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Treatment Planning > Prosthodontic Diagnostic Index > Flashcards

Prosthodontic Diagnostic Index Flashcards

1
Q

What is the advantage of a classification system?

A

Comprehensive evaluation and Assessment of all necessary parameters to help in Diagnosis, Treatment, and Prognosis

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2
Q

What are examples of classification systems?

A
  • ASA
  • Kennedy’s classification of edentulous space and Applegate’s rules
  • Other disciplines have classification systems
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3
Q

What are the potential benefits of the prosthodontic diagnostic index (PDI)?

A

(1) improved intraoperator consistency
(2) improved professional communication
(3) insurance reimbursement commensurate with complexity of care
(4) an improved screening tool for dental school admission clinics
(5) standardized criteria for outcomes assessment and research
(6) enhanced diagnostic consistency and
(7) a simplified aid in the decision-making process associated with referral

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4
Q

What are the 3 classifications in the prosthodontic diagnostic index (PDI)?

A

edentulous, partially edentulous, dentate

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5
Q

What are the four categories in each classification in the prosthodontic diagnostic index (PDI)?

A

class I - class IV

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6
Q

What is a class I category?

A

an uncomplicated clinical situation

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7
Q

What is a class IV category?

A

represents a complex clinical situation

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8
Q

What are the diagnostic criteria for deciding the classifications for complete edentulism?

A
  1. Bone Height (mandibular)
  2. Residual Ridge Morphology (maxilla)
  3. Muscle Attachments (mandibular)
  4. Maxillomandibular Relation
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9
Q

What are the diagnostic criteria for deciding the classifications for partial edentulism?

A
  1. Abutment Condition
  2. Occlusal Scheme
  3. Location / Extent Edentulous Areas
  4. Residual Ridge
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10
Q

What are the modifiers for all classifications?

A
  • Esthetic concerns / challenges
  • Presence of TMD symptoms
  • Oral manifestations of systemic disease
  • Psychosocial factors
  • Maxillofacial defects
  • Ataxia
  • Refractory Patient
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11
Q

What should the location and extend of edentulous area be for class I partial edentulism?

A
  • ideal or minimally compromised

edentulous area confined to a single arch and may include:
* anterior maxillary span that does not exceed 2 incisors,
* anterior mandibular span that does not exceed 4 missing incisors,or
* posterior span that does not exceed 2 premolars or 1 premolar and 1 molar

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12
Q

What should the abutment condition be for class I partial edentulism?

A
  • ideal or minimally compromised
    no need for pre-prosthetic therapy
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13
Q

What should the occlusion be for class I partial edentulism?

A
  • ideal or minimally compromised
  • no need for pre-prosthetic therapy
  • Class I molar and jaw relationships.
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14
Q

What are the biomechanical considerations for partial fixed dental prosthesis (FDP)?

A
  • Number of abutment teeth and number of missing teeth (simple vs complex)
  • Splinted or pier abutment
  • Non-parallel abutments
  • Combined anterior and posterior FDP
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15
Q

In a class I partial edentulist the residual ride is considered type…

A

A

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16
Q

In a class I partial edentulist there is a single edentulous area in ___ sextant

A

1

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17
Q

What is the most common FDP to replace more than two teeth with success?

A

mandibular anterior FDP

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18
Q

What has a better prognosis: mandibular or maxillary?

A

mandibular

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19
Q

What are the weakest potential abutments for an anterior FDP with canines?

A

Adjacent premolar and lateral incisor

20
Q

With a maxillary anterior replacement the forces are directed?

A

outside inter-abutment axis & directed outward

21
Q

In a class II partial edentulist what is the location and extent of the edentulous area?

A

both arches have edentulous spaces and one of the following…
* anterior maxillary span that does not exceed 2 incisors
* anterior mandibular span that does not exceed 4 missing incisors
* posterior span that does not exceed 2 premolars or 1 premolar and 1 molar
* Any missing canine (maxillary or mandibular)

22
Q

In a class II partial edentulist what is the abutment condition?

A

*Insufficient tooth structure to retain or support intracoronal or extracoronal restorations – 1 or 2 sextants
*Abutments in 1 - 2 sextants require localized adjunctive therapy (minor)

23
Q

In a class II partial edentulist what is the occlusion?

A

*Occlusion requires localized adjunctive therapy (enameloplasty – prematurities)
*Class I molar and jaw relationships are seen.

24
Q

What should you consider when replacing missing canines?

A
  • Adjacent premolar and lateral incisor are weakest potential abutments
  • Maxillary replacement – forces outside inter-abutment axis & directed outward
  • Best restored with implant-supported single crown
25
Q

Occlusal interferences produced when FDP made to…

A

over-erupted opposing dentition

26
Q

What are the problems with tilted molar abutments?

A
  • Generally poor abutments
  • Mesial wall must be over-reduced/overtapered (↓ resistance)
  • Distal adjacent tooth may intrude on the path of insertion
    —Mesial surface may need re-contouring or restoration or extraction
    —Consider orthodontic uprighting (3rd molar extraction)
27
Q

What is molar uprighting?

A
  • Places abutment in better position for preparation
  • Distributes forces under loading through long axis of tooth(helps prevent/eliminate mesial bony defects)
  • Enables replacement of optimum occlusion
28
Q

What does a tilted molar abutment: non-rigid attachment do?

