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MOUTH
PREPARATION
FOR CD ‫پوهنتون‬‫علومو‬‫طبي‬‫د‬‫کابل‬‫د‬
Dr.HedayatullahEhsan
TABLE OF CONTENTS
Introduction
01
Tissues Conditioning
Treatment
04
Methods of
Treatment
02
Nutritional Program
05
Correction of the occlusion of
old restorations
03
Soft Tissue
Correction
Bony Tissue
Correction
06 07
Introduction
Mouth preparations are
identified as those procedures
that are accomplished to
prepare the mouth for
reception of prosthesis.
‫ماده‬‫آ‬‫ساختن‬‫جوف‬‫دهن‬‫به‬‫عنوآن‬‫یک‬
‫سلسلسه‬‫سیجرهای‬‫و‬‫پر‬‫شناخته‬‫شده‬‫که‬‫توسط‬
‫ن‬‫آ‬‫جوف‬‫دهن‬‫آی‬‫ر‬‫ب‬‫خذ‬‫آ‬‫و‬‫پذیرش‬‫تیزه‬‫و‬‫پر‬‫ا‬
‫ماده‬‫آ‬‫میگردد‬.
Introduction
Many conditions in the edentulous mouth should be
corrected or treated prior to the construction of
complete dentures. Often, patients are not aware
that tissues in their mouth have been damaged or
deformed by the presence of old restorations. Other
conditions may have developed or be present which
must be altered to increase chances for success of
new dentures. The patient must be made aware of
these problems.
METHODS OF TREATMENT
Some of the methods of treatment to correct
edentulous mouths include : (1) removal of the
dentures from the mouth for an extended period of
time to allow deformed tissue of the residual ridges or
temporomandibular joints to recover its normal form,
(2) surgery, (3) correction of the occlusion of old
restorations, (4) tissue placement by means of tissue
treatment material, and (5) nutritional therapy.
1. Correction of the occlusion of old restorations:
• It may be necessary to eliminate deflective
occlusal contacts in eccentric positions and;
• To establish harmony between centric occlusion
and centric relation.
• Heavy contacts between opposing anterior teeth
causes a decreased vertical relation of occlusion.
• These corrections reduce traumatic forces of
occlusion to the supporting tissues and joints
and;
• Reduce the time that the dentures must be left
out of the mouth before construction of new
dentures is begun.
KUMS
• This treatment is indicated for those patients who
cannot leave their old dentures out of the mouth for a
sufficient length of time to allow the supporting tissues
to become healthy.
• It may be necessary to correct the extent of tissue
coverage by the denture base so that all usable
supporting tissues will be included in the treatment.
• Tissue treatment material permits movement of the
denture base so that its position becomes compatible
with the existing occlusion and allows displaced tissues
to recover and assume their original position.
2.Tissues Conditioning Treatment
(Tissue Placement or treatment material):
KUMS
2.Tissues Conditioning Treatment
(Tissue Placement or treatment material):
Nutritional Program
● A good nutritional program is needed for all patients, particularly
for the elderly patient with complete dentures.
● The metabolic efficiency of the geriatric patient has been
decreased because of his age, and his masticatory efficiency has
been decreased because of the loss of his natural teeth.
● Vitamin C in large doses helps combat capillary fragility and
large doses of Vitamin B aid in tissue recovery.
● An over-all diet that is low in carbohydrate and fat and high in
protein is recommended for these patients.
.
MP for CD
▪ All patients are required to leave their old dentures out of the
mouth for 24 to 48 hours to allow the supporting tissue to recover its
normal form prior to making impressions for new dentures.
▪ This procedure is generally followed even after the use of tissue
treatment material or other corrective methods.
MP for CD
KUMSHyperplastic Tissue.-Increased pressure or chronic
irritation may produce excessive connective tissue proliferation.
Hyperplastic tissue often forms around the labial border of
immediate dentures when “follow-up” treatment has not been
provided.
• Excess pressures from heavy contacts of opposing anterior
teeth is a primary cause of hyperplastic tissue.
• Other causes of hyperplastic tissue include deflective occlusal
contacts, which cause the denture to shift from its resting
position, and ill-filling dentures with sharp borders.
• In some instances, removal of the old dentures from the
mouth will allow sufficient response of the tissue so that no
other treatment will be necessary.
SOFT TISSUE CORRECTIONS
KUMSHyperplasticTissue.
SOFT TISSUE CORRECTIONS
SOFT TISSUE CORRECTIONS
Papillomatosis.-Inflammatory papillary hyperplasia often occurs in
the region surrounding the median palatal raphe.
• Chronically inflamed tissues of palates may vary from mild hyperplasias
to conditions which could be precancerous.
• The cause of papillomatosis is sometimes vague.
• Since papillomatosis could be a precancerous lesion, treatment is
controlled in a different manner from that for other soft tissue changes.
• The patient is required to leave the dentures out of the mouth for 7 to
10 days.
• If the irritated tissue remains inflamed after this treatment, a biopsy is
made.
• If sign of tumor so the surgery should be done.
SOFT TISSUE CORRECTIONS
Papillomatosis.
SOFT TISSUE CORRECTIONS
Papillomatosis.
SOFT TISSUE CORRECTIONS
• When the pathologic report indicates hyperplasia, then several
procedures can be followed.
• The dentures can simply be left out of the mouth until the
inflammation subsides, tissue treatment material can be placed in
the dentures, or
• The whole of the palatal part of the upper denture can be removed
and the patient can wear a palateless upper denture until the tissue
becomes healthy.
SOFT TISSUE CORRECTIONS
Papillomatosis
SOFT TISSUE CORRECTIONS
Papillomatosis
KUMSFibrous Moveable Tissue.-Tissue contours may
appear to represent a well-formed edentulous ridge.
• The cause of this bony resorption and replacement by fibrous
moveable tissue may be occlusion, excess pressure from ill
fitting dentures, general systemic conditions, or combinations
of these factors.
• Treatment of moveable fibrous tissue is based on its severity
and the health of the patient.
• Surgery in combination with an immediate temporary reline
of the dentures is most often the treatment of choice.
• When surgery is contraindicated, the dentures are left out of
the mouth until the desired improvement is achieved.
SOFT TISSUE CORRECTIONS
KUMS
Fibrous
Moveable
Tissue.
SOFT TISSUE CORRECTIONS
SOFT TISSUE CORRECTIONS
Vestibular Corrections.-Certain corrections that involve the
reflections or vestibular spaces are desirable to enhance retention of the
completed dentures.
• In some instances, the upper labial frenum may be composed of a
strong band of fibrous connective tissue that inserts on the lingual
side of the crest of the residual ridge.
