Diese Präsentation wurde erfolgreich gemeldet.
Wir verwenden Ihre LinkedIn Profilangaben und Informationen zu Ihren Aktivitäten, um Anzeigen zu personalisieren und Ihnen relevantere Inhalte anzuzeigen. Sie können Ihre Anzeigeneinstellungen jederzeit ändern.
Vinay PavanKumar .K
II year pg. student
Dept of Prosthodontics
AECS Maaruti College of Dental Sciences
Patient
interview
Clinical
Examination
Treatment
planning
•Purpose &
Uniqueness of Rx
•Shared Decision
Making
•General
exa...
“Most clinicians also choose an RPD for a partially
edentulous patient if they need to restore lost residual
ridge, achiev...
According to GPT 8
 Diagnosis : the determination of the nature of a
disease
 Treatment plan : the sequence of procedure...
 The delineation of each patient’s uniqueness
occurs through the patient interview and clinical
examination process.
 Th...
 understanding the patient’s desires or chief
concerns/complaints regarding his or her
condition
 ascertaining the patie...
The dentist should follow a sequence
that includes:
1. Chief complaint and its history
2. Medical history review
3. Dental...
 Personal and psychological factors are
significant to the success of prosthodontic
treatment
 House classification
- Ph...
 The process of clinical examination involves
two stages :
- Medical examination
- Oral examination
A comprehensive medic...
Systemic disordes include:
 Hypertension
 Diabetes
 Pernicious anemia
 Vitamin or nutritional deficiencies
 Osteoporo...
 Climacteric (i.e., menopausal changes)
 Parkinsonism
 Salivary gland disorders
 TM disturbances
 Post radiation ther...
An oral examination should be accomplished in
the following sequence :
 visual examination,
 pain relief and temporary r...
This includes : extra oral and intra oral examination.
TMJ - tenderness, mouth opening deviation & clicking
 No of teeth present with their clinical evaluation
 Malposed teeth
 Carious teeth
 Existing restoration- sensitivity ...
 to determine the need and management of
acute needs and whether a prophylaxis is
required to conduct a thorough oral
exa...
 areas of infection and other pathologies
 the presence of root fragments, foreign objects,
bone spicules and irregular ...
 the presence of root canal fillings
 evaluation of periodontal conditions present
 to evaluate the alveolar support of...
 To locate inferior borders of lingual mandibular
major connectors.
 oral hygiene status before prosthodontic treatment ...
• Anatomic consideration
- Root length, size and form
• vitality tests
• caries evaluation
• Periodontal health
• Malposit...
• Supplements oral examination
• Permit a topographic survey of the dental arch
• Patient education and motivation
• Custo...
 verification of appropriate
mouth modifications for a
removable partial denture.
 To determine the most
desirable path ...
 To determine whether tooth and
bony areas of interference will need
to be eliminated surgically or by
selecting a differ...
• Occlusal plane & relationships
• Abutment tooth contours
• Rest seat areas
• Interarch space
• Residual ridge relation
•...
 The objectives of any prosthodontic treatment
may be stated as follows:
 the elimination of disease
 the preservation,...
 Based on diagnostic findings, The American
College of Prosthodontists (ACP) has
developed a classification system for pa...
 Edentulous area confined to a
single arch
 Abutment conditions -No
preprosthetic therapy is indicated
 Occlusal charac...
 Edentulous area – Both arches
 Abutment- Abutments in 1 or 2
sextants have less tooth
structure or support intra or ext...
 Any posterior maxillary or
mandibular edentulous area
greater than 3 teeth or 2 molars.
Any edentulous areas including
a...
 Entire occlusion must be
reestablished. Class II molar
and jaw relationships are
seen.
 Residual alveolar bone
height o...
 Any edentulous area or
combination of edentulous
areas requiring a high level of
patient compliance
 Abutments in 4 or ...
 Entire occlusion must be
reestablished, including
changes in the occlusal
vertical dimension. Class II
div 2 and Class I...
 Individual diagnostic criteria are evaluated and the
appropriate box is checked. The most advanced finding
determines th...
1. Any single criterion of a more complex class
places the patient into the more complex class.
2. Consideration of future...
4. If there is an esthetic concern/challenge, the
classification is increased in complexity by one
level in Class I and II...
 Implant supported fixed dental prosthesis
 Fixed dental prosthesis
 Removable partial denture
 Complete denture
 Com...
 Distal extension situations
 After recent extractions
 Long span
 Need for cross-arch stabilization
 Excessive loss ...
 It is a communication model
 a process where the provider and the patient
identify together the best course of care.
 ...
Computer-designed
polycarbonate RPD
framework.
Digital partial design and manufacturing: using 3D printing
technology to f...
Valplast RPDs with
anterior flexible nylon
clasps.
A cast metal framework
with metal clasps and
flexible nylon polyamide
r...
Mandibular overlay
unilateral distal extension
RPD with tooth-colored
acrylic resin processed to
the metal framework
Mandi...
Minimize rotation about an axis in a Kennedy
Class I or II arch, or any long modification span
 direct retainers
 rests
Phase I
 Collection and
evaluation of data
 Pain, infection control
 Biopsy
 Patient motivation
Phase II
 Removal of ...
Phase III
 Preprosthetic surgical procedures
 Definitive endodontic procedures
 Definitive restoration of teeth
 Fixed...
Phase IV
 Construction of removable partial denture
 Reinforcement of education and motivation of
patient
Phase V
 Post...
 The four components of a SOAP note are
Subjective, Objective, Assessment, and Plan
 The SOAP note format is used to sta...
 Plan the amount of time and appointment schedule
 Provides information to the patient.
 Estimate the professional fees...
 Carr AB, Brown DT, McCracken’s Removable Partial
Prosthodontics, 12th edition, Canada, Elsevier Publishers,
2011, pp:150...
 McCord JF, Grey JA, Winstanley RB, Johnson A, A
Clinical Overview of Removable Prostheses: 1. Factors
to Consider in Pla...
Diagnosis and treatment planning in removable partial denture
Diagnosis and treatment planning in removable partial denture
Nächste SlideShare
Wird geladen in …5
×

