Removable Prosthodontics
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Transcript of Removable Prosthodontics
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Removable ProsthodonticsRemovable Prosthodontics
Chapter 52Chapter 52
Copyright 2003, Elsevier Science (USA).All rights reserved. No part of this product may be reproduced or transmitted in any
form or by any means, electronic or mechanical, including input into or storage in any
information system, without permission in writingfrom the publisher.
PowerPoint presentation slides may be displayed and may be reproduced in print
form for instructional purposes only, provided a proper copyright notice appears on
the last page of each print-out.
Produced in the United States of America
ISBN 0-7216-9770-4
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Copyright 2003, Elsevier Science (USA). All rights reserved.
IntroductionIntroduction
Removable prosthodontics is thespecialty of dentistry that replaces missingteeth with a removable prosthesis.
Removable partial denture, also referredto as a partial, replaces one or more teeth inthe same arch.
Removable full denture, also referred to
as a denture, replaces all of the teeth in onearch.
Removable prosthodontics is thespecialty of dentistry that replaces missingteeth with a removable prosthesis.
Removable partial denture, also referredto as a p
artial, replaces one or more teeth inthe same arch.
Removable full denture, also referred to
as a denture, replaces all of the teeth in onearch.
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 52-1 Removable partial denture.Fig. 52-1 Removable partial denture.
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 52-2 Full denture.Fig. 52-2 Full denture.
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ExtraoralFactors thatInfluence the Choiceof a Removable ProsthesisExtraoralFactors thatInfluence the Choiceof a Removable Prosthesis
Physical health
Mental health
Motivation
Age
Dietary habits
Socioeconomic factors
Occupation
Physical health
Mental health
Motivation
Age
Dietary habits
Socioeconomic factors
Occupation
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Musculature
Salivary flow
Residual alveolar ridge
Oral mucosa
Oral habits
Tori
Musculature
Salivary flow
Residual alveolar ridge
Oral mucosa
Oral habits
Tori
IntraoralFactors thatInfluence the Choiceof a Removable ProsthesisIntraoralFactors thatInfluence the Choiceof a Removable Prosthesis
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Indications for a Removable PartialDentureIndications for a Removable PartialDenture
To replace several teeth in the same quadrant orin both quadrants of the same arch.
As a temporary replacement for missing teeth ina child.
To replace missing teeth for patients who do notwant a fixed bridge or implants.
For the patient who finds it easier to maintaingood oral hygiene.
To serve as a splint to support periodontallyinvolved teeth.
To replace several teeth in the same quadrant orin both quadrants of the same arch.
As a temporary replacement for missing teeth ina child.
To replace missing teeth for patients who do notwant a fixed bridge or implants.
For the patient who finds it easier to maintaingood oral hygiene.
To serve as a splint to support periodontallyinvolved teeth.
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Contraindications for a RemovablePartial DentureContraindications for a Removable
Partial Denture
A lack of suitable teeth in the arch to support,stabilize, and retain the removable prosthesis.
Rampant caries or severe periodontal
conditions that threaten the remaining teeth inthe arch.
A lack of patient acceptance for estheticreasons.
Chronic poor oral hygiene.
A lack of suitable teeth in the arch to support,stabilize, and retain the removable prosthesis.
Rampant caries or severe periodontal
conditions that threaten the remaining teeth inthe arch.
A lack of patient acceptance for estheticreasons.
Chronic poor oral hygiene.
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Components of a Partial DentureComponents of a Partial Denture
Framework
The cast metal skeleton that providessupport for the remaining components of the
prosthesis. Connectors
Join various parts of the partial together
Major connector
Minor connector
Framework
The cast metal skeleton that providessupport for the remaining components of the
prosthesis. Connectors
Join various parts of the partial together
Major connector
Minor connector
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Retainer Known as a clasp, it supports and provides
stability to the partial denture by partiallycircling an abutment tooth.
Rest A metal projection designed to control the
seating of the prosthesis.
Artificial teeth
Constructed from either acrylic or porcelain.
