View
201
Download
0
Category
Tags:
Preview:
Citation preview
Unusual design, Swinglock, Rotational, Attachments
RPD III (3207-417) 2hr0900-1100 Aug 27, 2010Vichet Chindavanigวเชฏฐ จนดาวณค
Intro. Unusual design
Ordinary RPD uses straight guiding plane directing path of placement and removal.
Some situations where key abutments are insufficient or the available abutments are mobile.
Unusual designs may accommodate retention and reduce RPD component
ฟนปลอมบางสวนถอดไดทวไปใชระนาบน าทเปนเสนตรง ประกอบใชก าหนดทศการใส-ถอดชนฟนปลอม
บางสถานการณ ฟนหลกส าคญมไมพอ หรอฟนหลกซตางๆ นนโยก
ลกษณะออกแบบไมธรรมดานชวยตอแรงยด อาจลดสวน-ประกอบโครงสรางฟนปลอม
Vichet Chindavanig วเชฏฐ จนดาวณค
Objectives
Able to justify which clasp should be applied in certain situations (bar v.s. circumfer.)
Introduction to precision attachments, coping and telescopic dentures
Understanding the indications, contraindications, and how-to for the following design
Rotational: AP, PA, unilateral
Swinglock design
Vichet Chindavanig วเชฏฐ จนดาวณค
Objectives
สามารถตดสนใจเลอกประเภทตะขอได (ตะขอแทง กบตะขอโอบรอบ) กบสถานการณจ าเพาะหนงใด
แนะน าใหรจก หนวยยดแมนย า ครอบตอฟน และฟนปลอมครอบตอฟน ฟนปลอมครอมหลก
เขาใจ รจกขอบงช ขอหามใชตางๆ และการออกแบบฟนปลอมเคลอนหมน แบบตางๆ ฟนปลอมลอคยดดวยบานพบ
Vichet Chindavanig วเชฏฐ จนดาวณค
Preamble ปฐมบท
See "The Dentist Of Jaipur" // a funny shortfilm by Falk Peplinski
http://www.youtube.com/watch?v=WR8tIjTykbE 4:40min.
Fact -where socioeconomic and number of qualified
dentists are not sufficient
Nature of Complete dentures
Starts from empty space
Retention < ?
Stability < ?
Chewing efficiency < ?
Vichet Chindavanig วเชฏฐ จนดาวณค
Photos by Jim Collis CDT
http://www.youtube.com/watch?v=jBbZNdUbLJM
Nature of Crown & bridges
Cut tooth >
Leak ?
Break ?
Cost ?
Vichet Chindavanig วเชฏฐ จนดาวณค
Nature of Crown & bridges
Cut natural tooth structures
Good for structural damaged teeth
Decay potential from leaking, open margin, short margin
Vichet Chindavanig วเชฏฐ จนดาวณค
Blockout die before waxing
Nature of RPDs
Vichet Chindavanig วเชฏฐ จนดาวณค
Selecting components and designing decision are more difficult than CD, C&B ?
Nature of RPDs / requirements
Vichet Chindavanig วเชฏฐ จนดาวณค
Placing on both hard and soft tissues
Design > biomechanics ?
Pain free when used ?
Is retention adequate ?
Esthetics ?
Get along with remaining teeth?
Occlusal scheme variation?
จาก Brudvick JS. ADV Rem Partial Dentures. Quintessence Pub.
1999
End results solving problems (RPD) digital technology
Computor aid design (cad)
http://www.youtube.com/watch?v=aSy0P6Sa3C8
2:09min.
http://www.youtube.com/watch?v=XA_i8GCWBp
A&feature=related 2:13min. Investment cost?
Conventional design (various types) from U of
Michigan, an old lecture, but being principles
http://www.youtube.com/watch?v=L0bdNpCZVck&feature=related 47:56min.
Vichet Chindavanig วเชฏฐ จนดาวณค
End results solving problems (RPD) wrought wire
The difference between bar clasps and
circumferential clasps (Push-Pull)
Retention, esthetics, nature of mechanics?
