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Tindakan Preprostetik dan

Sistem Rujukan
Acing Habibie Mude
Examinati
on, Pre Jaw
diagnosis, prostetik Primary Secondary Try-in Denture
relation Follow-up
and (Mouth impression impression procedure insertion
preparation) record
treatment
planning
Background
• Mouth preparation is fundamental to a successful
removable denture service.
• Mouth preparation follows the preliminary diagnosis
and the development of a tentative treatment plan
• Mouth preparation includes procedures in 4 categories:
 Oral surgical preparation
 Conditioning of abused and irritated tissue
 Periodontal preparation
 Preparation of abutment teeth
OBJECTIVES

1. To return the mouth to optimum health


2. To eliminate any condition that would be detrimental to
the success of RPD
A. Oral surgical preparation

 Pre-prosthetic surgical treatment for denture patient should be


completed as early as possible.
 Necessary endodontic surgery, periodontal surgery, and oral surgery
should be planned, so that they can be completed during the same
time frame.
 The longer the interval between the surgery and the impression
procedure, the more complete the healing and consequently the
more stable the denture-bearing areas.
Various surgical preparation
Extractions Bony spines and knife-edge
Removal of residual roots ridges
Impacted teeth Dentofacial Abnormality
Malposed teeth Osseointegrated devices
Cysts and Odontogenic Tumors Augmentation of Alveolar Bone
Exostoses and Tori
Hyperplastic Tissue
Muscle attachments and Frena
Torus palatine Torus mandible Exostoses

Residual root
B. Conditioning of abused and irritated tissue

• Patients who require conditioning treatment often demonstrate the


following symptoms:
1. Inflammation and irritation of the mucosa covering denture
bearing areas
2. Distortion of normal anatomic structures, such as incisive papillae,
rugae and retromolar pads
3. Burning sensation in residual ridge areas, the tongue and the
cheeks and lips
• These conditions are usually associated with ill-fitting or
poorly occluding removable partial dentures.
• However, nutritional deficiencies, endocrine imbalances,
severe health problems (diabetes or blood dyscrasias), and
bruxism must be considered in a differential diagnosis.
How to use tissue conditioning materials
The tissue conditioning materials are elastopolymers that continue to flow
for an extended period, permitting distorted tissues to rebound and assume
their normal form.
Maximum benefit from using tissue conditioning materials may be obtained
by
1. Eliminating deflective or interfering occlusal contacts of old dentures (by
remounting in an articulator if necessary);
2. Extending denture bases to proper form to enhance support, retention,
and stability
3. Relieving the tissue side of denture bases sufficiently (2 mm) to provide
space for even thickness and distribution of conditioning material;
4. Applying the material in amounts sufficient to provide support and a
cushioning effect
5. Following the manufacturer’s instructions
6. Many dentists find that intervals of 4 to 7 days between changes of the
conditioning material are clinically acceptable
C. Periodontal preparation

• Periodontal preparation of the mouth usually follows any oral surgical


procedure and is performed simultaneously with tissue conditioning
procedures.
Objectives of Periodontal Therapy
The basic objective is the return to health of supporting structures of the
teeth, creating an environment in which the periodontium may be maintained.
The specific criteria for satisfying this objective are as follows:
1. Removal and control of all etiologic factors contributing to periodontal
disease along with reduction or elimination of bleeding on probing.
2. Elimination of, or reduction in, the pocket depth of all pockets with the
establishment of healthy gingival sulci whenever possible.
3. Establishment of functional atraumatic occlusal relationships and tooth
stability
4. Development of a personalized plaque control program and a definitive
maintenance schedule
Treatment Planning
Periodontal treatment planning can be divided into three
phases:
1. Disease control or Initial Therapy – Eliminate or reduce
local causative factors before any surgical procedures are
accomplished
2. Surgery phase – Periodontal surgery, free gingival grafts,
osseous grafts, or pocket reduction is accomplished
3. Recall and maintenance – 3 – 4 month intervals
Initial Disease Control Therapy (Phase 1):

1. Oral Hygiene Instructions


2. Scaling Root Planning
3. Elimination of Local Irritating Factors other than Calculus
4. Elimination of Gross Occlusal Interferences
5. Temporary Splinting
6. Use of a Night guard
7. Minor Tooth Movement
Definitive Periodontal Surgery (Phase 2)
Periodontal Surgery:
1. Periodontal Flaps
2. GTR (Guided Tissue Regeneration)
3. Periodontal Plastic Surgery (Mucogingival Surgery)
Recall Maintenance (Phase 3)
3 – 4 month recall to maintain the results achieved by non
surgical and surgical therapy
Advantages of Periodontal Therapy
1. Elimination of periodontal disease removes a primary
causative factor in Tooth Loss
2. Better environment for restorative correction
3. Response of strategic but questionable teeth to periodontal
therapy provides an important opportunity for reevaluating
their prognosis
4. Reaction of patient to periodontal procedures and degree of
cooperation
C. Preparation of abutment teeth
Abutment Teeth Preparation include:
1. Abutment Restorations
2. Contouring Wax Patterns
3. Rest Seats