Tooth Prep. for RPDs

Question 1

what are the four phases of a restorative treatment plan?

Answer 1

• immediate treatment
• initial (hygienic or preparatory) phase
• reconstructive (corrective) phase
• maintenance

Question 2

what is the immediate treatment phase?

Answer 2

patient who comes in complaining of pain or who has an acute infection relating to their teeth (needs managed straight away)

Question 3

what is an example of immediate treatment?

Answer 3

extraction of tooth

Question 4

what is the initial phase of RPD plan?

Answer 4

dentist establishes oral and dental health status

Question 5

what could occur during the initial phase of the RPD treatment plan?

Answer 5

• scaling and root planing
• periodontal probing
• investigate diet
• alcohol & smoking advice

Question 6

what is the reconstructive phase of the RPD treatment plan?

Answer 6

deciding how the RPD is going to be designed

Question 7

what are the main aspects of mouth preparation?

Answer 7

• initial prosthetic treatment
• pre-prosthetic surgery
• periodontal treatment
• orthodontic treatment
• fixed prosthodontic treatment and endodontics
• tooth prep

Question 8

what is initial prosthetic treatment?

Answer 8

• repairs and additions to current RPD / teeth
• temporary relines of denture
• occlusal adjustment
• treatment of denture stomatitis

Question 9

what is pre-prosthetic surgery?

Answer 9

• remove retained roots / unerupted teeth
• remove any pathology
• improve contours or edentulous areas (by reducing bony prominences and hyperplastic soft tissues)
• eliminate prominent fraenal attachments

Question 10

what is periodontal treatment?

Answer 10

• establish health in perio tissues
• assess patient motivation
• detailed instruction in oral hygiene procedures
• scaling and root planing
• periodontal surgery

Question 11

what is orthodontic treatment?

Answer 11

• to optimise space
• to optimise abutment alignment
(may be used in cleft patients, hypodontia patients, perio patients)

Question 12

why do we need to prepare teeth before?

Answer 12

• provide rest seats
• establish guide surfaces
• modify unfavourable survey lines
• create retentive areas

Question 13

what instruments are normally used for tooth prep?

Answer 13

• rotary diamond instruments

* special burrs, stones and abrasive-impregnated rubber wheels/points

Question 14

why are rotary instruments used in tooth prep?

Answer 14

to shape enamel surfaces

Question 15

why are special burrs/stones/rubber wheels etc used in tooth prep?

Answer 15

to smooth and polish the resultant roughened enamel surface

Question 16

what is the purpose of rest seats?

Answer 16

• produce favourable tooth surface for support
• prevent interference with occlusion
• reduce prominence of the rest (so patient isn’t aware of it)

Question 17

what teeth are more suitable for rest seat modification?

Answer 17

• well formed cingulums are normally chosen as it is easier to get good attachment
• maxillary canines are a good choice

Question 18

what other ways can rest seats be used?

Answer 18

1. produce a rest seat in composite applied to cingulum area
2. bond a cast metal cingulum to tooth

Question 19

what are guide planes?

Answer 19

two or more parallel axial surfaces on abutment teeth, which limit the path of insertion of a denture

Question 20

what do guide planes provide?

Answer 20

• increased stability
• reciprocation
• prevention of clasp deformation
• improved appearance

Question 21

how are guide planes prepared?

Answer 21

• guide surface should extend vertically 3mm but be kept as far from the gingival margin as possible
• not more than 0.5mm of enamel should be removed

Question 22

how can retentive areas be created?

Answer 22

by addition of acid-etched composite (ultra fine or hybrid composites)