Par 2 - RPD Delivery Flashcards
what are the areas to watch out for when evaluating tissue adaptation?
- bony prominences
- frenal attachments
- tissue undercuts (mylohyoid area, lateral surfaces of tuberosities)
What is the purpose of phoenix?
to identify overextension
- more imp. for DE’s bc they require max extension
When would you do an intraoral occlusal adjustment of an RPD? An extraoral occlusal adjustment?
Intraoral: ex. Kennedy class 3; stable contacts & supported
Extraoral: requires clinical remount due to poor support; ex. distal extension
What are indications for extraoral correction of an RPD?
- RPD w/ long extension base
- extension base RPD w/ mobile soft tissue
- RPD opposed by complete denture
What are the steps for a clinical remount?
- Acquire accurate interocclusal record
- Remove RPD & bite registration from mouth
- Make alginate “pick up” impression w/ RPD fully seated in mouth (block out undercuts & pour w/ RPD in impression)
- Mount RPD against opposing cast or denture
What are the advantages of clinical remount?
- consistent, repeated closure
- static - no tissue compression
- better visibility
If you had more than 1 rpd, which one would you adjust first?
- 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.
Describe the #139 plier.
“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
Describe the #200 plier.
“three-pronged”; only time you will use this in clinic is if you are adjusting retentive portion of a T-clasp
What would cause tongue biting?
If you have the posterior teeth set to lingual
What could resolve cheek biting from RPD?
make sure you have some horizontal overlap in the posterior teeth to help protect against cheek biting
What would cause gagging from an RPD?
MX major connector not being properly adapted to the palate (usu due to poor impression)
What would cause a sore tooth from an RPD?
retentive clasp being too tight OR a rest that is interfering w/ occlusion (may be too high)
Rests & clasps must be at least ___ mm thick.
1 mm
What does PDI stand for and what does it determine?
PDI = Prosthodontic DIagnostic Index; determines complexity of case
What are the PDI Classifications?
Class I: ideal or minimally compromised
Class II: moderately compromised
Class III: substantially compromised
Class IV: severely compromised
What are the 4 diagnostic categories for PDI?
- location & extent of edentulous area(s)
- condition of abutment teeth
- occlusal scheme
- residual ridge
What is important/special about PDI Class IV?
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.
Missing teeth in only one arch is what PDI Class?
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
What is the radiographic MD ridge height for a PDI Class I?
21 mm
Missing teeth in both arches is what PDI Class?
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)
What is the radiographic MD ridge height for a PDI Class II?
16-20mm
Describe PDI Class III.
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)
What is the radiographic MD ridge height for a PDI Class II?
11-15mm
Describe PDI Class IV.
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)
What is the radiographic MD ridge height for a PDI Class IV?
10mm or less
What are 2 possible causes of PDI Class IV?
- severe wear
2. loss of posterior support