188

Teilen

Herunterladen, um offline zu lesen

Diagnosis and treatment planning in removable partial denture

Herunterladen, um offline zu lesen

diagnosis, treatment planning, intra-oral and abutment evaluation,

Ähnliche Bücher

Kostenlos mit einer 30-tägigen Testversion von Scribd

Alle anzeigen

Ähnliche Hörbücher

Kostenlos mit einer 30-tägigen Testversion von Scribd

Alle anzeigen

Diagnosis and treatment planning in removable partial denture

  1. 1. Vinay PavanKumar .K II year pg. student Dept of Prosthodontics AECS Maaruti College of Dental Sciences
  2. 2. Patient interview Clinical Examination Treatment planning •Purpose & Uniqueness of Rx •Shared Decision Making •General examination •Oral examination •Interpretation of Examination Data •Development & phases of Rx plan
  3. 3. “Most clinicians also choose an RPD for a partially edentulous patient if they need to restore lost residual ridge, achieve appropriate esthetics, increase masticatory efficiency, and improve phonetics but are unable to do so with dental implants or fixed partial dentures due to financial constraints or patient desires” - Bohnenkamp DM Removable Partial Dentures : Clinical Concepts, Dent Clin N Am 58 (2014) 69–89 “Problems related to RPDs may be associated with errors in diagnosis and treatment planning, including inadequate mouth preparation “ - McCord JF et al Dent Update 2003; 30: 88–97
  4. 4. According to GPT 8  Diagnosis : the determination of the nature of a disease  Treatment plan : the sequence of procedures planned for the treatment of a patient after diagnosis
  5. 5.  The delineation of each patient’s uniqueness occurs through the patient interview and clinical examination process.  The ultimate treatment is individualized to address disease management and the coordinated restorative and prosthetic needs that are unique to the patient.
  6. 6.  understanding the patient’s desires or chief concerns/complaints regarding his or her condition  ascertaining the patient’s dental needs through a clinical examination,  developing a treatment plan that reflects the best management of desires and need  Executing appropriately sequenced treatment with planned follow-up
  7. 7. The dentist should follow a sequence that includes: 1. Chief complaint and its history 2. Medical history review 3. Dental history review, especially related to previous prosthetic experience(s) 4. Patient expectations
  8. 8.  Personal and psychological factors are significant to the success of prosthodontic treatment  House classification - Philosophical - Exacting - Hysterical - Indifferent House classification revisited : - Ideal - Submitter - Reluctant - Indifferent - Resistant
  9. 9.  The process of clinical examination involves two stages : - Medical examination - Oral examination A comprehensive medical history includes : - systemic disorders (Chronic degenerative or dysfunctional diseases) - Medication history - Diet - Habits
  10. 10. Systemic disordes include:  Hypertension  Diabetes  Pernicious anemia  Vitamin or nutritional deficiencies  Osteoporosis  Chronic pulmonary disease (i.e.,emphysema and chronic bronchitis)
  11. 11.  Climacteric (i.e., menopausal changes)  Parkinsonism  Salivary gland disorders  TM disturbances  Post radiation therapy  Bell ’ s palsy  Lichen planus  Fungal infections
  12. 12. An oral examination should be accomplished in the following sequence :  visual examination,  pain relief and temporary restorations,  radiographs,  evaluation of abutment and periodontium,  vitality tests of individual teeth,  determination of the floor of the mouth position,  Oral prophylaxis and impressions of each arch.
  13. 13. This includes : extra oral and intra oral examination. TMJ - tenderness, mouth opening deviation & clicking
  14. 14.  No of teeth present with their clinical evaluation  Malposed teeth  Carious teeth  Existing restoration- sensitivity to percussion  Periodontium  Residual ridges  Saliva  Investing structures  Occlusion and occlusal plane  Oral hygiene index
  15. 15.  to determine the need and management of acute needs and whether a prophylaxis is required to conduct a thorough oral examination.  to relieve discomfort arising from tooth defects  the extent of caries and arrest further caries activity
  16. 16.  areas of infection and other pathologies  the presence of root fragments, foreign objects, bone spicules and irregular ridge formations  the presence and extent of caries and the relation of carious lesions to the pulp and periodontal attachment  evaluation of existing restorations : evidence of recurrent caries, marginal leakage, and overhanging gingival margins
