PDI Lecture Part 1 Flashcards
what is the main advantage of classification systems
comprehensive evaluation and assessment of all necessary parameters to help in diagnosis, treatment and prognosis
what are the potential benefits of the PDI system
- improved intraoperatory consistency
- improved professional communication
- insurance reimbursement commensurate with complexity of care
- an improved screening tool for dental school admission clinics
- standardized criteria for outcomes and research
- enhanced diagnostic consistency
- a simplified aid in the decision making process associated with referral
what are the 3 classifications of PDI
- edentulous
- partially edentulous
- dentate
what are the 4 categories in the PDI
class I - class IV
what is class 1
an uncomplicated clinical situation
- straightforward
what is class IV
represents a complex clinical situation
- most debilitated edentulous conditition
what are the diagnostic criteria
- bone height - mandibular only
- residual bone morphology- maxilla only
- muscle attachments mandibular - mandibular only
- maxillomandibular relation
what is class II
denture supporting anatomy degraded
what is class III
anatomy degraded, surgical revision needed, additional factors are present
what are other variables that contribute to increased difficulty
the presence of implants
- gag reflex
- tongue size
- interarch space
- psychosocial conditions
- systemic conditions
- refractory patient
how is mandibular bone height measureed
at the least height
how is mandibular bone height classified
- 21mm or greater - type 1
- 16-20 mm- type II
- 11-15 - type III
- 10mm or less - type IV
what are the types for muscle attachment
- type A: all regions have attached mucosa without undue impingement during function
- type B: no attached mucosa in labial vestibule; mentalis muscle attaches near the crest of ridge
- type C: no attached mucosa in anterior lingual vestibule; genioglossus and mentalis muscle near ridge crest
- type D: attached mucosa only in posterior lingual region; mucosal base detached in all other regions
- type E: no attached mucosa in any region
what PDI class is type A for muscle attachments
PDI class I or II
what PDI class is type B for muscle attachments
PDI class I or II
what PDI class is type C for muscle attachments
PDI class III
what PDI class is type D for muscle attachments
PDI class IV
what PDI class is type E for muscle attachments
PDI class IV
what are the types for residual ridge morphology
- type A: adequate vestibular depth, absence of tori, palatal morphology will resist movement of the denture
- type B: posterior buccal vestibule lost, tuberosity/hamular notch poorly defined
- type C: anterior labial vestibule lost, mobile anterior ridge, palatal vault offers little resistance to movement of denture
- type D: anterior and posterior vestibules lost, tori interfere with posterior border of denture, hyperplastic and mobile anterior ridge
what PDI class is type A for residual ridge morphology
PDI class I
what PDI class is type B for residual ridge morphology
PDI class II
what PDI class is type C for residual ridge morphology
PDI class III
what PDI class is type D for residual ridge morphology
- PDI class IV
what are the classes for maxillomandibular relationship
- class I: most favorable
- class II: requires tooth position outside normal ridge and articulation for esthetics, phonetics and articulation
- class III- requires tooth position outside normal ridge relation for esthetics, phonetics and articulation; possible anterior or posterior cross bite
what are the PDI classes for class I maxillomandibular relationships
PDI class I, II, III, or IV
what are the PDI classes for class II maxillomandibular relationships
PDI class III or IV
what are the PDI classes for class III maxillomandibular relationships
PDI class III or IV
describe class I maxillomandibular relationship
maxillomandibular relationship allows tooth position that has normal articulation with the teeth supported by the residual ridge
describe the class II maxillomandibular relationships
-maxillomandibular relationship allows tooth position outside the normal ridge relation in order to attain phonetics and articulation
- anterior or posterior tooth position not supported by the residual ridge
- anterior vertical overlap that exceeds the principles of articulation
describe the class III maxillomandibular relationship
skeletal class III relation
describe the class IV complete edentulous patient
- residual bone height: least vertical height of the mandible
- class I, II, and III maxillomandibular relationship
- residual ridge offers no ressitance to horizontal or vertical movement- maxilla
- location of muscle attachments with significant influence on denture base stability and retention- mandible
what are the parameters that increase complexity of treatment
- conditions that require pre prosthetic surgery
- limited interarch space
- tongue anatomy
what are the conditions that require pre prosthetic surgery and what PDI class are they
- minor/major soft tissue procedures: PDI class III or IV
- minor/major hard tissue procedures: PDI class III or IV
- implant placment (simple)- no augmentation required: PDI class III
- implants with bone graft- complex: PDI Class III or IV
- correction of dentofacial deformities: PDI class III or IV
- multiple extractions -> complete edentulism for immediate dentures: PDI CLass III or IV
what is the number for limited interarch space and what PDI is this
18-20mm : PDI class III
what are the type of tongue anatomy and what PDI are they
- large ( occludes with interdental space) : PDI class III
-hyperactive - with retracted position
what are the modifiers for all PDI classifications that increase the complexity and classification level
-esthetic concerns/ challenges
- presence of TMD symptoms
- oral manifestations of systemic disease
- psychosocial factors
- maxillofacial defects
- ataxia
- refractory patient
what is a refractory patient
- a patient who has chronic complaints following appropriate therapy
- they continue to have difficulty in achieving their treatment expectations despite the throughoughness or frequency of the tx provided