2.1 Object and nature of prosthetic Dentistry.

Semester two - topic 1

Define Prosthetic Dentistry

It is the dental speciality pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or maxillofacial tissues using biocompatible substitutes.

What is Prosthodontist?

1. A specialist in Prosthodontics

2. A dentist who was successfully completed an advanced education program in Prosthodontics that is accredited by the appropriate accrediting body. In the United States, that body is the Commission on Dental Accreditation of American Dental Association / ADA/.

What is a prothesis?

1. an artificial replacement of an absent part of the human body

2. a therapeutic device to improve or alter function

3. a device used to aid in accomplishing a desired surgical result

What are the three types of prothesis’?

1. Dental prosthesis

2. Maxillofacial prosthesis

3. Ancillary prosthesis

What are the two types of dental prosthesis?

1. Fixed dental prosthesis

2. Removable dental prosthesis

What are the three types of FDP under fixed dental prosthesis?

1. Cement retained FDP

2. Screw Retained FDP

3. Friction Retained FDP

What are the two types of RDP’s under Removable dental prosthesis?

1. Complete RDP

2. Partial RDP

Remember!!!

Remember!!!

What is oral facial complex?

in dental prosthetics it refers to the integration and function of prosthetic components within the oral and facial regions with the function of:

1. Mastication

2. Swallowing

3. Breathing

4. Speech

5. Special organs : smell, taste and vision

What are the bones of the oral facial complex?

Cranium, maxilla and mandible

What are the joints of the oral facial complex?

TMJ, stylomandibular ligament and sphenomandibular ligament capsular ligament

What are the muscles of mastication?

1. Temporalis

2. Masseter

3. Buccinator

4. Orbicularis oris

What are the muscles during masticatory movements?

1. Opening - depressor jaw muscles : mylohyoid/ digastric/ inferior lateral pterygoid

2. Closing - elevator jaw muscles : medial pterygoid/ superficial masseter / temporalis

What are the extrinsic tounge muscles?

1. Genioglossus

2. Styloglossus

3. Hyoglossus

List the small glands in the oral and facial region

1. Labials

2. Buccales

3. Palatine

List the big glands in the oral and facial region

1. Parotid

2. Submandibularis

3. Sublingualis

How many types of papillae are present on tongue?

4

What are the 4 types of papillae on tongue?

• Fungiform papillae

• Filiform papillae

• Foliate papillae

• Cicumvallate papillae

What are the tongue muscles divided into?

Intrinsic and extrinsic

What does the intrinsic muscles of the tongue do?

They change the shape of the tongue

What are the intrinsic muscles of the tongue?

• M. longitudinalis linguae

• M. transversus linguae

• M. verticalis linguae

What does the extrinsic muscle of the tongue do?

Responsible for the tongues protrusion and retrusion

What is an example of an extrinsic muscle of the tongue?

Genioglossus muscle

What is the tongue innervated by?

Innervated by the hypoglossal nerve (cranial nerve XII)

What is the role of the tongue in tongue activity?

• Anchoring and moving the tongue

• Involved in jaw movements, respiration, speech, taste, mastication, swallowing and sucking

Define a tooth

A tooth is a hard, calcified structure found in the jawbone (either the maxilla or mandible). It’s used for chewing and grinding food during the process of mastication.

What is are dental embrasures?

They are the spaces that you can find around a tooth where the curvature of the tooth surface starts to move away from the adjacent tooth

What are the names for the types of dental embrasures?

• Occlusal/Incisal

• Facial

• Lingual

• Gingival

How many teeth make up Primary (Deciduous) Teeth?

consists of 20 teeth

When does Primary (Deciduous) Teeth begin forming?

begin forming during first trimester of pregnancy

when does Primary (Deciduous) Teeth start erupting?

typically start erupting around 6 months of age

At what age would a child have a complete primary dentition of Primary (Deciduous) Teeth?

Most children have a complete primary dentition by 3 years old

Describe the morphology of deciduous teeth

• Thinner enamel and whiter than the permanent teeth

• Rounded crowns with constricted cervix

• More prominent cervical ridge

• Roots of anterior teeth are longer and narrower than the permanent

• Roots of molars are longer and more slender and flare greatly, comparing to the permanent

How many teeth does Secondary (permanent) teeth consist of?

consists of 32 teeth in most cases

when does Secondary (permanent) teeth start erupting?

being erupting at 6 years of age

when are Secondary (permanent) teeth fully erupted?

most permanent teeth have erupted by age 12

what Secondary (permanent) tooth is an exception in terms of erupting by age of 12?

Third molars (wisdom teeth) are the exceptions, often appearing late teens or early teens

Remember!!!

Remember!!!

What is mixed dentition?

the transition phase in dental development where a person has both primary (deciduous) teeth and secondary (permanent) teeth present in the mouth.

