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Essentials of Prosthodontics
SH Soratur
PART 1: INTRODUCTION
1:
Applied Anatomy and Physiology
ORAL CAVITY (MOUTH)
Boundaries
Contents of the Oral Cavity
Permanent Teeth
Description of Tooth
Histology of Tooth
1st Permanent Molar “Key of Occlusion”
EDENTULOUS STATE
Denture Foundation “Denture-bearing Areas”
The Tongue
Parts of Tongue
Functions of Tongue
Significance of Tongue
The Lips and Cheeks
Muscles of the Lips
Functions
Significance
Soft Palate
The Muscles of Soft Palate
Functions of Soft Palate
Floor of the Mouth
Functions of Salivary Glands
Temperomandibular Joint—TMJ
Muscles of Mastication
Accessory Muscles of Mastication
Movements of the Mandible
Lateral Movement (Side to Side) Rotatory
For Example
“Bennet Movement”
Christiansen Phenomena
Opening Movement—Mechanism
For Example
Muscles of Mastication—Classification
Muscles are also Classified by their Action
Basic Movements of the Mandible
Functional Movements of Mandible
Opening and Closing
Movements of Mandible can also be Classified as
Positions of Mandible
Yet Another Classification of Mandibular Movement
Axis During Jaw Movements
Saliva
Composition
Functions of Saliva
Mastication (Chewing)
Types of Reflexes
Role of Tongue During Mastication
Role of Hard Palate
Role of Cheeks and Lips
Factors Influencing the Strength of Bite
Effects of Vigorous Mastication on Oral Tissues
Swallowing
1st Stage: Oral Phase
2nd Stage: Pharyngeal Phase
3rd Stage: Oesophageal Phase
The Muscles taking Part in Swallowing
CONCLUSION
Main Functions of Teeth—Natural or Artificial
2:
Prosthodontics
DEFINITIONS
Word Origin and Meaning
Abutment
Dental
Jacket Crown
Branches of Prosthodonties
Complete Dentures
Functions
Restores
Materials used to Make
Requirements (Fig. 2.6)
Partial Dentures
Functions
To Restore
Requirements
Conventional Complete Dentures
Immediate Denture
Over Denture
Implant Denture
Tissue Borne Partial Denture
Tooth Borne Partial Denture
Disjunct Denture
Interim Denture
Transitional Denture
Treatment Denture
Claspless Denture
Spoon Denture
Sectional Denture
Every Denture
Maxillofacial Prosthesis
Obturator
Word Origin and Meaning
Gunning Splint
Full Crown
Pinlay Type 3/4th Crown
Pinledge Type 3/4th Crown
Difference between Appliance and Dental Prosthesis
For Example
Scope and Limitations of Prosthodontics
3:
Retention and Stability
(COMPLETE DENTURES)
DIFFERENCE BETWEEN NATURAL TEETH AND DENTURES (ARTIFICIAL SET OF TEETH)
DEFINITIONS
Retention
Stability
Retaining Forces on the Denture
Displacing Forces on the Denture
Adhesion
To Increase Adhesion
Cohesion
POST DAM
ATMOSPHERIC PRESSURE
Stability is Achieved by
In Short
CONCLUSION
Thus
Therefore;
4:
Preprosthetic Surgery
DEFINITION
Aim of Preprosthetic Surgery
How to Avoid Some of the Surgical Procedures?
