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1. Central occlusion definition .CO signs. Characteristic of two fundamental elements of CO elements.

Central occlusion: maximal interdentally contacts between upper & lower jaws. This contact occurs when mandible goes from the central position to forward on 0.5- .5 mm. the condyle is situated on base of articular eminence ! glenoid fossa" . #t happens when there is bilateral contraction of muscles that ele$ate the mandible. 4 signs of Central Occlusion: %or all teeth " &ental: '$ery tooth has ( antagonists) .except lower central incisor & third upper molars. The midline of face coincides with inter incisor line. *nterior buccal cusp of first molar of maxilla is situated between anterior buccal cusp & middle buccal cusp of mandible first molar. +pper dental arch is wide !large" than lower dental arch. That)s mean that maxilla o$erlapping mandible. (" ,uscular: ,uscles that ele$ate mandible ma-e symmetrical bilateral contraction. ." T,/: the condyle of mandible is situated on the base of slop of articular eminence !glenoid fossa". 0" &eglutition: in Central 1cclusion $ery con$enient to swallow. For frontal group: ,edial face line is situated in the same plane with inter incisor line between upper incisor. +pper frontal teeth co$er lower teeth till 2.. For lateral group: 3uccal cusp of upper lateral teeth is located outside from the same cusp of lower lateral teeth. first upper molar contact with first lower molar co$ering it on (2. & and second lower molar co$ering it on 2. but medial $estibular cusp of first molar is situated in fissure mesio $estibular & central $estibular of lower first molar.

2. Bite definition .physiologic and pathologic types of the bite.


3ite 4occlusion5 definition: is closure of dental rows or group of teeth during different mandible mo$ements. 1cclusion can be physiologic and pathologic 6ateral7 anterior7 posterior .and central occlusion Physiologic: . 1rthognat !presence of all signs of C1". (. 8ead to head occlusion: +pper frontal incisors !their cutting edges" ha$e a contact with cutting edges of lower frontal incisor. .. 3iprognat: frontal teeth of upper & lower jaw together with their al$eolar process ha$e $estibular inclination. 0. 1pistognat occlusion: frontal teeth of upper and lower jaws together with their al$eolar process ha$e oral inclination. Pathologic: 8as disturbance in function . 9rognaty: is characteri:ed by forward position of upper teeth .presence of cleft !space" between upper and lower teeth. ;ey of occlusion: $estibular medial cusp of first upper molar is locali:ed on $estibular medial cusp of first molar and (nd premolar of lower jaw. (. 9rogeny: is characteri:ed by forward position of lower teeth .lower frontal teeth o$erlap the upper teeth. ;ey of occlusion: cusp of st molar is situated between st & (nd molar of lower jaw or ma-e contact with cusp of (nd lower molar. .. &eep occlusion: is characteri:ed by deep !big" o$erlap of upper frontal teeth. Can be trauma of gingi$al by cutting edges of the teeth. ;ey of occlusion is normal 0. Crossed occlusion!cross bite": is characteri:ed by $estibular cusp of lateral lower teeth o$erlap the cusp of lateral upper teeth. Can be unilateral & bilateral. <elation between frontal teeth is normal. 5. 1pened occlusion: is characteri:ed by absence of frontal teeth contact .no change in -ey occlusion.

3. Mandibular meaning.

est !osition "M !# definition. $unctional test of M ! determination .practical

MRP: one of the articular positions of mandible due to minimal contraction of masticatory muscle & total relaxation of mimic muscle. This position is appeared when the mandible doesn)t participate in chewing7 speech. &ue to this position there is inter-occlusion space between jaws about (-. mm. this space can $ary from = mm due to pathological abrasion. #n ,<9 participate acti$e & passi$e elements. *cti$e: tones of muscle !ele$ator7 depressor" 9assi$e: T,/7 negati$e pressure in mandible. For determination of MRP special test: . 9atient should spea- & after finishing of speech the mandible will stay in position of physiological test. (. to say word with 4a5> test of wild .. to say word with 4c5>. test of sil$er-man 0. to say word with 4f5>. test of <obinson 5. to count from =0 till ?0 =. functional swallowing Importance: ,<9 is orientation for construction of different prosthesis & apparatus. %or determination of high of occlusion by anatomic @physiological method. %or determine $ertical dimension7 $ertical diminutionA ,<9 (-.mm.

%. &efinition of $ree 'ay (pace and $ree (peech (pace .practical importance.
%ree Bay Cpace: this is the space in ,<9 when minimal contraction of masticatory muscle and total relaxation of mimic muscle. This space is about (-. mm. %ree Cpeech Cpace5: is indi$idual foe e$eryone 7 this is disturbance between upper and lower jaw due to saying 4a5 maximal distance and 4c5 minimal distance . #mportance: necessary for tal-ing.

). &ifinition of *eight Of Central Occlusion. Method of determination .


Definition: is the distance between al$eolar processes in position of central occlusion with loosing the last pair of teeth antagonist inter-al$eolar height become not fixed. This fact considerable change of face expression. Daso-labial and chin fold becomes deeper7 the angle of mouth fall down because of reduction of orbicularis oris muscle function. this muscle become flabby and this lead to their atrophy Emimic and masticatoryF Gertical dimension A ,<9 @ (mm ,ethods: 1. anatomical . anthropometrical:

open mouth widely 7external shoulder of compass applied on chin and nasal top after that close the mouth not change position of compass shoulders #f internal to will situated on nasal top and external shoulders one on chin and second on pupil. This position corresponds with relati$e rest position E,<p" $ertical dimension (-. mm less. !. anatomic"physiological the position of mandible when the muscle are relaxed and between upper and lower jaw teeth appear interocclusal space (-. mm to draw ( points sub-nasal and mental patient sited and loo-s forward Bith help of spatula is measured and fixed distance this tow point. #ntroduce occlusal rims and determine the $ertical height of occlusion7 $ertical dimension should be less on ( that why we remo$e wax from lower. %. functional

+. ,eutral Mandible !osition definition. &etermination methods


Datural mandible position A ,<9 A physiological rest Definition: the postural !upright" position of mandible when the patient is resting comfortably in the upright position and the condyle are in a natural unstained position in the glenoid fossa. The mandible muscle is in state of minimum tonic contraction to maintain posture and o$ercome its force of gra$ity. Methods: . ;antoro$ich method: press on chin of patient during closure of mouth. This method is rare7 because it)s possible to o$er press and dislocate mandible distally from C1 !disad$antage". (. 3ounding of head posterior and simultaneously close the mouth. &ue to this method7 the supra-hyoid group of muscle displaced the mandible related to maxilla in C1. .. Test of swallowing act. 9atient swallow sali$a & close the mouth. in this moment the mandible relate to maxilla in C1. 0. 3etel man method: the dr. applies his index finger on occlusal surface of lateral lower molars 7 the thumbs are on the chin of patient. 9atient should close the jaw and bite the finger of dr . . . . &uring closure7 the finger goes away in oris $estibule7 by pressing on chin the mandible will be in C1. 5. #y $#%ean & 'or#edam: 1pening the mouth and -eep in this position for .0 sec. Clowly close the mouth and directs the mo$ement of closure by doctor7 until feeling the articular condyle and first contact occlusion. to repeat the mo(ement se(eral time: - ,aximum opening - relaxing -closure to the first contact

-. (ign of central occlusion characteristic for all teeth in orthognatic .inds of bite.
1. Dental: '$ery tooth has ( antagonists) .except lower central incisor & third upper molars. The midline of face coincides with inter incisor line. *nterior buccal cusp of first molar of maxilla is situated between anterior buccal cusp & middle buccal cusp of mandible first molar. +pper dental arch is wide !large" than lower dental arch. That)s mean that maxilla o$erlapping mandible. (. ,uscular: ,uscles that ele$ate mandible ma-e symmetrical bilateral contraction. .. T,/: the condyle of mandible is situated on the base of slop of articular eminence !glenoid fossa". 0. &eglutition: in C1 $ery con$enient to swallow.

/. $unctional or dynamic occlusion definition. type.


Functional occlusal contact: #n lateral parts: contact on side created by cusps on other side created by occlusal fissures !central7 peripheral and inter-dental fossa of teeth occlusal surface" in frontal part: contact of5 head to head5 type. 8ead to head type and contact created by incisor edge of lower incisor teeth and palatal surface of upper teeth !deep occlusion". )on functional contact of occlusion:

Contact: cusp to cusp type cusp to slop of the cusp flat contact !due to pathologic abrasion" absence of occlusal contact. ! groups of occlusal contact: st group: occlusal contact created by $estibular cusps of lower premolars and molars and occlusal fossa of upper lateral teeth. (nd group: occlusal contact created by incisor cutting edge of lower frontal teeth and palatal surface of upper frontal teeth. .rd group: occlusal contact created by palatal cusp of upper premolar and molar and occlusal fosses of lower lateral teeth.

0. Clinical e1amination conse2uence. Component parts of sub3ecti4e e1amination.


*u#%ecti(e e+amination: " Complains. (" 8istory of patient. ." 8istory of diseases. O#%ecti(e e+amination: *" 'xtra oral

3" intra oral.

,+tra oral e+amination: Inspection: . Cymmetry of the face. (. color of the s-in 7 $isible mucosa .. 'xpression of face. 0. . floors examination7 all of them should be eHual one to another: st floor: till supra-orbital line. nd ( floor: till nasal wings. .rd floor: till the lower edge of mandible !chin" 5. Dasolabial line. =. *ngle of mouth ?. 9athological formation. Palpation: . T,/: a" at rest and during mo$ement of mouth b" 1pen and close mouth !le$el of amplitude" by application of index and middle finger in area of condyle. (. ,uscle palpation : ,imic muscle. ,asticatory muscle !to palpate e$ery muscle separate in relaxed and forced position. a" extra oral>close the mouth $ery tightly b" #ntra oral and extra oral by index finger. .. Painful paints (allae: . Cupra-orbital. (. canine fossa. .. ,ental foramen. *s- if the patent has pain. 5. 6ymph node palpation: occipital7 auricular7 sub-mandibular7 sub-mental. %ront & bac- of CC, muscle. $uscultation: T,/: osculate the joint region >pathological sound7 crac-. ,ild-se$er crepitating. Intraoral e+amination: #nspection: color of lips transition from outside to inside7 correlation of lips and oris $estibule mucosa. degree of mouth opening !if has Trismus" #f during opening the mo$ement of mandible free7 with2without de$iation. ,ucosa of oris $estibule: color7 moist7 with2without pathological formation. type of occlusion !orthognat7 head to head".

inspection of dental arch and e$ery teeth separate &ental arch shape!u 7$7 w" - Cymmetry Teethfrom upper right side..left side ..left lower..right lower.. #f present caries7 change in color. #f present 3& 79<*&7C& Come abnormalities of teeth!small7 big777" Cigns of C& 8ow the upper teeth o$erlap the lower teeth!if present midline 7-ey of occlusion". Inspection of al(eolar process: *trophy !degree of atrophy". 9rotuberance7 tuberosity de$elopment. -ard palate exostoses if it)s total edentia 'xamination of 9otsdam area 7 trans$ersal and incisi$e papilla. 9lace !border"of muscle attachment. Inspection of mucosa: Color7 atrophied7 billability7 resilience. if painful during mastication Trans$ersal ,-B and sagital spa cur$e. *ign of central occlusion : dental muscle T,/ &eglutition. .ongue inspection : dimension 7hyper 2hypo-throphic7 edema 9athological formation. Bhite deposit near the tongue root. *ali(ary gland : stenon and warton ducts dental formula by #&% 9alpation: - 1f al$eolar process. - 1f e$ery teeth separate. - Cali$ary gland under tongue. - Tuberesity de$elopment - 1f muscle7 dental tooth mobility. 9ercussion: of teeth 15.ob3ecti4e e1amination conse2uence in prosthetic department. e1tra oral e1amination .6M7 e1amination "cancelled#

118 intra oral e1amination conse2uence9 order and criteria of teeth e1amination 9 :&$ recording 9 e1amples
Intra oral e+amination: I)*PIC.IO): - Color of lips transition from outside to inside 7correlation of lips and oris $estibule mucosa (- &egree of mouth opening ! if has Trismus " .- #f during opening the mo$ement of mandible free 7 with 2 without de$iation 0- ,ucosa of oris $estibules: color7 moist7 with 2 without pathological formation. 5- Type of occlusion !orthodontic7 head to head >." =- #nspection of dental arch and e$ery tooth separate : Dental arch: shape !+7 G7 B"7 symmetry Teeth: from upper right side7 left side7 left lower7 left upper. #f present caries 7 changes in color

#f present 3& 7 9<*& 7 C& . Come abnormalities of teeth !small7 big>7" signs of C1 : dental frontal and lateral 8ow the upper teeth o$erlap lower !if present midline7 -ey of occlusion" . Inspection of al(eolar process: - *trophy ! degree of atrophy " - 9rotuberance7 tuberosity de$elopment. - 8ard palate ! if present torus " - 'xostoses - #f it id total edentia ! type by Cchroder & ;eller " - 'xamination of post dam area 7 trans$ersal rugae & incisi$e papilla - 9lace !border" of muscle attachment. Inspection of mucosa : - Color7 atrophy7 pliability7 resilience. - #f painful during mastication - Classification by lejuyax & supple. - Condition of frenulum Trans$ersal ,-B & Cagittal spee cur$e . Cigns of central occlusion: .dental (. ,uscle .. T,/ .ongue inspection: - &imension7 hyper 2 hypo-throphic7 edema. - 9athological formation. - Bhite deposition near the tongue root . *ali(ary gland stenon or worthon duct if hypertrophied7 obstruction. Dental formula #y IDF - -I -(- !%our parts of dental arch" . +pper right side (. +pper left side .. 6ower left side 0. 6ower right side P$/P$.IO): 1f lower al$eolar process 1f e$ery tooth separate %luctuation 7 sali$ary gland under the tongue 'xostoses Tubresity de$elopment > 1f muscles7 dental tooth mobility. P,RC0.IO): of the teeth.