• Such a frenum prevents apposition of the natural upper central
incisors and will dislodge or interfere with the border seal of the
upper denture.
• Since the labial frenum does not contain a muscle, this tissue can be
removed surgically (frenectomy) prior to construction of new
dentures.
SOFT TISSUE CORRECTIONS
Vestibular Corrections..
KUMS
VestibularCorrections.SOFT TISSUE CORRECTIONS
KUMS
Other pathologic forms, such
as benign and malignant tumors, cysts, and
tubercular and syphilitic lesions, in the
edentulous mouth are treated in a
comparable manner to those in the
dentulous mouth.
SOFT TISSUE CORRECTIONS
BONY TISSUE CORRECTIONS
Undercuts.- excessively large or undercut maxillary tuberosities must be
treated surgically.
• Many times the bony protuberance can be left on one side and surgically
corrected only on the opposite side of the mouth.
• Bony reductions in the anterior part of either ridge should be performed
only in extreme situations.
• The bone of this part of the mouth is often unnecessarily trimmed and the
patient suffers reduced denture stability for the rest of his life.
• Diagnostic casts can be surveyed as a guide to the amount of tissue that
must be removed.
BONY TISSUE
CORRECTIONS
UndercutsA
BONY TISSUE
CORRECTIONS
UndercutsA
BONY TISSUE CORRECTIONS
Tori.- Mandibular tori are almost always removed as the tissue covering is thin
and the tori quite frequently extend into the region of the border seal of the lower
denture.
• Mandibular tori are found in approximately 7 per cent of the general adult
population.
• Most palatal tori are not removed unless they are excessively undercut or
extend into the area of the vibrating line and interfere with the posterior
palatal seal of the upper denture.
• Relief must be provided in the denture has either arbitrarily or by a functional
procedure upon completion of the upper denture.
• Maxillary tori are found in approximately 21 per cent of the population.
BONY TISSUE CORRECTIONS
• Tori.-B
• GenialSpines.-C
• KnifeEdgeRidges.-D
KUMS
Sharp Spines or Spicules.-Sharp projections of the
alveolar process, that remain following removal of teeth, press
on the mucosa from its inside surface and cause discomfort to
the patient.
• Sometimes the stimulation from massage of the finger will
speed resorption of these projections.
• When this procedure fails, they are removed surgically
with little operative or postoperative difficulty.
BONY TISSUE CORRECTIONS
KUMS
Genial Spines.-Severe resorption of the residual ridge
may cause the genial spines to become exceedingly sharp and
prominent in relation to the residual ridge.
• On rare occasions, these spines are reduced surgically as
even the movement of the overlying mucosa from pressure
of the nearby denture base causes soreness.
• However, in most instances no treatment is given and the
patient is informed of the limitations that these structures
will place on the completed dentures.
BONY TISSUE CORRECTIONS
KUMS
Knife Edge Ridges.-Sharp ridges must be palpated
well before enthusiastically launching into a surgical program.
• The anatomic nature of the knife edge ridge is often such
that surgery offers only temporary relief and another
sharp narrow ridge may become prominent in a few
months.
• The only available treatment for this kind of ridge is often
adequate provisions for relief in the impression and
completed dentures.
BONY TISSUE CORRECTIONS
KUMS
Exostoses.- Excess bone formation may occur from
unknown causes in various parts of the residual ridge.
• These projections of bone are surgically removed if they
interfere in any way with denture construction.
BONY TISSUE CORRECTIONS
INTERARCH SPACE CORRECTIONS
• When insufficient space exists between the maxillary
tuberosities and the retromolar pads, the tuberosities should
be surgically corrected to permit the denture bases to cover all
available tissue and end on moveable tissue.
• The surgery is performed on the tuberosities and not on the
retromolar pads because of the anatomic structures contained
within the pad (temporal tendon, pterygomandibular raphe,
superior constructor and buccinator muscle fibers, and palatal-
type mucous glands).
KUMSINTERARCHSPACECORRECTIONS
BONY TISSUE CORRECTIONS
INTERARCH SPACE CORRECTIONS
• In addition to creating needed space, removal of this tissue
allows the occlusal plane of the upper denture to be oriented
in such a manner that resultant forces are directed toward the
ridge and tend to seat the upper denture rather than dislodge
it.
• When health conditions, proximity of the maxillary sinus, or
other factors make surgical intervention impractical, then
metal sections can be incorporated in both denture bases
posteriorly to utilize a small interarch space.
SUMMARYOF THE ABOVE LESSONS
• The dentist is obligated to construct the best
complete dentures possible.
• The dentures can be no better than their supporting
foundation.
• Methods outlining tissue improvement programs for
various conditions of the edentulous mouth have
been described.
1. Oral surgical preparation:
‫آز‬‫تند‬‫ر‬‫گرددعبا‬‫آ‬‫ر‬‫آج‬‫قبل‬ ‫همه‬ ‫آز‬‫باید‬‫که‬‫آحی‬‫ر‬‫ج‬‫سیجرحای‬‫و‬‫پر‬‫تمام‬:
•‫نهفته‬‫دندآنهای‬‫نوع‬‫هر‬‫کردن‬‫خارج‬٬‫یافته‬‫ج‬‫و‬‫خر‬ ‫نیمه‬٬‫باقیمانده‬‫های‬‫ریشه‬٬‫ج‬‫و‬‫خر‬‫بیجا‬‫دندآنهای‬
‫یافته‬٬‫درجه‬ ‫تحرکیت‬‫با‬‫دندآنهای‬‫تمام‬‫و‬۲.
•‫سیستها‬‫تمام‬‫بردن‬‫بین‬‫آز‬٬‫دندآنی‬‫های‬‫ر‬‫تومو‬٬‫آستخوآنی‬‫آت‬‫ز‬‫تبار‬٬‫وسی‬‫ر‬‫تو‬‫تالت‬‫ک‬٬‫تالت‬‫ک‬‫تمام‬‫و‬
‫دهن‬‫در‬‫آضافی‬.
•‫عضالت‬‫ساختن‬ ‫منظم‬‫و‬‫درست‬٬‫فرینولومها‬٬‫آستخوآنی‬ ‫تیز‬‫های‬‫کناره‬‫و‬.
•‫دندآنی‬‫آمپلنتهای‬‫یعنی‬‫فلزی‬‫دندآنی‬‫های‬‫دیوآیس‬‫دآدن‬‫آر‬‫ر‬‫ق‬.
•‫کا‬‫تیز‬‫و‬‫پر‬‫کردن‬‫نصب‬‫جهت‬‫آلویولر‬‫آستخوآن‬‫آیش‬‫ز‬‫آف‬‫دیگر‬‫آصطالح‬‫به‬‫یا‬‫تقویت‬‫مل‬.