Type of Surgical Procedures
Surgical Procedures on Teeth
Surgical Procedures on Bone
Reduction of Large Maxillary Tuberosity
Resection of Mylohyoid Ridge
Prominent Genial Tubercles
Reduction of Prominent Maxilla
Inter Cortical Alveolectomy
Excision of Exostoses
Removal of Mandibular Torus
Surgical Procedures on Soft Tissues
Gingival Hypertrophy “Denture Granulomas”
Flabby Ridges
Removing Flabby Ridge
Surgery—For Sulcus Extension
Sulcus Extention-(Deepening the Sulcus)
Epithelial Inlay
Knife-edge-ridge-Smoothening
Frenectomy
PART 2: LABORATORY PROCEDURES FOR COMPLETE DENTURES
5:
Making of Cast and Model
DEFINITIONS
TYPES OF CASTS/MODELS
IDEAL PROPERTIES OF CAST/MODEL MATERIALS
NECESSITY OF CAST/MODEL
MAKING A CAST
PRELIMINARY BEFORE CASTING
Separating the Cast from Impression
Making Working Cast
Making a Dentulous or Partially Dentulous Cast
Separating the Dentulous Cast from the Impression
Boxing an Impression to make a Cast
Trimming Cast/Model
Method
TRIMMING STUDY MODELS
Duplication of Cast/Model
CONCLUSION
6:
Making Special Trays
CONCLUSIONS (Fig. 6.8)
7:
Making Jaw Registration Blocks
DEFINITION
Base Materials can be
Rim Materials can be
Making Registration Blocks with Shellac Base and Modelling Wax Rim for Edentulous Jaws
Preliminaries
Adapting a Shellac Base Plate over the Cast
CONCLUSION (Figs 7.7 to 7.9)
8:
Articulators and Mounting
DEFINITION
Types of Articulators (Fig. 8.1)
Mounting on Simple Hinge Articulator
Preliminaries before Mounting
Mounting the Upper Cast
CONCLUSIONS
MOUNTING ON THE FREE PLANE ARTICULATOR
Advantages of Using This Articulator
Mounting Procedure (Fig. 8.6)
CONCLUSION
MANDIBLE MOVEMENTS VERSES ARTICULATOR MOVEMENT
In Natural Condition
In the Articulator
9:
Setting-up of Teeth
SETTING-UP IN NORMAL OCCLUSION
Object of Set Up
General Principles
Methods of Setting up of Teeth
Ideal Set-up in Normal Occlusion: Preliminaries before Starting of Set-up
Individual Tooth Orientation
Manufacturer's Name Primadent
Procedure
Maxillary Anteriors
Central Incisor
Lateral Incisor
Canine
Mandibular Anteriors
Central Incisor
Lateral Incisor
Canine
Maxillary Posteriors
First Premolar
Second Premolar
First Molar (Fig. 9.4)
Second Molar
Mandibular Posteriors
First Molar
Second Molar
Second Premolar
First Premolar (Fig. 9.7)
Balanced Occlusion
DEFINITIONS
Advantages of Balanced Articulation
Factors Affecting Balanced Articulation
DEFINITIONS
Teeth for Balanced Articulation
Fully Adjustable Articulator
Handling of Face Bow
Definition
Preliminaries Before Mounting
Steps in Mounting
CONCLUSION
Waxing up: Carving and Polishing
Methods of Adding Wax
Contouring
Conclusion
10:
Acrylisation
PACKING THE ACRYLIC DOUGH (Fig. 10.4)
Tools for Mixing
CURING
Heat Cure Method
BENCH COOLING
DE-FLASKING
ROUGH FINISHING AND ABRADING
POLISHING
CONCLUSION
ACRYLIC RESIN
COMPOSITION OF HEAT CURE ACRYLIC RESIN
COLD MOULD SEAL- (One Product's Trade Name –“Stellon”)
Composition
HOW COULD MOULD SEAL WORKS
DEFECTS IN HEAT CURED ACRYLIC DENTURES
PREVENTION OF DEFECTS
11:
Repair, Relining, Rebasing, Etc.
