Care of Dental Prostheses Ch 29

interim prosthesis (provisional prosthesis/restoration)

TEMPORARY; a fixed or removable dental prosthesis designed to enhance esthetics, stabilization, and/or function for a limited period of time, after which it is to be replaced by a definitive dental or maxillofacial prosthesis; often used to assist in determination of the therapeutic effectiveness of a specific treatment plan or the form and function of the planned for definitive prosthesis

removable partial denture

a dental prosthesis that supplies teeth and/or associated structures in a partially edentulous jaw and can be removed/replaced at will; rests on oral mucosa; consists of stable metal framework of chrome cobalt with clasps and rest seats or precision attachments to engage abutment teeth, base that is freq. made of plastic acrylic resin, and teeth made of porcelain, plastic resin, or metal

ultrasonic cleaner

a device in which a denture is placed in water or some type of solvent cleaner that uses ultrasonic waves to dislodge debris on a denture

obturator

a removable prosthesis used to close a congenital or acquired opening, such as for a cleft palate, an area lost because of trauma, or after surgery for removal of a diseased area

fixed partial denture

a replacement for one or more missing teeth that is securely retained to natural teeth and/or dental implant abutments that furnish the primary support for the prosthesis; also called a fixed prosthesis or bridge

rest

a rigid, stabilizing extension of a fixed or removable partial denture that contacts a remaining tooth or teeth; prevents movement towards the mucosa and transmits functional forces to the teeth

coping

a thin covering or crown

abutment

a tooth or implant used for the support or retention of a fixed or removable prosthesis

precision attachment

a type of connector that consists of a metal receptacle and a close fitting part; the metal receptacle usually is included within the restoration of an abutment tooth, and the close fitting part is attached to a pontic or removable partial denture framework

pontic

an artificial tooth on a partial denture that replaces a missing natural tooth, restores it's function, and usually occupies the space previously filled by the natural crown

denture stomatitis

an inflammation of the oral mucosa that bears a complete or partial removable dental prosthesis, typically a denture

immediate denture

any removable dental prosthesis fabricated for placement immediately following the removal of a natural tooth/teeth; due to amount of bone remodeling after extraction, the denture is usually relined or rebased approx 6 months later

prosthesis

artificial replacement of an absent part of the body that may be a therapeutic device (improve or alter function) or a device employed to aid in accomplishing a desired surgical result; dental prosthesis replaces one or more teeth and supporting structures and may be fixed or removable

denture

artificial substitute for missing natural teeth and adjacent tissues

the health of underlying issues can be negatively affected by removable partial denture because ___?___

biofilm tends to accumulate more readily and in greater quantities; BIOFILM CONTROL IS A MAJOR FACTOR IN MAINTAINING THE LONG-TERM HEALTH OF ABUTMENT TEETH for a removable partial denture

when cleaning removable denture for patient, denture is placed in ___?___

cleaning solution in isolated bag in an ultrasonic cleaner

regarding care of natural teeth

daily biofilm control with toothbrushing & interdental care, topical fluoride use, and diet all need special consideration to maintain remaining teeth, especially abutment teeth, which if lost will make appliance useless

missing teeth replacement options

dental implants, fixed prosthesis, removable prosthesis

complete denture

dental prosthesis that replaces the entire dentition and associated structures; may be a complete maxillary denture, a complete mandibular, or both

Fixed oral prostheses/appliances

fixed partial denture, periodontal splint, implant-supported complete denture, orthodontic appliance, spance maintainer

care procedures for fixed prostheses

loosen debris with oral irrigator, biofilm removal with sulcular brushing AND Charters position for gingival surface of pontic, use nonabrasive, fluoride containing dentifrice (acidulated fluoride CONTRINDICATED for porcelain and composite restorations), interdental care (proximal surface of abutment and gingival surface cleaning) with tufted floss being most efficient for fixed partial cleaning