Vichet Chindavanig วเชฏฐ จนดาวณค
การใชลวดรด (wrought wire) กบบางสถานการณ
Vichet Chindavanig วเชฏฐ จนดาวณคPrefabricated connector wire and Ball clasps
การใชลวดรด (wrought wire) กบบางสถานการณ
Vichet Chindavanig วเชฏฐ จนดาวณค
แถวบน ภาพ Spoon dentures จาก Osborne J, Lamie GA
Partial dentures. 2nd ed, OxfordBalkwell Scientific Publications, 1959
End results solving problems (RPD) :bar clasp
A bar clasp provides more retentive force
than a circumferential clasp (same angle
of convergence, and same degree of
undercut)
Why? Because bar clasp -is a push type
(ชนดดน), circumferential clasp -is a drag type (ชนดดง). ใหเปรยบเทยบกบการเขนลอรถตะกราของรานสรรพสนคา ขามสงกดขวางลกระนาด เขน-ดง ตางกน?
Vichet Chindavanig วเชฏฐ จนดาวณค
End results solving problems (RPD)
Vichet Chindavanig วเชฏฐ จนดาวณค
Application of bar clasps
End results solving problems (RPD)
Swinglock removable partial denture
Multiple push type clasp being completely locked by a hinge and latch (บานพบ และขอเกยว)
Do not allow RPD movements
Vichet Chindavanig วเชฏฐ จนดาวณค
End results solving problems (RPD)
Precision attachments Need more work, tools, precision (less margin of error
and expense
Vichet Chindavanig วเชฏฐ จนดาวณค
Activating, and attachment removal tools
Nature of its structures
End results solving problems (RPD)
Precision attachments
ด http://www.preat.com/ceka.html
Vichet Chindavanig วเชฏฐ จนดาวณคComplete overdenture
Removable partial denture
Attachments - nature
Vichet Chindavanig วเชฏฐ จนดาวณค
Require abutment restoration – crown,
root cap, root canal treatment, tooth splinting, tooth decoronate (ตดซฟน)
Provide esthetics (no clasp is seen)
Splint abutment (where distal extension is presence or abutments are not strong)
Rotational design
Vichet Chindavanig วเชฏฐ จนดาวณค
Rotational design
AP, PA, and unilateral design
End result – rotational design
Reducing parts (clasp?)
Not reducing RPD retention (lock?)
Serve esthetics demand (attachment?)
Vichet Chindavanig วเชฏฐ จนดาวณค
How to make clasp
fit to the abutment ?
How to reduce number of the clasp?
Many clasp?
Nature of RPDs คดทบทวนกอน?
How do they work?
A piece of rigid material
formed into anatomical
structures to which
replacing missing organs.
Arch integrity >
chewing
capability >occlusal
anatomy (Link to
Posselt and computor animation)
RPD ท างานไดอยางไร ชนวสดแขงตรง สรางรปเปน
โครงสรางกายวภาคตางๆ ททดแทนอวยวะสวนทสญเสยไป
โคงขากรรไกรทตอเนอง > ประสทธภาพการบดเคยว
ความสามารถบดเคยว > ขนกบรปกายวภาคฟน
ดการเคลอนขากรรไกร 0:46min.
http://www.youtube.com/watch?v=9rA7VPUQqPQ
Vichet Chindavanig วเชฏฐ จนดาวณค
End Part 1
Vichet Chindavanig วเชฏฐ จนดาวณค
Rotational designremovable partial denture
Part 2; In detail
ฟนปลอมบางสวนถอดไดเคลอนหมน
Vichet Chindavanig วเชฏฐ จนดาวณค
Objectives
Understand the principles, classifications
Indications and advantages
Techniques in clinical and laboratory
Apply factual knowledge to general design
Vichet Chindavanig วเชฏฐ จนดาวณค
Principles
Utilize undercut at proximal surface of
abutment teeth as retentive area for rigid
proximal plate. This undercut and
projection of metal part will provide
reasonable retentive force to RPDs.
Eliminate and reduce unnecessary conventional clasps.
