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
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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)
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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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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
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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
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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
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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)
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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
 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
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Manufacturing of dentures
The denture is made on the working
model.
This is an indirect method.
Indirect method requires impression.
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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
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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
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Inlays
lenka.roubalikova@tiscali.cz 35
Crown and its cementation
Root canal inlay and crown
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lenka.roubalikova@tiscali.cz 37
Bridge
Removable partial dentures,
complete dentures
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