Prostho Lecture - Midterms.pdf

September 24, 2024 Major connector Maxillary Major Connector - Palatal strap - Double palatal bar (Antero-posteroir palatal strap) - Horseshoe (U-shaped) - Full palatal Area coverage is governed by the length of PALATAL STRAP...

September 24, 2024 Major connector Maxillary Major Connector - Palatal strap - Double palatal bar (Antero-posteroir palatal strap) - Horseshoe (U-shaped) - Full palatal Area coverage is governed by the length of PALATAL STRAP edentulous and the amount of support it - Most versatile and widely used requires. - Can be made narrow for tooth supported prosthesis *2 pics on whiteboard - Can be wide for long eden. span - Rarely annoying to patient and no interference to phonetics and speech. (Because hindi siya nakaka-affect sa playground of the tongue) *In the violet portion (yun ang playground of the tongue) Indications DOUBLE PALATAL - Class III edentulous area - Antero posterior palatal strap - Edentulous span are tooth bounded - "Anterior Palatal Correction" - There is minimal need for palatal (APPC) support - Can also be used in cases where there are 3 supporting abutment Should be wide and thin rather than narrow and thick to achieve rigidity and to be as innocuous (Unnoticeable) as possible to the tongue Indications - Anterior and posterior abutments are widely separated - Presence of torus palatinus - Patient’s mental attitude - Replacement of anterior and posterior teeth - Class I and II arches, long edentulous span class II with Anterior strap: 8-10mm modification Lateral strap: 7-9mm - Class IV arches Posterior strap: 4-7mm PALATAL HORSESHOE (U-SHAPE) Indications - Several Anterior teeth are to be replaced Gingival relief area (pink line): 6-8mm - Presence of torus palatinus which Function: To prevent food impaction extends far posteriorly Reference point: away from the cervical - Periodontally weakened teeth - Deep palatal vault which needs Minimum window (Green): 15 mm stabilization - Bar should be wide and flat - Anterior border should be positioned on the depression and slopes of rugae/Valley of rugae - Posterior bar should be located as far posterior as possible (anterior to the vibrating line) at 90 degrees it *Least favorable Major connector due to its should be extend up to the flexibility (dahil walang presence ng hamular notch posterior strap) (pero ito ang ginagamit lagi - Bar should be placed 90 degrees to ni doc sa clinic!!!!!) the median palatine suture. COMPLETE PALATAL COVERAGE - Sublingual Bar (FULL PALATAL COVERAGE) LINGUAL BAR - Simplest of all mandibular major connector - Most common lower Major connector Indications - No need for indirect retention and stabilization of weakened teeth - Sufficient space exist between the Indications slightly elevated alveololingual - Presence of 2 distal extension bases sulcus and lingual gingival tissue - Presence of 6 anterior teeth only - Class III arches with posterior - 8-10 mm space from the lingual modification frenum - Class I with 1 to 4 premolars - Absence of pedunculated torus Contraindications (because it can impinge the taurus) - Px with lingual torus - Px with high elevation of the Floor of the mouth BEADING - Px with high lingual frenum attachment Configuration- one half pear shape in cross section - Upper Anterior and posterior border should be lightly beaded to ensure intimate contact with the mucosa - Creating a very shallow depression (0.5mm) MANDIBULAR MAJOR CONNECTORS - Lingual bar - Lingual plate - Double Lingual bar - Labial Bar LINGUAL PLATE More than 8 - lingual bar Less than 8 - lingual plate (Linguoplate, lingual strap, lingual shield, Lingual Apron) Indications the upper border of the plate should ideally - Need for indirect retention be placed in the middle third of the lingual - Presence of lingual torus surface of the mandibular anterior teeth. - High frenal attachment, space for lingual bar is limited Terminal rest (placed in prepared rest - Stabilization against horizontal seats on the occlusal, lingual, or incisal rotation, retention support and px surfaces) comfort, preservation of health of the tissue, esthetic consideration Disadvantages - Class I and II situations where - Loss of physiologic stimulation from residual ridges have undergone food during mastication excessive vertical resorption - Non utilization of the cleansing - Stabilization of periodontally action of saliva weakened anterior teeth - Covers most of the tissue may be contributory to caries and - Px with high calculator formation periodontal disease tendency - If not properly designed it may cause - In case of diastema (spacing) = used more harm than good interrupted lingual plate (nakababa) Interrupted lingual plate: used when lingual plate is indicated but presence will be unsightly because of large interdental spaces. - Use to deflect food from impacting into the interproximal surfaces DOUBLE LINGUAL BAR (Kennedy bar or - Presence of bony and tissue Split bar) undercut - Referred to as continuous lingual - Less than 7-8mm space between bar the alveololingual sulcus and lingual - *Major contribution: Horizontal gingival crevices. stability of the prosthesis  - Similar to lingual plate except that upper lip is uniformly pulled upward portion covering the marginal gingiva showing antero-posterior teeth, is removed Advantages: similar to lingual plate Complex smile Disadvantage: Space collects food and - characterized by movement of the produces more irritation lower lip and wide movement of the upper lip. - Also known as spontaneous smile (usually involuntary) LABIAL BAR Indications - Inoperable tori is large that the design for a lingual bar is impossible - When lower anteriors or premolars are lingually inclined Different types of smile Commissure smile - when people greet each other in social context or unusual locations - toothless smile - The commissures are pulled upward not showing the teeth Cuspid or social smile - Globally used in self portraits divulged in social networks. 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