When does mixed dentition usually occur?

Typically occurs between the ages of 6 and 12

What is Hypodontia?

missing one or few teeth due to development issues

What is anodontia?

Rare condition where all primary or permanent teeth are missing

Give two conditions that affect oral function and aesthetics

Hypodontia and Anodontia

Classification: Incisors

function as cutting or shearing instruments for food

Classification: canines

possess the longest roots of all teeth and are located at the corners of the dental arch

Classification: premolars

act like the canines in the tearing of food and are similar to molars in the grinding of food

Classification: molars

located nearest to the temporomandibular joint (TMJ), which serves as the fulcrum during function

What are the tooth surfaces?

Apical, labial, lingual, distal, mesial

Tooth surfaces: apical

pertaining to the apex or root of the tooth

Tooth surfaces: labial

pertaining to the lip; describes the front surface of the anterior teeth

Tooth surfaces: lingual

pertaining to the tongue; describes the back (interior) surface of all teeth

Tooth surfaces: distal

the surfaces of the tooth that is away from the median line

Tooth surfaces: mesial

the surface of the tooth that is toward the median line

Dental Tissue: Enamel

Outermost layer of tooth, very hard, protects tooth from decay

Dental Tissue: dentin

beneath enamel, also hard, supports enamel and carries some nerve fibers

Dental Tissue: odontoblast layer

these cells create dentin and are located at boundary of the pulp chamber

Dental Tissue: Pulp chamber

Soft tissue in centre of the tooth that contains nerves and blood vessels

Dental Tissue: gingiva

also known as gums, soft tissue that surrounds teeth and covers alveolar bone

Dental Tissue: periodontal ligament

soft tissue that helps anchor tooth to surrounding alveolar bone

Dental Tissue: cementum

hard tissue that covers the tooth root and helps anchor it in place with help of periodontal ligament

Dental Tissue: alveolar bone

part of jawbone that holds the tooth sockets

Dental Tissue: pulp canals

pathways in roots of teeth that carry nerves and blood vessels to the pulp chamber

Dental Tissue: apical foramen

Opening at tip of the tooth’s root where nerves and blood vessels enter tooth

Remember!!

Remember!!

What does the anatomic crown do?

portion of tooth covered by enamel

What does the anatomic root do?

It is the lower two thirds of a tooth

What does the pulp chamber have?

It houses the dental pulp, an organ of myelinated and unmyelinated nerves, arteries, veins, lymph channels, connective tissue cells and various other cells

Tooth sides: incisal

the cutting/tearing edge, in posterior teeth will be occlusal which is used for grinding the food

Tooth sides: mesial

tooth surface towards the median line

Tooth sides: distal

tooth surface away from the median line

List the periodontal tissues

• gingiva

• alveolar bone

• periodontal ligament

• cementum

List the hard tissues of the tooth

• enamel

• dentin

• cementum

• alveolar bone

What are the soft tissues of the tooth?

• pulp chamber

• Gingiva

• peridontal ligament

Enamel:

Characteristics:

1. Hardest tissue in the body, highly……

2. ……structure with enamel….

3. no nerve supply, ……

4. …..-soluble

Vulnerability:

1. Vulnerable at pH ….. or lower

2. Cannot….

3. …… with age

4. Remineralization aided by ….., saliva

What are the three types of dentin?

primary, secondary and tertiary “reparative” dentin

what does primary dentin do?

forms initial shape of tooth

When is secondary dentin deposited and onto what?

it is deposited after primary dentin on all internal aspects of the pulp cavity

How is tertiary “reparative” dentin formed and in repose to what?

is formed by replacement odontoblasts in response to moderate level irritation or trauma

Dentin

Characteristics:

1. It is ….. than enamel, susceptible to wear

2. Sensitive, lacks ……..

3. Primary dentin forms…….; secondary adds to it

Vulnerability:

1. Demineralizes at pH …. or lower

2. ……produced (primary, secondary, tertiary)

3. Forms ……dentin in response to irritants

1. softer

2. nerve supply

3. initial

1. 6.5

2. continuously

3. tertiary

Cementum

Characteristics:

1. covers….., mineralized

2. works with periodontal ligament to…..

Vulnerability:

1. …..than enamel, dentin

2. not…..

Dental Pulp

Characteristics:

1. …..part, soft tissue with nerves, blood vessels

2. provides…….for the tooth

3. ……..in crowns, root has pulp canals

Vulnerability:

1. Typically sensitive to …….

Tooth sides: Lingual

pertaining to the tongue; describes the back surface of the teeth

Tooth sides: Labial

pertaining to the lips; describes front surface of the teeth

Tooth sides: Apical

pertaining to the apex or root of the tooth

The dental tissue: Pulp chamber

The soft tissue in the centre of the tooth that contains nerves and blood vessels