Retainer Known as a clasp, it supports and provides
stability to the partial denture by partiallycircling an abutment tooth.
Rest A metal projection designed to control the
seating of the prosthesis.
Artificial teeth
Constructed from either acrylic or porcelain.
Components of a Partial Denture-contdComponents of a Partial Denture-contd
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Appointment Sequencing for a PartialDentureAppointment Sequencing for a PartialDenture
Appointment 1: Records
Updated health and dental history.
Prophylaxis.
Preliminary impressions. Radiographs.
Photographs.
Appointment 1: Records
Updated health and dental history.
Prophylaxis.
Preliminary impressions. Radiographs.
Photographs.
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Appointment 2: Preparation
Prepare the teeth.
Take the final impression.
Take the occlusal registration. Select the shade and mold of the teeth.
Prepare the laboratory prescription.
Appointment 2: Preparation
Prepare the teeth.
Take the final impression.
Take the occlusal registration. Select the shade and mold of the teeth.
Prepare the laboratory prescription.
Appointment Sequencing for a PartialDenture-contdAppointment Sequencing for a PartialDenture-contd
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Appointment 3: Try-in
Evaluate the fit, comfort, and function ofthe appliance.
Evaluate the shade, mold, and arrangementof the teeth.
Take new occlusal registration.
Note any changes on the laboratoryprescription.
Appointment 3: Try-in
Evaluate the fit, comfort, and function ofthe appliance.
Evaluate the shade, mold, and arrangementof the teeth.
Take new occlusal registration.
Note any changes on the laboratoryprescription.
Appointment Sequencing for a PartialDenture-contdAppointment Sequencing for a PartialDenture-contd
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Appointment 4: Delivery
Have patient place partial.
Check occlusion.
Detect any pressure points. Check retainers for tension on the natural
abutment teeth.
Polish partial. Give patient home instructions.
Appointment 4: Delivery
Have patient place partial.
Check occlusion.
Detect any pressure points. Check retainers for tension on the natural
abutment teeth.
Polish partial. Give patient home instructions.
Appointment Sequencing for a PartialDenture-contdAppointment Sequencing for a PartialDenture-contd
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Home Care Instructions for aPartial DentureHome Care Instructions for aPartial Denture
Store prosthesis in water or a moist airtightcontainer when not wearing it.
After eating, remove from mouth and brush orrinse the retainers, rests, and complete partial.
Brush and floss abutment teeth and naturalteeth to keep them free of food debris andplaque.
Advise patient not to adjust the partial denture.
Store prosthesis in water or a moist airtightcontainer when not wearing it.
After eating, remove from mouth and brush orrinse the retainers, rests, and complete partial.
Brush and floss abutment teeth and naturalteeth to keep them free of food debris andplaque.
Advise patient not to adjust the partial denture.
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Appointment 5: Postdelivery check
Evaluate the fit.
Check the mucosa for pressure areas and
sore spots. Evaluate the function of the prosthesis.
Appointment 5: Postdelivery check
Evaluate the fit.
Check the mucosa for pressure areas and
sore spots. Evaluate the function of the prosthesis.
Appointment Sequencing for a PartialDenture-contdAppointment Sequencing for a PartialDenture-contd
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Indications for a Full DentureIndications for a Full Denture
The patient is edentulous.
The remaining teeth cannot be saved.
The remaining teeth cannot support a
removable partial denture, and no acceptablealternatives are available.
The patient refuses alternative treatmentrecommendations.
The patient is edentulous.
The remaining teeth cannot be saved.
The remaining teeth cannot support a
removable partial denture, and no acceptablealternatives are available.
The patient refuses alternative treatmentrecommendations.
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Contraindications for a Full DentureContraindications for a Full Denture
Another acceptable alternative is available.
Physical or mental illness affects the patient'sability to cooperate during the fabrication ofthe denture and to accept or wear thedenture.
The patient is hypersensitive to denturematerials.
The patient is not interested in replacingmissing teeth.
Another acceptable alternative is available.
