lroubalikova@gmail.com 1 Prosthetics I. Rehabilitation of the masticatory apparatus lenka.roubalikova@tiscali.cz 2 Damaged teeth – reconstruction of the crown Missing teeth - appropriate prothesis (denture) Function of dentition Food admission Trituration (comminution) of food Fonation Aesthetics - psychology lroubalikova@gmail.com 3 Consequence of not treated dentition – malfunction of dentition Insufficient comminution of food – digestive disorders – irritation, diseases of the digestion apparatus. Disorders of fonation Alteration external appearance (teeth support soft tissues, keep intermaxillary relations) Psychological aspect of lost teeth (sign of health, good social position,self-realization) lenka.roubalikova@tiscali.cz 4 lenka.roubalikova@tiscali.cz 5 Prothesis – prosthetic treatment Dentures are 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 lenka.roubalikova@tiscali.cz 6 Aim of prosthetic treatmnt Rehabilitation of: Function Comfort Aesthetics Fonation lenka.roubalikova@tiscali.cz 7 Fixed dentures Cemented on the teeth or implants – inlays, crowns, bridges, lenka.roubalikova@tiscali.cz 8 Removable dentures Partial Complete (full) lenka.roubalikova@tiscali.cz 9 Procedures In dental surgery In dental laboratory Special instruments Basic (main) materials (metal alloys, ceramics,polymers) Auxilliary (accessory) materials (impression, carving, models, insulating investing, grinding, polishing) lenka.roubalikova@tiscali.cz 10 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 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 level of oral hygiene 8. X-ray examination 9. Study impressioons – study models 10. Detail evaluation of the abutment teeth (pilots) – most important teeth –canines, premolars lenka.roubalikova@tiscali.cz 12 Classification of pilots (abutment teeth) Pilots I. class Canines Molars (1st, 2nd) lenka.roubalikova@tiscali.cz 13 Classification of pilots (abutment teeth) Pilots II. st class Incisors - maxillary incosors, pemolars lenka.roubalikova@tiscali.cz 14 Classification of pilots (abutment teeth) Pilots III. class Mandibular incisors, third molars, all teethe with bad biological factor lenka.roubalikova@tiscali.cz 15 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 lenka.roubalikova@tiscali.cz 16 Way of the transfer of masticatory forces Tooth Tooth and oral mucosa Oral mucosa lenka.roubalikova@tiscali.cz 17 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) lenka.roubalikova@tiscali.cz 18 Classification of defects Voldřich II. Class Reduced dental arch, thenlast tooth is the second molar. With gaps Without gaps Bilateral Unilateral lenka.roubalikova@tiscali.cz 19 Classification of defects Voldřich III. Class Individual teeth or small groups of teeth lenka.roubalikova@tiscali.cz 20 Classification of defects Voldřich IV. Class Edentulous dental arch lenka.roubalikova@tiscali.cz 21 Manufacturing of dentures Model of gypsum (plaster) – model of a denture (wax pattern). lenka.roubalikova@tiscali.cz 22 Impressions of the jaw - negativ The impression is filled with a casting material (gypsum) – poured into Model (various purpose) lenka.roubalikova@tiscali.cz 23 Models  Working model – the denture is produced on this model (special procedures)  Opposing model (antagonal) - necessary for the recognition of intermaxillary relationship  Study model – for study purposes (planning dentures, orthodontics etc.) Impressions Impression of the dental arch (where we intend replacement of teeth) Impression of opposite dental arch Registration of intermaxillary relationship lenka.roubalikova@tiscali.cz 24 lenka.roubalikova@tiscali.cz 29 Manufacturing of dentures The denture is made on the working model. This is an indirect method. Indirect method requires impression. lenka.roubalikova@tiscali.cz 30 Manufacturing of dentures Indirect method Indirect method requires taking impression. The denture is made in dental laboratory. lenka.roubalikova@tiscali.cz 31 Manufacturing of dentures The denture is made without any impression This is direct method Direct method does not require impression lenka.roubalikova@tiscali.cz 32 Manufacturing of dentures Direct method No impression The model of the denture is made directly in the mouth (of special wax or resin) For some cases only CAD CAM method The denture or its part is made using special devices. The treated area is scanned directly in oral cavity or on a model (SCANNER) The denture is planned in computer The denture (or its part) is made by computer assisted procedure – cutting or sintering (SPECIAL DEVICE – MILLING MACHINE OR SINTERING MACHINE) lenka.roubalikova@tiscali.cz 33 lenka.roubalikova@tiscali.cz 34 Inlays lenka.roubalikova@tiscali.cz 35 Crown and its cementation Root canal inlay and crown lenka.roubalikova@tiscali.cz 36 lenka.roubalikova@tiscali.cz 37 Bridge Removable partial dentures, complete dentures lenka.roubalikova@tiscali.cz 38