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Pros Final Flashcards

1
Q

Can gutta percha be removed immediately after endodontic treatment and post space prepared?

A

Adequately condensed gutta percha can be safely removed immediately after endodontic treatment

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2
Q

value v hue v chroma

A

value brightness

bue color

chroma saturationvalue most important

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3
Q

Mutually protected occlusion

A

“ The posterior teeth protect the anterior teeth and the anterior teeth protect the posterior teeth”

Characteristics:

  1. MIP occurs with condyles in centric relation
  2. Posterior teeth “hold shim”
  3. Anterior teeth “drag shim”
  4. Immediate separation (no contacts) of posterior teeth in any eccentric movement
  5. Anterior guidance: anterior teeth provide separation of posterior teeth in eccentric movements
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4
Q

Exposure of centrals in youth during long E

A

50-70%

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5
Q

Post cement options

A

Zinc Phosphate

Glass Ionomer

Polycarboxylate

Resin

Resin modified glass ionomer

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6
Q

how much central exposed during “Emma”

A

youth: 1-4mm

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7
Q

Cement retained implant crown occ

A
  • Lighter than natural teeth**
  • 30 microns vertical depression
  • Implants not depressible
  • Instruct patient to clench
  • Drag two thicknesses of shim
  • Eliminate excursive contacts
  • Consult centric relation
  • First point of contact
  • CR-MIP slide
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8
Q

Full coverage guidelines for anterior teeth after endo

A

Anteror teeth are subjected to lateral forces

For anteriors, full coverage = crown

Crown not required: Intact marginal ridges, conservative endodontic access, acceptable esthetics

Crown required: Inadequate remaining coronal tooth structure, FDP abutment, RDP abutment, unacceptable esthetics (there is another option…veneer)

Most anterior teeth that require a crown also require a post

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9
Q

Manufacturer rec screw torque

A
  • 3i –20 N-cm
  • Nobel –35 N-cm

75% of average failur torque of screws

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10
Q

Interim restoration definition

A

A transitional restoration that provides protection, stabilization, and functionbefore fabrication of the definitive prosthesis. It may also be used to determine the esthetic, functional, and therapeutic effectivenessof a treatment plan.

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11
Q

The resistance triad

A

Antirotation

ferrule

remaining vertical tooth structure

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12
Q

proper axial reduction is…

A

2 mm functional cusps

1.5mm elsewhere

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13
Q

Reasons for PVS in implant impressions

A
  • Rigidity
  • Accuracy
  • Can pour multiple casts
  • High dimensional stability
  • No odor/unpleasant taste
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14
Q

When exporting dicom to use with bluesky, what must you do

A

Ananomize the file

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15
Q

What are the parts of a clasp?

A
  • Rest
  • Body
  • Shoulder
  • Reciprocal Arm
  • Retentive Arm
  • Retentive Terminal
  • Minor Connector
  • Approach Arm
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16
Q

Tongue size

A

House

Class 1: Normal size, development, functionSufficient teeth present to maintain normal form/function

  • Class 2: Teeth have been absent long enough to permit a change in the form and function of the tongue
  • Class 3: Excessively large tongueAll teeth have been absent for an extended period of time, allowing for abnormal development of the size of the tongue

Inefficient dentures can lead to the development of Class 3 tongue

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17
Q

Advantages of cast post

A

Universal application

Customized, intimate fit

Best core to post adaptation

Increased control: core fabrication/angulation

Built-in antirotation

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18
Q

when scanning cast what KVP and MA should be used

A

80/10

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19
Q

biomet 3i colors and sizes

A

pink 3.25

blue-4mm

yellow-5mm

green-6mm

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20
Q

Post insertion maintenance

A

changes in the residual ridge

chairside soft relines every 3+ weeks prn

at about 6 months hard reline or make remote denture

occlusalequilibration/clinical remount

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21
Q

Resin cement

A

Virtually insoluble

High compressive strength

Very technique sensitive!

Need auto-cure capabilities, not dual cure!

The eugenol effect

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22
Q

Casts should be soaked in what before trimming?

A

SDS! DO NOT TRIM A DRY CAST?

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23
Q

What material should be avoided using the direst interim technique

A

PMMA

should use bis acryl instead

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24
Q

Do endodontically treated teeth need crowns?

A

Sorenson and Martinoff, JPD 1984•1233 teeth, 1-25 years

  • Anteriors –no significant improvement
  • Posteriors –significant improvement

“Crowns should generally be used on endodontically treated posterior teeth but are not necessary on relatively sound anterior teeth.”