0.deglution.

128 Consecuti4eness of dental arch clinical e1amination 9 physiological ; pathological types"cancelled# 138 clinical e1amination of edentulous area of al4eolar process and mucosa of oral ca4ity 9 three types of mucosa according to mobility propreties 9 anatomical formation <
.ypes of mucosa : - *cti$e mobile ! free mucosa " - 9assi$e mobile ! attached to al$eolar process " - ,ixed ! between them " >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>(== " > 11 #

1%8 Clinical e1amination of static ; dynamic occlusion9 occlusal contact recording<


Central occlusion: is a static occlusion7 correlation between dental arches in Cagittal trans$ersal & $ertical plan7 when between dental arches present the multiple dental contacts ? @ (== >1 . Dynamic occlusion: ! anterior forward 7 posterior bac-ward 7 lateral left 7 right " - $nterior occlusion: is determined due to propulsion of lower jaw & characteri:ed by contact head to head. in this position can be determined free point contact bonwill ! in frontal & ( in lateral parts " or absence of

contacts between lateral teeth 7 condyle are situated on slope of articular 'minence 7 muscles are not in maximal contact . Posterior occlusion : due to pressure on mental region ! for determination of ,9 " by 'antoro(ich method 7 in this position teeth ha$e contact only in lateral parts 7 condyle are situated on the top of articular fossa ! the most deep part of fossa" /ateral occlusion: can be left & right due to lateral occlusion between dental arches distinguish wor-ing side & balance side. On 1or2ing side teeth ha$e contact with the same cusps !upper buccal with lower buccal" On #alance side with different cusps contact !upper palatal with lower buccal"7 due to excessi$e displacement of lower jaw on the wor-ing side ca not be contacts. $symmetry of the face3 condyle has different position in articular fossa: on wor-ing side near the shape of articular eminence with a little rotation mo$ement7 on balance side condyle is situated on top of articular eminence.

1) A Clinical ; !ara clinical e1amination of ma1illofacial region muscles<


Clinical e+amination: palpation of muscles Palpation 4 during relax & contraction7 e$ery muscle separate7 extra oral method & mixed !extra @ intra oral" ,+tra oral 4 intra oral: if presence spasm7 tenderness7 wea-ness.

The function of the masticatory muscles can be changed due to pathological states:
- 6oose of teeth - &isorder in T,/ - Changes in high of occlusion Para 4 clinical e+amination: - 'lectromyography: during mo$ement of masticatory muscles will be registrant bio potential.

*pplication of electrodes on the s-in ! muscles "7 functional test of masticatory muscles on the chee- in the state of ,<9 !physiological test position 7 during closer of teeth in anterior 7 lateral position7 during swallowing & mastication . *fter registration we can stud the forms of cur$es potential. 0sing in case of : 9& 7 T& 7 anomalies of stoma. Cystem >
,yotonometry: muscle tone measurement.

1+. Cancelled
1-8 =lectro8odonto8diagnosis and thermo8diagnosis method of pulp status specify parameters of norm < %or determine the real stat of dental tissue we need 'lecro-odonto- diagnosis:
%or hard tissue lesion 9athological abrasion7 erosion. 8ypoplasia %lorosis Teeth trauma: pulp chamber Censibility of pulp chamber ,"D"M allow us to determine the le$el of sensibility of dental ner$ous system 7 which indicate us the situation of pulp & periodontium . '-&-, for determination of electrical sensibility. - #n healthy (-= ,a - #n pulp inflammation till 00 m* - Decrosis of pulp till =0 m* - 9ulp J per-apical tissue =0-K0 m* - 9eriodontium 00 @ (0 m* .hermo 4 diagnosis: determination of relation of the tooth on thermal irritation ! cold2 hot water " or can be -

spray . 1/8 Masticatory efficiency9 definition. =numerate the static ; dynamic methods. (pecify the Bgapo4e coefficient.
Masticatory efficiency: this is force in L that can be accepted by e$ery teeth. 3asic function of stom. Cystem is act of mastication 7 that)s why the determination of chewing efficiency is $ery important during ma-ing plan of orthopedic treatment . ( Mroups : static method 7 dynamic method .

*.$.IC M.-OD*: ;hober : with help of gnato-dinamometr 7 ta-e in consideration the indi$idual properties of each of tooth : - Golume of chewing surface (- D5 of roots7 cusps . .- #mplantation. +nite of measure is lateral incisor . Mamle2 3 $gapo( 3 O5 man : they changed the method 7 they consider that in norm if all teeth are present the mastication efficiency A 00 . 'ach teeth ha$e coefficient !L" . if one of teeth has not antagonist his mastication efficiency A0 . O+man : ta-e in consideration the functional state of the teeth 7 which is determined by degree of their mobility : degree -N mastication efficiency 00L (degree-N50L .degree-N 0

Ctatic method has disad$antages:


Cant correct determine the role of each teeth during mastication &oesn)t ta-e in consideration the type of occlusion7 intensi$ely of chewing7 force of mastication pressure >. 8e role of tongue & etc.. *M*91G: O?=50.( (.05=? O O?=50.( (.05=? O 1P,*D: O?=50.( O?=50.( (.05=? O (.05=? O

108 &ynamic method of mastication efficiency determination9 define the degree of mastication efficiency by rubino4if in the sie4e remain 255 mg<
D6)$MIC M,.-OD*: Christenson method: the patient should chew a nut7 after 50 chewing mo$ements the all mass is collected & dried in thermostat ! 00c"7 after that by 4d5 of particles is determined the masticatory efficiency . 7ellman method : in norm stoma. Cystem chews 5gr of nut during 50 sec5 7 the dry mass should be less than (.0 mm in 4d5 Ru#ino( method : nut ! 0.O gram A O00 mg " determine the time from starting of chewing till act of swallowing 7 in norm it ta-es 0 sec5 if presence disturbance it ta-es more time till act of swallowing & 4d5 of particular till 0 sec 4 is bigger . If in the sie(e remain 88 mg : O00mg 0 sec =00mg 0 sec O00 00L 7 =00 xL 7 - xA?5L !mastication efficiency".

25 A Changes in functional state of teeth parodotium according to the degree of al4eolar process atrophy by .urlens.y odonto8paradonto8gramma <
OP7: is a static method that considers functional state of teeth7 which can help to doctor to appreciate the masticatory efficiency. OP7: is a scheme of dental formula in which filling !submitting" the data about state of each teeth during clinical examination7 x- ray in$estigation & data of dent dynamometer. OP7: static method by degree of implantation appreciate the functional state of teeth. - D- norm - Q - atrophy of bone degree.

R- ( degree S- . degree . Bith help of paradontogram 7 the doctor can appreciate the functional state of teeth on upper & lower jaw > 7separate functional groups of teeth & results 7 which the doctor is recei$ed 7 ma-e plane of orthopedic treatment 7 which can exclude the o$erload on the support teeth . (. &uring chewing of food the teeth recei$ed a different force !pressure" : incisors 5- 0 -g 7 premolars .- O -g 7 molars (0-.0 -g . .. The healthy periodontium can recei$e more bigger pressure depend on le$el of intensity of masticatory muscle force !50L" from all pressure that it can recei$e . 0. The a$erage between them is storage for special situations . Be need OP7 because e$ery teeth has own dental implantation for determination which teeth will be for support teeth . -

21. Ceneral and local indication and contraindications to prosthetic treatment.


Indication: 6ocal: . Change in structure7 form7 $olume7 color7 place of teeth that cannot treated by conser$ati$e method. (. To restore occlusal surface of affected teeth. .. To restore the function of stoma. Cystem. 0. <estore partial7 total edentation. 5. Trauma of maxilla-facial region7 fractures of crown. =. *t pathological erosion7 as splint element in periodontal disease. Meneral . Changes in ner$ous system7 M# Egastritis doudenitisF which cause by dental pathology. (. 'sthetic Contraindication 6ocal . mil- teeth (. ,obility of .rd degree. .. if present periodontal diseases in acute form- relati$e 0. #n per apical area none treated process. 5. Cmall short tooth crown7 fragile tooth tissue. =. Tumor. ?. deep occlusion Meneral . ,ental disorders. (. epilepsy .. young patient 0. ,yocardial infarction Ein acute form"7 cardio $ascular disease @ relati$e. 5. *llergy to some components.

22. Ceneral and special methods of the oral ca4ity preparing to prosthetic treatment.

. assignation of organism in general: infectious 7 psychotic 7 cardio-$ascular diseases 7 diseases which can influence on the state EprocessF and success of the treatment li-e : epilepsy 7 diabetes mellitus 7 allergy. (. assignation of oral ca4ityD treatment of caries and it)s complication 7 lesions of teeth 7 periodontal and mucosal diseases 7 extraction of root by indication 7 endodontic treatment 7extraction of teeth of .rd degree 7 apical resection and etc.> .. 7eneral and local prophyla+is7 hygienic procedures7 prophylaxis of general pathological states of organism7 which can lead to eHuilibrium disturbance of stoma. Cystem and explain to patient the hygienic rules of oral ca$ity.

23. Cancelled 2%8 &efinition of impression9 impression classification by the techni2ue of their getting9 complications during ta.ing impression< "Cancelled#
Classification #y techni9ue of getting: - #n one stage ! layer": with gypsum7 alginate7 stence. (- #n two stages !double layer" : with silicone material . .- #mpression with help of copper ring. 0- 1cclusal impression. 5- 9artial 2 total impression. *tages of getting impression: - Choose the impression material (- Choose the tray ! for upper2 lower jaw " .- 9reparation of impression material 0- *pplication of impression material on tray 5- 'nter the tray with impression material into oral ca$ity & application on dental row. =- ,argins design of impression ?- Ta-ing out the impression from oral ca$ity O- *ppreciation the Huality of impression. Complications during ta2ing impression: - Basn)t choosing the correct impression material. (- Basn)t choosing the correct tray. .- Basn)t prepare good the impression material ! too much liHuid or solid ". 0- Basn)t apply correct of impression material on tray ! spaces 7 not co$er the whole borders ". 5- Basn)t correct apply on dental row the tray ! dental row should be .5 cm from the $estibular border of tray & not ma-ing more . =- <emo$al of the tray too early. ?- Basn)t ma-e margin design

2)8 6wo methods of 1 step ta.ing impression 9 specify using materials ; techni2ue < st method step ta-ing impression.
Ta-ing with one impression material7 which applied on tray into oral ca$ity. ! alginate 7 stense 7 gypsum 7 0 peen"

(nd method
-

step ta-ing impression:

Ta-ing with one impression material !syringe" which applied on dental row & after the tray will apply on dental row . with special de$ice ! li-e gun " which has cartridge & mix the impression material inside the gun >

2+8 Method of ta.ing impression in occlusion 9 impression materials classification by postolachi 9 birsa 9 e1amples .
Method of ta2ing impression in occlusion:

#mage of both dental arches in C1 by wax or thermoplastic material .


Indication: - %or bridge denture.

