Prostho 1

Prosthodontics Revision Notes (Detailed – NEET MDS)

1. Complete Denture Prosthodontics

Biologic Principles

Support: resistance to vertical seating forces.
- Maxilla: palate (primary), alveolar ridge crest.
- Mandible: buccal shelf (primary), retromolar pad.
Retention: resistance to dislodgement along path of insertion.
- Factors: adhesion, cohesion, surface tension, atmospheric pressure, peripheral seal.
Stability: resistance to horizontal/rotational forces.
- Influenced by ridge height, form, occlusal scheme, denture base extension.

Impression Theories

Mucostatic → minimal pressure, records mucosa at rest.
Mucocompressive → pressure during impression, tissues displaced.
Selective pressure → pressure applied at stress-bearing areas, relief at non-stress areas (most accepted).

Jaw Relations

VDR (rest) – VDO (occlusion) = interocclusal rest space (2–4 mm).
Centric relation: condyles in most anterior-superior position in glenoid fossa, independent of teeth.
Facebow: transfers spatial relationship of maxilla to articulator.

Occlusion in CD

Balanced occlusion = simultaneous contact of teeth in centric & eccentric movements → prevents tipping.
Hanau’s Quint:
- Condylar guidance (cannot be altered)
- Incisal guidance (determined by esthetics/function)
- Occlusal plane
- Cuspal inclination
- Compensating curve

Common Errors

VDO too high → clicking of teeth, soreness, difficulty closing lips.
VDO too low → drooping face, angular cheilitis.

2. Removable Partial Denture (RPD)

Kennedy’s Classification

I: Bilateral distal extension.
II: Unilateral distal extension.
III: Unilateral bounded edentulous.
IV: Single bilateral anterior crossing midline.
(Applegate’s rules used to classify properly)

Components

Major connector: unites components on one arch.
- Maxilla: palatal strap, horseshoe, complete palatal coverage.
- Mandible: lingual bar (most common), lingual plate.
Minor connector: joins major connector to other components.
Direct retainer (clasp): engages undercut → resists displacement.
Indirect retainer: prevents rotation around fulcrum line in distal-extension cases.
Rest: provides vertical support.

Surveying

Determines path of insertion, presence of undercuts.
Survey lines: high, mid, low, or diagonal.

3. Fixed Partial Denture (FPD)

Principles of Tooth Preparation (Shillingburg)

Preservation of tooth structure.
Retention form → prevents removal along path of insertion.
Resistance form → prevents dislodgement by apical/oblique forces.
Structural durability.
Marginal integrity.

Finish Lines

Chamfer → metal.
Shoulder → all-ceramic.
Shoulder with bevel → PFM.
Feather edge → avoided (overcontoured).

Pontics

Hygienic (sanitary): posterior, easy cleaning.
Ridge lap: esthetic, but poor hygiene.
Modified ridge lap: compromise.
Ovate: most esthetic, requires ridge preparation.

Cements

Zn phosphate → high compressive strength, low pH.
GIC → fluoride release.
Resin cement → high strength, esthetic.

4. Implantology

Osseointegration

Direct structural & functional connection between implant surface & bone (Brånemark, 1952).
Healing period: 3–6 months (mandible faster than maxilla).

Bone Quality (Lekholm & Zarb)

I: Homogeneous dense cortical (best).
II: Thick cortical, dense trabecular.
III: Thin cortical, dense trabecular.
IV: Thin cortical, sparse trabecular (worst prognosis).

Implant Materials/Surfaces

Titanium → biocompatible, corrosion resistant.
Surface treatments: Ti plasma spray, HA coating, sandblasting, acid-etching.

Surgical Protocols

Two-stage: implant placed → covered → uncovered after healing.
One-stage: implant with healing abutment exposed during healing.

5. Occlusion

Curves

Curve of Spee → anteroposterior curve of occlusion.
Curve of Wilson → mediolateral curve.
Monson’s sphere → 4-inch radius sphere (theoretical).