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25
Q

indication for a post in a premolar

A

Difficult to restore

Lack of :•Dentin walls to retain core

  • Dentin to place pins
  • Vertical support for post

Delicate root anatomy

Consider custom post/core if increased function

Decision based on remaining tooth structure following crown preparation

Retain all sound dentin

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26
Q

Tear strength and resistance to deformation increases or decreases with time?

A

Increases

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27
Q

Reason for selecting prefab post/direct core

A
  • Almost any clinical situation other than those listed as indications for the cast post/core
  • There are almost as many prefabricated post systems as there are clinical situations in which to employ them
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28
Q

Cast post disadvantages

A

More tooth structure

removed

Increased time and cost

Requires temporization

Tapered form

Critical fit

requirements/stresses

Increased root fracture

potential

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29
Q

Define CR?

A

The maxillo-mandibular relationship in which the condyles articulate with the thinnest avascular portion of their respective disks with the complex in the anterio-superior position against the slopes of the articular eminencies. This position is independent of tooth contact.

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30
Q

Rule of thirds cast modification

A

Jerbi ‘66

Assumes normal periodontal relationship

Teeth decoronated1.0mm sub-FGM

gingival, middlem vestibular thirds

Stone-Plastygingival third to mid third

  • depth: labial recess of teeth
  • Represents collapse of labial gingival tissusetoward

preserve incisive papilla

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31
Q

Adv and disadv of tapered posts

A

Conservation of tooth structure•Less dentin removal than parallel or cast

Stress distribution•No sharp corners at terminus (vs. parallel)

Retention•Least retentive

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32
Q

analogue

A

replica

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33
Q

Schneid & Mattie Classification

A

–A modification of the Kennedy Classification

–Indicates arch configuration, and implant location

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34
Q

What are 4 Mandibular Major Connectors?

A
  1. Lingual Plate
  2. Double Lingual Bar
  3. Labial Bar
  4. Lingual Bar
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35
Q

Advantages of interim RPD

A

Tongue and facial musculature position virtually unaltered

Allows for “normal”chewing

Provides comfort, esthetics, learning period

Healing period can be extendedMore stable foundation

Allows continued diagnostic evaluation

May help with acclimation to removable prosthesis

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36
Q

Adv and disadv of PMMA

A

•Advantages

–Good marginal fit

–Good transverse strength

–Good polishability

–Durability

•Disadvantages

–High exothermicheat increase

–Low abrasion resistance

–Free monomer toxic to pulp

–High volumetric shrinkage

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37
Q

Things to assess in existing dentures

A

Esthetics

Phonetics

Retention

Stability

Extensions

OVD

CR

Characterization

Palate (smooth?)

Wear

Comfort

Hygiene

Pt adaptation to denture

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38
Q

Mucosa

A

Thickness

Condition

  • Normal
  • Irritiated
  • diseased
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39
Q

ways to get restorative anatomical symphysis

A

CBCT of cast

lab optical scan of cast or impression

optical scan of mouth

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40
Q

What is the optimal post length?

A

Lab study –ideal is ¾ root length

Post at least equal to crown length or two-thirds the length of the root, whichever is greater, while maintaining an apical seal

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41
Q

What are Applegate’s 8 Rules?

A
  1. Classifcation should follow rather than precede extractions that might alter the original classification
  2. If a third molar is missing and not to be replaced, it is not considered in the classification
  3. If a third molar is present and is to be used as an abutment, it is considered in the classification
  4. If a second molar is missing and is not to be repalced, it is not considered in the classification
  5. The most posterior edentulous area or areas always determines the classification
  6. Edentulous areas other than those determining the classification are referred to as modification spaces and are designated by their number
  7. The extent of the modification is not considered, only the number of additional edentulous areas
  8. There can be no modification areas in class IV arches. Any edentulous area lying posterior to the single bilateral area determines the classification
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42
Q

C contacts

A

•C contacts-Stamp cusps of maxillary teeth occlude with shearing cusps of mandibular teeth

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43
Q

What are some uses of diagnostic mounting?