Vichet Chindavanig วเชฏฐ จนดาวณค
Classification; rotational design
posterior teeth
placement AP, P
anterior teeth
placement
unilateral
ใสฟนหลง หมนหนา-หลง, หมนหลง-หนา
ใสฟนหนา ใสซกเดยว
Vichet Chindavanig วเชฏฐ จนดาวณค
หลกการ –ใชกบจ าแนกเคนเนดท 3
AP, PA เหมาะกบ Kennedy class III,
modification 1 ทลกษณะชองวางสมมาตรกน มฟนหลงซสดทายลม
Unilateral เหมาะกบ Kennedy class III ทไมมชองวางทสอง
Missing anterior teeth-no clasp at abutment next to the spacing
Vichet Chindavanig วเชฏฐ จนดาวณค
หลกการ -ใชสวนคอดดานประชดของฟนลมยด
ขากรรไกรลางซสดทายไมตองมตะขอ
Vichet Chindavanig วเชฏฐ จนดาวณค
Ordinary RPD
Rotational design
เมอใชใสฟนหลง ขากรรไกรบน
จากเอกสารของ Krol, Finzen –ขาพเจา มความเหนแยงวา ธรรมชาตฟนกรามซบน มกมสวนคอดดานไกลกลางนอยไปหรออาจไมพอ ควรโอบตะขอจากดานไกลกลางจบพนทคอดดานใกลกลาง การเหนแยงนอาจน าไปสแบบโครงสรางทดกวา ดงลกษณะตะขอทภาพสไลดท 16 บนขวา
Vichet Chindavanig วเชฏฐ จนดาวณค
Unilateral - ใสฟนซกเดยว
มตะขอตวเดยว ซฟนประชดเหงอกวางไมมตะขอ
ใชสวนคอดทดานไกลกลางฟนหนา, ดานใกลกลางกรามนอย ใชแผนประชด (proximal plate) เขาจบพนทคอดคอฟน
Unilateral rotational RPDOne clasp retained RPD
Vichet Chindavanig วเชฏฐ จนดาวณค
เมอใชใสฟนหนา ขากรรไกรบน
ไมมตะขอทฟนเขยว, ใชสวนคอดดานประชดเหงอกวาง แผนประชดเขายดในพนทคอดกอน, ตะขอโอบรอบทฟนกราม
จงใสลงเขาทภายหลง
Vichet Chindavanig วเชฏฐ จนดาวณค
Indications and advantages
Some modification areas and abutments
adjacent to those modification areas may
not have proper contour for conventional
clasps.
Anterior edentulous area and abutments
next to those areas may not suitable to
place conventional clasps, because it is contradictory to esthetics of the patient.
Vichet Chindavanig วเชฏฐ จนดาวณค
Indications and advantages
Reduction of clasps will affect directly to
esthetics, amount of plaque adhesion to
abutment tooth.
Without addition modification for retentive
areas as conventional clasp, tooth
structure is preserved.
Vichet Chindavanig วเชฏฐ จนดาวณค
Techniques in clinical and laboratory
Indicate and measure the amount of
undercut on proximal area of abutment
tooth
How…
Vichet Chindavanig วเชฏฐ จนดาวณค
Clinical and laboratory techniques
Indicate and mark tripod that relates to
path of placement in two different marks.
Measure amount of undercuts
Alteration of tooth contour in a duplicate
cast before working in patient’s mouth
Laboratory instruction and order form
Vichet Chindavanig วเชฏฐ จนดาวณค
Rotational design
Example
Vichet Chindavanig วเชฏฐ จนดาวณค
References/further reading
Removable partial dentures with rotational paths of insertion: Problem analysis. Firtell D., Jacobson T. E., JPD 1983 July, Vol. 50 No.1, pp. 8-15
Rest seat designs for inclined posterior abutments: A photoelastic comparison. Sansom B., Flinton R.J., Parks V.J., Pelleu Jr. G. B., Kingman A. JPD. 1987 July, Vol.58 No.1, pp. 57-61
Vichet Chindavanig วเชฏฐ จนดาวณค
References/further reading
Dual-path design for removable partial dentures. King G. E. JPD 1978. Apr., Vol.39, No.4, pp. 392-395
Rotational path removable partial denture design. Jacobson T. E., Krol A. J., JPD 1982. Vol.48, No.4, pp. 370-376
Satisfying esthetic demands with rotational path partial dentures. JADA 1982. Sept.,Vol.105, pp. 460-465
Vichet Chindavanig วเชฏฐ จนดาวณค
References/further reading
A new clasping system for unilateral distal
extension removable partial dentures.