Classification of impression materials by bostolachi & birsa : ! based on state of impression "
,/$*.IC: - <e$ersible hydrocolloid ! helin 7 dentacol " - Don re$ersible hydrocolloid ! chromopan 7 elastic " *ynthetic elastomers:

C'6#C1D#C : ! sielot 7 speedex 7 xantopren 7dentaflex 7 TJ 7 micron light " 916UC+6%*T': ! thlodent 7 surflex " 916U'T8'< : ! impregun 7 polygel " -$RD M$.,RI$/*: - <e$ersible : thermoplastic masses ! stence " - Don re$ersible : crystal materials ! gypsum "

2-8 !artial dentations9 etiology9 enumerate factors that influence on !& 9 clinical picture 9 facial " e1tra oral # symptoms < 9artial edentation absence of to .- 5 teeth on one jaw
,tiology: 7enetic factors: ! primary partial edentation " - &isorders in bud formation lead to 7 hypodontia & oligodontia . - Complete absence of teeth bud 7 anodontia . $c9uired factors: !secondary edentation" - Caries & its complications - Teeth inclusion ! situation # other place most often canine" - 9eriodontal disease - 1peration because of tumor - Trauma - a$itaminosis - systemic diseases ! diabetes 7 hypertension " - iatrogenic 7! after incorrect treatment teeth were extracted - Cocial @ economic causes. Facial :e+tra oral; symptoms:

. parts of sings: !frontal7 lateral. frontal & lateral" Depend on: number of loosing teeth7 topographical location of edentation.
. in frontal : falling down of superior lip 7 decrease of $ertical dimension : (. #n lateral: Cymmetry7 both sides7 !asymmetry7 one side7 of the face". .. %rontal & lateral: all together. ,+tra oral symptoms depend on: - Type of edentation & topography. - Time past after extraction of teeth & type of extraction. - *ge of patient. - Type of occlusion. - Dumber of missing teeth condition of hard tooth tissue & periodontium. - 'tiological factors of 9artial edentation. - Meneral condition. ,+tra oral symptoms can #e : *bsent : ! in small defect " 7 no changes in lower third of face & soft tissue Doticed : ! in big defect 7 old patient " -falling down of superior lip -falling down of chec-changing in lower third of face

2/. :nner "intraoral# symptoms of partial edentation. &ental arch defects and al4eolar process in edentulous area. &escription
Intraoral symptoms: . &efect in or both jaws of dental row. !disorders of or ( dental row integrity" (. &isintegration of dental row because of ( groups !functional and non-functional"2 .. 9atient complains:- 9ain in remained teeth 7soft tissue 7T,/7 tongue - &isorders of mastication7 phonation7 esthetics. - M#. Tract disorders7 ner$ous system disorders. 0. Teeth migration :- 8ori:ontal 2$ertical. - Con$ergation 2 V 1< di$ergation V 2

Dental arch defect: . Cmall defect !absence of -. teeth". (. ,edium defect !absence of 0-O teeth". .. 6arge defect !absence more than O teeth". Dote: all these defect can be treated with bridge or 9<&. ,+tended su#total edentia : presence of -5 teeth in the dental arch it can be treated with 9<&. Classification of al(eolar process : !by form" 1. Darrow till .mm . ,iddle 0-5 mm !. Bide more than = mm

20. Classification of partial edentation by E=,,=&F and E=,,=&F B!!G=CB6= .diagnoses in partial edentation e1amples.
Classification #y ',)),D6: C6*CC bilateral terminal defects of dental row. C6*CC (unilateral terminal defects of dental row. C6*CC .unilateral defect is limited of dental row. C6*CC 0 defect of the frontal teeth. Classification of 2ennedy applegate: only in subtotal edentation presence of ( classes more 5and = C6*CC 5as .rd class 7but limit absence of lateral and frontal teeth ! or (" shouldn)t pass the middline C6*CC = unilateral limit defect 7 limits just by posterior teeth !not frontal". Importance : st class is the most gra$e or se$ere state of patient other classes from (nd untill 0th become more easy. The se$erity may increase the ris- factor of complications: - T,/ disorders. - ,astication insufficincy . - Teeth migration. Dote: in combined defects we use the smaller class for 'P: if present .rd and 0th class must to chose the .rd class. Diagnoses: .parts of diagnoses . ,ain disease. (. Complication. .. Cecondar or additional associated disorder. ,ay include: . *natomical and clinical diagnoses (. Topographical edentation. .. Clinical form of edentation. 0. 'tiological 7e$oluti$e 7 functional diagnoses. 5. &iagnoses of complication. =. 9rognoses ,+ample: partial secondary edentation (nd class st subclass by -ennedy on upper jaw after caries complication 7 .rd class 7 st subclass by -ennedy on the lower jaw after caries complication7with masticatory insufficincy 50L by agappo$ 7 esthetic and phonetic disorders

>35 is part from >20

31. general and local indications for prosthetic treatment of partial edentation with bridge denture. Bd4antages and disad4antages of bridge denture. Indications:
. (. .. 0. . (. .. 0. 9artial edentation not more than .-0 teeth of absence. Bhen there is condition to create parallelism between support teeth !during preparation"2 #n multiple includes defects. To restore the integrity of dental row and function of stomatognatic system. Ci:e and topography of dental row defect. %unctional $alue of remained teeth. Condition of teeth antagonists. 9atient 7age7 sex7 profession and psychological condition.

Indications depend on:

$d(antages of <D:
. <estoration of integrity of dental row and functions !mastication and phonation".

Disad(antages:
. (. .. 0. 5. =. ?. &eep preparation. *llergic and toxic reactions &amage of soft tissue. 1$erloading of support teeth !big disad$antage" #nfluence of support teeth on marginal periodontium. Dot chosen correct pontic element. #n terminal defect of dental row can)t use 3& as treatment.

32. two groups of prosthetic area elements in partial edentation. Characteristics. !ractical importance.
. dental periodontal support: remained teeth with their periodontium this support has a rule of importance for fixation 7holding or restrain !to stay in place"7stabili:ation and effecti$eness of prosthesis.

%ixation7 holding and stabili:ation of prosthesis depend on:


. (. .. 0. 5. Dumber of remained teeth Topographical location of present teeth. *xes of implantation of present teeth !Con$ergation or di$ergation". Crown morphologyfor fixation elements !clasps". The state of occlusion and periodontium of present teeth

The number of remained teeth influences on prosthesis stabili:ation. This factor related to topographical location. %or example: - #f the group of teeth in plane less fa$orable for fixation. - #f the same numbers of teeth but in different planesbetter fixation. (. Mucosal #one support:" !fibro mucosa and bone of the both jaws".

#mportance: for fixation 7 stabili:ation of prosthesis and to be resistant to masticatory pressure by remo$able denture. *nd can ha$e different degree of atrophy. ,ucosa can be:
. *cti$e mobile !on chee-s" (. %ixed !on bone 7palate and al$eolar bone". .. 9assi$e sulcus !between fixed and acti$e the chee-s and bone limit for base of prosthesis.

*natomical structures of mucosa:- the folds7 frenum7 sali$ary ducts!should be ta-en in consideration for a$oiding complications and worsening of Huality of prosthesis. ... ,orphological characteristics of teeth crowns limited edentulous dental row area pointing the meaning of sHuares on Gestibular surface.
. Be need the morphology of the crown foe fixation elements of prosthesis !clasps". (. The :one between eHuator and cer$ical part fo crown is called subeHuatorial :one !located dental segment of clasps". .. The :one abo$e the eHuator called supra eHuatorial :one !here will be located elastic segment of clasps" 0. %or stabili:ation we di$ide the tooth crown into 0 sHuares by lining $ertical and hori:ontal lines.

The dental segment must ha$e a tight contact with tooth tissue and its end must be situated under the :one with fa$orable retention and must co$ered the $estibular surface not less than (2. from mesio-distal distance the importance of $ertical 6.

3%.Gist the factors promoting change of remained teeth position at partial edentation phenomenon of teeth migration.
*ge of defect. Ctructure of al$eolar bone. 9rimary anomalies of teeth position. Ctatic and dynamic contacts with teeth antagonists. Meneral state of organism Changes of position of remained teeth called secondary anomalies of teeth position. Changes of teeth position due to secondary anomalies can be: hori:ontal migration. - $ertical migration. $; -ori=ontal migration can #e in directions:" - ,edial direction. - &istal direction. . (. .. 0. 5.

This migrations clinically can be in ( forms:


. #nclination7 when the axe of tooth is inclined. !the crown of the tooth inclined into side of defect 7apex of root into opposite side" (. *xe position change 7 when the tooth is displaced without inclination into side of defect !$ery rare form". <; >ertical migration" migration into (ertical plane this migration clinically can #e in forms: . &ento-al$eolar elongation when teeth disploded into side of defect together with al$eolar process7 without changes of clinical crown. (. 'xcursion of teeth 7 when the teeth are displaced into side of defect7 without al$eolar process !high of clinical crown of the tooth".

3). =numerate factors defining the periodontal tissue state and 4alue of remained teeth in partial edentation.
Periodontal tissue state:- for determining the degree of tooth resistance in al$eola in relation to force of tooth mobility. *nd e$ery tooth has reser$e force of periodontium and can be determined by following elements: - #mplantation of tooth in the bone. - ,orphology of the root !length7 width and number of roots" - Dutrition of periodontium. >alue3 morphology of remained teeth cro1n: *nalysis of crown morphology !$alue" molars on diagnostic model 7 we need it to -now for retenti$e elements !clasps". <etenti$eness of supra-eHuatorial :one is more prominent in teeth with short and cylindrical form of crown. %or the crown hasn)t retenti$e :ones reHuire co$ering by micro prosthesis on which create artificial retenti$e elements.

3+. classification of mucosa of prosthetic field at partial edentation by (H!!G=. !ractical importance.
i. ii. iii. C/$** 1 healthy fibro-mucosa with medium thic-ness and small due to the degree of pliability7 this type of mucosa has well Huality of amorti:ation during mastication and doesn)t allow to prosthesis to mo$e from prosthetic field. C/$** atrophied and $ery thin gingi$al with little degree of pliability7 low degree of amorti:ation7 has negati$e influence during mastication. C/$** ! hypertrophied and thic- fibro-mucosa with great degree of pliability lead to mo$ement of prosthesis from the prosthetic filed.

i$.

C/$** 4 hypertrophied and mo$able mucosa with non regular thic-ness.

Practical importance: the thic-ness and elasticity of mucosa of prosthetic field determines the le$el of holding and refrain ,aintenance of prosthesis in oral ca$ity and determines the degree of its pliability to remo$able denture.

3-. ma1illary mucosal classification by G:H,=& and degree of its pliability by EHGB7=,EO 9stages. Classification #y /I0),D: :of palate; 4 =ones:
i. ii. iii. i$. ?O), 1 Cagittal sutura the mucosa is thin firmly adjacent to bone and $ery sensible to forces !0.5- mm" ?O), al$eolar ridge with adjacent narrow7 strip7 which is widening by way to molars7 with low le$el of pliability !0.5- mm". ?O), ! trans$ersal palatal fold sat the anterior 2. of hard palatemedium degree of pliability because of layers of subcutaneous fatty tissue ! -(mm" ?O), 4 posterior 2. of hard palate glandular :one with great degree of pliability called :one of shredder ! .-0mm".

'0/$@,)'O classification: depend on different :ones of buffer $aries from !0.5-(.5mm". 3/.30 ma1illary prosthetic area bone classification at partial edentation by G=7OF,=I. !oint out the most unfa4orable "negati4e# class. Ma1illary tubercles classification 9types of hard palate and its practical importance.
$l(eolar process: i. -igh and 1ill mar2ed al(eolar process 1ith (esti#ular and lingual slope7 parallel between them without exostoses ii. Medium degree of al(eolar process atrophy $estibular and lingual slope are slightly obliHue as a result of loss of bone base iii. $l(eolar process 1ith little prosthetic (alue and great degree of atrophy because of wearing non corresponding prosthesis. i$. $l(eolar process 1ith negati(e prosthetic (alue and $ery great degree of atrophy !partial2total" as a result of wearing non corresponding prosthesis. Ma+illary protu#erance: i. Fa(ora#le7 retenti$e protuberances with parallel slopes. ii. Protu#erances 1ith medium degree of relief prominence7 fa$orable for prosthesis fixation. iii. Protu#erance 1ith degree of relief prominence !without any relief"7 that does not gi$e any possibility to pro$ide prosthesis stability is negati$e. i$. Protu#erances that re9uire surgical modeling for remo$ing mar-ed retention places or create interferences with opposite al$eolar process. -ard palate: i. Deep 1ith hori=ontal 1ide surface hard palate7 which pro$ides maximal adhesion7 without palatal torus7 with medium palatal joint non-sensiti$e for pressure7 with Cchroder :ones of a little depressi$eness. this -ind of hard palate is the most fa$orable for future prosthetic stabili:ation. ii. Medium mar2ed hard palate7 but wide enough7 di$ided by medium joint with relief sensible to pressure and reHuiring isolation during remo$able prosthesis manufacturing. iii. 7ently sloping hard palate with little prosthetic $alue characteri:ing by the absence of hori:ontal surface and the presence of ( obliHue slopes that cannot pro$ide stability of remo$al prosthesis. i$. *loping hard palate 1ith prolonged *chroder =one di$ided by $ery sharp medium joint7 which sometimes has a form of well mar-ed palate torus. This type does not allow remo$able prosthesis adhesion.

%5. Mandible prosthesis area bone classification by G=7OF=HI. :ndicate the unfa4orable forms of mandible protuberance type.
$l(eolar process:

*l$eolar process with good prosthetic (alue 7slightly atrophied7 with well mar-ed $estibular and lingual slopes7 painless without exostoses and the mandibular torus7 with smooth inner obliHue lines. This type the most fa$orable for prosthetic treatment with remo$able denture. ii. *l$eolar process with medium prosthetic (alue7 but still able to stabili:e and use the remo$able denture. iii. *l$eolar process with little prosthetic (alue7 with mar-ed resorption because the wearing not adeHuate prosthesis. i$. *l$eolar process with negati(e prosthetic (alue7 with conca$e relief in frontal and Cagittal plane. 'xternal and inner obliHue lines are near the al$eolar ridge. ,ental foramen is situated on the prosthetic filed 7 the bone is $ery painfull at pressing on it. Mandi#le protu#erance: i. ,andible protuberance are fa(ora#le for sta#ili=ation and fixing of remo$able denture 7not mo$able7 co$ered by healthy fibro-mucosa. ii. ,andible protuberance are less fa(ora#le for sta#ili=ation and fixing for remo$able denture7 but still able to be used prosthetic 7 less con$ex and more mo$able7 more depressible. iii. ,andible protuberances are (ery slightly fa(ora#le for sta#ili=ation and fixing of <&. due to mar-ed pterygo-mandibullary ligaments with unfa$orable because prosthesis of bad Huality and not eHuilibrated. i$. ,andible protuberances with negati(e prosthetic (alue for sta#ili=ation and fixing of <&. 7which are not possible to be used.

i.