  17. 17.  the presence of root canal fillings  evaluation of periodontal conditions present  to evaluate the alveolar support of abutment teeth, their number, the supporting length and morphology of their roots  the relative amount of alveolar bone loss suffered through pathogenic processes, and the amount of alveolar support remaining
  18. 18.  To locate inferior borders of lingual mandibular major connectors.  oral hygiene status before prosthodontic treatment is important.  The impression for the diagnostic cast is usually made with an irreversible hydrocolloid in a stock (perforated or rim lock) impression tray.
  19. 19. • Anatomic consideration - Root length, size and form • vitality tests • caries evaluation • Periodontal health • Malpositions • Analysis of Occlusal Factors
  20. 20. • Supplements oral examination • Permit a topographic survey of the dental arch • Patient education and motivation • Custom tray fabrication • Constant reference • Patient's record
  21. 21.  verification of appropriate mouth modifications for a removable partial denture.  To determine the most desirable path of placement that will eliminate or minimize interference to placement and removal  To locate and measure areas of the teeth that may be used for retention
  22. 22.  To determine whether tooth and bony areas of interference will need to be eliminated surgically or by selecting a different path of placement  To determine the most suitable path of placement that will permit locating retainers and artificial teeth to the best esthetic advantage.  To permit an accurate charting of the mouth preparation to be made including the preparation of proximal tooth surfaces to provide guiding
  23. 23. • Occlusal plane & relationships • Abutment tooth contours • Rest seat areas • Interarch space • Residual ridge relation • Tissue contours
  24. 24.  The objectives of any prosthodontic treatment may be stated as follows:  the elimination of disease  the preservation, restoration, and maintenance of the health of the remaining teeth and oral tissues  the selected replacement of lost teeth; for the purpose of restoration of function  comfort and in esthetically pleasing manner
  25. 25.  Based on diagnostic findings, The American College of Prosthodontists (ACP) has developed a classification system for partial edentulism  Criteria 1: Location and extent of the edentulous area(s)  Criteria 2: Abutment conditions  Criteria 3: Occlusion  Criteria 4: Residual ridge
  26. 26.  Edentulous area confined to a single arch  Abutment conditions -No preprosthetic therapy is indicated  Occlusal characteristics- Class I molar jaw relationships are seen  Residual bone height of ≥21 mm
  27. 27.  Edentulous area – Both arches  Abutment- Abutments in 1 or 2 sextants have less tooth structure or support intra or extra coronal restorations  Occlusion- Localized adjunctive therapy Class I molar and jaw relationships are seen  Residual bone height of 16 to 20 mm
  28. 28.  Any posterior maxillary or mandibular edentulous area greater than 3 teeth or 2 molars. Any edentulous areas including anterior and posterior areas of 3 or more teeth.  Abutments in 3 sextants have insufficient tooth structure to retain or support intracoronal or extracoronal restorations.
  29. 29.  Entire occlusion must be reestablished. Class II molar and jaw relationships are seen.  Residual alveolar bone height of 11 to 15 mm
  30. 30.  Any edentulous area or combination of edentulous areas requiring a high level of patient compliance  Abutments in 4 or more sextants have insufficient tooth structure to retain or support intracoronal or extracoronal restorations.
  31. 31.  Entire occlusion must be reestablished, including changes in the occlusal vertical dimension. Class II div 2 and Class III molar and jaw relationships are seen.  Residual vertical bone height of ≤10 mm
  32. 32.  Individual diagnostic criteria are evaluated and the appropriate box is checked. The most advanced finding determines the final classification Classification System for Partial Edentulism, Journal of Prosthodontics Vol. 11, no. 3, 2002: 181 – 193.
  33. 33. 1. Any single criterion of a more complex class places the patient into the more complex class. 2. Consideration of future treatment procedures must not influence the diagnostic level. 3. Initial preprosthetic treatment and/or adjunctive therapy can change the initial classification level.
