Onlay Partial Denture

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Onlay partial denture

Anterior teeth attrition Vertical dimension decrease RPD - abrasionhttp:dent.ghil.com/

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

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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

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

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

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

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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

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

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

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Approaching techniqueOVD r

q .

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

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Interim removable partial denture

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

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

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

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

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

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

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

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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

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