DIFFERENTIAL DIAGNOSIS

,FIXED /REMOVABLE
PROSTHESIS
DR AYESHA SADAF
What motivated you to come today in the
class?
 Learning outcomes
Students should be able to

1. Understand basic terminologies that will be used in

fixed Prosthodontics

2. Understand the indication of fixed partial denture &

contraindications

3. Able to integrate the RPD and FPD terminologies.

Objectives of Prosthodontic Treatment

Elimination of diseases

Preservation of remaining teeth & oral tissues

Selected replacement of lost teeth

Restoration of function & Esthetics

 Elimination of Disease
CONTROL OF CARIES
Control of Periodontal Disease
FIXED PROSTHODONTICS
CROWN
■ A crown is an extra coronal cemented
restoration that covers the outer portion of
clinical crown.
CROWN

■ A crown is an extra coronal

cemented restoration that covers the
outer portion of clinical crown.
Full Veneer crown & Partial
veneer crown
■ If it covers all surfaces the restoration is called
complete veneer crown.

■ If some surfaces or portions of the clinical crown are

replaced then it is called Partial veneer crown.
 Intra coronal / Indirect

Restorations Restorations
 Intra coronal Restorations

Inlays
■ A fixed intracoronal restoration

■ A dental restoration made outside of a tooth to

correspond to the form of the prepared cavity,
which is then luted into the tooth
Onlay
Onlay is an extracoronal restoration that
covers one or more than one cusps
adjoining occlusal surfaces of tooth
 FIXED PARTIAL DENTURE

The fixed partial denture is a prosthetic

appliance, permanently attached to remaining
teeth, which replaces one or more missing
teeth
FIXED PARTIAL DENTURE
Dental surveyor
Definition
An instrument used to
determine the relative
parallelism of two or
more surfaces of the
teeth or other parts of
the cast of a dental arch.
*
In fixed Prosthodontics

Parallelism is a must
Retention in Removable
Prosthodontics

QUALITY OF THE DENTURE TO

RESIST THE FORCES ACTING
AWAY FROM THE DENTURE BASE
 Retention In Fixed Prosthodontics

Retention prevents removal of the restoration

along the path of insertion or long axis of the
tooth preparation..
SUPPORT

Resistance of the denture

resisting the denture bases
against the forces acting
towards the denture base
Resistance in Fixed Prosthodontics

■ Resistance prevents dislodgment of the restoration

by forces directed in an apical or oblique direction
and pre-vents any movement of the restoration
under occlusal force
STABILITY

RESISTANCE OF THE DENTURE

TOWARDS THE ROTATIONAL
FORCES
Resistance in Fixed prosthodontics is
same as support and stability in
Removable Prosthodontics
Height of Contour &
Undercut
■Height of contour
•Suprabulge

•Undercut =
Infrabulge
■ Any areas cervical to
HOC used for
placement of retentive
clasp components
■ Areas occlusal to the
HOC used for the
placement of no
retentive, stabilizing, or
reciprocating
components. *
 Non-undercut Area

e rc ut
Und
here

30
Types of undercuts

Tooth Undercuts *

Soft Tissues or bony

Undercuts(on lingual
side of ridge) #

31
 RULE
Retentive tip should usually be
designed to be placed in the
gingival 1/3
Path of Insertion

Path that the prosthesis

is
–Placed/removed
–Usually a single path
Path of Insertion (P.I)
The Direction in Which a Restoration/
Prosthesis Moves From the Point of Initial
Contact With the Supporting Teeth to the
Terminal Resting Position Where the Occlusal
Rests Are Seated and the Denture Base Is in
Contact With the Tissue

Path of Removal (P.R)

Reverse of the Path of Insertion *
34
SEQUENCE OF RPD THERAPY

1. DETAILED HISTORY
2. HISTORY OF CHIEF
COMPLAINT
3. DENTAL HISTORY
4. MEDICAL HISTORY
5. SOCIAL HISTORY
6. DRUG HISTORY
A PRELIMINARY ORAL EXAMINATION

EMERGENCY TREATMENT e.g, pain relief,

extractions, endodontic treatment.

PROPHYLAXIS

FULL MOUTH RADIOGRAPHS

DIAGNOSTIC CASTS

MOUNTING RECORDS
CONTRAINDICATIONS OF FIXED PARTIAL DENTURE

AGE OF PATIENT: Less than 18 years

Tooth reduction sufficient to

reestablish normal coronal
LARGE PULP anatomy in the cast restoration
often compromises the health
of the pulpal tissues.

LACK OF CLINICAL CROWN HEIGHT

CONTRAINDICATIONS OF FIXED PARTIAL DENTURE

LONG EDENTULOUS SPAN

MORE THAN 3 TEETH MISSING

ALL ANTERIOR TEETH MISSING

CONTRAINDICATIONS OF FIXED PARTIAL DENTURE

LOSS OF SUPPORTING TISSUE

LACK OF PERIODONTAL
SUPPORT

LACK OF SUFFICIENT BONE

HEIGHT & WIDTH
INDICATIONS OF REMOVABLE PARTIAL DENTURE

DISTAL EXTENSION SITUATIONS

KENNEDYS CLASS 1

KENNEDYS CLASS 2
INDICATIONS OF REMOVABLE PARTIAL DENTURE

AFTER RECENT EXTRACTION

INTERIM RPD

TEMPORARY RPD
 INDICATIONS OF RPD

PATIENTS DESIRES

Patients sometimes insist on removable prostheses in place of

fixed prostheses
1. to avoid operative procedures on sound, healthy teeth
2. to avoid the placement of one or more implants
3. for economic reasons.
4. Patients who have had unpleasant experiences with
previous dental procedures often object strenuously to the
tooth reduction required for fixed prosthesis fabrication
INDICATIONS OF REMOVABLE PARTIAL DENTURE

A VERY SOUND ABUTMENT TOOTH

FOR NON-INVASIVE, CONSERVATIVE

TREATMENT OPTIONS
 INDICATIONS FOR RPD

UNFAVOURABLE MAXILLOMANDIBULAR RELATIONSHIPS

SKELETAL CLASS 2

SKELETAL CLASS 3