Causes and consequences of tooth loss (1).ppt
- 1. Resto. 2 DR MARIE AIMEE 1
- 2. Causes, Consequences Of Tooth Loss & treatment options 2
- 3. Learning outcomes Causes of tooth loss Various consequences of tooth loss Prosthetic options for replacement of missing teeth Managing the tooth loss SIX phases of partial denture service 3
- 4. Causes Tooth Loss Dental diseases periodontal disease and tooth decay. Advanced tooth wear Trauma Fear -Afraid of dentist and never consult one, even if they have a tooth ache. Not consulting for a problem in your mouth can worsen the condition over time and eventually lead to tooth loss. Finances : Many people assume that dental treatments are too expensive. Consider extraction as the cheap option 4
- 5. SYSTEMIC DISEASES Rheumatoid arthritis High blood pressure Diabetes mellitus Genetics Aging 5
- 6. Epidemiology And Patterns Of Tooth Loss. Studies in Rwanda?( your assignment) Which teeth are lost first? 6
- 7. Problems associated with tooth loss Poor esthetics/appearance Speech impairment Tooth movement: drifting, tilting, super eruption of remaining teeth Impairment of mastication: Leads to improper chewing of food, swallowing of large particles. In some cases developing digestive system problems Overload /Increased occlusal load on remaining teeth; tooth wear, periodontal tissues loss, TMJ pain, pain in muscles of mastication Loss of vertical dimension Most common problem in cases of posterior teeth loss TMJ problems Angular cheilitis. 7
- 8. Problems associated with tooth loss ….. Mandibular deviation Due to over eruption of teeth which acts as interferences in mandibular border movements. It can be lead to discomfort and problems in masticatory system and TMJ. Loss of alveolar bone Avoiding certain foods because of chewing problems- nutrition problems Psychosocial problems Affects your self-esteem as tooth loss impinges on your smile and the way your face looks. Avoiding going out in public because of social embarrassment. Anxiety and self-consciousness. 8
- 9. Consequences of tooth loss Problem with Mastication Undesirable tooth movement: Mesial drifting Premature occlusal contacts Traumatic occlusion Super eruption Bone resorption 9
- 10. Consequences of tooth loss Compromised Facial Aesthetics Decreased lip support Decreased lower facial height 10
- 11. Consequences of tooth loss contd Loss of vertical dimension Increased occlusal load on existing teeth: Drifting, tooth surface loss 11
- 12. Introduction on removable partial denture Definitions 1. Partial denture: A prosthesis that replaces one or more, but not all of the natural teeth and supporting structures. It is supported by the teeth and/or the mucosa. It may be fixed (i.e. a bridge) or removable. 2. Removable partial denture (RPD): A partial denture that can be removed and replaced in the mouth by the patient 12
- 13. 3. Interim denture (provisional; temporary): A denture used for a short interval of time to provide: a. esthetics, mastication, occlusal support and convenience. b. conditioning of the patient to accept the final prosthesis. 4. Retention: Resistance to removal from the tissues or teeth 13
- 14. 5. Stability: Resistance to movement in a horizontal direction (anterior-posteriorly or medio-laterally 6. Support: Resistance to movement towards the tissues or teeth 7. Abutment: A tooth that supports a partial denture. 8. Retainer: A component of a partial denture that provides both retention and support for the partial denture 14
- 15. B. Treatment Objectives 1. preserve remaining teeth and supporting structures 2. restore esthetics and phonetics 3. restore and/or improve mastication 4. restore health, comfort and quality of life 15
- 16. Tooth replacement options for a Partially Edentulous Patients Dental implants A fixed bridge Conventional bridge Resin retained fixed partial dentures Removable Partial and complete dentures Not to replace 16
- 17. Tooth replacement options for a Partially Edentulous Patients Dental implants are considered to be the best and most comfortable tooth replacement solution. They are also the most expensive. An implant is an artificial root that is anchored to the bone and on which a crown is placed. It feels like a real tooth and does not require other teeth for support. A fixed bridge is a set of three or more crowns fused together, where the one in the middle (pontic) replaces the missing tooth. The crowns on the edge cover your own teeth which are used as anchors. A bridge can not be removed and is very aesthetic, looking like your real teeth. Partial and complete dentures are removable and replace several (partial) or all (complete) missing teeth. Since they are not fixed, they are not as comfortable as implants or bridges, and do not help you chew foods as effectively. But depending where your missing teeth are, dentures can give your smile an aesthetic look. Partials also prevent your other teeth of shifting and moving. Not to replace 17
