Prosthetic IV. Removable dentures I. Removable dentures I. Removable partial dentures Complete denture [USEMAP] * Patient can remove the denture -Care for the denture: cleaning -These dentures can be anchored on the teeth or implants -The teeth can transfer the masticatory forces or be only for retention of the denture -Retention of complete denture – adhesion on mucosa - - Removable dentures I. [USEMAP] lenka.roubalikova@tiscali.cz 4 Classification of pilots (abutment teeth) •Pilots I. class •Canines •Molars (1st, 2nd) • • • [USEMAP] lenka.roubalikova@tiscali.cz 5 Classification of pilots (abutment teeth) •Pilots II. st class •Incisors - maxillary incisors, premolars • • lenka.roubalikova@tiscali.cz 6 Classification of pilots (abutment teeth) •Pilots III. class •Mandibular incisors, third molars, all teethe •with bad biological factor lenka.roubalikova@tiscali.cz 7 Biological factor ØCaries ØPulp vitality ØLevel of the endodontic treatment ØLevel of the resorption of the alveolar bone ØPeriodontium ØRelationship to antagonists ØRelationship to neihgbour teeth [USEMAP] lenka.roubalikova@tiscali.cz 8 Classification of defects Voldřich •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 1st class or their equivalents) [USEMAP] Way of the transfer of masticatory forces ØTooth ØTooth and oral mucosa ØOral mucosa ØImplants Ø • Tooth and/or oral mucosa/Implants • • bone [USEMAP] lenka.roubalikova@tiscali.cz 10 Classification of defects Voldřich •II. Class •Reduced dental arch, then last tooth is the •canine • •With gaps •Without gaps •Bilateral •Unilateral • [USEMAP] lenka.roubalikova@tiscali.cz 11 Classification of defects Voldřich •III. Class • •Individual teeth or small groups of teeth [USEMAP] lenka.roubalikova@tiscali.cz 12 Classification of defects Voldřich •IV. Class • •Edentulous dental arch [USEMAP] Removable partial dentures •Class I. •Dental arch with gaps (interruptions) •Teeth supported (borne) dentures • •Class II. •Reduced (shortened) dental arch •Teeth and tissue supported (borne) •dentures [USEMAP] Components * Base –replaces missing part of alveol and supports arteficial teeth. [USEMAP] Base (basis) * Supports the supplied teeth and effects the transfer of occlusal stresses to the supporting oral structures. * •Different materials – metal framework •+ resin (attached to the metal framework) •Or resin only * * [USEMAP] Base * Accuracy of adaptaion to the tissues with low volume change * Dense, non irritating surface that is capable of receiving and maintaining a good finish * Low thermal conductivity * Low specific gravity * Sufficient strength – resitance to fracture * Easily kept clean * Aesthetics acceptability * Potential for future relining * Low initial cost * * [USEMAP] lenka.roubalikova@tiscali.cz 17 The materiál for base: Methylmetacrylate • [USEMAP] Components * Elements of anchorage •Clasps– casted clasps, wire clasps, •combined clasps. • •Anchorage supporting bar • •Attachements • •Telescope crowns [USEMAP] Clasps • • • Surface retainers – they lie on the surface • of teeth • •Arms – one, two or three arms • • [USEMAP] Clasps * One armed • • [USEMAP] Clasps • * Two armed • [USEMAP] Clasps • • * Three armed clasp [USEMAP] Components * Teeth – acrylic teeth • - porcelain teeth • [USEMAP] Clasps * One arm made of wire • ØSimple retainer, only in simply temporary prothesis. ØIt can damage the tooth because no stabilization (bracing) [USEMAP] Clasps * Two arms clasps •One arm for retention (wire) •One arm for stabilization against horizontal •forces [USEMAP] Clasps * Three arms clasps •One arm for retention (wire) •One arm for stabilization (bracing) against •horizontal forces •On arm for transmission of occlusal forces [USEMAP] * * Clasp made of wire and a cast part - combined * * Clasp completely cast Classification of the clasps ass to the material [USEMAP] Clasp – three armed cast •One part for retention (going under the • •maximal convexity) • •One part for stabilization against horizontal • •forces (upon the maximal convexity) • •On arm for transmission of occlusal forces • •(the rest) • • [USEMAP] Rests * Any unit of a partial denture that rests upon a tooth surface to provide vertical support to the denture is called a rest • •Upon the occlusal surface (premolar, •molar) • •Upon the lingual surface (prepared) of anterior teeth [USEMAP] Rests * Transmitted forces parallel to the long axis of the tooth will prevent movement in a cervical direction. [USEMAP] Other elements of anchorage • •Anchorage supporting bar • •Attachements • •Telescope crowns * [USEMAP] Anchorage supporting bar Obsah obrázku červená Popis byl vytvořen automaticky [USEMAP] Attachements Obsah obrázku text Popis byl vytvořen automaticky Patrix – male