Mouth Preparations

By Dr. Vishaal Bhat on Sunday 30 December 2007 with 0 comments



The key to success is to restore oral health prior to tooth modification.


Tissue conditioning-

Denture removal

Tissue conditioning

Antimycotic medications


Oral Surgery-

Extractions

Hopeless teeth, residual roots into mucosa, malposed teeth, impactions


It is very important to try to maintain and salvage distal abutments


Other surgical considerations may include-

1) Tori

2) Ridge reduction or augmentation

3) Orthognathic surgery

4) Muscle attachments and vestibuloplasty



Periodontics-

1) Initial preparation and PCI

2) Pocket elimination

3) Free gingival grafts, osseous grafts

4) Tissue hyperplasia




Endodontics-

If in doubt- Do it!


Operative-

Examine all restorations on abutment carefully, replace any questionable restoration and ensure adequate bulk, depth and width if placing rests.


Prosthodontics-

Surveyed crowns may be required-

Advantages-

Creation of "ideal" contours and undercuts

Splinting

Precision attachments

Correction of occlusal plane


II Tooth Modification


Prior to altering teeth the following must be completed

1) Fully surveyed and designed study casts with tooth modifications indicated.

2) Patient education


III Modification sequence


1) Guiding planes

Width 3-4mm, molars 4-5mm,length undetermined

These should include not only proximal surfaces but lingual and interproximal surfaces as needed


2) Height of contour-

Frequently overlooked! Requires recontouring of labial and lingual surfaces to ensure clasping elements will be at the junction of the gingival and middle thirds of the tooth. Normal procedure is to lower the line. Commonly the facial line angle where the clasp arm originates needs to be altered to eliminate an undercut and allow a more direct approach to the gingival third.




3) Retentive contour-

To decrease the amount of undercut

To increase depth of undercut, must be elliptical, smooth and gradual, NOT A DIMPLE!

Composite resin or resin retained?


4) Rests

Occlusal, lingual, incisal


After mouth preparations are completed, smooth sharp angles and polish using rotary instruments starting with coarse instrumentation and progressing toward fine (ie. flour of pumice, amalgloss) do not use flouride containing polishing media prior to making a final impression with irreversible hydrocolloid (alginate).

Category: Prosthodontics Notes

POST COMMENT

0 comments:

Post a Comment