2. PATIENT INTERVIEW
Establish rapport with the patient
Gain insight into the psychological makeup of the
patient
Explore any physical condition that may effect the
treatment
Ascertain the patient expectations of treatment
3. STRUCTURE OF INTERVIEW
Dental history - In the dental history it is important to find
out why teeth have been lost.
If lost by caries If lost by
periodontal
disease
Presence of removal partial
Dentures will increase the
possibility of further carious
activity
Every effort must be made to
discover and eliminate its cause
4. DIET
The patient diet should be evaluated
If the patient have sugar containing diet a change
must be effected.
The problem caused by the sugar is compounded by
the wear of removal partial dentures because the prosthesis
shield the microorganism from the cleansing and buffering
action of patient saliva.
5. HABITS
Patient habit should be evaluated to determine
whether the effect the prognosis of the treatment.
Bruxism and clenching
Tongue thrusting
6. EVALUATION OF ORAL HYGIENE
It is critical to the prognosis of the patient treatment
Inadequate oral hygiene must be recognized early in
the diagnostic procedure so that a preventive dentistry
programme can be evaluated.
7. EVALUATION OF CARIES SUSCEPTIBILITY
The presence of large number of restored teeth
Sign of recurrent caries
Evidence of decalcification
8. ORAL PROPHYLAXIS
Supragingival calculus should be removed and oral
prophylaxis should be performed
The diagnostic cast and definitive intraoral examination
will be more accurate if teeth are cleaned
9. RADIOGRAPH
Complete series of periapical and a full mouth
radiograph is essential for definitive examination of partially
edentulous patient
Full mouth radiograph is ideal for screening for
pathological condition
10. Periapical radiographs helps in determining
1. Crown root ratio of remaining teeth
2. Status of periodontal ligament space
3. Lamina dura of abutment teeth
4. Quantity of bone on the residual ridge in
edentulous area
11. DIAGNOSTIC IMPRESSION AND CAST
A diagnostic procedure for a partially edentulous
patient must be considered incomplete unless it includes the
evaluation of accurate diagnostic cast.
12. MOUNTED DIAGNOSTIC CAST
Uses includes the following :
Extruded teeth, low hanging tuberosities, lack of inter
arch space, malposed teeth and defective restoration are
readily apparent.
They provide a detail analysis of patient occlusion
Aid in the education of the patient and in presentation
of the treatment planning.
They provide a permanent dental record of the patient
condition before treatment.
13. Centric jaw relation record
Bone to bone relation
Recorded repeatedly and verified
Best reference point
14. Methods of determining centric jaw relation
Conventional method
Bilateral manipulation of the mandible
Alteration of protrusion and retrusion
15.
16. Media for recording centric jaw relation
Wax
Impression pastes
Plaster of paris
Dental stone
Acrylic resin
Modeling plastic
waxes
Soft wax
Hard wax
20. Evaluation of sensitivity to percussion
Tooth movement caused by-prosthesis or
occlusion
Traumatic occlusion
Periapical or pulpal abscesses
Acute pulpitis
Gingivitis or periodontitis
Cracked tooth syndrome
21. Evaluation of mobile teeth
Traumatic occlusion
Inflammatory changes in periodontal ligament
Loss of alveolar bone support
22. Splinting of abutment teeth
Indications
Remaining teeth have reduced support-
periodontal disease
Teeth with short ,tapered roots
Presence of two or three widely spaced
retainable teeth
23. Evaluation of periodontium
Pocket depth in excess of 3mm
Furcation involvement
Deviation from normal color and contour of gingiva
Marginal exudate
Abutment teeth have less than 2mm of attached gingiva
Treatment
Root scaling and planning
Gingivectomy
Periodontal flap procedures
Free gingival grafts
24. Evaluation of hard tissue abnormalities
Torus palatinus
Torus mandibularis
Exostosis and undercuts
Mandibular tuberosity
25. Evaluation of soft tissue abnormalities
Labial frenum
Hypertrophic lingual frenum
Unsupported and hypermobile gingiva
26.
27. Evaluation of radiographic survey
Caries
Existing restorations
Root fragments and other foreign bodies
Unerupted third molars
Abutment teeth
Root length,size ,form
Crown/root ratio
Lamina dura
Periodontal ligament space
Bone index areas
33. Treat at centric relation or centric occlusion?
Coincidence of centric relation or centric occlusion
Absence of posterior tooth contacts
Situation in which all posterior tooth contacts are to be restored
with cast restorations
Only a few posterior contacts
Clinical symptoms of occlusal trauma
34. Diagnostic wax-up
Provide a guide for tooth preparation
Indicate problems that may be encountered during
treatment
35. Development of treatment plan
Phase1
Collection and evaluation of diagnostic data
Immediate treatment to control pain and
infection
Biopsy or referral of patient
Development of treatment plan
Education and motivation of patient
36. Phase 2
Removal of deep caries followed by
temporary restoration
Extripation of inflamed pulp
Removal of nonretainable teeth
Periodontal treatment
Occlusal equilibration
38. Phase 4
Removal partial denture
Reinforcement of education and motivation
39. Phase 5
Postinsertion care
Periodic recall
40. Q1. The first step in the diagnostic mounting
procedure is the mounting of the maxillary cast
on a
a) Fully adjustable articulator
b) Semi-adjustable articulator
c) Denar articulator
d)Free plane articulator
41. Q2. Face bow which requires styli to be placed
on selected points on the face is
a) Whip mix
b) Hanau spring bow
c) Hanau SM
d)Hanau H2
42. Q3. Beyron’s point is located _ mm anterior to
the posterior margin of the tragus of the ear on
a line to the outer canthus of the eye
a) 11
b) 12
c) 13
d)14
43. Q4. While adjusting the articulator, the
following setting are followed for condylar
guidance, Bennett guide and incisal table
respectively
a) 30, 15, 0
b) 0, 30, 15
c) 15, 30, 0
d) 30, 0, 15
44. Q5. Ramfjord and Ash (1971) have stated
that three factors must be controlled in order
to succeed in determining centric jaw
relation. Which one is not among them?
a) Psychologic stress
b) Pain in temporomandibular joints
c) Muscle memory
d) Systemic illness
45. Q6. In which method of recording jaw
relation does the operator place all four
fingers of his hand on the lower border of the
mandible and thumbs over the symphysis?
a) Bilateral manipulation of the mandible
b) Alternate protrusion and retrusion
c) Both a and b
d) Use of an occlusal splint
46. Q7. Which of the following is not used to
record centric jaw relation
a) Acrylic resin
b) ZoE paste
c) Dental stone
d) All of the above are used
47. Q8. While using metal impregnated wax, water
bath temperature kept is
a) 40°C
b) 43°C
c) 45°C
d) 37°C