3. -The dentist conducts a thorough clinical examination of
the patient's oral cavity, evaluating the remaining teeth,
oral tissues, and overall oral health.
Clinical Examination:
01
- Alginate or silicone impressions of the patient's arches
are taken to create accurate models of the oral cavity.
Impressions:
02
- X-rays (such as panoramic radiographs) may be used
to assess the condition of the remaining teeth and the
bone structure.
Radiographic Examination:
03
- Analyzing the patient's bite (occlusion) is crucial to
ensure that the removable denture will function properly
and be comfortable.
Occlusal Analysis:
04
features of these
examination
4. 05. Oral Health Assessment:
- Assessing the health of the soft tissues, including the gums
and oral mucosa, is essential to ensure there are no
contraindications for denture placement.
06. Photographic Documentation:
- Photographs may be taken to document the patient's oral
condition and for communication with the dental laboratory.
07. Bite Registration:
- Accurate bite registration records are taken to determine the
relationship between the upper and lower jaws.
08. Tooth Shade and Shape
Selection:
- The dentist and patient select the desired shade and shape of
artificial teeth to match the patient's natural teeth and esthetic
preferences.
5. Laboratory Methods
01 Model Fabrication
- Using the impressions, stone or plaster models are
created to replicate the patient's oral arches.
02 Wax Try-In
- A wax setup of the denture is created to allow the
patient and dentist to evaluate the fit, aesthetics, and
function of the prosthesis.
03 Framework Design
- In cases of removable partial dentures, the framework,
which supports the artificial teeth, is custom-designed
based on the clinical findings and bite registration.
6. 04 Tooth Setup
- Artificial teeth are set up in wax according to the
patient's preferences and occlusal requirements.
05 Final Processing
- Once the patient approves the wax try-in, the denture
is processed in acrylic or other materials to create the final
prosthesis.
06 Fit and Function Testing
- The completed denture is tested for fit, stability, and
occlusal harmony.
07 Delivery and Follow-up
- The removable denture is delivered to the patient, and
follow-up appointments are scheduled to address any
necessary adjustments.
7. Rationale for Diagnosis
Accurate diagnosis is crucial for planning appropriate dental
treatment. It helps the dentist determine the best approach to
restore oral function and aesthetics in cases of partial tooth loss..
Diagnosis enables the dentist to assess the prognosis of the
patient's dental condition. It helps in understanding the expected
outcomes of treatment and whether the remaining teeth can be
preserved.
Identifying the causes of partial tooth loss allows for preventive
measures to be taken. For example, addressing underlying gum
disease can prevent further tooth loss.
Diagnosis helps in tailoring treatment options to the patient's
specific needs, considering factors like the patient's age, overall
health, and dental preferences.
For many patients, the appearance of their smile is important. A
proper diagnosis helps in achieving optimal esthetic results through
treatment.
8. Causes of Partial Absence of Teeth
Developmental Anomalies: Abnormal tooth
development, such as hypodontia (missing teeth),
oligodontia (fewer teeth than normal), or
supernumerary teeth (extra teeth), can be a cause
of partial tooth absence.
Orthodontic Extractions: In some
cases, orthodontic treatment may involve the
removal of teeth to create space or align the
bite properly.
Impacted Teeth: Teeth that do not erupt
properly or are blocked from coming in can
become impacted and may need to be extracted
Periodontal Disease: Gum disease, such as
gingivitis and periodontitis, can lead to tooth loss.
The inflammation and infection of the supporting
tissues around teeth can cause them to become
loose and eventually be lost.
Congenital Factors: Some individuals may
have congenital conditions or genetic
predispositions that affect the development of their
teeth, leading to partial absence.
Trauma: Accidents or injuries to the mouth
can result in the fracture or loss of teeth.
Sports injuries, falls, or vehicular accidents
are common causes.
Tooth Decay (Caries): Dental caries,
commonly known as cavities, can lead to the loss
of teeth. If left untreated, cavities can progress and
result in the need for extractions..
Medical Conditions and Medications:
Certain systemic medical conditions or
medications can have adverse effects on dental
health and contribute to tooth loss.
Aging: Natural wear and tear on teeth and oral structures
over time can result in the loss of teeth, especially in older
adults.