‫احی‬‫ر‬‫ج‬‫به‬‫بوط‬‫ر‬‫م‬ ‫دهن‬‫جوف‬‫ی‬‫ساز‬ ‫ماده‬‫ا‬‫از‬ ‫تصاویر‬
KUMS‫ک‬‫دلیل‬‫هر‬‫بنابر‬‫یعنی‬‫آند‬‫دندآن‬‫بدون‬‫که‬‫آنساج‬‫تمام‬‫بخش‬‫آین‬‫در‬‫آز‬‫دندآنها‬‫ه‬
‫س‬ ‫وضعیت‬‫نمودن‬‫پیدآ‬‫جهت‬‫کامل‬‫سی‬‫ر‬‫بر‬ ‫یک‬‫آبتدآ‬‫آست‬‫رفته‬‫میان‬‫یا‬‫و‬‫الم‬
‫ک‬‫تیز‬‫و‬‫پر‬‫تحمل‬‫قابلیت‬‫آنساج‬‫آین‬‫یا‬‫آ‬‫که‬‫میکنیم‬‫آ‬‫ر‬‫آج‬‫سالم‬‫غیر‬‫و‬‫دآرد‬‫آ‬‫ر‬‫امل‬
‫خیر‬‫یا‬.
‫آشیدگیها‬‫ر‬‫خ‬٬‫گیها‬‫بریده‬٬‫ماها‬‫و‬‫تر‬٬‫دیگر‬‫ضایعات‬‫و‬٬‫قابلیت‬‫سی‬‫ر‬‫بر‬‫بالخره‬‫و‬
‫بوط‬‫و‬‫مر‬‫آنساج‬‫در‬‫تیز‬‫و‬‫پر‬‫طرف‬‫آز‬‫آحتمالی‬‫لی‬‫ز‬‫آکلو‬‫فشارهای‬‫تحمل‬‫بدون‬‫ه‬
‫پر‬‫نشست‬‫آز‬‫قبل‬‫آ‬‫ر‬‫ضایعات‬‫و‬‫فات‬‫آ‬‫تمام‬‫و‬‫میکنیم‬‫سی‬‫ر‬‫بر‬‫آ‬‫ر‬‫دندآن‬‫تیز‬‫و‬
‫میسازیم‬‫ماده‬‫آ‬‫آ‬‫ر‬‫دهن‬‫جوف‬‫و‬‫برطرف‬.
Preparation of the edentulous tissues:
KUMSThere are certain periodontal procedures that should be considered
involving soft/hard tissue abnormalities. After oral hygiene measures, scaling
and root planning have been carried out periodontal surgery may be
recommended for:
1. No bony defects – excess gingiva | gingivectomy
2. NO bony defect – inadequate gingiva | micro gingival surgery
3. Bony defect – osseous surgery
One of the more common and useful procedures is “salvaging the buried
crown” increasing the crown length of a major abutment by a simple
gingivectomy procedure.
‫هم‬ ‫که‬‫دآرد‬ ‫وجود‬‫ژی‬‫پیریودونتولو‬ ‫آنساج‬‫به‬‫مربوط‬‫مشخص‬ ‫و‬‫معیین‬‫سیجرهای‬‫و‬‫پر‬‫تعدآد‬‫یک‬‫بخش‬‫آین‬‫در‬
‫میسازد‬‫دخیل‬‫آ‬‫ر‬‫سخت‬‫آنساج‬‫هم‬ ‫و‬‫نرم‬‫آنساج‬‫آبنارملتیهای‬.‫و‬‫سکلینگ‬ ‫و‬‫دهن‬‫آلصحه‬ ‫حفظ‬‫آقدآمات‬‫آز‬‫بعد‬
‫میگردد‬ ‫آ‬‫ر‬‫آج‬‫ر‬‫منظو‬‫سه‬‫آی‬‫ر‬‫ب‬‫پیریودونتل‬ ‫آحی‬‫ر‬‫ج‬‫پالنینگ‬ ‫ت‬‫و‬‫ر‬:
‫آضافی‬‫بیره‬–‫تومی‬‫جینجیوک‬
‫ناکافی‬‫بیره‬–‫آحی‬‫ر‬‫ج‬‫جینجیول‬‫و‬‫مایکر‬
‫آستخوآنی‬‫ضایعات‬–‫آحی‬‫ر‬‫ج‬‫آوسیوس‬
‫میبا‬‫تومی‬‫جینجیویک‬‫طریق‬ ‫آز‬‫پایه‬‫دندآن‬ ‫تاج‬‫یا‬ ‫ن‬‫و‬‫کر‬‫طول‬‫آیش‬‫ز‬‫آف‬‫آز‬‫عبارت‬ ‫مهم‬ ‫خیلی‬‫سیجرهای‬‫و‬‫پر‬ ‫آز‬‫یکی‬‫شد‬.
Periodontal treatment
KUMS1. Removal and control of all etiologic factors contributing to
periodontal disease along with reduction or elimination of bleeding
on probing.
2. Elimination of, or reduction in, the pocket depth of all pockets with
the establishment of healthy gingival sulci whenever possible.
3. Establishment of functional atraumatic occlusal relationships and
tooth stability.
4. Development of a personalized plaque control program and a
definitive maintenance schedule.
۱-‫یا‬‫بینگ‬‫و‬‫پر‬‫هنگام‬‫خونریزی‬‫باعث‬‫یا‬ ‫و‬‫پیریودونتل‬‫آض‬‫ر‬‫آم‬‫باعث‬ ‫که‬‫های‬‫ر‬‫تو‬‫فک‬‫تمام‬‫بردن‬‫بین‬ ‫آز‬‫میباشد‬‫معاینه‬.
۲-‫د‬ ‫آی‬‫بیره‬‫سالم‬ ‫سلکس‬‫یک‬‫ساختن‬‫مهیا‬‫با‬‫آه‬‫ر‬‫هم‬ ‫آی‬‫بیره‬‫تهای‬‫پاک‬‫عمق‬‫دآدن‬‫کاهش‬‫یا‬‫بردن‬‫بین‬‫آز‬‫آمکان‬‫ت‬‫ر‬‫صو‬‫ر‬
‫میباشد‬.
۳-‫ثب‬‫آیجاد‬‫با‬ ‫آه‬‫ر‬‫هم‬‫بودند‬‫شده‬‫نامنظم‬‫ماها‬‫و‬‫تر‬ ‫آثر‬‫در‬ ‫که‬ ‫لی‬‫ز‬‫آکلو‬‫آبط‬‫و‬‫ر‬‫تمام‬‫کردن‬‫مهیا‬ ‫و‬‫دن‬‫ر‬‫و‬‫آ‬‫بوجود‬‫درست‬‫ات‬
‫دندآنها‬.
