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Dr David C. Attrill d.c.attrill@bham.ac.uk Review some of the different options for replacing missing teeth and possible benefits Consider possibility of NOT replacing missing teeth Define some of the important terminology used in prosthetics Identify key components of removable partial dentures (retention/support)
What is prosthetics?
That branch of dentistry that deals with the replacement of missing teeth, and/or the replacement of missing tooth tissues Fixed prosthodontics (crowns/bridges) Removable prosthodontics (dentures) [implant retained/supported prosthodontics]
Complete dentures
Failure of all preventative strategies Loss of all teeth Replacement of 24-28 teeth in most cases
Transitional denture
Remaining natural dentition compromised Prosthesis(es) designed to smooth the inevitable transition between partial dentures and complete dentures Dentures designed in such a was as to facilitate addition of prosthetic teeth as and when remaining teeth need to be extracted
RPD - definition
A prosthesis (denture) that replaces some teeth in a partially dentate arch. It can be removed from the mouth (by the patient!) and replaced at will
Bridge - definition
Also called fixed partial denture (US) A prosthesis that replaces some missing teeth that cannot be removed at will by the patient
Cantilever adhesive bridge (distal cantilver in this instance) Avoids relatively large denture components where only one or two teeth need to be replaced Very selective set of circumstances; adjacent teeth need to be in relatively good condition Possible oral health benefits (cf. denture) in longer term
[Jepson et. al.; BDJ 2001 191(3) 140-144]
Osseointegrated implant
A device, usually made of metal (Ti) which is inserted into the bone 1) Body (implant)
Fixture, surgically placed in bone
2) Abutment
Supports and/or retains the prosthesis or superstructure
3) Superstructure
Classification of Saddles
Bounded Saddles
(teeth present at both ends of the saddle area)
Free-end saddles
(teeth present at only the anterior end of the saddle)
Support
The foundation area on which a dental prosthesis rests
or alternatively
Classification of Support
Tooth Mucosa Combination of tooth and mucosa
Others i.e. implants, overdenture (tooth)
Retention
That quality inherent in a prosthesis acting to resist movement or displacement away from the mucosa
Mechanical Retention
Mechanical retention is commonly achieved in RPD prosthodontics by the use of clasps Terminal portion of a clasp engages an undercut area on a tooth surface Gingivally approaching vs. Occlusally approaching
Major connector
That component of a denture which unites saddles of a denture
Cast metal (Co-Cr) Acrylic resin