Garver D. G., JPD. 1978, Mar.,Vol.39, pp.
268-273
Cosmetic and removable partial dentures-
The Class IV partially edentulous patient.
Zarb G. A., Mackay H. F., JPD 1981 Oct.
Vol.46, No.4, pp. 360-368
Vichet Chindavanig วเชฏฐ จนดาวณค
References/further reading
Design variations of the rotational path
removable partial denture. Schwartz R. S.,
Murchison D. G., JPD 1987, Sept. Vol.58, No.3, pp. 336-338
Vichet Chindavanig วเชฏฐ จนดาวณค
Int J Prosthodont. 1988 Jul-Aug;1(1):17-27.Rotational path removable partial dentures: Part 1. Replacement of posterior teeth.Krol AJ, Finzen FC.
Int J Prosthodont. 1988 Sep-Oct;1(2):135-42.Rotational path removable partial dentures: Part 2. Replacement of anterior teeth.Krol AJ, Finzen FC.
ขอคดเหน
แนวคดเรองสวนพก (เรสท) ขนาดยาว ท าใหเสยเนอฟนมาก แตขอดนนจะไดจดหมนทไกลจากสวนคอด
แนวคดเรองสวนพกทลก ท าใหเสยเนอฟนมาก แตขอดนนจะไดระนาบน า (guiding plane) จากความลก
แนวคดเรองขยายสวนพกเปนรปดอกจก (ไพปอก) ท าใหเสยเนอฟนมาก แตขอดนนจะใหการโอบลอม (encirclement)
ภายในซฟน
Vichet Chindavanig วเชฏฐ จนดาวณค
Swing-lock design
Part 3; In detail
ฟนปลอมลอคยดดวยบานพบ
Vichet Chindavanig วเชฏฐ จนดาวณค
Objectives/contents
Principle of the design
Indications/advantag-es
Contraindication/dis-advantages
Clinical techniques
Laboratory techniques
Lab-dentist communication
ใชตะขอแทงหลายตว แขงตรง เหมาะกบกรณฟนหลกนอย ไม
แขงแรง ขาดหลกส าคญ ไมเหมาะกบผดแลความสะอาด
ไมด สามารถทางมอต า ความงามไมด
ใชบานพบ และขอเกยว ก าหนดต าแหนงชดเจน วาดภาพ
ตรวจโครงขผงกอนเหวยงโลหะ
Vichet Chindavanig วเชฏฐ จนดาวณค
Principles of the design
Form and component parts
Consist of latch and hinge, with labial bar
that has multiple bar clasps
Major connector is a lingual plate
Multiple rest seats
May consisting with other clasps if there are modification space(s)
Vichet Chindavanig วเชฏฐ จนดาวณค
Principles of the design
Vichet Chindavanig วเชฏฐ จนดาวณค
Principles of the design
เปนฟนปลอมบางสวนชนดถอดไดโครงสรางเปนโลหะหลอ มแผนดานลนและดานเพดาน มแทงโลหะดานขางแกมหรอรมฝปาก (LABIAL BAR) ทเปดปดไดดวยบานพบ และจะมตะขอในรปของตะขอแทง (BAR CLASP) ตอตงฉากขนมาจากแทงโลหะดานขางแกมหรอรมฝปากนน การลอคยดแทงโลหะทท าหนาทเปนหนวยยดหลก (DIRECT RETAINER) เกดขนโดยหวเกยว (LOCK) ยดกบ สลก (LATCH) ซงยนออกมาจากโครงสรางของโครงยด (RETENTIVE FRAMEWORK)
Vichet Chindavanig วเชฏฐ จนดาวณค
Examples
Multiple rests may required for maximum support.
Vichet Chindavanig วเชฏฐ จนดาวณค
Examples
Without regular recall & check-up,
resorbtion of edentulous ridge will cause damages to remaining teeth.
