Clinical Examination Of Fixed Prosthodontics

Done by :
Abrar , Alaa, Asrar, Ghadeer
Clinical Examination Of Fixed Prosthodontics

Outline
Definition
Basic Examination Techniques
Types of Examination :
A-General Examination
B-Temporoma-ndibular joint examination
C- Extraoral examination
D-Intra-oral examination
References

Clinical Examination
An examination consist of the
clinician’s use of sight, touch , and
hearing to detect conditions outside
the normal range.

Basic Examination Techniques
Inspection
Diascopy
Palpation
Probing

Percussion
Auscultation
Aspiration
Evaluation of Function
Basic Examination Techniques

Types of Examination
A-General
Examination
B-Temporoma-
ndibular joint
examination
C- Extraoral
examination
D-Intra-oral
examination

A-General Examination
• Gait
• weight
• Anemia
• jaundice. • Respiration, pulse,
temperature and
blood

B- TMJ Examination
Bilateral palpation anterior to the
auricular tragi while the patient opens
and closed the mouth, can locate:
Disorder In The Posterior Attachment Of The Disk.
Tenderness Clicking Or Pain Is Noted.
Jaw Opening Of Less Than 40 Mm Indicates Restriction.
Deviation From Midline Also Recoded.
Maximum Lateral Movment Can Then Measured (Normal Is About 12 Mm).

Also ..Masseter and temporal muscle are
palpated for signs of tenderness and
classified as mild,moderate or severe
B- TMJ Examination

C- Extraoral Examination
1- FACIAL ASYMMETRY
Acromegaly
Exophthalmic goitre
Mongolism
Cretinism
Myxodema
General appearance of the patients face may be suggestive of
certainas:diseases

2- CERVICAL LYMPHNODES

3- Lips And Mouth
 Visibility during normal and exaggerated smiling.
 This can be critical during FIXED PROSTHODONTIC
TREATMENT PLANNING
“NEGATIVE SPACE”:- The space between maxillary
and mandibular anteriors during normal smile.
 Missing teeth, diastemas and fractured or poorly
restored teeth affect negative space and require
correction
Examination of lips

3- Lips And Mouth
•Average opening>50mm
• Restricted opening<35mm (intracapsular changes in the joints)
• Midline deviation :normal is 12mm
 Mouth opening

D- Intraoral Examination
• Condition of the soft tissues , teeth and supporting structures.
• This information can be properly evaluated during treatment
planning only if objective indices, rather than vague assessments,
are used.

a- Oral hygiene and periodontal examination.
b-examination of teeth
b- Abnormal habits.
c- Edentulous ridge.
d- Occlusion.
e- Prospective abutment.
This should be carried out in a systematic way to include the following steps:

-The long-term periodontal health is necessary for successful fixed
prosthodontics.
-The existing periodontal disease must be corrected before any definitive
prosthodontic treatment is undertaken.
A- Oral Hygiene And Periodontal Examination :

• Status of bacterial accumulation
• The response of the host tissues and the degree of
irreversible damage.
• Long term periodontal health is essential to
successful fixed prosthodontic treatment.
• Existing periodontal disease must be corrected.
Periodontal
examination
• An accurate charting of the state of the dentition will
reveal important information about the condition of
the teeth and will facilitate treatment planning
Dental chart:

B-Examination of teeth:
1.Absence of teeth,dental caries, any restoration ,wear facets
, fractures,abrasion,malformation and erosion are noted.
2.pocket depth

C- Abnormal habits:
- They should be identified as:
bruxism, pipe smoking and pencil
biting this would affect the type of the
prosthesis, retainer and design.

D- Edentulous ridge:
The relationship of edentulous spans if more than one
should be recorded. The form, the texture and the
colour of the ridge mucosa.
Also the number and the length of the edentulous
span are a critical factors for treatment planning.

E- Occlusion :
1 - Wear facets.
2 - Presence of any premature contacts.
3- Cuspal interference.
4- Amount of slide between the retruded and the maximumintercuspation.
5 - Existence and amount of anterior guidance.
Occlusal evaluation should be carried out for :

F-Prospective abutment  An abutment should be :
-a vital tooth
- Strong enough to withstand the forces directed to
the missing teeth.
-Not exhibit mobility.
 If it asympotomatic endodontically treated
tooth can be considered for an abutment
provided it can withstand the forces transmitted
to it.
 The supporting tissues surrounding the
abutment teeth should be healthy and free from
inflammation..

 Evaluation of abutment teeth
F-Prospective abutment
1-Crown root ratio.
2-Root configuration.
3-Periodontal surface area.
4-Vitality testing.

1-Crown root ratio.
An abutment teeth should have a combined peri-cemental
area equal to or greater in peri-cemental area than the
tooth or teeth to be replaced (Antes law)
 Favourable crown root ratio is 1:1

2-Root configuration.
Root shape :short conical roots give lees support.
Divergent multiple roots give good support.

3-Periodontal surface area.
Root surface area: larger teeth will have greater
surface area and handle stress better..

4-Vitality testing.
Prior to any restorative treatment,pulpal health must be assessed by
measuring the response to percussion as well as thermal and
electrical stimulation

References
http://www.webdental.com/profiles/blogs/diagnosis-and-treatment-
planning-in-fixed-partial-dentures
http://jaypeedigital.com/pdfdisplay.aspx?ISBN=9788180617812/essay&key=
&sno=Amj1PxyjzsU=&CHAP=rkRfaDGG5TE=
http://www.scribd.com/mobile/doc/61597382

Clinical Examination Of Fixed Prosthodontics

Clinical Examination Of Fixed Prosthodontics

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