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COMMT.'NITY DENTISTRY qII
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PUBLIC HEAITH
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WORLD EE;Af,TH ORGANIZATION (WHO) is the agency responsib,Le for the health goals
April 7 is WORLD HEALTH DAY-
DEIII]IAI PIIBLICH HE;AITH is main concerned wlth:
A. Prevention of dental disease
B. Promotion of dental and oraf heafth
C. Prolongation of life
CORAZON AQUINO was the first who introduced dental public health rn the PHL.

HEALTH is a state of compl-ete physical, mental and sociaf well-being and not
merely an absence of disease.
HEAITH PROMOIfON is a set of educational economic and environmental incentlves t-o
support behavioraf changes that lead to a better fevel of health.
1082: RLIRAL I{EiALTH LAW
RiA,
Proclamation 559 is NATTONAI ORAI HEALTH MONTH during FEBRUARY-

HEAITH PROGRjFTM is a timed-series of service act ivrti-es requiring physical, human

and financial resources to achieve health policy obj ectives .
"IIEALTH for ALL by year 2000" was a program for health promotion.
t DECLARED durinq SEPT. 7918
FORMALLY LAUNCHED duringr SEPT. 1981
I HEJAITH I'4ATNTEIiIAI.ICE ORGANIZATION ( HMO )

EXAI,IPLES: Medicard, Maxicare and Philamcare

I PRIMARY HEAITH CARE ELEMENTS:

1. Health education 5. fmmunization against infections
2. Promotion of food supply and nutrition 6. Prevention of endemic disease
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3. Adequate supply of safe water 1. TreatmenL of common disease
4. Materna] and chifd CAIC B- Prov-ision oI essential druqs
STT'DIES
L The two (2) useful tools LN community dentrstry are EPIDBfIOLOGY and
BIOSTATISTICS.

t 1. EPIDE!4IOLOGY is used for studying determinants of the diseases.

.IOHN SNO}I is the EATHER OE EPIDEM]OLOGY
EPTDE}CIOLOGtrST has a function of PROGNOST]CATOR.
t
INDICES USED IN DENTAI EPIDEMIOLOGY:
A. DMF (Decayed, Missing, Eilled) by H. Kleinn J.W. Knutson and C. Palmer.
t D is the MORBIDITY of the tooth.
M is the MORTALITY of the tooth.
B- R.CI (Root Caries Index) measures attach rate of caries on exposed root
I surface.
C. pHp*M (Personal Hygiene Performance Irrdex Modifieci)
l_ Measures piaque on FIVE zones of faciaL and iinqrrai to.rth su::far:es

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 D. OHf-S (Oral Hygiene Index - Simplified) - Measures plaque and calculus on SIX
surfaces of six teeth (Sextant).
COMPONENTS: A. Debris lndex
B. CaIcu]us index
E. cI (Gingival Index) measures the gingival inflammation and bl-eeding.
F. NIDR-GI (National Instltute of Dental- Research Gingival lndex) - Measures
gingival bleeding onIy.
G. PI (Periodontal Index) measures gingivitis, l-oss of epithelial attachment and
alveorar bone Ioss.
H. CPITN (Community Periodontal Index of Treatment Needs) estimates dental
services need by populatlon.
I. PLAQITE INDEXmeasures the area of plaque covering the CLINICAI CROWN.
The best time to do plaque index is
REMEtr'TBER:
A. OHI-S is by GREENE and VERMILLION
B. PERIODONTAL INDEX is by RUSSEL
C. CPITN is by CUTRESS and AINAtr"IO
D. PLAQUE INDEX is by SILLNESS and I,OE.
E. PHP-INDEX is by PODSIIADLEY and HAIEY
2- is used to quantify disease status in the community"
DESCRIPTfVE EPIDBVIIOTOGY
A. INCIDENCE refers to the number of NEW CASES that will occur within a
population during a specific time period.
B. PREi\rlttENCE is a proportion of OLD and NEW CASES of a qiven population
I affected by a condition at a given point in time.
I
3. A}TALYTICAI EPIDB4TOIOGY is used for:
I a. Determining the etlology of the disease
L e- Conceptualizing the disease status of the community-
C. Estabfishing causal relationship between risk factor and outcome.
I

I 4. EXPERD.{ENTAI EPIDB4TOLOGY is used primarily for intervention studies - It deals

with provj-ng a hypothesis.
I
I REMEMBER:
I A. The difference of EXPERIMENTAI to analytical and descriptive is THE
I TNVESTTGATOR CAN IANrPrrr,ATE nIDEPENDENT VARTABtES -
B. Distribution of dental caries in a community is best described by DESCRIPTI\IE
IL EPIDEVTIOLOGY.

I S. PRosPEcTn/E CoHoRT STUDY is corrrnonly used in the area of occupationai health

I
L hazards.
; O. RAIIDOMIZED COIEROLLED TRIAL is a study in which people are allocated at random
I to receive one of the serreral clinical interventions.
SEQUENCE IN PLANNING A RANDOMIZED CONTROLLED TRIAf-:
A. Protocol
B. Sel-ec1-ion of subject (samoJ-e size) - It depends on the hypothesis
L C " Randomi-zat-ion

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771,
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 D. Intervention
E. EoIlow-up and assessment
1. DOT,BLE BLIND STTIDY iS ONE iN which neither the participants nor the
experiments know who is receiving a particular treatment. Thj s is used to
decrease the bias.
1. BIOSTATISTICS is a scientific discipline concerned with the application of
statistical method of problems in biology and medicine - It is the mathematics of
coilection, organization, and interpretation of numeric data having to do with
Iiving organisms.
USES:
A. Investigate relatronship between human condj-tions and possible causal
factors.
B- Co11ect, tabulate and report mortality and morbidity.
C. Test hypothesis related to causation of disease.
MORIAIITY is the state of being subject to death.
A. INEAI.IT MORTAIITY RATE - measures the death bef ow 1 year of age.
B. CIIILD MORTAIITY R;LTE - measures death between 1-4 years of age.

