diagnosis

1. Diagnosis and tt planning in
FDP-I
Dr Jitendra Rao
Dept of Prosthodontics

2. Objectives of Prosthodontic treatment
• Elimination of disease
• Preservation of health
• Restoration of lost teeth & oral function in an esthetic
manner

3. Prosthodontics
Discipline of dental sciences dealing with restoration of
• Oral function
• Health
• Comfort of oral and maxillofacial tissue by the artificial
substitutes
it includes ---
A. Fixed- It refers to the restoration or replacement of tooth that can be attached to natural
teeth and /or roots and can not be removed by the patient himself.
B. Removable
C. Maxillofacial prosthesis

4. FIXED PROSTHODONTICS - :
Is the branch of prosthodontics concerned with the
replacement or restoration of teeth by artificial substitutes
that not readily removed from the mouth.
Retainer Retainer
Pontic
connector connector
Abutment

5. • Components- are
• Pontics – Are artificial teeth of a fixed partial denture that
replace missing natural teeth
• Retainers-Part of FPD that unites the abutments to the
pontics and surrounds all or part of prepared crown
• Connectors-Joins the pontic and retainers together
• Abutments- Part of a tooth that support or retains the
prosthesis and receives direct masticatory load from opposing
arch
• Residual Ridge- portion of residual bone and its soft tissue
covering

6. Fixed dental prosthesis(FDP)
- Crown & Bridge,Laminates
- Dental implant with crown & bridge
- Implant supported over denture
- Implant supported FPD

7. Diagnosis and tt planning
• Diagnosis – It is the determination of nature of disease
process
• Treatment plan-The sequence of procedures planned for
the treatment of a patient following diagnosis
• decide the prognosis of the patients
• Treatment- Is any measure designed to remedy a careful
evaluation of all available information, a definitive
diagnosis and a realistic treatment plan that offers a
favourable prognosis.

8. • There are seven elements to a good diagnostic work-up:
• Chief complaint
• Vitality testing
• history
• extra-oral examination
• intra-oral examination
• diagnostic casts
• radiographic evaluation

9. 1.Chief Complaint:
It should be recorded in patients own words. The accuracy
and significance of patient’s primary reason /reasons should
be analyzed first. This will reveal problems and conditions of
which the patient is often unaware
2.History:
A patient’s history should include all necessary information
concerning the reasons for seeking treatment along with any
personal details and past medical and dental experiences that
are pertinent. A screening questionnaire is useful for history
taking.

10. .Medical History:
An accurate and current general medical history should
include any medication the patient is taking as well as all
relevant medical conditions
.Dental History:
Primarily and significantly patient’s periodontal, restorative
and endodontic history should be noted. Orthodontic history
should be an integral part of the assessment of a
prosthodontic rehabilitation
3.Extraoral Examination:
During extraoral examinations cervical lymph nodes, TMJ and
muscles of mastication are palpated.

11. Temporo-mandibular joints:
 The TMJ is palpated bilaterally just anterior to the auricular tragic.
 During mandibular movement clicking, crepitus or alteration of the
range of joint is noted.
 Maximum jaw opening less than 40mm indicates jaw restriction,
because the average opening is greater than 50mm.
 Any deviation from the midline is also recorded. Maximum lateral
movement can be measured (normal is about 12mm).
• Muscles of mastication
A brief palpation of masseter, temporalis, medial pterygoid, lateral
pterygoid, trapezius and sternocleido mastoid muscles may reveal
tenderness. The patient may demonstrate limited opening due to
spasm of the masseter or temporalis muscle.

12. 4.Intraoral Examination:
• First the patient’s general oral hygiene is
observed.
• The presence or absence of inflammation should
be noted along with gingival architecture and
stippling. The existence of pockets should be
entered in the record and their location and
depth chartered.
• The presence and amount of tooth mobility
should be recorded with special attention paid to
any relationship with occlusal prematurities and
to potential abutment teeth

13. 5.Radiographic Evaluation:
• Radiographs provide the information to help and correlate all
the facts that have been collected in listening to the patient,
examining the mouth and evaluating the diagnostic casts
• The crown-root ratio of abutment teeth can be calculated.
The length, configuration and direction of these roots should
also be examined.
• Any widening of periodontal ligament should be correlated
with occlusal prematurities or occlusal trauma.

15. 6.Vitality Testing:
• Prior to any restorative treatment, pulpal health must be
assessed, usually by measuring the response to percussion and
thermal and electrical stimulation.
• A diagnosis of non-vitality can be confirmed by preparing a test
cavity before the administration of local anesthetic.
• Electric pulp tester can be also helpful in the assessment of vitality
7. Diagnostic Casts:
• Articulated diagnostic casts are essential in planning fixed
prosthodontic treatment.
• They provide critical information not directly available during the
clinical examination, static and dynamic relationships of the teeth can
be examined without interference from protective neuromuscular
reflexes.
• They also reveal those aspects of occlusion not detectable within the
confines of the mouth.