impression surface liners

occasionally encountered and are long-term material that is not to be removed and is a temp soft liner, tissue conditioner, or perm soft silicone liner

areas requiring special attention when removing biofilm from bridges

proximal surface of an abutment tooth and the gingiva adjacent to a pontic

removable oral prostheses/appliances

removal partial denture (which can be natural-tooth supported or implant supported), complete denture, overdenture, obturator, removable orthodontic appliance, removable space maintainer, Hawley appliance

prosthesis care

rinsing to remove loose debris beneficial, especially when brushing not possible, brushing with with clasp brush and/or denture brush recommended, and cleaning with immersion; SHOULD NOT USE REGULAR TOOTHBRUSH (and def not same toothbrush used for natural teeth) OR POWER BRUSH

denture adhesive

soft material used to adhere a denture to the underlying mucosa; also referred to as an adherent

patients with prostheses may be at a greater risk for dental caries and periodontal infections because of ___?___

the biofilm-friendly margins of restorations, under clasps, and under fixed prostheses; AREAS REQUIRING SPECIAL ATTENTION: margins, gingival surface of pontic, beneath connectors

occlusal vertical dimension

the distance measured btw two points when the occluding members are in contact

the longevity of the removable appliance depends on ___?___ AND the health of the natural teeth depends on ___?___

the longevity of the removable appliance depends on the health of the supporting teeth AND the health of the natural teeth depends on the cleanliness of the prosthesis

a customized regimen for personal care should involve ___?___

the natural teeth as well as the fixed and removable prostheses and be specific to the individual pt's needs

residual ridges

the portion of the residual bone and its soft tissue covering that remains after the removal of teeth

components of complete denture

•BASE: part that rests on oral mucosa and to which teeth are attached; made of plastic acrylic resin, metal, or combo of both •SURFACES: impression surface that lies on residual ridges and adjacent tissue; polished surface of outer/external of denture; occlusal surface that contacts (or nearly contacts) opposing arch; •TEETH: made of plastic acrylic resin, composite resin, or porcelain

types of oral prostheses & appliances

•FIXED: fixed partial denture, periodontal splint, implant-supported complete denture, orthodontic appliance, space maintainer; •REMOVABLE: removal partial denture which can be natural-tooth supported or implant supported, complete denture, overdenture, obturator, removable orthodontic appliance, removable space maintainer, Hawley appliance

3 types of natural tooth supported fixed partial dentures (as opposed to an implant supported fixed partial)

•TRADITIONAL/BILATERAL: supported by 1 or more natural teeth at each end (retainer on abutments at each end with pontic in middle); •CANTILEVEL: pontic at one end only and supported by 1 or more abutment teeth with retainers on them; •RESIN RETAINED (maryland bridge): wing-like extensions are bonded with resin cement to etched enamel

criteria for fixed partial denture

•biologically & aesthetically harmonious with teeth/surrounding periodontium, •all parts accessible for cleaning; •must not interfere with cleaning of remaining natural teeth; •must not traumatize oral tissues; •restores functions of missing tooth/teeth

description of a bridge (fixed partial denture prostheses)

•composed of abutment, connector, pontic; •fabricated from metal, ceramic, commonly combo of both; •fixed to natural tooth or implant with cement and not removable

RISKS of not replacing missing teeth

•migration of adjacent teeth: tilting & rotation of teeth may lead to perio problems as they are more difficult to clean and may lead to misdirected occlusal forces when chewing; •migration of opposing teeth (supereruption); •remaining teeth may suffer from the added function and stress leading to fx's and tooth loss; •loss of occlusal vertical dimension: overclosure may occur and TMJD may result

objective of prosthesis care

•to attain & maintain oral health & function; •control biofilm for prevention of caries and perio infections; BASIC DAILY SELF CARE OBJECTIVES: •remove loose debris & attached biofilm, •disinfect appliance to get rid of odor & to eliminate potential irritants to teeth/oral tissues; PROFESSIONAL CLEANING: •removal of stain and calculus