MORBIDITY is the state of being ill, diseases or unhealthy

2. STATISTICSis the practice, study, or resuft of the application of mathematical
functions of col.Iect-ions of data in order to summarize or extrapolate the data.
TYPES:
A. INEEREIIIIALSTATISTICS all ow someone ro generalize from the samp]e of data
to a larger group of subj ects.
It needs IIYPOTTIESIS TESTfNG to check if the hypothetical study is consistent.
I

TYPES OF HYPOTHESIS:
A. PARAMETRIC TEST: Student t-test, ANOVA, Pearson correlation test
I B. NON-PA&AMETRfC TEST: Mann-V{hitney test, Wilcoxon siqned-rank test
Kruskall-Wa1lis test, Spearman correlation test-
L B. DESCRIPTI\,E STATISTICSis a way to summarizinq data or lettlng one number
stand for a group of numbers. Three wa.ys we can summar)-ze data:
1 - TABULAR representation data

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2. GRAPHICAL representation data
3. NUMERICAI representation data
C- EREQTENCY DISTRIBUT]ON rs a tabulation of values that one or more variables
L take in a sample.
mL.i .l ,,^^^.
alrrJ ^ rD^ t1.-cta-
A. To give example of the sample size
L B. To assure that the contents of a table are fuJ-Iy defined.
C. To assists the read.er to check the validity cf the authors arguments-
i D. NORI{AL DISTRIBUTION
probability distribution.
aS random variation that conforms to a particul-ar
I

E. SKEI(ED DISTR]BUTICI}{ is svnrmel-ri cal with di spersion skewed to the left or

right of the median.
TERMS:

.l *t't
 L. MEAII (AVERAGE) is the value obtained by adding afl the measurements and
dividing by the number of measurements.
2. MEDIAN is the middle measurement in a set of ciata where half the data is above
and half the data is below the number
3 " MODE is the most frequent measurement in a set of data
4. R;AIIGE is the dif ference between the highest and lowest value in the
distribution
5. \IARIANCE & STAI{DARD DE\IIA:IION measure variabitity withrn the distribuEion.
5.1I/ARIANCE is the square of the stanciard deviation
5.2 STATiIDARD DEUIA:IION is the number that indicates how much on average each
value in the distribution deviat4es from the mean of the distribution.
6. ARRAY is the arrangement of data from lowest to highest.
1 - E'REQT ENCY is the number of observations that falls at one point or range on a
measurement scale "

TECHNIQUES OE DATA COLLECT]ON:

1 .PRII"ARY TECHNIQUE: Personal interviews, Telephone interviews and
questionnaires.
2. SECOIIDARY TEHCNIQUE: Government census-
3. TERTIARY TECHNIQI,E: TextbooKS.

REMEMBER:
A. POPULATION is any entire group of items that possess one basic defined
characteristic in common.
B. The POPULATION GROWTH RATE is 2.38
C- The GLOBAf, averaqe of DENTAL MANPOWER to population is 1:1,000
D. The other name of population is
E. ARITHMETIC MEAN is also known as AVERAGE.
E. SAMPIE is a representative portion of the population
3. EUGENICS is termed proposed by GAJ-TON, rt aims to improve the qenetic
endowment of human population.
TYPES:
A. POSITTVE EUGENICS refcrS tO improvement of genetic composition by
encouraging carriers of desirable genotypes to bear the responsibi-1ity of
parenthood.
B. NEGATIVE EUGENICS refers to kilting the weak and defective, sterilizing
those suffering from hereditary dlsease to reduce frequency of hereditary
disease -

NOTE: EUTHENICS is the manipulating the environment in which the genes can
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express themselves readifv.
TYPES OE SAMPLING METHODS:
L as one in which every element ln the population
1- RjAIIDOM SAIfPLING is defined has
an equal and independent chanqe of being selected.
I 2. STRATIFIED SAD4PLING is the method of selection wherein individuafs are
selected according to certain strata or subgror,rp l-o diminrsh the chance of sample
fluctuation
1
3 " SYSTEIfTC SAMPLING is usually obtained by drawi ng a number and then selecti-ng
every individual -
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4. JUDGING SAMPLING is use when someone with knowledge of the population may
select sample in arbitrary ways to represent the population-
5. when a group is chosen because it
COII\IENIENCE SAIvIPLINGis happens to be
convenient and may represent the popul-ation-
TYPES OE ANALYSIS:
1. CORRECTION AI{ALYSIS is used to determine the strength of relationship
ASSOC]ATEDBETWEEN VARIABLES .
TYPES:
A. PEARSON CORRE].ATION: associated between TWO CONTINUOUS VARIABLES.
B. SPEARIE}I CORREI,ATTON: associated between TWO ORDINAI, VARIABLES.
C. CSI-SQUARE TEST: associated between TWO CATEGORICAI VARIABLES.
D. PAIRED T-TEST: associated between TWO RELATED VARIABLES.
E. IIIDEPENDENT T-TEST: associated between TWO INDEPENDENT VAR]ABLES.