A
  • Simulation of jaw movements
  • Analysis of occlusal plane
  • Critical Analysis of occlusion and disoclusion
  • Visualization of anatomy and restorations/how they relate to the opposing arch
  • Abutment size and angulation
  • Diagnostic preparations
  • Analysis of available restorative space
  • Analysis of edentulous spans
  • Soft Tissue Corrective Procedures
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44
Q

Indications for a post in molar

A

Rarely need to retain core

Single prefabricated post in largest canal

Macromechanical and micromechanical (bonding) retention recommended

Core retained by threaded pins, amalgam pins, bonding, post

Bonding decreases with thermocycling and functional loading due to fatigue

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45
Q

What are the five principles that govern prep design

A
  1. Preservation of tooth structure
  2. Retention and resistance
  3. Structural durability
  4. Marginal integrity
  5. Preservation of the periodontium
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46
Q

What is a Kratochvil: I Bar?

A
  • Mesial rest, distal rest in adjacent tooth
  • I-bar placed at greatest prominence of facial surface of abutment tooth
  • Guide plane: line angle to line angle reciprocation
  • proximal plate on long distal guiding plane, from marginal ridge to the tooth-tissue junction and 2 mm onto attached tissue
  • Must physiologically adjust metal-tissue contact area with chloroform/rouge
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47
Q

What are 5 factors in implant success?

A
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48
Q

Ferrule

A
  • Crown restoration ferrule is important
  • 1.5-2.0 mm dentin coronal to shoulder is critical
  • Maintain facial/lingual dentin on anterior teeth
  • *Crown lengthening or orthodontic extrusion may be required vs alternative
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49
Q

biomet 3i prosthetic connection

A

Certain internal connection

internal hex with click seating

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50
Q

Tongue position

A

Wright

Normal: Tongue fills the floor of the mouth confined by the mandibular teeth

lateral borders rest on the occlusal surfaces of posterior teeth

apex rests on the incisal edges of the anterior teeth

there is no aberration in tongue size or activity

Class 1 Retracted: Tongue is retractedfloor of the mouth pulled downward and is exposed back to the molar area

lateral borders raised above the occlusal plane

apex is pulled down into the floor of the mouth

Class 2 Retracted: Tongue is very tense and pulled backward and upwardapex is pulled back in to the body of the tongue and almost disappears

lateral borders rest above the mandibular occlusal plane

floor of the mouth is raised and tense

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51
Q

When should impression for final prosthesis be made

A

3-4 weeks after extraction

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52
Q

Adequate axial height of the prep should be

A

4 mm posterior, 3mm premoalr forward

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53
Q

A contacts

A

Shearing cusps of maxillary teeth occlude with stamp cusps of mandibular teeth

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54
Q

Elevations

A

“Cusp tips”
“– Marginal ridges”
“– Triangular ridges”
“– Central ridges (Buccal/ lingual contours)”
“– Supplemental ridges”

“Elements”

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55
Q

Polycarboxylate

A

Half the compressive strength of zinc phosphate

Some bonding to tooth structure

Some clinical handling difficulties

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56
Q

Palatal Sensitivity

A

Class1 Normal

Class 2 Hyposensitive

Class 3 Hypersensitive

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57
Q

Post Palatal Seal

A

Naylor

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58
Q

B contacts

A

Stamp cusps of maxillary teeth occlude with stamp cusps of mandibular teeth

•Most difficult to attain and maintain

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59
Q

Nobel biocare colors and sizes

A

pink-narrow platform 3.5mm

yellow-regular platform-4.3mm

blue- wide platform-5mm

green-6mm

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60
Q

average central size

A
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61
Q

What makes a good prep/restoration

A
  • Appropriate reduction
  • Retention
  • Resistance
  • Well-sealed margins
  • Comfortable for the patient
  • Esthetic final product
  • Long-lasting crown
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62
Q

Man Ridge types

A
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63
Q

coping

A

covering

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64
Q

Depressions

A

–Supplemental grooves

–Developmental grooves

–Fossas

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65
Q

Occlusal Force Equations

A
  • A+B contacts = stability
  • C + B contacts = stability
  • A + B + C = stability
  • A + C only = maxillary teeth move buccally, mandibular teeth move lingually
  • Bonly = maxillary teeth move lingually, mandibular teeth move buccally
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66
Q

What is the height of a locator combination

A

3.177

cuff height can vary from 1-6mm

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67
Q

What is the incidence of endodontics after tooth preparation?

A

3 –23 %

FDPs higher than single crowns

Problems later

rather than early

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68
Q

Adv of implant assisted rpd

A

–Distal extension support

–Reduced bone resorption

–Elimination of unestheticretentive elements

–Decreased stress on abutments

–Improved comfort and patient satisfaction

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69
Q

What are the functions of a rest?

