REPLACING MISSING TEETH

Question 1

planning for missing teeth

Answer 1

final tx may not be implemented for some time
need a predicable and durable sol
consider need for transitional restorations
build in contingency planning
realistic tx plan

Question 2

partially dentate pt possible solutions

Answer 2

1) no tx
2) orthodontic space closure
3) restoring spaces with removable prostheses
4) restoring spaces with fixed prostheses
5) restoring spaces with endosseous implants

Question 3

shortened dental arch

Answer 3

adequate function with a reduced dentition
9-10 pairs occluding teeth
no detrimental effect from prothesis

Question 4

functional dentition defintion

Answer 4

the retention throughout life of a functional aesthetic natural dentition not less than 20 teeth and not requiring a prothesis

Question 5

evidence for a shortened dental arch

Answer 5

masticatory effect no effect
no problem to TMJ and periodontal tissue
fixed or removable prothesis ( no diff between but fixed requires less sig maintenance)

Question 6

restorative options for replacing missing teeth

Answer 6

1) composite build ups
2) removable partial dentures
3) bridges
4) implants
- money
- time to integrate 3 mn

Question 7

clinical exam involves

Answer 7

• occlusal relationship – guidance?
• inter occlusal space
• centre line (missing incisors can cause drifting)
• lip smile line
• position of teeth present
• shape and position of potential abutments
• restorative and vitality status of teeth

Question 8

radiograhic examination

Answer 8

• position of normal anatomical features
• pathological conditions
• periapical status of abutment teeth
• alveolar support of abutment teeth
• root remnants and foreign bodies
• alveolar height and width

Question 9

RPD provides

Answer 9

replaces the whole dento alveolar complex
- non destructive
fully reversible

effective permanent or transitional option

Question 10

what can RPDs/bridges prvent

Answer 10

drifting and over eruption

Question 11

disadvanatages of RPDs

Answer 11

1) plaque accumulation
2) direct trauma from components
3) poor distribution of occlusal forces
- may create torquing forces
- teeth may be loosened
4) intolerance of major connector
- eg full plate
- lingual bar
5) poor appearance of clasps
- esp in pts with a high lip line
6) difficulty in pt acceptance

Question 12

what can RPDs help progress

Answer 12

caries
perio disease
chronic atrophic candida

Question 13

what happens if pt gets candida infection

Answer 13

have to replace denture as the surface will have microbes

need to treat pt too

Question 14

advanatges of RPDs

Answer 14

1) non invasive
2) versatile
3) keep tx options open
4) can restore long spans
5) will replace teeth and supporting structures
6) removable to assist cleaning
7) can be modified for progressive tooth loss and bone resorption

Question 15

RPD success is dependant on

Answer 15

Clinician
-	adequate dental care
Technician
-	accurate construction
Patient 
-	plaque control

Question 16

acyrlic dentures indications

Answer 16

• remaining teeth have poor prognosis
• diagnostic/interim denture is required
• for young pts to allow for growth
• when only a few teeth remain

Question 17

indicaitons for CoCr dentures

Answer 17

• generally denture of choice for permanent prothesis

- when sufficient, healthy, tooth support can be obtained

Question 18

fixed partial dentures/bridges

Answer 18

• replace teeth only
• destructive
• unpredictable long term prognosis
• Design of choice is single unit adhesive cantilevered

Question 19

implants

Answer 19

Replace teeth

• can replace bone/soft tissue with grafts
• surgical option with higher morbidity