2. STTDENT T-TESI is used to compare the two means to determine the probability
Lhat the difference between mean is greater than the expected by chance.
3. AIIAIYSIS OE \IARTAIICE (ANOVA) by ROIiIAL FISIIER is a colf ection of statisticaf
models and their associated estimation procedures used to analyze the difference
among group means in a sample.
3. 1 O![E-IAY A]IO\rA is used when there is one independent variab1e and one
dependent variable and there are more than two groups.
3.2 TIIO-IUAY AIIOVA is used when there are two independent variabLes and one
dependent variable and the means of more than two groups has to be compare.
4- IBI{N-WHITNEY U TEST is a nonparametric alternative test to the independent t-
test used to compare two sample means that come from the same population, and
used to test whether two sampfe means are equal or not.
5- IYTLCOXON SIGNED-RjAI{K TEST is used to compare two ref at-ed samples, matched
samples, or repeated measurements on a single sample to assess whether their
population mean ranks differ.
6. is used for testing whether samples originate f rom the
KRUSKiAI-IBLLIS TEST
same distribution. It is used for compare two or more independent samples of
equal or different sample size.
TYPES OF C}IART:
1. LfNE GRAPH is a type of chart which displays information as a series of data
points that portrays what is TRENDING.
2. BAR GBAPII is type of chart with TWO-DIMENSIONAI representaticn
3. HISTOGRiAI'I is type of chart that consists of set rectangles toughing one
another whose base is on the horizontal axis.
4. SCATTER DIAGRAM is used to show the correlation/association or relat,ionship
between two sets of varlabl-es measure on the same unit.
CATEGORIES OE TESTED INDIVIDUA]-S
A- TRUE POSITI1IE are those who test positive for a condition and are positive.
B. FALSE POSITM are those who tesi- positive for a condrtion but are neqative"
C. TRIIE NEGATIVE are thcse who test rregative and are negatrve

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D. EAISE NEGATil/E are those who Eest negative but are positive.
TYPES OF ERRORS:
A. EALSE POSITIVE REST LT means that the test indicates presence of the disease
when it is absent.
B. EALSE NEGATM RESITLT means that the test indicates absence of the disease
when it is present.
TRIAGfNG is a process of rapidly classifying the rnjured on the basis of severity
of injuries and the li-kelihood of their survival with prompt medical
interventions.
COLOR CODING IN TRIAGE:
A. RED - highly priority Lreatment
B. YELLOW - medium priority
C. GREEN - ambulat-ory patients
D. BLACK - moribund patients
FLUORIDE
It was first isofated by FRENCH CHEMIST known as I@ISSAIiI during 1886.
DaiIy cal-oric requirement for FLUORIDE 1s 1mg.
DIETARY PRODUCTS:
A. SAIMON and SABDINES contain the HIGHEST (20-40ppm) fluoride.
B. TEA contains the highest fluoride (400ppm)among the BEVERAGES.
C. CHEESE contains the highest fluoride among MILK PRODUCTS.

PERCENTAGE OF REDUCTION OE DENTAI CARIES:

FLUORIDATION is appJ-ication of FLUORIDE in SYSTEMIC and TOPICAL. It was first
study in GRAND RAPIDS (MICHIGAN, USA) .
FLUORIDIZATION is application of ELUORIDE in TOPICAL on1y.

1. 50-65t- FLOURIDATION by COMMUNTTY

RECOMMENDED DOSE: 0.7-1.2ppm
MAXIMUM PERCENTAGE OF REDUCTION is 7O$.
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2. 35-40t- ELUORIDATION by SCHoOL

RECOMMENDED DOSE: 3-4 ppm

RA 3526 FLUORIDATION LAW (Jtne 22, 1953)

An act authorizing the appropriation of funds as aid to the national waterworks
of sewage authoritv for the ELUORIDATION of water supplv in the PHILIPPINES.
3. 30-40$_ FLUORIDIZATION
t
A. ACIDTLAIED PIIOSPIIATE ELUORIDE (1.238 APE) by BRUDEVOLD.
This is the most commonly used professionally applied.
B, SODTIIM FLUORTDE (2? NaF) by KNUTSoN.
This is the most common fluoride over-the-counter.
Tt iS also used rn WATER ELLTORIDATION.
Most common applied on the root surface to prevent hypersensitivity after SRP.
t
NOTE: 0.05$ NaF is used as I{OUTHRINSE that reduces caries formation bv 20$

C. S"AhINOUS ELUORTDE (8-102 SnE) by MUHLER.

The first fluoride found in the dentifrices.
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I

RARELY used because it produces

4 " 20-35t - FLUORIDE DENTRIFICES was first accepted during l-954.
CONTENTS OF A DENTRIEICE:
A. SODITM I'ONOFLUOROPHOSPHATE is the malor form of fluoride.
B. DICAICIITM PHOSPEATE inactivates fluoride and the polishinq agenr-.
C. TETRASODfUM PYROPEOSPHATE is the anti-calcufar that gives ABRASIVE
property.
D. (Glycerol, Sorbitol and Propylene glycoi) prevents water foss
HtMECTAI.ITS
and hardening on exposure to air.
E. SODITM LATRYL SULPHATE is the detergent used.
COLOR CODE OE DENTIERICE:
FLUORIDE TOXICIIY:
A. GREEN: A11 ingredients are NATURA-L. 1. Mi.Ik of lvlagnesia
B. BLIrE: Ingredients are NATURAL + MEDICINE.
C. RED: Ingredients are NATURAL + CHEMICAI. 2 " Syrup of Ipecac
D. BLACK: AII ingredients are CHEMICAI.
FLUOROSIS
An ENDEMIC condition that changes the enamef surface as a result of being exposed
to too much fluoride via SYSTEMIC on1y.
FLUOROSIS INDHK is by DEAN.
I"OTTLI}IG EIIIAMEL was first described in ITALY by McKAY And BLACK.
ENDEMIC in: Ag,no, Pangasinan and BACOOR, Cavite.

