New Selection and arrangement of teeth in rpd · 2017. 12. 9. · 2. Set the Central Incisor first...

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Tikrit University College of Dentistry Lec-8- prosthetic Dr: Reem /4 th class Selection and arrangement of teeth in rpd upon completion of the articulator mounting and a thorough assessment of the occlusal requirements, the practitioner should be able to perform the proper arrangement of prosthetic teeth.While selecting the replacement teeth, the clinician must carefully consider the esthetic and functional requirements of the patient, the structural requirements of the RPD and the materials to be used in prosthesis construction. TYPES OF REPLACEMENT TEETH(MATERIALS):- 1-Commercially available acrylic resin teeth (Ant. & Post.) 2-Commercially available porcelain teeth (Ant. & Post.) 3-Commercially available composite resin teeth (Ant. & Post.) 4- Metal replacement for posterior teeth (gold) PORCELAIN TEETH ADVANTAGES:- 1-Greater translucency and depth of color give a natural appearance. 2-harder than acrylic 3-resist wear 4-resist staining 5-they easily removed from the base of because there no chemical reaction between porcelain and acrylic denture base (benefit in rebasing). DISAVANTAGES 1-clicking sound of the teeth covert the denture being noisy

Transcript of New Selection and arrangement of teeth in rpd · 2017. 12. 9. · 2. Set the Central Incisor first...

Page 1: New Selection and arrangement of teeth in rpd · 2017. 12. 9. · 2. Set the Central Incisor first if the teeth are missing across the midline to reestablish the midline. 3. If required

Tikrit University College of Dentistry Lec-8-prostheticDr:Reem/4thclass

Selectionandarrangementofteethinrpd

uponcompletionofthearticulatormountingandathoroughassessmentoftheocclusalrequirements,thepractitionershouldbeabletoperformtheproperarrangementofprostheticteeth.Whileselectingthereplacementteeth,theclinicianmustcarefullyconsidertheestheticandfunctionalrequirementsofthepatient,thestructuralrequirementsoftheRPDandthematerialstobeusedinprosthesisconstruction.

TYPESOFREPLACEMENTTEETH(MATERIALS):-

1-Commerciallyavailableacrylicresinteeth(Ant.&Post.)

2-Commerciallyavailableporcelainteeth(Ant.&Post.)

3-Commerciallyavailablecompositeresinteeth(Ant.&Post.)

4-Metalreplacementforposteriorteeth(gold)

PORCELAINTEETH

ADVANTAGES:-

1-Greatertranslucencyanddepthofcolorgiveanaturalappearance.

2-harderthanacrylic

3-resistwear

4-resiststaining

5-theyeasilyremovedfromthebaseofbecausetherenochemicalreactionbetweenporcelainandacrylicdenturebase(benefitinrebasing).

DISAVANTAGES

1-clickingsoundoftheteethcovertthedenturebeingnoisy

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Tikrit University College of Dentistry Lec-8-prostheticDr:Reem/4thclass

2-brittle

3-detachmentoftoothfromthedenturebase

4-difficulttofabricateandtrim

5-causewearingofopposingnaturalteeth.

ACRYLICTEETH

ADVANTAGES:

1-easytoadjustandtrim

2-chemicalbondingtodenturebase

3-easytofabricate

4-lighter

DISADVANTAGES:-

1- susceptibletoabrasion2- easilystained3- inrebasing(difficulttoremovetheteethfromthedenturebase)

ANTERIORTEETHARRANGEMENT

themostdifficultpartofarranginganteriordentureteethisdirectlyrelatedtoalossofrestorativespace.Unlessanteriorteetharereplacedimmediatelyfollowingtheirextraction,thenaturalteethadjacenttothespacewilleitherdriftortiltintothespaceandproducedecreaseintherestorativespace.Anattemptshouldhavebeenmadetoregaintheoriginalwidthofthespacebyreshapingtheproximalsurfacesoftheadjacentteeth.

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Tikrit University College of Dentistry Lec-8-prostheticDr:Reem/4thclass

Iftheentirewidthcannotberecovered,considerationshouldbegiventooverlappingtheartificialteethsothatanormalsizedtoothmaybeusedtoharmonizewiththepatient,sfaceandremainingteeth.

Becauseoftheiravailability,easeofadjustment,andsurfacewearcharacteristics,acrylicresinteetharemorecommonlyusedthanareporcelainteeth.Whileestheticallypleasingporcelainbrittleandcauseacceleratedwearofopposingenamel,gold,andacrylicresinsurfaces.

Whenselectingdentureteeth,thedentistshoulduseshadeguideprovidedbythetoothmanufacturer.Artificialteethshouldbematchedascloselyaspossibletotheadjacenttoothbyusingnaturallight,theabilitytodiscriminatebetweenshadesdecreasesrapidlyasaresultofeyefatigue.

Aftershadeselectionthepractitionershouldselectappropriatemold.Eachmoldexhibitadefinedsizeandshape,aswellasdistinctivesurfacecharacteristics.

