Lec:7 Prosthodontic Dr. Thekra Ismael
Lec:7 Prosthodontic Dr. Thekra Ismael
Lec:7 Prosthodontic Dr. Thekra Ismael
Thekra Ismael
Class IV
This classification level depicts the most debilitated edentulous condition.
Surgical reconstruction is almost always indicated but cannot always be
accomplished because of the patient's health, preferences,
dental history, and financial considerations. When surgical revision is not
an option, prosthodontics techniques of a specialized nature must be used
to achieve an adequate treatment outcome.
Residual vertical bone height of 10 mm or less measured at the
least vertical height of the mandible on a panoramic radiograph.
Residual ridge offers no resistance to horizontal or vertical
movement; Type D maxilla.
Muscle attachment location that can be expected to have
significant influence on denture base stability and retention;
Type D or E mandible.
Class I, II, or III maxillomandibular relationships.
Major conditions requiring preprosthetic surgery:
I) complex implant placement, augmentation
2) surgical correction of dentofacial deformities;
3) hard tissue augmentation required;
4) major soft tissue revision required, ie, vestibular extensions with or
without soft tissue grafting.
History of paresthesia or dysesthesia.
Insufficient interarch space with surgical correction required.
Acquired or congenital maxillofacial defects.
Severe oral manifestation of systemic disease or conditions such
as sequelae from oncological treatment.
Maxillo-mandibular ataxia (incoordination).
Hyperactivity of tongue that can be associated with a retracted
tongue position and/or its associated morphology.
Hyperactive gag reflex managed with medication.
Refractory patient (a patient who presents with chronic
complaints following appropriate therapy).
These patients may continue to have difficult achieving their treatment
expectations despite the thoroughness or frequency of the treatments
provided.
Psychosocial conditions warranting professional intervention
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