PART 3: CLINICAL PROCEDURES FOR COMPLETE DENTURES
12:
Examination of Patient
CONCLUSION
Attitude of Patient
13:
Making Impressions of Edentulous Jaws
INTRODUCTION
Definition
Aim
Ideal Impression
Denture Foundation
Peripheral Border Tissues
Maxillary Denture
Impression Materials used During Complete Denture Construction
Ideal Properties of Impression Material
Impression Compound
Composition
Probable Composition of Two Products
Disadvantages of Impression Compound
Advantages of Impression Compound
Nature of Impression Compound Thermoplastic
Composition
Setting Mechanism and Reaction
Setting Reaction
Advantages of ZOE Paste
Disadvantages of ZOE Paste
Alginate Based IR-Reversible Hydrocolloid
Advantages of Alginate Impression Material
Disadvantages of Alginates
Types of Impressions
Impression Trays
Requirements of Impression Tray
Classification of Trays
Use of Impression Tray
Materials for Making Special Tray
Types of Trays
Stock Trays
Special Tray
Use of Special Tray
Close Fitting Special Tray
Spacer Special Tray or Loose Fitting Tray
Casco Series
Patient's Version of Impression
Problems Met with Making Impressions
For Upper Impression
Tools Required for Making Impression
PROCEDURES
Preliminary Impression
Mandibular Compound Impression
Manipulation of Compound
CONCLUSION
Maxillary Compound Impression
Manipulation of Impression Compound
CONCLUSION (Fig. 13.11)
Precautions while Manipulating Impression Compound
Preliminary Impressions by using Alginate
Selection of Stock Trays
Manipulation of Alginate based impression Material—Steps
Steps
Mandibular Impression
Maxillary Impression
CONCLUSION
Making Final Impression
Check the Special Tray for
Instruments and Materials for Border Moulding
Procedure
Maxillary Special Tray
Final impression with ZOE Impression Paste
Manipulation of ZOE Paste
Mixing
Insertion in the Mouth and Making Impression
Remove the Tray Out of the Mouth
CONCLUSION
14:
Jaw Relations
INTRODUCTION
DEFINITIONS
Physiologic Rest Position
Vertical Dimension—Occlusal
Vertical Dimension—Postural
Freeway Space or Interocclusal Clearance
Results of Wrong Vertical Dimension (Fig. 14.2)
DEFINITIONS
Centric Relation
Centric Occlusion
Crux of Jaw Relation
Guiding the Mandible
Procedure of Establishing Jaw Relations
Stages
Details
Trimming the Maxillary Occlusal Rim
Trimming the Mandibular Occlusal Rim
Registering the Position of Centric Relation
Gothic Arch Tracing
Principle
Tracing Device Attachment
CONCLUSION
Records for Fully Adjustable Articulator
Recording the Condylar Angle
Procedure
Recording the Relation of Maxilla to the Condylar Heads (i.e. Glenoid Fossae)
Procedure
15:
Selection of Artificial Teeth and Try-in
16:
Fitting the Dentures and Teething Troubles
PART 4: PARTIAL DENTURES
17:
Classification
PARTIAL DENTURE
Causes for Loss of Natural Tooth
Why Lost Natural Tooth to be Replaced
Requirements for Good Partial Denture
What Happens if the Lost Natural Tooth is not Replaced
TYPES OF PARTIAL DENTURES
CLASSIFICATION
Modifications
18:
Design of Cast Partial Dentures
OBJECTS OF DESIGN
How to Achieve the Aim
Denture Support or Resistance to Loading
Magnitude of Force
Bone (Alveolar Bone)
Types of Forces
In Short
ENTIRELY TOOTH SUPPORTED CLASS III PD (Fig. 18.3)
Other Factors Influencing Design of Partial Dentures
Danger of Partial Denture
SURVEYING
Origin and Meaning of the Word
Definition of Surveyor
Parts of Surveyor
In Short
REASONS FOR SURVEYING
POSITION OF CAST ON SURVEYOR TABLE
RECORDING THE MOST ACCEPTABLE PATH OF INSERTION and REMOVAL
LATERAL TILT OF THE CAST
GUIDING PLANES
RETENTIVE AREAS
DEFINITION OF SURVEYING
USE OF SURVEY LINES
USE OF UNDERCUTS
TYPE OF SURVEY LINES
OBJECT OF TILTING
Factors Influencing the Tilt
OBJECT OF SURVEYING THE DIAGNOSTIC CASTS
OBJECT OF SURVEYING MASTER CAST
BLOCK OUT MATERIALS
ADVANTAGES OF PARTIAL DENTURE MADE AFTER SURVEYING THE MODEL
USING SURVEYOR
DETAILED SURVEYING PROCEDURE
MEANING OF WORDS
19:
Components of Cast Partial Denture
FUNCTIONS OF SADDLES