Thepractitionermustestimatethesizesofthepatient,snaturalmaxillarycentralincisors,thisaccomplishedby:-

TheHOUSETECHNIQUE:coordinatesthewidthandlengthofeachmaxillarycentralincisor,thedentistdeterminethepatient,sbizygomaticwidthanddividedby(16),toestimatethelengthoftheclinicalcrown,thedentistestimatethelengthbychintohairlinedistanceanddividedby16.

TheoverallformorshapeoftheteethisestablishedbyLEONWILLIAMS:Theshapeofanteriorteethiscloselyrelatedtofacialform.Teethareusuallydividedintofourbasicform(square,tapering,squaretaperingandovoid).

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Tikrit University College of Dentistry Lec-8-prostheticDr:Reem/4thclass

GIUDLINEFORSETTINGANTERIORTEETH

1.Replacetheacrylicresinrecordbaseattachedtotheframeworkwiththebase-platewaxbase.

2.SettheCentralIncisorfirstiftheteetharemissingacrossthemidlinetoreestablishthemidline.

3.Ifrequired–reshapetheridgelapportionoftheartificialtoothwithoutshorteningtheclinicalcrownlengthsubstantially.

4-Placetheteethasnearlyaspossiblewheretheoriginalnaturaltoothwaslocated.

5.Proximalsurfaceoftheartificialtoothmayneedtobere-contouredforbetteradaptationtotheadjacentnaturaltooth,withoutloosingitsmorphology.

6.Thedenturebaseflangesshouldbecarefullycontoured&smoothed.Removetheexcesswaxfromtheteethandtheframework.

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Tikrit University College of Dentistry Lec-8-prostheticDr:Reem/4thclass

POSTERIORTEETHSELECTIONANDARRANGEMENT:-

posteriorteethmustnotonlyfitintotheavailableedentulousspaces,butalsomustbeinharmonywiththeopposingocclusalsurfaces.thefollowingmustfollowtheposteriorarrangementteeth:-

1- Thedentistshouldnotbeoverlyconcernedwithreplacingtheexactnumberandtypeofteeth,forexamples,theedentulousspacemayhavebeenoccupiedbyasecondpremolarand1stmolarbutbecauseofdriftingoftheremainingteeththemostsuitablereplacementmaywellbetwopremolars.

2- acrylicteetharealsoindicatedinposteriorteeth.Porcelainteethareindicatedonlyiftheywillopposesimilarporcelainsurfaces.

3- shadeselectionshouldbeaccomplished.4- Thepractitionershouldthenchoosetheappropriatemold.5- Thepractitionermustconsidertheocclusogingivalheightforeach

replacementtooth.6- oneoftheprimarygoalsinestablishinganeffectiveocclusalschemeisto

developanacceptablepatternofmaxilla-mandibularcontacts.Todothis,itisnecessarytosetthedentureteethataheightthatisslightlygreaterthantheproposedocclusalverticaldimension.Theoperatormaythenperformcorrectivegrindingprocedureswhich(1)returntheteethtotheproposedocclusalverticaldimensionand(2)providemaximumplannedcontactbetweenopposingocclusalsurface.Thisdonebyincreasetheincisalpinsettingby0.5mm

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Tikrit University College of Dentistry Lec-8-prostheticDr:Reem/4thclass

thenmarkedusingarticulatingpaperandadjustedbyusingappropriatebursinalaboratoryhandpiece.

POSITIONINGADENTURETOOTHADJACENTTOACLASPASSEMBLY

PositioningthedenturetoothadjacenttotheabutmenthavingaclasporaMinorConn.usuallyrequires,

a.trimmingoftheproximalsurfaceandtheridgelapportionoftoothcarefully-Nottoover-reducetheheightofthebuccalsurfaceforestheticreasons

b.Thetoothshouldfirstbeadjustedtofitthecastwithoutframeworkandthenreadjustedafterplacingtheframeworkonthecast.

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Tikrit University College of Dentistry Lec-8-prostheticDr:Reem/4thclass

Theremainingteethshouldthenbepositionedinmaximumintercuspation.Someocclusaladjustmentorleavingsmallspacingbetweentwodentureteethmaybenecessary.

Forthemandibularposteriorteeth,centralgrooveshouldbeplacedoverthecrestoftheridge.

Thedesiredocclusalcontactsforartificialteethforremovablepartialdenturesvaryaccordingtotheclassofpartiallyedentulousarchbeingtreated.Thefollowingisabriefsummaryofthevariousocclusalschemesthatmaybeusedinremovablepartialdenturetherapy.

1- Simultaneousbilateralocclusalcontactofopposingposteriorteethshouldbepresent.

2- Foratoothbornremovablepartialdenture,theocclusionshouldbesimilartoaharmoniousnaturaldentition

3- foraremovablepartialopposingacompletedenture,balancedarticulationisdesirable.

4- InclassIVapplication,itisdesirabletohavelightcontactwithopposingnaturalteethinmaximalintercuspalposition.

5- Artificialteethshouldnotbepositionedontheupwardinclineofthemandibularridge.(asitascendsthemandibularramus).


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