QTIESTIONS:
A. What is the most effective mean of increasing the fluoride on the external
surface of the tooth?
B. What is the best method in fluoride application for 6-72 years old?
C. What is a Colorado stain?
EOUR LEVELS OE PREVENTIONS OF CARIES EOP.IVIAT]ON:
A. PRII'IORDIAL LEVEL prevents the disease in countries or popul-ation group in
which they have NOT appeared. It prevents development of risk factors.
B. PRIIARI LwEL prevents the disease BEFORE it occurs.
EXAMPLES: Efuoridation and sealants.

C. eliminates or reduces the disease

SECOI{DARY LEVEL AETER they occur.
EXAMPLES: Restorations (Amalgam, composite et aI)

D. TERTLARY LEVEL limits a disability from a disease and rehabilitates and

individual in Iater stages to restore tissues after the fail-ure of secondary
prevention.
EXAMPLES: Dentures, crowns and bridges.
CATEGORIES OF BIO-MEDICAL IYASTE
WASTE CATEGORY:
I: Hrrman Anatomic waste (Hrrman tissuesf organs, body parts)
If: Animal waste
IfI: Waste from laboratory cultures, stocks or specimens
fV: V{aste SHARPS (Needles, syringe, sca1pe1s, blades, gIass, etc)
V: Contaminated medicines
VI: Soiled waste (blood and body fluids)

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WHO-recommended COLOR SCHEME
A. BLACK PLASTIC BAG - general non-infectious and non-hazardous
B. BROI{N with I'IARNING S${BOL- chemicaf or pharmaceutical
C. YELLOW - highly infectious, pathologj-ca1 wastes, sharp objects.
GERIATRICS
People aged 60 years old and above.
SENILITY i-s the most common psychological disorder.
1. is the malor cause of tooth lose.
PERfODONTAI DISEASE
They have LESS caries but MORE periodontal disease.
PRIMARY CONCERN: OSTEOPOROSIS as a resuft to loss of aII teeth.
2. SENILE CARIES is associated wlth gingival recession.Asymptomatic due tc
degenerated odontoblastic process.
3. DENTT'RES
The most recommended method to clean the denture is to BRUSH with DETERGENTS.
DENTTRE CLEN{SERS main component is SODIIM PERBORATE.

EISTORY
A. PIERRE EAUCHARD, a surgeon, is the EATHER of MODERN DENTISTRY.
B- OHIO COLLEGE of DENTAI SITRGERY (1931) is the OLDEST DENTAI SCHOOL in the
WORLD.
C. B,AITII"IOR COLLEGE of DENTAL SIRGERY (1840) was the FIRST DENTAL SCHOOL.
D. EARVARD I,NN/ERSITY (7861) is the EIRST AEEILIATED DENTA]- INSTITUTION.
E. DE OCAI'{PO MELORIAL COLLEGE is The OLDEST DENTA-T, SCHOOL in thE PHIL]PPINES.
E. WILLIAM I{ORTON was the first successful public demonstration of ETHER.
G. HORjACE WELLS introduced NITROUS OXIDE in public health.
H. EDMTI{D I(ELLS was the first dental assistant.
I . ALE:RED PONES is the FATHER of DENTA], HYGIENE.
J. IRENE NEIVI'IAN receives the first denta]- hygiene license"
K. 1,913-79L1, CONNECTICUT became the FIRST STATE to pass dentaf hygiene
exarnination.
L. 1938, }{YLON TOOTHBRUSH was the first made with synthetic bristl-es.
M. COLGATE is the first toothpaste.
N. 1960, "Eour-handed" dentistry becomes popular.
O. L962, BOT{EN discovered Bis-GIt4A used in composite resin-

177
 PROSTHODONTTCS
(FI)GD BRIDGE / REMOVABLE PARTIA], and COMPLETE DENTURES)
DENTAI }'{ATERIAIS
PROSTHETICS is the art or science of supplyinq parts of the human body part with
suitabl-e substitutes .
PROSTIIETIST is the health care professionai that ciesigns and measures medical
supportive devices.
PROSTHESIS is an artificial- device that repl-aces a missing body part.
IMPRESSTON }fATERIALS
1. COLLOIDAI SOLUTIONS
They are the first impression materials and the least dimension stabllity.
PROPERTIES: 1. II4BIBfTION- the process of absorbing the water.
2. SYNERESIS is the process of releasing the water.
A. REVERSIBLE HYDROCOLLOTDS
AGAR has the longest shelf-life. ft has a property of HYSTERESIS/ the abllity of
material to change its form based on iemperature.
COMPONENTS: A. WATER
B. AGAR
B. IRREVERSfBI.E HDROCOLLOIDS
AIGII{ATE is the most corTrmon impressron material used. It is the cheapest and the
LEAST dimensional stability.
COMPONENTS:
souluM (POI'ASST.UM) l\rc_LNA',r',E 120\) REACTOR
CAT,CTI]M SITT F'ATF', (1 69d)
DIATOMACEOUS EARTII or SILICA (502) FILLER
TRISODIUM PHOSPHATE (1?) RETARDER

WAYS TO DECREASE SETTING TIME

1. INCREASE WATER TEMPERATURE
2. M]X VIGOROUSLY
3" DECREASE the water (38-4OmL)-powder (15-16qm) ratio.

2 - IMPRESSION COMPOIJND is used only in a single tooth impresslon wlth NO

undercuts.
3. ZINC OXIDE-EUGENOI IMPRESSfON PASTE is useci only irr complete edentuious
impression without undercuts -

