PROSTHO SUMMARY

MANAL, AL DAHABI ETC

Note prostho by DR.R

Impression
For flabby ridge - mucostatic impression or plaster of paris
For raduial ridge - dynamic impressions
Impression for distal extent at rest- zoe
Distal end show function tissue details- hindle teq
Impression plaster or ZNOE PASTE - jaw relation
Impression elastomer - radiotherapy pt
Best impression for dentist. ;polyether under moist conditions
can absorb water , most stiffness material
Heat resist - polyamide

Least accurate impression material - compound

Least accurate elastic material - alginate
Most accurate - silicone can be poured from 24hr - 1week -
used inter occlusal

Compund - stock tray

Alginate - custom tray

Impression with retraction cord after crown length need -21

days

Remake primry impression

Displace and move during setting
Incorrect tray position
Excessive impression on tray
Void
Incorrect border formation
Poor detail
Cement
Cement irritates the pulp - zn-phosphate
Cement best retention crown- resin
Cement under porcelain veneer - resin
Cement chemical bond to enamel - zn-polycarpolayte
Fracture in all ceramic crown - RMGI
Steps under crown ; Contouring - glaze - polish - cementation -
inserting crown
Gic type :
1 luting
2 resto
3 liner / base
4 pit / fissure

Clasp - btw rpd and abutment Prevent dislodgment of denture

Direct retainer
-intracronal
-extracoronal

A- suprabulge (above surveyline)

- circumferential clasp : non aesthetic - cause caries - rigid
-tooth supported rpd - minimum flexibility not used in distal
extension cause stress on abutment and pdl - used in class 3
but no need as it is tooth supported
- Ring ; tilted molar - disadvantage cause caries better to use
alternative clasp
- Combination : distal extention with undercut abutment - class
1-2
- Embrasure - tooth opposite to edentulous area

Rpi minimal stress on tooth and gingiva and pdl - premolar

abutment to distal extended saddle
distal Extention
Contraindicated ; tilted ,undercut ,shallow

B- infrabluge ( below suurvyline )

- ibar - not used undercut - BL TILTED - shallow vestibule ///
used in esthetic - small under cut - distal extension
- T bar
- Bar type -not used with large undercut
- Y type

Under cut in abutment use - wrought wire with round cross

section

Reverse akrr better then aker clasp - retention and prevent

tipping force on abutment

Class 3 - bar type , anker, combination

Clasp 2 arm
Retentive - Retention supra or infra but should be in undercut -
primary retention
Reciprocal - stable

Major connector

Lingual palate
Shallow lingual sulcs
High lingual frenum
Mobile anti
Less then 7mm
Not used in crowding

Lingual bar are the opposite exactly

Lingual bar - simplest most common major connector
Crown
Staining in tooth all ceramic but if it says occlusion problem
etc full crown
Attrition - cast metal
Amelignesis imprefecta - full crown
Hypo maturation- hypo plastis - vneer
Erosin - tx eating disorder
Corwn dont fit margin - tight contact
Crown with occlusion problem - incorrectly related cast
Metal ceramic crown appear opaque - tooth not prepare in 2
plane
Crown check - proximal- margin - occlusal- contour - esthetic

Veneer
Alumina - under dark discoloration and has high strength
Castable - high translucency : dicor
Composite - direct
Etchable - high esthatice : empress

Condyle problem
Non working - down forward medial
Working - down forward lateral
Protrotive - down forward

Protrusive guidence solely depend

Mesial inclune mandi
Distal maxi

Metamerism - color appears different under ligth

Curve wilson - lingual cusp shorter then lingual buccal cusp

Compensation curve - balance occlusal when mandi protruded
Spee curve - anti posti
Esthetic in maxi denture - should appear incisal edge of maxi
teeth follow lowr lip when smiling

Headache complain
Bridge pain after placement headaches on opposite side -
myofascial pain syndrome
Migraine - throbbing - pulse sensation on side
Trigrminal - electric shock

Occlusal rest should be

1/3 facial lingual
1/5 between cusp
1.5mm deep base material
1 mm in thinnest portions