%1. point out the al4eolar process shape by !=6 BEOJ(E:: 9 practical importance.
#ts depending on al$eolar process in edentulous area we can see the forms of atrophy . Trape:oid for good retention of denture. (. Triangular bed for fixation. .. 9arabolic medium retention. Practical importance: to maintain good stabili:ation for prosthetic denture.

%2. acryl remo4able denture"B &#. Component parts. Characteristics of artificial teeth in B &."cancelled#
P$RD consists of: . *rtificial teeth !acryl7 ceramic7 combine ,2* 7,2C". (. Caddle support for artificial teeth. .. Connectors of saddle !palatal and lingual". 0. Cupport maintenance and anchorage 7stabili:ation elements clasps7 morpho-functional elements !mucosa7 chee-s7 remained teeth". Characteristics of artificial teeth in P$RD: . Chould ha$e correct anatomical forms for ma-ing functions and esthestic aspects corespond to the color of remained teeth (. To ha$e enough durability!stability"7 especially during mastication. .. &o not ha$e chemical raction with food or sali$a. 0. Tightly connected with base of denture. 5. &o not harm the organs of oral ca$ity. =. To be easy for polishing and grinding. ?. To ressi$e mastication pressure. %3. characteristics of 2 group of fi1ation9 retention and stabiliKation of ! B&."cancelled# *ta#ility and supporting elements of PR$D :classification;: . 9refab element !clasps and special system" (. ,orpho-functional elements !cheec-s7 muscles adhesion7 remain teeth". *imple clasps: . Cimple acrylic clasp7 fixed on :- Tooth - *$eolar process.

- ,ixed. (. Cimple metalic clasps:- 9lane clasps - Bire clasps. .. Cimple acryl-metalic clasp. *pecial systems: . Telescopic system consist of: - Cylindric cap. - *rtificial crown. (. &older system. Morpho"functional elements: " Chee-s (" ,uscles ." *dhesion 0" <emain teeth 5" Come anatomical structures: !frenum7 exostoses7 internal and external opliHue line7 tuberosity" .ypes of PR$D according to used fi+ation system: . 3y screwing: remo$able telescopic aparatus with fixation system by screwing. (. 3y friction: telescopic7 attachment bars7 clasps. .. 3y anchoring with clasp. Retention of the denture- resistance that has denture after fixing in prosthetic field *ta#ility" is ability of a denture to remain firm and constant when applied forces to it can be: !method of fixation" - 9hysical - ,echanical - 3iochemical

%%.characteristics of segments and demands for wire clasps used in ! B&.clasps lines 9indication. "cancelled#
*egments of 1ire clasp: . demand of wire clasps from 0..-0.5mm stainless steel (. Clasp should hang (2. from the tooth surface. .. 'lastic segment should be inside of acryl (mm from support tooth 0. %ixing segments to be paralell to aleo$lar process (mm into oral surface the length should be A not less then .5mm Clasps lines-line which passes through support teeth. This lines is axis surround which can be rotation of the prosthesis. ! direction of lines: . Trans$ersal direction (. Cagittal direction. .. 1bliHue directon !diagonal" )ote: the better is obliHue for fixation of prosthesis. ! types of fi+ation of prosthesis: . 9ointed ! support teeth for clasp" (. 6iniar !sagittal 7trans$ersal7 diagonal"Aclasp lines should passes the eHual path. 1f base of prosthesis. .. 9lane !. and more support teeth". Indication: . %or upper jaw better diagonal line (. %or lower jaw better trans$ersal lines.

%). types of clasps used in B&. Classification.


.he more often used clasps are: . Cer$ico-occlusial open clasps. (. Cer$ico-al$eolar open clasp. .. Cer$ico-occlusal turned clasp. 0. Circular clasp by jac-son and adams 5. ,uco-a$eolar clasp =. &ento-gingi$al clasp by -emmeny ?. Telescopic clasp consists of prosthetic elements:

O. &older system. Classification of clasps: . 3y material: (. 3y topography: .. 3y form :

Cylindrical cap *rtificial crown

,etal *cryl ,ixed &ental *l$eolar &ento-al$eolar.

0.

5.

=. ?.

- <ound - 8alf round - Continuated 3y $olume of o$erlapping the support tooth - Cer$ico-occlusal open clasps - Cer$ico-al$eolar open clasps. - Cer$ico-occlusal turened clasps - Circular clasps by jac-son and adam - ,uco-al$eolar clasp. - &ento-gingi$al clasp by -emmeny 3y function : - %ixation - Cupport - ,ixed 3y method of manufacturing : - 3y casting - 3y cur$ing of wire 3y of type correction to base !saddles": - <egid W - 'lastic.

%+. Borders of !B & on upper and lower 3aw <


On the ma+illa: The prosthesis base on the upper jaw consist of : saddle palatal plate !that is in contact with mucosa of prosthetic field and remained teeth" - The palatal plate co$ers the palate and toothless al$eolar process completely. The $estibular edge of saddles comes till the bottom of al$eolar fold7 in the area of the natural mucosa7 being in the right contact. - &istally it co$ers the maxilla protuberance completely !in terminal edentation" coming into the palatal plate along the line . - The palatal edge of the plate are in contact with cer$ical area of frontal remained teeth. - #n the lateral area it ends on the supra eHuatorial :one of remained teeth. .he mandi#le: Gestibular saddles on the <& come till the bottom of al$eolar fold in the area of the neutral mucosa. &istally in terminal edentation it co$ers the mandible protuberance completely or partially !depends on its prosthetic $alue" . The frontal third coming down to inner obliHue line and stretching hori:ontally. Ma+illa limits: Gestibule: lower on 0.5 ml from neutral mucosa pass all frenulum !$estibule7 buccal". &istal: co$er completely the maxilla tuborosity and post dam area !linia *". 9alatal in lateral remain teeth co$ers the supra eHuatorial area #n frontal remained teeth depend on bite.!in orthognate" till eHuatorial area7 in deep occlusion !cer$ical area" Mandi#le limits:

&istal: not in e$ery cases we can co$er completely the mandibular protuberance. !&epend on pliability of mucosa there" Gestibular: upper on 0.5mm from neutral mucosa pass all frenulum. 6ingual: frontal till 0.5mm upper from neutral mucosa. 9osterior inner obliHue line7 #n the main teeth !frontal & lateral" Xalways co$er till supra-eHuatorial area.

%-8 :ndications for !B & with metal frame wor. and elastic lining ma.ing .materials<
Indications: . %or patients with freHuent and many times brea-downs of 9*<& !simple". (. #n patients with strong masticatory muscles. .. #n patients with bruxism . 0. *llergy to components !acryl". Materials: - 6ining steel7 thic-ness 0.5-0.Kmm stamping method. - Cr-Co7 T#T*D+,by casting method indications to elastic lining : . +neHual atrophy of al$eolar ridge with dry7 small pliability of mucosa when there is no normal method for fixations of prosthesis. (. #n presence of exostoses7 sharp edges7 sharp inner obliHue line & when the surgical method is contraindicated. .. &ue to manufacturing of difficult maxilla facial prosthesis. 0. #n manufacturing of immediate prosthesis with extraction of many teeth. 5. #n chronic diseases of mucosa. =. *llergy to acryl. ?. 9ainful sensation of mucosa. 'lastic layer can be applied on whole basis of prosthetic or just in correct parts within two techniHues may direct or indirect elastic layers material : - orthosil - 'ladent.

%/8biomechanics of !B & enumerate factors that influence on denture displacement<


Due to #ilateral terminal edentation the $ertical forces which act near retainer teeth one of the sides !right" ma-e deeper immersing the saddle of prosthesis and the remained teeth will be displaced $estibular side on the opposite side !left" opposite process: saddle of prosthesis mo$e away from the prosthetic field. - 3y the action of hori:ontal !lateral" forces the saddle of the prosthesis will be act on oral slope of al$eolar process !from one side" on the opposite side act on $estibular slope. - The force that acts on posterior part of saddles will ma-e deeper and displace the prosthesis posterior. - #n the region of retainer teeth on the side of acting force the saddle of prosthesis will go away from the prosthetic field. - 1n the opposite side the clasp will displace the retainer tooth orally7 but the saddle will go away from prosthetic field. - +nder influence of masticatory forces <& can be displaced in $ertical7 trans$ersal and sagittal directions. Factors that can a(oid the displacements of prosthetics: . Clasp line. (. *dhesion and stic-ing. .. *natomical retention. 0. Yuality of manufacture elastic segment of clasp. .he degree of displacement is depending: - Topography of defect. - &egree of pliability of mucosa. - &egree of al$eolar process atrophy. - <etenti$eness of prosthetic field. The displacement of prosthesis during functioncan lead or o$er accelerate the atrophy of bone support . Factors that can cause to P$RD displacement: . ,astication pressure.

(. +sing stic-y food.!always" .. *ction of periphery muscle. 0. Mra$ity of the denture. 5. degree of al$eolar process atrophy =. *bsence of teeth on distal area. ?. 9alatal torus !$olume& position". O. Technical-constructi$e factor. >ery important for the #iomechanics of P$RD is: Clasp lines. number of retainer teeth 9osition of clasps of these retainer teeth. Fi+ation of the prosthesis can #e: . 9ointed. (. liner !Cagittal7 trans$ersal7 diagonal" .. %latted. The correct choice of retainer teeth is important for the spreading of masticatory pressure. For clasp fi+ation should #e: Ctable. high clinical crown Bith good prominent eHuator. Bithout morph functional disorders in per apical region. 9ointed fixation less fa$orable. 6inear fixation more fa$orable.

%08inummerate functional forces that influence on !B & .e1plain the biomechanics of such .ind of denture when 4ertical force influences near the natural teeth on ma1illa on second class of partial edentation by Eennedy<
. ,asticatory pressure by way of artificial teeth transferred on the base of denture. (. %orces that appear during mastication act in hori:ontal and $ertical planes. *econd class #y 'ennedy: unilateral terminal edentation. *pply force on base near the support tooth !with one clasp" the saddle near support tooth goes deeper but the distal part is opposite de-touched and displaced $estibular one.

)5.)1.)2. "cancelled# )3. clinical picture of partial edentation in case of absence of occlusion and clinical laboratory steps of !B & manufacturing <
Clinical picture of partial edentation in case of a#sent occlusion :: third clinical situation; A no sings of co :for all groups ;: . ,edial facial line. (. +pper frontal teeth co$er one third. .. antagonist 0. ;ey of occlusion. 5. 3uccal cusps of upper lateral incisors are located outside from buccal of lower lateral teeth. =. %ran-furt line !lateral area"is not parallel to lateral area . ?. #n frontal area inter-pupilar line is not parallel to frontal area. Clinical la# stages of PR$D in a#sence of occlusion : Clinical: . 'xamination of patient. (. &iagnosis and plane of treatment. .. Ta-ing impression. /a#oratory: ,a-ing model. ,a-ing wax base with occlusal rims. Clinical: . Testing in model and oral ca$ity. (. &etermination of $ertical dimension by anatomic-physiological method. .. fixed $ertical dimension and co : drawing the lines on $estibular surface of occlusal rims : For arrangement of artificial teeth:

,idline. %or width artificial teeth. 8ori:ontal !smile"7 determine high of artificial teeth. Canine linefor width of artificial teeth should be correspond to pupil line . /a#oratory: . %ixation in articulator in co. (. ,anufacturing of clasp and arrangement of artificial teeth. Clinical: Chec-ing in model and in oral ca$ity !. stages": limits correlation between saddle and limit teeth occlusal contact. /a#oratory: . %inal modeling of wax reproduction. (. Mypsum Hui$ete and modeling. !Transfer wax to acryl". .. 9olishing and grinding.

