in partial fulfilment of btech: dental technology, department of dental sciences, cput, 2008 by...
TRANSCRIPT
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In partial fulfilment of BTech: Dental Technology, Department of Dental Sciences, CPUT, 2008
by Nicolea Jacobs
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OVERVIEW Patient History Definition Clinical Treatment Possible Treatment Options Chosen Treatment Option Advantages and Disadvantages Laboratory Procedures Problems Experienced Future Treatment Options References Acknowledgements
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PATIENT HISTORY A 36 year-old female
Complained of tooth ache, gingival erythema, swelling, and bleeding1
Referred to the Tygerberg Hospital UWC Dentistry Faculty
Inflammation on the margins of the gingiva, and caries on certain teeth (Fig. 1)1,2
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PATIENT HISTORY (cont.)
Fig. 1: Marginal gingivitis1
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DEFINITION
Mild inflammation of gingival tissue3
Exists around teeth3
Amona – a human ailment4
Irritating effects caused by bacterial plaque4
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CLINICAL TREATMENT
Received mouth wash for plaque formation and sensitivity of the gum tissue2,5
Teeth with caries were extracted Most teeth with inflammation were extracted Maxillary 2∙1, 2∙8, and 1∙7 were prepared for single
crowns Remaining standing teeth were the 1∙1, 1∙8 and
2∙5
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POSSIBLE TREATMENT OPTIONS MAXILLA MANDIBLE
Removable acrylic partial denture6
Fixed partial prosthesis7
Metallic removable partial denture7
Combined precision attachment denture8,9
Conventional acrylic denture8,9,10
Implant-retained overdenture10,11
14 unit bridge prosthesis10,11
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CHOSEN TREATMENT OPTIONMAXILLA MANDIBLE
Combined precision attachment denture
2∙1 metal-ceramic crown 2∙8 and 1∙7 milled gold
crowns Metallic removable
partial denture
Conventional acrylic denture with labial gum tinting
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ADVANTAGES OF POSSIBLE TREATMENT OPTIONSMAXILLA
Conventional removable partial denture6,12
Fixed partial prosthesis6
Metallic removable partial denture6,9,12
Combined precision attachment denture12,14
Less expensive than all options6,12
Good aesthetics6,12
Excellent retention- retentive arms6,9,12
Excellent retention and stability - combination12
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ADVANTAGES OF POSSIBLE TREATMENT OPTIONSMANDIBLE
Conventional acrylic denture6,12
Implant - retained overdenture11,13
14 unit bridge prosthesis14
Least expensive of all the choices6,14
Excellent stability and retention
Good aesthetics
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DISADVANTAGES OF POSSIBLE TREATMENT OPTIONSMAXILLA
Conventional removable partial denture6,12,14
Fixed partial prosthesis10,11,15
Metallic removable partial denture6,12,14
Combined precision attachment denture7,8,9,11,15
Insufficient stability and retention11,14,15
Most expensive option Lack of aesthetics –
clasp arms Bone resorption
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DISADVANTAGES OF POSSIBLE TREATMENT OPTIONSMANDIBLE
Conventional acrylic denture14
Implant - retained overdenture15
14 unit bridge prosthesis15
Less stability and aesthetics14,15
Most expensive treatment option
Too expensive compared to a conventional denture
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LABORATORY PROCEDURESFIRST PHASE: Poured final model Fabricated record block for bite registration (Fig. 2) Articulate case
Fig. 2: Bite registration
F. Goetze
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LABORATORY PROCEDURES (cont.)SECOND PHASE: Prepared model for 2∙1 metal-ceramic crown Waxed coping with metal collar Cast coping Fabricated metal-ceramic crown (Fig. 3)
Fig. 3: Metal-ceramic crown
F. Goetze
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LABORATORY PROCEDURES (cont.)THIRD PHASE: Wax crowns on 1∙7 and 2∙8 Milled wax crowns Cast gold crowns Milled cast gold crowns (Fig. 4) Polished 1∙7 and 2∙8 gold crowns Precision attachments offers controlled wear, less
wear, and have standard interchangeable parts9,10
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LABORATORY PROCEDURES (cont.)