A
  • Allows slight movement - short span
  • Keyway in distal of premolar to avoid intrusion of molar (mesial seating action)
  • Must prepare box in distal of premolar preparation
    —(To accommodate the female / keyway)
29
Q

What are the indications to use a non-rigid connector?

A
  • Pier Abutment FPD
  • Long span FPD with multiple abutments
  • Non-parallel abutments – Tipped molar
  • Planning for failure
30
Q

What is the custom incisal guide for?

A
  • The custom incisal guide provides a record of the incisal guidance that has been established with provisional restorations or a diagnostic wax-up.
  • The custom incisal guide table provides a record for the lab to create the desired anterior guidance in the produced prostheses.
31
Q

In a class III partial edentulist what is the location and extent of the edentulous area?

A

*1 or both arches; compromised support of abutment teeth
*Posterior maxillary or mandibular edentulous area > 3 teeth or 2 molars
*Any edentulous areas including anterior and posterior areas of 3 or more teeth

32
Q

In a class III partial edentulist what is the abutment condition?

A

*Insufficient tooth structure to retain or support intracoronal or extracoronal restorations – 3 sextants
*More substantial localized adjunctive therapy (perio, endo, ortho treatments) – 3 sextants

33
Q

In a class III partial edentulist what is the occlusion?

A

*Entire occlusion must be re-established, but without any change in the occlusal vertical dimension.
*Class II molar and jaw relationships are present

34
Q

What classifies a class III partially edentulous patient?

A
  • Any edentulous areas including anterior and posterior areas of 3 or more teeth
  • Maxillary canine and 2 contiguous teeth
35
Q

In a class IV partial edentulist what is the location and extent of the edentulous area?

A

Any edentulous area or combination of edentulous areas requiring a high level of patient compliance

36
Q

In a class IV partial edentulist what is the abutment condition?

A

Abutments in 4 or more sextants have insufficient tooth structure to retain or support intracoronal or extracoronal restorations.
*Abutments in 4 or more sextants require extensive adjunctive therapy (ie, periodontal, endodontic, or orthodontic procedures).
*Abutments have guarded prognoses

37
Q

In a class IV partial edentulist what is the occlusion?

A

*Entire occlusion must be reestablished, including changes in the occlusal vertical dimension
*Class II division 2 and Class III molar and jaw relationships are seen

38
Q

What do you do for a class IV partial edntualism (extensive attrition)?

A

Stabilized Record Base for Interocclusal Record with large edentulous space; then modified for anterior segment

39
Q

What are the diagnostic criteria for deciding the completely dentate patient?

A
  1. Tooth Condition
  2. Occlusal Scheme
40
Q

What is the tooth condition and occlusal scheme for a class I dentate patient?

A
  • Ideal or minimally compromised tooth condition
    —No localized adjunctive therapy required
    —Pathosis that affects the coronal morphology of three or
    less teeth; one sextant
  • Ideal or minimally compromised occlusal scheme
    —No pre-prosthetic therapy required
    —Contiguous, intact dental arches
    —Class I molar and jaw relationships
41
Q

What is the tooth condition and occlusal scheme for a class II dentate patient?

A

Moderately compromised tooth condition
*Insufficient tooth structure to retain or support intracoronal or extracoronalrestorations – one sextant
*Pathosis that affects the coronal morphology of 4 or more teeth in a sextant
*Pathosis can be in 2 sextants and can be in opposing arches
*Teeth require localized adjunctive therapy, i.e., periodontal, endodontic ororthodontic procedure for a single tooth or in a single sextant.

Moderately compromised occlusal scheme
*Occlusal scheme requires localized adjunctive therapy
*Anterior guidance is intact
*Class I molar and jaw relationships

42
Q

What is a class II dentate patient?

A
  • 1 sextant exhibits 3 defective restorations with an esthetic component
  • Additional variables of gingival architecture and individual tooth proportions increase the complexity of diagnosis
43
Q

What is the tooth condition and occlusal scheme for a class III dentate patient?

A
  • Substantially Compromised Tooth Condition
  • Insufficient tooth structure to retain or support intracoronal or extracoronal restoration— 2 sextants
  • Pathosis that affects the coronal morphology of 4 or more teeth in 3 or more sextants
  • Pathosis can be in 3 sextants in the same arch and/or in opposing arches
  • Teeth require more substantial localized adjunctive therapy, i.e., periodontal, endodontic or orthodontic procedures for teeth in 2 sextants
  • Substantially Compromised Occlusal Scheme
  • Occlusal scheme requires major therapy to maintain the entire occlusal scheme without any change in the occlusal vertical dimension
44
Q

What is the tooth condition and occlusal scheme for a class IV dentate patient?

A

-Severely Compromised Tooth Condition
*Insufficient tooth structure to retain or support intracoronal or extracoronal restorations – 3 or more sextants
*Pathosis affects coronal morphology of ≥ 4 teeth in all sextants
*Teeth in ≥4 sextants require extensive adjunctive therapy (perio, endo, or ortho)

-Severely Compromised Occlusal Scheme
*Occlusal scheme requires major therapy to re-establish the entire occlusal scheme including any changes in the occlusal vertical dimension
*Class II, Division 2 malocclusion
*Class III molar and jaw relationships

45
Q

Classification needs to be established in axiUm under:

A
  • Removable Prosthodontic Consults and
  • Fixed Prosthodontic Consults

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