Onlay Partial Denture

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Onlay partial denture

Anterior teeth attrition Vertical dimension decrease RPD -

A. EtiologyParafunctional occlusal habitsChronic bruxism Other oral habits : biting on needles, pipe stems, pencils, hairpins

A. EtiologyAbrasion : diet chewing of abrasive materials (rice, tabacco)Definition : defined as the wearing away of tooth tissue by external agents Occlusal abrasion is usually attributed to diet, chewing of abrasive. Environment factors : constant exposure to dust and grit

A. EtiologyErosion : chemical actionResult from excessive intake citrus juices, cola, chronic vomiting Incisal edge, lingual or occlusal surface : cupped-out appearance (unbalanced occlusal force)

Evaluation of Vertical DimensionOVD : occlusal vertical dimension VDO : vertical dimension of occlusion VDR : vertical dimension of rest

C. Methods of evaluationPosterior support History of wear Phonetic evaluation Inter-occlusal distance Facial appearance

C. Methods of evaluationPosterior supportLoss of posterior support is the most common cause of decreased occlusal vertical dimension Posterior collapsar : combination of missing, tipping, rotated and broken down teeth

C. Methods of evaluationPhonetic evaluation : speaking space S sound q incisal edge incisal edge 1mm inferior and lingual q , 1mm VD loss

C. Methods of evaluationInter-occlusal distance ; VDO, VDR 3mm excessive wer . . complete denture VD myomonitor .

Approaching techniqueOVD r

q .

Concepts of conservative treatment Trial period with interim prosthesisTransitional RPD (desired OVD) Use of acrylic splint Use of provisional restoration

Interim removable partial denture

Initial patient assessmentIntraoral examination Extraoral examination Smile analysis Phonetic evaluation Initial prostheses assessment

Initial patient assessmentIntra-oral examinationExcessive loss of tooth structure Healthy periodontum with sufficient bone Lack of posterior occlusion Class I jaw relationship

Initial patient assessmentExtra-oral examinationSlight decrease in facial height Inversion of maxillary lip Inter-occlusal rest space of 3 to 4mm

Initial patient assessmentSmile analysisNo touch of maxillary teeth to lower lip Straight maxillary incisal edge alignment to lower lip Increase vestibular space

Initial patient assessmentPhonetic evaluationF-V position inadequate in vertival plane S position : acquired Ssound deficiency

Initial patient assessmentInitial prostheses assessmentPoor plane of occlusion Lack of occlusion as a result of excessive wear of acrylic resin Inadequate border extensions

To determinate the VD4mm increase ( anterior incisor area) Direct assessment technique Diagnostic wax-up technique

Mounted diagnostic wax-upTo assess the patients tolerance & acceptance of restored OVD Use face-bow, centric relation, condylar angle (protrusive record, lateral check bite) Mount the semi-adjustable articulator