)%. (pecify stages and .inds of ta.ing impression of !B &9 manufacturing .possible complications during ta.ing impression at !B & manufacturing and its prophyla1is. =lastic impression materials<
.ypes of impression :: according to condition of soft tissue;. . $natomical: ta2ing by standard tray without ta-e into consideration the functional state of the soft tissue of prosthetic field. 2. Functional: ta-ing only by indi$idual tray usage of specific functional testes for registration the functional state of mucosa of prosthetic field. Methods of functional impression: . Don compressi$e : #n & ( classes by ;ennedy. ,anufacture of base with elastic lining. Bith elastic material. That will not permit too high pressure on prosthetic area. . Compressi(e: . #n partial edentia with high degree of mucosa pliability. (. &one by digital pressing on the indi$idual occlusal surface. .. ,anufacturing of rigid base. *electi(e compressi(e. 0. ,ixed. ,lastic material : first stage . ypeen cronax tropicalgin algenat . Possi#le complication during ta2ing impression of P$RD manufacturing ad its prophyla+is: #f we choose incorrect impression material or incorrect techniHue of ta-ing impression can be complication as: . The form of denture will be not correspond to prosthetic field . (. &is-balance & displacement of denture. .. 1$er occlusion or hypo occlusion. 0. Bounds in edentulous area. 5. 3ro-en of denture !because of pressure". =. *bsence of contact points. Pre(ention: Choose correct impression material. Correct techniHue of application. Complication during ta2ing impression: . Dot corresponded tray to prosthetic field. (. #ncorrect choosing of impression material.

.. 0. 5. =.

the mixing of material wasn)t good !too much liHuid or hard " not enough material !small portion of material can lead to absence of good limits of prosthetic field" didn)t apply enough pressure during ta-ing impression !compressi$e & non compressi$e" %orgot about anatomical structures li-e: frenulum.

))8inummerat methods of determination of hight of co "central occlusion #.indicate in which case it will be determined <
1. *natomical !not used" not clear determination (. antroponetrieal .. anatomic-physiological 4. %unctional contraction of muscles during closer. $natomic"physiological :re9uires using of occlusal rims; : 1. 3efore measure ,<9: ( points: a. sub nasal 22 b. mental. 2. #ntroduce upper occlusal rims it falling down lips7 chee-s7 and more. 3. 6oo- at the patient face and a little open mouth see upper occlusal rim !borders . situations": +pper ( mm than upper lip . at the same le$el lower on ( mm than upper lip better position 0. Bor- with $estibular surface. 6earn de$ice borders of occlusal rims : #n lateral area nasal-line should be parallel to occlusal rim line. #n frontal area inter-papilar line should be parallel to occlusal rim line. 5. #ntroduce lower occlusal rim the $ertical dimension !high of co" must be less on ( ml than ,<9. =. 8ot and stic- them in co . >ertical dimension B MRP 4 ml . & ( clinical situation of partial edentation when we ha$e non stabile or absence of occlusion.

)+ .in what clinical situation of partial edentation is it necessary to determine the neutral mandible position at co determination< Methods of determination and their characteristics.
#n ( & . clinical situations of partial edentation when we ha$e non stabile or absence of occlusion !when we use anatomic-physiological methods for determination of $ertical dimension " methods of determination of mandi#le rest position ::neutral position of mandi#le in determination of co ; : . 'antoro(ich method : press on chin of patient during closer of mouth .this method is rare because its possible to o$er press and dislocate mandible distally from co !disad$antage" (. <ounding of head posterior and simultaneously close the mouth. &ue to this method the supra-hyoid group of muscles displaced the mandible posterior and put it in co. .. Test of swallowing act: 9atients swallows sali$a and close the mouth. #n this moment the mandible relates to maxilla in co. 0. <etel man method: the doctor applies index fingers on occlusal surface of lateral lower molarsZ the thumbs are on the chin of patient. 9atient should close the jaws and bite the fingers of the doctor. &uring closures the fingers go away in oris $estibule7 by pressing on chin the mandible will be in co. C. #y a#%ean and 2or#endou : 1pening the mouth and -eep this position for .0sec. Clowly close the mouth and directs the mo$ements of closure by doctor7 until filing the articulator condyle and first contact occlusion. .o repeat the mo(ement se(eral times a. maximum opening . 3. relaxing c. Closure to the first contact.

)-. :nnumerate the peculiarities of clinical laboratory steps of !B & manufacturing and central occlusion determination at prosthetic treatment of both 3aws subtotal edentation
Clinical: . 'xamination of the patient. (. &iagnosis and plane of treatment. .. Ta-ing impression.

/a#oratory: ,a-ing auxiliary model. ,anufacture at indi$idual tray. Clinical: . Testing at indi$idual tray. (. Ta-ing functional impression. /a#oratory: . ,a-ing wor-ing model. (. ,anufacturing of wax base with occlusal rims. Clinical: . Testing in model and n oral ca$ity. (. determination of $ertical dimension !anatomic-physiological method " .. %ixed $ertical dimension in co : drawing lines on $estibular surface of occlusal rims : midline hori:ontal line Canine line /a#oratory: . Mypsum of wax base with occlusal rims in articulation in co. (. ,anufacturing of clasps and arrangement of artificial teeth. Clinical: Chec-ing of wax reproduction on model and in oral ca$ity3 ! stages: a. limits b. Correlations between saddle and limits c. 1cclusal contact 6aboratory: . %inal modeling of wax reproduction (. gypsum in Hui$ete and molding !transfer wax to acryl " .. Mrinding and polishing.

)/. B techni2ue of determination and importance of prosthetic plane in subtotal partial edentation at central inter83aws relation determination< "Cancelled# )0. B techni2ue of wa1 composition of !B & testing. 'hat mista.es can established in 4ertical plane.
.esting of P$RD 1a+ composition consist of stages: . Testing of wax composition in the model fixed in the articulator. (. Testing of wax composition in oral ca$ity. In articulator stages: . Chec-ing inter-dental contact with help of articulator paper. (. Chec-ing Huality of artificial teeth .arrangement in the area of al$eolar process. .. determination of correspondence artificial teeth ! si:e 7form 7color " 0. &etermination of limits of future remo$able denture. 5. Chec-ing situation of the clasps of denture. In the oral ca(ity stages: . 'xamination of extension7 retention and stability of the denture. (. 'xamination of clasps arms for non traumatic placement relati$e gingi$al margin of the teeth. .. 'xamination of dental- dental plural contacts !artificial teeth with other teeth7 in position of co". 0. Yuality of dental- dental contacts in functional occlusion. 5. Cpatula test in lateral area. =. &etermination of phonetic7 esthetic restoration. ?. Contact of $ertical and hori:ontal components of C/<. Control of (ertical components of the C@R: &epend on clinical situation presence 2absence of fixed $ertical dimension !stabile7 unstable co". 1. #f $ertical dimension was defined by contact opposite natural teeth7 the denture should be inserted and chec-ed contacts between natural and artificial teeth must ha$e touch contact between them. 2. #f not fixed $ertical dimension the denture should be inserted and chec-ing contact artificial and natural teeth in $ertical dimension that pro$ide free way space.

Mista2es: . Do contacts between artificial and natural teeth in $ertical dimension. (. Do free way space.

+5Lenumerate disad4antage symptoms during the !B & wa1 model chec.ing up if at last clinical step "occlusion recording# mandible had anterior "protrusion#position. &octorMs tactics.
In frontal area between the dental rows establish prognathic bite !the space between upper and lower" In lateral area cusp to cusp relation !not cusp to fissure" Cpace between frontal teeth. the space will increase bite. .o defect this 2ind of mista2e: 1hen during displacement of lower wax base with teeth interiorly between dental arches will establish correct relation. .actics: new wax composition with occlusal rims or &determination of C/< from lower base remo$e teeth new occlusion and C/< determination.

+1Lwhat will we do if the final !B & is not fi1ed on the prosthetic area and how to correct occlusion in this case
To chec- if presence some exercise masses on prosthesis or pores !during polymeri:ation"remo$e this excessi$e masses and rough surface to polish . to chec- clasps if they too much sharp .which disturb to prosthesis application can be easy defect by articulator paper which apply between prosthesis and natural teeth .the excessi$e material remo$e in se$eral times with round burs. #f exist space between prosthesis field use acryl . to chec- edges of prosthesis -Nif not ma-e a trauma in mucosa. *lso can be incorrect occlusion !upper7 lower7 lateral"to chec- with articulator paper. If increase occlusion remo$e all artificial teeth by applying on basis occlusal rims and determine C/<. If decrease occlusion apply on teeth of prosthesis a strip of wax and rearrangement of teeth 7 During lateral occlusions determine bloc-ing part not to grind the cusps which ma-es the $ertical dimension7 on lower this cusps are buccal7 on upper jaw is palatal. During protrusion of mandi#le can be bloc-ing pints !during deep bite" need to ma-e shots the frontal teeth

+28enumerate disad4antages of !B & and ad4antage of s.eletal remo4able denture.


Disad(antage of P$RD: - mucous-bone support is not adapted of mastication pressure (- Can lead to inflammation of the mucosa by o$erloading of remained teeth with future complication .- Trauma of marginal gingi$a and enamel of support teeth by clasps element. 0- Golumetric base !big in si:e" of the denture lead to disorder in sensation7 phonetic function. 5- *cryl can lead to allergic reaction. $d(antage of P*RD: - ,orphological functional restoration of dental arch integrity. (- %unctional occlusion restoration. .- 'sthetic phonetic restoration. 0- 9rophylactic action on tissue 5- #f to compare 9<*& *D& 9C<& has C,*6'< base and $olume creating comfort in oral ca$ity =- 8as dental @periodontal and mucosal-bone support. ?- 8as many $ariants of support elements. O- Consist from more metal that permit to be more strong and resistant. K- Can be used in case of allergic reaction from acryl. 0- 8as fa$orable action on morphology and physiology on stoma. Cystem - 9eriod of adaptation is shorter than 9<*&.

+38arch remo4able denture parts characteristics two 4ariants of saddles of s.eletiKed remo4able denture
Component parts of P*RD - 3ase of denture consists of: *. saddlemetal and mixed

3. artificial teeth acryl7 porcelain7 combined (- ,ain connecters .- Cecondary connectors 0- Cupport maintenance and anchorage7 stabili:ation elements 5- stress-bracers *addles of the denture :*RD; <epresent the part of denture that co$ers dental part of al$eolar ridges and where are situated artificial teeth *addles can #e: are $ery seldom and can be made by stumping or by casting consist from metal and acryl material.

+%8what are siKes of ma3or connectors presented by arch used for s.eletiKed remo4able denture on lower an upper 3aw9 their position
,ain connector !element that connect saddles of denture between each other : . bar (. plate .. continuous clasps The main connecter can ha$e different forms si:e depending on place of situation upper2lower jaw7 on type of occlusion Form of the #ar: Circular2o$al2semi o$al2semicircular2atypical Form the lo1er %a1 can #e used: . lingual bar with the width of .mm and the thic-ness .5-( mm (. lingual plate !dental-mucosal " .. continues clasps For the upper %a1 main connectors . palatal plate !complete and partial" (. palatal bar Palatal plate: Complete co$ers hard palate completely and the thic-ness 0.0-0.= mm !sometimes 0.. mm" 9artialcan be situated in the anterior7 posterior or medium of the hard palate. Chould touch the mucosa !no space"for suction Palatal #ar :arch;: . Cituated in the anterior part of posterior third of the hard palate and situated at the distance of 0.5- mm from mucosa. (. #n some cases the bar can be situated in the anterior part of hard palate !ex: in absence of frontal teeth" .. #n patient with prominent torus in medium of hard palate for this case: continuous clasp on frontal teeth and palatal arch in anterior part of posterior third of palate. 0. Thic-ness of main connectors on the upper jaw 0.Omm - mm and the width =-Omm !till 0 mm"

>038 etiology of complete edentation. :ntraoral and e1tra oral signs. edentulous patients
etiological factors di(ided into groups: . hereditary: bud formation disorders !hypo-dontia7 oligodontia7 anodontia" (. $c9uired: caries and its complication. Tooth inclusion !situation on of place" complete 2 partial periodontal disease operation because of tumor. Trauma a$itaminosis systemic diseases !diabetes mellitus .hypertension. #atrogenic !after incorrect treatment teeth were extracted" social @ economical causes *ymptoms of total edentation: e+tra"oral: " reduction of facial s-eleton (" &isplacement of mandible down and inside

ules of 3aws atrophy on

." &eformation and displacement of sub-nasal bone downward 0" 'xpressed lowering decrease of top of the nose 5" changes in frontal part of chee- bone =" &eepening of chee--bone fossa ?" 9rominence of nasal-labial and chin folds O" 6owering mouth commissural K" changes in soft tissues of maxilla- facial area !chee- and lips down " 0" changes in contraction of muscles ele$ating of mandible intra"oral: " complete absence of teeth ! 2 both jaws " (" different degree of mucosal atrophy ." different degree of al$eolar process atrophy till residual al$eolar process Rules :la1s; of %a1s atrophy on edentulous patient: 1) atrophy of al$eolar process is irre$ersible process and prosthetic treatment doesn)t stop it the irritant for the bone is extension of ligaments that are connected to the bone ! al$eolar process " and this al$eolar process cant undergoing to the force of shrin-ing that comes from base of remo$able denture (" atrophy can increased because of incorrect choosing of prosthetic treatment with uneHual spreading of masticatory pressure .!which is going mostly on al$eolar process " ." different people ha$e different degree of al$eolar process atrophy 0" hard palate become flat 5" the most less expressed atrophy of maxillary tuberosity and palatal torus D; atrophy of lo1er %a1 occurs not e9ual in different parts : - Central part the most prominent atrophy in lingual side - 8ori:ontal atrophy 7) atrophy of al$eolar process on maxilla centric *trophy of al$eolar process on mandible a centric

>0% 6M7 and muscles changes at complete edentationD


.M@ changes: " *s rule ha$e morph-functional7 atrophic character. (" after losing the teeth ha$e more expressed amplitude ! a specially when both al$eolar processes try to ma-e a contact " 3) temporal fossa becomes more flat 7 condyle are displaced forward and distally 0" lateral mo$ements of lower jaw and mo$ements of lower jaw forward pro$o-e essential pressure in T,/ and ma-e articular dis- thinner ! in some cases punched " 5" in the condition of relati$e physiological rest of lower jaw condyle occupied distal portion =" displacement of condyle distally in the large amplitude results in extension of articular capsule that often lead to luxation and sub luxation of lower jaw ?" the patient has a pain 7 headache 7hyper sali$ation 7 sensation of burning of mucosa and in the tongue ! syndrome of good friend " Changes in muscles: " ,imic muscles changes -N decrease tonus (" ,astication muscles changes-N the tonus of the muscles that ele$ate mandible is reduced gradually .will be present muscle tiredness7 spasm7 hype 2 hyper-tonicity of muscle7 hypertrophy7 pain in muscles.