Physical or mental illness affects the patient'sability to cooperate during the fabrication ofthe denture and to accept or wear thedenture.
The patient is hypersensitive to denturematerials.
The patient is not interested in replacingmissing teeth.
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Components of a Full DentureComponents of a Full Denture
Base
Designed to fit over the residual alveolarridge and surrounding gingival area.
Flange Part of the base that extends over the
attached mucosa from the cervical marginof the teeth to the border of the denture.
Base
Designed to fit over the residual alveolarridge and surrounding gingival area.
Flange Part of the base that extends over the
attached mucosa from the cervical marginof the teeth to the border of the denture.
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Post dam
Retention of a maxillary denture dependson the suction seal.
Artificial teeth Fabricated from acrylic or porcelain.
Post dam
Retention of a maxillary denture dependson the suction seal.
Artificial teeth Fabricated from acrylic or porcelain.
Components of a Full Denture-contdComponents of a Full Denture-contd
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Appointment Sequencing for a FullDentureAppointment Sequencing for a FullDenture
Appointment 1: Records
Updated health and dental history.
Preliminary impressions.
Radiographs. Photographs.
Appointment 1: Records
Updated health and dental history.
Preliminary impressions.
Radiographs. Photographs.
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Copyright 2003, Elsevier Science (USA). All rights reserved.
Appointment 2: Final impression
Essentials of a final impression for dentures
Landmarks of the dental arches are accuratelyreproduced.
Maxillary should include the hamular notches, postdam, tuberosities, and frenum attachments.
Mandibular should include the retromolar pads,oblique ridge, outline of the mylohyoid ridge andthe genial tubercles, plus the lingual, labial, and
buccal frena. Laboratory prescription
Appointment 2: Final impression
Essentials of a final impression for dentures
Landmarks of the dental arches are accuratelyreproduced.
Maxillary should include the hamular notches, postdam, tuberosities, and frenum attachments.
Mandibular should include the retromolar pads,oblique ridge, outline of the mylohyoid ridge andthe genial tubercles, plus the lingual, labial, and
buccal frena. Laboratory prescription
Appointment Sequencing for a FullDenture-contdAppointment Sequencing for a FullDenture-contd
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Appointment 3: Try-in ofbaseplate-occlusal rim
Occlusal rim records
Vertical dimensions evaluated. Occlusal relationship.
Smile line.
Canine eminence.
Select artificial teeth
Appointment 3: Try-in ofbaseplate-occlusal rim
Occlusal rim records
Vertical dimensions evaluated. Occlusal relationship.
Smile line.
Canine eminence.
Select artificial teeth
Appointment Sequencing for a FullDenture-contdAppointment Sequencing for a FullDenture-contd
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Appointment 3: Try-in ofbaseplate-occlusal rim-contd
Occlusal registration measurements
Centric relation. Protrusion.
Retrusion.
Lateral excursion.
Appointment 3: Try-in ofbaseplate-occlusal rim-contd
Occlusal registration measurements
Centric relation. Protrusion.
Retrusion.
Lateral excursion.
Appointment Sequencing for a FullDenture-contdAppointment Sequencing for a FullDenture-contd
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Appointment 4: Try-in
Denture is evaluated for fit, comfort, and stability.
Appearance of the denture, including the shade,mold, and alignment of the teeth, is verified.
Retention of the denture setup is checked as thepatient verbalizes the f, v, s, and th sounds;swallows; and yawns.
Occlusion of the denture is checked.
Laboratory prescription for the completion of thedenture is prepared.
Appointment 4: Try-in
Denture is evaluated for fit, comfort, and stability.
Appearance of the denture, including the shade,mold, and alignment of the teeth, is verified.
Retention of the denture setup is checked as thepatient verbalizes the f, v, s, and th sounds;swallows; and yawns.
Occlusion of the denture is checked.
Laboratory prescription for the completion of thedenture is prepared.
Appointment Sequencing for a FullDenture-contdAppointment Sequencing for a FullDenture-contd
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Appointment 5: Delivery
New denture is inserted into the patient'smouth.
