Professional Documents
Culture Documents
(PROSTHODONTICS)
Sumdili 11:52 AM Prosthetic Dentistry
History
taking
for
construction
1. Appearance: Aesthetics
2. Function: to restore function
of
partial
or
complete
Denture history
1. New denture wearer
2. Old denture wearer
3. Age of denture when was first worn
4. How many sets of denture worn
5. Haterial of denture
2.
3.
4.
5.
6.
7.
8.
9.
10.Bridges
11. Orthodontic therapy ,
12. Endodontically treated tooth
13. Splints
14. Previous treatment tried for present complaint
Medical history
Any medical condition
Anxiety and depression status of patient
History of stroke ,muscle disorders
Social history
1. Marital status
2. Mobility
3. Access for treatment
4. Drinking
5. Smoking
6. Job
7. Examination
Extraoral examination
1. TMJ positioning while closing and opening of jaw
2. Any clicking of TMJ
3. Masseter hypertrophy
4. Tenderness in joint or muscle of mastioation
Facial counture
1. Old photographs
2. Loss of dental bulge
3. Perioral skin wrinkling
4. Angular cheilitis
5. Vertical hight
6. Lip seal , over closure , or anterior openbite
Intra oral examination
1. mucosa
2. xerostomia,
3. candida mucosal ulceration
4. gingival hyperplasia
5. undercuts
Periodontal health
1. oral hygiene
2. periodontal status
3. mobility and drifting of remaining teeth
Caries
1. number of carious teeth
2. and filled teeth ,
3. recurrent caries
Occlusion
1. skeletal classification ,
2. competent lips ,
3. prognathism ,
4. overerypted teeth crowding or
5. spacing of teeth
Denture examination
1. present denture or
2. previous denture examination
3. Examine both interiorly and
4. extra oral exmmination
Upper denture
Overextension
to,The
external
mandible
oblique
ridge
of
3. Tongue thrust,
4. Clenching of jaw ,
5. eating on one side only
Radiographic Examination
1. periapicals
2. panaromics
3. occlusal
4. lateral cephalometrics and
5. tomograms
Some
cases
require
special
prosthodontoc examination
tests
and
additional
features
of
These are,
1. study cast
2. surveying
3. full occlusal assessment
4. diagnostic wax up
Surveying
1. Surveying of cast is useful in areas of undercut and
2. determine potential path of insertion ,
3. removal or displacement of partial denture
4. Is helpful for design of denture
Diagnostic wax up
May be helpful; for evaluation of alternative design
Can help patient evaluation of options
Alternative to denture
1. Fix appliance e.g. crown & brides or
2. Implant Or
3. Not wearing denture at all
Preprosthetic management
1. Any caries
2. Endodontic treatment
3. Periodontal trement must be controlled before any prsthodontic construction
2. Good support
3. Good muscle balance
4. Good occlusal balance And
5. stability
Denture border
Muscle balance
1. Muscle balance is achieved when the forces of muscles of lips , tongue ,
cheeks do not dislodge the denture during functional movements of the
mouth and
2. When the teeth are out of contact
3. Concave shape of denture polished surface gives a vertical seating force
when buccinator contract
4. A thinner denture flange in the premolar region results in more free
movement of the Modiolus ( the site of muscle fiber decussation from
buccinator and orbicularis oris muscle)
Occlusal balance
1. Occlusal balance is achieved when the forces of one denture do not dislodge
the other denture during functional jaw movements with the teeth in contact
2. This can be achieved by a balanced articulation
Stability
1. Is the ability of dentures to resist displacement by functional stresses.
2. Stability gives physiological comfort
Denture faults
1. Incorrect peripheral extension
2. Teeth set not in neutral zone
3. Un- balanced articulation
Burning mouth.
