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PEDIATRIC

PROSTHODONTICS

DR HIMANSHU KAPOOR

3RD YEAR

Dr. Himanshu Kapoor, Subharti Dental College, SVSU

HOW DOES TOOTH LOSE OCCUR?


• CARIES • TRAUMA • FRACTURE • INFECTION • CLEFT LIP AND PALATE • SYSTEMIC DISORDER • PREMATURE LOSE OF TOOTH • RADIATION DAMAGE • NEOPLASIA


WHY DO WE NEED PEDIATRIC PROSTHODONTICS?


• ESTHETICS

• SPEECH

• MASTICATION

• INTEGRITY OF DENTAL ARCHES

• HEALTH OF SUPPORTING TISSUES

• PREVENTION OF UNDESIRABLE HABBITS

• PSYCHOLOGICAL AND MENTAL HEALTH OF PATIENT.


PROSTHODONTIC REPLACEMENTS


• COMPLETE DENTURE CONSTRUCTION

• REMOVABLE PARTIAL DENTURE

• IMMEDIATE DENTURE

• OVERDENTURE

• OBTURATOR

• INTRAORAL APPLIANCE FOR INFANTS

• PEDODONTIC IMPLANTS (UNDER TRIAL)


ANATOMICAL AND PSYCHOLOGICAL

CONSIDERATION IN CHILD PATIENT.


ORAL MUCOSA AND SKIN

• Unlike adults, denture bearing mucosa is thick and well circulated.

• Therefore less prone to trauma.

• Skin changes e.g. giving proper denture can compensate skin folds.


Residual bone changes

• More porous more blood supply

• Faster healing

• Growth of dental arches required frequent change..


TONGUE AND TASTE CHANGES

• Lose of tooth result in placement of tongue between edentulous area

• Unlike adults inflammation and taste bud alteration is uncommon.


SALIVARY FLOW CHANGES

• Due to good salivary flow difficulty in wearing denture.


PSYCHOLOGY OF PATIENTS

• May develop inferiority complex.


CONDITION OF EDENTULOUS TEETH IN CHILD PATIENT

• Ectodermal dysplasia

• Ecc

• Trauma

• neoplasia


COMPLETE DENTURES

1. TRAY SELECTION

2. IMPRESSION MATERIAL

3. IMPRESSION MAKING

4. PRIMARY CAST

5. SECONDARY IMPRESSION

6. OCCLUSAL RIM FABRICATION


Difficulty in :-

• ECTODERMAL DYSPLASIA PATIENT

• CEREBRAL PALSY

• OSTEOPETROSIS PATIENT


7. RECORDING JAW RELATION

8. TEETH SELECTION


9. TEETH SETTING OF CHILDREN

• 2-5 YEAR OF AGE

• 6-7 YEAR

• 7-8 YEAR

• 9-10 YEAR

• 12-13 YEAR


10 . DENTURE DELIVERY


REMOVABLE PARTIAL DENTURE

ANY PROSTHESIS WHICH REPLACES SOME TEETH IN PARTIAL DENTAL ARCH .


CONTRAINDICATION

• WHEN FPD IS POSSIBLE

• DISABLED PATIENT

• UNCOPERATIVE PATIENT


COMPONENTS OF RPD

• DENTURE BASE

• RETENTIVE CLASP

• ARTIFICIOAL TEETH


STEPS OF CONSTRUCTION

• DIAGNOSIS AND TREATMENT PLANNING

• PRIMARY IMPRESSION

• JAW RELATION IF REQUIRED

• SELECTION OF ARTIFICIAL TEETH

• TRY IN PARTIAL DENTURE

• INSERTION OF PARTIAL DENTURE


LABORATORY STEPS

• POURING CASTE

• MAKING CUSTOM TRAY

• MAKING RECORD BASE AND OCLUSAL RIMS

• ARTICULATIOPN OF CAST

• TEETH ARANGEMENT

• ACRYLIZATION OF DENTURE

• FINISHING AND POLISHING


INDICATION

• DISTAL EXTENSION CARIES

• COMPROMISED DENTAL SUPPORT OF REMAINING TEETH

• EXCESSIVE BONE LOSS

• ESTHETICS

• CLOSURE OF CLEFT

• CORRECTION OF SPEECH

• PREVEBTION OF HARMFUL HABBITS

• AS SPACEMAINTAINER


OVERDENTURES

• Overdenture is complete or partial removable denture supported by retained roots and teeth to provide support ,stability, tactile and propioceptive sensation to reduce ridge resorption.


INDICATIONS

• PATIENT WITH VERY FEW TEETH

• TEETH WITH SMALL CLINICAL CROWN

• SMALL DENTAL ARCHES WITH LITTLE LIP SUPPORT

• LARGE SPACES BETWEEN TEETH WHICH IS DIFFICULT TO TREAT ORTHODONTICALLY

• CONGENITAL MALFUNCTIONS


CONTRAINDICATIONS

• COOPERATION OF PATIENT

• POOR ORAL HYGIENE

• PSYCHOLOGICAL FACTORS


ADVANTAGES

• PROVES SUPERIOR TREATMENT METHOD

• CONSERVATION OF ALVEOLAR RIDGE

• REMAINING ABUTMENT CONSERVATION

• BETTER STABILITY

• BETTER RETENTION

• MINIMAL PALATAL COVERAGE

• FEWER ADJUSTMENTS ARE REQUIRED


DISADVANTAGE

• BULKIER THAN COMPLETE DENTURE

• INCREASED RISK OF CARIES

• MORE EXPENSIVE THAN CONVENTIONAL DENTURES


OBTURATORS

PROSTHESIS USED TO CLOSE CONGENITAL OR ACQUIRED OPENING IN THE PALATE.


INDICATIONS

• CLEFT LIP AND PALATE

• ACQUIRED ORAL DEFECT OF MAXILLARY CARCINOMA


ADVANTAGE

• RESTORATION OF MASTICATION DEGLUTITION SPEECH

• ESTHETICS

• PSYCOLOGY

• NORMAL DEVELOPMENT OF REMAINING ORAL STRUCTURES


TYPE OF OBTURATORS

1. FEEDING OBTURATOR

2. SURGICAL OBTURATOR

3. INTERIOR OBTURATOR

4. HOLLOW OBTURATOR

5. METAL BASE OBTURATOR

6. PALATAL OBTURATOR:-

I. DENTAL

II. SPEECH BULB OBTURATOR.


THANKS

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