Diagnosis in Fixed Prosthodontics

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Questions and Answers

What is the primary purpose of radiographic examination in dental diagnostics?

To provide data that correlates with information from other diagnostic methods (correct)

To determine the age of the patient

To assess the facial aesthetics of a patient

To evaluate the economic status of the patient

Which of the following is NOT considered when performing an intra-oral examination?

Edentulous areas

Patient's psychological history (correct)

Remote areas of the mouth

Teeth and their investing structures

Which element is part of proper diagnosis according to the listed diagnostic components?

History (medical and dental) (correct)

Dentist's personal experience

Patient's socioeconomic background

Medications used by the patient

What does 'Ante's law' state regarding periodontal surface area?

The sum of the periodontal membrane surface area of abutment teeth should equal or exceed that of the replacement teeth Signup and view all the answers

Which type of radiograph is specifically useful for assessing the angulation of teeth and skeletal relationships?

Cephalometric x-ray Signup and view all the answers

What is the primary purpose of obtaining a patient's medical history in dental diagnosis?

To determine necessary precautions before treatment Signup and view all the answers

Which of the following is NOT considered a component of a proper diagnosis in dentistry?

Patient's social background Signup and view all the answers

Which of the following factors is prioritized in assessing a patient's chief complaint?

Functionality related to chewing or speaking Signup and view all the answers

What aspect should be particularly focused on during the evaluation of a patient's dental history?

Patient's expectation for treatment Signup and view all the answers

In the context of T.M.J. examination, what is an abnormal finding that may indicate an issue?

Clicking or crepitation sounds Signup and view all the answers

Which of the following is essential for a thorough occlusal evaluation?

Palpation of muscles around the jaw Signup and view all the answers

Which condition would typically go unnoticed if a patient does not provide their complete medical history?

Diabetes or potential need for premedication Signup and view all the answers

What role does the patient's psychological state play in the diagnosis process?

It can influence treatment acceptance and cooperation. Signup and view all the answers

What is a critical factor in the treatment planning for edentulous spans?

Dimensions of the edentulous span Signup and view all the answers

Which muscle activity is commonly associated with muscle pain in patients?

Parafunctional jaw activity Signup and view all the answers

What should be included during a systematic intra-oral examination?

Evaluation of oral hygiene and plaque Signup and view all the answers

Which of the following is essential when conducting an occlusal evaluation?

Existence of cuspal interferences Signup and view all the answers

What aspect of the diagnostic cast is important for it to be considered good quality?

It should be mounted in centric relation. Signup and view all the answers

When should cases suffering from parafunctional activities not be treated?

Unless the condition is corrected Signup and view all the answers

Which diagnostic imaging evaluation should be included as part of the elements of proper diagnosis?

Full mouth radiographic evaluation Signup and view all the answers

What is a common psychological consideration when evaluating a patient for joint dysfunction?

The patient's previous treatment experiences Signup and view all the answers

Study Notes

Diagnosis is a comprehensive process of collecting data and information.
The aim is to establish a treatment plan.
The process involves various elements, including:
- History (medical and dental)
- Temporomandibular joint (TMJ), occlusal evaluation, and muscles of mastication
- Intra-oral examination
- Diagnostic cast analysis
- Full mouth radiographic evaluation

Medical History

Gather comprehensive medical information using a questionnaire.
Identify potential risks or complications.
Determine appropriate treatment modifications.

Frequently Occurring Conditions

Allergic reactions
Hypertension and coronary heart diseases
Patients on anticoagulants
Rheumatic fever
Diabetes
Epilepsy
Infectious diseases

Dental History

Focus on the patient's chief complaint.
Assess previous dental treatments and patient's attitude towards treatment.
Understand the patient's expectations.

Patient Chief Complaint

Understand the patient's pain, discomfort, or functional issues, including:
- Pain, sensitivity, swelling
- Difficulty in speech or mastication
- Bad odor or taste
- Appearance or aesthetics

Previous Treatments and Patient Attitude

Gauge the patient's dental awareness and cooperation.

