Removable Prosthodontics Flashcards
Chossing a removable prosthesis: extraoral factors
Extraoral factors: influencing the choice of removable prosthesis are listed here:
- Physical health
- mental health
- motivation
- age
5.Dietary habits - socioeconomic factors
- occupation
Choosing a removable prosthesis: intraoral factors
Intraoral factors influencing the choice of a removable prosthesis are listed:
1.Musculature
2. flow of saliva
3. residual alveolar ridge
4. oral mucosa
5. oral habits
6. tori
Removable partial denture use: indication and contraindications
There are servera; indications for and contraindications to the use f removable partial dentures
- Indications for removable partial denture use:👍🏻
- Replacement for several teeth in the same quadrant or same arch
- temporary replacement for missing teeth in a child
*Replacement of missing teeth for patient who does not want to fixed bridge or implants.
*Replacement for the patient who finds it easier to maintain good oral hygiene
- replacement to serve as a splint to support periodontally involved teeth.
Contraindication to removable partial denture use👎🏻
* lack of suitable teeth in the arch to stabilize, and retain removable prosthesis
*Rampant caries or severe periodontal conditions that threaten the remaining teeth in arch
- A lack of patient acceptance for aesthetic reasons chronic poor oral hygiene
Components of patients denture
A partial denture consists of a framework, connector, retainer, rest and artificial teeth.
-Framework: The cast metal skeleton provides support the remaining components of the prosthesis.
-Connector: major and minor connectors join various parts f the partial together.
-Retainer: known as clasp. It supports and provides stability to the partial denture by partially circling an abutment tooth.
-Rest: is a metal projection designed to control the seating of the prosthesis.
-Artificial teeth: are constructed from either acrylic or porcelain.
Appointment sequencing for partial denture: 1-3
Steps in construction of a removable partial denture.
Appointment 1:
- updating health and dental history
- prophylaxis
-preliminary impressions
- radiographs
- photographs
Appointment 2:
- preparing the teeth
- final impression
-occlusal registration
- selecting the shade and mold of the teeth
- preparing the laboratory prescription.
Appointment 3:
- evaluating the fit, comfort, and functions of the appliance.
- Evaluating the shade, mold, and arrangement of the teeth
- New occlusal registration
- Noting any change on the Laboratory prescription.
Appointment sequencing for partial denture: 4-5
first appointments are necessary for the actual delivery and post-delivery check of the removable partial denture during apportionment 4-5
Appointment 4 delivery:
- Having the patient place the partial
- checking of occlusion
- detection of any pressure points
- checking of retainers for tension on the natural abutment teeth.
- polishing of the partial
-home instructions for the patient
Appointment 5 post-delivery check:
- Evaluation of the fit
- checking of the mucosa for pressure area and ore spots
- Evaluation of the function of the prothesis.
complete dentures: indications and contraindications
the use of removable complete dentures:
- Indications for complete denture use:👍🏻
-lack of motivation or ability to maintain existing teeth
-advanced periodontal disease with bone loss
- sufficient alveolar bone and oral mucosa necessary to support a complete denture
- financial constraints that means fixed prosthodotics
are not possible
-good overall health
-health gingival tissues
-good oral hygiene practice.
- Contraindications to complete denture use👎🏻
- lack of alveolar bone support due the periodontal disease or hereditary defects
- Poor overall health
- lack of motivation to adjust to and maintain a complete denture
- chronic poor oral hygiene
Basic compinets of complete dentures
-Base: made of acrylic. The base might have mesh screen imbedded into the acrylic for additional strength. The natural appearance of the base is result of pigmentation and fibers impregnated into the acrylic.
-Flange: Portion of the base extends over the attached mucosa from the cervical margin of the teeth of the denture border.
-post dam: The base of the maxillary denture requires a suction seal for retention. Therefore, the base material covers the entire hard palate for contact with the tissue forming the seal.
-Artificial teeth: teeth might be made of porcelain or acrylic resin. Although porcelain is more resistant to stain, teeth can be brittle and have a tendency to make a clacking noice on occlusion. some patients find this unappealing and unatural. Additionally, porcelain teeth cause faster resorption of the alveolar bone. Acrylic teeth are easier to polish, fit, and adjust.
construction of full dentures
appointment 1: Records: health and dental history are updated Initial impressions are taken.
appointment 2, Final impression: a custom tray made form diagnostic casts. Usinf beading wax, edges of the tray should extend 2 mm short of the mucobuccal fod.
appointment 3, try in of baseplate and occlusal rim: The shape, shade and material of artificial teeth are selected.
appointment 4 try in:
appointment 5 delivery: gingiva colored wax setup of the base with the with is retured for try in. The teeth are articulated according to the patient’s bite registration. A patient might require more than one wax setup try in.
appointment 6: the completed dentures are delivered to the patient.
Immediate Dentures
A patient who will be getting full dentures, but still has teeth has two options.
In first procedure the patient will require immediate dentures or the patient will be edentulous for 4 to 6 months.
Have All teeth removed and have an Alveoplasty:
- at one appointment , the dentist will remove all existing teeth and perform an alveoplasty. An alveoplasty shapes and contours the alveolar ridge ensuring the proper fit the full denture.
Have the posterior teeth removed, completely heal, return to have the anterior teeth removed:
- At one appointment, dentist will remove the posterior teeth and the patient will be allowed completely heal. During the healing process which typically lasts 4-6 months, the dull dentures will be fabricated. Upon return, the patient will have anterior teeth removed, and denture will be placed.
Denture Home care
For partial dentures:
-Store the prosthesis in water or moist, airtight container when not wearing it.
- After eating, remove the prosthesis from the mouth and bruh or rinse the retainer ,rests and complete partial.
-Brush and floss the abutment teeth and natural teeth to keep them free of food and plaque
- Do not adjust the partial denture
- Do not wear denture overnight
-soak it in an over the counter commercial cleaning solution.
For Patients receiving complete dentures:
- when not in use, the dentures should be stored in liquid to prevent dimensional changes. For overnight storage teh patient should use an over the counter commercial cleaner (rinsing thoroughly before placing it in the mouth)
- Remove and rinse the dentures daily
- Dentures can accumulate calculus. Use a denture brush and brush the teeth and denture using a non abrasive toothpaste
-Do not wear the dentures overnight. Removing the denture overnight allows the oral tissue to breath and relieved of the pressure of the dentures.
Reling and repairing full dentures
With time, a complete or full denture will need to be relined to accommodate changes to tissue and bone due to anatomic changes of the alveolar bone and oral mucosa. Pressure from constant use and time results in the loss of alveolar bone. This bone loss causes tissue Shrinkage. As a result, the prosthesis will lose its original fit.
Relining the denture will add a new layer of hard acrylic to the base of the denture. This process restores the fit of the prosthesis.
Repair of a dental prosthesis requires a visit to the dentist. While there are “at-home” denture repair kits in the marketplace, they are generally not recommended by the dental community.
A basic repair, such as replacing a tooth lost from the base, can be done in the dental office. More complex repairs might require that the denture be sent to a dental laboratory.
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