RPD - Then Turkey!

lunalovegood's version from 2015-11-23 04:09

Section 1

Question Answer
Retention. Interferences. Esthetics. Guiding Planes. 4 keystones of RPD design
The most desirable undercuts are...equal and balanced (the least amount necessary)
You can avoid them, block them out, or eliminate via surgery or different path of placement.interferences
These ensure predictable clasp retention and increasing their length increases frictional retention.Guiding planes
Retentive arm is ___ suprabulge and ___ infrabulge.2/3, 1/3
T/F - The entire RECIPROCATING arm is suprabulge.T (exits in middle 1/3 of tooth)
Surveying - You want to eliminate ___ and ___ tissue interferences.hard and soft
Increasing the length of guide plane also increases...frictional retention and resistance to rotation
Width of Guide Plane - widest portion of ___ ___, ___ B-L width of tooth, or ___ the distance between cusp tips.occlusal rest, 1/3 , 1/2
Tooth supported abutments _________-__mm and tissue supported _________-__mm.3-4mm and 1.5-2mm
Rest seats - reduce the marginal ridge by _________-__mm and the deepest part _________-__mm.1-1.5mm and 1.5-2mm
When are embrasure rests normally used?when no posterior modification space is present
Why would you use a hooded rest?for increased occlusal support, to decrease torque by lowering center of rotation (fyi mandibular 1st premolars only, never on distal abutment, 1-1.5mm reduction)
Why are incisal rests bad?poor esthetics, occlusal interference, increased torque forces (fyi primarily used as an indirect retainer and/or auxiliary rest)
Sequence - GORRPguide planes, occlusal adjustments, rest seats, reposition survey lines, polish prepared surfaces
To prepare guide plane in the mouth, you can use a straight fissure _________ or ___.bur or diamond
To reposition survey line in mouth, you can use a tapered _________ or ___.carbide or diamond
To create undercuts in the mouth, you can use a football ___ or ___.carbide or diamond


Question Answer
One path of placement/removalguide plane
Ensure intended action of RPD componentsguide plane
Eliminate/decrease gross food trapsguide plane
Increase frictional component of minor connectorsguide plane
Lowers HoC on proximal surfaces to allow better positioning of armsguide plane
Directs forces down long axis of teethrests
Prevents cervical movement of RPDrests
Limits lateral movement of RPDrests, minor connectors
Maintains retentive arm in proper vertical relationrests
Improves the occlusal planerests
Reduces proximal dead spacesurvey line repositioning
Easy passage of retainer armssurvey line repositioning
Esthetic placement of retainer armssurvey line repositioning
Transfer functional stress to abutmentsminor connectors
Transfer effect of retainers, rest, and stabilizing components to the rest of the denture (abutment to prosthesis)minor connectors
Unite retainers, rests, and denture base to the major connectorminor connector
Prevent/minimize framework bending during packing/processing procedurescast stops
Assists direct retainer to prevent displacement of distal extension by level action on opposite side of fulcrum line when denture base moves away from tissue in pure rotation about fulcrum lineindirect retainer


Question Answer
Rigiditymajor connector
Provides vertical support and protects soft tissuemajor connector
Provide a means for obtaining indirect retention where indicatedmajor connector
Provide means for placement of 1 or more denture basesmajor connector
Promote patient comfortmajor connector


