Prosthodontics Flashcards
Define an articulator
Reproduces occlusal relationship between the maxilla + mandible
2 extra oral consequences of missing teeth
TMJ problems
Changes in facial appearance
Why does facial appearance change due to missing teeth
Lack of downward pressure on alveolar bone causes bone loss
2 changes in facial appearance due to missing teeth
Maxilla regresses
Mandible protrudes
3 intra oral consequences of missing teeth
Alveolar resorption
Tooth movement
Tooth wear
2 functional consequences of missing teeth
Mastication
Speech
3 types of complete dentures
Removable
Implant retained
Implant supported
Describe implant retained complete dentures
Implants allow denture to ‘snap in place’
Describe implant supported complete dentures
Non removable and screw retained
2 types of saddle
Free end saddle
Bounded saddle
How many teeth are needed for function
20
Kennedy class 1
Bilateral free end saddles
Kennedy class 2
Unilateral free end saddle
Kennedy class 3
Posterior bounded saddle
Kennedy class 4
Anterior bounded saddle crossing midline
What does the Kennedy class describe
Distribution of missing teeth
What does the Craddock class describe
Denture’s resistance to occlusal directed load
Craddock class 1
Tooth support
Craddock class 2
Mucosa support
Craddock class 3
Mixed support
Describe what tooth support requires
Support on both adjacent abutment teeth
What is a shorted dental arch
No treatment option for those with missing posterior teeth
How many occlusal units does a shortened dental arch need for sufficient adaptive capacity
3-5 units
How many occlusal units is an occluding premolar worth in relation to a shortened dental arch
1 unit
How many occlusal units is an occluding molar worth in relation to a shortened dental arch
2 units
What teeth should you prioritise maintaining in a shortened dental arch
Anterior teeth + premolars
Advantage of tooth supported dentures
Don’t sink into tissues
Define support in relation to RPD’s
Resistance to vertical movement towards tissue
Define retention in relation to RPD’s
Resistance to vertical movement away from tissue
Define stability in relation to RPD’s
Resistance to horizontal movements
Define freeway space
Space between teeth at rest
4 checks for abutment teeth in RPD’s
Sound structure
Good edentulous ridge
Good roots
Good alveolar bone
3 special tests for abutment teeth in RPD’s
Periapical radiographs
Sensibility testing
Surveyed study models
2 base materials for RPD’s
Cobalt chrome
Acrylic
Define a flange in relation to RPD’s
Replacement tissue
Where does the flange in RPD’s extend to
Vestibular sulcus
What is a modification in relation to the Kennedy class
An extra saddle
Which Kennedy class cannot have a modification
Class 4
What occlusal load can a healthy tooth carry
It’s own load + 1.5 similar teeth
List the teeth in order of load bearing from highest to lowest
Molars
Canines
Premolars
Anteriors
Compare PDL support of an RPD compared to mucosa support
PDLs support is > 4 times the mucosal coverage of lost tooth
How far should RPD components be from the gingival margin
3mm
What is a characteristic of the Every RPD design
Wire stop on most posterior teeth
What is the function of a wire stop in RPD’s
Ensure distal tooth won’t drift posteriorly
What is the compressibility of the periodontium
0.1mm
What is the compressibility of the mucoperiosteum
2mm
What is the periodontium
Tooth attachment in the socket
What is the mucoperiosteum
Mucosal coverage of alveolar bone
Where is primary support in Craddock class 2/3 RPD’s
Upper = central palate Lower = buccal side of saddle areas
Where is secondary support in Craddock class 2/3 RPD’s
Upper = anterior palate + saddle areas Lower = central + lingual side of saddle areas
How do you know if tooth support is sufficient for RPD’s
Missing teeth total root area < max load
How do you find the max load of abutment teeth in RPD’s
Cumulative root area of abutment teeth X 1.5
What do rests do in RPD’s
Oppose denture base compressing tissues
How are different rest described in RPD’s
By the part of the tooth they contact
Where would cingulum rests be found
Anterior teeth
3 advantages of cingulum rests over incised rests in RPD’s
Better aesthetics
Stress applied lower causing less rotation
No occlusion interference
3 types of rests in RPD’s
Cingulum
Incisal
Occlusal
What is the most favourable type of rest
Occlusal
Where are rests placed for a bounded saddle in an RPD
Directly adjacent to saddle
Where are rests placed for a free end saddle in an RPD
Mesially