۴-‫آیجاد‬‫آز‬‫تا‬‫دندآنی‬ ‫پالک‬ ‫کننده‬‫نظارت‬ ‫و‬‫کنند‬ ‫ل‬‫و‬‫کنتر‬‫خود‬‫آم‬‫ر‬‫گ‬‫و‬‫پر‬‫یک‬‫کردن‬‫تهیه‬‫یا‬‫دن‬‫ر‬‫و‬‫آ‬‫بوجود‬‫جلوگیری‬‫پالک‬
‫گیرد‬‫ت‬‫ر‬‫صو‬.
Objectives Of Periodontal Therapy
Atlas Of Periodontal Therapy
KUMS
There are three phases Phase
1. Initial disease control therapy Phase
2. Definitive periodontal surgery Phase
3. Recall maintenance
‫آی‬‫ر‬‫ب‬‫تدآوی‬‫تمام‬‫حاالت‬‫مرضی‬‫یا‬‫ناسالم‬‫پیریو‬‫سه‬‫فاز‬‫یا‬‫سه‬‫مرحله‬‫وجود‬‫دآرد‬:
۱-‫فاز‬‫آول‬‫عبارت‬‫آز‬‫ل‬‫و‬‫کنتر‬‫مرض‬‫نو‬‫تشکل‬‫یافته‬.
۲-‫فاز‬‫دوم‬‫عبارت‬‫آز‬‫مرحله‬‫آحی‬‫ر‬‫ج‬‫یو‬‫و‬‫پیر‬‫بوده‬‫که‬‫فت‬‫آ‬‫به‬‫یک‬‫حد‬‫قابل‬‫مالحظه‬‫پ‬‫یشرفت‬
‫کرده‬.
۳-‫حفظ‬‫حالت‬‫آحیا‬‫شده‬‫به‬‫گونه‬‫سالم‬‫و‬‫پایدآر‬.
TREATMENT PLANNING of Perio:
KUMS
Definitive Periodontal Surgery
▪ Gingivectomy
▪ Periodontal Flap
▪ Mucogingival surgical procedures
‫آست‬‫بخش‬‫سه‬‫شامل‬:
•‫تومی‬‫جینجیوک‬
•‫فلپ‬‫پیریودونتل‬
•‫جینجیول‬‫و‬‫مایکر‬ ‫آحی‬‫ر‬‫ج‬‫سیجرهای‬‫و‬‫پر‬
TREATMENT PLANNING of Perio:
KUMS
Gingivectomy:
It is indicated to eliminate supra bony pockets. Pocket depth
confined to band of attached gingiva.
Periodontal flaps:
They may be used to perform osseous recontouring Osseous
recontouring may be indicated for pocket elimination, when
crown lengthening is needed.
‫تومی‬‫جینجیویک‬:‫آ‬‫بیره‬ ‫و‬‫آستخوآنی‬‫فوقانی‬‫تهای‬‫پاک‬‫تمام‬‫بردن‬‫آزبین‬‫آی‬‫ر‬‫ب‬‫ضافی‬.
‫فلپ‬‫پیریودونتل‬:‫و‬‫ینگ‬‫ر‬‫ریکانتو‬‫یعنی‬‫آستخوآن‬‫شکل‬‫کردن‬ ‫آصالح‬‫آی‬‫ر‬‫ب‬‫آیش‬‫ز‬‫آف‬‫آی‬‫ر‬‫ب‬‫یا‬
‫میگردد‬‫آستفاده‬‫باشد‬‫نیاز‬‫زمانیکه‬‫تاج‬‫یک‬‫طول‬.
TREATMENT PLANNING of Perio:
KUMS
Orthodontic preparation is carried out to
achieve the following:
▪ Reduce the need for prosthetic teeth as much as
possible.
▪ Position the teeth to allow the most natural
prosthetic replacement of teeth.
▪ Create sufficient vertical height to allow room for
placement of artificial teeth.
▪ Allow sufficient occlusal guidance on natural teeth.
•‫باشد‬‫آمکانش‬ ‫که‬‫حد‬‫تا‬‫تیز‬‫و‬‫پر‬‫به‬‫نیاز‬‫ساختن‬ ‫کم‬
•‫باشد‬‫آمکانش‬ ‫که‬ ‫حد‬‫تا‬‫طبیعی‬‫گونه‬‫به‬‫تیز‬‫و‬‫پر‬‫به‬‫دآدن‬‫درست‬‫موقعیت‬
•‫ید‬‫آ‬‫بوجود‬ ‫کافی‬ ‫جای‬‫تیز‬‫و‬‫پر‬ ‫آی‬‫ر‬‫ب‬‫تا‬ ‫کافی‬‫بگونه‬‫عمودی‬ ‫تفاع‬‫ر‬‫آ‬‫آیجاد‬
•‫میشو‬‫دآده‬‫طبیعی‬‫دندآنهای‬‫آی‬‫ر‬‫ب‬ ‫که‬‫مانند‬‫به‬ ‫لی‬‫ز‬‫آکلو‬‫رهنمود‬ ‫به‬‫دآدن‬ ‫آجازه‬‫د‬.
Orthodontic Considerations or Preparation
Endodontic And Restorative
Treatment
▪ Teeth with pulpal involvement and root end pathology are
candidates for endodontic therapy. Restorative therapy like - crowns,
inlays, onlays, restoration of carious lesions and replacement of
defective restorations should be integrated with endodontic
treatment.
▪ Use of pulpless teeth as an abutment: It is considered when pulpless
teeth that has been treated endodontically is presented as a
potential abutment in mouth of patient for whom a removable
partial denture is to be made.
4. Teeth preparation
Tooth modification is one of the simplest procedures and yet one of the most
neglected steps in mouth preparation. The main reason for this neglect is that if
dentin were exposed, abutments would be more susceptible to caries. Penetration of
the dentin can be prevented by careful radiographic interpretation. Susceptibility to
caries can be reduced by smoothing the involved tooth surfaces with fine disks,
rubber wheels, pumice and fluoride pastes.