Poor Oral Hygiene: Neglecting oral hygiene, such
as regular brushing and flossing, can lead to various
dental problems, including tooth loss.
9. Methods of
Clinical
Examination
1. Oral Inspection: The dentist visually inspects the oral cavity to assess the
overall condition, including the presence of any remaining teeth, the state of the
gums, and the soft tissues.
2. Palpation: By palpating the oral tissues, the dentist can evaluate the health
of the gums, bone, and surrounding structures for any tenderness, lesions, or
abnormalities.
3. X-rays: Radiographic examination (such as panoramic or periapical X-rays)
is conducted to assess bone density, the condition of remaining teeth, and any
pathological changes in the jaws.
4. Bite Analysis: The dentist checks the patient's bite (occlusion) to
determine the alignment of the upper and lower jaws and assess any issues with
the patient's bite relationship.
5. Mobility Assessment: For remaining teeth, the degree of mobility is
assessed to determine their stability and suitability for prosthodontic treatment.
6. Oral Hygiene Evaluation: The oral hygiene practices of the patient are
assessed to ensure a clean and healthy environment for prosthetic placement.
10. 1. Chewing Function: The patient's
ability to chew and perform functional
activities is assessed. This includes
evaluating how well they can process
food with their existing teeth or any
partial dentures.
2. Speech Evaluation: The dentist
may assess the patient's speech to
determine if tooth loss affects their
ability to articulate sounds clearly.
Functional
Methods
11. Assessment of Prosthetic Bed
Tissues
Gingival and Mucosal
Health
The condition of the
gums and oral mucosa is
evaluated to ensure they
are healthy and can
support the prosthesis
without irritation or
inflammation.
Bone Resorption
The level of bone
resorption in areas where
teeth are missing is
assessed, as this
influences the design of
the prosthesis.
Stability of the Ridge
The stability and shape of
the edentulous ridge (the
area where teeth are
missing) are examined to
determine the suitability
for partial denture
placement.
12. Rationale for Diagnosis:
1. Treatment Planning: A comprehensive diagnosis is essential for
developing a tailored treatment plan. This plan considers the patient's
specific oral health needs, functional requirements, and esthetic goals.
2. Prognosis: Diagnosis helps in determining the prognosis of the
patient's condition, which is vital for managing expectations and making
informed decisions about prosthetic treatment.
3. Prosthetic Design: Understanding the clinical and functional
status of the patient's oral tissues guides the design of the removable
partial denture to ensure proper fit, stability, and functionality.
4. Oral Health: Diagnosis reveals any underlying oral health issues
that may need to be addressed before prosthetic treatment, such as
treating gum disease or caries.
5. Esthetics: Assessment of the prosthetic bed tissues informs the
esthetic aspects of the prosthesis, ensuring that it integrates seamlessly
with the patient's natural oral structures.
6. Patient-Centered Care: A thorough diagnosis allows for a
patient-centered approach, taking into account the individual's
preferences, comfort, and specific needs in prosthodontic treatment.
13. Structure of Oral Mucosa
The outermost layer of the oral mucosa is the epithelium.
It consists of stratified squamous epithelium, which
varies in thickness depending on its location in the oral
cavity.
Epithelium:
Beneath the epithelium is the lamina propria, a layer of
loose connective tissue. It contains blood vessels,
nerves, and minor salivary glands.
Lamina Propria:
In some areas of the oral cavity, there is a deeper layer
called the submucosa, which contains more dense
connective tissue and larger blood vessels.
Submucosa:
14. Classification of
oral mucosa
The oral mucosa is classified into three
main types based on its location and
function
This type of mucosa is found on the gingiva (gums) and
hard palate. It is specialized for withstanding the
mechanical stresses of chewing.
Masticatory Mucosa:
Lining mucosa lines the inner surfaces of the cheeks, lips,
and the floor of the mouth. It is relatively thin and flexible,
allowing for a wide range of movements.
Lining Mucosa:
Specialized mucosa is located on the dorsal surface of the
tongue and contains structures like papillae, taste buds,
and lingual tonsils. It has unique features related to taste
and sensory perception.