Fig. 4: Milling of gold crowns
F. Goetze
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LABORATORY PROCEDURES (cont.)FOURTH PHASE: Preparing Co-Cr framework Wax-up Co-Cr (Fig. 5) Final Co-Cr framework (Fig. 6)
Fig. 5: Wax-up Co-Cr
framework
Fig. 6: Final Co-Cr framework
F. Goetze
F. Goetze
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LABORATORY PROCEDURES (cont.)FIFTH PHASE: Set-up on Co-Cr framework Crowns and framework attachment (Fig. 7) Poured and polished Co-Cr denture (Fig. 8)
Fig. 7: Attachment
Fig. 8: Final Co-Cr denture
Y. Chen
Y. Chen
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LABORATORY PROCEDURES (cont.) Set-up edentulous mandible Labial gum tinting (Fig. 9) Final mandibular denture (Fig. 10)
Fig. 9: Labial gum tinting
Fig. 10: Final mandibular denture
Y. Chen
Y. Chen
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LABORATORY PROCEDURES (cont.)
Fig. 11: Final case
Y. Chen
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PROBLEMS EXPERIENCED
Open margins on gold crowns after casting
Limited space on the buccal area of the coping for ceramic material
Finished chrome did not seat as desired
Porosity in mandibular denture
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FUTURE TREATMENT OPTIONS
Maxilla Fixed bridge prosthesis
Mandible Soft lining denture - tissue sensitivity 14 unit bridge prosthesis
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REFERENCES
1. Scully C. Handbook of Oral Disease. London: Martin Dunits.1999: 280-281.
2. Scully C, Flint SR, Porter SR. Oral Disease, 2nd ed. Singapore: Crispian Scully and Stephen Flint. 1989: 182.
3. Sweet Haven Publishing. Fundamentals of Dental Technology (1985). Available: http://www.waybuilder.net. 7 August 2008.
4. Roberts G. What is Marginal Gingivitis? Available: http://www.2hub.com. 7 August 2008.
5. Enrique B, Needleman HL, Karimbax N, Van Dyke TE. Periodontal and Gingival Health and Diseases. Singapore: Martin Dunits Ltd. 2001: 31-32.
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REFERENCES (cont.)
6. Rosentiel SF, Land MF, Fujimoto S. Contemporary Fixed Prosthodontics, 4th ed. Missouri: Mosby Inc. 2006: 273.
7. Soltner HM. Dental Labor National: Anchoring – band Attachments. Berlin: Dental Labor International. 2008; 4; 42.
8. Wulfes H. Precision Milling and Partial Denture Construction, 1st ed. Bremen: Academia Dental. 2004: 149.
9. Martin P. Attachments for Prosthetic Dentistry. Berlin: Quintessence Publishing Co Ltd. 1994: 11-12.
10. Ney JM. Crown and Bridge Manual. Hartford: JM Ney Company. 1972: 105-112, 125-128.
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REFERENCES (cont.)11. Preiskel HW. Precision Attachments in Prosthodontics: The
Applications of Intracoronal and Extra Coronal Attachments, Volume 1. Chicago: Quintessence Publishing Co. 1984: 85-99.
12. Stewart KL, Rudd KD, Kuebker WA. Clinical Removable Prtial Prosthodontics. Missouri: C.V. Mosby Company. 1983: 125-128.
13. Smith BGN. Planning and Making Crowns and Bridges, 3rd ed. Bremen: Martin Dunitz. 1998: 3-100.
14. Morrow RM, Rudd KD, Rhoads JE. Dental Laboratory Procedures - Complete Dentures, 2nd ed. St. Louis: C.V. Mosby Company. 1986: 545-550.
15. Naylor WP. Introduction to Metal Ceramic Technology. London: Quintessence Publishing Co. 1992: 36; 136-153.
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ACKNOWLEDGEMENTS Dr. Wright Mr. L Steyn Miss M Kruger Mr. Latief Mr. M Mazema
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THANK YOU