Tooth modification should follow an organized logical sequence:
1. Establishing guiding plane
2. Recontouring survey line.
3. Increasing retention
4. Occlusal relationship
5. Restorative procedures
6. Endodontic treatment
7. Complete veneer restorations
8. Rest seat preparations
RESOURCES
● PREPARATION OF THE MOUTH FOR COMPLETE DENTURES, KUNDOC.COM
● Stewart’s: Clinical Removable Partial Prosthodontics. Quintessence Books, Third
edition 2003
● Mc Cracken's: Removable Partial Prosthodontics. Mosby,Inc. Tenth edition 2000
● Mills M. Mouth preparation for removable partial dentures. J Am Dent Assoc
1960;60:154-159
● McCracken, W. L:Mouth Preparations for Partial Dentures, J. Pros. Den. 6:39-52,
1956
● Glann G.W, Ralph C. Mouth preparation for removable partial dentures. J. Pros Den
1950:10:698-706
● Prosthodontics - Complete Denture ( Mouth preparation & Impression ), YOYTUBE
● Deepak Nallaswamy Veeraiyan, 2003
.
THANKS!
‫مننه‬!‫سپاس‬‫جهان‬‫تان‬‫توجه‬‫از‬...

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Mouth Preparation for Complete Dentures by Dr. Hedayatullah Ehsan

  • 2. TABLE OF CONTENTS Introduction 01 Tissues Conditioning Treatment 04 Methods of Treatment 02 Nutritional Program 05 Correction of the occlusion of old restorations 03 Soft Tissue Correction Bony Tissue Correction 06 07
  • 3. Introduction Mouth preparations are identified as those procedures that are accomplished to prepare the mouth for reception of prosthesis. ‫ماده‬‫آ‬‫ساختن‬‫جوف‬‫دهن‬‫به‬‫عنوآن‬‫یک‬ ‫سلسلسه‬‫سیجرهای‬‫و‬‫پر‬‫شناخته‬‫شده‬‫که‬‫توسط‬ ‫ن‬‫آ‬‫جوف‬‫دهن‬‫آی‬‫ر‬‫ب‬‫خذ‬‫آ‬‫و‬‫پذیرش‬‫تیزه‬‫و‬‫پر‬‫ا‬ ‫ماده‬‫آ‬‫میگردد‬.
  • 4. Introduction Many conditions in the edentulous mouth should be corrected or treated prior to the construction of complete dentures. Often, patients are not aware that tissues in their mouth have been damaged or deformed by the presence of old restorations. Other conditions may have developed or be present which must be altered to increase chances for success of new dentures. The patient must be made aware of these problems.
  • 5. METHODS OF TREATMENT Some of the methods of treatment to correct edentulous mouths include : (1) removal of the dentures from the mouth for an extended period of time to allow deformed tissue of the residual ridges or temporomandibular joints to recover its normal form, (2) surgery, (3) correction of the occlusion of old restorations, (4) tissue placement by means of tissue treatment material, and (5) nutritional therapy.
  • 6. 1. Correction of the occlusion of old restorations: • It may be necessary to eliminate deflective occlusal contacts in eccentric positions and; • To establish harmony between centric occlusion and centric relation. • Heavy contacts between opposing anterior teeth causes a decreased vertical relation of occlusion. • These corrections reduce traumatic forces of occlusion to the supporting tissues and joints and; • Reduce the time that the dentures must be left out of the mouth before construction of new dentures is begun.
  • 7. KUMS • This treatment is indicated for those patients who cannot leave their old dentures out of the mouth for a sufficient length of time to allow the supporting tissues to become healthy. • It may be necessary to correct the extent of tissue coverage by the denture base so that all usable supporting tissues will be included in the treatment. • Tissue treatment material permits movement of the denture base so that its position becomes compatible with the existing occlusion and allows displaced tissues to recover and assume their original position. 2.Tissues Conditioning Treatment (Tissue Placement or treatment material):
  • 8. KUMS 2.Tissues Conditioning Treatment (Tissue Placement or treatment material):
  • 9. Nutritional Program ● A good nutritional program is needed for all patients, particularly for the elderly patient with complete dentures. ● The metabolic efficiency of the geriatric patient has been decreased because of his age, and his masticatory efficiency has been decreased because of the loss of his natural teeth. ● Vitamin C in large doses helps combat capillary fragility and large doses of Vitamin B aid in tissue recovery. ● An over-all diet that is low in carbohydrate and fat and high in protein is recommended for these patients. .
  • 10. MP for CD ▪ All patients are required to leave their old dentures out of the mouth for 24 to 48 hours to allow the supporting tissue to recover its normal form prior to making impressions for new dentures. ▪ This procedure is generally followed even after the use of tissue treatment material or other corrective methods.
  • 12. KUMSHyperplastic Tissue.-Increased pressure or chronic irritation may produce excessive connective tissue proliferation. Hyperplastic tissue often forms around the labial border of immediate dentures when “follow-up” treatment has not been provided. • Excess pressures from heavy contacts of opposing anterior teeth is a primary cause of hyperplastic tissue. • Other causes of hyperplastic tissue include deflective occlusal contacts, which cause the denture to shift from its resting position, and ill-filling dentures with sharp borders. • In some instances, removal of the old dentures from the mouth will allow sufficient response of the tissue so that no other treatment will be necessary. SOFT TISSUE CORRECTIONS
  • 14. SOFT TISSUE CORRECTIONS Papillomatosis.-Inflammatory papillary hyperplasia often occurs in the region surrounding the median palatal raphe. • Chronically inflamed tissues of palates may vary from mild hyperplasias to conditions which could be precancerous. • The cause of papillomatosis is sometimes vague. • Since papillomatosis could be a precancerous lesion, treatment is controlled in a different manner from that for other soft tissue changes. • The patient is required to leave the dentures out of the mouth for 7 to 10 days. • If the irritated tissue remains inflamed after this treatment, a biopsy is made. • If sign of tumor so the surgery should be done.
  • 17. SOFT TISSUE CORRECTIONS • When the pathologic report indicates hyperplasia, then several procedures can be followed. • The dentures can simply be left out of the mouth until the inflammation subsides, tissue treatment material can be placed in the dentures, or • The whole of the palatal part of the upper denture can be removed and the patient can wear a palateless upper denture until the tissue becomes healthy.
  • 20. KUMSFibrous Moveable Tissue.-Tissue contours may appear to represent a well-formed edentulous ridge. • The cause of this bony resorption and replacement by fibrous moveable tissue may be occlusion, excess pressure from ill fitting dentures, general systemic conditions, or combinations of these factors. • Treatment of moveable fibrous tissue is based on its severity and the health of the patient. • Surgery in combination with an immediate temporary reline of the dentures is most often the treatment of choice. • When surgery is contraindicated, the dentures are left out of the mouth until the desired improvement is achieved. SOFT TISSUE CORRECTIONS
  • 22. SOFT TISSUE CORRECTIONS Vestibular Corrections.-Certain corrections that involve the reflections or vestibular spaces are desirable to enhance retention of the completed dentures. • In some instances, the upper labial frenum may be composed of a strong band of fibrous connective tissue that inserts on the lingual side of the crest of the residual ridge. • Such a frenum prevents apposition of the natural upper central incisors and will dislodge or interfere with the border seal of the upper denture. • Since the labial frenum does not contain a muscle, this tissue can be removed surgically (frenectomy) prior to construction of new dentures.
