Pros rpd design features Flashcards
flange
the replacement tissue extending into the vestibular sulcus from the alveolar area
tooth support
directs the masticatory occlusal load through the periodontal ligaments of adjacent teeth
- more natural as it directs the load down the natural central axis which feels better for patients
mucosal support
requires a large surface area to prevent sinking into the mucosa
- can accelerate resorption of underlying tissue if not placed correctly
- spreads the load through the mucosa onto the bone
tooth borne support
craddock class 1 - directs load down the central axis of teeth
- protects the soft tissue from trauma
- more comfortable for the patient as it feels more natural
- directs the load of spaces into the PDL of abutment teeth
mucosal borne support
craddock class 2 - abutment teeth not involved
- load is directed through the residual ridge below the saddles
- large palate to maximise distribution
- reduces the occlusal table
- allows the denture base to move slightly which could cause damage to adjacent teeth
tooth and mucosa support
combination when there are still teeth available for support but not enough to completely support the load or in larger saddle areas
- MUST be used in free end saddle areas
order of teeth in load bearing
- molars
- canines
- premolars
- anteriors
the best teeth for providing tooth support are those with the largest…
root area
- depending on the health of the PD attachment
a tooth can bear
its own occlusal load plus one half of the load of similar teeth
what ratio should be considered when deciding if a tooth is suitable for support
the crown to root ratio
types of rests
- occlusal
- cingulum
- incisal (rarely used)
cutting tooth rests
may need to cut into a healthy tooth tissue to provide area for a rest seat without interfering with the occlusion
- not ideal
- try and seat rests in existing areas
axial tork
tilting and rotation of the tooth if the load is not directed down the central axis of the tooth
- minimised by placing the rest as close to the central axis of the tooth as possible
cingulum rests
placed on prominent cingulums
- can remove tooth tissue or add composite to produce a vertical stop for which the rest can sit on
functions of rests
- prevents RPD moving to soft tissues
- assists in distribution of occlusal load
- prevents over eruption of opposing teeth
- provides bracing to anterior teeth
- determines the acid of rotation on the free end saddles of RPDs
when is crown to root ratio unacceptable for using a tooth for support
all teeth used for support have their ratios added to give a total root area
- this is multiplied by 1.5
- if this exceeds the total of the ratios of the missing teeth then there is insufficient tooth support and mucosal support must be considered
in a bounded saddle, occlusal rests are placed
on either side of the saddle (one mesial one distal)
in a free end saddle, the occlusal rest is placed on the
other side of the tooth to the saddle (mesial side)
centric stop
the point where opposing teeth touch in centric occlusion
- should not place rest seats here as this can interfere with the occlusion and feel unnatural to patients
primary mucosal support comes from
- the hard palate (maxillary)
- the buccal shelf/sulcus and pear shaped pad (mandibular)
- the residual ridges
- the maxillary tuberosity
how far fro the gingival margi should a base place be placed
3mm to prevent bone resorption, pressure causing recession and to allow clearing and flow of saliva (no food traps)
paeriodontium can be displaced by
0.1mm
mucoperiosteum can be compressed by
2mm
if there is no hard tissue support to the mesial of the abutment tooth on a free end saddle, this could result in
DISTAL AXIAL TORQUE
- the denture sinks into the compressible mucoperiosteum over time
retention
the resistance of a denture to lifting away from the tissues
means of achieving retention
mechanical, frictional, muscular or physical means
denture features which aid retention
- altering the path of insertion
- clasps
- frictional contacts (guide planes)
achieving mechanical retention
- from a clasp
2. the clasp engages the undercut of the tooth under the maximum bulbosity