Prosthetics I
Rehabilitation of the masticatory apparatus
lenka.roubalikova@tiscali.cz
Damaged teeth
- reconstruction of the crown
Missing teeth
- appropriate prothesis (denture)
lenka.roubalikova@tiscali.cz 2
Prothesis
□ Individually made n Diferences
> in the type of defect, extent and location >in the size, shape and position of teeth
> in the quality of hard and soft tissues of the oral cavity
> in intermaxillary relations
lenka.roubalikova@tiscali.cz 3
Prothesis (denture)
Rehabilitation of:
> Function
> Comfort
> Aesthetics
> Fonation
lenka.roubalikova@tiscali.cz
4
Fixed dentures
□ Cemented on the teeth - crowns, bridges, inlays
lenka.roubalikova@tiscali.cz
5
Removable dentures
□ Partial
n Complete (full)
lenka.roubalikova@tiscali.cz
6
Procedures
> In dental surgery
> In dental laboratory
> Special instruments
> Basic (main) materials
(metal alloys, ceramics,polymers)
> Auxilliary (accessory) materials
(impression, carving, die, insulating investing, grinding, polishing)
lenka.roubalikova@tiscali.cz
7
Manufacturing of dentures
Model of gypsum (plaster) - model of a denture (wax pattern).
Model of a denture (wax pattern) directly in the mouth - rarely.
Denture is formed without a wax pattern i the dental lab.
n
lenka.roubalikova@tiscali.cz
8
Manufacturing of dentures
Model of gypsum (plaster) - model of a denture (wax pattern).
lenka.roubalikova@tiscali.cz
Impressions of the jaw - negativ
The impression is filled with a casting material (gypsum) - poured into
Model (various purpose)
lenka.roubalikova@tiscali.cz
10
Models
> Working model - the denture is produced on this model (special procedures)
> Opposing model (antagonal) - necessary for the recognition of intermaxillary relationship
> Bite regitration - wax
lenka.roubalikova@tiscali.cz
11
Manufactoring of dentures
>The denture (not the denture itself but the model of the denture) is produced on the working model.
>The model of the denture is made of the carving wax.
>The wax is replaced by the main (base) material.
lenka.roubalikova@tiscali.cz
12
Fabrication of dentures
The model (wax) of the denture is invested
The wax is removed from the form and the base material is placed into the form.
Wax removal:
The wax is burned out (for metal alloys) or removed by hot water (for polymers)
lenka.roubalikova@tiscali.cz
13
Tooth
lenka.roubalikova@tiscali.cz
14
Manufacturing of dentures
The method described above = indirect method
lenka.roubalikova@tiscali.cz
Manufacturing of dentures
Direct method
lenka.roubalikova@tiscali.cz
Manufacturing of dentures
No impression The model of the denture is made directly in the mouth For inlays only
lenka.roubalikova@tiscali.cz 24
Planning of the denture
Complex examination
1. Extent and location of the defect
2. Damage of the involved teeth (caries, fillings ate.)
3. Periodontium
4. Shape, size, position of teeth, relationhip to the neighbours
5. Occlusion, articulation - relationship to the antagonists
6. Quality of the alveolar process
7. The levelu of oral hygiene
8. X-ray examination
9. Study impressioons - study models
10. Detail evaluation of the abutment teeth (pilots) - most impoprtant teeth -canines, premolars
Classification of defects
Voldfich
I. Class
One or more teeth are missing Small gaps -1-2 teeth Big gaps 3-4 teeth at most. This big gaps must be demarcated by pilot of the best quality, (canine, 1st or second molars -pilots of 1 st class or their equivalents)
lenka.roubalikova@tiscali.cz 26
Classification of defects
Voldrich
II. Class
Reduced dental arch, thenlast tooth is the second molar.
With gaps Without gaps Bilateral Unilateral
lenka.roubalikova@tiscali.cz
27
Classification of defects
Voldfich
III. Class
Individual teeth or small groups of teeth
lenka.roubalikova@tiscali.cz
Classification of defects	
Voldfich	
IV. Class	
Edentulous dental arch	
lenka.roubalikova@tiscali.cz	29
Classification of pilots (abutment
teeth)
Pilots I. class Canines
Molars (1st, 2nd)
lenka.roubalikova@tiscali.cz
30
Classification of pilots (abutment
teeth)
Pilots II. st class
Incisors - maxillary incosors, pemolars
lenka.roubalikova@tiscali.cz
31
Classification of pilots (abutment
teeth)
Pilots III. class
Mandibular incisors, third molars, all teethe with bad biological factor
lenka.roubalikova@tiscali.cz
Biological factor
> Caries
> Pulp vitality
> Level of the endodontic treatment
> Level of the resorption of the alveolar bone
> Periodontium
> Relationship to antagonists
> Relationship to neihgbour teeth
lenka.roubalikova@tiscali.cz
Way of the transfer of masticatory
forces