  • 25. KUMS Other pathologic forms, such as benign and malignant tumors, cysts, and tubercular and syphilitic lesions, in the edentulous mouth are treated in a comparable manner to those in the dentulous mouth. SOFT TISSUE CORRECTIONS
  • 26. BONY TISSUE CORRECTIONS Undercuts.- excessively large or undercut maxillary tuberosities must be treated surgically. • Many times the bony protuberance can be left on one side and surgically corrected only on the opposite side of the mouth. • Bony reductions in the anterior part of either ridge should be performed only in extreme situations. • The bone of this part of the mouth is often unnecessarily trimmed and the patient suffers reduced denture stability for the rest of his life. • Diagnostic casts can be surveyed as a guide to the amount of tissue that must be removed.
  • 29. BONY TISSUE CORRECTIONS Tori.- Mandibular tori are almost always removed as the tissue covering is thin and the tori quite frequently extend into the region of the border seal of the lower denture. • Mandibular tori are found in approximately 7 per cent of the general adult population. • Most palatal tori are not removed unless they are excessively undercut or extend into the area of the vibrating line and interfere with the posterior palatal seal of the upper denture. • Relief must be provided in the denture has either arbitrarily or by a functional procedure upon completion of the upper denture. • Maxillary tori are found in approximately 21 per cent of the population.
  • 30. BONY TISSUE CORRECTIONS • Tori.-B • GenialSpines.-C • KnifeEdgeRidges.-D
  • 31. KUMS Sharp Spines or Spicules.-Sharp projections of the alveolar process, that remain following removal of teeth, press on the mucosa from its inside surface and cause discomfort to the patient. • Sometimes the stimulation from massage of the finger will speed resorption of these projections. • When this procedure fails, they are removed surgically with little operative or postoperative difficulty. BONY TISSUE CORRECTIONS
  • 32. KUMS Genial Spines.-Severe resorption of the residual ridge may cause the genial spines to become exceedingly sharp and prominent in relation to the residual ridge. • On rare occasions, these spines are reduced surgically as even the movement of the overlying mucosa from pressure of the nearby denture base causes soreness. • However, in most instances no treatment is given and the patient is informed of the limitations that these structures will place on the completed dentures. BONY TISSUE CORRECTIONS
  • 33. KUMS Knife Edge Ridges.-Sharp ridges must be palpated well before enthusiastically launching into a surgical program. • The anatomic nature of the knife edge ridge is often such that surgery offers only temporary relief and another sharp narrow ridge may become prominent in a few months. • The only available treatment for this kind of ridge is often adequate provisions for relief in the impression and completed dentures. BONY TISSUE CORRECTIONS
  • 34. KUMS Exostoses.- Excess bone formation may occur from unknown causes in various parts of the residual ridge. • These projections of bone are surgically removed if they interfere in any way with denture construction. BONY TISSUE CORRECTIONS
  • 35. INTERARCH SPACE CORRECTIONS • When insufficient space exists between the maxillary tuberosities and the retromolar pads, the tuberosities should be surgically corrected to permit the denture bases to cover all available tissue and end on moveable tissue. • The surgery is performed on the tuberosities and not on the retromolar pads because of the anatomic structures contained within the pad (temporal tendon, pterygomandibular raphe, superior constructor and buccinator muscle fibers, and palatal- type mucous glands).
  • 37. INTERARCH SPACE CORRECTIONS • In addition to creating needed space, removal of this tissue allows the occlusal plane of the upper denture to be oriented in such a manner that resultant forces are directed toward the ridge and tend to seat the upper denture rather than dislodge it. • When health conditions, proximity of the maxillary sinus, or other factors make surgical intervention impractical, then metal sections can be incorporated in both denture bases posteriorly to utilize a small interarch space.
  • 38. SUMMARYOF THE ABOVE LESSONS • The dentist is obligated to construct the best complete dentures possible. • The dentures can be no better than their supporting foundation. • Methods outlining tissue improvement programs for various conditions of the edentulous mouth have been described.
  • 39. 1. Oral surgical preparation: ‫آز‬‫تند‬‫ر‬‫گرددعبا‬‫آ‬‫ر‬‫آج‬‫قبل‬ ‫همه‬ ‫آز‬‫باید‬‫که‬‫آحی‬‫ر‬‫ج‬‫سیجرحای‬‫و‬‫پر‬‫تمام‬: •‫نهفته‬‫دندآنهای‬‫نوع‬‫هر‬‫کردن‬‫خارج‬٬‫یافته‬‫ج‬‫و‬‫خر‬ ‫نیمه‬٬‫باقیمانده‬‫های‬‫ریشه‬٬‫ج‬‫و‬‫خر‬‫بیجا‬‫دندآنهای‬ ‫یافته‬٬‫درجه‬ ‫تحرکیت‬‫با‬‫دندآنهای‬‫تمام‬‫و‬۲. •‫سیستها‬‫تمام‬‫بردن‬‫بین‬‫آز‬٬‫دندآنی‬‫های‬‫ر‬‫تومو‬٬‫آستخوآنی‬‫آت‬‫ز‬‫تبار‬٬‫وسی‬‫ر‬‫تو‬‫تالت‬‫ک‬٬‫تالت‬‫ک‬‫تمام‬‫و‬ ‫دهن‬‫در‬‫آضافی‬. •‫عضالت‬‫ساختن‬ ‫منظم‬‫و‬‫درست‬٬‫فرینولومها‬٬‫آستخوآنی‬ ‫تیز‬‫های‬‫کناره‬‫و‬. •‫دندآنی‬‫آمپلنتهای‬‫یعنی‬‫فلزی‬‫دندآنی‬‫های‬‫دیوآیس‬‫دآدن‬‫آر‬‫ر‬‫ق‬. •‫کا‬‫تیز‬‫و‬‫پر‬‫کردن‬‫نصب‬‫جهت‬‫آلویولر‬‫آستخوآن‬‫آیش‬‫ز‬‫آف‬‫دیگر‬‫آصطالح‬‫به‬‫یا‬‫تقویت‬‫مل‬.