Sensitivity to acrylic monomer
Speech difficulties
1. Difficult F, V sounds = incisors are set too far palatally
2. Difficulty with S, T, D sounds = incorrect palatal contour ->correct palatal
contour
3. S becomes th - incisors set too far palatally or palatal plate too thick
Clicking teeth
Due to increased occlusal vertical dimension
Peripheral seal
1. Is the of contact between the mobile mucosa and the denture surface and ,
2. is determined at the master impression stage
3. Good peripheral seal is good for the retention and stability
Potsdam is,
1. A round smooth line at the junction of hard and soft palate
2. Aids in peripheral seal of maxillary denture
Fraena,
1. Labial frenum ,
2. buccal frenum,
3. lingual freum and
4. buccal frenum
5. A technique of impression taking is adopted to obtain fraenal relief
Relief areas,
1. Small tori
2. Prominent mylohyoid ridge
3. prominent mental nerve foramen Often have to be relieved
retruded contact
position
2. This is the position of the mandibular condyles in the most retruded position
in the glenoid fossa
3. As this is the most reproduciable position
Balanced articulation
1. The complete denture should have a balanced articulation
2. Which is the continuous contact position of upper and lower cusps
3. all around dental arch during all closed grinding movements of mandible
Freeway space
1. 2-4 mm of free space in vertical dimension for construction of complete
denture
2. This is the distance between the two arches in rest position
3. This space is variable in individual mandibular movements in speech
Aesthetics
According to individual needs of patient
Without loss of functional concepts
Types of impressions
1. Mucocompressive and
2. Mucostatic
5.
laboratory remounting or
6.
resetting of teeth
Appearance problem
1. shade of tooth wrong
2. shape of teeth wrong
3. too much or too little tooth shows
4. lips look odd
5. face looks asymmetrical , patient unhappy
6. problem is treated by resetting of teeth
7. is due to incorrect recording vertical or horizontal components of occlusion
Speech problems
1. problem with F and V sounds or hissing S sounds
Retching
1. Retching is a protective reflex
2. Examination and impression taking is difficult
3. There may be psychiatric elements to retching
4. is treated by progressive adaptation to denture
5. construction of base plates first
6. hypnotherapy or desensitization therapy
Acrylic allergy
Prosthotics
that the immediate denture can be a spare denture if the new denture
breaks, is misplaced, or has to be repaired or relined in our laboratory.
3. For patients requiring a complete immediate denture, the back teeth are
often extracted six to eight weeks prior to the fabrication phase.
4. This allows the extraction sites to heal and a better-fitting immediate
complete denture to be fabricated.
Properties of Alginates
CHEMISTRY
1. On mixing the powder with water a sol is formed,
2. a chemical reaction takes place and
3. a
gel
is
formed.
Alginate
salt
2.
Calcium
salt
(e.g.
(e.g.
sodium
alginate)
calcium
sulphate)
3. Trisodium phosphate
SODIUM SULPHATE
+
CALCIUM ALGINATE
the
alginate
will
set
as
gel.
PROPERTIES of alginate
Good surface detail
Reaction is faster at higher temperatures
Elastic enough to be drawn over the undercuts, but tears over the deep
undercuts
Not dimensionally stable on storing due to evaporation
Non toxic and non irritant
Setting time can depend on technique
Alginate powder is unstable on storage in presence of moisture or in
warm temperatures
ADVANTAGES
1.
Non
toxic
2.
and
Good
non
surface
3.
Ease
of
use
4.
Cheap
and
good
irritant
detail
and
shelf
mix
life
DISADVANTAGES
1.
2.
3.
Poor
dimensional
Incompatibility
Setting
time
with
very
some
dependent
stability
dental
on
Denture maintenance
Rebasing is,
1. Replacement of all of denture base
2. When improvement in the fitting surface is required
3. Heat cure acrylic is the material of choices
Relining is,
Replacement of fitting surface with a self cure acrylic
operator
stones
handling
A dentures relining
1. can help make wearing dentures much more comfortable ,
2. but they should always be replaced every five years
3. to adjust to the natural changes of face and
4. the changes in the bone within mouth.