A
  • Direct forces along long axis of tooth
  • Vertical Stop
  • Can function as an indirect retainer in distal extension areas
  • Prevents tooth extrusion, food impaction
  • Correction of occlusal plane
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70
Q

Guidelines for full coverage of posterior teeth after endo

A

Posterior teeth are subjected to greater loads directed more vertically

Due to heavy loading and compromised tooth structure, posterior teeth always require “full coverage” after root canal treatment

For posteriors, full coverage = crown or cuspal coverage amalgam

Crown required: FDP or RDP abutment, premolar in the esthetic zone

Many posterior teeth that require a crown do not require a post

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71
Q

Bis acryl advantages and disadvantages

A

•Advantages

–Good marginal fit

–Low exothermic heat increase

–Good abrasion resistance

–Good transverse strength

–Low shrinkage

•Disadvantages

–Surface hardness

–Less stain resistance

–Limited shade selection

–Limited polishability

–Brittle

–Expensive

–Oxygen-inhibited layer

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72
Q

Advantages of Cusp to Fossa Occlusion

A
  • Forces in line with the long axis of teeth
  • Eliminates the “plunger cusp” effect
  • Greater stability to the dental arch
  • Less tendency towards tooth mobility
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73
Q

Post length recommendation

A

2/3 the root length

  • 1/2 the length of the root in bone
  • >Length of clinical crown
  • As long as possible with 5 mm of remaining gutta percha
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74
Q

Ridge Parallelism classes

A
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75
Q

thickness and goals of surgical guide

A

2mm

  • Goal: ridge fits the surgical guide= more predictable
  • NOT relieve denture to fit the ridge = more post operative visits
76
Q

What does beading the maxillary framework do?

A
  1. Beading depth and width of 0.5 - 1.0 mm
  2. Fades out 6 mm from free gingival margin
  3. Prevents collection of food under major connector
  4. Allows thinning of metal at borders
77
Q

How should you wait before pouring an alginate impression?

A

No more than 12 minutes

78
Q

Factors for implant success

A

Restorative plan

Accurate imaging

restorative/anatomical symphysis

precision guidance

surgical execution

79
Q

What are the requirements for obtaining CR?

A
  • Physiologic
  • Comfortable
  • Consistent when made
  • Repeatable over time
  • Not operator dependent
80
Q

3 types of occlusal schemes

A
  1. Balanced
    - Denture occlusion
  2. Group Function
    - Shared Function
  3. Mutually Protected
    - Canine Protected
81
Q

When should clinical remount be done

A

at least 2-3 weeks..when swelling and edema have subsided

82
Q

What are the 4 RDP components?

A
  1. Major Connector
  2. Minor Connector
  3. Rest
  4. Clasp Assembly
83
Q

Dynamics of mandibular movement deciphered by C. Stuart

A

Recognized that patterns of occlusal surfaces are resultants of patterns of mandibular movement

84
Q

Goals of gnathology

A

“1. CR occlusion 5. Cross-tooth stability”
“2. Uniform contacts in CR 6. Forces in the long axis”
“3. Cusp-fossa occlusion 7. Narrow occlusal table”
“4. Tripodism 8. Disclusion”

85
Q

Group Function

A

Characteristics:

  1. Total stress distributed among many teeth
  2. No interferences from closure to intercuspal position
  3. No balancing interferences in eccentric movements
86
Q

What are some requirements for a diagnostic mounting?

A
  • Alginate impressions
  • Diagnostic Casts
  • Facebow Record
  • Semi-adjustable articulator
  • CR records
  • Lateral and/or protrusive records
87
Q

types of posts for premolars

A
  • Pin or chamber retained core if adequate tooth structure following prep (i.e., conservative access)
  • If post/core required, cast vs. prefabricated depends on canal anatomy:•Ovoid canal = cast post/core
  • Circular canal = prefab (endowel, parapost)
88
Q

Abutment level

A

pertaining to the abutment

89
Q

What are 6 Maxillary Major Connectors?

A
  1. Posterior palatal bar
  2. Anteroposterior palatal bar
  3. Palatal strap
  4. Anteroposterior palatal strap
  5. Horseshoe
  6. Complete palate
90
Q

What types of articulators are Arcon and Non-Arcon?