Vichet Chindavanig วเชฏฐ จนดาวณค
Examples
Left fig. Inner part while hinge is open
Note: no metal contact to teeth
Right fig. Long clinical crowns
--------------------- Candidate for labial flange
Vichet Chindavanig วเชฏฐ จนดาวณค
Examples
Demonstrate esthetics modification to labial arch bar
Vichet Chindavanig วเชฏฐ จนดาวณค
Examples
Vichet Chindavanig วเชฏฐ จนดาวณค
Examples
Maxillofacial defect cases are indicated for
swinglock, if maximum retention is
required. Conventional RPD design may
not suitable to the prosthesis if retentive force does not meet requirement.
Vichet Chindavanig วเชฏฐ จนดาวณค
ไมใชกบเดก
Examples
If the labial bar is flexible, can be twisted;
retention will not obtain from hinge and
latch. If hinge is too loose I-bar struts will not hold the partial.
labial bar lack of rigidity will not serve Vichet Chindavanig วเชฏฐ จนดาวณค
Indications/Advantages
Lack of appropriate
retention, good tooth
contour
Abutments mobility
Missing key
abutments
Unfavourable soft
tissue contour
Economics
Tooth prognosis is questioned
ขาดพนทสวนยดทเหมาะสม ฟนหลกโยก ขาดฟนหลกส าคญ รปทรงเยอออนไมด ปจจยเศรษฐกจ ผลพยากรณโรคของซฟนยง
เปนปญหา
Vichet Chindavanig วเชฏฐ จนดาวณค
Contraindication/disadvantages
Shallow vestibule: for labial bar
High esthetics demand
Homecare :poor motivation cases
ด หนงสอการประชมวชาการทนตแพทยสมาคมแหงประเทศไทย 19-21 ธ.ค.2527 การใสฟนสวงลอคส าหรบอารช ทมปญหา โดย รศ.ทญ.โสภ ชาตสทธพนธ หนา 50-57
Vichet Chindavanig วเชฏฐ จนดาวณค
Clinical techniques
Requirements
1.Indicate, mark necessary anatomical landmarks on diagnostic model
Technique…?
2.Periodontal therapy should bring back healthy supporting tissues
3.consider, plan for other restorative works
Crown, additional retentive area by tooth alteration
Vichet Chindavanig วเชฏฐ จนดาวณค
Impression for framework
1.with a stock tray -must be taken with special care. Make sure that vestibular depth is correct and other movable tissue is not distort.
2.with an individual tray
Compare the two techniques
Select 1.or 2.on different occasion, and different objectives
Vichet Chindavanig วเชฏฐ จนดาวณค
Dental prescription Lab order form
Inscribe with pencil line on master model :
for framework design
Write and draw design detail on paper
Vichet Chindavanig วเชฏฐ จนดาวณค
Poor impression, Insufficient labial vestibule detail
Failures
Necessity of giving information to patient
before start making swinglock rem. partial
denture.
Necessity for good homecare
Necessity for periodic recall: evaluation
and frequency of relining
Vichet Chindavanig วเชฏฐ จนดาวณค
Attachments for RPDsand overlay prostheses
Part 4; in detail
หนวยยดแมนย า และฟนปลอมครอมหลก
Vichet Chindavanig วเชฏฐ จนดาวณค
Definition
Attachment = A mechanical device for fixation, retention and stabilization of a dental prosthesis.
Overlay = 1.If something is overlaid with something else, it is covered by it. 2.If you overlay one type of behavior, attitude or idea with another, you add one to the other, often in a superficial way.
From - CollinsCOBUILD English Dictionary
Vichet Chindavanig วเชฏฐ จนดาวณค
Objectives
Provide basic background of
1.attachments 2. overlay dentures and 3.telescopic crowns in prosthetic dentistry
Familiar with technical terms in attachment, overlay denture and telescopic crown
Inform alternative means for prosthetic dentistry… understand how the systems work
Vichet Chindavanig วเชฏฐ จนดาวณค
Contents
Why use attachments, telescopes
Classification
Nature of each type
Clinical techniques
Laboratory techniques
Vichet Chindavanig วเชฏฐ จนดาวณค
Why use attachments, overlay, or telescopic crowns
Initiative from 1. for esthetics requirement.