Patient's Expectations for Treatment

Focus on the patient's esthetic desires.

TMJ, Occlusal Evaluation, and Muscles of Mastication

Evaluate the TMJ for any evidence of pain, clicking, crepitation, or limited movement.
Assess muscle pain associated with parafunctional activities (bruxism) and faulty occlusion.

TMJ Evaluation

Ensure the TMJ is healthy with no signs of clicking, crepitation, or restricted movement.
Average maximum opening is 50mm, with less than 40mm considered limited.
Inquire about previous treatments for joint dysfunction.

Muscles of Mastication

Muscle pain is often linked to parafunctional jaw activity like clenching or bruxism.
Daily clenching contributes to muscle spasm.

Occlusal Evaluation

Evaluate wear facets, premature contacts, cuspal interference, and sliding in eccentric movements.
Assess anterior guidance.

Intra-Oral Examination

Perform a systematic evaluation covering:
- Oral hygiene
- Amount and areas of plaque and calculus
- Caries index
- Abnormal habits (pipe, smoker, pencil biting, bruxism)
- Edentulous ridge, including size and relationship of spans
- Occlusal evaluation.

Edentulous Ridge

Record the dimensions and relationship of edentulous spans.
Examine the form, texture, and color of the ridge mucosa.
Analyze the dimensions of the edentulous span, critical for treatment planning.

Occlusion

Examine wear facets (localized or widespread).
Identify any premature contacts.
Assess cuspal interference in eccentric movements.
Determine the amount of slide between detruded and maximum intercuspation position.
Evaluate the existence and amount of anterior guidance.

Prospective Abutment Examination

Conduct in conjunction with radiographs.
Evaluate:
- Carious lesions
- Pulp vitality
- Mobility
- Periodontal condition
- Axial inclination
- Coronal defects (color, attrition, crown morphology, rotation, overlapping)
- Supra and infra eruption.

Diagnostic Cast Analysis

Criteria for good diagnostic cast:
- Accurate reproduction of both arches
- No bubbles or nodules on the occlusal surface
- Mounted in centric occlusion on a semi-adjustable articulator using a facebow and wax record.
Diagnostic casts reveal:
- Distribution and dimensions of edentulous spans.
- Bite type and occlusal prematurities.
- Occlusal discrepancies and the need for establishing a new occlusal plane.
- Changes in teeth axial inclination for common path of insertion.
- Abutment teeth form, size, and malposition.
- Suitable bridge design.
- Trial tooth preparation and waxing before treatment.

Radiographic Examination

An integral part of diagnosis, providing information that helps correlate all collected data.
Includes intraoral films (periodical x-rays, bitewings), digital x-rays, and extraoral imaging.

Intra-oral Radiographic Evaluation

Used to evaluate:
- Teeth and their investing structures
- Edentulous areas
- Remote areas

Radiographic Examination of the Teeth and Investing Structures

Examine:
- Coronal, pulp, and root portion of the teeth
- Crown-root ratio
- Root configuration

Periodontal Surface Area

Ante's Law: The sum of periodontal membrane surface area of abutment teeth should be equal or larger than the teeth to be replaced.

Extra-oral Imaging

Panoramic x-ray
Cephalometric x-ray
Cone beam computed tomography (CBCT)
MRI scan

Panoramic X-ray

Provides a wide view of the jaws and teeth.

Cephalometric X-ray

Captures the profile of the skull and teeth for orthodontic and surgical planning.

Cone Beam Computed Tomography (CBCT)

Provides detailed three-dimensional images of the dental structures for implant planning and diagnosis.

MRI Scan

Provides detailed images of soft tissues and structures.

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Description

This quiz delves into the comprehensive process of diagnosis related to fixed prosthodontics. It covers essential aspects including medical and dental history, TMJ evaluation, and the importance of diagnostic cast analysis. Understanding these elements is crucial for establishing effective treatment plans.