3 intro to discipline

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  • 1. DEFINE •Prosthesis •Prosthodontics •Maxillofacial Prosthodontics •Fixed Prosthesis/Bridge •Crown •Bridge •Full Crown •Partial Crown •Components of a bridge (4) (define each)
  • 2. DIAGNOSIS and TREATMENT PLANNING • DEFINE Diagnosis – Treatment planning – • When is a FIXED Prosthesis/Bridge indicated • What are the factors that influence the design of a Fixed prosthesis (15) (BE READY TO EXPLAIN EACH FACTOR)
  • 3. PROSTHESIS/PROSTHETIC • Any artificial replacement of a missing body part.
  • 4. PROSTHODONTICS Is the branch of dentistry pertaining to the restoration and maintenance of oral function, comfort, appearance, and health of the patient by restoration of the natural teeth or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes or both.
  • 5. PROSTHODONTIC An artificial replacement of a missing tooth (teeth) or tooth structure.
  • 6. MAXILLOFACIAL PROSTHODONTICS • Branch of prosthodontics concerned with the replacement of stomatognathic and/or associated facial structures by artificial substitutes that may or may not be removed
  • 7. FIXED PROSTHESIS • A nonremovable prosthesis that is rigidly attached to two or more abutment teeth to replace one or more lost or missing teeth.
  • 8. CROWN • An artificial replacement the missing tooth structure by surrounding most or all of the remaining structure with a material such as metal, plastic or porcelain intended to reproduce the form and function of the tooth and in some instances, to restore or enhance the appearance
  • 9. BRIDGE • Is a nonremovable prosthesis that has one or more missing teeth replacement that is connected to two or more prepared abutment teeth
  • 10. FULL CROWN • An extracoronal restoration that includes all or nearly all of the surfaces of the clinical crown
  • 11. PARTIAL CROWN • An extracoronal restoration that includes all but one surface of the tooth
  • 12. COMPONENTS OF A BRIDGE • Abutment – the natural tooth/teeth to which the prosthesis is attached • Retainer – the restoration (usually a crown) that replaces the missing tooth/teeth structures (due to preparation) of the abutment to which the pontic is attached. • Pontic – the substitute for the lost/missing tooth or teeth. • Joint or Connector – the part that connects the pontic to the retainers
  • 13. DIAGNOSIS • Is the process of identifying an existing abnormal condition, to investigate the abnormality and to determine its cause.
  • 14. TREATMENT PLANNING • The scheduling (step by step) procedures and appointments designed to restore the oral health of the patient. Example Procedure/Day 1 – Px education, Prophy Procedure/Day 2 – Fillings Procedure/Day 3 – Crown/abutment prep Procedure/Day 4 –
  • 15. • A Fixed prosthesis is indicated whenever properly distributed and healthy teeth exist to serve as abutments provided that these teeth have suitable or capable of sustaining the additional load
  • 16. FACTORS THAT INFLUENCE THE DESIGN OF A BRIDGE • • • • • • • Crown Length Crown Form Degree of Mutilation Root Length and Form Crown-Root Ratio Ante’s Law Periodontal Health • • • • • • • • Mobility Span length Axial length Arch form Pulpal health Age of patient Long-term abutment prognosis Psychological factors
  • 17. Crown Length • Tooth/teeth must have adequate occluso-cervical length for better retention. • Short teeth often needs gingival recontouring (tooth lengthening) and/or full coverage (Full Crowns) preparations instead of using other designs for adequate retention. • It may also be necessary to prepare adjacent and joining 2 crowns together for better retention.
  • 18. Crown Form • Poorly developed cingula (lower anteriors) and cusp (lower premolars), short proximal walls (molars), thin incisal edge (lower incisors) and tapered crowns (upper incisors) interferes with parallelism during preparation makes partial coverage (partial crowns unacceptable both in retention and esthetics. It may need full coverage for retention and esthetics.
  • 19. Degree of Mutilation • Multiple carious lesions involving one or more surfaces and Size of fracture (chipped tooth) that may involve several surfaces may need an altered/modified design. It may also be necessary to remove unrestorable fractured tooth increasing the length of the bridge.
  • 20. Root Length and Form • Longer root is better than a shorter one. Thicker root is better than a thin one. Multirooted teeth are better than a monoroot. Roots that have parallel walls and developmental depressions can better withstand to forces. It may be necessary to have additional abutments therefore making a bridge longer than usual.
  • 21. Crown-Root Ratio • Stability requires sufficient anchorage. C-R ratio of 1:2 is ideal; 1:1.5 is satisfactory; 1:1 is minimal.
  • 22. Ante’s Law • The dimensions of the bridge are defined by Ante's Law: "The root surface area of the abutment teeth has to equal or surpass that of the teeth being replaced with pontics" or the combined periodontal ligament area of the abutments should be equal to or exceed that of the tooth or teeth to be replaced.
  • 23. Periodontal Health • Bone loss in periodontally compromised teeth are not able to withstand additional forces specially off-vertical forces. The design may need additional abutment/s to have sufficient stability or the design may be altered in such a way that it will promote effective oral hygiene.
  • 24. Tooth Mobility • Miller mobility 0 is ideal • Miller Mobility 1 is acceptable • Miller Mobility 2 needs evaluation of the cause • Miller Mobility 3 is not acceptable
  • 25. Span Length • The distance between abutment teeth affects the feasibility of placing a fixed prosthesis. The loss of 3 adjacent teeth will require a careful evaluation of other factors such as C-R ratio, Periodontal health, Root length and form, Mobility, and occlusion.
  • 26. Axial Alignment • The crowns of the proposed abutment teeth must be sufficiently well aligned that retentive preparations can be developed. Minor alterations in the alignment (tipping or rotation) often necessitates the use of full coverage.
  • 27. Arch Form • If the form of the prosthesis is an arc of a circle, a lever arm will be projected unless the span is segmented by a pier.
  • 28. Pulpal Health
  • 29. Age of patient
  • 30. Long-term abutment prognosis
  • 31. Psychology Factors