  • 41. KUMS‫ک‬‫دلیل‬‫هر‬‫بنابر‬‫یعنی‬‫آند‬‫دندآن‬‫بدون‬‫که‬‫آنساج‬‫تمام‬‫بخش‬‫آین‬‫در‬‫آز‬‫دندآنها‬‫ه‬ ‫س‬ ‫وضعیت‬‫نمودن‬‫پیدآ‬‫جهت‬‫کامل‬‫سی‬‫ر‬‫بر‬ ‫یک‬‫آبتدآ‬‫آست‬‫رفته‬‫میان‬‫یا‬‫و‬‫الم‬ ‫ک‬‫تیز‬‫و‬‫پر‬‫تحمل‬‫قابلیت‬‫آنساج‬‫آین‬‫یا‬‫آ‬‫که‬‫میکنیم‬‫آ‬‫ر‬‫آج‬‫سالم‬‫غیر‬‫و‬‫دآرد‬‫آ‬‫ر‬‫امل‬ ‫خیر‬‫یا‬. ‫آشیدگیها‬‫ر‬‫خ‬٬‫گیها‬‫بریده‬٬‫ماها‬‫و‬‫تر‬٬‫دیگر‬‫ضایعات‬‫و‬٬‫قابلیت‬‫سی‬‫ر‬‫بر‬‫بالخره‬‫و‬ ‫بوط‬‫و‬‫مر‬‫آنساج‬‫در‬‫تیز‬‫و‬‫پر‬‫طرف‬‫آز‬‫آحتمالی‬‫لی‬‫ز‬‫آکلو‬‫فشارهای‬‫تحمل‬‫بدون‬‫ه‬ ‫پر‬‫نشست‬‫آز‬‫قبل‬‫آ‬‫ر‬‫ضایعات‬‫و‬‫فات‬‫آ‬‫تمام‬‫و‬‫میکنیم‬‫سی‬‫ر‬‫بر‬‫آ‬‫ر‬‫دندآن‬‫تیز‬‫و‬ ‫میسازیم‬‫ماده‬‫آ‬‫آ‬‫ر‬‫دهن‬‫جوف‬‫و‬‫برطرف‬. Preparation of the edentulous tissues:
  • 42. KUMSThere are certain periodontal procedures that should be considered involving soft/hard tissue abnormalities. After oral hygiene measures, scaling and root planning have been carried out periodontal surgery may be recommended for: 1. No bony defects – excess gingiva | gingivectomy 2. NO bony defect – inadequate gingiva | micro gingival surgery 3. Bony defect – osseous surgery One of the more common and useful procedures is “salvaging the buried crown” increasing the crown length of a major abutment by a simple gingivectomy procedure. ‫هم‬ ‫که‬‫دآرد‬ ‫وجود‬‫ژی‬‫پیریودونتولو‬ ‫آنساج‬‫به‬‫مربوط‬‫مشخص‬ ‫و‬‫معیین‬‫سیجرهای‬‫و‬‫پر‬‫تعدآد‬‫یک‬‫بخش‬‫آین‬‫در‬ ‫میسازد‬‫دخیل‬‫آ‬‫ر‬‫سخت‬‫آنساج‬‫هم‬ ‫و‬‫نرم‬‫آنساج‬‫آبنارملتیهای‬.‫و‬‫سکلینگ‬ ‫و‬‫دهن‬‫آلصحه‬ ‫حفظ‬‫آقدآمات‬‫آز‬‫بعد‬ ‫میگردد‬ ‫آ‬‫ر‬‫آج‬‫ر‬‫منظو‬‫سه‬‫آی‬‫ر‬‫ب‬‫پیریودونتل‬ ‫آحی‬‫ر‬‫ج‬‫پالنینگ‬ ‫ت‬‫و‬‫ر‬: ‫آضافی‬‫بیره‬–‫تومی‬‫جینجیوک‬ ‫ناکافی‬‫بیره‬–‫آحی‬‫ر‬‫ج‬‫جینجیول‬‫و‬‫مایکر‬ ‫آستخوآنی‬‫ضایعات‬–‫آحی‬‫ر‬‫ج‬‫آوسیوس‬ ‫میبا‬‫تومی‬‫جینجیویک‬‫طریق‬ ‫آز‬‫پایه‬‫دندآن‬ ‫تاج‬‫یا‬ ‫ن‬‫و‬‫کر‬‫طول‬‫آیش‬‫ز‬‫آف‬‫آز‬‫عبارت‬ ‫مهم‬ ‫خیلی‬‫سیجرهای‬‫و‬‫پر‬ ‫آز‬‫یکی‬‫شد‬. Periodontal treatment
  • 43. KUMS1. Removal and control of all etiologic factors contributing to periodontal disease along with reduction or elimination of bleeding on probing. 2. Elimination of, or reduction in, the pocket depth of all pockets with the establishment of healthy gingival sulci whenever possible. 3. Establishment of functional atraumatic occlusal relationships and tooth stability. 4. Development of a personalized plaque control program and a definitive maintenance schedule. ۱-‫یا‬‫بینگ‬‫و‬‫پر‬‫هنگام‬‫خونریزی‬‫باعث‬‫یا‬ ‫و‬‫پیریودونتل‬‫آض‬‫ر‬‫آم‬‫باعث‬ ‫که‬‫های‬‫ر‬‫تو‬‫فک‬‫تمام‬‫بردن‬‫بین‬ ‫آز‬‫میباشد‬‫معاینه‬. ۲-‫د‬ ‫آی‬‫بیره‬‫سالم‬ ‫سلکس‬‫یک‬‫ساختن‬‫مهیا‬‫با‬‫آه‬‫ر‬‫هم‬ ‫آی‬‫بیره‬‫تهای‬‫پاک‬‫عمق‬‫دآدن‬‫کاهش‬‫یا‬‫بردن‬‫بین‬‫آز‬‫آمکان‬‫ت‬‫ر‬‫صو‬‫ر‬ ‫میباشد‬. ۳-‫ثب‬‫آیجاد‬‫با‬ ‫آه‬‫ر‬‫هم‬‫بودند‬‫شده‬‫نامنظم‬‫ماها‬‫و‬‫تر‬ ‫آثر‬‫در‬ ‫که‬ ‫لی‬‫ز‬‫آکلو‬‫آبط‬‫و‬‫ر‬‫تمام‬‫کردن‬‫مهیا‬ ‫و‬‫دن‬‫ر‬‫و‬‫آ‬‫بوجود‬‫درست‬‫ات‬ ‫دندآنها‬. ۴-‫آیجاد‬‫آز‬‫تا‬‫دندآنی‬ ‫پالک‬ ‫کننده‬‫نظارت‬ ‫و‬‫کنند‬ ‫ل‬‫و‬‫کنتر‬‫خود‬‫آم‬‫ر‬‫گ‬‫و‬‫پر‬‫یک‬‫کردن‬‫تهیه‬‫یا‬‫دن‬‫ر‬‫و‬‫آ‬‫بوجود‬‫جلوگیری‬‫پالک‬ ‫گیرد‬‫ت‬‫ر‬‫صو‬. Objectives Of Periodontal Therapy
  • 45. KUMS There are three phases Phase 1. Initial disease control therapy Phase 2. Definitive periodontal surgery Phase 3. Recall maintenance ‫آی‬‫ر‬‫ب‬‫تدآوی‬‫تمام‬‫حاالت‬‫مرضی‬‫یا‬‫ناسالم‬‫پیریو‬‫سه‬‫فاز‬‫یا‬‫سه‬‫مرحله‬‫وجود‬‫دآرد‬: ۱-‫فاز‬‫آول‬‫عبارت‬‫آز‬‫ل‬‫و‬‫کنتر‬‫مرض‬‫نو‬‫تشکل‬‫یافته‬. ۲-‫فاز‬‫دوم‬‫عبارت‬‫آز‬‫مرحله‬‫آحی‬‫ر‬‫ج‬‫یو‬‫و‬‫پیر‬‫بوده‬‫که‬‫فت‬‫آ‬‫به‬‫یک‬‫حد‬‫قابل‬‫مالحظه‬‫پ‬‫یشرفت‬ ‫کرده‬. ۳-‫حفظ‬‫حالت‬‫آحیا‬‫شده‬‫به‬‫گونه‬‫سالم‬‫و‬‫پایدآر‬. TREATMENT PLANNING of Perio:
