Pre-prosthetic treatment
INTRODUCTION :
The importance of pre-prosthetic analysis in the success of prosthetic treatment is no longer in doubt. The study of models on a parallelizer and on an articulator allows the practitioner to highlight the modifications to be made to the support structures of the prosthesis: dento-periodontal and osteo-mucosal.
This preprosthetic analysis concerns all disciplines, only the most common will be described, concerning dento-periodontal and osteo-mucosal support.
II-PREPROSTHETIC TREATMENT:
This is the set of actions that allow the oral cavity to be restored, in order to obtain the optimal conditions necessary for the prosthetic treatment itself (tissue and neuromusculo-articular conditioning, etc.).
Different types of pre-prosthetic treatment:
a-Periodontal treatment:
- Motivation for hygiene
- Scaling; resurfacing and curettage of pockets
- Retention of loose teeth
- Gum plastic surgery.
b- Surgical treatment:
- Extraction of decayed teeth; residual roots; loose teeth.
- Elimination of irritating thorns; exostoses; large torus which can cause instability of the prosthesis.
- Ridgeplasty; non-adherent mucosa ; undercut tuberosity
- Removal of low insert inserts or flanges.
c- Endodontic treatment:
- Treatment of all caries cavities.
- Coronal reconstruction of decayed teeth.
- Resumption of defective endodontic treatments.
d- Orthodontic treatment:
- Correction of malpositions.
- Restoration of contact points.
- Restoration of parallelism between the hook support teeth.
e-Occlusal balancing:
The importance of occlusal disorders, most often caused by edentulism, leads the practitioner to carry out two types of corrections:
- In the presence of pathologies: it is the balancing grinding:
- Eliminates premature contacts, to avoid asymmetrical displacement of the condyles.
- Restores maximum intercuspation occlusion corresponding to centric relation.
- Eliminates unwanted dental contacts in diduction and protrusion.
- Restoring an occlusal plane:
NB: grinding may involve a small thickness of dental tissue or require pulp removal and reconstruction with a sealed crown (in cases of severe egression).
f-Preparation of the teeth supporting the hooks:
A metal PPA cannot be inserted without preparation of the abutment teeth; these modifications affect the enamel and do not pose any risk to the teeth concerned.
- Preparation of occlusal supports:
Carried out with a diamond ball bur (0.2 mm) under spray.- Its shape is half-spoon at the level of the posterior teeth and a shoulder at the level of the incisors and canines.
- The marginal ridge is lowered (facing the lodge) to avoid interference of the secondary connection with the antagonist tooth in occlusion.
- Preparation of the guide surfaces:
- These preparations concern the proximal faces opposite the prosthetic saddles and the lingual faces supporting the wedging arms and the coronal bars.
- They will be prepared according to the chosen insertion axis to obtain parallelism between the different dental elements.
- The preparations are made with a cylindrical diamond burr (turbine under spray).
- Creation or modification of retraction zones:
Some teeth may not have a retraction zone necessary for retention, so a small depression of 0.2 to 0.3 mm deep can be created mesio-vestibularly (for prophylactic reasons) using a diamond ball bur.
NB: All preparations involve only enamel and the prepared teeth must be carefully polished with cups and polishing paste.
g-Transitional prosthesis:
It is a therapeutic prosthesis intended to restore aesthetics, which is an important psychological factor and prepare the masticatory system to receive the usual prosthesis.
Objectives of the temporary prosthesis:
- Restore aesthetics
- Tissue and neuro-musculo-articular conditioning:
Patients who have been without a prosthesis for too long suffer from joint and muscular problems that risk worsening if the ground is not prepared with a temporary prosthesis. - Restore occlusal balance.
- Promote the integration, stabilization and tolerance of the future prosthesis.
III-CONCLUSION:
Pre-prosthetic treatment is the key to the success of “definitive” prosthetic treatment, which aims not only to restore lost functions but also to preserve the remaining teeth in the arch.
Pre-prosthetic treatment
Wisdom teeth can cause infections if not removed in time.
Dental crowns protect teeth weakened by cavities or fractures.
Inflamed gums can be a sign of gingivitis or periodontitis.
Clear aligners discreetly and comfortably correct teeth.
Modern dental fillings use biocompatible and aesthetic materials.
Interdental brushes remove food debris between teeth.
Adequate hydration helps maintain healthy saliva, which is essential for dental health.