>0)# supporting "bearing# and functional area on upper 3aw. eisering space9 palatal torus 9classification by landaD
" *upport =ones of upper %a1: gi$es the possibility to -eep <& in different condition !fa$orable 2 unfa$orable" depending on si:e and form of residual al$eolar process 7 hard palate and maxillary tuberosity . <esidual al$eolar process can ha$e different $olume 7shape and determine the form of hard palate and deepness !$ault" ; Functional =ones areas : Gestibular :one ! fish poc-et 2 $estibule labial :one 2lateral $estibular space " &istal :one !post dam area" Palatal torus classification #y land: 1n the hard palate in the place of connection of palatal bones can appear palatal torus 7 different si:e 7 form and arrangement

" 9alatal torus of rounded form located distally (" 9alatal torus of elongated form ." 9alatal torus of ellipsoid form 7big in $olume and $ery prominent and located in frontal and middle part of hard palate 0" Darrow palatal torus but $ery elongated and situated in frontal part of hard palate 5" 9alatal torus that starting from frontal part and finished in distal part !whole length of hard palate "

>0+# supporting "bearing # and functional areas on lower 3aw at complete edentation D
*upport =ones :stress #earing =ones ; : *l$eolar process ,andible protuberance that in some cases can be co$ered partially 2totally with complete denture Functional =ones: . paired :ones: - Tone of mandible protuberance - 6ateral lingual :one - 6ateral $estibular :one ( unpaired :ones: - Central lingual :one - Central $estibular and lingual :one

>0-# muscles situated ne1t to the prosthetic field on upper and lower 3aws at complete edentation . practical importance .
" Masseter muscles: it ta-es origin from Tygomatic arch and inserts on the lateral surface of the mandible in front of the angle %unction ele$ation the mandible. ; Medial pterygoid muscle: 1rigin: ( heads: " &eeplateral surface of pterygoid process (" Cuperficial tuberosity and pyramidal process of maxilla #nsertionmedial surface of mandible near the angle %unction ele$ation and side-to-side mo$ements of mandible !; Mylohyoid muscle: Origin: mylohyoid line in the mandible. Insertion: anterior surface of the hyoid bone Function: to decrease !depress" the mandible 4; $nterior #elly of digastrieus muscle : Origin: digastrics fossa of mandible Insertion: body of hyoid bone Function: open mouth by decrease depress the mandible Importance: &ue to contraction of the muscles the mandible without problem achie$e maxilla !ele$ated" #f will be disorders in the muscles cause to T,/ changes !arthritis 7 pain.."

>0/# characteristics of functional Kones types of 4estibular slope of al4eolar 3aws processes at complete edentation. &escribe their importance.
Functional =ones: !secondary7 section7 seal " @ co$ers mucosa that come in contact with complete denture edges . " %unctional :ones of upper jaw : - Gestibular :one !poc-et $estibular labial space and $estibular lateral space" - &istal :one !post dam area" *urfaces of (esti#ular functional =one of ma+illa : ! forms of slope of al(eolar process: . Cteep (. Clightly sloping .. 1$erhanging 3y <*D&*+ : . <etenti$e (. Don-retenti$e .. 8alf-retenti$e

Functional =ones of lo1er %a1: ! paired =ones: - Tone of mandible protuberance - 6ateral lingual :one - 6ateral $estibular :one !fish poc-et" unpaired =ones : - Central lingual :one - Central $estibular and labial :one Gestibular lateral :one function: different denture insertion 7has form of depression !more or less" Gestibular central :one can be exostoses7 buccal frenulum in region 6ingual lateral :one anatomical: . torus mandibular 7 (. 1bliHue line !mylohyoid m. insertion " 6ingual central :one . 6ingual frenulum (.geniohyoid m.digastrieus m. insertion.

>00# types of al4eolar process at complete edentation according to (chroder and .oller classification and the degree of mucosa pliability by supple. Giund
*chroder classification of al(eolar process atrophy on the upper %a1 :! types ; . #s characteri:ed with well expressed al$eolar process eHual at all his extension with well prominent maxillary tuberosity and enough high palatal $ault. !deepness" transitory folds places of muscles attachments are situated relati$e high . This type of atrophy is more fa$orable for prosthetic treatment 7because of anatomical retention formation are expressed not interfere in the prosthetic fixation . (. #s characteri:ed by medium degree of al$eolar process7 preser$ed maxillary tuberosity and well prominent palatal $ault . Transitory folds are situated near the top of al$eolar process .in this case conditions for prosthetic treatment usually are well7 but at abrupt contraction of muscles surrounding prosthetic field can lead displacement of the denture . .. #s characteri:ed by abrupt atrophy of al$eolar process7 disappear of al$eolar process and flat hard palate . transiti$e fold 7labial frenum and place of muscles insertion are situated near to the top of al$eolar process at the le$el of hard palate. This type of atrophy not fa$orable for prosthetic treatment because of absence of anatomical retention formation and $ery often we ha$e displacement of complete denture . 'oller classification of al(eolar process atrophy :lo1er %a1; . Bell expressed al$eolar process eHual to at whole his extension with small degree of atrophy .this type is characteri:ed for simultaneous teeth extraction and fa$orable for prosthetic treatment . 3ecause anatomical formation are expressed well and not interfere denture fixation during mo$ements of lower jaw . (. +niform ad$anced atrophy of al$eolar process in some cases with in$ol$ement the body of mandible !4X5 al$eolar process " with accentuated atrophy of the bone mass 7created $ery different conditions for prosthetic treatment . $ery close placed insertion of the muscle 7near the top of al$eolar ridge 7lead to displacement of C& during the function .. Bell expressed atrophy of al$eolar process in lateral area and small atrophy in frontal area . this type of atrophy is relati$e fa$orable for prosthetic treatment because of atrophy of al$eolar process in lateral area not interfere micro mo$ements of C& in trans$ersal plane . retention :one only represented in frontal area and interfere displacement of C& in Cagittal area !plane" 0. Bell expressed atrophy of al$eolar process in frontal area and small atrophy of al$eolar process in lateral area .stability of denture is possible in trans$ersal plane and bad in Cagittal plane that creates possibility for sliding the denture forward. &egree of mucosa atrophy by supple : . 8ealthy mucosa with moderate thic-ness and elasticity resilience that can support shoc-s during mastication function and decrease displacement of C& (. *trophied thin mucosa with decrease resilience that cannot support pressure during mastication function and create not fa$orable condition during mastication .pain during mastication. .. Thic- mucosa with increase degree of resilience that lead to displacement of C& during function 0. 8ypertrophied mobile mucosa li-e a -oc-s-comb this type of mucosa need surgical treatment 6inud classification of hard palate mucosa: . Cagittal <aphae mucosa is thin 7tightly co$ers the bone and $ery sensiti$e to forces !0.5- mm" (. *l$eolar processwith small degree of mucosa resilience !0.5- mm" .. Cugae medium degree of mucosa resilience 7because of sub-mucosa fatty tissue ! -(mm" 0. Tone of Cchroder !glandular :one" with high degree of mucosa resilience.

155. Clinic and preclinical e1amination of complete edentulous patients. &iagnosis.


Clinical e+amination:

*u#%ecti(e: . Complains (. *namnesis morbi !history of disease" .. *namnesis $ita O#%ecti(e: ,+tra oral: . symmetry of the face (. color of the s-in7 $isible mucosa !lips7 conjuncti$a" .. expression of the face 4. three floors: till supra-orbital line till nasal wings till chin !mental" #n edentulous patient of ### floors 5. nasal-labial line =. angle of mouth ?. .M@: mo$ements of condyle open and close mouth crepitating O. muscles palpation !masseter7 temporal": extra oral & intraoral K. some pathological formations 0. palpation of painful points: - Cupra-orbital foramen !infra-orbital" - Canine fossa - ,ental foramen *s- the patient if he2she has a pain in these regions . Palpation of lymph nodes: - occipital - auricular - sub-mandibular - sub-mental - front2bac- of CC, muscle intraoral . Coloration of lips & oris $estibule !mucosa" - &egree of mouth opening . ,+amination of the al(eolar process - palpate the al$eolar process - degree of al$eolar process atrophy - the $estibular slope forms !. e+amination of oral mucosa :classification #y /e%uyeu+; - color of the mucosa !pale7 if painful" - degree of pliability !Cupple7 6iund" 0. examination of palatal torus !forms" by 6anda Diagnosis: Consists of ! parts: . ,ain !primary" disorder of stoma. system (. complication of primary disorder .. secondary disorder !disease" ,+: complete secondary edentation7 ## class by Cchroder on the upper jaw & ###class by ;oller on lower jaw after caries & its complications with mastication insufficiency by *gapo$. Para"clinical e+amination: . P-<ay !panoramic" (. arthrography !of T,/" .. electromyography- ',M !for muscles" - e$ery muscle separately - put electrode on face & register how the muscle wor-s - use functional probes !during rest7 mastication"

0. diagnostic models !to study on model is more exact" 151. Methods of fi1ation of complete "full# denture. &escriptions. "Cancelled#

152. $i1ation and stability of complete denture. $unctional denture suction and adhesion.
Fi+ation of CD is fixation of denture on prosthetic field on condition of relati$e physiological rest of the lower jaw. %or such fixation the presence of adhesion of the base of denture to orthopedic field is enough. *ta#ility of CD is the Huality of denture withstand !resist" the forces of the displacement in hori:ontal direction. #ts relationship of denture base to the underlying bone. Changes of soft tissue & bone under the denture lead to lac- of stability. To promote fixation and stability of C& anatomical formations are $ery important !palatal..." also additional factors that promote fi+ation and sta#ility of CD: - atmospheric pressure - adhesion - cohesion - mechanical loc-s - muscle control - patient tolerance *dhesion is the stic-ing one surface on another !denture to the prosthetic field". The surfaces should be wet. *dhesion we need only for the fixation !& not stability" without applying pressure on the C&. Cuction goes after adhesion !fixation" creation of $acuum for better retention. Be need it for stability of the denture !resist to the forces in different planes without displacement of the C&".

153. :ndi4idual tray. Ma.ing methods. Hsed materials and techni2ue for indi4idual tray ma.ing in clinic and in laboratory.
Indi(idual tray is a special tray for impression materials for the ta-ing functional !final" impression. Two methods for manufacturing indi$idual tray: . &irect !in clinic7 in oral ca$ity" -by 3rahman -by Gasilen-o (. indirect !in laboratory" Direct method3 techni9ue of manufacturing #y <rahman: . (2. of standard wax plate7 which is soft7 flex in two entering into oral ca$ity & adapted to maxilla. (. (2. of standard wax plate7 which is soft7 flex in three create horseshoe form & adapted to mandible. .. 9eculiarity of this method: we can remo$e or add wax for correction. 0. The indi$idual tray is ready if: there is no displacement of tray during swallowing7 & this tray has impression of prosthetic field. 5. The edges of tray should be formed in a way that the functional impression will be clear & the relief of transitional fold was imprinted. =. The distal edge of tray should be longer on -(mm than 9ost-&am area. .echni9ue #y >asilen2o: . better than 3rahman !easier" (. The edges of tray to ma-e shorter till the le$el of passi$e mobile mucosa !neutral bone" & adapt these edges by impression material due to ta-ing functional impression. .. for distal border longer than 9ost-&am area on 0.5cm 0. 9erforation by way of middle- fibrous :one on upper jaw for elimination of excessi$e impression material. Other method #i"layer impression::direct; st step thermo-plastic material !..." on standard tray nd ( step second layer by hard material !<epin7 liHuid silicone" create final impression7 4wash techniHue5 Materials used in manufacturing of indi(idual tray: - ,etal !aluminum" - thermo-plastic material !..." - Bax !(J. in oral ca$ity" - Cold cure acryl - 8ot cure acryl

15%. Chec.ing test of indi4idual tray border "periphery# by *erbst on upper and lower 3aws. :mpression ta.ing with indi4idual tray.
Functional tests #y -er#s for the ma+illa: ,aximal opening of the mouth: #f the tray is displaced7 the $estibular edge of the tray must be remo$ed from the pterygoid-mandible raphae & up to the place7 where the st molar is situated !distal $estibular area". Cuc-ing of lips: . *t tray displacement7 must be remo$ed $estibular edge at the area of buccal folds. &isplacement of lips in the tube !whi::ing": (. *t tray displacement frontal area is remo$ed. Functional tests #y -er#st for the mandi#le: Cwallowing mo$ement & maximal opening of the mouth: - #f the tray is displaced during swallowing- the distal edges of tray7 from tubercular periforme to sublingual line7 is remo$ed. *fter remo$ing of this area7 we as- the patient to open the mouth gradually till maximal opening7 if the tray is displaced from its distal edge7 it must shortened !remo$ed" from tubercular periforme till the place of (nd molar !$estibular". - ,o$ing up the patient)s top of tongue to the upper & lower lips7 if the tray is displacedZ the lingual edge of tray on the region of mylohyoid muscle is remo$ed. - The tip of the tongue touches the internal surface of the chee- !right & left". #f the tray is displaced opposite side of the tray is remo$ed. - The tip of the tongue is put on upper lip & to the tip of nose. #f the tray is displaced we remo$e from lingual area !place for frenulum". *cti$e mo$ements of muscles7 suc-ing the lips & ma-ing lips in tube. #f the tray is displaced we remo$e distally. Impression ta2ing 1ith indi(idual tray: #t is functional impression which is ta-en by indi$idual tray with siliconic material. %unctional impression which is ta-en during mo$ements.