Theories

Bonwill’s theory: equilateral triangle (4-inch sides) between condyles & incisal point.
Monson’s theory: teeth arranged on surface of a sphere (4-inch radius).

Mutually Protected Occlusion

Anteriors protect posteriors in eccentric.
Posteriors protect anteriors in centric.

6. Miscellaneous / Materials

Shade selection:
- Hue = color family (yellow, red).
- Chroma = intensity.
- Value = lightness/darkness (most critical).
Articulators:
- Simple hinge → opening/closing only.
- Mean value → average condylar settings.
- Semi-adjustable → adjusts for condylar guidance, Bennett angle.
- Fully adjustable → reproduces patient movements (pantograph used).
Maxillofacial prostheses:
- Obturator → palatal defects.
- Ocular, auricular, nasal prostheses.

Mnemonics + MCQs

1. Complete Denture (CD)

Key Mnemonics

Retention factors: CAAS → Cohesion, Adhesion, Atmospheric pressure, Surface tension.
Primary support areas: “Palate & Buccal shelf are prime” → Maxilla = Palate, Mandible = Buccal shelf.
Hanau’s Quint: Con In Oc Cu Co → Condylar guidance, Incisal guidance, Occlusal plane, Cuspal inclination, Compensating curve.

MCQs

Primary stress-bearing area in maxilla?
- a) Palatal rugae
- b) Residual ridge crest
- c) Palate (horizontal hard palate) ✅
- d) Alveolar mucosa
Interocclusal rest space normally is:
- a) 0.5 mm
- b) 1–2 mm
- c) 2–4 mm ✅
- d) 5–6 mm

2. Removable Partial Denture (RPD)

Key Mnemonics

Kennedy’s classification: I Bilateral, II One side, III Bounded, IV Front four
Major connectors Maxilla: SHPC → Strap, Horseshoe, Plate, Complete coverage.
Mandible: LB LP → Lingual bar, Lingual plate.

MCQs

Most common mandibular major connector?
- a) Lingual plate
- b) Lingual bar ✅
- c) Labial bar
- d) Sub-lingual bar
In Kennedy’s Class I, indirect retainers are placed:
- a) Adjacent to fulcrum line
- b) Perpendicular to fulcrum line
- c) Away from fulcrum line ✅
- d) On fulcrum line

3. Fixed Partial Denture (FPD)

Key Mnemonics

Principles of tooth prep (Shillingburg): PRRSM → Preservation, Retention, Resistance, Structural durability, Marginal integrity.
Finish lines: “Chamfer for metal, Shoulder for ceramic, Shoulder bevel for PFM”

MCQs

Best finish line for all-ceramic crown?
- a) Chamfer
- b) Shoulder ✅
- c) Feather edge
- d) Bevel
Most esthetic pontic design?
- a) Hygienic
- b) Ridge lap
- c) Ovate ✅
- d) Modified ridge lap

4. Implants

Key Mnemonics

Bone quality: “I Dense, II Good, III Fair, IV Poor” → Type I (best), Type IV (worst).
Osseointegration definition: coined by Brånemark, “bone locks to implant surface”.

MCQs

Best bone quality for implant success?
- a) Type I ✅
- b) Type II
- c) Type III
- d) Type IV
Healing period for osseointegration in mandible?
- a) 1–2 months
- b) 3 months ✅
- c) 6 months
- d) 9 months

5. Occlusion

Key Mnemonics

Curves: “Spee is S-curve (side), Wilson is W (width), Monson = Moon sphere”
Hanau’s Quint: already covered.
Mutually protected occlusion: Anteriors protect posteriors in eccentric, Posteriors protect anteriors in centric.

MCQs

Curve seen in sagittal plane?
- a) Spee ✅
- b) Wilson
- c) Monson
- d) Bonwill
Hanau’s Quint does NOT include:
- a) Incisal guidance
- b) Condylar guidance
- c) Occlusal plane
- d) Bennett angle ✅

6. Miscellaneous / Materials

Key Mnemonics

Shade selection: HSV → Hue, Saturation (Chroma), Value.
Articulators: Simple → Mean → Semi → Fully (increasing accuracy).