A
  • Both are semi-adjutable
  • Arcon: articulating condyle on mandibular element (whipmix) 3B
  • Non-Arcon: condyle on the maxillary element (Hanau) 3A
91
Q

Every effort must be made to avoid contact of the cast with…

A

Tap Water

92
Q

Tearing increases or decreases with rate of removal?

A

Tearing decreases with increased rate of removal

93
Q

implant level

A

pertaining to the implant

94
Q

Reasons for good denture impression

A

Establish desired denture borders

Maximize retention and stability by defining maximized support coverage

Minimize flange adjustment at insertion

95
Q

two implant systems we use

A

Nobel biocare

Biomet 3i

96
Q

What is the flexiblity of clasps determined by?

A
  • Length
  • Taper
  • Diameter
  • Cross-sectional form
  • Material
97
Q

Immediate denture approaches

A

One-Phase Immediate:

-FM Extraction with immediate denture delivery

One-Phase “Delayed”:

-FM extraction with delivery 3-4 weeks post extraction

Two-Phased Immediate

  • Extract posteriors (anterior), 6 weeks healing time, fabricate immediate denture, final extraction with immediate denturedelivery
  • Prn Follow-up resilient liners (X2-3), hard reline or fabricate new final denture 8-12 months
98
Q

What are some uses of diagnostic casts?

A
  • Diagnostic Waxing
  • Provisional Fabrication
  • Survey and Design
  • Radiographic Guides and Surgical Templates
  • Design Custom Trays
99
Q

Abutment def

A

supports and/or retains the prosthesis

100
Q

Ridge relationship classes

A
101
Q

What are the 4 steps to mounting a cast?

A
  1. Relate maxillary cast to the condylar axis (facebow)
  2. Relate the mandibular cast to the maxillary cast in centric relation position (CR record)
  3. Verify the accuracy of the mounting - 1st point of contact, AKA Centric Occlusion Contact)
  4. Set the OVD in MIP (incisal guide pin)
102
Q

Disadvantages of implant assisted rpd

A

Additional treatment cost

  • Additional surgical procedure
  • Extended treatment time
  • Careful treatment planning and interdisciplinary approach required
  • Technique-sensitive
  • Additional maintenance
  • Manual dexterity required
103
Q

Anterior Coupling/Anterior Articulation

A

•A comfortable articulation of anterior teeth that is necessary for anterior gudiance (separation of posterior teeth in eccentric movements.

104
Q

Four rule in arch

A

> four —consider removable partial denture

< four —consider complete denture

105
Q

Implant loading protocols

A
  • Immediate = < 1 week
  • Early = 1 week –2 months
  • Conventional = > 2 months
  • Immediate and early loading
  • Insertion torque ≥ 20 –45 Ncm
  • Absence of systemic or local contraindications
  • Clinical benefits exceed risks
106
Q

Post canal prep principles

A
  • Seal unaffected by method of gutta percha removal…heat vs. rotary
  • Seal unaffected by time of gutta percha removal…immediate vs. delayed
  • Ideal: 5 mm of gutta percha
  • Absolute minimum: 4 mm
107
Q

Stamp cusps

A

–Maxillary lingual cusps

–Mandibular buccal cusps

•

108
Q

Steps of the wax try in

A

Verify OVD

Verify CR mounting

Verify occlusalPlane

Verify position of teeth that are set

109
Q

Selecting posts for molars

A
  • Pin or chamber retained cores work well if have adequate tooth structure following preparation (i.e., conservative access)
  • Post/core required if < 4mm remaining height above pulpal floor or no room for intracoronal retentive features
110
Q

What are the most common post and core failures

A

Loosening of the post

Tooth fracture

111
Q

what is used for interim cement space

A

rubber cement

112
Q

What is the chemical reaction for alginate?

A
113
Q

Prefab post advantages

A

Time…

Can usually be done in 1 appointment

Cost…

Less expensive than cast gold

Temporization…

Less hassle than with temporary post & core

114
Q

Rationale for overdenture abutments

A

Maintain bone support

Possibly help with stability

Proprioception

Decrease combination syndrome

115
Q

What are 4 ways to obtain CR?

