Onlay partial denture

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Onlay partial denture

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• Anterior teeth attrition
• Vertical dimension decrease
• RPD - abrasion

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A. Etiology

• Parafunctional occlusal habits
• Chronic bruxism
• Other oral habits biting on needles, pipe
  stems, pencils, hairpins

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A. Etiology

• Abrasion diet chewing of abrasive materials
  (rice, tabacco)
• Definition defined as the wearing away of tooth
  tissue by external agents
• Occlusal abrasion is usually attributed to diet,
  chewing of abrasive.
• Environment factors constant exposure to dust
  and grit

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A. Etiology

• Erosion chemical action
• Result from excessive intake citrus juices, cola,
  chronic vomiting
• Incisal edge, lingual or occlusal surface
  cupped-out appearance (unbalanced occlusal force)

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Evaluation of Vertical Dimension

• OVD occlusal vertical dimension
• VDO vertical dimension of occlusion
• VDR vertical dimension of rest

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C. Methods of evaluation

• Posterior support
• History of wear
• Phonetic evaluation
• Inter-occlusal distance
• Facial appearance

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C. Methods of evaluation

• Posterior support
• Loss of posterior support is the most common
  cause of decreased occlusal vertical dimension
• Posterior collapsar combination of missing,
  tipping, rotated and broken down teeth

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C. Methods of evaluation

• Phonetic evaluation speaking space? ?? ?? ????
  S sound? ?? ??? incisal edge? ?? incisal edge?
  ?? 1mm ?? inferior and lingual? ???, 1mm??? ???
  ??? VD? loss? ??? ?

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C. Methods of evaluation

• Inter-occlusal distance VDO, VDR?? 3mm ?? ???
  ??? excessive wer? ??? ??. ?? ??? ?? ??? ??. ???
  complete denture??? ??? VD?? ??? ????? ??
  myomonitor? ????? ??.

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Approaching technique

• OVD? ?? ??? ??? ? ? ?? ??? ??? ?? ?? ??.
• Concepts of conservative treatment
• Trial period with interim prosthesis
• Transitional RPD (desired OVD)
• Use of acrylic splint
• Use of provisional restoration

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Interim removable partial denture
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Initial patient assessment

• Intraoral examination
• Extraoral examination
• Smile analysis
• Phonetic evaluation
• Initial prostheses assessment

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Initial patient assessment

• Intra-oral examination
• Excessive loss of tooth structure
• Healthy periodontum with sufficient bone
• Lack of posterior occlusion
• Class I jaw relationship

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Initial patient assessment

• Extra-oral examination
• Slight decrease in facial height
• Inversion of maxillary lip
• Inter-occlusal rest space of 3 to 4mm

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Initial patient assessment

• Smile analysis
• No touch of maxillary teeth to lower lip
• Straight maxillary incisal edge alignment to
  lower lip
• Increase vestibular space

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Initial patient assessment

• Phonetic evaluation
• F-V position inadequate in vertival plane
• S position acquired Ssound deficiency

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Initial patient assessment

• Initial prostheses assessment
• Poor plane of occlusion
• Lack of occlusion as a result of excessive wear
  of acrylic resin
• Inadequate border extensions

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To determinate the VD

• 4mm increase ( anterior incisor area)
• Direct assessment technique
• Diagnostic wax-up technique

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Mounted diagnostic wax-up

• To assess the patients tolerance acceptance of
  restored OVD
• Use face-bow, centric relation, condylar angle
  (protrusive record, lateral check bite)
• Mount the semi-adjustable articulator

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