Introduction to Removable

Prosthodontics

Introduction to

Introduction to Dentistry

Introduction toIntroduction toRemovable ProsthodonticsRemovable Prosthodontics

Hello there We previously know that we have different divisions of prosthodontics, and as Dr. Saleh has already spoken to you about fixed & Implant prosthodontics, the remaining division we are going to speak of in this lecture is Removable Prosthodontics & teeth denture prosthetics.

Definitions ( just for knowledge ) : PROSTHETICS : is the art and science of supplying artificial replacements for

missing parts of the human body (ex. Missing hand, eye , ear ..Etc).

PROSTHESIS : is an artificial replacement for an absent part of the human body.

PROSTHODONTICS : The branch of dental science that pertains to the

replacement of missing teeth and oral tissues.

Terminology:Prosthodontics (Prosthetic dentistry):The branch of dentistal science that deals with the replacement of missing teeth & oral tissues & craniofacial structures. From the roots of the word: Prostho, stands for the replacement, and Dontics represent teeth. ***This means it aims on replacing parts of the oral and maxillofacial structure.

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The divisions of prosthodontics

FixedRemovable

MaxillofacialImplants

1.1. RemovableRemovable: It is replacement of missing teeth and adjacent structures for edentulous area with prosthesis designed to be removed and placed back inside by the patient .

** It includes two kinds

Removable complete prosthodontics: the patient is completely edentulous and it is supported by alveolar bone and oral mucosa .

Removable partial prosthodontics: the patient is partially edentulous replacing one or more tooth in an arch and it will be retained and supported by underlying tissues and remaining teeth.

NOTE((edentulous is the condition in which the mouth is deficient of teeth (toothless) or partially edentulous patients who have some of their teeth))

2.2. FixedFixed:: it is cemented and stays inside the patient’s mouth, the patient cannot take it off, (such as fixed crowns or bridges) .

-Golden crowns were commonly used in the past, but currently patients don’t like the appearance it gives on their anterior teeth. Therefore, it is not so common anymore.

- We also have Porcelain-fused-to metal (PMF) , is a metal core tooth cover with porcelain crown (Porcelain is the closest to the natural fibers of the teeth)

* Crowns as we know are a one-tooth procedure . *only the dentist can undergo the required procedures.

-Bridges are also a common procedure for a patient who is missing one or two teeth. The two teeth in contact with the

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complete and partial removable prosthodontics

PMF

golden and porcelain crowns

gap are crowned after being trimmed and the gap is bridged with and artificial tooth ( اصطناعي .(سن

Not all teeth require us to trim them>>what we do is that we trim slightly from the inside toward the palate, we don’t trim the outside, and we make a special bridge that will stick towards the inside of the teeth via an adhesive bridge( الالصق .(الجسر

3.3. maxillofacial & maxillofacial & 44. Implant prosthodontics. Implant prosthodontics:: these two divisions are overlapped with fixed and removable .*for example: we can have a fixed/removable crown over a natural tooth or on an implant tooth. This way we have: removable /fixed maxillofacial (which is on the natural tooth) or removable/fixed on an implant .

Dental implant>>A prosthetic device of alloplastic material implanted into the oral tissues beneath the mucosal and/or periosteal layer and/or within the bone to provide retention and support for a fixed or removable prosthesis.

implant prosthodontics (restorations placed on implants) >>these types of implants are cemented in the jaw bone by a titanium nail and covered with a crown, so we can either have fixed or removable prosthetics on implanted teeth as much as on natural teeth. .

maxillofacial prosthodontics>> The branch of prosthodontics concerned with restoration and/or replacement of the stomatognathic ( الفكي and craniofacial (الفمويstructures قحفيه .with prosthesis ((هياكل

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dental implant

* it’s not all about teeth, it can be any part of the face, Jaw, eye, nose...Etc

The reasons why maxillofacial prosthetics are used are usually:

different oral diseases trauma and malignancy

Sometimes prosthesis reaches all the way in the back of the patient’s mouth where the palate is >> In this case, the nose is opened with the palate, there an artificial stopper (( اصطناعيه .is placed in the maxilla سداده

* Therefore, it is given the term maxillary obturator and it totally occludes the oral-nasal opening.