A
  • Chin Point Guidance
  • Bimanual Manipulation
  • Leaf Gauge
  • Lucia Jig
116
Q

Maximum intercuspation

A

a closed contacting and static relationship of the teeth (MIP –maximum intercuspalposition)

  • Total contacting area may not exceed 4mm2
  • Nature provides a consistency to occluding parts

–Elevations and depressions

–Cusps and fossae

–Ridges and grooves

117
Q

Balanced occlusion

A
  • Simultaneous cross-arch contacts during eccentric movements
  • Theory: balanced and distributed horizontal forces lead to oral health and provide denture stability
  • Indications: Complete Dentures

Group

118
Q

Post cementation keys for max ret

A

Post surface irregularities: serrated, threaded or sand blasted…and vented

Passive but intimate fit to reduce film thickness

Canal space decontaminated

Lentulo spiral for cement placement

Slow, intermittent seating to reduce stresses

119
Q

Gnathology

A

“Definition: the science that treats the biology of the masticatory system as a whole: i.e., the morphology, anatomy, histology, physiology, pathology and the therapeutics of the jaws or masticatory system and the teeth as they relate to the health of the whole body, including applicable diagnostic, therapeutic, and rehabilitation”
“dures.”

120
Q

Post Retention triad

A

Post lenght

cementation

post style

121
Q

biomet healing abutment numbers

A
122
Q

Max Ridge and vault types

A
123
Q

Active Posts

A

Derive retentive/resistance features by actively engaging into root-space dentin

May be either self-tapping or require a separate tapping procedure

Best to restrict use of active post to short canals (heroics)

124
Q

Zinc Phosphate

A

Long clinical history

Good compressive strength and film thickness

Soluble in oral environment

125
Q

What are the 3 philosophies of RPD Construction?

A
  1. Equalized Support (stress-breakers)
  2. Physiologic (functional) basing
  3. Broad stress distribution
126
Q

marginal adaptation of indirect v direct technique

A

“The marginal accuracy of the treatment restoration made by the indirect technique was significantly better than that of those made by the direct technique.”Crispin BJ, Watson JF, Caputo AA. J Prosthet Dent, 1980

“The indirect technique produceda more acceptable gingival margin for the provisional restoration tested in the study.”Monday JJ, Blais D: J Prosthet Dent 1985

127
Q

for 3 or fewer implants is there a difference beweent pick up and transfer impression tech

A

no

128
Q

What is needed for the final denture lab set up

A

Facebow

Determine appropriate OVD

Centric relation record*

Select/verify denture teeth

Posterior palatal seal

Provide max and man esthetic parameters to Lab technician (midline, I length, reference tooth, etc.)

129
Q

Disadvantages of immeadiate dentures

A

Time–more office visits

Patient management during on-going changes

Impressions –border capture can be difficult

Interocclusalrelation records –stability

limited or no anterior try-in

130
Q

Where does stability come from in an RPD?

A
  • Guide Planes
  • Reciprocation
  • Lingual Plating
  • Rests
  • Denture Base
131
Q

At what point should you consider removable

A

when interarch space approaches 15mm

132
Q

Classifications of partially edentualous ridges

A

–Kennedy

–McDermott

–Schneid and Mattie

133
Q

Can a silver point maintain its apical seal when a portion will be removed during post preparation?

A

The removal of a portion of a silver point during post preparation causes apical leakage

134
Q

PEMA advantages and disadvantages

A

•Advantages

–Good polishability

–Minimal exothermic heat increase

–Good stain resistance

–Low shrinkage

•Disadvantages

–Surface hardness

–Transverse strength

–Durability

–Fracture toughness

135
Q

Tripoidal contacts

A
  • Each cusp contacts three points on the opposing tooth
  • Mesial to distal stability–by closure stoppers and equalizers
  • Buccal to lingual stability–by A,B,C contacts
136
Q

Lateral throat form

A

Neil classification

137
Q

Describe a RPI Kroll?

A
  • Mesial Rest
  • Short Proximal Plate
  • I-bar direct retainer (Mid F to MF)
138
Q

What are 4 types of rests?

A
  1. Occlusal Rest
  2. Cingulum Rest
  3. Incisal Rest
  4. Lingual Rest
139
Q

What are the indications for an RPD?