Why?
Because patient demanded no clasp
appearance from removable prosthesis.
Others are … 2. for correction, addition,
prevention, preservation, or preparation for prospect future plan.
Vichet Chindavanig วเชฏฐ จนดาวณค
Reasons for the use of attachments
Correction & Addition of retention, support, stability, esthetics
Prevention & Preservation of remaining structures, preserve sensory output from periodontal ligaments, preventing possible damage to the remaining structures
Preparation for future; some abutments may terminate… new prosthesis may not require, due to modification plan
Vichet Chindavanig วเชฏฐ จนดาวณค
General classification
Precision (แมนย า) or semiprecision (กงแมนย า), depending on method of
fabrication and tolerance to the fit.
According to their relationship to the abutment teeth, they can be classified as intracoronal and extracoronal attachments.
According to shapes – strut (ตม), bar (แทงคาน)
Vichet Chindavanig วเชฏฐ จนดาวณค
Introduction to form of attachments
Crowned abutment & RPD with
attachment (splinting is optional, การดามยดฟนหลกเปนทางเลอก)
Vichet Chindavanig วเชฏฐ จนดาวณค
Ceka
Introduction to the form of
overlay prostheses
Removable prosthesis placed over the reduced abutments (height)
Bar Coping & overlayVichet Chindavanig วเชฏฐ จนดาวณค
Classification (attachments)
Classified by force directed, movements,
shapes, or means of attaching between
two parts
Rigid (แขงตรง) and Non-rigid (resilient) (หยนตว) Bar (แทงคาน) and Stud (ตมยด) Mechanical force (แรงยดเชงกล) and magnet
force (แรงยดแมเหลก)
Vichet Chindavanig วเชฏฐ จนดาวณค
Classified by position
Classified by location of attachment
(Relation to tooth circumference)
Intra-radicular: within tooth circumference
Extra-radicular : outside tooth
circumference (consider as cantilever,
extension, projection)
So called :intra-coronal (ในกรอบซฟน), extra-
coronal attachments (หนวยยดนอกกรอบซฟน)
Vichet Chindavanig วเชฏฐ จนดาวณค
Classified by mobility
Rigid type Non-rigid type (resilient)
Vichet Chindavanig วเชฏฐ จนดาวณค
Classified by form
Bar แทงคาน Stud ตมยด
Vichet Chindavanig วเชฏฐ จนดาวณค
Variations
Mechanical แรงยดเชงกล
Non-mechanical > Magnet
ไมใชกลไกเชงกล ใชแรงแมเหลก
Vichet Chindavanig วเชฏฐ จนดาวณค
Rigid & Non-rigid attachments
Rigid attachment: does not allow any
movements of removable prosthesis.
Non-rigid attachment: allow certain degree and specific direction of movements.
Non-rigid ขยบได Rigid แขงตรง ขยบไมได
Vichet Chindavanig วเชฏฐ จนดาวณค
Rigid attachment: no movementsallowed to the prosthesis
Why? - Splinting abutment
Chewing efficiency is not reduced, strong.
Application to removable partial denturesVichet Chindavanig วเชฏฐ จนดาวณค
Rigid attachment: no movements allowed to the prosthesis.
When & where
Abutments are strong, healthy, well
maintain, good prognosis
Rigid type แขงตรง ขยบไมได Vichet Chindavanig วเชฏฐ จนดาวณค
Rigid attachment: no movementsallowed to the prosthesis
Why?
Application to Cr&Br work - non-parallel
abutment
Vichet Chindavanig วเชฏฐ จนดาวณค
Rigid & non-rigid
Resilience attachment (หนวยยดหยนตว) allows certain degree and specific direction of movements.
Resilient type ขยบได หยนตวได Vichet Chindavanig วเชฏฐ จนดาวณค
Non-rigid
Why movements are allowed?
To reduce torque and leverage forces to the supporting abutments.