- 18. Tooth replacement options for a Partially Edentulous Patients A fixed bridge is a set of three or more crowns fused together, where the one in the middle (pontic) replaces the missing tooth. Abutment: The crowns on the edge cover your own teeth which are used as anchors. A bridge can not be removed and is very aesthetic, looking like real teeth. 18
- 19. Fixed Partial Denture 19
- 20. Fixed partial denture: Before and after 20
- 21. Resin retained fixed partial denture 21
- 22. Resin retained fixed partial denture 22
- 23. Tooth replacement options for a Partially Edentulous Patients Dental implants Considered to be the best and most comfortable tooth replacement solution. The most expensive. An implant is an artificial root that is anchored to the bone and on which a crown is placed. It feels like a real tooth and does not require other teeth for support. 23
- 24. Implant 24
- 26. Factors that govern the clinical decisions on type of prosthesis Dental factors Abutment teeth present Number of teeth lost Poston of tooth loss Periodontal consideration-tooth support State of the teeth-strength of tooth tissues Root canal Rx proposed or required Quality of underlying ridge or bone Presence of soft or hard tissue pathology 26
- 27. Factors that govern the clinical decisions on type of prosthesis Patient factors Patient wishes and expectations of treatment Age Susceptibility to dental diseases Caries experience Periodontal experience Medical conditions Social factors Diet Smoking history Cost involved 27
- 28. Indications For Removable Partial Denture Therapy Long-span edentulous areas Following recent extractions/ Immediate need to replace extracted teeth Distal extension situations/No abutment tooth posterior to the edentulous space Reduced periodontal support for remaining teeth Esthetics of primary concern in anterior region Need for cross-arch stabilization Excessive bone loss within the residual ridge Physical or emotional problems exhibited by patients Patient desires/ economic considerations Unfavorable maxillo-mandibular relationships 28
- 29. Rationale For Removable Partial Dentures The primary purpose of removable partial denture therapy must always be “the preservation teeth that which remains, and not the meticulous replacement of that which has been lost”. Additional purposes of removable partial denture therapy: Maintaining or improving phonetics, Establishing or increasing masticatory efficiency, Stabilizing dental relationships and developing the required esthetics 29
- 30. Benefits /Advantages of RPDs Dentures can help patients in a number of ways: 1. Mastication - chewing ability is improved by replacing edentulous areas with denture teeth. 2. Aesthetics - the presence of teeth provide a natural facial appearance, and wearing a denture to replace missing teeth provides support for the lips and cheeks and corrects the collapsed appearance that occurs after losing teeth. 3. Phonetics/improved speech - by replacing missing teeth, especially the anteriors, patients are better able to speak by improving pronunciation of those words containing sibilants or fricatives. 4. Self-Esteem - Patients feel better about themselves. 5. Maintaining the health of the masticatory system: preventing undesirable tooth movement improving distribution of occlusal load 6. Low cost 30
- 31. Partial dentures may…. Give support to periodontally diseased teeth Restore vertical facial dimension Prevent TMJ problems Prevent toot drifting or over erupting Stimulate non used tissues support collapsed associated structures –tonicity of muscles of the lips and checks Improve oral hygiene by preventing stagnating of food in disused areas 31
- 32. Choice between fixed or removable partial denture Consider Number of remaining teeth and /or missing teeth Distribution of remaining teeth Periodontal support of remaining teeth Occlusion of reaming teeth Bounded saddle areas or not Length of edentulous span Patient’s hygiene (and patent motivation) Cost of procedures. 32
- 33. Cases Best Left Untreated By Partial Dentures Ask the following questions and arriving at a positive response : Are existing teeth and supporting structures healthy and stable? Is mastication efficient? Are speech and appearance good? Is occlusion such that there is no possibility of over eruption of teeth or drifting of teeth? Is the oral hygiene poor? Is the patient willing to change Is the patient free of TMJ problems or is she likely to acquire them? Is the patient mental attitude toward dentures questionable Is there an indication that medically the patient should not have partial dentures? 33
- 34. disadvantages of Rpd Disadvantages Patient acceptance may be poor Connectors cover soft tissues such as palate and gingivae Coverage of gingival margins will lead to plaque retention and increase periodontal disease and caries Aesthetics compromised by retentive elements such as clasps Moderate maintenance requirements and durability 34
- 35. Thank you 35