lenka.roubalikova@tiscali.cz 1
Prosthetics I.
Rehabilitation of the
masticatory apparatus
Classification of defects,
dentures, abutment teeth,
inlays – crown and root
Function of dentition
Food admission
Trituration (comminution) of food
Fonation
Aesthetics - psychology
lenka.roubalikova@tiscali.cz 2
If no prosthetic rehabilitation
Bad comminution of food – bad digestion
– irritation, diseases of the digestion
apparatus.
Bad fonation
Psychological aspect of lost teeth
Disorders of TMJ
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Prosthetic dentistry –
replacement of
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Damaged teeth
– reconstruction of the crown
(inlays, crowns)
Missing teeth
- appropriate prothesis (denture)
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Prothesis
Individually made
Diferences
in the type of defect, extent and location
in the size, shape and position of teeth
in the quality of hard and soft tissues of
the oral cavity
in intermaxillary relations
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Prothesis (denture)
Rehabilitation of:
Function
Comfort
Aesthetics
Fonation
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Fixed dentures
Cemented on the teeth – inlays
crowns, bridges,
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Removable dentures
Partial
Complete (full)
Prosthetic dentistry –
replacement of
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Damaged teeth
– reconstruction of the crown
(inlays, crowns)
Missing teeth
- appropriate prothesis (denture)
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Prothesis
Individually made
Diferences
in the type of defect, extent and location
in the size, shape and position of teeth
in the quality of hard and soft tissues of
the oral cavity
in intermaxillary relations
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Planning of the denture
Complex examination
1. Extent and location of the defect
2. Damage of the involved teeth (caries, fillings atc.)
3. Periodontium (supportive tissues)
4. Shape, size, position of teeth, relationhip to the neighbours
5. Occlusion, articulation – relationship to the antagonists
6. Quality of the alveolar process
7. The level of oral hygiene
8. X-ray examination
9. Study impressions – study models
10. Detail evaluation of the abutment teeth (pilots) – most important
teeth –canines, premolars
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Classification of defects
Voldřich
I. Class – dental arch with gaps
One or more teeth are missing
Small gaps – 1 – 2 teeth
Big gaps 3 – 4 teeth at most. This big gaps
must be demarcated by pilot of the best
quality. (canine, 1st or second molars –
pilots of 1st class or their equivalents)
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Classification of defects
Voldřich
II. Class
Reduced (shortenened) dental arch, then last tooth
is the second premolar.
With gaps
Without gaps
Bilateral
Unilateral
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Classification of defects
Voldřich
III. Class
Individual teeth or small groups of teeth
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Classification of defects
Voldřich
IV. Class
Edentulous dental arch
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Classification of pilots (abutment
teeth)
Pilots I. class
Canines
Molars (1st, 2nd)
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Classification of pilots (abutment
teeth)
Pilots II. st class
Incisors - maxillary incosors, pemolars
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Classification of pilots (abutment
teeth)
Pilots II. st class
Incisors - maxillary incosors, pemolars
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Classification of pilots (abutment
teeth)
Pilots III. class
Mandibular incisors, third molars, all teethe
with bad biological factor
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Biological factor
Caries
Pulp vitality
Level of the endodontic treatment
Level of the resorption of the alveolar bone
Periodontium
Relationship to antagonists
Relationship to neihgbour teeth
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Way of the transfer of masticatory
forces
Tooth
Tooth and oral mucosa
Oral mucosa
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Classification of dentures
I. Class – fixes or removable bridges
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Classification of dentures
III. Class –removable denture
- Tissue born denture (sometimes also tooth
and tissue born denture)
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Classification of dentures
II. Class removable dentures
With metal framework and tooth and tissue
borne dentures
The way of transfer of masticatory forces tooth
and oral mucosa
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Classification of dentures
IV. Class – complete denture
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Procedures
In dental surgery
In dental laboratory
Special instruments
Basic (main) materials
(metal alloys, ceramics,polymers)
Auxilliary (accessory) materials
(impression, carving, die, insulating
investing, grinding, polishing)
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Manufacturing of dentures
Model of gypsum (plaster) – model of a
denture (wax pattern).
Model of a denture (wax pattern) directly in
the mouth – rarely.
Denture is formed without a wax pattern in
the dental lab.
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Manufacturing of dentures
Model of gypsum (plaster) – model of a
denture (wax pattern).
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Impressions of the jaw - negativ
The impression is filled with a casting
material (gypsum) – poured into
Model
(various purpose)
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Impression material
Tooth
Impression
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Models
 Working model – the denture is produced on
this model (special procedures)
 Opposing model (antagonal) - necessary for
the recognition of intermaxillary relationship
 Bite regitration - wax
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Manufactoring of dentures
The denture (not the denture itself but the
model of the denture) is produced on the
working model.
The model of the denture is made of the
carving wax.
The wax is replaced by the main (base)
material.
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Fabrication of dentures
The model (wax) of the denture is invested
The wax is removed from the form and the base
material is placed into the form.
Wax removal:
The wax is burned out (for metal alloys)
or removed by hot water (for polymers)
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Gypsum
Impression
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Plaster
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The model (wax pattern)
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The model
(wax pattern)
The investing material
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The form
The melted alloy
The investing material
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The crown
The melted alloy
The investing material
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The metal crown
Plaster
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Manufacturing of dentures
The method described above = indirect
method
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Manufacturing of dentures
Direct method
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Manufacturing of dentures
Direct method
No impression
The model of the denture is made directly in
the mouth
For inlays only
Fixed dentures
Restore the form (and function)
Cemented on (in the ) prepared teeth
Can not be removed
Fixed dentures
Inlays /onlays
Crowns
Bridges
Inlay
Onlay
Overlay
Partial crown
Crown
Korunka
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Root canal inlay
Root post
Stump, snag
Crown
Root canal filling
Root
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Ferrrule effect
Sörensen, Martinoff,1984
Wedge effect
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Post
1/3
2/3
Schillinburg, Kessler, 1982
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Efekt obroučky – ferrule efffect