Prosthodontics and Bone Loss in Dentistry

Bone Loss

• Bone loss is greater in the mandible than in the maxilla.
• Bone loss is more pronounced posteriorly than anteriorly.
• Bone loss produces broader mandibular arch and constricted maxillary arch.

Attached Gingiva

• Attached gingiva of the alveolar bone is replaced with less keratinized oral mucosa.
• Less keratinized oral mucosa is more easily traumatized.

Esthetic Impact

• Anatomical changes can pose challenges for the fabrication of prostheses.
• Challenges can occur with implant-supported prostheses and removable partial dentures.
• Temporary prostheses serve for esthetics and function for a short period.

Denture Base

• Part of a denture that rests on the base tissue.
• Holds the teeth in place.
• Expected outcomes accompany the common clinical course of a prosthesis.
• Unexpected needs can include tissue damage.

Shared Decision Making

• Patients need to recognize behavioral issues related to plaque control to maintain a state of oral health.

Tooth Supported Prostheses

• Major categories of partial tooth loss:
  • Teeth both anterior and posterior to edentulous space (tooth supported space).
  • Teeth anterior only to edentulous space (tooth and tissue supported space).
• RPDs utilize abutment teeth and supporting tissues for stability, support, and retention.
• RPDs without teeth support at each end of the replacement teeth are extension base RPDs.
• Possible disadvantages of clasp-retained RPDs:
  • Strain on abutment teeth due to improper tooth prep or clasp design.
  • Loss of tissue support under distal extension bases.
  • Clasps can be unesthetic, particularly when placed on visible tooth surfaces.
  • Caries may form beneath clasp components.

Six Phases of Partial Denture Service

• Education of Patient: Informs the patient about health matters for informed consent, patient cooperation, and compliance.
• Diagnosis, Treatment Planning, Design, Treatment Sequencing, and Mouth Preparation: Includes thorough medical and dental histories, complete oral examination, and radiographic interpretation.
  • Includes the condition of existing restorations, periodontal conditions, response to previous treatment, and vitality of remaining teeth.
• Support for Distal Extension Denture Bases: Does not apply to treatment with intracoronal retainers.
• Establishment and Verification of Occlusal Relations and Tooth Arrangements: Important step in the construction of RPDs.

Types of Rests

• Types of Rests (named by location):
  • Occlusal rest: Contacts the occlusal surface of a tooth.
  • Lingual/Cingulum rest: Fits into a depression on an abutment tooth's lingual surface.
  • Incisal rest: Contacts a tooth at the incisal edge.

Major Connector Definitions

• Linguoplate major connector: Covers the lingual surfaces of the natural teeth.
• Palatal plate major connector: Covers a significant portion of the palatal surface.
• Palatal strap: Anterioposterior dimension not less than 8 mm that traverses the palate.
• Palatal bar: Crosses the palate with a characteristic half-oval shape.
• Types of Palatal Bars
  • Palatal bar: More than 8 mm in anterioposterior dimension.
  • Palatal strap: Less than 8 mm in anterioposterior dimension.

Centric Jaw Relation/Centric Occlusion

• Occlusion of opposing teeth when the mandible is at centric relation.
• May or may not coincide with the maximal intercuspal position.

Balanced Occlusion

• Simultaneous bilateral occlusal contact of anterior and posterior teeth during excursive movements.

Functional Occlusal Registration

• Occlusal contact of maxillary and mandibular teeth during mastication and deglutition.

Casting Terms

• Cast: Life-size likeness formed from poured or injected molten material.
• Investment cast: Made of a material that withstands high temperatures.
• Dental stones: Alpha-form of calcium sulfate hemihydrate.
• Dental cast surveyor: Paralleling instrument used to locate contours and the relative positions of teeth in prosthesis design.

Ridge Definitions

• Residual/edentulous ridge: Portion of residual bone and its soft tissue covering remaining after teeth removal.
• Basal seat/denture foundation area: Oral anatomy supporting a denture.

Clasp Definitions'

• Clasp: Component of the clasp assembly that engages a portion of the tooth surface.
• Retentive clasp: Component of the clasp assembly that engages a portion of the tooth surface.
• Reciprocal clasp: Counteracts the retention of the retentive clasp.
• Cingulum: Part of a tooth that connects the mesial and distal marginal ridges of the tooth.
• Incisal/occlusal rest: A rigid extension of a removable partial denture that contacts the occlusal or incisal surface of a tooth.
• Minor connector: Connects major connectors to the other parts of removable partial dentures.

This quiz examines key concepts in prosthodontics, focusing on bone loss, attached gingiva, and the esthetic impact of anatomical changes on dental prosthetics. Explore the challenges faced when fabricating prostheses and the importance of shared decision-making in maintaining oral health.