Shade and mold of the artificial teeth are
checked for natural appearance.
Patient is requested to perform facialexpressions and the actions of swallowing,chewing, and speaking, using s and th sounds.
Occlusion is checked. Home instructions are given.
Appointment 5: Delivery
New denture is inserted into the patient'smouth.
Shade and mold of the artificial teeth are
checked for natural appearance.
Patient is requested to perform facialexpressions and the actions of swallowing,chewing, and speaking, using s and th sounds.
Occlusion is checked. Home instructions are given.
Appointment Sequencing for a FullDenture-contdAppointment Sequencing for a FullDenture-contd
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Thoroughly rinse the oral tissues at least oncedaily.
All surfaces of the denture should be
thoroughly cleaned with a denture brush andmild abrasive.
When dentures are not in the mouth, theymust be stored in a moist, airtight container to
prevent drying and warpage.
Thoroughly rinse the oral tissues at least oncedaily.
All surfaces of the denture should be
thoroughly cleaned with a denture brush andmild abrasive.
When dentures are not in the mouth, theymust be stored in a moist, airtight container to
prevent drying and warpage.
Home Care Instructions for a FullDentureHome Care Instructions for a FullDenture
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Appointment 6: Postdelivery of a fulldenture
Check the mucosa for pressure areas and
sore spots. Schedule recall appointment.
Appointment 6: Postdelivery of a fulldenture
Check the mucosa for pressure areas and
sore spots. Schedule recall appointment.
Appointment Sequencing for a FullDenture-contdAppointment Sequencing for a FullDenture-contd
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Immediate DenturesImmediate Dentures
Type of denture that is placed immediatelyafter the extraction of a patient's remaininganterior teeth. This type of denture serves asa compress and bandage to protect thesurgical site.
Type of denture that is placed immediatelyafter the extraction of a patient's remaininganterior teeth. This type of denture serves asa compress and bandage to protect thesurgical site.
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Construction of an Immediate DentureConstruction of an Immediate Denture
Occlusal wax rims are completed with posteriorteeth and tried in before extraction of anteriorteeth. The denture, complete with the anteriorteeth, is constructed, sterilized, and ready for
placement at the time of surgery. Surgical template
Clear plastic impression tray of the anteriorarea that the surgeon uses as a guide in
properly contouring the remaining alveolarridge.
Occlusal wax rims are completed with posteriorteeth and tried in before extraction of anteriorteeth. The denture, complete with the anteriorteeth, is constructed, sterilized, and ready for
placement at the time of surgery. Surgical template
Clear plastic impression tray of the anteriorarea that the surgeon uses as a guide in
properly contouring the remaining alveolarridge.
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Denture ReliningDenture Relining
Relining is accomplished by placing a newlayer of denture resin over the tissue surfaceof the prosthesis.
Impression is taken with the present
denture used as the impression tray. Patient is instructed to close-in normal
occlusion.
Denture and written prescription are sentto the laboratory technician for relining.
Relining is accomplished by placing a newlayer of denture resin over the tissue surfaceof the prosthesis.
Impression is taken with the present
denture used as the impression tray. Patient is instructed to close-in normal
occlusion.
Denture and written prescription are sentto the laboratory technician for relining.
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Denture RepairsDenture Repairs
Simple repairs can be handled in the dentaloffice laboratory by using cold-cured acrylics.
Complicated repairs, particularly those
involving the replacement of teeth or thecomplex fracture of the denture, are usuallysent to the dental laboratory technician.
Simple repairs can be handled in the dentaloffice laboratory by using cold-cured acrylics.
Complicated repairs, particularly those
involving the replacement of teeth or thecomplex fracture of the denture, are usuallysent to the dental laboratory technician.
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Fig 52-19 Broken denture.Fig 52-19 Broken denture.
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Denture DuplicationDenture Duplication
Because dentures can break or require timefor relining, the patient should have aduplicate denture made.
Because dentures can break or require timefor relining, the patient should have aduplicate denture made.