DIAGNOSIS AND
TREATMENT PLANNING
DR MUHAMMAD RIZWAN MEMON
F.C.P.S (T) (Prosthodontics)
Patient Interview
Demographic data
Chief complaint and its history
Medical history review
Dental history review
Patient expectations
Infection Control
Doctor:
– Gloves
– Mask
– Glasses
Instruments:
– Sterilization
Operatory:
– Scrubbing & wiping of surfaces
– Carefully handling of disposable materials
Clinical Examination
Extra Oral:
– TMJ, Mouth opening etc
Intra Oral:
– Existing Teeth
Periodontal health
Occlusion
Conservative & Endodontic status
– Residual ridges
– Height of floor of mouth
Radiographic Examination
Periodontal bone loss
Structure of basal bone in denture bearing
areas
Presence of perapical bone loss &
furcation involvement
Examination of Diagnostic Casts
Permit view of occlusion from lingual & buccal
aspects, degree of overclosure, amount of
interocclusal space available etc
Permit topographic survey of occlusion
Permits a logical & comprehensive presentation
to the patient
Individual impression trays may be fabricated
Used as constant reference as the work
progress
Become a permanent part of patient record
Treatment Planning
Phase-1
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Collection & evaluation of diagnostic data
Treatment of emergency conditions
Determining type of prosthesis
Patient motivation
Phase-2
– Preprosthetic mouth preparation ( Relief of pain, Oral
surgical procedures, Periodontal therapy, Correction of
occlusal plane, Orthodontic correction, Splinting
weakened teeth
– Making primary impression
– Patient motivation
Phase-3
– Designing the RDP
Phase-4
– Prosthetic mouth preparation (Preparation of
undercuts, guide planes & rest seats)
– Making the final impression
– Patient motivation
Phase-5
– Fabrication of RDP
Phase-6
– Insertion
– Post insertion management
– Periodic recall and review
Differential Diagnosis
Fixed OR Removable Dental Prosthesis
Indications for fixed restorations
– Tooth-bounded edentulous regions
– Modification spaces
– Anterior modification spaces
– Replacement of unilaterally missing molars
(SDA)
Indications for removable restorations
– Distal extension situations
– After recent extractions
– Long span
– Need for effect of bilateral stabilization
– Excessive loss of residual bone
– Unusually sound abutment teeth
– Abutments with guarded prognosis
– Economic considerations