What material are rests made of
Cast metal
2 properties of cobalt chrome denture base
Rigid
Strong
2 properties of acrylic denture base
Flexible
Weak
How are rests connected to cobalt chrome base dentures
Directly connected to major connector or by minor connectors
How are rest connected to acrylic base dentures
Incorporated mechanically
3 ways of achieving retention in RPD’s
Mechanical
Muscular
Physical
What is the mechanical method of retention in RPD’s
Clasps
What is a clasp made of for = RPD’s
Wrought metal
2 types of clasps in RPD’s
Gingivally approaching
Occlusally approaching
What teeth would you use gingival approaching clasps on in RPD’s
Anteriors + premolars
What is a clasp in RPD’s
Metal arm that retains denture in mouth
Why is a clasp linked to a rest more effective in RPD’s
Rest prevents clasp slipping down tooth
What is the muscular method of retention in RPD’s
Muscles act on the shape of the denture base
What is the physical method of retention in RPD’s
The coverage of the mucosa
3 forces involved in the physical method of retention in RPD’s
Adhesion
Cohesion
Atmospheric pressure
Define adhesion in relation to RPD’s
Surface force of saliva on denture + mucosa
Define cohesion in relation to RPD’s
Forces within saliva + viscosity
Define atmospheric pressure in relation to RPD’s
Resistance to displacing factors
2 classification of of retention in RPD’s
Direct
Indirect
Define direct retention in RPD’s
Denture’s resistance to vertical displacement
Define indirect retention in RPD’s
Denture’s resistance to rotational displacement
Where should direct retention be in RPD’s
Close to base of adjacent abutment teeth
What is a supplementary method of direct retention in RPD’s
Guide planes
Where should guide planes be in RPD’s
Close to base of abutment teeth + parallel to path of insertion
5 types of indirect retainers in RPD’s
Major connectors Minor connectors Rests Saddles Denture base
What is the clasp axis in RPD”s
Axis of rotation
Where should indirect retention be placed in RPD’s
Perpendicular to axis of rotation
What is a reciprocating arm in RPD’s
Opposing element to each clasp unit
What does a reciprocating arm do in RPD’s
Prevents clasp pressure acting on tooth + moving it
What does the path of insertion allow in RPD’s
Anterior retention without clasps
What is the ideal pattern of retention in RPD’s
Triangular
What is the pattern of retention in RPD’s
Number of retainers in an arch
What colour are saddles in the system of deign of RPD’s
Yellow
What colour is support in the system of deign of RPD’s
Red
What colour is retention in the system of deign of RPD’s
Green
What colour is bracing + reciprocation in the system of deign of RPD’s
Blue
What colour are connectors in the system of deign of RPD’s
Black
What is an RPI RPD
Stress relieving clasp system
Where are RPIs used in RPD’s
Free end saddles
Why are RPI’s ideal for free end saddles in RPD’s
Prevent stress on last abutment tooth
3 parts of an RPI in RPD’s
Mesial occlusal rest
Proximal guide plate adjacent to saddle
Gingivally approaching I-bar clasp
What is a proximal guide plate in an RPI RPD
Guide surface of 2-3mm undercut
Where does the gingival approaching I-bar clasp contact the abutment tooth of an RPI RPD
Greatest prominence of tooth contour
What Kennedy class is an RPI ideal for in RPD’s
Class 1 lower denture
Define the major connector of RPD’s
Rigid part connecting components on both sides of an arch
2 types of major connector design of an RPD
Closed
Open
2 advantages of a major connector closed designing RPD’s
More contact withe adjacent teeth
Greater retention
What is necessary for a closed design major connector in RPD’s
Guide planes
2 advantages of an open design major connector in RPD’s
No gingival coverage
Saliva clearance
How can a major connector add indirect retention to an RPD
Extend major connector to resist functional forces
2 things beading of a major connector do in RPD’s
Intimate contact between denture + tissue
Prevents food ingression
Where is beading of a major connector in RPD’s
Along border but stops 3mm from gingival margin
How thick should the cross section of a plate major connector be in RPD’s
0.5mm
What Craddock class is a plate major connector often used for in RPD’s
Class 2 designs
What is an advantage of a bar major connector in RPD’s
Less mucosal coverage
What Craddock class is a bar major connector often used for in RPD’s
Class 1 designs
5 cobalt chrome maxillary major connector designs for RPD’s
Anterior Mid palatal Anterior/posterior bar (ring) Horseshoe Posterior palatal