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DR MAYANK SINGH DEPTT. OF PROSTHODONTICS. PATIENT INTERVIEW  Establish rapport with the patient  Gain insight into the psychological makeup of the patient.

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Presentation on theme: "DR MAYANK SINGH DEPTT. OF PROSTHODONTICS. PATIENT INTERVIEW  Establish rapport with the patient  Gain insight into the psychological makeup of the patient."— Presentation transcript:

1 DR MAYANK SINGH DEPTT. OF PROSTHODONTICS

2 PATIENT INTERVIEW  Establish rapport with the patient  Gain insight into the psychological makeup of the patient  Explore any physical condition that may effect the treatment  Ascertain the patient expectations of treatment

3 STRUCTURE OF INTERVIEW Dental history - In the dental history it is important to find out why teeth have been lost. If lost by caries If lost by periodontal disease Presence of removal partial Dentures will increase the possibility of further carious activity Every effort must be made to discover and eliminate its cause

4 DIET  The patient diet should be evaluated  If the patient have sugar containing diet a change must be effected.  The problem caused by the sugar is compounded by the wear of removal partial dentures because the prosthesis shield the microorganism from the cleansing and buffering action of patient saliva.

5 HABITS  Patient habit should be evaluated to determine whether the effect the prognosis of the treatment.  Bruxism and clenching  Tongue thrusting

6 EVALUATION OF ORAL HYGIENE It is critical to the prognosis of the patient treatment Inadequate oral hygiene must be recognized early in the diagnostic procedure so that a preventive dentistry programme can be evaluated.

7 EVALUATION OF CARIES SUSCEPTIBILITY The presence of large number of restored teeth Sign of recurrent caries Evidence of decalcification

8 ORAL PROPHYLAXIS Supragingival calculus should be removed and oral prophylaxis should be performed The diagnostic cast and definitive intraoral examination will be more accurate if teeth are cleaned

9 RADIOGRAPH Complete series of periapical and a full mouth radiograph is essential for definitive examination of partially edentulous patient Full mouth radiograph is ideal for screening for pathological condition

10 Periapical radiographs helps in determining 1.Crown root ratio of remaining teeth 2.Status of periodontal ligament space 3.Lamina dura of abutment teeth 4.Quantity of bone on the residual ridge in edentulous area

11 DIAGNOSTIC IMPRESSION AND CAST A diagnostic procedure for a partially edentulous patient must be considered incomplete unless it includes the evaluation of accurate diagnostic cast.

12 MOUNTED DIAGNOSTIC CAST Uses includes the following : Extruded teeth, low hanging tuberosities, lack of inter arch space, malposed teeth and defective restoration are readily apparent. They provide a detail analysis of patient occlusion Aid in the education of the patient and in presentation of the treatment planning. They provide a permanent dental record of the patient condition before treatment.

13 Centric jaw relation record Bone to bone relation Bone to bone relation Recorded repeatedly and verified Best reference point Recorded repeatedly and verified Best reference point

14 Methods of determining centric jaw relation Conventional method Conventional method Bilateral manipulation of the mandible Bilateral manipulation of the mandible Alteration of protrusion and retrusion Alteration of protrusion and retrusion

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16 Media for recording centric jaw relation Wax Wax Impression pastes Impression pastes Plaster of paris Plaster of paris Dental stone Dental stone Acrylic resin Acrylic resin Modeling plastic Modeling plastic waxes waxes  Soft wax  Hard wax

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19 Definitive oral examination Evaluation of caries and existing restoration Evaluation of caries and existing restoration

20 Evaluation of sensitivity to percussion Evaluation of sensitivity to percussion Tooth movement caused by-prosthesis or occlusion Tooth movement caused by-prosthesis or occlusion Traumatic occlusion Traumatic occlusion Periapical or pulpal abscesses Periapical or pulpal abscesses Acute pulpitis Acute pulpitis Gingivitis or periodontitis Gingivitis or periodontitis Cracked tooth syndrome Cracked tooth syndrome

21 Evaluation of mobile teeth Traumatic occlusion Traumatic occlusion Inflammatory changes in periodontal ligament Inflammatory changes in periodontal ligament Loss of alveolar bone support Loss of alveolar bone support

22 Splinting of abutment teeth Indications Indications Remaining teeth have reduced support- periodontal disease Remaining teeth have reduced support- periodontal disease Teeth with short,tapered roots Teeth with short,tapered roots Presence of two or three widely spaced retainable teeth Presence of two or three widely spaced retainable teeth

23 Evaluation of periodontium Pocket depth in excess of 3mm Pocket depth in excess of 3mm Furcation involvement Furcation involvement Deviation from normal color and contour of gingiva Deviation from normal color and contour of gingiva Marginal exudate Marginal exudate Abutment teeth have less than 2mm of attached gingiva Abutment teeth have less than 2mm of attached gingivaTreatment Root scaling and planning Root scaling and planning Gingivectomy Gingivectomy Periodontal flap procedures Periodontal flap procedures Free gingival grafts Free gingival grafts

24 Evaluation of hard tissue abnormalities Torus palatinus Torus palatinus Torus mandibularis Torus mandibularis Exostosis and undercuts Exostosis and undercuts Mandibular tuberosity Mandibular tuberosity

25 Evaluation of soft tissue abnormalities Labial frenum Labial frenum Hypertrophic lingual frenum Hypertrophic lingual frenum Unsupported and hypermobile gingiva Unsupported and hypermobile gingiva