Fpd - success 70-80 % 10-15 yr

Fpd finish line above gingival crest

After crown lengthening osseouse resection protho resto wait

3-6 months

Gide plane - parllel to path insertion 2-3 mm occlusal gingival

height

Tours ;
Ill fiting denture brusim cortical bone slow grow edentlous

Screw implant_ limit space or less then 5mm

Cemented implant _for tilted implant

Space btw frame metal work and margin -6mm

taking impression or setting impressions quickly - hot water

Shorten setting time (poring time)- slurry water

Measure verticel dimension - willi gauge / calliper

Measure bizygomatic width -facebow

Reline -self cure acrylic

Rebase - heat cure acrylic

advantages of overdenture -
Propricoption only felt by real teeth
Inturn help reduce resorption

Non rigid connector - use for 1 missing tooth

Ap stap most rigid major connector used in class 2&4

Minimum taper 6 degree

Minimum convergence 12 degree

Management of knife ridge

Cove buccal flange
Narrow occulsal for retention

Problem in denture
Stuff lip - displacement force of denture

Class 3 tooth support no need for indirect returner

Gap btw soldered part 0.2mm

Ridge augmentation - create volume of bone for implant

( increase high and width)
By autogenouse bone from anti iliac crest hip or rib
Increased monomers -
Shrinking , porosity , more time to reach packing

Risin bonded bridge -2 type maryland and rochette used in

mobile teeth
Contra indicated in :
Poor oh
Large restoration
Malposition teeth

Cantilever bridge contraindications :

Rct
Short root

Fixed contra indicated :

Caries
Resorbed rigde

Best root under fixed :

Divergent root - long
Conical - shor lt - poor support

Bridge color appear milky shade or cloudy ;

Excessive fired

Cd : most common complain after insersion 24hr - over

extended laceration

F swound like v :
Long tooth or anti

Under postdam - air bubbles

Over postdam - deep sharp - sore spots
Under extended - loss of retention
Ovee extended -

Lower denture opposite natural ; working side contact

Continue fracture PFM - inadequate frame work

-
Spure former placed in greatest bulky area
Sectional cast post - molar
Residul - un polymerized monomer
Toughness - ability of material to absorb energy before
fracture
Lugting agent - prevent restoration dislodgment

To get centric relation condyle should be - anti superior

Distance between margin and major connector - 6 mm in maxi
And 3-4 in mandible
Stress bearing area in and buccal shelf
Occlusal trauma in implant cause - bone loss
Prepare anti maxi all for metal ceramic - custom insisal guide
should be made
Complete denture - iscisive papilla , midsagittal - ala nose

Trauma in underlying supporting tissue can decrease ovd by

msitake
Ovd increase
Hyperactive matication
Occlusal force
Trauma in basal
Tmj disorder
Face elongated
Clicking sound in speech
Measure the thickness of crown - iwanson calipers

Custam post - less tooth structure removal

Glass fiber post - better adaptratiom - esthatic - fracture

resistance

Matrix band extand abouve the margin ridge - 2 mm mim 1

mm
and 1 mm below gangival margin

Arcon articulator- condule attached to lower memebrr with

fossa in maxilla

Non arcon - maxilla condyle And fossa

Primary failure of all ceramic crown - radial crack

Retraction cord - 4 min cerate 0.2 mm

2 min if we use clay retention paste

Accurate of hinge positions - kinematic facebow record centric

relation

Upper denture bubble in postdam area means underdam -

remake

Percentage of mandi riDge resorption - 4% higher compre to

maxi

Uncontrol DM - more bone resporption

Post space - 5mm apical seal

Bleeding after gently probing - acute gingivitis

Rotating of denture - fixed by indirect retainer

Increased VD - clenching

Crown all ceramic after 2 weeks redness around and bleeding

around crown only - make crown like tooth structure

Side effect of retraction cord with epinephrine - systemic effect

of vasoconstriction

Least esthetic clasp - ring clasp

Fixed bridge rocking - tx remake

Fixed bridge bubble on abutment - caused by increased
cement space