  34. 34. 4. If there is an esthetic concern/challenge, the classification is increased in complexity by one level in Class I and II patients. 5. In the presence of TMD symptoms, the classification is increased in complexity by one or more levels in Class I and II patients. 6. In the situation where the patient presents with an edentulous mandible opposing a partially edentulous or dentate maxilla, Class IV.
  35. 35.  Implant supported fixed dental prosthesis  Fixed dental prosthesis  Removable partial denture  Complete denture  Combination of the above  No treatment at all
  36. 36.  Distal extension situations  After recent extractions  Long span  Need for cross-arch stabilization  Excessive loss of residual bone  Sound abutment teeth  Abutment with guarded prognosis  Economic considerations
  37. 37.  It is a communication model  a process where the provider and the patient identify together the best course of care.  it addresses the need to fully inform patients about risks and benefits of care options  ensures that patient values and preferences play a prominent role in the process.
  38. 38. Computer-designed polycarbonate RPD framework. Digital partial design and manufacturing: using 3D printing technology to fabricate RPD frameworks
  39. 39. Valplast RPDs with anterior flexible nylon clasps. A cast metal framework with metal clasps and flexible nylon polyamide retentive clasps Bohnenkamp DM Removable Partial Dentures : Clinical Concepts, Dent Clin N Am 2014; 58: 69–89
  40. 40. Mandibular overlay unilateral distal extension RPD with tooth-colored acrylic resin processed to the metal framework Mandibular overlay RPD metal framework Bohnenkamp DM Removable Partial Dentures : Clinical Concepts, Dent Clin N Am 2014; 58: 69–89
  41. 41. Minimize rotation about an axis in a Kennedy Class I or II arch, or any long modification span  direct retainers  rests
  42. 42. Phase I  Collection and evaluation of data  Pain, infection control  Biopsy  Patient motivation Phase II  Removal of deep caries  Extirpation of necrotic pulp  Extraction of non- retainable teeth  Periodontal treatment  Interim prosthesis  Occlusal equilibrium  Patient education
  43. 43. Phase III  Preprosthetic surgical procedures  Definitive endodontic procedures  Definitive restoration of teeth  Fixed partial denture construction  Reinforcement of education and motivation of the patient
  44. 44. Phase IV  Construction of removable partial denture  Reinforcement of education and motivation of patient Phase V  Post insertion care  Periodic recall  Reinforcement of education and motivation of patient.
  45. 45.  The four components of a SOAP note are Subjective, Objective, Assessment, and Plan  The SOAP note format is used to standardize medical evaluation entries made in clinical records. The SOAP note is written to facilitate improved communication among all involved in caring for the patient and to display the assessment, problems and plans in an organized format.
  46. 46.  Plan the amount of time and appointment schedule  Provides information to the patient.  Estimate the professional fees for the treatment.  Coordinate the schedule for dental laboratory procedures  Meet the legal requirements of informed consent
  47. 47.  Carr AB, Brown DT, McCracken’s Removable Partial Prosthodontics, 12th edition, Canada, Elsevier Publishers, 2011, pp:150-184  Stewart, Rudd, Kuebkar, Clinical Removable Partial Prosthodontics, 2nd edition, India, All India Publishers and Distributors, 2001, pp:117-220  Jones DJ,Gracia LT, Removable Partial Dentures : A Clinician’s guide, 1st edition, Singapore, Wiley-Blackwell, 2009, pp : 11-38  Garry TJ, Nimmo A, Skiba JF, Ahlstrom RH, Smith CR, Koumjian JH, Arbree NS, Classification system for partial edentulism, J Prosthodont 2002;11,3:181-193
  48. 48.  McCord JF, Grey JA, Winstanley RB, Johnson A, A Clinical Overview of Removable Prostheses: 1. Factors to Consider in Planning a Removable Partial Denture, Dent Update 2002; 29: 376-381  Bohnenkamp DM Removable Partial Dentures : Clinical Concepts, Dent Clin N Am 2014; 58: 69–89  Gamer et al, M. M. House mental classification revisited: Intersection of particular patient types and particular dentist’s needs, J Prosthet Dent 2003;89:297- 302  Davenport JC, Basker RM, Heath JR, Ralph JP, Glantz PO, The removable partial denture equation, Brit Dent J 2000; 189: 414–424
  • ZuhraAli1