Specialized Mucosa:
15. Properties of Oral Mucosa
01 The degree of keratinization varies
among different types of oral mucosa.
Some areas are keratinized (stratified
squamous epithelium with a tough,
keratinized surface), while others are
non-keratinized (lacking the tough outer
layer).
Keratinization:
03 The oral mucosa is rich in
sensory nerve endings,
making it sensitive to touch,
temperature, and pain.
Sensation:
02 Depending on the location,
the oral mucosa can be
moist or relatively dry. Moist
areas are associated with
minor salivary glands.
Moisture
16. definitions of the concepts
A transitional fold refers to a
specialized area or ridge of oral
mucosa that marks the junction
between two types of oral mucosa,
such as masticatory and lining
mucosa. These folds are often seen
in areas where the oral mucosa
transitions from a more rigid,
keratinized structure to a softer,
non-keratinized structure.
Transitional folds are typically found
in regions like the junction between
the attached gingiva and the buccal
mucosa.
Transitional Fold
Compliance, in the context of the
oral mucosa, refers to its ability to
deform or adapt to the forces
exerted upon it during various oral
functions, such as chewing,
speaking, or swallowing. It
describes the flexibility and
elasticity of the oral mucosa,
allowing it to accommodate
movement and pressure, which is
important for oral functions and
prosthodontic considerations.
Compliance of Oral
Mucosa
The mobility of oral mucosa
pertains to its capacity to move or
shift within the oral cavity. This
movement can be seen during
various oral activities, such as
tongue movement, lip and cheek
motion, and the displacement of
oral tissues during speaking,
smiling, and eating. The mobility
of the oral mucosa contributes to
its adaptability for oral functions
and dental prosthesis stability.
Mobility of Oral Mucosa
17. Masticatory Mucosa:
- Location: This type of mucosa is found in areas subject to significant mechanical
stress during mastication (chewing). It includes the gingiva (gums) and the hard
palate.
- Structure: Masticatory mucosa is highly keratinized to withstand mechanical
forces and abrasion.
Lining Mucosa:
- Location: Lining mucosa lines the inner surfaces of the cheeks, lips, floor of the
mouth, and the soft palate.
- Structure: It is non-keratinized and has a smooth, moist surface. It provides
flexibility and allows for various oral functions.
Specialized Mucosa:
- Location: The dorsal surface of the tongue contains specialized mucosa, especially
in the form of papillae and taste buds.
- Structure: This type of mucosa is involved in taste sensation and may contain
papillae with taste buds.
Classification of Oral Mucosa
18. prosthetic field and prosthetic bed
Prosthetic Bed:
The prosthetic bed is the foundation or
supporting structure within the prosthetic field
where the dental prosthesis will rest. It
includes the remaining natural teeth, soft
tissues, and underlying bone. Proper
evaluation of the prosthetic bed's health and
characteristics is crucial for prosthodontic
treatment planning, ensuring the stability and
longevity of the prosthesis.
Prosthetic Field:
The prosthetic field refers to the specific area
within the oral cavity where a dental prosthesis,
such as a partial denture or dental implant, is
designed to fit and function. It encompasses the
region where the artificial teeth or appliances will
be placed to replace missing natural teeth.
Accurate assessment and preparation of the
prosthetic field are essential for the successful
placement and functionality of dental prostheses.
19. - Suppli and Lund categorized the oral mucosa into three
zones based on characteristics:
- Masticatory Mucosa: Resistant to mechanical stress,
such as the gingiva and hard palate.
- Specialized Mucosa: Responsible for functions like
taste, as seen in the dorsal surface of the tongue.
- Lining Mucosa: Non-keratinized and typically found on
the inner surfaces of the cheeks, lips, and floor of the mouth.
Characteristics of the Oral
Mucosa (Suppli and Lund):
20. Pain Sensitivity of
the Oral Mucosa
- The pain sensitivity of the oral
mucosa can vary depending on
the specific location and
individual factors. Some areas,
like the gums and tongue, have
a higher density of sensory
nerve endings and may be more
sensitive to pain, while others,
like the hard palate, are less
sensitive. Pain sensitivity in the
oral mucosa is influenced by
factors such as inflammation,
injury, and individual pain
thresholds.
