TYPES OF RPD | assresin appliance, resin with wire clasp, resin with castsed clasp |
maxillary teeth will be lost before mandibular | INTERarch Difference |
posterior teeth will be lost before anteriors | INTRAarch Difference |
Remaining teeth usually | Mandibular anterior/Mandibular canine |
anatomical result of tooth loss | broader mandible and constriction of maxilla |
clinical significance of anatomic loss of teeth | hard time setting the pontics esp with remaining tooth because the jaw relationship is already class III |
why does the jaw protrude? | compensate to cover/ close the mouth |
Changes in facial features due to: | altered lip support, reduced facial height |
Attached gingiva is replaced with | less keratinized oral mucosa |
clinical significance of less keratinized oral mucosa | prone to trauma, lacerations, or to ulcers |
physiologic effects of tooth loss | diminished masticatory effect, speech |
serve the role of reducing food to a point that it is ready for swallowing. | Teeth or prostheses |
ability to reduce food to a certain size in a given time frame | masticatory efficiency |
index of food reduction | masticatory efficiency |
TOOTH REPLACEMENT FROM THE PATIENT’S PERSPECTIVE | improves health/condition but not necessarily cure |
improves health/condition but not necessarily cure | EXPECTED OUTCOMES |
Those that might involve factors related to our control or manipulation as a dentist. | UNEXPECTED OUTCOMES |
tissue damage, tissue abuse, design of dentures, materials that you use for the denture, or the design if you are fabricating RPD | UNEXPECTED OUTCOMES |
Related to our control of manipulation:from faulty design not considering the impingement of tissues | Tissue damage |
Related to our control of manipulation:Allergic reaction sample | Tissue damage |
Related to our control of manipulation:rushing and randomly make a design leading to unexpected result (Correct design, correct px interview, correct manipulation and being prepared we can remedy the 3) | Prosthesis design |
Those that we cannot control: | accidental trauma, parafunctional habits |
A typical sequence is used to discuss tooth replacement options: | dental implant supported prosthesis, fixed prosthesis, rpd/cd |
Purpose of Classification: | facilitate treatment decisions on the basis of treatment complexity |
Complexity is determined from the four broad diagnostic categories | Location and extent of edentulous areas, Condition of the abutments, Occlusal characteristics and requirements, Residual ridge characteristics |
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCH (KENNEDY):Bilateral edentulous area located posterior to the remaining natural teeth | CLASS I |
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCH (KENNEDY):Also called bilateral distal extension cases | CLASS I |
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCH (KENNEDY):Unilateral edentulous area located posterior to the remaining natural teeth | CLASS II |
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCH (KENNEDY):Also called unilateral distal extension case | CLASS II |
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCH (KENNEDY):Unilateral edentulous area with remaining natural teeth both anterior and posterior to it | CLASS III |
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCH (KENNEDY):Single, but bilateral edentulous area located anterior to the remaining natural teeth | CLASS IV |
Requirements of an Acceptable Method of Classification | It should permit immediate visualization of the type of partially edentulous arch that is being considered, It should permit immediate differentiation between tooth-supported and tooth-tissue-supported RPD, It should be universally acceptable |
What then defines important differences between these prostheses? | technical outcomes, physical outcomes, esthetic outcomes, maintenance needs, initial and future costs, physiologic outcomes |
The replacement prosthesis ideally should provide | function, level of comfort as equivalent as possible to normal dentition (gold standard). |