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Prosthodontics > partial dentures system of design > Flashcards

partial dentures system of design Flashcards

1
Q

what are some alternative treatments to partial dentures

A
  • no active treatment
  • fixed prosthesis, either conventional or resin bonded
  • implant retained prosthesis
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2
Q

why is it important for the clinicians to be the one to design the denture

A

we have seen the patient, know their story and what they expect
condition of the teeth, oral health
we have assessed current dentures and occlusion
have a more complete understanding of alternatives and can give clear cost information

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3
Q

what are the key principles to partial denture design

A

replace lost tissue and teeth, restore function, speech and aesthetics
minimise damage to adjacent teeth, restorations and tissues
designed with periodontal health in mind

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4
Q

what is the systematic approach to denture design

A

0 - case assessment
1 - classification of support for each saddle
2a - choose the denture base material
2b - connect saddles together
3 - choose the path of insertion and delineate undercuts
4 - resistant of movement away from the teeth
5 - indirect retention
6 - resistance of movement toward the teeth and tissues
7 - resistance to horizontal movement
8 - simplification

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5
Q

how are saddles connected together

A

connectors. literally.

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6
Q

what is surveying

A

choose the path of insertion and delineate undercuts

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7
Q

what is retention

A

resistance of movement away from the teeth

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8
Q

what is support

A

resistance of movement toward the teeth and tissues

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9
Q

what is bracing or reciprocation

A

resisting horizontal movement

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10
Q

label the partial denture and provide a short description of their function

A

from the top down

  • major connector (lingual bar) to connect the parts
  • cingulum rest (support and indirect retention)
  • acrylic tooth restoring natural tooth
  • pink acrylic restoring lost mucosa and bone
  • occlusal rest for support
  • ring clasp for retention
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11
Q

what is a saddle

A

an area of oral mucosa where teeth are being replaced

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12
Q

how are edentulous saddles classified for partial dentures

A

Craddock classification based on how the saddle is loaded. Kennedy classification based on the location of the saddles.

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13
Q

describe the craddock classifications

A

Class 1 - tooth borne
class II - mucosa borne
class III - tooth and mucosa borne
class IV - implant borne
class V - implant and mucosa borne

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14
Q

describe the Kennedy classifications

A

class I - bilateral free end saddle
class II - unilateral free end saddle
class III - single bounded saddle not crossing the midline
class IV - single bounded saddle crossing the midline

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15
Q
A

Kennedy class I

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16
Q
A

Kennedy class 2

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17
Q
A

Kennedy class III

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18
Q
A

Kennedy class IV

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19
Q

what is the difference between Kennedy class III and IV

A

III is not crossing the midline but IV does cross the midline

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20
Q

which saddle should be used to define the main Kennedy classifications

A

the most posterior saddle

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21
Q

what is the solution if there is more than 1 edentulous saddle

A

modifications are used to refine the basic classification, but the most posterior saddle will be used to define the main Kennedy classification

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22
Q

can you have a modification for all saddle classes

A

not class IV

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23
Q

what are the options for denture base material

A

acrylic
cobalt chrome
polyether ether ketone
flexible
gold

24
Q

what are the two types of connectors

A

major connectors which connect all the components
minor connectors which connect rests, clasps and bracing arms

25
Q

what are the common mandibular major connectors

A

acrylic plate, lingual bar, lingual plate

26
Q
A

acrylic plate

27
Q
A

lingual bar

28
Q
A

lingual plate

29
Q
A

mid palatal bar

30
Q
A

anterior palatal bar

31
Q

how to choose the path of insertion and delineate undercuts

A

surveying casts
surveyor or digital surveying
choose retentive elements
path of insertion and removal of the denture

32
Q

retention means…

A

resistance of the denture to vertical displacement lifting away from the tissues

33
Q

what are some common methods of retention

A

clasps
soft tissue undercuts
adhesion
friction
path of insertion
precision attachments and implants

34
Q

how is indirect retention achieved

A

by one or more indirect retainers that reduce the tendency for a denture base to move in an occlusal direction or rotate about the fulcrum line

35
Q

describe how the indirect retention occurs in this picture

A

incisal rest X transfers, but the fulcrum line AB to AC. as D rises on the new fulcrum, clasps act indirectly to resist this movement, the further C is away from AB the more effective the indirect retention will be

36
Q

what are the two methods of rests to support the partial denture

A

occlusal and cingulum rests

37
Q

what happens if there is inadequate denture support

A

It will sink into the tissues and traumatise them

38
Q

what can be done if there is insufficient occlusal space for a rest

A

prepare rest seats with a drill

39
Q

what is the horizontal movement that must be resisted in a partial denture

A

bracing of forward, backward and lateral dislodging forces

40
Q

what does reciprocation prevent

A

clasp arms moving the clasped tooth

41
Q

what do reciprocal arms do

A

prevent the tooth movement and engage the undercut

42
Q

why should partial dentures be kept simple

A

complex designs have complex failures and problems
patient prefers simple
meet the demands of economic viability of working within health services

43
Q

which saddle support is the least damaging

A

tooth borne

44
Q

what is a clasp

A

something resting on the tooth to reduce the tendency for the denture to move

45
Q

what are the functions of occlusal rests for partial removable denture

A
  • provide vertical support for the partial denture
  • maintain components in their planned positions
  • maintain established occlusal relationships by preventing settling of the denture
  • prevent impingement of the soft tissues
  • directs and distributes occlusal loads to abutment teeth
46
Q

what shape should occlusal rests be

A

rounded triangular shape with the apex toward the centre of the occlusal surface

47
Q

why do the clasps have to cover both sides of the tooth ie wrap around it

A

the tooth would move otherwise

48
Q

basic sequence of design

A

saddles
support
retention
bracing and reciprocation
connector
indirect retention
review of completed design

49
Q

what does RPD design need to satisfy

A

the four principles shown to promote continued oral health
- effective support
- clearance of gingival margins
- simplicity
- rigid connector

50
Q

why is the movement potential less for a tooth supported prosthesis

A

the functional loading is provided by the teeth

51
Q

what is the residual ridge

A

remaining alveolar bone and overlying connective tissue covered with mucosa

52
Q

how are tooth supported partial dentures retained and stabilised

A

by a clasp at each edentulous space

53
Q

what is a requirement for clasps

A

they need to flex sufficiently during placement and removal of the denture to pass over the height of the contour of the teeth

54
Q

describe the pros and cons of acrylic denture bases

A

pros
- affordable
- easy to repair

cons
- likely to break and crack
- stain

55
Q

describe the pros and cons of cobalt chrome denture bases

A

pros
- strong and durable
- lighter and thinner than acrylic so more comfortable to wear
- less likely to stain
- more resistant to temperature changes

cons
- more expensive
- harder to adjust

56
Q

what are the pros of cobalt chrome partial dentures

A
  • custom designed for gums and bite
  • can be made smaller to uncover more of the palate
  • help prevent neighbouring teeth from moving out of position
  • better for your overall oral hygiene

Prosthodontics (8 decks)

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