15). 6ypes of functional impression depending on border tray height and compression degree on the mucosa of the prosthetic field. :ndications.
I. $ccording to the height of impression edges: . %unctional impression with edges in the area of passi$e mucosa !natural :one" proper functional impression for denture with good relief of bone tissue. (. %unctional suction impression edges of impression cross the neutral :one on -(mm. II. $ccording to the methods of impression edges: . 'dges of functional impression are made by passi$e mo$ements of mucosa. (. 'dges of functional impression are made by acti$e mo$ements of mucosa !reali:ation of functional tests". .. 'dges of functional impression are made by acti$e mastication mo$ements & other functions of stoma. Cystem. 0. ,ixed formations of edges of functional impression. III. $ccording to compression degree on the mucosa: . Compressi$e impression- is ta-en by pressure techniHue7 manually by the doctor7 under chewing pressure & closing- pressure on mucosa. (. &e-compressi$e impression- non pressure !muco-static" .. Celecti$e impression- more distal7 less proximal !depends on type of mucosa". Indications: %or Compressi$e: . #n case of pliable mucosa !compress buffer :one" $essels compression 1f prosthetic field & ma-ing them empty !without blood" (. with non-perforated tray .. 6ow liHuid material !$iscous": gypsum7 silicon. 0. the pressure should be continuously !non-stop" & the pressure is stopped only after the hardening of the material 5. better fixation with this -ind of impression For De"compressi(e: - in case of low pliability of mucosa - presence of palatal torus - with high liHuid materials:

&entaflex Pantopren Tn% paste - with perforated tray For *electi(e: - for #G class by Cupple - with perforated tray !in region of non-pliable mucosa

15+. !eculiarities of 4estibular cur4e and height of upper occlusal rims modeling. &etermination of prosthetic plane.
Modeling of (esti#ular surface of the upper occlusal rim: . ,ust be determination of the Huality of upper wax occlusal rim. *fter this7 its disinfection & introducing into oral ca$ity. (. &etermination the possible balancing of wax borders with occlusal rims. .. afterwards7 wor-ing with $estibular surface: closing of the mouth & if we see some protrusion of frontal surface lip & lateral surface we remo$e from occlusal rim7 if the lip is falling down we add wax to the occlusal rim. Determination of the height of upper occlusal rim: #t is determined simultaneously with the determination of the le$el & direction of prosthetic plane. - The edges of the upper occlusal rim in frontal area should be in - .5mm lower than the edge of upper lip or to be at the same le$el !but in the lower occlusal rim lower in - .5mm than the lower lip". Determination of the le(el & direction of prosthetic plane: %ox: to use special de$ice with internal & external plane occlusal plane - 6ine that connected external auditory canal !tragus" & spino-nasalis is [[ to occlusal plane !line which goes on incisal edge & top of distal palatal cusp of (nd upper molar". - in lateral area occlusal plane should be [[ to trago-nasal line !tragusspino-nasalis" - in frontal area occlusal plane should be [[ to inter-pupil line

15-. &efinitionD Central 7aws elationships9 *eight of the Bite9 $ree (peech (pace9 :nter8 occlusal !hysiological (pace. (tages of Central 7aws elationships at complete edentation determination.
Central @a1s Relationships is a situation of mandible in regards to maxilla when the condyle occupied not forced !rest" position to the base of the slope of articular eminence7 not depending on the presence or absence of the teeth. This C/< is eHuilibrated by all components of stomatognat system in . planes !$ertical7 trans$ersal & Cagittal" & create inter-jaws relationship that pro$ide optimal si:e of the lower third of the face called physiological si:e. %rom this C/ position of mandible7 begin & finish all the mo$ements of the lower jaw. -eight of the <ite :height of occlusionE inter"al(eolar height; in !C'" is the distance between al$eolar processes in the position of C1 with losing the left pair of teeth antagonist inter-al$eolar height becomes not fixed. This fact considerably changes the face expression7 nasal-labial & chin folds become deeper7 the angles of the mouth fall down because of reduction of m.orbicularis oris function. This muscle becomes flabby & it leads to its atrophy !mimic & masticatory". Free *peech *pace for reali:ing of the phonetic function is needed %CC. The smallest space is created when patient pronounces 4C57 biggest 4*<5 This space is indi$idual & its si:e depends on the character of phonation & it can be changed during lifetime7 day7 & depends on the CDC of the patient. Inter"occlusal Physiological *pace clinically7 it is determined as the difference between the height of rest position & occlusal height of using the same random points on the face. #nter-occlusal Cpace is approximately (-0mm7 but it can be in some people .5-?mm. it can be changed during lifetime7 after teeth extraction. The condition of relati$e physiological rest position of mandible !,<9" is one of articulation position of the mandible in minimal acti$ity of masticatory muscles & full relaxation of mimic muscles. The tonus of & muscles is eHual. *tages of Central @a1s Relationships at complete edentation determination: . modeling $estibular surface of upper occlusal rim (. determination of height of upper occlusal rim .. determination of le$el & direction of prosthetic plane 0. determination of height of occlusion

5. determination & fixation !register" of C/< =. determination \ drawing on upper occlusal rim7 smile7 canine & central lines ?. determination of color7 si:e & form of artificial teeth

15/. Methods of height of occlusion and Central 7aws determination.

elationships at complete edentation

Methods of determination of height of occlusion: - anatomical !not used" - anthropometrical - anatomic-physiological - functional $nthropometrical method: using of Mering)s compass for the determination of automatic points of gold section. 1pen mouth widely external shoulders of compass applied on chin & top of the nose Close the mouth without changing the position of compass shoulders #f the internal top will situated on nasal top & external shoulders0ne on the chin & second on pupil This position !(" corresponds with relati$e rest position !,<9" $ertical dimension (-.mm less $natomic"physiological method: - the position of the mandible when the muscles are relaxed & between upper & lower jaw teeth appears the inter-occlusal space (-.mm - to draw ( points: sub-nasal7 mental - patient is sitting & loo-ing forward - with help of spatula is measured & fixed distance these ( points - #ntroduce occlusal rims & determine the $ertical ... of occlusion $ertical dimension should be less than (.mm that is why we remo$e wax from lower rim (-.mm Methods for determination of MRP !mandibular rest position": - 'antoro(ich: during closer of mouth the doctor applies pressure on the patient)s chin7 *fter remo$ing mandible goes forward till rest position - functional test" maximal protrusion of lower jaw for 00-50 sec & after muscle tiredness the mandible will come in rest position - swallowing test - Cears- proposed molar relax. #f the doctor will put his finger on st molar & as- the patient to close the mouth7 the mandible will be in rest position - with the tip of the tongue touch $ibrating !9ost dam" line in moment of mouth closure

150. Methods of fi1ation of Central 7aws teeth setting in complete denture.

elationship. &etermination of landmar.s for artificial

Methods of fi+ation of Central @a1s Relationship: -ot method: on upper occlusal rim ma-e hot...7 lower occlusal rim is dissol$ed !ma-e soft". This method reHuires the control of $ertical dimension. Cold method: on upper occlusal rim ma-e hutches 7 on lower occlusal rim apply the soft strip of wax & blocbetween them7 li-e a -ey loc-. *fter that to draw the lines: smile7 canine7 central. /andmar2s for artificial teeth arrangement: 0pper %a1: . central incisors are situated between central line & ha$e no contact a little with glass plane !surface" (. lateral incisors $estibular surface incline medially & ha$e no contact with cutting edge on mm from glass pad !surface" .. canine with cutting edge7 contact with glass pad 0. st premolar buccal cusp contact with glass7 palatal cusp has no contact on mm from glass 5. (nd premolar both cusps ha$e contact with glass pad =. st molar- medial-palatal cusp has contact with glass7 others: medial-buccalA on 0.5mm7 distal-buccalA on .5mm7 distal-palatalA on mm from glass pad ?. (nd molar has no contact with glass pad7 medial-buccal cuspA on .5mm7 others: on (-(.5mm /o1er %a1: . in correlation to upper jaw J to the bite J creation of maximal inter-cusps fissure

(. teeth should be situated in the middle of al$eolar process .. the $ertical axes of frontal upper teeth goes a little to $estibular $ertical axes of lateral teeth goes in the middle of al$eolar process 0. upper jaw should ha$e form of half-elipsed7 lower jaw- parabolic 5. it is also necessary to chec- the contact during mo$ement to lateral sides !balance side7 wor-ing side" /andmar2s: - smile line to determine the height of artificial teeth - canine linefor width of artificial teeth !edges of the wing of the nose" - middle linefor central incisors arrangement.

115. 6echni2ue of intraoral and e1tra oral registration of mandible mo4ements at complete edentation. !ractical importance. 6echni2ue of artificial teeth arrangement in complete denture by Cysi.
,+tra"oral: Cpecial de$ice- facial arches by Misi . 9encil on the le$el of condyle ! .0- .. cm in front of tragus" (. &e$ice consists from intra & extra-oral parts .. intra-oral- 4+5-shaped plate connect with extra-oral 0. extra-oral- writing de$ices !T,/ area7 patient chin" 5. for registration: mandible forward7 register the degree of condyle displacement Cagittal angle articular trajectory #ntraoral registration: #t is based on the method by Christensen7 he obser$ed that in case of mandible mo$ements forward before the occlusal surface of occlusal rims in the area of molars appears triangle space with top loo-ing forward. This phenomenon was called Christensen phenomenon7 it is used at indi$iduali:ation of occlusal surface of occlusal rims & creation of cur$es by spee & ,-B .echni9ue of artificial teeth arrangement in complete denture #y 7isi: !#n articulator type Misi simplex & using of glass pad plate" 0pper %a1: - #ncisor edge of central incisors & top of canines must ha$e contact with prosthetic plane - 6ateral incisors- distance 0.5- .0mm to prosthetic plane - Canines contact with prosthetic plane st premolar contact with prosthetic plane only with $estibular cusp - (nd premolar contact with both cusps st molar medial-palatal cusp has contact medial-buccal- distance 0.5mm distal-buccal- distance .5mm distal-palatal- distance mm - (nd molar has no contact7 continuation of st molar line /o1er %a1: - begin with st molar !-ey of occlusion"7 but $estibular cusps of st molar will be places in medial-distal fissure of st upper molar - Canine- the top of canine will be between upper (nd incisor & canine - Central & lateral incisors [[ to middle line & has a little $estibular inclination. #ncisor edge will be co$ered on -( mm by upper incisors st premolar- $estibular cusp between upper canine & st premolar nd - ( premolar- $estibular cusp between upper st & (nd premolar - (nd molar- according with upper (nd molar

111. techni2ue of intra oral and e1tra oral control of the complete denture wa1 composition. !ossible mista.es at the stage of height of occlusion. &etermination. Clinical signs. &octors tactic.
,5.R$ OR$/ controls of CD 1a+ composition: . Control of acludater Huality absences of step or balancing of occludator 7 fixation of height of occlusion .

