Class IV.

Answer 25

1) Location & extent: extensive and occur in both arches
- include acquired or congenital defects, at least 1 edentulous area has guarded prognosis
2) Condition of abutments: In 4 or more sextants have insufficient tooth structure
3) Occlusion: Reestablishment of entire occlusal scheme with change in VDO
4) Residual ridge morphology: Class IV complete edentulism (10 mm or less)

Question 26

What is the radiographic MD ridge height for a PDI Class IV?

Answer 26

10mm or less

Question 27

What are 2 possible causes of PDI Class IV?

Answer 27

1. severe wear

2. loss of posterior support