* we previously mentioned maxillofacial tooth prosthetics can be supported by natural or implant tooth.

NOTE ((Obturator :A prosthesis used to close a congenital or acquired tissue opening , primarily of the hard palate and/or adjacent alveolar structures .))

the advantages of the Palate: separating the food & drinks from the nasal

cavity in speaking in swallowing

Important information you need to know:

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Obturator

Dentulous: is a condition in which the complete set of natural teeth are present in the mouth (dentate).

Edentulous: is the condition in which the mouth is deficient of teeth (toothless) or partially edentulous patients who have some of their teeth.(I have mentioned it before )

**in the second condition (completely edentulous /toothless) we apply complete dentures, and as we noticed it has a natural looking gum with something like blood vessels

** If a patient is partially edentulous, we can make him prosthesis, in this case it is partial prosthesis.

But some are completely edentulous as we mentioned; due to different oral diseases, severe oral cavities, gingivitis that leads to tooth loss, trauma or rarely born with no teeth bud ( االسنان . the refore no teeth growth( براعم**In this case we do a complete prosthesis.

Types of Dentures:1.1. over denture >> is applied over a tooth by removing the crown and leaving

the root or removing a part of the tooth or on an implant, It has its advantages. (the doctor said that’s all we need to know for now.)

2.2. immediate denture >> A complete denture or removable partial denture fabricated for replacement immediately following the removable ofnatural teeth .It is actually very useful for the patient. Now suppose I extracted his tooth/teeth, it might take weeks and sometimes a month to get his denture ready to be worn , how would the patient go on with his practical life with no teeth ? For that we have immediate denture (a removable prosthesis), as a temporary solution.

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3.3. single dentures>> which are a type of artificial dentures (he said we don’t have to know much about it.)

Dentures can be :

1. Complete : A removable dental prosthesis that replaces the entire dentition and associated structures of the maxilla or mandible.

2. Partial: A dental prosthesis that restores one or more but not all of the natural teeth and or associated parts and that is supported in part by (natural teeth , dental implant supported crowns , abutments or other fixed partial dentures and/or the mucosa.)** It may be:

Fixed >>A partial denture that is cemented to natural teeth or tooth roots and/or dental implants.

Removable >> (I have mentioned it before in page 3 )

the descriptions of the Prosthesis: Retention : The quality inherent in the prosthesis acting

to resist the forces of dislodgment along the path of placement . Stability : The quality of a prosthesis to be firm , steady, or constant, to resist

displacement by functional horizontal or rotational stresses . Support : the foundation area on which a dental

prosthesis rest .

Difference between Natural & Artificial teeth:Natural teeth Artificial teeth

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over denture immediate denture

single dentures

Fixed partial denture

Efficiency

Firmly rooted in the bone ofthe jaws, in consequences

they can incise, tear and finelygrind food of any characterbecause the lower teeth canmove across the upper teethwith a powerful shearing

action.

Artificial dentures, on the otherhand rest on the gums and areheld there by weak forces, Inaddition they are subjected topowerful displacing forces, sotheir efficiency as masticating

apparatus is limitedThis efficiency can vary withinwide limits depending on theshape and size of the covering

these jaws, the mental attitude ofthe patient to the denture

Speech The speech of denture wearershould be normal once the

tongue and lips haveadapted themselves to the

denturesAppearance Esthetically no great difference

Denture Surfaces:

1.Fitting Surface: (Intaglio) is the denture surface determined by the impression.2.Polished Surface: (Cameo) is the surface that starts from the border of the denture and includes the facial (labial and buccal), lingual and palatal Surfaces facing the cheeks, lips and tongue.3.Occlusal Surface: is the surface which makes contact with its antagonist.