(. Control of models Huality of models !absences crac-s smoothing of contours 7 defects on the of surfaces"7 the middle plane of the model should coincide with middle plane of occludators presence of orienteer)s on the model ! smile line7 middle line 7 center line" !. Central of 1a+ composition consist of: a" Control of artificial teeth color7 si:e7 form7 inter incisor line coincides with middle line of the face the degree of teeth o$erlapping. - The upper incisor should not o$erlap lower incisors more than on -( mm7 also in lateral not too much o$erlap - *ll teeth should situate in the middle of al$eolar process ! except upper frontal: (V. externally and 2. internally" - '$ery tooth has ( antagonists - Cpec & ,-B cur$es b" &uring control of wax bases- pay attention on correctness of functional borders of prosthetic field 7 modeling of interdentally papilla & $estibular slopes of the base I).R$OR$/ control of CD 1a+es composition: . Chec-ing extension 7 retention & stability of the dents (. Chec-ing esthetic .. Chec-ing $ertical & hori:ontal components of /< Chec2ing e+tension3 retention & sta#ility: - *t medium degree of mouth opening7 from the upper lip le$el should be seen only incisor edges of upper teeth7 but during smiling @ till cer$ical area. - %orm of teeth @ correspond to form of face - Control position of canine7 inter-dental contacts degree of excremation of cur$es spee & ,-B. - #nter-dental space ! as- patient to say se$eral words" - Control $estibular & lingual extension @ to ma-e some mo$ement with the tongue . - <etention @ chec-ing by pressure on premolar if present balance. - Ctability @ also apply pressure on premolar ? molar on each side & if presence rotary displacement Chec2ing esthetics: - exam frontal & lateral area with closed& half open of mouth - middle line 7 occlusal plan: !comper2 inter-papular line" - si:e 7 color of teeth Chec2ing (ertical components of @R: #ncreased or decreased of $ertical dimensions7 by ( points: nasal & chin: - #f decreased patient has facial expression li-e in C' - #f increased chin & nasal-labial folds will be smooth during the spea-ing. Chec2ing hori=ontal components of @R: - if teeth ha$e maximal inter-dental contact if the mandible goes bac- !retreaded position" /< - #f not- new registration of hori:ontal /<. PO**I</, mista2es at the stages of height of occlusion determination D groups: . ,ista-es made during $ertical dimension of occlusion determination !increased or decreased" (. ,ista-es made because of Cagittal or trans$ersal mandible displacement . .. ,ista-es made because of occlusal rims displacement during determination of $ertical dimension &C/<. Correction of these mista-es @ is made by manufacturing of new occlusal rims & determination of C/<. 0. ,ista-es made because of displacement of record base ! wax base J1.C." from the prosthetic field . 5. ,ista-es made because of deformation of record base. =. ,ista-es made because of compression of mucosa of prosthetic field.

112. !ossible complications during the neutral 3aw relationships at complete edentation recording clinical symptoms. &r. 6actics.
&isplacement of mandible interiorly 7 posterior7 left &right & fixation in this position: #nteriorly progeny 9osterior progeny

6ateral high bite7 displacement of mandible center space between lateral teeth from canine till molars for correction of this mista-es remo$al of artificial teeth from the lower wax base7 manufacturing of new occlusal rim & registration of new C/<. &isplacement of wax bases with occlusal rims from the prosthetic field7 because of uneHual pressure on occlusal rim during their contact due to determination of C/< . Clinically: testing of wax reproduction of C& in oral ca$ity & appearance of absence of inter-dental contacts group !4spatula symptom5" & presence of free space between dental arches7 depending on place of prosthesis displacement from prosthetic field. #f displacement in distal part from prosthetic field Clinically: prominent o$erlapping of lower frontal teeth by upper teeth & presence of space between lateral teeth in position of C1. - #f in frontal part clinically: space between frontal teeth in position of C1. - #f displacement in side !lateral" clinically: contact of teeth on opposite side & free space on displaced side in position of C1. - %or correction of this mista-es apply strip of wax on artificial teeth & as- the patient to close jaws by teeth in printingthe models put in correct position & again gypsum in occludator for rearrangement of teeth. ,ista-es during deformation of wax bases during fixation of C/< 7 when the wax bases J occlusal rims were made with incorrect reHuirement -N balancing of the wax base & space between base & model. C/I)IC$//6: !high" bite & uneHual contact of lateral teeth & presence of space in frontal region . %or correction of this mista-e -N new wax bases7 occlusal rims & new C/< registration.

113. Oral ca4ity hygiene recommendations for patients using complete denture. (teps of getting used complete denture.
. Bith prosthesis the patient can eat different food !cold7 hot7 bread7 meat7 hard &liHuid". 3ut to eat nuts 7 sugar hard product are for bided. (. To ta-e care about prosthesis7 to brush with tooth brush & powderVpaste !new exist special paste for prosthesis cleaning"7 to clean in water !normal temperature" before & after food. The prosthesis should not clean in hot water because it can lead to deformation of prosthesis. .. *t the beginning of usage to use for (0h !adaptation". Bhen the patient will not pay attention on prosthesis to remo$e in the night to clean it & put in water with tablet. *t the morning again to clean & apply in to oral ca$ity. *teps of adaptation #y 'urliands2yF Phase 1irritation stage !5 days- ( wee-s" #n this stage abuse hypersali$ation7 prominent $omiting reflex 7 changes in speech7 mastication efficiency 7 non-coordination mo$ements of mandible. Phase partial inhibition !(nd day- 5th day after complete denture setting" #n this stagepartial reestablish of functions decreasing of sali$ation7 decreasing $omit reflex7 the mo$ements of mandible become more coordinated patient feels more in comfort. 9hase. total inhibition ! month after C& setting7 some till = month" #n this stage disappear the unpleasant sensation & prosthesis is not feels as foreign body7 opposite without prosthesis patient feels discomfort.

11%. !ossible reasons of bad complete denture fi1ation. Correction roles.


1. Disorders in (al(e =ones :distal3 lateral3 circular; : - The distal $al$e :one is situated at the region of post dam area !line *" - between hard & soft palate -( mm. for finding this region strip of wax apply on distal area of prosthesis & with finger pressure imprint it7 to chec- this distal $al$e :one !$acuum" the doctor should apply pressure in the region of palatine near incisors7 the direction of pressure is $estibular7 and it there is displacement of prosthesis7 that mean the this distal $al$e :one is the reason for bad fixation. - To chec- the lateral $al$e :one to apply pressure on occlusal surface & $estibular surface of side & to see if there is displacement from opposite side !lateral $al$e :one bad $acuum. (. The borders of prosthesis are not correct ! at the regions of frenum 7 tuberosity" .. The functional tests were not made properly. FOR Correction: - To ma-e the functional tests again & see when the C& was remo$ed !displaced" . *ccording to these functional tests remo$e from the denture in place where the problem is.

De$er should be remo$ed from internal surface of the denture !surface of al$eolar ridge"7 only the borders can be remo$ed.

11). 6he borders of complete remo4able denture on the upper and the lower 3aws.
0pper %a1 CD: . Gestibular surface till transitional fold ! neutral :one" (. Gestibular the upper labial frenum7 due to upper lip 'xtension7 the frenum should not attach !ma-e a contact with prosthesis7 if the frenum will touch the prosthesis will be trauma of frenum& basis of prosthesis will displace from prosthesis field. .. 6ateral area: transitional fold !neutral :one". 0. &istal area: prosthesis co$ers the tuberosity. %rom tuberosity the border goes by way of distal $al$e :one !line *" /o1er %a1 #orders of CD: . Gestibular areaZ presence of lower labial frenum 7 due to extension of lip not to traumati:e the frenum . (. 6ateral area buccal transitional fold .. &istal area co$er the protuberances partially or totally. 0. 6ingual areaco$er till obliHue line !mylohyoid insertion" left & right7 anterior surround the lingual frenum. Correction: . ,a-e longer or shorter the borders of prosthesis for lower jaw and creation of peripheral $al$e :one.

11+. :ndications and clinical laboratory stages of complete remo4able denture ma.ing with double layer or metal framewor. base.
Indications for dou#le"layer CD: layer elastic layer !elastic acryl". ( layer acryl layer. . Dot uniform atrophy of al$eolus process with dry small pliable mucosa when any will -now methods cannot help for denture fixation. (. 9resence of sharp bone protuberance and exostoses of prosthetic field. 9resence of sharp inner obliHue line and contraindication for surgical preparation7 when the hard basis of prosthesis causes se$ere pain. .. %or manufactory of difficult maxilla @ facial prosthesis 0. %or manufacturing of immediate prosthesis with remo$able of big amount of teeth. 5. #f exist chronic disease of oral ca$ity mucosa =. #f exist allergy to acryl prosthesis ?. #f exist increased pain sensation of mucosa. methods of manufacturing " layers #asis : - &irect ! in oral ca$ity ": . %rom the old denture remo$e mm for the future elastic layer J ma-e hutches. (. *pply elastic material ! elastomeric 7 elastoplasts" (- #ndirect ! lab" ( methodsZ . ,ethod : . ,odel change in acryl ! polymeri:ation" (. Mypsum in cu$ete. .. 'lastic material polymeri:ation !the same time of polymeri:ation" (. ,ethod (: . Mypsum in cu$ete : half of cu$ete with dentures 2 ( half of cu$ete with wax !polymeri:ation the same time" J! between them polyethylene" . I)D,C$.IO) FOR M,.$/ <$*, OF CD: . %reHuent fracture of C&. (. To ma-e hea$ier the lower C& 7 for better C& fixation .. 3ruxism 0. *llergy to acryl 5. %or better feeling of temperature of the food techni9ues of metal #ase manufacturing: . 3y stamping ! thic-ness 0.. @ 0.0mm" by hammering (. 3y casting !0.0 0.K mm" : Cast system application %ire proof layer J molding furniture

Bax dissol$ing 7 during 7 burning the form Casting alloy application.

11-. ebasing or relining of complete remo4able denture indications . clinical "direct# and indirect "laboratory# methods of relining
I)DIC$.IO)* FOR R,/I)I)7: . #n immediate denture at .-= months after the original construction. (. &ue to poor adaptation and resorption of al$eolar process. .. Bhen many appointments need for manufacturing a new denture can cause physical or mental stress. #n cause of chronic illness. 0. 'lder patient can)t or poor adaptation to denture. !*ging". I)DIC$.IO) FOR R,<$*I)7 ! replace all the pin--acrylic base material without changing of occlusal relationship of teeth". . Dot corresponding of denture to prosthetic field as result of :. *trophy of bone. (. Don Hualities impression. .. Technician mista-es decreased borders of prosthesis edges. 0. &enture undergoes to warming for a long time. (. 3ro-en denture7 old denture. .. #n immediate denture. DIR,C. M,.-OD OF R,/I)I)7 :I) OR$/ C$>I.6; . <emo$e mm inside of denture. (. %iles the denture with soft material: . Coft base prime !self curing" (. <eline soft !MC reline". .. Cilicone rubbers. *nd hardiness to a rubbery consistency !before ma-e hutches " .. application of $arnish Coft material- for .0 minute !duralines". I)DIR,C. M,.-OD OF R,/I)I)7 :I) /a#oratory; . Ta-ing impression with elastic material exist denture !not with help of tray". (. Mypsum if prosthesis with impression ma-e in cu$ete ! flas-ing " .. *fter remo$ing of impression material by acryl of this impressions material by acryl 0. 9olymeri:ation of acryl.

11/. Cancelled 110. :ndication and techni2ue of reinforced complete denture. Hsed material.
Indication: . %racture (. Crac-s ! -( places". .. ,ore good adaptation. 0. Change of prosthetic field !after operation". 5. 3iomechanical !in mo$ement @ problems7 pressure come in one point". #ncorrect laboratory stages. .echni9ue of reinforced CD: . 6ine of fracture V cra-e in (-. places cause by dichlorethenelic glue7 to contact the part of prosthesis by line fracture and wait (-0 minute. (. ,a-e gypsum model @ apply Gaseline on model and prosthesis to ma-e a center model by how portion of gypsum. .. <emo$e the prosthesis from the model and brea- it the lines of crac-s !which was with glue". 0. 'xtend the line of fracture in each side for -( mm and ma-e hutches in the edges. 5. ,odel and counter model co$er by $arnish7 after parts of prosthesis apply on model7 the correction of applying chec- with contra model7 ma-ing plastic !acryl" consistency and apply on fracture line. 3efore co$er by monomers and co$er !press" by contra model polymeri:ation M$.,RI$/*: . ,etal wire J ( types of glass fibers !e$ersti-s". (. Mlue dichrarethend. .. 9oly ethylene fibers !ultra light @modulus". 0. Carbone2 graphite fibers.

125. techni2ue of remo4able denture from 4aloplast by casting manufacturing. Bd4antages


$d(antages: . %lexible denture from nylon (. %or replacement of hard clasps by flexible material and pressure on support teeth. .. 9ressure spreads on whole mucosa 0. Comfortable for the patient. 5. 'sthetic =. Can be used in partial <&. *D& #D C1,96'T' remo$able denture7 proxism7 T,/ disorders. ?. ,anufacturing by method of treatment O. 8a$en)t monomer !for allergy" K. Color can be chosen corresponding to gingi$a7 transparent 0. Dot hea$y . #n patients who don)t want to prepare teeth for bridge denture and implants. (. &oes not cause allergy7 durable more than acryl. .echni9ue: . Do preparation of teeth in the clinic and ta-e impression from alginate (. #n laboratory ma-ing model7 counter model and central occlusion fixation. .. ,a-e wax reproduction. 0. <eplacement of wax by injected nylon !Galplast injection" 3efore testing in the oral ca$ity to put in hot water for good adaptation.

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