A
  • Long edentulous span
  • Resorbed ridge
  • Reduced periodontal support
  • Cross-arch stabilization
  • No posterior abutment
  • Physical or emotional problems
  • Multiple edentulous spaces
  • Esthetics
  • Patient Desires
  • Financial Implications
140
Q

interim material choices

A
  1. Poly methyl methacrylate (PMMA)
    - Alike, Duralay, Jet, Cr & Br Resin
  2. Poly ethyl methacrylate (PEMA)
    - Snap
  3. Bis-Acryl
    - Self-cure: Integrity, Protemp II
    - Light-cured: Radica
141
Q

Nobel connection types

A

External hex

internal connical

internal trichannel

142
Q

Inter arch space classes

A
143
Q

Anterior teeth post type selcetion rationals

A
  • Cast post/core: coronally-flared canals, multiple preps, tapered roots, excessively wide or ovoid canals, small teeth (most man incisors)
  • Prefab: Round roots with round canals that are not coronally flared, (most maxillary anteriors, mandibular cuspids)
144
Q

Advantages of immeadiate dentures

A

Esthetics –remaining teeth assist denture tooth placement

Appearance is affected minimally

Mastication during healing phase

Patient health –no procrastination

Better healing –denture bandage

Better ridge form –controlled contours

Face Esthetics: cheek and lip support maintained

Occlusal vertical dimension*maintained

Quicker learning –speaking/eating during healing phase

145
Q

Cement retain interproximal contacts

A

Drag one, hold two

146
Q

What is a reasonable bulk of alginate between tray and teeth?

A

5-7 mm

147
Q

Closed tray

A

impression tray with no opening

148
Q

What must a clasp design provide?

A
  • Vertical Support
  • Stability (bracing)
  • ENCIRLCEMENT
  • Retention
  • Reciprocation
  • Passivity
149
Q

Border attachements

A

Class 1: Attachments high in maxilla or low in mandible with relation to ridge crest (0.5 inches or more between level of attachment and crest of ridge).

Class 2: Attachment height in relation to the crest of the ridges between 0.25 and 0.50 inches.

Class 3: Attachment height is less than 0.25 inches from the ridge crest.

150
Q

What is syneresis and imbibition?

A

Syneresis: Shrinkge due to water loss - gel filaments contact and squeeze out water

Imbibition: alginate abosrbs water (swells) on immersion

151
Q

Frenum attachment classification

A

Class 1: High in the maxilla or low in the mandible with respect to the crest of the ridge

Class 2: Medium

Class 3:Frena encroachon crest of the ridge and may interfere with the denture seal Surgical correction may be required

152
Q

Equalizers

A

•PURPOSE

–Equalizes forces exerted by closure stoppers, providing mesial-distal stability

•LOCATION

–Mesial incline of maxillaryposterior teeth

–Distal inclines of mandibularposterior teeth

153
Q

How much alginate and water would you need ideally?

A

28 gm alginate/68-72 cc Distilled water

154
Q

Reasons for chosing cast post and core

A
  • Multiple post/core preps
  • Crown realignment
  • Excessively flared or elliptical canals
  • Small teeth -retention of core to post
155
Q

Seven points of the mandibular plane

A
  • Point 1 –incisal edge of man central incisors (anterior point)
  • Points 2,3 –man first premolars at height of commissures
  • Points 4,5 –lingual cusps of man first molars at level of lateral border of tongue
  • Points 6,7 –flat plane from ant point to DB cusps of man second molars will bisect retromolar pads (all other cusps below this plane)
156
Q

Two phase surgical schedule

A

Phase I: removal of posterior teeth (and other hopeless teeth)Fabrication of interim RPD immediate or delayed 10-14 days

Phase II: removal of remaining anterior (posterior) teeth immediately prior to denture deliveryApproximately 6 weeks after initial extractions

157
Q

What are 4 characteristics of Major Connectors?

A
  1. Rigidity
  2. Avoid impingment of the free gingival margin
  3. Avoid creating food traps
  4. Patient comfort
158
Q

Parallel PostsAdvantages and Disadvantages

A

Retention•More retentive than tapered post

Greater removal of dentin•Remember: Any dentin left behind provides strength

159
Q

open tray

A

impression tray with opening at the impant site

160
Q

How much gutta percha should be retained to preserve the apical seal?

A

4 –5 mm

5 mm is best and safest

161
Q

GI

A

Same compressive strength as zinc phosphate

Bonds to tooth structure

162
Q

What are 4 clasp designs?

A
  1. Circumferential Clasp
  2. Bar Clasp
  3. Suprabulge
  4. Infrabulge
163
Q

What are the uses of a 3 piece cast analysis?

