Classification of defects of sets of teeth

according to their topography and size

Martin TvrdoňTeaching Hospital and Policlinic

of the Academician L. Dérer, Bratislava, Slovakia

Introduction

• In dental prosthetics there exists an unfortunate situation as since the end of the 19 century many different diagnostic classification systems of defects in sets of teeth have been formulated. We have collected almost 40 systems from the schools of the world.

Review of the different ciassifications of defects of dentition by Soviar et all./1986/ Andrik and all./1984/ and added data

1. Group - Localization and extension of defectsKennedy (1928), Koller (1928), Wild (1933), Martin (1939), Fäldvári a Lärinczi (1951),

Betelmann a Bynin (1951), Ga1asinska-Langsbergerova (1952), Rouot (1959), Lejoyeux (1957), Applegate (1960), Gab-ri10v (1966), Korber (1966), Soviar, Bilý, Pokorný (1980), Fiset (1973), Fabián (1979), Skinner (1959), Steffe1 (1973) Koller

(1943, 1954), Vo1dfich (1950), Andrik (1986), Graber a kol. (1984), Geering (1986).

2. Group – Types of denturesCummer (1920), Bai1yn (1928), Balters (1935), E1brecht (1936), Beckett (1953), Takác

(1981), Vacek (1982), Knowles (1963), McCracken (1963), Andrik (1986), Pasankiewicz (1972)

3. Group – Frequency of defects of sets of teeth

4. Group – Intermaxillary relationship of defects Mathé (1950), Steinhardt (1965), Rehm (1956), Eichner (1955), Wajs (1984), Skinner

(1959)

Korber /1966/

Eichner /1955/

Kennedy /1928/

Consequences /at least two/:

• 1. Exchange of the experiences of the prosthetic treatment among the experts is more or less complicated

• 2. It is an obstacle at the development of Prosthodontics as a science

Worlwide try of unification

• The World Dental Cogress 1966 in Wurzburg /Germany/ which was devoted to the problem of Classification of defects of sets of teeth. There was not achieved the aggreement about the unified classification /diagnosis/ of defects of sets of teeth

• Where is a problem?

• Cummer, 1912 16In one jaw is possible 2 = 65.536 casesof ideal teeth /idealy sound/If there is taken into the consideration only one real

property of the tooth e.g. caries- it is 167 = 43,046.721 casesIf combination of maxilla and mandible /intermaxillary

relationship/ = practically the infinite number of cases

Our proposal of classification of the defects in sets of dentition

…is based on the principle- that the absence of one,two or all teeth is a

functional and morphological disease with health 1.local consequences /integration of dental

arch,intermaxillary relationship,TMJ, speach, processing of the food, esthetics-psychic condition etc/

2.and general diseases consequences /GIT, focal infection etc./

The main criteria for distinquishing the classes

1. the functional topography in sets of teeth /objective cr./ 2. the gradual enlargement of defective regions during

the life of the man /objectve individual criterion/ 3. transmission of masticatory pressure of prosthetic

dentures : tooth, tooth-tissue, tissue-tooth and tissue /objective criterion/

4. distance and mutual location between the remaining teeth – possibility of mutual splinting/objective criterion/

5. classes of abutment teeth /objective criterion/ 6. the biological factor of the tooth including surrounding

periodontal tissue /objective individual criterion/ 7. …and other objective criteria

1.Functional areas of dentition and main functional forces

2.Gradual enlargement of defective regions

• Gradual enlargement of defective regionsis individual. The progressive loss of theteeth depends on the genetic factors and the personal attitude to the oral health

during the life - but special situation e.g. traumatism, neoplasmsetc.

3. Mutual position between the remaining teeth

• A single or group of remaining teeth which are in linear relationship. It is recommended to be splinted

• The remaining teeth are located in one functional area /incisal, canine, molar/. It is recommended to be mutualy splinted :

1. If two teeth are present - between them is a linear relationship

2. if three and more teeth are present : 2.1. linear relationship - recomm.to be splinted 2.2 areal relationship – recomm.to be splinted The distance between the remaining teeth is too large -

there is no possibility to be mutually connected

• Why splint?

Linear and areal anchorage

4. Classes of abutment teeth

5.Biological factor of a tooth

• …and now classes,designsand treatment

Class I.A.

Some examples:

Some examples:

Class II.A.

• Some examples:

New solutions at II class A – free end saddle

Fixed-fixed bridges with tissue supported glass pad abutment at

Class II A – free end saddle

Cantilever pontic at the II.class A – free end saddle:

Fixed-fixed bridge with posterior cantilever pontic of Class II A– free

end saddle

Class II.B.

Majority of the alveolar ridge is edentulous – its relevance for stability and retentiom of the

denture increases

• Some examples:

Class III.A.

Class III.B.

Class III.C.

Conclusions

1. The classes are generate according to the objective and firm criteria which would be understable to both contemporary as well as future experts

2. The natural regions are represented by forces of specific directions and intensities

and they are respected in the diagnose and the treatment as well

3. Easy to be applied by dental surgeons 4. Availability for easy computer programming

• Thank you for your attention!