lenka.roubalikova@tiscali.cz 1
Prosthetics I.
Rehabilitation of the
masticatory apparatus
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
lenka.roubalikova@tiscali.cz 3
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Damaged teeth
– reconstruction of the crown
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 – crowns, bridges,
inlays
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Removable dentures
Partial
Complete (full)
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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.
lenka.roubalikova@tiscali.cz 11
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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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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Impression material
Tooth
Impression
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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
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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
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 levelů of oral hygiene
8. X-ray examination
9. Study impressioons – study models
10. Detail evaluation of the abutment teeth (pilots) – most impoprtant
teeth –canines, premolars
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Classification of defects
Voldřich
I. Class
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 dental arch, thenlast tooth is the
second molar.
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 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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rosol=kov?
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The tooth after the endodontic
treatment
Risk of
reinfection
fracture
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Zábrus hrbolků!!!
Myslet na rezistenci už v počátku
endodontického ošetření!!!
Tvar endodontické
kavity!!!
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Edelhoff et al.; Core build-up of endodontically treated teeth
Scientific statement of the German Society of Dental Oral and Craniomandibular
Sciences 2003
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Post
1/3
2/3
Schillinburg, Kessler, 1982
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Ferrrule effect
Sörensen, Martinoff,1984
Wedge effect
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Efekt obroučky – ferrule efffect
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Root canal inlay fabrication
Direct method
Indirect method