SCENARIO 2

By: group 6
Broken teeth
Mrs. Rosi, 42, came to the dentist's office to make dentures in the upper front
teeth that had been treated for nerves one week ago. Mrs. Rosi also complained
that the maxillary dentures could not be used because the original teeth where the
wire was broken. Intraoral examination 15 16 17 24 25 26 28 35 missing teeth
with maxillary diagnosis according to Class II kennedy modification 1, 11 teeth
crown remaining 1/3 cervical and temporarily patched, 18 radic teeth, 36 carious
teeth mesial part vitality test (+) and calculus of almost all teeth. Radiographic
examination revealed root canal filling in tooth 11. Examination of the denture
previously was not in accordance with the biomechanical principle because the
design of the tooth implant 14 used a type 1 suture design.
The dentist explained that in this case treatment was needed to overcome the
dental and oral health problems. Furthermore, the anterior teeth were made of
costom peg crowns on tooth 11, teeth 35 were made with conventional bridges with
34 and 36 supporting teeth, while the upper posterior teeth were made with
conventional removable partial dentures with acrylic bases. For more details,
dentists describe the design of dentures that are right for Ny. Rosi knows more
about artificial teeth made.
Clarification of term
1. Biomechanical principles

2. Graft

3. Custom pegs

4. Conventional Bridge

5. Tipping design type 1

6. Radices
Find a problem and brainstorming
1. What is the initial treatment plan for the scenario?
creating a healthy oral environment, 18 radic extractions, scaling, patching, 18
tooth extractions first and then teeth 36 caries clean and maintain OH after
treatment
2. What are the indications that the supporting teeth will be made a bridge?
root cells are perfect, not tilted and does not shake, vital, non-vital teeth that are
treated (PSA) first, good bone support, harmonious jaw shape, strong enamel and
dentin
3. What are the parts of the bridge gears?
abutments, pontics, retainers and connectors
4. What are the other classifications according to Kennedy?
There are 4 classes, bilateral free end, bilateral free end, anterior and posterior
closed sadle, sadle closed through the median line, and there are other
modifications, namely class modification according to Kennedy according to
Swedson and Selarko.
 Find a problem and brainstorming
5. What are the indications of the teeth made by the costom peg crown?
Repair crowns, aesthetics, and tooth fractures
6. What are the stages for designing tooth implants?
There are 4 stages, determining the class of each toothless region, determining the types of
support for each sadle, determining the type of retainer, determining the mcam connector.
7. What kind of leverage class or class is in accordance with the biomechanical principle
according to the scenario?
class 1 for tooth class 3 which still has teeth or free end, class 2 resistance point is in the
middle between pressure and fulcrum.
8. What are the types of grafts?
Ring craps, dauble akers, multiple claps
9. What was done to tooth 36 before bridge maintenance?
Depending on the depth of caries, if more than 2 mm is patched, if email caries is not
necessary, if dentin caries is patched first
10 Why do doctors choose acrylic resin rather than metal frames?
Allergy supporting tissue that will be made if it is still healthy is chosen acrylic rather than a
metal frame, and is inexpensive
Learning objective
1. Students are able to understand and explain partial tooth loss
examinations
2. Students are able to understand and explain the diagnosis of
partial tooth loss
3. Students are able to understand and explain the treatment plan
for partial tooth loss
4. Students are able to understand and explain the design of a
partial tooth loss treatment plan
5. Students are able to understand and explain the principles of
biomechanics in GTSL
6. Students are able to understand and explain the classification of
partial tooth loss
7. Students are able to understand and explain the types of GTC
8. Students are able to understand and explain the types of GTSL
1. Students are able to understand and
explain partial tooth loss examinations
1. Subjective Examination
a. Personal Data
b. General Health Data
c. Dental and Oral Health Data
2. Objective Examination
a.Exraoral Examination
c. Intraoral Examination
1. Saliva
2. Mucosa
3. Teeth
4. Alveolar bone
3. Radiographic Examination
a. Dental photos (GTC):
b. Panoramic photos (GTL / GTSL)
2. Students are able to understand and
explain the diagnosis of partial tooth
loss
Diagnosis according to kennedy for the maxilla is
Class 2 modification 1 due to bilateral free end and
18 root teeth and extraction, for lower jaw that is
Class 3 closed saddle kennedy
3. Students are able to understand and
explain the treatment plan for partial tooth
loss
1. Initial / preliminary treatment plan (prepostodontic)
2. Final treatment plan
Making partial dentures
a. Fixed denture (GTC)
b. Removable partial denture (GTSL)
1) Temporary GTSL (immediate)
2) permanent (conventional) GTSL
4. Students are able to understand and
explain the design of a partial tooth
loss treatment plan
Design stage
1. Determine the class of each toothless region.
2. Determine the type of support from each saddle.
3. determine the type of anchoring
4. Determine the type of connector.
5. Students are able to understand and
explain the principles of biomechanics
in GTSL
Removable partial dentures function well and make
patients feel comfortable if the creator understands
the various styles that take place when GTSL is
functioning. These styles include:
1) Occlusal style
2) Lateral force
3) Anti-posterior style
4) Moving style
5) Rotational movement
5. Students are able to understand and
explain the principles of biomechanics
in GTSL
There are three types of levers
1. first-class lever, fulcrum
point in the middle,
resistance at one end and
pressure (effort)
2. second-class lever: fulcrum
point at the end.
3. third-class lever: fulcrum
point at one end,
resistance at the opposite
end and pressure in the
middle. This type of lever
is not found in GTSL.
6. Students are able to understand and
explain the classification of partial tooth
loss
Tooth loss classification:
(1) Kennedy Classification:
(a) Class I: The edentulous area is located in the posterior part of the tooth still present and are on
both sides of the jaw
(b) Class II: The edentulous area is located in the posterior part of the tooth still present, but only
on one side of the jaw.
(c) Class III: The edentulous area is located both posterior and anterior to the remaining teeth and
only in one jaw.
(d) Class IV: The edentulous area passes through the midline of the jaw and is located in the
anterior part of the remaining teeth.

Based on tooth loss according to Swenson

Class 1: unilateral free end
Class II: bilateral free end
Class III: anterior and posterior closed sadles
Class IV: anterior closed sadle that has crossed the median line
6. Students are able to understand and
explain the classification of partial
tooth loss
Based on tooth loss according to Soelarko
 Class I: toothless area, free end.

 Class II: toothless area, free end.

 Class III: a combination of Class I and Class II. In this

classification, each class is divided into three divisions,
namely:
1) Division I: toothless area is on one side.
2) Division II: toothless areas are on two sides.
3) Division III: toothless area is anterior, past the
median line.
7. Students are able to understand and
explain the types of GTC

Kind of GTC Design

a. Fixed-fixed bridge
b. Semi fixed bridge
c. Cantilever bridge
d. Spring cantilever bridge
e. Bridge compound
f. Adhesive bridge / resin-bonded fixed partial
denture / maryland bridge
 8. Students are able to understand and
explain the types of GTSL
Victor L.S classifies removable
partial dentures based on
1. network of supporters,
namely:
a. Tooth borne
b. Mucosa borne
c. Tooth and mucosa borne,

2. Based on the Installation Time

a. Conventional denture
b. Immediate denture