removable pros tho don tics

8/2/2019 Removable Pros Tho Don Tics

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Copyright 2003, Elsevier Science (USA). All rights reserved.

Introduction

Removable prosthodontics is thespecialty of dentistry that replaces missingteeth with a removable prosthesis.

Removable partial denture,alsoreferredto 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.


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Fig. 52-1 Removable partial denture.


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Fig. 52-2 Full denture.


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Extraoral Factors that Influence the Choiceof a Removable Prosthesis

Physical health Mental health

Motivation

Age

Dietary habits

Socioeconomic factors

Occupation


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Musculature Salivary flow

Residual alveolar ridge

Oral mucosa

Oral habits

Tori

Intraoral Factors that Influence the Choiceof a Removable Prosthesis


7/34Copyright 2003, Elsevier Science (USA). All rights reserved.

Indications 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.



Contraindications for a RemovablePartial Denture A lack of suitable teeth in the arch to support,

stabilize, and retain the removable prosthesis.

Rampant caries or severe periodontalconditions that threaten the remaining teeth inthe arch.

A lack of patient acceptance for estheticreasons.

Chronic poor oral hygiene.



Components of a Partial Denture

Framework The cast metal skeleton that provides

support for the remaining components of theprosthesis.

Connectors

Join various parts of the partial together

Major connector

Minor connector



Retainer Known as a clasp, it supports and provides

stability to the partial denture by partiallycircling an abutment tooth.

RestA metal projection designed to control the

seating of the prosthesis.

Artificial teeth

Constructed from either acrylic or porcelain.

Components of a Partial Denture-contd



Appointment Sequencing for a PartialDenture

Appointment 1: Records Updated health and dental history.

Prophylaxis.

Preliminary impressions. Radiographs.

Photographs.



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-contd



Appointment 3: Try-in Evaluate the fit, comfort, and function of

the appliance.

Evaluate the shade, mold, and arrangementof the teeth.

Take new occlusal registration.

Note any changes on the laboratory

prescription.




Appointment 4: Delivery Have patient place partial.

Check occlusion.

Detect any pressure points.

Check retainers for tension on the naturalabutment teeth.

Polish partial.

Give patient home instructions.



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Home 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.


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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.



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Indications 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.


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Contraindications 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 the

denture. The patient is hypersensitive to denture

materials.

The patient is not interested in replacing

missing teeth.


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Components of a Full Denture

Base Designed to fit over the residual alveolar

ridge 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 depends

on the suction seal.

Artificial teeth Fabricated from acrylic or porcelain.

Components of a Full Denture-contd


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Appointment Sequencing for a FullDenture

Appointment 1: Records Updated health and dental history.

Preliminary impressions.

Radiographs. Photographs.


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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-contd

f ll


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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


A i S i f ll


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Appointment 3: Try-in ofbaseplate-occlusal rim-contd

Occlusal registration measurements

Centric relation. Protrusion.

Retrusion.

Lateral excursion.


A i S i f F ll


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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 thsounds;swallows; and yawns.

Occlusion of the denture is checked.

Laboratory prescription for the completion of thedenture is prepared.


A i S i f F ll


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Appointment 5: Delivery New denture is inserted into the patient's

mouth.

Shade and mold of the artificial teeth are

checked for natural appearance. Patient is requested to perform facial

expressions and the actions of swallowing,chewing, and speaking, using sand thsounds.

Occlusion is checked. Home instructions are given.


H C I i f F ll


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Thoroughly rinse the oral tissues at least oncedaily.

All surfaces of the denture should bethoroughly 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 FullDenture

A i S i f F ll


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Appointment 6: Postdelivery of a fulldenture

Check the mucosa for pressure areas andsore spots.

Schedule recall appointment.



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Immediate 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 the

surgical site.


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Construction 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.


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Denture 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 sent

to the laboratory technician for relining.


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Denture Repairs

Simple repairs can be handled in the dentaloffice laboratory by using cold-cured acrylics.

Complicated repairs, particularly thoseinvolving 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.


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Denture Duplication

Because dentures can break or require timefor relining, the patient should have aduplicate denture made.

removable pros tho don tics

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