THE MINISTRY OF PUBLIC HEALTH OF REPUBLIC MOLDOVA

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STATE MEDICAL AND PHARMASEUTICAL UNIVERSITY

" NICOLAE TESTEMIŢANU "

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DEPARTMENT OF PROSTHETIC DENTISTRY

METHODICAL ELABORATION

to practical lessons
for the students of IV year VII therm

Kishinev 2017
 The list of practical manual skills
on orthopedic dentistry for the students of IV year VII semester

Name ___________________ Gr. _______________

№ Practical manual skills Obligatory Demonstrate The The

d signature signature of
of the the teacher
student
1 a) examination of the patients with partial 2
edentation, diagnosis, treatment planing;
b) determination kind of the bite. 2
2 a)examination of the patients with partial 2
edentation, diagnosis, treatment planing
depending on pathology;
b) determination kind of the bite. 2
3 a) getting impressions from prosthetic field 5
at partial edentation with elastic impression
material;
b) testing individual impression tray and
getting functional impression at subtotal 1
partial edentation.
4 Getting double impressions from prosthetic 2
field.
5 Planning Partial Removable Acrylic 2
Denture and choosing support teeth.
6 Determination and fixation of central 1
occlusion or central jaws relationships.
7 Trial stages of prosthetic treatment of partial 1
edentation with PRAD.
8 Correcting and imposing PRAD. 1
9 Examination of the patients and 1
determination of the indications to
prosthetic treatment with Partial Removable
Skeletized Denture.
10 Planning PRSD depending on clinical 1
situation according to Kennedy
classification.
11 Surveying working casts. 1
12 Testing metal framework of PRSD in the 1
oral cavity.
13 Imposing PRSD in the oral cavity. 1
14 Preparation of support teeth at daily 2
patients.
15 Testing artificial crowns and bridge 1
dentures.
16 Determination and fixation of central 1
occlusion with gypsum blocks.
17 Fixation of fix dental prosthesis. 1
Notes:
. The practical skills necessary for independent performance and demonstration are carried out with materials destined for the students
which are fixed in a special register book.
. In case of not fulfilling the given list the student is obliged to get practical certification at extra classes (not according to the time-table.
. According to the decision of department, in exclusive cases, the part of practical skills can be conditionally transferred for performance
n the following semester.
. Writing off materials, intended for performing the practical skills by the students, is carried out according to the working orders of the
Ministry of public health Services with factor 2, authorized Administrative Council of Dental Clinic.
 The document has been translated by University Assistant M. Ceban.
Methodical elaboration Nr. 1

Theme: Partial extended edentation. Patient’s examination.

Component parts of the diagnosis. The indications to prosthetic treatment of partial
extended edentation with Partial Removable Acrylic Prosthesis (PRAP).

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge on clinical picture, clinical and
paraclinical methods of the patients examination with partial extended edentation, definition of class of partial edentation
by Kennedy, Costa, Kennedy-Applegate, Gavrilov; definition of state of mucousa by Supple; formulation of the diagnosis.
Learning outcomes: the features of clinical and para clinical patients examination, formulation of the diagnosis and
planning the treatment are demonstrated.
The students practically: spend clinical and paraclinical patients examination, formulate the diagnosis, conduct reception
of the patients.
The contents of the lesson:
The partial edentation may be defined as the absence from 1 to 13-15 teeth on the dento-alveolar arch. The extended
partial edentation - absence more than 6 teeth on one jaw.
Ethiological factors theoreticaly can be divided into hereditary and obtained factors.
Examination of the patients with extended partial edentation includes subjective and objective examination. Subjective
examination includes more often meeting complains of the patients on pain, alveolar hyperestesia, functional disorders,
static and dynamic misbalance of stomatognat system. Objective examination of the patients with partial edentation
includes extra oral and intraoral examination. Prosthetic field in partial edentation consists from all elements of
stomatognat system that are in contact with partial removable denture: remained teeth, residual alveolar process, hard
palate, mucousa of the oral cavity. Depending on functional and morphological structure elements of the prosthetic field are
devided into two groups:
a) remained teeth with their parodontium that form dental-periodontal support and
b) fibromucosa and bone of the both jaws that form mucosal-bone support.

Plan of the subject:

1. Discussion of a theme ----------------------------------------------------------------------30 min.
2. Demonstration of the thematic patient and definition of class of partial edentation by different authors, definition of state
of mucousa by Supple; formulation of the diagnosis ------------25 min.
3. Reception of the patients ------------------------------------------------------------------------180 min.
4. Conclusion -------------------------------------------------------------------------------------------5 min.