REQUIREMENT OF IDEAL DENTURE BASE
MATERIALS USED FOR SADDLES
ADVANTAGES OF CHROME COBALT BASE
DISADVANTAGES
METHODS OF ATTACHING ARTIFICIAL TEETH TO METAL BASE
STRESS BREAKER DESIGN
ORIGIN
DEFINITION
Advantages of Stress Breaker Design
Disadvantages
Advantages of Rigid Design
Disadvantages
Types of Stress Breakers
RESTS
Definition
TYPES OF RESTS
FUNCTIONS OF RESTS
PRINCIPLES OF REST DESIGN
OCCLUSAL REST and REST SEAT
Lingual Rests
Preparation
Incisal Rests
Connectors
Major Connectors
Requirements
Mandibular Major Connectors
Lingual Bar
Fabrication of Bar
Contraindications
Indications
Location
Maxillary Major Connectors
Palatal Bars
Placement
Single Broad Palatal Major Connector
Indications
Anterior-Posterior Bar Combination
Indications
Nature and Location
U Shaped Palatal Major Connector
Palatal Plate Type of Major Connector
Advantages
Disadvantage
Full Palatal Coverage Major Connector
Indications
Minor Connector
Requirements
DIRECT RETAINER CLASP (EXTRA CORONAL)
Definition
Why Clasp is Necessary
Another Definition of a Clasp
REQUIREMENTS OF A CLASP
PRINCIPLEs OF CLASP DESIGN
HOW A CLASP WORKS
HOW MANY CLASPS FOR A DENTURE
FACTORS AFFECTING THE SELECTION OF CLASP
Which Teeth to Clasp
CLASSIFICATION OF CLASPS
Circumferential or Encircling Clasp
Disadvantages
Advantages
Ring Clasp (Fig. 19.8)
Back Action Clasp
Two Arm Encircling Clasp
Advantage
Disadvantage
One Arm Clasp
Embrasure/Inter Dental Clasp
JACKSON CRIB
Multiple Clasp
HALF AND HALF CLASP
BAR CLASP/PROJECTING/GINGIVALLY APPROCHING (Fig. 19.11)
T SHAPED
U SHAPED
C SHAPED
L SHAPED
Ball and Socket Type of Clasp (Fig. 19.12 and 19.13)
Indications for Bar Type of Clasp
CONTRAINDICATION
Advantages
COMBINATION CLASPS
Advantages
Disadvantages
Indications
INDIRECT RETAINER
Definition
Indications
Contraindication
NATURE AND LOCATION
TYPES OF INDIRECT RETAINER
Intracoronal Direct Retainer-Precision Attachments
How It works?
Precision Attachments
FULCRUM LINE (Fig. 19.16)
Definition
STEPS IN DESIGNING
CONCLUSION
20:
Clinical and Laboratory Procedures
MOUTH PREPARATION
PERIODONTAL PREPARATION
STAGES OF PERIODONTAL TREATMENT
Preparation of Abutment Teeth
Types of Abutments
Restorations Done to Abutment
Steps in Abutment Preparation
Inlay Preparation on Abutment Tooth
Crown Preparation on Abutment Tooth
GOLD INLAY/GOLD CROWN-CASTING
METHOD EMPLOYED—“LOST WAX PROCESS”
DIE
Definition
Master Die
To Increase Resistance to Abrasion
Method of Making a Removable Die
Double Pour Technique
Mix Die Stone
Making a Die from Copper Band Impression
Main Points
Making Inlay Wax Pattern on a Die
In Case of Crown Patterns (Fig. 20.8)
SPRUING
Reservoir
Removing the Wax Pattern from the Die
Crucible Former
Investing
Hand Investing
Vacuum Investing
Vacuum Investing Unit
Wax Burnout and Heating the Ring
Casting the Metal
Centrifugal Casting Machine
Actual Procedure
Cleaning the Casting—Pickling
Finishing and Polishing
Fitting to the Tooth
BITE ANALYSIS
BITE REHABILITATION
IMPRESSION FOR PARTIAL DENTURE
Functional Selective Tissue Displacement Impression Method
Method in Short
Convectional Impression for Partial Denture
Method
Composition
Advantages
CONCLUSION
Mucostatic Impression
Mucocompressive Impression
Selective Tissue Displacement Impression
COMPOSITION
Investment Materials used for Chrome Cobalt Casting
Mixed Ratio
PROCEDURE
Duplicating the Master Model (Fig. 20.19)
Wax Pattern
Spruing
Casting Ring
Investing
Wax Elimination and Heating the Ring
Casting
Preliminaries
Technique
DE-FLASKING AND FINISHING
Indications for Cast RPD
Why Cast RPD Fails
All acrylic RPD
Prevention of “Gum Stripping”
Retention of All Acrylic Partial Dentures
PART 5: CROWNS, BRIDGES, AND MISCELLANEOUS
21:
Crowns
22:
Bridges
23:
Implant Denture
24:
Obturators
MATERIALS TO MAKE OBTURATOR
Construction of Fixed Type of Obturator
Steps
Movable Obturator
Functions
Types of Hinges
Procedure
25:
Maxillofacial Prosthesis
CONCLUSION
INDEX
TOC
Index
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