Www.themegallery.com The fabrication of a maxillary and a mandibular prosthesis to restore the natural dentition of a patient Elwin Burger In Partial fulfilment

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The fabrication of a maxillary and a mandibular prosthesis to restore the natural dentition of a

patient

Elwin BurgerIn Partial fulfilment of BTech: Dental Technology

Department of Dental Sciences CPUT 2008


Overview

Patient history Comparative study Clinical procedures Treatment options Treatment options: Advantages and disadvantages Treatment of choice Technical laboratory procedures Problems experienced Future treatment options Conclusion Acknowledgements References


Patient history

Gender: Male

Age: 55

Middle class income group

History of severe periodontitis

Loss of some maxillary teeth

Loss of all mandibular teethFig 1. Gingiva and gum resorption1


Clinical Procedures

Cleaning and scaling

Periodontal surgery

Extractions

Tooth preparations for crowns Fig 4. Example of Periodontitis3


Comparative study

Fig 2. Boys vs Girls1 Fig 3. Age groups vs Oral hygiene1


Treatment Options

Implant-retained bridge

Dentures

Upper acrylic RPD

Upper CoCr RPD

Implant-retained overdenture

Maxilla and mandible


Clinical option 1

Implant retained bridgeR150 000

Advantages• Improve aesthetics1

• Tooth-saving1

• Improve patient confidence1

• Reliable2

• Long life expectancy2

Disadvantages• Expensive2

• Time consuming2 • Discomfort or pain2

• Bruising and minor swelling2 • Crown replacement in 10-15 years2

Fig 5.11


Clinical option 2

Advantages • Improve natural appearance.4 • Made from durable materials4 • Last between five to ten years4

• Correction of masticatory and related problems5

Disadvantages•Take time to get use to4

• Speech problems• Mouth irritation or sores4

• Replacement after time4

• Masticatory deficiencies4

• Bulky Fig 6.7

DenturesR 1313


Clinical option 3

Partial acrylic RPDR 587

Advantages• Replace missing teeth3

• Improve mastication and oral health3

• Preserving natural teeth3

• Improve aesthetics• Comfourtable4

Disadvantages•Tooth Damage caused by moving clasps4 • Traps food• Loss of fit4

• Tipping can occur4

• Speech difficulty

Fig 7.15


Clinical option 4

Partial CoCr RPDR1977

Advantages• Biocompatible and hypoallergenic2

• Provide added strength2 • Natural feeling2

• Weight may contribute to additional denture stability6

Disadvantages• Oral hygiene is essential2

• May feel bulky2

• Frequent maintenance and examinations necessary4

• More expensive than acrylic RPD

Fig 8.


Clinical option 5

IR overdentureR 26 000

Advantages• Can be removed easilly.4

• Excellent stability4

• Lower cost• Good hygienic properties6

• Good aesthetics

Disadvantages• Increased cost6

• Discomfort • Implant takes time to heal4

Fig 9.7


Treatment of Choice: Maxilla

Add Your TitleAdd Your Title

PFM Crown on 2.1

Gold Crowns on 1.7, 2.8 with precision

milled shoulder attachments

Cobalt Chrome RPD

Fig 10. Kennedy classification 3 mod 2


Treatment of choice: Mandible

Full acrylic denture with selective labial gum tinting

Fig 11. Tinted mandibular denture

F Goetzer


Technical Laboratory Procedures

1-6

2.Fabrication of PFM Crown

3.Wax up and precision mill of posterior crowns in wax stage

4.Cast gold crowns, trim and precision mill

5.Duplicate and pour refractory model

6.Wax up and Sprue of CoCr RPD

1.Standard model preparation


Technical Laboratory Procedures cont.

7-9

7.Invest and elimination of wax

8.Cast, trim and finish of Cobalt Chrome RPD

9.Set up of artificial teeth


Technical laboratory procedure cont.

Fig 12. Milling of wax crowns Fig 13. PFM and milled gold crowns

Fig 14. Wax Design Fig 15. Cast, trimmed and high shined

E. Burger E. Burger

E. Burger E. Burger


Problems Experienced

Millingdifficulties

Porosity

Incomplete Casting

Poor fitting around Gold Crowns


Future treatment options

14 Unit upper and lower implant-retained bridge

(Full oral rehabilitation)

Dental Implants

Full upper and lower dentures

Implant-retained overdentures


Conclusion

Dentist

Patient

Technologist

Final prosthesis

Fig 15 Complete prosthesis

F. Goetzer


Acknowledgements

Mr. M Mazeema

Mr. A Latief

Mr. LA Steyn

Dr. J Wright

Mrs. A De la Crouse


References1. Lindhe J. Clinical Periodontology and Implant Dentistry. 4th ed.

Oxford: Publishing Co. 2003: 47-53 2. MayoClinic.com-Tools for Healthier Lives. Available:

http://www.mayoclionic.com/health/periodontitis. 26 July 20083. Oral Health-Common Problems- All About Periodontitis. Available:

http://www.health24.com/medical/condition_centres. 26 July 2008.4. Smith GNB. Planning and Making Crowns and Bridges. 3rd ed.

London: Martin Dunitz Ltd. 1998: 24-25.5. Van Noort R. Introduction to Dental Materials. 2nd ed. Edinburgh:

Elsevier Science Ltd. 2002: 180, 238, 240.6. Wulfes H. Precision Milling and Partial Denture Constructions-A

Manual. 1st ed. Bremen: Academia Dental International School BEGO Germany. 2004: 57-59; 138; 195.

7. Muraoka H. A Colour Atlas of Complete Denture Fabrication. Chicago: Quitessence Publishing Company. 1989: 41-43.

8. Babbush CA. Dental Implants- The Art and Science. Philadelphia: W B Saunders Company. 2001: 3-19.


References cont.9. Morrow RM, Rudd KD, Rhoads JE. Dental Laboratory Procedures-

Complete Dentures. Volume 1. St. Louis: The CV Mosby Company. 1986: 223-240, 312-320.

10. Basker RM, Davenport JC. Prosthetic Treatment of the Edentulous Patient. 4th ed. Oxford: Blackwell Publishing co. 2002: 146-241.

11. Roberts DH. Fixed Bridge Prostheses. 2nd ed. England: John Wright and Sons Ltd. 1980: 129-130, 139-140, 166.

12. Mclean JW. The Science and Art of Dental Ceramics. Volume 1- The Nature of Dental Ceramics and their Clinical use. Chicago: Quintessence Publishing Co. 1979: 23-28, 37-39.

13. Dykema RW. Johnston’s Modern Practice in Fixed Prosthodontics. 4th ed. Philadelphia: W.B Saunders Company. 1986: 8-16, 22-25, 60-63.

14. Jenkins G. Precision Attachments- A Link to Successful Restorative Treatment. London: Quintessence Publishing Co. Ltd. 1999: 33-40.

15. Stewart KL. Clinical Removable Partial Prosthodontics. St. Louis: The C V Mosby Company. 1983: 18-20; 56-60.


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Www.themegallery.com The fabrication of a maxillary and a mandibular prosthesis to restore the natural dentition of a patient Elwin Burger In Partial fulfilment