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That branch of dentistry that pertains to the restoration and maintenance of oral function, comfort,
appearance, and health of the patient by the restoration of natural teeth
and or replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial
substitutes. - ✔✔Prosthodontics:
a) Location and extent of the edentulous area or areas
b) Condition of the abutment teeth
c) Occlusal scheme
d) Residual ridge - ✔✔Prosthodontic Diagnostic Index (PDI): by ACP, American College of Prosthodontists
(Class I to IV)
a) Span length.
b) Span configuration.
c) Abutment alignment.
d) Abutment condition.
e) Occlusion.
f) Periodontal condition.
g) Ridge form.
h) General features. - ✔✔Factors to consider for Replacement of Missing Teeth:
a) History: dental and medical
b) TMJ / Occlusal evaluation
c) Intraoral examination
d) Diagnostic Casts
e) Full mouth radiographs - ✔✔Elements of Good Diagnostic Workup: (Shillingburg, P. 2)
,a) Treatment of symptoms
b) Stabilization of deteriorating conditions
c) Definitive therapy
d) Program of follow up care - ✔✔Treatment Sequence:
a) Preservation of tooth structure
b) Preservation of the Periodontium
c) Retention and resistance
d) Structural durability
e) Marginal integrity - ✔✔Q: What are the tooth preparation requirements?
Retention:
Prevents removal of the restoration along the path of insertion or long axis
of the tooth preparation.
Bridges- dislodges in M/D direction, therefore use B/L grooves to increase
retention.
Crowns- dislodges in B/L direction, therefore use M/D grooves to increase
retention.
Resistance:
Prevents dislodgment of the restoration by forces directed in an apical or
oblique direction and prevents any movement of the restoration under
occlusal forces. - ✔✔Retention and Resistance:
Biologic: conservation of tooth structure, prevention of damage during tooth
preparations, avoidance of over contouring, Supragingival margins, harmonious
occlusion and protection against root fracture.
Mechanical: Retention and resistance form, avoid deformation
Esthetic: Minimal display of metal substructure, maximum thickness of porcelain,
, porcelain occlusal surfaces, Subgingival margins. - ✔✔Q: What are the Fixed partial denture (FPD)
considerations?
1) Taper or parallelism of axial walls of preparation (3 degrees per wall)
2) Length of axial wall of preparation
3) Substitution of internal features (grooves, boxes, pins)
4) Surface area with rough texture
5) Freedom of Displacement
5) Path of insertion limitations (angle of convergence, parallel to long axis of tooth)
6) Magnitude of dislodging forces
7) Type of cement - ✔✔Q: What are the factors that determine Retention and
Resistance?
a) to visualize preparations walls.
b) Prevent undercuts.
c) Compensate for inaccuracies in the fabrication process.
d) Permit better seating of restoration during cementation. - ✔✔Taper / angle of convergence of
preparations (6 degrees, actual 19-23
degrees):
a. Destruction of tooth structure.
b. Retention.
c. Esthetics.
d. Plaque control.
e. Financial consideration. - ✔✔Factors to determine use of Direct versus Indirect restorations:
a) Class 5 lesions or erosion or abrasions
b) Tunnel Preparations for proximal surfaces
c) Root caries in geriatric and periodontal patients