COMPONENTS: A. TIBE 1 BASE: ZINC OXDE (8121

B. TUBE 2REACTOR: EUGENOL (12-752)

4. EI.ASTOMERS
They afl have the best result if there rs EREE OF SUREACE MOISTURE.

A- BOLYSUL$'IDEis the only mater-ra.i. ihai causes stain when in contact to clothes.
Among the elastomers, this should be poured withrr-r 1 HOUR because of the IIIATER
END-PRODUCT
COMPOi'[EfiTS: A. E: Mer,;apta.rr
B " ALYS?: l-ea,J !'e r:.:;;< i iie
t "r(J
-L! L'
r_

B. POLYETHER is the most affected with the presence of surface moisture. Thls
materiaf is difficult to remove from the mouth because it is the MOST RIGID.
COML-ONENTS: A. BA.SE: Polyether
B. CATALYST: Glycol
C. CROSS-LINKING AGENT: A1ky1-aromatic sul-fonate
C. SILTCONES
COMPONENTS: A. POY{DER(FILLER) : Silica
B. CATALYST: Tin Octoate

C.1 COIIDENSATION (CONVENTIONAI) SfLICONE records the surface very weJ-1 but it
has a LOW TEAR STRENGTH. Thls impression material has a POOR DIMENSION SATBILITY
because of its END-PRODUCT,

NOTE: It is advisable to wait 20 to 30 minutes before pouring for stress

relaxation
C.2 ADDITION (VINYL POLYSILOXANE) SILICONE is more expensive than
condensation. This material has the MOST D]MENSION STAB]LITY, that the pouring
can be delay up to 1 WEEK.
is done with heavy putty and light putty. The former is
PTIITY-IIASH TECENfQUE
applied on the perforated-stock tray while the Iatter is a syringe-type
applied on the tooth surface to record the margins accurately.
A. ONE-STAGE
B. TWO-STAGE is used for resilient and non-resilient tissues
TYPES OF IMPRESSION TECIINIQUE:
1. PRESSURE (EUNCTIONAI) is when the tissues are compressed during impression to
stimul-ate the same amount of pressure.
2. NON-PRESSIIRE (MUCOSTATIC) is when there is i{O PRESSURE appliecl durin<;
impression. It is done with the use of OVERSIZED TRAY and it requires no BORDED
MOLDING. The impression material used is ZnO-Eugenol impression paste

3. SELECTIVE is best suited for withstanding forces of mastication. It is done

with the used of CUSTOM TRAY.
TRAY:
1. PERFORATED-SIOCK TRiAY is the most cornmon which is used to ANY PATIENTS' JAW.

2. CUSTOM TRAY is the most cornmon which is used to ANY INDIVIDUAI'S JAW.
The best custom tray is with STABILITY and LACK OE DISPLACEMENT.
SfGD.IIFICANCE: The most j-mportant factor in taking an accurate impression is the
SIZE OE THE IMPRESSION TRAY.
WORKING TD.{E SETTING TIME
AGAR 7 minutes 5 minutes
AIGINATE 2 5 minutes 3 5 minutes
ZINC OXIDE_EUGENOL 3-5 minutes 5-10 minutes
POLYSULEIDE 5-f mlnutes 8-12 m-inutes
POLYETHER 2 - 5 minutes 4 5 minutes
CONDENSATION SILICCNE 3 mi nutes 5'-8 rnrnutes
'*---l
ADDTTION STLICO}IE mrn 1 ..rao
ruLg.l i
l

L79
GYPSUM PRODUCTS
CAICIUM SULFATE DIHYDRATE is the natural form of qlrpsums.
CAICIUM SULFATE HEMIHYDRATE is the qypsum form.
They are afl ADA spec 25.
1. PLASTER OF PARIS has IRREGULAR and POROUS particle form, made up of BETA-
hemihydrate. The processing procedure nLrrst be in OPEN KETTLE under > 10OoC.
A. TYPE I: ]MPRESSION PI.ASTER
B. TYPE II: MODEL PI"ASTER
2. DENIAI STONE has REGULAR and LESSER POROUS particle form, made up of AIPHA-
hemihydrate. The processing procedure must be in OPEN-KETTLE or STEAMED UNDER
PRESSURE under > 100oC.
A. TYPE IrI: YELLOW STOIVE or MICROSTONE
3. DfE STOIIE has LARGER and DENSER particle form. The processing procedure must
be in OPEN-KETTLE with 30% Calcium chloride under > 100oC.
A. TYPE r\I: DENSfTE has high strength and low expansion
B. IYPE V: DIEKEtrN has high expansion.
EFFECTS V{HEN THE WATER - POWDER RATIO IS TNCREASiED:
A. DECREASED surface hardness resultj,ng to WEAKER MIX.
CIRCTLAR METHOD must be done in mj-xing the qypsum products.
B. DECREASED compressive strength.
DECREASED expansion
D. INCREASED SETTING TIIM (St).
D.1 The most reliable method to control the ST of gypsum is to CONTROL THE
TEMPER.ATURE OE. I{ATER.
D.2. 28 POTASSIUM SULFATE is used to regulate the ST.

RETARDER ACCEI,ERJATOR
Borax 2* Potassirfit su]-fate
Sodium citrate Sodium chloride
CAST is the life-slze fikeness of the oral cavity.
DIE j-s the positive reproduction of the prepared tooth.
TYPES OF CAST:
1. DIAGNOSTICCAST is made for studying.
2, !$ORKING CASI is made for mounting in the articulators.
3. REEtsACTORY CiA"ST is made for investinq metals.
PERfPHERY: 3-4mm
BASE: 15-16mm

REMEMBER:
A. It can be disinfected with 1:10 SODIi-r.}4 HYPOCHLORITE for 30 minutes or IOPHOR
SPRAY.
B. BEADING of cast is done to increasing the contact to the tissue.
IMTESTT{ENTS
They are also known as REE"RACIOR.Y lif&fERIAtS, the materials which are suitable fo:r
forming a mold into molten alloys or cast alloys.