MCQs

Most important factor in shade selection?
- a) Hue
- b) Chroma
- c) Value ✅
- d) Transparency
Which articulator reproduces patient’s mandibular movements most accurately?
- a) Simple hinge
- b) Semi-adjustable
- c) Fully adjustable ✅
- d) Mean value

Prosthodontics Flashcards (100 Q&A Deck)

Complete Denture (CD)

Q: Primary support in maxilla? → A: Horizontal hard palate.
Q: Primary support in mandible? → A: Buccal shelf.
Q: Secondary stress-bearing area (maxilla)? → A: Alveolar ridge crest.
Q: Secondary stress-bearing area (mandible)? → A: Alveolar ridge crest.
Q: Retention factors mnemonic? → A: CAAS (Cohesion, Adhesion, Atmos pressure, Surface tension).
Q: Stability depends on? → A: Ridge height, form, occlusion, base extension.
Q: Impression theories? → A: Mucostatic, Mucocompressive, Selective pressure.
Q: Best impression philosophy? → A: Selective pressure.
Q: VDR – VDO = ? → A: Interocclusal rest space (2–4 mm).
Q: Centric relation defined as? → A: Condyles in anterior-superior position independent of teeth.
Q: Hanau’s Quint? → A: Condylar guidance, Incisal guidance, Occlusal plane, Cuspal inclination, Compensating curve.
Q: Condylar guidance determined by? → A: Patient’s TMJ anatomy.
Q: Occlusal plane should be parallel to? → A: Ala-tragus line.
Q: High VDO signs? → A: Clicking, soreness, lips apart.
Q: Low VDO signs? → A: Drooping face, angular cheilitis.
Q: House’s classification? → A: Philosophic, Exacting, Indifferent, Hysterical.
Q: Facebow function? → A: Transfers maxillary relation to articulator.
Q: Posterior palatal seal extends to? → A: Vibrating line.
Q: Posterior palatal seal function? → A: Improves retention.
Q: Common complaint with overextended flanges? → A: Tissue soreness, ulceration.

Removable Partial Denture (RPD)

Q: Kennedy Class I? → A: Bilateral distal extension.
Q: Kennedy Class II? → A: Unilateral distal extension.
Q: Kennedy Class III? → A: Unilateral bounded.
Q: Kennedy Class IV? → A: Single bilateral anterior (crossing midline).
Q: Applegate’s rules? → A: Rules for classifying RPD (example: missing third molars not considered).
Q: Most common mandibular major connector? → A: Lingual bar.
Q: Minimum sulcus depth for lingual bar? → A: 8 mm.
Q: Alternative if sulcus depth <8 mm? → A: Lingual plate.
Q: Maxillary major connectors? → A: Palatal strap, horseshoe, palatal plate, complete palatal coverage.
Q: Direct retainer = ? → A: Clasp engaging undercut.
Q: Indirect retainer function? → A: Prevents rotation around fulcrum line.
Q: Fulcrum line passes through? → A: Most posterior abutments.
Q: Rest function? → A: Provides vertical support.
Q: Surveying used for? → A: Path of insertion, undercuts, survey lines.
Q: Common clasp type? → A: Circumferential clasp.
Q: Most esthetic clasp? → A: I-bar clasp.
Q: Kennedy class most common? → A: Class I.
Q: Tooth most commonly used as abutment? → A: Canine.
Q: Tripoding in surveyor? → A: To record tilt of cast.
Q: RPI system stands for? → A: Rest, Proximal plate, I-bar clasp.

