Methods of inspection, diagnostics and orthopaedic dental treatment of patients with the defects of crown part of teeth.

Fig 1-1 A full veneer crown covers all of the clinical crown of a tooth. The example is of a metal-ceramic crown. Fig 1-2 A partial veneer crown covers only portions of the clinical crown. The facial sur­face is usually left unveneered.

Fig 1-3 Inlays are intracoronal restorations with minimal to moderate extensions made oi gold alloy (A) or a ceramic material (B).

Fig 1-4 An onlay is an intracoronal restoration with an occlusal veneer. Fig 1-5 A laminate veneer is a thin layer of porcelain or cast ceramic that is bonded to the facial surface of a tooth with resin.

Connector Pontic Retainer Abutment Preparation Abutment Fig 1-6 The components of a fixed partial denture.

Fig 1-7 The joints are palpated as the patient opens and closes to detect signs of dysfunction. Fig 1-8 The masseter muscle can be palpated extraorally by placing your fingers over the lateral surfaces of the ramus of the mandible.

Fig 1-9 Fingers are placed over the patient's temples to feel the temporalis muscle.

Fig 1-10 The index finger is used to touch the medial pterygoid muscle on the inner surface of the ramus. Fig 1-11 The little finger is inserted facial to the maxillary teeth and around distal to the pterygomaxillary, or hamular, notch to palpate the lateral pterygoid muscle.

Fig 1-12 The trapezius muscle is felt at the base of the skull, high on the neck. Fig 1-13 The sternocleidomastoid muscle is grasped between the thumb and forefingers on the side of the neck. The muscle can be accentuated by a slight turn of the patient's head.

Fig 1-14 The distance between maxillary and mandibular incisors is measured when the patient is instructed to open "all the way" (A). If the patient can only open part way (B), the cause should be determined.

Fig 1-15 If opening is limited, the patient should be instructed to use a finger to indicate the area that hurts.

Fig 1-16 Rubber gloves, a surgical mask, and eye protection are important for safeguarding dental office personnel.

Fig A severely damaged maxillary dentition (A) restored with metal-ceramic fixed prostheses (B). C, Complete cast crown restores mandibular molar. D, Three-unit fixed dental prosthesis replacing missing mandibular premolar. (C, Courtesy of Dr. X Lepe. D, Courtesy of Dr. J. Nelson.)

Fig Poor appearance is a common reason for seeking restorative dental treatment.

Fig Severe gingival hyperplasia associated with anticonvulsant drug use. (Courtesy of Dr. P. B. Robinson.)

Fig A, Extensive damage caused by self-induced acid regurgitation. Note that the lingual surfaces are bare of enamel except for a narrow band at the gingival margin. B, Teeth prepared for partial-cove rage restorations. C, Definitive cast. D and E, The completed restoration.

Fig Defective endodontics has led to recurrence of a periapical lesion. Re-treatment is required

Fig Apical root resorption after orthodontic treatment.

Fig Auricular palpation of the posterior aspects of the temporo­mandibular joints.

Fig Maximum opening of more than 50 mm (A) and lateral move­ment of about 1 2 mm (B) are normal.

Fig Muscle palpation. A, The masseter. B, The temporal muscle. C, The trapezius muscle. D, The sternocleidomastoi d muscle. E, The floor of the mouth.

Palpation is best done bilaterally, simultaneously asking the patient to identify any differences between left and right.

Fig Smile analysis is an important part of the examination, particularly when anterior crowns or fixed dental prostheses are being con­sidered. A, Some individuals show considerable gingival tissue during an exaggerated smile. B, Others may not show the gingival margins of even the central incisors.

Fig The "negative space" between the maxillary and mandibular teeth is assessed during the examination.