1g.R
SPRIrE FORMERis a channel throuqh which molten alloy flow during investments. The
size of the sprue former VARIES ACCORDINGLY and should be attached to the
THICKEST PORTION OF THE PATTERN- The best angulation must be 45o to the surface.

THREE COMPONENTS:
7. REEtsACTORY Silicon dioxide (Quartz, trid}rmite or cristobatite)
I{ATERIALS:
EUNCTIONS: A- To withstand the high temperature during investment
B" Regulates thermal- expans:-on
2. BINDERS
A. is used for CASTING GOLD (ADA 2) that can withstand the
GPYSUM-BONDED
temperature up to 550-7OOoc for 30 mi-nutes and then QUENCHING.
REMEIBER:
A. If IOOoC only, it WEAKENS because the water of crystallization is driven-off"
B. Ii 2OO-400oC on1y, there wrll be SHRINKAGE"
c. rf >1,300oF, the sULEUR (DroxrDE) qas wilt be released.
B. PHOSPIIATE-BOIIDED is used for metal ceramic, cobalt-chromium al]oys that can
withstand high temperature castinq.
B.1 TYPE I: Eor BASED-METAI- alloys
B.2 TYPE fI: Eor Removable Partiai denture.
NOTE: BASED-METAI, AILOYS (BSM)AIE thE a1l-oys that DO NOT contain noble metals "
They are substitute for GOLD type IIl and IV alloys. BSM for partial. denture is
resistant to tarnish and corrosion due its PASSIVITY and it hAS HIGH T'TODULUS OF
EI,ASTICTTY than GOLD TvpC ff I ANd TV.

C. SILICA-BONDED is not used anymore.

3. OTHERS: Sodlum chloride, Boric acid, Potassium sulfate, graphite and Mq oxide.
PROLONG HEATING A DENTAI CASTING TNVESTME\]TS
OF R,ESL]LTS TO:
1 - Disintegration of the investrnent materials
2. Rougrh molds of investments
3. Contamination of alloys.
REMB4BER:
A. The setting expansion of casting investment is 0-1 - 0.58.
B. Addiitg ASBESTOS aiiows room for therrrLai expansic-rn and aids irr removitrg the
investments.

RIA)(ES
They are thermoplastic materials which are sol1d at room temperature but meft
without decomposition to form mobile liquid.
They have the HfGHEST CO-EEFICIENT THERT'flL EXPAI{SION among all dental materials,
LOII COMPRESSfVE STR., and LOI{ }IODULUS OF ELASTICfTY.
I{ARPAGE is the most conunon problem of all waxes.

NATURAL COMPONENTS OE WAXES:

A. PARAEFIN Came fTom MINERALS
B. BEA${Alt( I'IOUTI{ TEMPERATURE WAX) came frorrL Ii'iSECTS.
C. CARNAIXBA came from PLLM TREE.
D" CANDELI"A" tr&X came from PLANTS.

1R1
CLASSIEICATION ACCORDING TO USE:
1. PATTERN I{AX:
A. INLAY IB:X (ADA 4 ) contains: 60t PARRjAFIN
20t CARI\ATJBA
58 BEESI{AX
NOTE: 5t GUM DAI4{ER is added to increase the TOUGHNESS.

B. is used for the pattern for the metaflic framework of RPD. These
CA,STING WAX
waxes are available in the form of 28- and 3O-gauge (0.40 x 0-32mm) thickness
2. PROCESSING IGI(:
A. BOXING IIAX is used to form a plaster or stone from an impression of the
edentulous arch.
B. STICKY TIAX is used to assemble metallic orf resin in a fixed temperature
position during solderj-ng or repair procedure.
It contains: 608 BEESI{AX
17* G{,M DAMMER

C. UTILITY IIAX is a standard perforated tray for use with hydrccolloids may
easily be brought to a more desirable contour and prevent distortion of the
impression.
3. CORRECTWE I[AX: Bite wax is used for bite regj-stration.
QUESTTONS:
A. What is the main component of inlay wax?
B. What is the best way to prevent WARPAGE of pattern?
C. What is the best thing to preserve its dimension if wax cannot be invested
immediatelv?

ARTICT ITATOR A mechanical instrument representing the TMJ and laws.

TYPES:
A. f
CLASS (SIMPLE HINGE) accepts single static reqistration only. It only
records the VERTICAI MOTION.

B. CLASS fI (ARBITRARY) accepts HORIZONTAI and VERTICAL but not oriented to Tl4J"
It uses average anatomlcal Iandmark to approximate hinge movement.
C, CLASS IfI (SEMI-ADJUSTABLE) stimulates CONDYLAR pathways and al-l-ows
orientation of the casts relative to the TMJ.
C.1 ARCOhI is when condyiar elements are on the fower member of the
articulator, mechanical fossae are placed on the upper member of the arti-culator.
C.2 NON-ARCON is when condylar path stimulating glenoid fossa are attached to
the lower member, condylar el-ements are placed on the upper portion of the
articular.
D- I1/ is the only type that accepts 3-dimensional dynamic registration of
CLASS
mandibufar movements and TMJ. It uses FACEBOWS and PANTOGRAPHS.
FACEBSW is a caliper-fike device used to record the MAXILI,A-TMJ axis of the
patient, It records the KINEMATIC value of the patient's jaw"

{o1
ro<
r

PAIITOGR.LPHSis the device that records the 3-dimensionaf movement of the

mandible. This device is made up of TWO FACEBOWS and STYLUS (LEAD).
THREE (3) DIMENSION MOVEMENTS OE THE JAW by POSSELI
1. IRONTAL: Up and down movement giving a SHIELD diagram
2. HORIZONTAI: Side to side movement giving a DIAMOND diagram.
3. SAGfTTAL: Eorward and backward.
II{ITER@CLUSAI. RECORDS
1. BIIE REGISTRATION with the use of wax or an elastic material with the correct
CENTRIC RELATION of the patient.

