LECTURE #1: SDS CLINICAL FORMS, CLINICAL PROTOCOL, LECTURE CONTENTS AND
A discussion of the above items will include the following clinical forms.
1. SDS Clinical Evaluation Form
2. SDS TMD Screening History & Exam Form
3. SDS Exam/Diagnosis for RPD Patients
4. SDS Design & Design Modification for RPD’s
5. Worksheet: Interim and Transitional RPD’s
6. Sample Treatment Plan Form
7. Sample of Treatment Sequence for RPD Patients
8. Sample of Treatment Sequence for Complete Denture Patients
9. Sample Dental Laboratory Worksheet (for teeth set‐up)
10. Sample Dental Laboratory Worksheet (for denture processing)
11. Summary Form of Accomplished Clinical Procedures
LECTURE #2: TEMPOROMANDIBULAR DISORDERS: SCREENING ISTORY & EXAM FOR
ROUTINE DENTAL PATIENTS.
2. Origin, purpose, and advantages of TMD screening
3. TMD screening forms
4. How to perform a TMD screening history
5. Classic TMD symptoms
6. How to perform a TMD screening examination, including digital palpation
7. Relation of tension headaches to TMD
8. When to refer a patient to a TMD specialist
9. Each student will fill out his/her TMD self‐screening history form
10. Each student will perform a TMD self‐screening exam
• McNeill C (Ed.). Temporomandibular Disorders‐Guidelines for Classification,
Assessment and Management. Quintessence, London, 1993, pages 11‐16,
• Nassif J, Hilsen K. Screening for Temporomandibular Disorders: History and
Clinical Examinaon. Journal of Prosthodoncs, 1992;1:42‐46 (September).
LECTURE #3: TREATMENT OF ABUSED AND PATHOLOGIC ORAL TISSUES.
b. Pathoses related to denture wearing.
(1) Pseudo epitheliomatous hyperplasia (palatal papillary hyperplasia)
(2) Denture induced stomatitis (DIS) (pressure, plaque, denture
(3) Denture induced hyperkeratosis
(4) Epulis fissuratum
(5) Excessive resilient (flabby) ridge mucosa
c. Pathoses not related to denture wearing
1. Chemical injury (i.e. aspirin burn)
2. Radiation mucositis
3. Xerostomic mucositis
4. Hyperkeratosis not under denture baring surface
5. Smoker's mucositis
d. Etiology of denture induced stomatitis (DIS)
(1) Systemic factors
(b) Endocrine dysfunction
(c) Nutritional deficiencies
(e) Xerostomia (medication, diabetes)
(2) Local factors
(b) Continuous wear
(c) Poor Oral Hygiene
(d) Acrylic resin allergy
(e) Candida albicans infection
e. Mechanisms making oral tissues susceptible to DIS
(1) Increased epithelial permeability
(2) Acidic environment
(3) Aerobic environment
f. Treatment for abused oral tissues
(1) Identify/eliminate etiology
(2) Recondition the oral tissues with conditioners
(b) Coe Comfort
(c) Coe Soft
(3) Surgical procedures
(4) Leave dentures out of mouth
(5) Reconstruct prosthesis with accuracy
(6) Use antibacterial agents in denture (Chlorhexidine, Listerine,
(7) Denture cleansers and denture cleaning methods
• Textbook of Complete Dentures by Rahn AO, Heartwell CM, 5th ed,
Williams & Wilkens Co; Balmore 1993 pp. 407‐412, 414, 419‐425, (all
LECTURE #4: MANAGEMENT OF REDUCED RESIDUAL ALVEOLAR RIDGES.
b. Oral aspects of aging (Zarb)
c. Etiology of atrophic bone resorption (Rahn)
1. Local factors
2. Systemic factors
d. General considerations for treatment planning
e. Intraoral assessment
1. Direction of bone loss
2. Biomechanical factors and associated problems
3. Oral mucosa factors and associated problems
f. Preservation of the residual alveolar ridges
g. Patient management/treatment ‐ Non‐surgical methods and techniques
1. Fundamental principles
2. Philosophies for occlusal types/arrangement
3. Patient education and reasonable expectations
h. Patient management ‐ Surgical techniques
1. Soft tissue surgical techniques
(a) Vestibular extension procedures
(b) Autogenous soft tissue overlay grafts
2. Soft tissue surgical techniques for the partially edentulous mouth
3. Hard tissue surgical techniques
− Osseointegrated implants
− Osteotomy autogenous bone graft (mandibular)
• Visor osteotomy
• Modified Visor osteotomy
• Interpositional bone graft
− Alloplastic ridge augmentation graft
• Hydroxyapatite alone
• Hydroxyapatite in combination
• Problems with use of hydroxyapatite
• Rahn A, Heartwell C.: Textbook of Complete Dentures, 5th Ed., WB Saunders
Co., Philadelphia, 1993, pages 185‐211, (all required reading).
• Zarb G, Bolender C, Hickey J, Carlsson G: Boucher's Prosthodontic Treatment
for Edentulous Paents, 10th Ed, CV Mosby Co, Chicago, 1990. pp. 38‐46,
LECTURE #5: PROSTHODONTIC TREATMENT PLANNNING IN OLDER ADULTS.
1. Characteristics of the elderly patient:
I. Age related changes.
a. Sensory changes
b. Cognitive changes
c. Psychosocial aspects
II. Oral Physiology and Aging.
a. Salivary glands
b. Oral Mucosa
c. Oral motor function
d. Oral sensory function
2. Factors influencing Prosthodontic Treatment Planning.
3. Objectives of Prosthodontic Treatment Planning.
a. Partially edentulous patient
b. Completely edentulous patient
4. Identification of Treatment Needs and Demands.
a. Partially edentulous elderly
b. Completely edentulous elderly
5. Identification of the Risk Factors.
I. Partially edentulous patient
a. Periodontal situation
b. Caries activity
c. Residual ridge resorption
d. Functional problems of masticatory system
II. Complete denture wearer
6. General Health of the Elderly.
7. Choice of Prosthodontic Treatment Modalities.
a. Fixed Partial Dentures and the elderly
b. Removable Partial Dentures and the elderly
c. Overdentures and the elderly
d. Complete dentures and the elderly
8. Decision Making in Treatment Planning.
a. Patient’s factors
b. Prosthodontist’s factors
9. Treatment Planning Recommendations.
10. Post Treatment Phase ‐ Aids for maintaining adequate oral hygiene.
LECTURE #6: PATIENT REQUIRING A SINGLE COMPLETE DENTURE.
1. General considerations in construction & delivery
2. Single complete "denture syndrome"
3. Preventive measures
3. Minimizing occlusal forces on the denture foundation
a. Complicating factors for the single mandibular complete denture
b. Favorable situations for the mandibular complete denture
c. Special considerations for maxillomandibular jaw relations
d. Indications for modifying the opposing mandibular natural/artificial
e. Occlusal adjustment ‐ perfecting the plane of occlusion of the opposing
natural teeth: Two methods (one using an occlusal metal template)
f. Improving the occlusal plane of the opposing "mesially tilted molar"
g. establishing the vertical and horizontal overlap
h. Occlusal requirements of the single complete denture
i. Artificial posterior teeth selection
j. Placement (insertion) visit