Chapter 12 Prosthodontics -...

Chapter 12

• Prosthodontics

Wednesday, May 25, 2016 Golbarg Kolahi 1

Prosthesis

• [prahs-THEE-sis]

• A replacement for a missing body part

Prosthesis

• In the dental field, it is a fixed or removable appliance replacing

removed or non-erupted tooth or teeth.

Fixed Appliance

• Eg. cemented crown

• Placed in the mouth not intended for removal.

Removable appliance

Placed in and out of the mouth at the patient’s will.

Implantology

• The science of dental implants, involves the use of both fixed and

removable appliances.

Types and characteristics

of prosthodontic materials

Noble metals

• Valuable alloys. Eg. Gold, palladium, platinum

Base metals

• Chromium – cobalt or chromium –nickel used alone or in a mixture with noble

alloys.

Porcelain

• Hard translucent ceramic substance fused to the surface of a metal

crown as shells and veneer covers to give the appearance of a natural

tooth surface.

Composite

• Resin metal used for tooth colored replacement.

Acrylic

• Synthetic resin material used for covering of metal frameworks or as

natural tissue replacement.

Characteristics of prosthodontic

materials

Hardness

• Ability of a material to withstand penetration.

Tensil strength

• Capability of a material to be stretched.

Elasticity

• Ability of a material to be stretched and the resume its original shape.

Ductility

• Ability of a material to be drawn or hammered out as into a fine wire

without breaking.

Elongation

• Ability of a material to stretch before permanent deformation begins.

Fixed prosthodontics

• Various appliances from singular crown to a full arched bridge.

• A solid castered or milled restoration involving some occlusal and

proximal surfaces cemented into a tooth preparation

• A solid casted or milled restoration covering some occlusal tooth cusps

and side wall area that is cemented onto the prepared site.

• Tooth-shaped cover replacement for a missing crown area

cemented onto the remaining prepared crown surfaces

Full crown

• Cast metal, tooth shaped cover replacing the entire crown area. During

treatment acrylic resin crowns could be used as a temporary crown cover.

Dowel crown

• Full crown cover with dowel pin extending into the root canal of a pulpless

tooth, usually positioned on anterior teeth.

Veneer

• Direct veneer

• Indirect veneer

Direct veneer

• Placed and cured directly on the tooth surface

Indirect veneer

• Tooth material is prepared in the lab and later cemented onto the tooth

structure.

Bridge

• A prosthesis used to replace one or more teeth of fixed or removable

nature.

Fixed bridge

• Cemented into the oral cavity and not removed by the patient

Maryland bridge

(Resin-bonded bridge)

• Replaces anterior or posterior tooth cemented directly to the adjacent or

abutting teeth.

Cantilever bridge

• Bridge with one unsupported end, usually saddled.

Bridge

• A bridge has three structural parts: Pontic – Abutment -Adjacent teeth

Pontic

• Artificial tooth part of the bridge replacing the missing tooth and

restoring function to the bite.

Abutment

• Natural tooth or teeth prepared to hold or support the remaining

part of the bridgework in position.

Adjacent teeth

• May be included in units if they are involved in the bridge area.

Removable dental Prosthesis

• Prostheses that could be taken in and out at patient’s will.

Complete denture

• Removable appliance composed of artificial teeth replacing the entire

dentition of either jaws.

Partial denture

• A framework of artificial teeth replacing one or more teeth in an arch.

Immediate denture

• Placed into the mouth at the time the natural teeth are surgically removed.

Overdenture

• Prepared to fit upon implant posts or prepared retained roots.

Structural components

of dental appliances

Framework

• Metal skeleton onto which a removable prosthesis is constructed.

Saddle

• Part of the structure used for balancing the prosthesis as a base for

placement of artificial teeth.

• Small extensions of removable prosthesis made to sit atop the adjoining

teeth.

• Extensions of partial framework that grasp the adjoining teeth to

provide support and retention of the prosthesis.

Denture base

• Acrylic part of the denture prosthesis substituting for the gingival tissue.

Flange

• Projecting rim or lower edge of the prosthesis.

Post dam

• Posterior edge of the maxillary denture that helps maintain the denture and

suction.

Impression material

Elastomeric

• Impression material must be elastomeric (having rubber like

properties)to be pliable during the impression process.

Elastic impression items

Hydrocolloids

• Reversible

• Irriversible

Reversible hydrocolloid

• Can change from a solid or gel state to a liquid form and back again

depending on the temperature changes.

Irreversible hydrocolloid

• Once chemically set cannot be reversed or used again.

• Eg.Alginate

Imbibition

• Swelling from absorption of water and fluid loss causes shrinkage.

Rubber bases

• Impression material exhibiting rubberish characteristics often in a

twin cartridge(base and accelerator/activator ) and mixed into a

homogeneous mass.

Compound

• A thermoplastic impression material supplied in blocks and is heated to a

soft pliable mass placed in the impression tray, then put into the mouth.

Impression tray

• A transport device for the impression material to be inserted into the

patient’s oral cavity for taking impression of one or more teeth or an

entire edentulous arch.

Try-in adjustment

Seating

• Placement and fitting of prosthesis for trying-in and final

cementation.

Condylar inclination

• Bite relationship and TMJ involvement.

Movements involve the condyle

Centric

• Occuring when condyle rests in the temporal bone during biting, resting

and mouth movements.

Protrusion

• Measurement with the mandible thrust forward with the lower jaw out.

Retrusion

• Measurement with the mandible drawn backward.

Lateral excursion

• Measurement with side-to-side movement of the mandible.

Use of implants in prosthodontics

• There are different types of implants and each is used in a specific area,

depending on the available bone.

Root form implant-endosseous

• Screw type device that is screwed or cemented into the mandibular

Plate form implant

• Flat plate style used for the narrow jaw one.

Subperiosteal

• Placed under the peridontium and stabilized on the mandibular bone.

Transosteal

• Larger plate stabilized on the lower border of the mandibular bone with

posts extending through the gingiva.

Osseointegration

• Implant appliances must bond with the bone tissue to obtain

stability which is called Osseointegration.

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