Introduction and Terminology

Dr. MUSAB M. ABU ARQOUB

 INTRODUCTION TO
PROSTHETICS
A prosthesis
is the replacement of an absent part of
the human body by some artificial part
such as an eye a leg or denture.
Prosthetics, then is the art and science
of supplying artificial replacement for
an absent part of the human body .
Prosthodontics
may be defined as that branch
of dentistry pertaining to restoration and
maintenance of oral functions, comfort,
appearance, and health of patient by the
restoration of natural and/or the
replacement of missing teeth and
contiguous oral and maxillofacial tissues
with artificial substitute.
Prosthodontics or prosthetic
: dentistry
is the art and science of designing
and fitting
artificial substitutes to replace lost or
.missing tissue
The replacement of missing teeth in partially
edentulous arch may be accomplished by a
fixed prosthesis or by a removable prosthesis .
A fixed partial denture is not designed to be
removed patient .
 Connector Pontic
Retainer
Abutment
Preparation Abutment
Preparation

Abutment

Abutment
Edentulous
Ridge
A removable partial denture

is designed so that it can be

conveniently removed
from the mouth and replaced by
..the patient

.
 A removable partial denture

Insertion
 transitional

esthetics
? Why are dantures necessary
? Why we do dantures
In order to answer this question the functions of
: teeth must be understood , these are

. To divide the food finally -1

To assist tongue and lips to form some of the -2
. sounds of speech
. the teeth form an important feature of the face -3
Why the total lose of teeth is unpleasant
? state

. it places limitation on the diet -1

. it produces a certain sibilance in the speech -2
. esthetic changes -3
. Produce confidence loosing -4
 Complete Denture
Complete Denture :
a removable dental prosthesis that
replace the entire dentition and
associated structures of the
.maxillae and mandible
 Complete Edentulism
• Edentulism, defined as total tooth loss, is more prevalent
among persons with less than a high school education,
those without dental insurance, non-Hispanic blacks, and
current everyday smokers (CDC, 1999)

• Between the 1950s and the early 1990s the prevalence of

edentulism in the United States decreased from 50% to
42% among people aged 65 and older, from 28% to 11%
for 45- to 64-year-olds, and from 5% to 2% for persons 18
to 44 years old (Oliver & Brown, 1993
1998 National Health Interview Survey, National
Center for Health Statistics,
and the 1999 Behavioral Risk Factor Surveillance
System, CDC
stability
Stabilization:
The seating of removable
denture So that it will not
tilt or be displaced under
.pressure
Retention
The Retention of Complete
Denture
• Retention : that quality inherent
in the prosthesis acting to resist
the forces of dislodgment along
the path of placement.
 The Retention of Complete
Denture
• Interfacial force:
Adhision
Cohesion
• Oral and facial musculature.
• Atmospheric pressure.
• Undercuts , rotational insertion paths and
parallel walls.
What are the displacing forces causing
? instability
The most powerful displacing forces are the
muscles surrounding the oral cavity , and the
. tongue
: Other displacing forces
. the interference and locking of the cuspes -1
. viscous and sticky food -2
. gravity -3
What the retaining forces available to
? counteracted displacement

: Physical forces
. Adhesion and cohesion *
. Atmospheric pressure *
. Undercut area
. Acquired muscular control
Adhesion
 Adhesion

Adheesionis the physical attraction of

unlike moleccules for each other.
 drops adhering to a Dew
spider web
Adhison of saliva to the mucous membrane
and the denture base is achieved through
ionic forces between charged salivary
glycoproteins and surface epitheikiumor
.acrilic resin
Another version of adhesion is
observed between denture bases and
.the mucous membranes
The amount of retention provided by adhesion
:depending on
• The shape of the mouth.
• Its surface area.
• The closeness of the apposition of the
denture to the tissues.
• The direction of the displacing forces.
The amount of retention provided by
adhesion proportionate to the area
covered by the denture.

A complete lower denture covers a very

small surface area compared an upper ,
and its adhesion is correspondingly less.
Cohesion
 Cohesion
Cohesion is the physical attraction of
.like molecules for each other
Normal saliva not very cohesive so
that most of the retentive force of
deture-mucosa interface comes
.from adhesive
• The viscosity of the saliva is of
importance in the phenomenon of
cohesion.
• saliva which is more viscous than
normal prevents the denture and
tissues coming into sufficiently close
contact because its increases the
thickness of the saliva film and this
reduces the cohesive force.
 The oral and Facial musculature
(Acquired muscular control)
The oral and facial musculature supply
:supplementary retentive forces provided
• The teeth are positioned in the “neutral
zone” between the cheeks and tongue.
• The polished surface of the dentures are
properly shaped
• The complete denture have three surfaces
that must harmonize with the oral biological
environment.
• The dentures polished surfaces are contoured
as to support and contact the cheeks.
• The impression or basal
surfaces are fitted to the
bassal seats.
• The occlusal surface of one
denture must fit those of the
opposing denture.
 For musculature to be most
:effectivein providing retention
• The denture bases must be properly
extended to cover the maximum area
possible ,without interfering in the health
and function of the structures that
surround the denture.
• The oclussal plane must be at the
correct level.
• The arch from the teeth must be in the
neutral zone between the tongue and
the cheeks.
Atmospheric pressure
• Atmospheric pressure
The pressure acting on the fitting surface of
the denture is less than that acting on the
polished surface which, of course, is
atmospheric pressure.
This difference between these two pressures
provides a positive force to maintain the
denture in place.
Retention due to atmospheric
pressure is:
Directly proportionate to the area
covered by the denture base.
To be effective the denture must
have a perfect seal around its enteric
border.
Proper border molding is essential for
taking advantage of this retentive
mechanism.
Undercut area
 Undercut area
Undercut: the portion of the surface of
an object that is below the height of
contour in relationship to the path of
.placement
Undercut: the contour of cross-sectional
portion of a residual rige or dental
arch that prevents the insertion of a
.prosthesis
Types of undercuts

Tooth Undercuts.1

Soft Tissues or.2

.bony Undercuts
 :Undercut
An undercut is
formed when the
base of an object
is smaller than its
top

Undercut Area
 Height of contour •
Suprabulge •

= Undercut •
Infrabulge •
Make Custom Trays
More Accurate Impressions
 Block-Out Undercuts
Baseplate wax •
Prevent tray from •
locking onto cast
Lubricate cast •
(Petroleum jelly or
Alcote)
Block all undercuts
 Undercut area

It is sometimes possible to insert

an denture is one direction into
undercut area and thus obtain a
purely mechanical resistance to
displacement.
Undercuts can be extremely
helpful to retention of prosthesis:
Lateral tuberosities.
Maxillary premolar areas.
Distolingual areas.
Lingual mandibular areas.
 Gravity
Gravity acts as a retentive
force for the mandibular
denture and displace force for
the maxillary denture.
 Hardy and Kapur
The retention and stability that is achieved
from adhesion, cohesion, and interfacial
surface tension are able to resist only those
dislodging forces that act perpendicular to
the denture base.
Horizontal forces and lateral torquing of
the maxillary denture can be resisted only
by adequate border seal.