lec.1,lec 2.ppt
- 1. INTRODUCTION OF REMOVABLE PARTIAL DENTURE LEC.1 Assis.Prof.Radhwan Himmadi Hasan 1
- 2. CAUSES OF TOOTH LOSS • CARIES • PERIODONTAL DISEASES • TRAUMATIC INJURIES • CYSTS, MALIGNANCIES AND TUMORS • RADIATION THERAPY FOR TUMORS • CONGENITALLY MISSING TEETH • FAILURE TO ERUPT (IMPACTED TEETH) 2
- 3. SEQUELAE OF TOOTH LOSS • RESORPTION: THE SOCKET GRADUALLY REMODELS UNTIL IT ASSUMES THE SHAPE OF THE ROUNDED EDENTULOUS RIDGE. • TILTING • DRIFTING • OCCLUSAL DISHARMONY LEADS TO DISCOMFORT, PAIN, OR DAMAGE TO TEMPOROMANDIBULAR JOINTS. Assis.Prof.Radhwan Himmadi Hasan 3
- 4. 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. 4
- 5. REMOVABLE PARTIAL DENTURE (RPD) A PARTIAL DENTURE THAT CAN BE REMOVED AND REPLACED IN THE MOUTH BY THE PATIENT. ; IT IS EITHER ACRYLIC TYPE OR METALLIC TYPE (COBALT/CHROME) 5
- 6. • FOR ESTHETIC REASON • FOR PROPER FUNCTION AND OCCLUSION (TO BE ABLE TO MASTICATE FOOD PROPERLY) . • TO PREVENT EXTRUSION OF OPPOSING TEETH (SUPER-ERUPTION), AND MIGRATION OR TILTING OF ADJACENT TEETH. 6 INDICATIONS FOR RPD
- 7. 4- TO STIMULATE THE UNDERLYING RIDGE AND MUCOSA( PREVENT DISUSE ATROPHY). 5- TO RESTORE THE PHONETIC PROBLEMS ASSOCIATED WITH LOSS OF TEETH (ESPECIALLY ANTERIOR TEETH). 6- FOR SUPPORT FACIAL MUSCULATURE (PROPER BALANCE OF MUSCULAR RELATIONSHIP). 7- TO RESTORE THE PSYCHOLOGICAL STATUS OF THE PATIENT 7 OBJECTIVE OF RPD
- 8. INDICATIONS FOR RPD • LENGTH OF EDENTULOUS: RPD PREFERRED FOR LONGER EDENTULOUS ARCHES. • ABUTMENT TOOTH: WHEN THERE IS NO TOOTH POSTERIOR TO THE EDENTULOUS SPACE TO ACT AS AN ABUTMENT, A RPD IS PREFERRED. 8
- 9. • PERIODONTAL SUPPORT OF REMAINING TEETH: WHEN IT IS POOR RPD IS PREFERRED BECAUSE IT REQUIRES LESS SUPPORT FROM THE ABUTMENT TEETH. • CROSS ARCH STABILIZATION: WHEN A REMAINING TEETH HAVE TO BE STABILIZED AGAINST LATERAL AND ANTERIOR-POSTERIOR FORCES, A RPD IS INDICATED. 9
- 10. • EXCESSIVE BONE LOSS: IN RPD, THE ARTIFICIAL TOOTH CAN BE POSITIONED AS PER THE OPERATORS PREFERENCES AND THE DENTURE BASE CAN BE FABRICATED TO PROVIDE REQUIRED SUPPORT AND AESTHETICS. • AESTHETICS: RPD PROVIDE BETTER AESTHETICS BECAUSE THE DENTURE BASE GIVES THE Assis.Prof.Radhwan Himmadi Hasan 10
- 11. • IMMEDIATE TOOTH REPLACEMENT AFTER EXTRACTION • EMOTIONAL PROBLEMS: THE APPOINTMENT FOR REMOVABLE PARTIAL DENTURE IS SHORTER AND LESS DEMANDING TO PATIENT. • PATIENT DESIRES: PATIENT INSIST ON RPD OVER FPD FOR THE FOLLOWING REASONS: • TO AVOID OPERATIVE PROCEDURES ON NORMAL TOOTH. • FOR ECONOMIC REASONS. 11
- 12. COMPONENT OF RPD • MAJOR CONNECTORS • MINOR CONNECTORS • RESTS • DIRECT RETAINERS • STABILIZING OR RECIPROCAL COMPONENTS (AS PARTS OF A CLASP ASSEMBLY) • INDIRECT RETAINERS (IF THE PROSTHESIS HAS DISTAL EXTENSION BASES). • ONE OR MORE BASES EACH SUPPORT ONE TO SEVERAL REPLACEMENT TEETH. 12
- 13. FIXED PARTIAL DENTURE • PARTIAL DENTURE THAT LUTES OR OTHERWISE SECURELY RETAINED TO (NATURAL TEETH, TOOTH ROOTS, AND/OR DENTAL IMPLANT) THAT FURNISH THE PRIMARY SUPPORT AND RETENTION FOR THE PROSTHESIS. 13 Indications of fixed partial denture 1. Unilateral bounded edentulous short span. 2. Class IV Kennedy with normal loss of bone. 3. Modification area located anteriorly with class I and class II Kennedy classification for simplify the design of removable partial denture.
