James Field - Removable Prosthodontics at a Glance

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Library of Congress Cataloging-in-Publication Data

Names: Field, James, 1979- author. | Storey, Claire, author.

Title: Removable prosthodontics at a glance / James Field, Claire Storey.

Description: Hoboken, NJ : Wiley-Blackwell, 2020. | Includes bibliographical references and index.

Identifiers: LCCN 2019056770 (print) | LCCN 2019056771 (ebook) | ISBN 9781119510741 (paperback) | ISBN 9781119510710 (adobe pdf) | ISBN 9781119510697 (epub)

Subjects: LCSH: Dentures. | Prosthodontics.

Classification: LCC RK656 .F495 2020 (print) | LCC RK656 (ebook) | DDC 617.6/92—dc23

LC record available at https://lccn.loc.gov/2019056770

LC ebook record available at https://lccn.loc.gov/2019056771

Cover Design: Wiley

Cover Image: Courtesy of James Field

1 Cover

2 About the companion website About the companion website

3 1 Introduction 1 Introduction Removable prosthodontics is often described as a ‘black art’ – the Marmite of dentistry; practitioners tend to either love it or hate it. Fortunately, we love it – and with some simple guidance, hopefully you will too. Like most operative interventions, success depends on: The skill of the dentist The technical difficulty of the case The patient's perceptions, ideas and expectations Providing prostheses that are satisfactory to the patient is a challenge – and there are many reasons why patients can be dissatisfied with the finished result. Many relate to social aspects of patients’ lives – how they are able to interact with others, particularly when eating and speaking. Common reasons include: Unacceptable aesthetics Inability to chew food properly Inability to enjoy the same foods as before Problems with speech Discomfort or persistent pain Disagreements over time and cost Despite the diversity of complaints, there is often a common thread running through them all – lack of information exchange and an inappropriate level of patient expectation. We would therefore argue that the most important skill when making satisfactory removable prostheses is that of communication. Communication and expectations The clinical process

4 2 The function of removable prostheses Function Restoring vs improving Quality of life Risks of removable prostheses

5 3 Stability and retention Stability Retention Stability vs retention The gag reflex

6 4 Patient assessment for complete dentures The patient and the rationale for treatment Prosthodontic history Clinical examination Ridge assessment Assessment of existing prostheses

7 5 Edentulous ridge presentations Upper edentulous ridges Lower edentulous ridges

8 6 Patient assessment for partial dentures The patient and the rationale for treatment Prosthodontic history Clinical examination Ridge assessment Partial denture classification Assessment of existing prostheses Radiographic assessment

9 7 Factors complicating success Prognosis and justification Risk factors

10 8 Accessibility and operator position Posture and operating position Move yourself, and the patient Upper arches Lower arches Control of the prostheses and trays Other considerations

11 9 Pre-prosthetic treatment Extraoral assessment Edentulous patients Partially dentate patients Periodontal disease and caries Implants

12 10 Revisiting the anatomy Upper arch Lower arch

13 11 Making a primary impression – complete dentures Choice of tray Material Lower arches

14 12 Making a primary impression – partial dentures Choice of tray Material

15 13 Special trays Materials Tray spacers and tissue stops Handles Material retention and support Full seating

16 14 Compound and putty materials – handling and manipulation Compound and greenstick Putty

17 15 Recording an upper functional impression Checking the special tray Important functional anatomy Posterior border Partial dentures

18 16 Recording a lower functional impression Checking the special tray Important functional anatomy Labial sulcus Posterior and disto-lingual anatomy Partial dentures

19 17 Managing fibrous ridges Mucostatic Mucocompressive

20 18 Denture bases Types of denture base Alternative denture base materials