Vichet Chindavanig วเชฏฐ จนดาวณค
Bar แทงคาน & Stud ตมยด
Bar provides rigid splinting among
abutments, Stud provides freedom of
minor (natural) movements to each abutment
Vichet Chindavanig วเชฏฐ จนดาวณค
Bar attachments
Classified by rigid & non-rigid action to
prosthesis
Rigid type : called “bar unit”
“แทงตรง” ขยบหมนไมได
Non-rigid type : called “bar joint”
“แทงขอตอ” ขยบหมนได
Vichet Chindavanig วเชฏฐ จนดาวณค
Selection of attachments
Indication for use depending on dentist
decision
Decision making is based upon purpose,
the action of prosthesis to abutments
Factors influence to decision are… cost,
availablility in local lab, dentist-technician
dexterity, esthetics, maintenance, situation of abutments and soft tissue etc.
Vichet Chindavanig วเชฏฐ จนดาวณค
Rigid & Non-rigid bars
Bar unit
Number of
abutment
Usually four
teeth at
appropriate
pattern of distribution
Bar joint
Number of
abutment
Usually two teeth splint together
Vichet Chindavanig วเชฏฐ จนดาวณค
Bars : Nature
Direct &control forces
Reduction of lateral forces to shortened abutments
Splinting, stabilization
Improve esthetics (mal-aligned tooth)
Require tooth preparation, invasive Tx?
May need RCT (intentional, or abutment is a RCT tooth)
Direction of root canal may cause technical difficulties
Vichet Chindavanig วเชฏฐ จนดาวณค
Possible solution
Vichet Chindavanig วเชฏฐ จนดาวณค
See - http://www.sterngold.com/Sterngold/attachments/index.aspx?catId=01
Studs : Nature
Less problems with remaking prosthesis if one abutment terminates
Selectively activate retention on each abutment
Splinting,
stabilization to
multiple abutments
are only from
prosthesis
High risk : if only
single tooth remain in an arch
Vichet Chindavanig วเชฏฐ จนดาวณค
Studs : Nature
Allow free movement to each abutment tooth (conditioning) with spacer placement
Use spacer during cementation of attachment to rem. prosthesis
Require a spacer
Vichet Chindavanig วเชฏฐ จนดาวณค
Studs : Nature
With a spacer: allow tooth and ridge support
Remove spacer, and check clearance
ใชแหวนรองขณะยดหนวยยดแมนย า และเอาออกเมอใชงาน
Require a spacerVichet Chindavanig วเชฏฐ จนดาวณค
Ceka
Rem. Prosthesis must be in used (pre-function) for a
period of time. It is to ensure dynamic changes of softtissue supporting base.
Vichet Chindavanig วเชฏฐ จนดาวณค
Ceka
Studs : Nature
This design (from fig.)
Without a spacer: it is
total tooth supported
Require multiple
numbers, reinforced
bridge structure, and
need appropriate
abutment distribution
Vichet Chindavanig วเชฏฐ จนดาวณค
See -Precision Attachments in Prosthodontics: Overdentures
and Telescopic Prosthesis [Hardcover]Harold W. Preiskel (Author)
Ceka
Studs : Nature
Less problems with
remaking prosthesis if
one abutment
terminates (extracted)
Selectively activate
retention on each abutment
Four attachments were activated for retentive force.
If any one of these abutment were terminate, other cantooth will be activated, replacing retentive force.
Vichet Chindavanig วเชฏฐ จนดาวณค
Ceka
Require pre-function of removable prosthesis,before direct installing the attachments to denture.
Vichet Chindavanig วเชฏฐ จนดาวณค
Milling machine
Two or more studs require accurate locating techniqueby high precision dental surveyor. It is the use of
milling machine. (เครองกลง กรอตดเชงขนาน)Vichet Chindavanig วเชฏฐ จนดาวณค
milling machine
Dentist’s requirements
Need special tools to remove, activate retention, and deactivate retention
Activating tool
อปกรณ ลด-เพมแรงยดTightening - Removing tool
อปกรณ ไขแนน-หมนถอด
Rider on bar attachment is of different material
Differ in color? Differ in retention
Riders
รางฝง
Holder
ทจบเปลยน อปกรณใสหนวยยด
Clip
หนวยยดVichet Chindavanig วเชฏฐ จนดาวณค
Bar joint : movable
Distal ends move tissueward
Axis of rotation to denture is importance to
equal distribution of leverage force acting
to abutments (two abutments joined with bar).