Fixed Partial Denture (FPD)

Q: Principles of tooth prep (Shillingburg)? → A: PRRSM (Preservation, Retention, Resistance, Structural durability, Marginal integrity).
Q: Retention vs resistance? → A: Retention prevents removal along path; resistance prevents dislodgement by oblique/apical forces.
Q: Best finish line for metal crowns? → A: Chamfer.
Q: Best finish line for all-ceramic? → A: Shoulder.
Q: Finish line least recommended? → A: Feather edge.
Q: PFM crown finish line? → A: Shoulder with bevel.
Q: Most esthetic pontic? → A: Ovate.
Q: Pontic for posterior with hygiene importance? → A: Hygienic (sanitary).
Q: Pontic with poor hygiene? → A: Ridge lap.
Q: Connectors must resist? → A: Torsional forces.
Q: Strongest cement? → A: Resin cement.
Q: Cement with fluoride release? → A: GIC.
Q: Zn phosphate drawback? → A: Low pH, pulp irritation.
Q: FPD connector shape preferred? → A: Rounded.
Q: Minimum crown-root ratio acceptable? → A: 1:1.
Q: Ante’s law? → A: Perio support of abutments ≥ support of pontics.
Q: Most favorable root form for abutment? → A: Multi-rooted, divergent roots.
Q: Minimum occluso-gingival height for crown? → A: 4 mm.
Q: Retention increases with? → A: Decreasing taper.
Q: Ideal taper per wall? → A: 6°.

Implantology

Q: Father of modern implantology? → A: Brånemark.
Q: Osseointegration defined as? → A: Direct bone-implant connection.
Q: Healing time in mandible? → A: 3 months.
Q: Healing time in maxilla? → A: 6 months.
Q: Best bone quality? → A: Type I (dense cortical).
Q: Worst bone quality? → A: Type IV.
Q: Most common implant material? → A: Titanium.
Q: Ti alloy used? → A: Ti-6Al-4V.
Q: Implant surface modifications? → A: HA coating, Ti plasma spray, sandblasting, acid-etch.
Q: Two-stage surgery advantage? → A: Reduced micromovement during healing.
Q: One-stage surgery advantage? → A: No second surgery needed.
Q: Minimum bone height for implant? → A: 10 mm.
Q: Minimum bone width? → A: 6 mm.
Q: Minimum distance from vital structures (like IAN)? → A: 2 mm.
Q: Minimum distance between two implants? → A: 3 mm.
Q: Minimum distance from adjacent tooth? → A: 1.5 mm.
Q: Implant success criteria (Albrektsson)? → A: Mobility <1 mm, bone loss <0.2 mm/year.
Q: Implant failure earliest cause? → A: Lack of osseointegration.
Q: Late implant failure cause? → A: Peri-implantitis.
Q: Survival rate highest in? → A: Mandible (anterior region).

Occlusion

Q: Curve of Spee? → A: Anteroposterior curve.
Q: Curve of Wilson? → A: Mediolateral curve.
Q: Monson’s sphere radius? → A: 4 inches.
Q: Bonwill’s triangle side length? → A: 4 inches.
Q: Hanau’s Quint factors? → A: CG, IG, OP, CI, CC.
Q: Condylar guidance is? → A: Fixed/anatomic factor.
Q: Incisal guidance is? → A: Variable/controlled by dentist.
Q: Mutually protected occlusion definition? → A: Anteriors protect posteriors in eccentric; posteriors protect anteriors in centric.
Q: Group function occlusion? → A: Multiple teeth contact on working side.
Q: Balanced occlusion definition? → A: Simultaneous contacts in centric + eccentric.

Miscellaneous

Q: Shade selection 3 dimensions? → A: Hue, Chroma, Value.
Q: Most important shade factor? → A: Value.
Q: Shade selection lighting? → A: Daylight (5500K).
Q: Best time for shade selection? → A: Morning.
Q: Articulator types? → A: Simple hinge, Mean value, Semi-adjustable, Fully adjustable.
Q: Most accurate articulator? → A: Fully adjustable.
Q: Device to record mandibular movements? → A: Pantograph.
Q: Maxillofacial prosthesis for palatal defects? → A: Obturator.
Q: Ear prosthesis called? → A: Auricular prosthesis.
Q: Eye prosthesis called? → A: Ocular prosthesis.

Page updated

Google Sites

Report abuse