  • 46. KUMS Definitive Periodontal Surgery ▪ Gingivectomy ▪ Periodontal Flap ▪ Mucogingival surgical procedures ‫آست‬‫بخش‬‫سه‬‫شامل‬: •‫تومی‬‫جینجیوک‬ •‫فلپ‬‫پیریودونتل‬ •‫جینجیول‬‫و‬‫مایکر‬ ‫آحی‬‫ر‬‫ج‬‫سیجرهای‬‫و‬‫پر‬ TREATMENT PLANNING of Perio:
  • 47. KUMS Gingivectomy: It is indicated to eliminate supra bony pockets. Pocket depth confined to band of attached gingiva. Periodontal flaps: They may be used to perform osseous recontouring Osseous recontouring may be indicated for pocket elimination, when crown lengthening is needed. ‫تومی‬‫جینجیویک‬:‫آ‬‫بیره‬ ‫و‬‫آستخوآنی‬‫فوقانی‬‫تهای‬‫پاک‬‫تمام‬‫بردن‬‫آزبین‬‫آی‬‫ر‬‫ب‬‫ضافی‬. ‫فلپ‬‫پیریودونتل‬:‫و‬‫ینگ‬‫ر‬‫ریکانتو‬‫یعنی‬‫آستخوآن‬‫شکل‬‫کردن‬ ‫آصالح‬‫آی‬‫ر‬‫ب‬‫آیش‬‫ز‬‫آف‬‫آی‬‫ر‬‫ب‬‫یا‬ ‫میگردد‬‫آستفاده‬‫باشد‬‫نیاز‬‫زمانیکه‬‫تاج‬‫یک‬‫طول‬. TREATMENT PLANNING of Perio:
  • 48. KUMS Orthodontic preparation is carried out to achieve the following: ▪ Reduce the need for prosthetic teeth as much as possible. ▪ Position the teeth to allow the most natural prosthetic replacement of teeth. ▪ Create sufficient vertical height to allow room for placement of artificial teeth. ▪ Allow sufficient occlusal guidance on natural teeth. •‫باشد‬‫آمکانش‬ ‫که‬‫حد‬‫تا‬‫تیز‬‫و‬‫پر‬‫به‬‫نیاز‬‫ساختن‬ ‫کم‬ •‫باشد‬‫آمکانش‬ ‫که‬ ‫حد‬‫تا‬‫طبیعی‬‫گونه‬‫به‬‫تیز‬‫و‬‫پر‬‫به‬‫دآدن‬‫درست‬‫موقعیت‬ •‫ید‬‫آ‬‫بوجود‬ ‫کافی‬ ‫جای‬‫تیز‬‫و‬‫پر‬ ‫آی‬‫ر‬‫ب‬‫تا‬ ‫کافی‬‫بگونه‬‫عمودی‬ ‫تفاع‬‫ر‬‫آ‬‫آیجاد‬ •‫میشو‬‫دآده‬‫طبیعی‬‫دندآنهای‬‫آی‬‫ر‬‫ب‬ ‫که‬‫مانند‬‫به‬ ‫لی‬‫ز‬‫آکلو‬‫رهنمود‬ ‫به‬‫دآدن‬ ‫آجازه‬‫د‬. Orthodontic Considerations or Preparation
  • 49. Endodontic And Restorative Treatment ▪ Teeth with pulpal involvement and root end pathology are candidates for endodontic therapy. Restorative therapy like - crowns, inlays, onlays, restoration of carious lesions and replacement of defective restorations should be integrated with endodontic treatment. ▪ Use of pulpless teeth as an abutment: It is considered when pulpless teeth that has been treated endodontically is presented as a potential abutment in mouth of patient for whom a removable partial denture is to be made.
  • 50. 4. Teeth preparation Tooth modification is one of the simplest procedures and yet one of the most neglected steps in mouth preparation. The main reason for this neglect is that if dentin were exposed, abutments would be more susceptible to caries. Penetration of the dentin can be prevented by careful radiographic interpretation. Susceptibility to caries can be reduced by smoothing the involved tooth surfaces with fine disks, rubber wheels, pumice and fluoride pastes. Tooth modification should follow an organized logical sequence: 1. Establishing guiding plane 2. Recontouring survey line. 3. Increasing retention 4. Occlusal relationship 5. Restorative procedures 6. Endodontic treatment 7. Complete veneer restorations 8. Rest seat preparations
  • 51. RESOURCES ● PREPARATION OF THE MOUTH FOR COMPLETE DENTURES, KUNDOC.COM ● Stewart’s: Clinical Removable Partial Prosthodontics. Quintessence Books, Third edition 2003 ● Mc Cracken's: Removable Partial Prosthodontics. Mosby,Inc. Tenth edition 2000 ● Mills M. Mouth preparation for removable partial dentures. J Am Dent Assoc 1960;60:154-159 ● McCracken, W. L:Mouth Preparations for Partial Dentures, J. Pros. Den. 6:39-52, 1956 ● Glann G.W, Ralph C. Mouth preparation for removable partial dentures. J. Pros Den 1950:10:698-706 ● Prosthodontics - Complete Denture ( Mouth preparation & Impression ), YOYTUBE ● Deepak Nallaswamy Veeraiyan, 2003 .