8. B- TMJ Examination
Bilateral palpation anterior to the
auricular tragi while the patient opens
and closed the mouth, can locate:
Disorder In The Posterior Attachment Of The Disk.
Tenderness Clicking Or Pain Is Noted.
Jaw Opening Of Less Than 40 Mm Indicates Restriction.
Deviation From Midline Also Recoded.
Maximum Lateral Movment Can Then Measured (Normal Is About 12 Mm).
9. Also ..Masseter and temporal muscle are
palpated for signs of tenderness and
classified as mild,moderate or severe
B- TMJ Examination
10. C- Extraoral Examination
1- FACIAL ASYMMETRY
Acromegaly
Exophthalmic goitre
Mongolism
Cretinism
Myxodema
General appearance of the patients face may be suggestive of
certainas:diseases
12. 3- Lips And Mouth
Visibility during normal and exaggerated smiling.
This can be critical during FIXED PROSTHODONTIC
TREATMENT PLANNING
“NEGATIVE SPACE”:- The space between maxillary
and mandibular anteriors during normal smile.
Missing teeth, diastemas and fractured or poorly
restored teeth affect negative space and require
correction
Examination of lips
C- Extraoral Examination
13. 3- Lips And Mouth
•Average opening>50mm
• Restricted opening<35mm (intracapsular changes in the joints)
• Midline deviation :normal is 12mm
Mouth opening
C- Extraoral Examination
14. D- Intraoral Examination
• Condition of the soft tissues , teeth and supporting structures.
• This information can be properly evaluated during treatment
planning only if objective indices, rather than vague assessments,
are used.
15. D- Intraoral Examination
a- Oral hygiene and periodontal examination.
b-examination of teeth
b- Abnormal habits.
c- Edentulous ridge.
d- Occlusion.
e- Prospective abutment.
This should be carried out in a systematic way to include the following steps:
16. -The long-term periodontal health is necessary for successful fixed
prosthodontics.
-The existing periodontal disease must be corrected before any definitive
prosthodontic treatment is undertaken.
A- Oral Hygiene And Periodontal Examination :
D- Intraoral Examination
17. D- Intraoral Examination
• Status of bacterial accumulation
• The response of the host tissues and the degree of
irreversible damage.
• Long term periodontal health is essential to
successful fixed prosthodontic treatment.
• Existing periodontal disease must be corrected.
Periodontal
examination
• An accurate charting of the state of the dentition will
reveal important information about the condition of
the teeth and will facilitate treatment planning
Dental chart:
18. D- Intraoral Examination
B-Examination of teeth:
1.Absence of teeth,dental caries, any restoration ,wear facets
, fractures,abrasion,malformation and erosion are noted.
2.pocket depth
19. D- Intraoral Examination
C- Abnormal habits:
- They should be identified as:
bruxism, pipe smoking and pencil
biting this would affect the type of the
prosthesis, retainer and design.
20. D- Intraoral Examination
D- Edentulous ridge:
The relationship of edentulous spans if more than one
should be recorded. The form, the texture and the
colour of the ridge mucosa.
Also the number and the length of the edentulous
span are a critical factors for treatment planning.
21. D- Intraoral Examination
E- Occlusion :
1 - Wear facets.
2 - Presence of any premature contacts.
3- Cuspal interference.
4- Amount of slide between the retruded and the maximumintercuspation.
5 - Existence and amount of anterior guidance.
Occlusal evaluation should be carried out for :
22. D- Intraoral Examination
F-Prospective abutment An abutment should be :
-a vital tooth
- Strong enough to withstand the forces directed to
the missing teeth.
-Not exhibit mobility.
If it asympotomatic endodontically treated
tooth can be considered for an abutment
provided it can withstand the forces transmitted
to it.
The supporting tissues surrounding the
abutment teeth should be healthy and free from
inflammation..
24. D- Intraoral Examination
Evaluation of abutment teeth
F-Prospective abutment
1-Crown root ratio.
An abutment teeth should have a combined peri-cemental
area equal to or greater in peri-cemental area than the
tooth or teeth to be replaced (Antes law)
Favourable crown root ratio is 1:1
25. D- Intraoral Examination
Evaluation of abutment teeth
F-Prospective abutment
2-Root configuration.
Root shape :short conical roots give lees support.
Divergent multiple roots give good support.
26. D- Intraoral Examination
Evaluation of abutment teeth
F-Prospective abutment
3-Periodontal surface area.
Root surface area: larger teeth will have greater
surface area and handle stress better..
27. D- Intraoral Examination
Evaluation of abutment teeth
F-Prospective abutment
4-Vitality testing.
Prior to any restorative treatment,pulpal health must be assessed by
measuring the response to percussion as well as thermal and
electrical stimulation