Vichet Chindavanig วเชฏฐ จนดาวณค
Level of each abutment should allow bar connector
run parallel to the occlusal plane (to equilibrate forcesdirected to supporting ridges).
Bar joint : movable
Vichet Chindavanig วเชฏฐ จนดาวณค
Parallel to occ. plane
Implant supported bar unit
Inter-arch spacing and height of bar unit
affect directly to the difficulties in tooth set-up, and strength of the denture.
Vichet Chindavanig วเชฏฐ จนดาวณค
Vichet Chindavanig วเชฏฐ จนดาวณคก าหนดต าแหนงขนาน วางต าแหนงสมพนธกบซฟน
Ceka attachment
Lab & Clinical technique
Fabricate crowns and RPD frame in one visit.Dentist should attach male parts intra-orally.
Ceka attachment
Vichet Chindavanig วเชฏฐ จนดาวณค
Ceka attachment
Problem with size and
gingival hygiene, new designswere introduced to EU market.
Vichet Chindavanig วเชฏฐ จนดาวณค
Ceka attachment
Homecare
Better access with
brush.
Classified tooth height
by different angles
30, 45, 60 degree.
Vichet Chindavanig วเชฏฐ จนดาวณค
Fixing a retentive unit
Using self-cured resin
ใชเรซนบมแขงเองไดยด Snap-on
ใชการแนบยดกบชองโพรงทเตรยมไว
Vichet Chindavanig วเชฏฐ จนดาวณค
Magnet: what to consider
Magnet & keeper
Force, shape & size,
Magnet half life, corrosion
Vichet Chindavanig วเชฏฐ จนดาวณคSee- New Magnetic Applications in Clinical DentistryAuthor(s)/Editor(s): Ai, Minoru/Shiau, Yuh-Yuan
Overlay,Telescope: Nature
Save periodontium
(case of improper
Cr:Root ratio length)
Prolong life time of
abutment
Preserve proprioception
Require tooth
preparation, invasive
Tx?
May need RCT
(intentional, or
abutment is a RCT tooth)
Vichet Chindavanig วเชฏฐ จนดาวณค
Filled with amalgam
Coping classification -Short, medium, long copings
Left dome-shaped coping, right thimble-shaped coping
Vichet Chindavanig วเชฏฐ จนดาวณค
Selecting the form
is mostly
depending on tooth condition.
Vichet Chindavanig วเชฏฐ จนดาวณคครอบตอฟน ครอบรากฟน
Telescopes crowns ครอบสองชน
Primary crown
Secondary crown
(telescope crown)
Role of guiding plane to retentive force
Vichet Chindavanig วเชฏฐ จนดาวณค
Fabrication techniques
Wax-cast 1, Wax-cast 2
Wax-cast 1, Electroformed 2 ขนรปดวยไฟฟา
Vichet Chindavanig วเชฏฐ จนดาวณค
Resistance form รปทรงตานแรงระนาบ, แรงกระท าดานขาง
Vichet Chindavanig วเชฏฐ จนดาวณค
Overlay removable removable partial denture
lying over primary crowns (or copings)
ฟนปลอมถอดไดครอบทบซอนครอบฟนOverlay bridge lying over primary crowns (or copings)
สะพานฟนครอบซอนครอบฟน
Vichet Chindavanig วเชฏฐ จนดาวณค
หากขาดการดแลฟนหลกทด ไมนานการผเสยหายเกดขนควรใช ครม แสตนนสฟลออไรด เปนประจ าทาทบตอฟนปองกนผ
Interim overlay RemovablePartial denture
ฟนปลอมบางสวนถอดไดครอมทบชนดใชชวคราว
Vichet Chindavanig วเชฏฐ จนดาวณคฟนสกระดบวกฤต สญเสยมตดงสบฟน
Vichet Chindavanig วเชฏฐ จนดาวณค
End Document
เมอเปลยนเปนงานตดแนนชวคราว
Recommended