RPD Design and Oral Health

Question 1

Name 3 main concerns of oral health and RPDs

Answer 1

1. Plaque and oral hygiene
2. Coverage of marginal gingivae and mucosa
3. Occlusal forces transmitted to teeth by RPDs

Question 2

Describe the damage plaque can cause to:

 a) Teeth
 b) Periodontal Tissues
 c) Edentulous Areas

Answer 2

Teeth - Caries
Periodontal Tissues - Gingival inflammation
Edentulous Areas - Inflammation of mucous membrane and stomatitis

Question 3

Describe the damage direct trauma can cause to:

 a) Teeth
 b) Periodontal Tissues
 c) Edentulous Areas

Answer 3

Teeth - Abrasion of teeth with clasps and fractures of restorations
Periodontal Tissues - Gingival ulceration and pain
Edentulous Area - Inflammation of mucous membrane and hyperplasia

Question 4

Describe the damage excessive functional force can cause to:

 a) Teeth
 b) Periodontal Tissues
 c) Edentulous Areas
 d) Muscles of Mastication

Answer 4

Teeth - Inflammation of periodontal ligament leading to pain
Periodontal Tissues - Tooth mobility
Edentulous area - Inflammation of mucous membrane and bone resorption
Muscles of Mastication - Muscle dysfunction e.g TMD, pain

Question 5

Describe the findings of Brill et al 1977, regarding RPDs

Answer 5

• Introduction of RPD adversely affects prevailing ecological situation
• Simplification of design reduces damaging potential
• Use of RPDs leads to detrimental changes in quantity and quality of plaque formation (more plaque and more anaerobic microbes)

Question 6

Name 5 clinical examinations used by Kurtis et al 2003, to examine effects of RPDs on patient’s oral health

Answer 6

1. Plaque index
2. Gingival index
3. Probing depths
4. Probing attachment
5. GCF sampling

Question 7

Describe El Ghamrawy 1980, finding on toothbrushing and RPDs

Answer 7

Intensive toothbrushing is effective in reducing accumulation of plaque on abutment teeth

Question 8

Describe the findings of Bergman and Ericson 1989 cross sectional study, and Vanzehavern et al 2003 longitudinal study, with regards to RPDs and periodontal health

Answer 8

• Carefully planned prosthetic treatment and adequate checks on oral and dental hygeine little damage will result to periodontal tissues
• RPD itself is not responsible for significant increase in rate of caries

Question 9

Describe the findings of Jacobson 1987, with regards to RPD design

Answer 9

• Some patient can maintain meticulous levels of home care regardless of prosthesis design
• However, RPDs should be fabricated along guidelines which benefit majority of patients
• Minimal tissue coverage by framework components
• Elimination of components when possible without compromising biomechanical requirements

Question 10

Describe 5 components of maintaining oral health in provision of RPDs

Answer 10

1. Assessment and selection of patient, including diagnosis and treatment plan
2. Denture design
3. Denture construction
4. Post-insertion instruction (hygiene demonstration)
5. Further review and maintenance programme