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27 Evaluation of radiographic survey Caries Caries Existing restorations Existing restorations Root fragments and other foreign bodies Root fragments and other foreign bodies Unerupted third molars Unerupted third molars Abutment teeth Abutment teeth Root length,size,form Root length,size,form Crown/root ratio Crown/root ratio Lamina dura Lamina dura Periodontal ligament space Periodontal ligament space Bone index areas Bone index areas

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29 Evaluation of mounted diagnostic casts Interarch distance Interarch distance Occlusal plane Occlusal plane

30 Irregular occlusal plane Irregular occlusal plane Enameloplasty Enameloplasty Extracoronal cast metallic restorations Extracoronal cast metallic restorations Extraction Extraction

31 Occlusal interferences Bruxism Bruxism Excessive wear of teeth Excessive wear of teeth Chipping or fracture Chipping or fracture Increased mobility Increased mobility Tooth migration Tooth migration Injury to TMJ-muscle spasm,pain and joint symptoms Injury to TMJ-muscle spasm,pain and joint symptoms

32 Occlusal equilibration Selective grinding or coronal reshaping of tooth with the intent of equalizing occlusal stress Selective grinding or coronal reshaping of tooth with the intent of equalizing occlusal stress

33 Treat at centric relation or centric occlusion? Coincidence of centric relation or centric occlusion Coincidence of centric relation or centric occlusion Absence of posterior tooth contacts Absence of posterior tooth contacts Situation in which all posterior tooth contacts are to be restored with cast restorations Situation in which all posterior tooth contacts are to be restored with cast restorations Only a few posterior contacts Only a few posterior contacts Clinical symptoms of occlusal trauma Clinical symptoms of occlusal trauma

34 Diagnostic wax-up Provide a guide for tooth preparation Provide a guide for tooth preparation Indicate problems that may be encountered during treatment Indicate problems that may be encountered during treatment

35 Development of treatment plan Phase1 Phase1 Collection and evaluation of diagnostic data Collection and evaluation of diagnostic data Immediate treatment to control pain and infection Biopsy or referral of patient Development of treatment plan Education and motivation of patient

36 Phase 2 Phase 2 Removal of deep caries followed by temporary restoration Removal of deep caries followed by temporary restoration Extripation of inflamed pulp Extripation of inflamed pulp Removal of nonretainable teeth Removal of nonretainable teeth Periodontal treatment Periodontal treatment Occlusal equilibration Occlusal equilibration

37 Phase 3 Phase 3 Preprosthetic surgical procedures Preprosthetic surgical procedures Definitive endodontic procedures Definitive endodontic procedures Fixed partial denture construction Fixed partial denture construction

38 Phase 4 Phase 4 Removal partial denture Removal partial denture Reinforcement of education and motivation Reinforcement of education and motivation

39 Phase 5 Phase 5 Postinsertion care Postinsertion care Periodic recall Periodic recall

40 Q1. The first step in the diagnostic mounting procedure is the mounting of the maxillary cast on a Q1. The first step in the diagnostic mounting procedure is the mounting of the maxillary cast on a a) Fully adjustable articulator b) Semi-adjustable articulator c) Denar articulator d)Free plane articulator

41 Q2. Face bow which requires styli to be placed on selected points on the face is Q2. Face bow which requires styli to be placed on selected points on the face is a) Whip mix b) Hanau spring bow c) Hanau SM d)Hanau H2

42 Q3. Beyron’s point is located _ mm anterior to the posterior margin of the tragus of the ear on a line to the outer canthus of the eye Q3. Beyron’s point is located _ mm anterior to the posterior margin of the tragus of the ear on a line to the outer canthus of the eye a) 11 b) 12 c) 13 d)14

43 Q4. While adjusting the articulator, the following setting are followed for condylar guidance, Bennett guide and incisal table respectively Q4. While adjusting the articulator, the following setting are followed for condylar guidance, Bennett guide and incisal table respectively a) 30, 15, 0 b) 0, 30, 15 c) 15, 30, 0 d) 30, 0, 15

44 Q5. Ramfjord and Ash (1971) have stated that three factors must be controlled in order to succeed in determining centric jaw relation. Which one is not among them? Q5. Ramfjord and Ash (1971) have stated that three factors must be controlled in order to succeed in determining centric jaw relation. Which one is not among them? a) Psychologic stress b) Pain in temporomandibular joints c) Muscle memory d) Systemic illness

45 Q6. In which method of recording jaw relation does the operator place all four fingers of his hand on the lower border of the mandible and thumbs over the symphysis? Q6. In which method of recording jaw relation does the operator place all four fingers of his hand on the lower border of the mandible and thumbs over the symphysis? a) Bilateral manipulation of the mandible b) Alternate protrusion and retrusion c) Both a and b d) Use of an occlusal splint

46 Q7. Which of the following is not used to record centric jaw relation Q7. Which of the following is not used to record centric jaw relation a) Acrylic resin b) ZoE paste c) Dental stone d) All of the above are used

47 Q8. While using metal impregnated wax, water bath temperature kept is Q8. While using metal impregnated wax, water bath temperature kept is a) 40°C b) 43°C c) 45°C d) 37°C

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49 ANSWERS 1. B 1. B 2. D 2. D 3. C 3. C 4. A 4. A 5. D 5. D 6. B 6. B 7. A 7. A 8. B 8. B


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