2. PROTRUSI\IE RECORD is done by as puttlng the bite into edge to edqe. When done,
thcrc should be CHRISTENSEN,S PHENOMENON.
3. LATERLL EXCT'RSION RECORD
3.1 WORKIIIG CONDYI.E moves DOWNWARD, EORWARD and LATERAL (Outward)
3-2 NON-WORKING CO{DYLE moves , , .

oCCTUSAI PI,ANE
1. INIERPITPILLIIRY LINE is the horizontal reference for the orlentation of
maxillary teeth and occlusal plane.
2. ALA-TRiAGUS LINE or is used for posterior teeth occlusaf
alignment.
PRE -PROSTHETIC TREJB,I}4ENE
1. CROI|N LENGTEENING is a soft tissue removal for tooth wi-thout adequate tooth
structure or short crown.
MAIN OBJECTIVE: To develop a EERRULE of 1.5 - 2.0mm

2. FORCED ERUPTION is done with orthodontic extrusion movement to produce a 1:1

crown-root ratio.
3. RIDGE AUGMENTATION is a soft or hard tissue grafting of edentulous ridge or
pontic spaces.
3.1 VISOR OSTEOTOMI( is to increase the height of the mandibular ridgre to
provide DENTURE SUPPORT.
4. REI.&IiAL OE. FLABBY TISSUE because it will provide a poor SUPPORT for the
dentures.
5. INELAT'ftATORY PAPfLLARY HYFERPIJASIA caused by ILL-EITTING DENTURE.
LOCAT]ON:
TREATMENT:

6. TUBEROSIIY REDUCTION is done unilateral reduction, i-f possible.

1 . REBfiOVAI, OE BOBrY EXOSTOSES
A. TORUS PAIATINUS
B. TORUS !{AI{DIBIIT.ARIS

P}IONETTCS
MECIAN]SMS EOR SPEECH PRODUCTION
1. INfgI&ECIR: Motor speech production
2. : Lungs and associated muscfes -
3. VIBR"&EOR.: Vocal Cords.
183
4. RESONATOR: Oral cavity, nasal cavity, pharyngeal cavitles and paranasal sinus.
5. AREICIILATOR: Lips, tongue, soft palate, hard palate and teeth.
SPEECE SOT'NDS
E'RICATn/ES EandV It determines the proper
If V sounds F, the set is fOO HIGH. position of the anterior teeth"
If E sounds V, the set ls T@ LOW.
Ltr}iIGT'ODENTAI T, D, N, L (Those, These, There) It determines the LABfOLINGUAI-
position of the anterior teeth.
SIBTI,ATNS s, z (Sixty -) This will get the value of the
CLOSEST SPEAKING SPACE.
BII.EBIAI, BtP,M It is used to assess the correct
inter-arch space.
SPEjAKf,Ne SPACE by STLVERIGN is the minimal amount of space between upper and
lower teeth that should approach end to end but not touch.
A. When the space is TOO IilAflROI,if, it results to: "
B- trfhen the space is TOO BROAD, it results to:
GENERAL TERMS
1. VDO (VERTICAL DTMENSION AT OCCLUSION)
2. \/DR (VERTICAI DIMENSION AT REST)
3. FS (FREEWAY SPACE) is al-so known as INTEROCCLUSAI SPACE between maxilla and
mandible when the mandible is at rest.
4. CR (CENTRIC RELATION) 'LIGAMENT-GUIDED" or "RETRUDED-GUIDED" position.
It records the most ANTERIOR and SUPERIOR portion of the condyle within the
glenoid fossa. Gothic arch tracing device is used to record CR.
5. CO (CENTRIC OCCLUSION) *TOOTH-GUIDED"
It records the complete intercuspation (MrP) of opposing teeth independent of
condylar position.
MfP (MAXIMUM INTERCUSPAI POSITION) - The cusp to fossa relationship.
6. RP (RESTING POSITION) *MUSCLE_GUIDED"
ft records the position of the mandible at physiologi-c rest.

REI{OVABI,E COMPLETE DENTT'FE

1 . PREI,IMINERYIMSRESSION
2. BCIRDER !&LDTNG
A. I.frI(rLLARY
A.1 POSIERIOR PALATAL SEAL is the posterior border of maxillary complete
denture that puts pressure on displaceable tissue near the junct-ion of HA,RD and
SOET PAI,ATE.
LANDIvIARKS: A. Hamular NOTCH (Pterygomandibular notch)
B. Eovea palatinae
A.2 \IIBRATIIIG LfNE is the imaginary line demarcating the MOVABLE and NON-
MOVABLE OE THE SOFT PA],ATE.
A.2.1, ANTERIOR VIBRATINS Lfh{E: Say \"Aif, with short vigorous bursts.
L.2.2 FOSTERIOR VIBR&9ING LINE: 2mm anterior to the fovea.
REMEMBER.:
A- The form of posterior palatal- seal varies ba-sed on PA-LATAL FORM.
B. The BRA LINE is 4-6mm r,viCe and 0.5-1mm depth.
L*4
L. EXCESSfVE DEPTH results to unseating of the denture.
B. }[ANDIBUI,AR
B.1 DISTOBUCCAI EXTENSION: Masseler musc].e
B-2 DISTOLfNGUAI EXTENSION: Superior constrictor pharyngeal muscle
B. 3 RETROI'T,OHYOID FI.A}IGE (S_FLANGE) : Mylohyoid
B.4 LINGUAL E'RENUM: Produces the lingual FLANGE.
B. 5 A}iITERIOR EXTENSION: Mentalis