Checking questions:

1. Ethiology of partial edentation.

2. Subjective examination of the patients with partial edentation.
3. Objective examination of the patients with partial edentation:
a) extraoral examination;
b) intraoral examination.
4. Para-clinical examination of the patient with partial edentation.
5. Clinical picture of partial edentation.
6. Classification of partial edentation by Kennedy, Costa, Kennedy-Applegate, Gavrilov.
7. Characteristic of the dental-parodontal bear complex that provide denture support.
8. Classification of mucousa by Supple, Luind.
9. Classification of bone support at maxilla by Lejoyeux.
10.Classification of bone support at the mandible by Lejoyeux.
11.Argumentation of joint dereglations.
12.Argumentation of muscles dereglation.
13.Dyagnosis and its components parts.
14.Indications for partial removable prosthesis manufacturing.
15.Peculiarities (particularityes) of prosthetic field preparation to prosthetic treatment with partial removable
prosthesis.
 Methodical elaboration Nr. 2

Theme: Indications to prosthetic treatment of partial extended edentation with

Partial Removable Acrylic Prosthesis (PRAP). Technique of getting impressions.
Clinical-laboratory stages of Partial Removable Acrylic Denture (PRAD)
manufacturing.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge on the
indications to removable acrylic prosthesis manufacturing in extended edentation, methods of getting
impressions and determination of limits of partial removable acrylic prosthesis, study clinical-
laboratory stages of PRAD manufacturing.
The students practically: chose variations of future PRAP, get impressions, determine the limits of
bases of removable acrylic prosthesis and note practical experiences.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration of getting impression and determination of limits of removable prosthesis-----20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. Partial removable prosthesis varieties.

2. Indications to partial removable acrylic prosthesis manufacturing.
3. Contraindications to partial removable acrylic prosthesis manufacturing.
4. Biomecanics of partial removable acrylic prosthesis.
5. Component parts of partial removable acrylic prosthesis. Characteristics.
6. Requirements to support teeth.
7. What the limits of removable prosthesis on the maxilla?
8. What the limits of removable prosthesis on the mandible?
9. Constructive peculiarities of removable acrylic prosthesis by Kemeny.
10. Constructive peculiarities of removable acrylic prosthesis by Itighin.
11. Methods of getting impressions at removable acrylic prosthesis manufacturing, steps of
getting impressions.
12. Possible complications during taking impressions and their maintains.
13. Modern impression materials. Characteristics.
14. Enumerate clinical stages of PRAD manufacturing.
15. Enumerate technical stages of PRAD manufacturing.
 Methodical elaboration Nr. 3

Theme: Definition of central occlusion or central relationships at prosthetic

treatment with PRAD.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge about
methods of determination and fixation of central occlusion or central jaws relationships at different
defects of tooth rows, determination of the colour of artificial teeth.
The students practically: students together wih teacher determine and fix central occlusion or central
jaws relationships at different defects of tooth rows and note practical experiences.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. Definition of central occlusion.

2. Definition of interocclusal correlations.
3. Central occlusion signs and their practical value.
4. Classification of partial edentation depending on clinical situation in intermaxilar
correlation.
5. Determination of intermaxilar correlation in case of stabil occlusion (first clinical
situation).
6. Determination of intermaxilar correlation in case of instabil occlusion (second clinical
situation).
7. Determination of intermaxilar correlation in case of absence of occlusion (third clinic
situation).
8. Consecutivity of determination and registration of intermaxilar centric relationships.
9. Metods of vertical occlusal dimension determination. Anatomy-physiological method.
10. What kinds of lines we draw on occlusal border? Method and practical value.
11. What criteria of choosing artificial teeth?
12. Technique of neutral lower jaw position determination.
13. Methods of fixation of central occlusion (central jaws relationships).
 Methodical elaboration Nr. 4

Theme: Methods of fixation and stabilization of PRAD.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge about
fixation and stabilisation of PRAD, using different support elements and their component parts.
The students practically: determine support teeth, types of the clusps, fixation and stabilization of
PRAD and note practical experiences.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. Enumerate stabilising and supporting elements of partial removable acrylic denture.