    Sep. 21, 2021
  • KhadijaBizgarn

    Sep. 13, 2021
  • rubasreebalu1

    Jun. 14, 2021
  • PragallapatiHarika

    Apr. 15, 2021
  • arumirza

    Apr. 2, 2021
  • anashmiaslmi

    Mar. 24, 2021
  • ssuser709280

    Mar. 24, 2021
  • DR0s0s

    Mar. 17, 2021
  • MonikaaPenumallu

    Feb. 19, 2021
  • DakshitaAgarwal1

    Jan. 5, 2021
  • ChandiniYerubandi

    Dec. 26, 2020
  • NoorFahim

    Nov. 20, 2020
  • KhushbuBaraiya

    Oct. 10, 2020
  • tugcesahn

    Oct. 6, 2020
  • RahulAjith7

    Oct. 6, 2020
  • SanikaPatil10

    Aug. 29, 2020
  • SrikarMannan

    Aug. 18, 2020
  • RadhikavsVs

    Jul. 3, 2020
  • GayathriSA1

    Jul. 2, 2020
  • DrsridharChowdary

    Apr. 25, 2020

diagnosis, treatment planning, intra-oral and abutment evaluation,

Aufrufe

Aufrufe insgesamt

54.900

Auf Slideshare

0

Aus Einbettungen

0

Anzahl der Einbettungen

84

Befehle

Downloads

2.459

Geteilt

0

Kommentare

0

Likes

188

×