- 14. DENTAL IMPLANT • THE DENTAL IMPLANTS ARE CONSIDERED ADJUNCTS IN FIXED AND REMOVABLE THERAPY. HOWEVER, NOT ALL PATIENTS ARE CANDIDATES FOR DENTAL IMPLANT THERAPY 14
- 15. . •Classification of Partially Edentulous Arches 15
- 16. KENNEDY’S CLASSIFICATION CLASS I: BILATERAL EDENTULOUS AREAS LOCATED POSTERIOR TO THE REMAINING NATURAL TEETH. 16 Class II: unilateral edentulous areas located posterior to the remaining natural teeth.
- 17. • CLASS III: UNILATERAL EDENTULOUS AREA WITH NATURAL TEETH ANTERIOR AND POSTERIOR TO IT, I.E. THIS INDICATES A SINGLE EDENTULOUS AREA WHICH DOESN’T CROSS THE MIDLINE OF THE ARCH, WITH TEETH PRESENT ON BOTH SIDES OF IT. 17
- 18. • CLASS IV:. SINGLE, BUT (CROSSING THE MIDLINE) , • EDENTULOUS AREA LOCATED ANTERIOR TO THE REMAINING NATURAL TEETH
- 19. APPLEGATE’S RULES • RULE 1: CLASSIFICATION SHOULD FOLLOW RATHER THAN PRECEDE EXTRACTIONS THAT MIGHT ALTER THE ORIGINAL CLASSIFICATION. • RULE 2: IF THE THIRD MOLAR IS MISSING AND NOT TO BE REPLACED, IT IS NOT CONSIDERED IN THE CLASSIFICATION. • RULE 3: IF THE THIRD MOLAR IS PRESENT AND IS TO BE USED AS AN ABUTMENT, IT IS CONSIDERED IN THE CLASSIFICATION. • RULE 4: IF THE SECOND MOLAR IS MISSING AND IS NOT TO BE REPLACED, IT IS NOT CONSIDERED IN THE CLASSIFICATION. 19
- 20. • RULE 5: THE MOST POSTERIOR EDENTULOUS AREA OR AREAS ALWAYS DETERMINE THE CLASSIFICATION. • RULE 6: EDENTULOUS AREAS OTHER THAN THOSE, WHICH DETERMINE THE CLASSIFICATION, ARE REFERRED TO AS MODIFICATION SPACES AND ARE DESIGNATED BY THEIR NO: • RULE 7: THE EXTEND OF THE MODIFICATION IS NOT CONSIDERED, ONLY THE NO: OF EDENTULOUS AREAS, I.E. THE NO: OF TEETH MISSING IN THE MODIFICATION SPACES IS NOT CONSIDERED ONLY THE NO: OF ADDITIONAL EDENTULOUS SPACES ARE CONSIDERED. • RULE 8: THERE CAN BE NO MODIFICATION AREAS IN CLASS IV. BECAUSE ANY ADDITIONAL EDENTULOUS SPACE WILL DEFINITELY BE POSTERIOR TO IT AND WILL DETERMINE THE CLASSIFICATION. 20
- 22. 22
- 23. 23