1. immediate
replacement
of
extracted
tooth
2. no aesthetic loss,
Copy denture is
1. When
old
denture
is
used
to
make
new
denture.
fault
present
in
the
old
denture
is
likely
to
be
repeated.
splint
Centric
Occlusion
Centric
Relation = retruded
contact
position
3. in which the condyles articulate with the thinnest avascular portion of their
respective disks
4. With the complex in the anterior-superior position against the slopes of the
articular eminences.
5. This position is independent of tooth contact.
6. syn. retruded contact position
Compensating
Curve
1. The anteroposterior curvature (in the median plane) and the mediolateral
curvature (in the frontal plane)
2. in the alignment of the occluding surfaces and incisal edges of artificial
teeth
3. that are used to develop balanced occlusion.
Cross-Bite= reverse
articulation
1. When the maxillary teeth occlude with buccal cusps contact the central
fossa of the mandibular teeth.
2. An occlusal relationship in which the mandibular teeth are located facial to
the opposing maxillary teeth;
3. the maxillary buccal cusps are positioned in the central fossae of the
mandibular
teeth.
Curve
archaic sees Compensating Curve
of
Monson
Functional
Occlusion
is the contacts of the maxillary and mandibular teeth during mastication and
deglutition.
Most common Denture problems
Can be due to ,
1. Denture errors or
2. Patient factors
Causes of pain,
1. Rough fitting surface
2. Errors in occlusion
3. bruxism
4. Retained root
5. Sharp alveolar ridge
6. Premature contact
7. Excessive bone resorption mental foramen pressure or exposure in
localised area of pain
8. Leverage due to unstable denture
9. Clasp arm too high
1. In the laboratory, the free end saddle areas on the master cast are sectioned
off.
2. The denture is then positioned on the model and the new saddle areas are
poured.
3. The resulting model represents the free end saddle areas under conditions,
which mimic functional load.
4. Denture construction then continues as normal.
5. The distribution of loading of the free end saddles is improved and denture is
more stable.
How long do I leave the impression in the mouth before it's fully
set?
1. Setting time in the mouth is based on use of room temperature water.
2. All materials will gel in 5 minutes except one.
3. Lavender Acculoid requires 7 minutes to gel.
How
do
disinfect
my
hydrocolloid
impressions?
Sterilization Pouches
Sterilization Pouches offer not only the highest quality dental pouch, but also
features the patented Internal-Processing-Indicator. Available in 12 sizes
Any items such as impression trays and facebow forks that are
placed in the mouth,
Should be heat-sterilized.
Contaminated Stone Casts
Contaminated stone casts transferred to or from a laboratory area
or a clinic
1. should be sprayed with a complex phenol disinfectant and
2. allowed to set for 10 minutes before rinsing thoroughly with water.
3. A protective mask must be worn when using a model trimmer.
Other Work-Related Items
1. All other work-related items (articulators, case pans, etc.)
2. which are transferred from a clinic to a laboratory area or vice versa
3. must be disinfected.
4. Moving parts of the articulator should not be disinfected since this may
impair function.
Avoid:
Sticky foods like caramel, gum, taffy
Hard candy
Chewing on ice
Popcorn kernels or "old maids
An Articulator
1. An articulator assists in the fabrication of removable appliances (dentures),
2. is a mechanical device used to casts of the maxillary and mandibular teeth
are fixed and
3. reproduces recorded positions of the mandible in relation to the maxilla.
4. fixed prosthodontic restorations (crowns, bridges, inlays and onlays)and
orthodontic appliances.
Plane line articulator
1. The simplest type of articulator consisting of a simple hinge joint.
2. No lateral or sliding movements are possible with a plane line articulator.
3. An articulator that allows that reproduces movement of the mandible only in
a sagittal plane