2. Requirements to metal clasp made of wire.
3. How to choose the clasps line? Its practical value.
4. Components of clasps and its position.
5. Enumerate the more often used types of clasps.
6. The differents between Jackson and Adams clasps?
7. Indications to telescopic clasps manufacturing. The position of clasp elements with regard
to supporting tooth and prosthetic base. .
8. What is Dolder system and indications to its manufacturing.
9. Anatomic formings taken into consideration at planing the treatment.
10. Byomecanics of partial removable acrylic prosthesis.
11. Types and indications to Kemeny clusps manufacturing.
12. Types and indications to combined clusps manufacturing.
 Methodical elaboration Nr. 5

Theme: Checking the design (waxen composition) of Partial Removable Acrylic

Prosthesis (the trial stage of treatment). Imposing the PRAP (the insertion stage of
treatment). Correction.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge about
technical and clinical criteria of quality of PRAD, technique of PRAD testing in the oral cavity,
determination of the mistakes made at the previous stages and methods of their removing.
The students practically: determine quality of PRAD in articulator and in the oral cavity and note
practical experiences.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. What is the number of stage of wax composition probe and purpose of its making.
2. Stages of wax composition probe.
3. Qualitative determination of wax composition on the model fixed in simulator.
4. Qualitative determination of wax composition in the oral cavity.
5. Qualitative determination of dental-dental contacts in position of central occlusion.
6. Control of fiziognomic aspect.
7. Control of phonetic aspect.
8. How to contol vertical occlusal dimension?
9. Requirements to prosthesis base on this stage.
10. Requirements to clasps.
11. Method of testing neutral position of the lower jaw.
12. Doctor’s tactic in case of increasing or reduction of vertical occlusal dimension?
13. Doctor’s tactic in case of uniform dental-dental contacts on one half of dental arch and
absence of occlusion on another one? What mistakes and during what stage were made?
14. Individualization of the base of PRAD to prosthetic field.
15. Individualization of the clusps of PRAD to support teeth. Tools.
16. Individualization of occlusion. Tools.
 Methodical elaboration Nr. 6

Theme: Skeletized partial removable prosthesis (PRSP). Constructive elements.

Dental-periodontal, mucosal-bone and combined support.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge about
disadvantages of PRAD and advantages of PRSP, types of PRSP and their constructive elements.
The students practically: take part in reception of the patients, examination of the patients with
partial edentation taking attention on dental-parodontal, mucosal-bone and combined kind of support
of PRSP and note made work.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. Dizavantages of parţial removable acrilic prothesis.

2. Advantages of partial removable skeletized prothesis.
3. Characterized dento-parodontal support. Practical value.
4. Characterized muco-bone support. Practical value.
5. Enumerate component parts of Partial Removable Skeletized Prosthesis.
6. Saddles of skeletized prosthesis. Varieties. Function.
7. Main Connectors. Varieties. Function.
8. Secondary Conectors. Clasification.
9. Dental support elements: a) clasps and clasps systems;
b) special sistems.
10. The Dolder bar. Indications to using.
11. Disjunctive elements of maintaining, support and stability. Varieties.
12.Biomechaniс of Partial Removable Sheletized Prosthesis.
13.Dimension and placing of Main Connector on the maxilla.
14. Dimension and placing of Main Connectors on the mandible.
 Methodical elaboration Nr. 7

Theme: Indications and contra-indications to prosthetic treatment of partial

extended edentation with Partial Removable Skeletized Prosthesis.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge about
indications to prosthetic treatment of partial edentation with Partial Removable Skeletized Denture
(PRSD) and methods of getting impressions.
The students practically: determine the indications to PRSD manufacturing and take part in getting
impressions.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. Indications to Partial Removable Skeletized Prosthesis manufacturing.

2. Enumerate varieties of Partial Removable Skeletized Prosthesis construction.
3. Dizavantages of Partial Removable Skeletized Prosthesis made by soldering method.
4. Advantages of Partial Removable Skeletized Prosthesis made by cast method:
a) on the model;
b) without model.
5. Division on dental surface on the quadrants. Purpose.
6. Situation of the clasps elements on the support teeth.
7. In what order are placed elements of the attacement on the support teeth and on the
saddles of Partial Removable Skeletized Prosthesis?
8. In what cases does the continuous clasp play the principal role of Main Connector?
9. Antibasculant elements of Partial Removable Skeletized Prosthesis . Placing.
10. Modern alloys using for Partial Removable Skeletized Prosthesis manufacturing.
11. Getting impressions at Partial Removable Skeletized Prosthesis manufacturing. Varieties.
12. Modern impression materials. Characteristics.
13. Realisation of superhard models, with removable thermorezistant bont. Using materials.
 Methodical elaboration Nr. 8

