Chapter 12
•
• Prosthodontics
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Prosthesis
• [prahs-THEE-sis]
• A replacement for a missing body part
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Prosthesis
• In the dental field, it is a fixed or removable appliance replacing
removed or non-erupted tooth or teeth.
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Fixed Appliance
• Eg. cemented crown
• Placed in the mouth not intended for removal.
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Removable appliance
Placed in and out of the mouth at the patient’s will.
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Implantology
• The science of dental implants, involves the use of both fixed and
removable appliances.
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Types and characteristics
of prosthodontic materials
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Noble metals
• Valuable alloys. Eg. Gold, palladium, platinum
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Base metals
• Chromium – cobalt or chromium –nickel used alone or in a mixture with noble
alloys.
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Porcelain
(PFM)
• Hard translucent ceramic substance fused to the surface of a metal
crown as shells and veneer covers to give the appearance of a natural
tooth surface.
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Composite
• Resin metal used for tooth colored replacement.
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Acrylic
• Synthetic resin material used for covering of metal frameworks or as
natural tissue replacement.
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Characteristics of prosthodontic
materials
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Hardness
• Ability of a material to withstand penetration.
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Tensil strength
• Capability of a material to be stretched.
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Elasticity
• Ability of a material to be stretched and the resume its original shape.
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Ductility
• Ability of a material to be drawn or hammered out as into a fine wire
without breaking.
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Elongation
• Ability of a material to stretch before permanent deformation begins.
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Fixed prosthodontics
• Various appliances from singular crown to a full arched bridge.
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Inlay
• A solid castered or milled restoration involving some occlusal and
proximal surfaces cemented into a tooth preparation
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Onlay
• A solid casted or milled restoration covering some occlusal tooth cusps
and side wall area that is cemented onto the prepared site.
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Crown
• Tooth-shaped cover replacement for a missing crown area
cemented onto the remaining prepared crown surfaces
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Full crown
• Cast metal, tooth shaped cover replacing the entire crown area. During
treatment acrylic resin crowns could be used as a temporary crown cover.
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Dowel crown
• Full crown cover with dowel pin extending into the root canal of a pulpless
tooth, usually positioned on anterior teeth.
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Veneer
• Direct veneer
• Indirect veneer
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Direct veneer
• Placed and cured directly on the tooth surface
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Indirect veneer
• Tooth material is prepared in the lab and later cemented onto the tooth
structure.
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Bridge
• A prosthesis used to replace one or more teeth of fixed or removable
nature.
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Fixed bridge
• Cemented into the oral cavity and not removed by the patient
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Maryland bridge
(Resin-bonded bridge)
• Replaces anterior or posterior tooth cemented directly to the adjacent or
abutting teeth.
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Cantilever bridge
• Bridge with one unsupported end, usually saddled.
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Bridge
• A bridge has three structural parts: Pontic – Abutment -Adjacent teeth
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Pontic
• Artificial tooth part of the bridge replacing the missing tooth and
restoring function to the bite.
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Abutment
• Natural tooth or teeth prepared to hold or support the remaining
part of the bridgework in position.
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Adjacent teeth
• May be included in units if they are involved in the bridge area.
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Removable dental Prosthesis
• Prostheses that could be taken in and out at patient’s will.
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Complete denture
• Removable appliance composed of artificial teeth replacing the entire
dentition of either jaws.
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Partial denture
• A framework of artificial teeth replacing one or more teeth in an arch.
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Immediate denture
• Placed into the mouth at the time the natural teeth are surgically removed.
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Overdenture
• Prepared to fit upon implant posts or prepared retained roots.
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Structural components
of dental appliances
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Framework
• Metal skeleton onto which a removable prosthesis is constructed.
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Saddle
• Part of the structure used for balancing the prosthesis as a base for
placement of artificial teeth.
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Rests
• Small extensions of removable prosthesis made to sit atop the adjoining
teeth.
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Clasp
• Extensions of partial framework that grasp the adjoining teeth to
provide support and retention of the prosthesis.
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Denture base
• Acrylic part of the denture prosthesis substituting for the gingival tissue.
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Flange
• Projecting rim or lower edge of the prosthesis.
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Post dam
• Posterior edge of the maxillary denture that helps maintain the denture and
suction.
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Impression material
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Elastomeric
• Impression material must be elastomeric (having rubber like
properties)to be pliable during the impression process.
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Elastic impression items
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Hydrocolloids
• Reversible
• Irriversible
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Reversible hydrocolloid
• Can change from a solid or gel state to a liquid form and back again
depending on the temperature changes.
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Irreversible hydrocolloid
• Once chemically set cannot be reversed or used again.
• Eg.Alginate
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Imbibition
• Swelling from absorption of water and fluid loss causes shrinkage.
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Rubber bases
• Impression material exhibiting rubberish characteristics often in a
twin cartridge(base and accelerator/activator ) and mixed into a
homogeneous mass.
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Compound
• A thermoplastic impression material supplied in blocks and is heated to a
soft pliable mass placed in the impression tray, then put into the mouth.
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Impression tray
• A transport device for the impression material to be inserted into the
patient’s oral cavity for taking impression of one or more teeth or an
entire edentulous arch.
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Try-in adjustment
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Seating
• Placement and fitting of prosthesis for trying-in and final
cementation.
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Condylar inclination
• Bite relationship and TMJ involvement.
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Movements involve the condyle
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Centric
• Occuring when condyle rests in the temporal bone during biting, resting
and mouth movements.
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Protrusion
• Measurement with the mandible thrust forward with the lower jaw out.
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Retrusion
• Measurement with the mandible drawn backward.
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Lateral excursion
• Measurement with side-to-side movement of the mandible.
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Use of implants in prosthodontics
• There are different types of implants and each is used in a specific area,
depending on the available bone.
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Root form implant-endosseous
• Screw type device that is screwed or cemented into the mandibular
bone.
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Plate form implant
• Flat plate style used for the narrow jaw one.
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Subperiosteal
• Placed under the peridontium and stabilized on the mandibular bone.
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Transosteal
• Larger plate stabilized on the lower border of the mandibular bone with
posts extending through the gingiva.
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Osseointegration
• Implant appliances must bond with the bone tissue to obtain
stability which is called Osseointegration.
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