Diagnosis Related to Fixed Prosthodontics PDF

D I AG N O S I S R E L AT E D TO F I X E D P RO ST H O D O N T I C S Diagnosis is simply defined as the procedure of collecting data and informations through different channels so that a proper line of treatment could be proposed.  Elements of proper diagnosis I - History (medical and dental) I...

D I AG N O S I S R E L AT E D TO F I X E D P RO ST H O D O N T I C S Diagnosis is simply defined as the procedure of collecting data and informations through different channels so that a proper line of treatment could be proposed.  Elements of proper diagnosis I - History (medical and dental) II- T M J, Occlusal evaluation and muscles of mastication III- Intra-oral examination IV- Diagnostic cast analysis V- Full mouth radiographic evaluation  1- HISTORY A) Medical history In most dental offices and dental schools, the medical history is accomplished through the use a comprehensive health questionnaire form To determine any special precautions to be taken before the start of the treatment Any selective treatment which might be postponed or eliminated because of the patient `s psychological or physical health Any necessary premedication  THERE ARE SOME CONDITION WHICH OCCUR FREQUENTLY - Allergic - Hypertension and coronary heart diseases - Patients receiving anticoagulant - Rheumatic fever - Diabetic patients - Epileptic patients - Infectious disease  B-DENTAL HISTORY This should be focused on - Patient chief complaint - Previous treatments and patient s attitude - Patient s expectation for treatment - PATIENT CHIEF COMPLAINT The patient should express in his own words the exact nature of complaint Comfort (pain, sensitivity, swelling) Function (difficulty in speech or mastication) Social (bad odor or taste) Appearance or esthetics PREVIOUS TREATMENTS AND PATIENT'S ATTITUDE This gives an insight into the patient s level of dental awareness and the expected patient`s cooperation - PATIENT S EXPECTATION FOR TREATMENT Special attention should be given to the esthetic effect anticipated by the patient  Elements of proper diagnosis I - History (medical and dental) II- T M J, Occlusal evaluation and muscles of mastication III- Intra-oral examination IV- Diagnostic cast analysis V- Full mouth radiographic evaluation II- T M J, OCCLUSAL EVALUATION AND MUSCLES OF MASTICATION 1- T.M.J 2- MUSCLES OF MASTICATION 3-OCCLUSAL EVALUATION II- T M J, OCCLUSAL EVALUATION AND MUSCLES OF MASTICATION 1-Temporomandibular joint II- T M J, OCCLUSAL EVALUATION AND MUSCLES OF MASTICATION It should be health with no evidence of clicking II- T M J, OCCLUSAL EVALUATION AND MUSCLES OF MASTICATION crepitation or limiting of movement on opening or closing or lateral shifting Maximum opening less than 40 mm( average 50 mm) II- T M J, OCCLUSAL EVALUATION AND MUSCLES OF MASTICATION The patient should be questioned regarding any previous treatment for joint dysfunction (e.g., occlusal devices, medications, biofeedback, or physical therapy exercise II- T M J, OCCLUSAL EVALUATION AND MUSCLES OF MASTICATION MUSCLES OF MASTICATION Muscle pain is usually associated with Parafunctional jaw activity related to stress or faulty occlusion A common cause of muscle spasm is the daily routine clenching of teeth and continuous biting 3- 0CCLUSAL EVALUATION Cases suffering from parafunctional activities should not be treated unless this condition to be corrected  Elements of proper diagnosis I - History (medical and dental) II- T M J, Occlusal evaluation and muscles of mastication III- Intra-oral examination IV- Diagnostic cast analysis V- Full mouth radiographic evaluation III- INTRA ORAL EXAMINATION This should be carried in a systematic manner to include the following THIS SHOULD BE CARRIED IN A SYSTEMATIC MANNER TO INCLUDE THE FOLLOWING Oral hygiene Amount and areas of dental plaque and calculus caries index  ABNORMAL HABITS Pipe , smoker ,pencil biting , bruxism Edentulous ridge  EDENTULOUS RIDGE The relationship of edentulous spans if more than one should be recorded Examine the form and texture and color of the ridge mucosa Dimensions of edentulous span is critical deciding factor in the treatment planning  OCCLUSION Occlusal evaluation should be carried out for Wear facets ( localized or wide spread) Presence of any premature contacts Existence of cuspal interference in eccentric movement Amount of slide between the detruded and maximum intercuspation position Existence and amount of anterior guidance  PROSPECTIVE ABUTMENT This should be carried in conjunction with radiographs - Carious lesions Condition of the pulp (vitality) Mobility Periodontal condition Prospective abutment Axial inclination  PROSPECTIVE ABUTMENT Coronal defect - color - Attrition - Crown morphology - Rotation and over lapping Supra and infra eruption  Elements of proper diagnosis I - History (medical and dental) II- T M J, Occlusal evaluation and muscles of mastication III- Intra-oral examination IV- Diagnostic cast analysis V- Full mouth radiographic evaluation IV-DIAGNOSTIC CAST Criteria of good diagnostic cast - Accurate reproduction of both arch - No bubbles or nodules on the Occlusal surface - Mounted in centric occlusion on a semi adjustable articulator by means of a face bow and wax record DIAGNOSTIC CASTS REVEAL 1- Distributing and dimensions of edentulous span 2-Type of bite and Occlusal prematurities 3-occlusal discrepancies and the need to establish a new Occlusal plane 4-Changes in teeth axial inclination for common path of insertion 5-Abutment teeth form, size and mal- position 6-plainning the suitable bridge design 7- Trial tooth preparation and waxing prior to initiate the treatment  Elements of proper diagnosis I - History (medical and dental) II- T M J, Occlusal evaluation and muscles of mastication III- Intra-oral examination IV- Diagnostic cast analysis V- Full mouth radiographic evaluation V-RADIOGRAPHIC EXAMINATION It is an integral part of the diagnostic procedure as it provides the dentist with information which help to correlate all of the facts and data that have been collected from other channels Intra oral films Periodical x ray Bitewings Digital X-Ray Intra-oral radiographic are utilized to evaluate 1- Teeth and their investing structures 2- Edentulous area 3- Remote area RADIOGRAPHIC EXAMINATION OF THE TEETH AND INVESTING STRUCTURES Coronal part Pulp portion Root portion Crow root ratio Root configuration PERIODONTAL SURFACE AREA It has been stated that "the sum of the periodontal membrane surface area of the abutment teeth should be equal or larger than the tooth /teeth to be replaced This statement was referred to as Ante s law EXTRA ORAL - Panoramic ray - Cephalometric x- ray - Cone beam computed tomography - MRI scan PANORAMIC X RAY CEPHALOMETRIC X RAY CONE BEAM COMPUTED TOMOGRAPHY Cone beam computed tomography ( CBCT ) ]  MRI SCAN The MRI scan is a medical imaging procedure that uses a magnetic field and radio waves to take pictures of your body's interior. It is used to investigate or diagnose conditions that affect soft tissue such as tumors or brain disorders THANK YOU