A
  • Instant Equilibration
  • Evaluation of anterior coupling
  • Mutually protected articulation
  • Reasonableness of restoring in CR
164
Q

Pankey Mann Schuyler Tx goals

A
  • MIP with condyles in Centric Relation
  • Group function on working side
  • Non-interference of posterior teeth on non working side
  • Anterior guidance during lateral excursions and disclusion of posteriors in protrusion
  • Anterior coupling but within 0.1 to 0.5 mm –Long Centric
  • Posterior occlusal contact “areas” rather than tripodizedcontacts
165
Q

Contraindications of immeadiate dentures

A

Frank pathology / Medical expediency

Extreme mal-relation of jaws

Patient preference: resistance to additional procedures

166
Q

What are the prep parameters of an occlusal rest?

A
  • Triangular and concave shaped
  • Rounded Apex
  • Should follow the fossa outline
  • Inclined towards the center of the tooth
  • Should allow for minimum 1.0 mm metal thickness
167
Q

Pt instructions after denture insertion

A

Keep denture in for the first 24 hrscontrols bleeding

aids in clot formation

decreases swelling

1stweek –adjustments prn

Care of oral tissues

Care of dentures

Nutrition/hydration

168
Q

What is the minimum space requird for a lingual bar?

A
  • 8 mm from the gingival margin to the floor of the mouth
  • 3 mm from free gingibal margin to superior border of the bar
  • The bar should be at least 5 mm in heigh
169
Q

What are the labeled patrs of an implant

A
  • A = 0.7 mm hex height
  • B = collar height
  • E = implant diameter
  • G = Threaded length (body)
  • K = apex diameter
  • L = collar diameter
  • M = hex width
170
Q

Screw retained implant crown interproximal contacts

A
  • More difficult in posterior
  • Drag two thicknesses of shim*
  • No binding on adjacent teeth
171
Q

Clossure stoppers

A

PURPOSE

–Stops closure of mandible as it relates to maxilla

–Neutralizes forces exerted by equalizers

•LOCATION

–Distalincline of maxillaryposterior teeth

–Mesialinclines of mandibularposterior teeth

172
Q

Shearing cusps

A

–Maxillary buccal cusps

–Mandibular lingual cusps

173
Q

Criteria for selecting abutments

A

Periodontal status

Endodontic potential –treatable??

Positional considerations –how many and where??

Caries status

  1. No < 6 mm of root supported by bone

2 Considerable horizontal and vertical mobility - poor choice

3 Band of attached gingiva – no < 2mm

Two canines –most common but may not be the best choice(canine eminence)

Avoid tissue undercuts

Adjacent abutments –unacceptableSpace of at least one tooth width apart

Opposing abutments –contraindicated inter-occlusalrestorative room

*Caries status must be assessed carefully*

174
Q

Advantages of indirect interim technique

A

-Stronger-Better fit-Increased Density-Polymerized at higher temp-Processed on cast, decreases shrinkage

175
Q

Indications for implant assisted rpd

A

–Esthetics

–Oral hygiene

–Extensive ridge defects

–Financial limitations

–Extension base applications

176
Q

Prefab post disadvantages

A

Fit…

Not as precise as cast post

Crown angulation…

No compensation ability

Antirotation…

Must be provided by additional means

177
Q

Palatal throat form

A

House

178
Q

McDermott classification

A

–A modification of the Kennedy Classification

–Indicates arch configuration, and natural tooth abutment location

179
Q

Size of canal space for post

A
  • ≤ 1/3 root width
  • Uniformly thick root walls
180
Q

Post dia principles

A
  • In contrast to post length, increasing post diameter does not increase retention
  • Thick posts weaken teeth
  • Thin posts may distort
  • Beware of variations in dentin thickness (esp. man molars) and curvatures
181
Q

What can pt expect

A

SPEECH: encourage patient to practice

DISCOMFORT: tell the dentist

EATING: a learning process

SALIVA: may be excessive in the beginning

182
Q

What is proper O reduction

A

1.5-2mm

183
Q

How important is the amount of remaining coronal tooth structure?

A

Cervical tooth structure should be retained or the finish line should be extended cervically to engage 1 or 2 mm of tooth structure

184
Q

recommended taper of preparation

A
185
Q

Interim res requirements

A
  1. Pulpal protection
  2. Positional stability
  3. Occlusal function
  4. Easily cleaned
  5. Nonimpinging margins
  6. Strength and retention
  7. Esthetics
186
Q

How important is post diameter?

A

Diameter should be controlled to preserve root structure

Post diameters should not exceed one third of root diameter at any location

Post tip diameter should usually be 1 mm or less

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