Maxillary Major Connector Stuff MOSTLY
Question Answer
Location of major connectors affected by desire to avoid...tissue impingement, tongue irritation, food impaction, gagging, and ending in incisal 1/3 of anterior teeth
In the MAXILLARY, the major connector is __mm from free gingival margin.6mm
In the MANDIBULAR, the major connector is __mm from free gingival margin.3mm
Your patient has a short-span class III. What connector could you use?palatal bar (generally we don't like this)
Where can you definitely not use a palatal bar?anterior to the 2nd premolars
Palatal Bar - advantages?few, not mentioned, should be avoided if possible
Palatal Bar - disadvantages?bulky (rigidity), uncomfortable to pt, little vertical support from bony palate, support comes from rests on remaining teeth
Palatal Strap - Ant-Post dimension should be at least __mm for proper rigidity.8mm
Palatal Strap - advantages?thin, but rigid - minimal tissue coverage (HOWFUCKINGEVER a disadvantage is increased tissue coverage. idk)
Palatal Strap - disadvantages?bulky, increased tissue coverage, may be objectionable to pt
Anteroposterior palatal bar - anterior is ___ like palatal ___. Posterior is half ____ like palatal ___.flat, palatal strap - oval, palatal bar
Anteroposterior palatal bar - advantages?rigidity, minimizes soft tissue coverage, palatal tori that cannot be removed
Anteroposterior palatal bar - disadvantages?may be bothersome to tongue/interfere with phonetics, contraindicated in pts with reduced periodontal support
Thin band of metal running along the lingual surfaces of remaining teeth and extending on palatal tissues 6-8mm.horseshoe connector
Horseshoe connector - anterior border? posterior border?anterior terminates in valley of rugae OR on cingula of anterior teeth, posterior located at turning point of palate
Horseshoe connector - indications?large inoperable torus, severe palatal undercuts lingual to posteriors, when anterior teeth are being replaced
Horseshoe connector - contraindications?ANYTIME another connector can be used, large distal extensions
Horseshoe connector - advantages?conforms to pt's previous experience
Horseshoe connector - disadvantages?flexibility, required additional bulk for rigidity
Anteroposterior palatal STRAP - each strap should be at least __mm8mm
Anteroposterior palatal STRAP - borders should be kept _________ mm from the free gingival margin.6mm
Anteroposterior palatal STRAP - if the anterior teeth are not being replaced, where should the anterior strap be located?as posterior as possible
Anteroposterior palatal STRAP - the open area should be at least _________ x _________ mm2 x 15 mm
Anteroposterior palatal STRAP - indications?circumvent torus, tissue support not a vital need, strong widely separated abutments (class II or large class III), pt. preference
Anteroposterior palatal STRAP - contraindications?high narrow vaults, phonetic interference, some maxillary designs due to narrow bulky straps
Anteroposterior palatal STRAP - advantages?rigidity, minimal tissue coverage
Anteroposterior palatal STRAP - disadvantages?poor tissue support, food entrapment, deglutition impeded by posterior bar, extensive length of borders can irritate tongue, difficult to cast accurately
Provides the greatest tissue coverage and ultimate rigidity.complete palate, palatal plate
Palatal plate - use the PPS like in dentures?no no no!
Palatal plate - anterior border? posterior border?anterior border between rugae valleys and 6mm from gingival margin OR cover cingula of anterior teeth, posterior border is hard and soft tissue junction
Palatal plate - indications?ALL CLASS I and most Class II, when maximum support and additional retention are necessary, cleft palate patients, heavy occlusal forces, anterior teeth replacement
Palatal plate - contraindications?may interfere with phonetics, severely undercut torus
Palatal plate - advantages?rigidity, uniformly thin plate, reproduces palatal contours, interfacial surface tension increases retention, good thermal conductivity, more resistant to C. Albicans
Palatal plate - disadvantages?pt objects to broad coverage, more difficult to cast and fit, pt. prone to develop soft tissue hyperplasia
Minor elevations that slightly displace soft tissuebead lines
Bead lines - width and depth ?0.5mm - 1mm
Bead lines - purpose?mechanical seal, prevent food packing, guide for finishing, compensates for casting inaccuracies, increases rigidity


Palatal Strap Yes or No?
Question Answer
Class IIIyes
Class I and IIno
Small posterior edentulous areayes
Minimal tissue support requiredyes
Pt. preferenceyes
Severe palatal undercutsno
Large torusno
RPD to replace anterior teethno
Definitive support for palatal tissue requiredno