Denture Borders: The margins of the denture base at the junction of the polished and impression surface.Denture flanges: Is the vertical extension of the denture base that extends from the cervices of the teeth to the borders of the denture flanges they are named according to location.

LabialBuccallingual

Function of the denture's base: TEETH

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1. To Provide the retention and stability of the denture.2. To carry and support the teeth.3. To represent the gums.4. To assist the teeth in supporting the cheeks and lips.

Function of denture's teeth:1.To assist in preparing food for deglutition.2.To provide a pleasing and natural appearance. BASE3.To assist in speech.

Steps of Complete Denture Construction

Clinical Laboratory

1.Examination of the patientPrimary impression

Pouring study cast diagnostic castConstruction of special custom tray

2.Final impression Pouring master castConstruction of record blocks

3.Recording of jaw relations -Mounting of the casts onthe articulator

-Arrangement of teeth-Wax contouring

4.Try-in the denture. Denture processing:Flsking,

wax elimination,packing of acrylic resin,

CuringLaboratory remountFinishing& polishing

5.Denture insertion- Instruction to the patient

- Clinical remount

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Summary

Prosthodontics (Prosthetic dentistry):The branch of dentistal science that deals with the replacement of missing teeth & oral tissues & craniofacial structures. From the roots of the word: Prostho, stands for the replacement, and Dontics represent teeth.

The divisions of prosthodontics

-Fixed: is something which is cemented in the patient’s mouth (crowns & bridges)-Removable: can be taken off and placed back inside by the patient

-Maxillofacial: it’s not all about teeth, it can be any part of the face, Jaw, eye, nose...Etc-implant: cemented in the jaw bone by a titanium nail and covered with a crown

** We have two major divisions: complete removable prosthodontics & partial prosthodontics.

Dentulous: is a condition in which the complete set of natural teeth are present in the mouth (dentate).

edentulous: is the condition in which the mouth is deficient of teeth (toothless) or partially edentulous patients who have some of their teeth.

we have different types of dentures we have:-over denture: a denture applied over a tooth by removing the crown and leaving the

root, removing a part of the tooth or on an implant.

-Immediate denture: is actually very useful for the patient. Now suppose I extracted his tooth/teeth, it might take weeks and sometimes a month to get his denture ready

to be worn , how would the patient go on with his practical life with no teeth ? For that we have immediate denture (a removable prosthesis), as a temporary solution

-single dentures: which are a type of artificial dentures.

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*dentures can be partial or complete

the descriptions of the Prosthesis: Retention : The quality inherent in the prosthesis acting

to resist the forces of dislodgment along the path of placement . Stability : The quality of a prosthesis to be firm , steady, or constant, to resist

displacement by functional horizontal or rotational stresses . Support : the foundation area on which a dental

prosthesis rest .

Denture Surfaces:

1.Fitting Surface (Intaglio)2.Polished Surface (Cameo) 3.Occlusal Surface

Function of the denture's base: 1. To Provide the retention and stability of the denture.2. To carry and support the teeth.3. To represent the gums.4. To assist the teeth in supporting the cheeks and lips.

Function of denture's teeth:1.To assist in preparing food for deglutition.2.To provide a pleasing and natural appearance3.To assist in speech.

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Questions:

1- Prostho, stands for the replacement, and Dontics represent teeth. True false

2-Dentulous and edentulous mean In order : toothless /toothless with tooth/toothless none of the answers are correct

3-the divisions of prosthodontics are :-……………………………………………………………….-……………………………………………………………….-……………………………………………………………….-……………………………………………………………….

4-denture flanges are named according to …………………

5-what type of denture is shown in the picture: ……………………………..

6-the flitting surface of the denture is called …………....and the polished surface is called ………………

Good Luck

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