Replacing missing teeth Flashcards
What ways can you plan for missing teeth?
Final treatment may not be implemented for some time
Need a predictable and durable solution
Consider the need for transitional restorations
Build in contingency planning
Manage patient expectations
Realistic treatment plan
What are the treatment options for a partially dentate patient?
No treatment
Orthodontic space closure
Restoring spaces with removable prostheses
Restoring spaces with fixed protheses
Restoring spaced with endosseous implants
What is a functional dentition?
Need 10 pairs of occluding teeth
The retention throughout life of a functional aesthetic natural dentition of no less than 20 teeth and not requiring a prothesis
What is a shortened dental arch?
Adequate function achieves with a reduced dentition
9-10 pairs of occluding teeth
No detrimental effect from prosthesis
What is the minimum for optimum function?
21+ teeth almost dietary freedom (can eat what you want
21+ teeth - no need for prosthesis
What is the masticatory efficiency of a SDA?
Comprising anterior and premolar teeth fulfill the requirements of a funcitonal dentition
Does having a SSDA affect TMD joints?
No evidence it causes overloading of the joints and teeth
Neuromuscular regulatory systems control the max clenching strength in accordance with the occlusal scheme
What is the prosthodontic management of a SDA?
No difference in survival between SDA’s restored with removable or fixed adhesive prostheses
But fixed requires less maintenance
What are the restorative options for pt with missing teeth?
Composite build ups
RPD
Bridge
Implants
What do you look for on clinical examination?
Occlusal relationship Inter-occlusal space Centre line Lip smile line Position of teeth present Shape and position of potential abutments Restorative and vitality status of teeth
What do you look for on radiographic examination?
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
Why use RPD?
Replace the whole dento-alveolar complex
Non-destructive complex
Fully reversible
Effective permanent or transitional option
Advantages of RPD?
Appearance Mastication Prevent tooth movement Better load distribution Prepare for complete dentures Non-invasive Versatile Keep treatment options open Can restore long spans Will replace teeth and supporting structures Removable to assist cleaning Can be modified for progressive tooth loss and resorption
What are the disadvantages of RPD?
Plaque accumulation Direct trauma from components Poor distribution of occlusal forces Intolerance of major connector Poor appearance of clasps Difficulty in patient acceptance Insidious nature of; caries, perio disease, chronic atrophic candidosis
What does the success of an RPD rely on?
The clinician - adequate dental care
The technician - accurate construction
The patient - plaque control
