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Process of determination of the nature of disease process

Diagnosis is the examination of the physical state, evaluation of the mental or psychological makeup and understanding the need of each patient to ensure a predictable result

Is any measure designed to remedy a disease

Treatment planning means developing a coarse of action that comprises the ramification and sequelae of treatment to save the patent need.

Name Proper


Treatment planning - general health, time and affordability Selection of teeth shape , shade , form and materials Arrangement of teeth Characterization Adaptability Clinical procedure

Treatment planning, affordability, dependency Selection of teeth shape , shade and form Arrangement of teeth Characterization dentogenic concept Physiological and psychological changes

Treatment planning dependence Selection and approval of teeth and arrangement Psychological state of the patient

Economic background and Social status Determines on oral health and esthetics Mental Attitude of the patient Formulating Treatment planning- cost , time ,characterization Appointments

Deciding Appointment Treatment plan Recall or future references

The dentist should meet the mind of the patient before he meets the mouth of the patient De Van 1942

What is your Problem and why do you seek treatment?

Lost all teeth and need dentures
Old denture are unsatisfactory/ ill fitting.

Old denture worn out /broken/ lost.

Any other

How long have you been without natural teeth. Primary reason for loss of teeth. Why do you mainly require denture.

General constitution

Medical History

Relation to denture success Precautions prior to and during treatment Avoid post treatment complications Altering Prosthodontics procedures and treatment plan Determines the dental prognosis


Known condition for fist time Sign and symptom Habit of sweet eating Severity of the disease condition 3P= polyphgasia, polyuria, polydispia Delayed wound healing Dryness of mouth Infection of the oral cavity Management: Blood sugar level to know the severity Medical management in case of high sugar level If under control patient motivation and councelling
Consequences of using the denture in diabetic condition Retention loosing the body weit=gth , bone resorption frequent relining Diet counciling non sugar food. Procedure must be atraumatic Appointment without altering fooding time During impression mucostatis impression material
During jaw relation- proper reduced height might cause angular chelitis Centric relation improper might cause sliding fo denture , repeating ulceration Arrrangement of the teeth mono planre of semianatomic teeth , Proper finishing and poslishing of the denture

Knoeledge of hypo/hyper glycemic shock


Diabeties develop after the treatment Loosenes of the denture in the morning time poly urea at night Infection denture stomatitis , canadasis Delayed wound healing due to sharp edge of the denture Resorption of the bone will be more Mucosa will be frasile burning sensation, repeated ulceration
Reduce sharp edges Relining might be needed Tissue conditioner

Significance Active stage

No treatment Medical consultation High chance of cross contamination

Highly contagious with aerosol Anti tubercular drugs xerostomia and retention might be decreased Tubercular ulceration Decrease retention with rapid weight loss Retention of denture should be proper- pps should be proper, relief of frenum

Causes of fainting Hypo volumic Septic etc

Management according to cause Obstruction of airway Removal of denture

Appointment timing short appointment Medication to reduce anxiety Pre prosthetic surgery

Tonicity of the muscle/ neuromuscular control Difficult in clinical procedure Neuraligia- trigger point

Sharp edges

Appointment timing Position Management of Attack in clinic

Activation with material like acrylic, ZnOe, gloves,

Mucositis Xerostomia Debleting condition Osteoradionecrosis Six month after therapy ideal / at least 3 month Radio opadue material should be removed if in the path of therapy reflection of radiation to other part causing management

Chief complaint Years of edentulous Duration of edentulous Previous dentures Existing current denture Pre extraction records Denture success

Diet Oral hygiene habit Other habits

Family status

Education status

Mental status
Classification by: MM House 1937 Philosophic Exacting Hysterical Indifferent

Patient expectations




Selection of
size of the teeth
shape of the teeth.

Mesiodistal width of the anterior six teeth = 1/3 of bizygomatic width of the face

Mesiodistal width of the central incisor= 1/16 of bizygomatic width of the face

Shape of the teeth = inverted image of the face.

Class I

Class II

Class III

Indicates the relative size of the upper and lower jaw and vertical jaw relation. Aids in teeth arrangement
Convex profile- class II disharmony Concave profile- class III disharmony Overjet and overbite relation

Any pathological conditions


Jaw relation

Facial complexion Eye Colour Hair Colour

Type Contour Length Mobility

Philtrum to the lower border Of the vermilion border of the lip

Base of the nose to the philtrum of the lips

Masseter. Temporalis. External pterygoid muscle Internal pterygoid muscle

Examination of tmj based on

sounds Movements

A finger should be placed in the immediate pre-auricular area, gently applying pressure on the lateral head of the condyle while the jaw is closed. The level of pain and discomfort on each side should be assessed and compared.

2 types of joint sound:

Clicks - single explosive noise
Crepitus - continuous 'grating' noise

Normal Range of motion

Opening >40 mm in Male

>35 mm in Female
Lateral >8 mm in both sexes



Palpable/nonpalpable Area Tender/non-tender Movable/fixed

Large Medium Small

Square Tapering Ovoid combination


Class I Class II Class III


Class I Class II Class III

Adequate Excessive Inadequate





Flatter the soft palate, the broader the of the vibrating line area

Class III

Class II

Class I