Question Answer
Lingual bar - Superior border is _________-__mm inferior to gingival margin4-6mm
Lingual bar - Inferior border is height of ___ ___ with tongue slightly elevated.lingual sulcus
Lingual bar - I'm confused. So our superior border is 4-6mm inferior to gingival margin, BUT our bar height minimum is __mm and it mentions allowing 3mm of space between gingival margins and superior border of bar. Sayyy what that math don't add up.4-6
Lingual bar - Indications?8-9mm between floor and free ging margin, tooth supported applications, anterior teeth do not require stabilization, loss of anterior not contemplated, pt preference, severely overlap anteriors, wide diastemas present
Lingual bar - Contraindications?shallow floor of mouth, prominent frenum, inoperable tori, teeth in linguoversion, teeth require stabilization, contingency planning
Lingual bar - Advantages?simplicity, least tissue and tooth coverage, less tongue interference when properly placed, easier to eval fit of framework, esthetics
Lingual bar - Disadvantages?increased bulk for rigidity, minimal stabilization of RPD, may interfere with patient's tongue, decreased support for the RPD (no issue contact)
T/F - Relief should be provided beneath a major connector to prevent its settling into areas of possible interference, such as inoperable tori or elevated median palatal sutures.T
T/F - Appropriate relief beneath major connector avoids the need for its adjustment after tissue damage has occurred.T
A lingual plate and lingual bar are browsing through cosmo magazine and both are like OMG WE ARE BOTH SO ___ ___ shaped!half-pear shaped
Like a lingual bar, but with thin, solid piece of metal extending from its superior border, carried onto the lingual surfaces of the teeth and presents a scalloped appearance.lingual plate
Lingual plate - where do the supporting rests need to be?no further posterior than mesial fossae of the first premolars
Lingual plate - superior border? inferior border?superior border is in intimate contact with lingual surfaces of teeth above cingula, inferior border at height of alveolar lingual sulcus with tongue elevated
Lingual plate - Indications?prominent frenum, high floor of mouth, anterior tooth stabilization, contingency planning, enhance rigidity with minimal bulk, large tori
Lingual plate - Contraindications?prominent diastemas, severely overlap anteriors, teeth in linguoversion
Lingual plate - Advantages?increased rigidity w/o prominent bulk, can be used to splint periodontally compromised teeth, contingency planning
Lingual plate - Disadvantages?extensive tooth coverage, may promote decalcification/perio problems, more difficult to assure fit
Characteristics of both lingual bar and lingual plate.double lingual bar
Double lingual bar - Rests should be placed at each end of the ____ bar.upper (no further posterior than mesial fossae of the first premolars)
Double lingual bar aka...Kennedy bar
Double lingual bar - upper bar should be _________-_________ mm in height and __mm in thickness.2-3mm wide and 1mm thick
Double lingual bar - Advantages?extends indirect retention in anterior direction, contributes to horizontal stabilization of the prosthesis, allows free flow of saliva and the marginal gingiva receives natural stimulation
Double lingual bar - Disadvantages?tendency to trap debris, irritating to tongue
Longer than other mandibular major connects to ensure rigidity, more height and thicker. Superior border at least 4mm from buccal and labial free gingival margin, inferior border is located at the junction of the attached and unattached mucosa.labial bar
Labial bar - Indications?lingual inclined anterior or posterior teeth, prominent superiorly located inoperable tori
Labial bar - Contraindications?where tooth positioning will permit any other connector!
Labial bar - Advantages?permits RPD to be fabricated (lol)
Labial bar - Disadvantages?difficult to fabricate, must be bulky to be rigid, ugly, traps food in vestibular area, pt acceptance generally poor (distorts lower lip unless relatively immobile)


Question Answer
Name 3 things minor connectors join to major connector.clasp assembly, indirect retainers/auxiliary rests, denture base
T/F - The approach arm for vertical projection or bar type clasp is a minor connector.T
Minor connectors must be RIGID, need BULK for that. Must be positioned so they don't ___ oral tissues. Located on ____ ___ next to edentulous area or lingual embrasure. They are broad ___-___ and thin _________-_________ for easier/natural placement of prosthetic tooth.irritate, proximal surfaces, B-L and M-D
Maxillary extension - how far?as far posterior as possible
Mandibular extension - how far?2/3 the length of the edentulous ridge
Denture to MajConr - longitudinal and transverse struts that form ladder-like network, can be used whenever multiple teeth are being construction
Denture to MajConr - should longitudinal struts be positioned along the crest of the ridge?no no no no no!
Denture to Maj Conr - Rigid metallic screen, difficult to pack acrylic, small openings mean weaker attachment, may interfere with the arrangement of teeth mesh construction
Distal extension, 2x2mm depression incorporated during waxing process to the posterior strut of minor connector crossing the center of the ridge.Cast stops
Prevent/minimize framework bending during packing/processing procedurescast stops
Often used in conjuction with metal denture basesbead, nailhead or wire construction
Cast fit directly against underlying soft tissues, no relief beneathbead, nailhead or wire construction
Bead, nailhead, or wire construction - Advantages?improved hygiene and enhanced thermal stimulation
Bead, nailhead, or wire construction - Disadvantages?Difficulty adjusting and relining cast metal bases and weak attachment to resin
Bead, nailhead, or wire construction - Indications?short-span, tooth supported applications in patients with well-healed ridges
Approach arms for bar-type clasps - approaches tooth from ___ directionapical
Approach arms for bar-type clasps - must not cross ...soft tissue undercut