part Matrix – female part [USEMAP] Attachements on implants * [USEMAP] Telescope crowns [USEMAP] Components * Connectors -Major -Minor - •Connect the parts of denture • [USEMAP] Major connector * Connect the parts of the prothesis -All other parts are directly or indirectly attached to it -Must be rigid – stresses may be effectively distributed over the entire area • [USEMAP] Mandibular major connector * Lingual bar * Lingual plate (continouos bar retainer and • lingual bar) • [USEMAP] Maxillary major connector * Anterior and posterior palatal bar * * U- shaped palatal connector * * Palatal plate - type connector [USEMAP] Minor connectors * Arising from the major connector – join the major connector with other parts of the denture. * * Placed not on a convex surface of the abutment teeth but in embarasure [USEMAP] * * Lingual plate [USEMAP] * Anterior palatal bar Posterior palatal bar Minor connector [USEMAP] Obsah obrázku příslušenství, knoflík oliva, řetěz, náhrdelník Popis byl vytvořen automaticky Obsah obrázku příslušenství Popis byl vytvořen automaticky Palatal plate Lingual bar [USEMAP] Removable dentures I. and II. Dentures with metal framework [USEMAP] Removable dentures – classes * * Class I. * * Dental arch with gaps (interruptions) * * Teeth supported (borne) dentures * * Class II. * * Reduced (shortened) dental arch * * Teeth and tissue supported (borne) * • dentures [USEMAP] Removable dentures – classes * •Class III. • •Single teeth • •Loss of the most important abutment teeth (big gaps – more than 4 teeth) • •Mostly tissue (borne) dentures, sometimes teeth supported •additionally • •Class IV. • •Complete denture • •Tissue supported (borne) • • [USEMAP] Class I and II dentures with the metal framework * * Class I. denture Components: Metal framework Base Clasps Arteficial teeth [USEMAP] Class I and II dentures with the metal framework * * Lingual plate [USEMAP] * Class I and II dentures with the metal framework Anterior palatal bar Posterior palatal bar Minor connector [USEMAP] Sequences of operations •Taking impressions (alginate. Both jaws always ! [USEMAP] Sequences of operations •Pouring – gypsum models. •Fabrication of the individual impression tray •if necessary. •If not, fabrication of the bite template: The bite template is necessary for The registration of the intermaxillary Relationship. It consist of the shellack base and the wax walls. Wax walls Shellack base [USEMAP] Custom trays Obsah obrázku text, snímek obrazovky Popis byl vytvořen automaticky [USEMAP] Sequences of operation * Registration of the intermaxillary relationship. The registrate [USEMAP] Sequences of operation * Preparation of the model for backup. All undercuts are blocked out Also the space under the future framework Using heated wax [USEMAP] Sequences of operations * Backup using the reversibile impression agar based material in a special flask * Pouring of this impression with -the investing material – casting model * [USEMAP] Sequences of operations * Fabrication of the wax pattern of the metal framework. Influx system [USEMAP] Sequences of operations * Investment with the same investing material –a special flask. The wax is burnt out and the form is heated in a special oven. After that the casting process is performed using a special casting machine. [USEMAP] Sequences of operation * After casting and cooling the framework is taken out, the inflow system must be cut off. [USEMAP] Sequences of operation * The cast is grinded, polished and adapted on the former gypsum model The final framework is tried out [USEMAP] Sequences of operation * The arteficial teeth will be applied acc. to intermaxillary registrate in articulator. [USEMAP] * Arteficial teeth - acrylic [USEMAP] Sequences of operation * The denture is finished, polished and tried in. [USEMAP] Sequences of operation * After trying out of the denture with wax base and teeth the denture is completed * The framework with the wax pattern of the base and teeth has been put into a flask, the wax has removed and replaced with a resin dought. The resin base is polymerized using heating. [USEMAP] Final product * Check: •Occlusion •Retention •Fonation •Aesthetics •Cleaning •Check in dental office • [USEMAP] Feedback * For which classes of removable dentures is necessary to fabricate the metal framework? * * On which model is the wax pattern of the framework made? * * What is the method of „lost wax“ ? Feedback * Which parts does the partial removable denture consist of? * Describe the sequences of operations of these dentures. Explain the main difference between class I. and II. removable dentures. * What is the purpose of the bite template? Which part does it consist of? * Explain the term „investment“ .