Replacing Missing Teeth Flashcards

1
Q

How to plan for missing teeth?

A

Restorative treatment will not be implemented for years - need stability first
Need a predictable and durable solution
Consider need for transitional restorations
Build in contingency planning
Pt expectations
Realistic tx plan

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2
Q

Options for partially dentate pts?

A

No tx - shortened dental arch
Ortho space closure
Restore spaces with removable/fixed prostheses
Restore spaces with endosseous implants

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3
Q

Shortened dental arch?

A

Adequate function achieved with a reduced dentition
9-10 pairs of occluding teeth
No detrimental effect from prosthesis

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4
Q

What is a functional dentition?

A

Retention throughout life of a functional aesthetic natural dentition with no less than 20 teeth and not requiring a prosthesis

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5
Q

What number of teeth may require prosthesis?

What to consider with a shortened dental arch?

A

Less than 21
21+ = almost dietary freedom
BUT consider masticatory efficiency, problems to TMJ and periodontal tissues, fixed or removable prosthesis?

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6
Q

What is masticatory efficiency?

A

Shortened dental arches comprising anterior and premolar teeth, in general, fulfil the requirements of a functional dention

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7
Q

Effects of TMD joints?

A

No evidence that shortened dental arch causes overloading of joints and teeth
Neuromuscular regulatory systems control maximum clenching strength in accordance with the occlusal scheme

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8
Q

Restorative options for missing teeth?

A

Composite build ups
RPD
Bridges
Implants

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9
Q

Clinical exam for missing teeth?

A
Occlusal relationship - guidance?
Inter-occlusal space
Centre line
Lip smile line
Position of teeth present
Shape and position of potential abutments
Restorative and vitality status of teeth
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10
Q

Radiographic exam?

A
Position of normal anatomical features
Pathological conditions
Periapical status of abutment teeth
Alveolar support of abutment teeth
Root remnants and foreign bodies
Alveolar height and width
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11
Q

RPD features?

A

Replace the whole dento-alveolar complex
Non destructive
Fully reversible
Effective permanent or transitional option

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12
Q

Disadvantages of RPD?

A
Plaque accumulation
Direct trauma from components
Poor distribution of occlusal forces
Intolerance of major connector 
Poor appearance of clasps
Difficulty in pt acceptance

Insidious nature of:

  • Caries
  • PD
  • Chronic atrophic candidosis
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13
Q

Advantages of RPD?

A

Non-invasive
Versatile
Keep tx options open
Can restore long spans
Will replace teeth and supporting structures
Removable to assist cleaning
Can be modified for progressive tooth loss and bone resorption

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14
Q

RPD or no RPD?

A

Some form of damage is inevitable
Problems not always reported or noted
Appropriate maintenance is required

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15
Q

What does the success of an RPD depend on?

A

Clinician - adequate dental care
Technician - accurate construction
Pt - plaque control
All working as a team

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16
Q

Acrylic RPD features?

A
Low cost
Ease of modification
Short denture life expectancy
Alterations required: relines
Following tooth loss
17
Q

Indications for acrylic RPDs?

A

Remaining teeth have poor prognosis
Diagnostic denture is required
For young pt to allow for growth
When only a few teeth remain

18
Q

Indications for Co/Cr RPDs?

A

Generally the denture of choice for a permanent prosthesis

When sufficient, healthy, tooth support can be obtained

19
Q

Features of fixed partial dentures?

A

Replace teeth only
Destructive
Unpredictable long term prognosis
Design of choice: Single unit adhesive cantilevered

20
Q

Features of implants?

A

Replace teeth
Can replace bone/soft tissue with grafts
Surgical option with higher morbidity
Predictable success rate >90%