Theme:Clinical-laboratory stages of Partial Removable Skeletized Prosthesis

manufacturing. Surveying.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge about
clinical-laboratory stages of PRSD manufacturing, functional role of this denture.
The students practically: take part in reception of the patients with partial edentation, plan treatment,
take part in preparation of the support teeth under different kind of artificial crowns and special
systems and note made work.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. Enumerate clinical steps of Partial Removable Skeletized Prosthesis manufacturing

without making artificial crowns on the supporting teeth.
2. Enumerate laboratory steps of Partial Removable Skeletized Prosthesis manufacturing
without making artificial crowns on the supporting teeth.
3. Enumerate clinical steps of partial removable skeletized prosthesis manufacturing with
making artificial crowns on the supporting teeth.
4. Enumerate laboratory steps of partial removable skeletized prosthesis manufacturing
with making artificial crowns on the supporting teeth.
5. Particularities of support teeth preparation and formation the palce for clasp elements
placing.
6. Surveying. Free method.
7. Surveying. Method of choosing.
8. Surveying.. Method by Novac.
9. Enumerate way (path) of insertion and dezinsertion of Partial Removable Skeletized
Denture.
10. Determination of intermaxilar relationsheeps in different clinical situations.
 Methodical elaboration Nr. 9

Theme: Particularities of designing the Partial Removable Skeletized Prosthesis at I -

IV class of partial edentation by Kennedy.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge about
biomechanics of PRSD at I – IV class of partial edentation by Kennedy, clinical varieties of terminal
defects, conception of PRSD depending on type of edentation.
The students practically: study different type of of terminal defects and plan design of PRSD
depending on results of surveying, note their practical skills.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Control questions:

1. Essence of morpho-pathological analysis of prosthetic field elements.

2. Biomecanics of PRSD at bilateral terminal edentation.
3. What are the most frequently used clasps in biterminal edentation?
4. Main Connectors used in I –IV class by Kennedy.
5. Usage of attachments in terminal edentation.
6. Particularities of usage of Disjunctive elements in biterminal edentation.
7. Biomechanics of Partial Removable Skeletized Prosthesis in I –IV class by Kennedy.
8. Particularities of planing Partial Removable Scheletized Prosthesis in uniterminal
edentation.
9. Particularities of usage of Disjunctive elements in uniterminal edentation.
10. In what cases at uniterminal edentation are antibasculants used?
 Methodical elaboration Nr. 10

Theme: Clinical picture at subtotal edentation and particularities of prosthetic

treatment with Partial Removable Skeletized Prosthesis with application of special
systems.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge clinical
picture of subtotal edentation and indications to prosthetic treatment with using Dolder-Rumpel system
The students practically: take part in reception of the patients with subtotal edentation and planning
treatment with Dolder-Rumpel system using and made work.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. Ethiology and clinical picture of subtotal edentation.

2. Indications to usage of Dolder-Rumpel system.
3. Component elements of Dolder-Rumpel system.
4. Clinical-laboratory stages at skeletized prosthesis manufacturing using Dolder-Rumpel
system.
5. Indications to PRSD on attachments manufacturing.
6. Types of attchements ased in PRSD.
7. Biomechanics of PRSD fixed on attachements.
 Methodical elaboration Nr. 11 - 12

Theme: Testing the metal skeleton of Partial Removable Skeletized Prosthesis in the
oral cavity.

Place of work: clinic room.

The purpose of the lesson: during the lesson students materialize the received knowledge about
methods of testing the PRSD in the oral cavity, determine the quality of PRSD and requirements to it.
The students practically: determine on the model and in the oral cavity the quality of metal frame of
PRSD and choose artificial teeth.

Plan of the subject:

1. Discussion of a theme ------------------------------------------------------------------------------------30 min.

2. Demonstration ---------------------------------------------------------------------------------------------20 min.
3. Reception of the patients -------------------------------------------------------------------------------185 min.
4. Conclusion ---------------------------------------------------------------------------------------------------5
min.

Checking questions:

1. Testing the metal framework of Partial Removable Skeletized Prosthesis on articulator.

Requirements.
2. Testing the metal framework of Partial Removable Skeletized Prosthesis on prosthetic
field in the oral cavity.
3. the path of insertion and desinsertion of PRSD.
4. Clinical requirements elements of metal framework of Partial Removablşe Skeletized
Denture.
5. Possible mistakes at metal framework of PRSP manufacturing and the metods of their
correcting.
6. Determination of central occlusion with metal framework in the oral cavity.
7. Testing the PRSP in the oral cavity?
8. Indications and methods of correction the base of PRSP and occlusal relationships.
 Methodical elaboration Nr. 13 - 16

Reception of the patients.

Methodical elaboration Nr. 17

Theme: Practical control of the students. The test - control.

The document has been translated by University Assistant M. Ceban.