3. RECORD BASE&OCCLUSAI Rry

OCCLUSAI RECORD RIM: AIITERfOR 3-5mm
PREI'OLAR 5-7mm
MOI"AR B-10mm

PIIRPOSES:
A. Determines and estabfishes the VDO.
A.1 VERTICAI LENGTH of UPPER: 2mm show when re]axed
A.2 VERTICAI LENGTH OE LOIVER: Omm show when re.l-axed
B. Makes maxillo-mandibular jaw records (CR - CO)
C. Establishes and locates the future of the artificial teeth
. Jm 6llYr 6n 6o
SETTING THE ARTIFICIAI TEETH. ,itan+.)fr<, / ntahrr(^\ /.9'^x'"
FIRST: ASSESSMENT OE PONTICS (1"t: 99!gn - 2nd: SIZE - 3'tr: MOLD)
TYPES OF PONTICS: r
1. pIASTIC is the most cofltmon - ve|+ ri&cplo\ol tu crn'tt^rl Lcr)( 1g.^2 ,n4r't1 cah:{
.
f-,.' Vd
r

2 . "ACRYLIC RESIN bonds to the dcnture base 1y "

3- FORCELLTN .bonds to the denture base lvlHtlHANI(lALLr-- c,,tiC,M^3

NOTES:
NEVER use porcelain pontic in anterior teeth & pla-stic pont-ic in posterior teeth.
PONTICS are smal-l-er than the naturaf teeth.
Q.r - --, r
'
A. SETTING OF MAXILLARY &ANTERIOR TEETH

central, incisor -
I,ATERAL INCISORS - above the occlusal plane.
Ca\IINES - ce must Start the MIP. rrnLrr(\nrr^n t.tt(;r,ra3, p(lt\ yus'\61"

NOTE: INCISAL et IDANCE is the mechanical equivalent of horizontal and vertical

overla \r//r9+ -
t( - ft/ts'Oa\
D\.Uy lr'i
OBJECTIVES:
1*kEsrsEtrcs - brisr
A. Denture teeth depend upon the RELATIVE IIHITENESS or BLACKNESS of i-ts cofor.
'2. PHOI{ET]CS
A. Set too palatal: will sound "th"
B. Set too far labia]: It will looi< fErger and lighter.
3. RT
A. PRII\4ARILY determined by the facial surfaces of teer-h and stimulated by the
a a.
B. Lablaf i-nc-lination of 150.

18s
 QTIESTIONS:
A. The best way to check the position of maxifl-ary anterior 1S nv] r ion^l "
B. The most stabfe landmark in the oral cavitv is: rncrS. v C L ; tra

B. SETTING OE MAXILLARY POSTERIOR

DL cusp is 0.5mm above, and

MB and DB cusps: 1mm above
2l[D }'IOLAR: AII cusps have no contact with 1.5mm above

C. SETT]NG OE MANDIBU],AR TEETH

1SI },!OI"AR: cusp should engage in embrasure of max 1st molar and 2nd pm
2ND PREIiCI.AR
1ST PREI,TOI.AR
2I{D MOI.AR

t> ? n aa fvval l4,n rr tr on

QIIESTIONS:
Curve of Spee ? F ndru- V i)5 |'oY1 ov Lur'lt
.

A. What is uf q"\ hqc.\ tethl

B. What is Compensating cur F-nKru '?-ot+tn cx wn/Y
C. What is curve of wi]son? 5no'' \tnHra\ uurvt ut tLt+h
D. What is Curve of Monsoon: A'r'vu ro-'g odi-tnlr c ^g,0.6
[a+<-a u^^/{-.

REMEMBER:
frA. The main function of compensating curve is to Iusion in
B. The value of Curve of Monsoon is 4 inch squar r}w iY f c^&o lq r,tn\ I
nrglhacnaialc_
t/,. Fa\ yna\6rial 5 ^
5. FABRICATING
Denture base used:
>(.t. uEiAT-cuRE AcRyLrc REsrN (p ) - Most common.

IE DENTURE BASE IS TOO TH]CK:

L. Lisping wifl occur
2. I__q_f are the most affected sound.

REMEMBER:
A. There is should be proper heatinq cycle because of the possibility of p y
due to boiling of monomers.
B. Excessive amount of monomer results to i
C. ! during fabricatinq resufts to Bglqsjgi"es.
6. DELTVERY
A. The denture should be stored in
1. RECALL
A. Erraluation of denture
B. Proper srn,allowing will

1E6
t'

B. POST-OPERATTVE:

done when there is bone resorption. d acrylic is useo.

B "2 G Replacement of the entire denture base while keepinq the same
denture teeth in their:
QTJESTIONS:
A- What is the disadvantage of relining e rebasing? t-l-t rang( ol o<iJqsidn
B. What svstemic condition requires annual relining 5, rebasinq? Qqalg+'9 dsr.
IIIMEDfATE DENTTRE A type of denture that is delivered immediately f q
extraction that to guide the shaping of the rldge
in the cast- Impression taking before extraction of the tooth.
ADVANTAGE: AbIe to duplicate the position of natural teeth.
DfSADVANTAGE: No anterior try-r-n

NOTE: RELINfNG is doneafter 5months and 10 months post-extract-ion"

OVERDENTTRE A type of denture that
stabilized with natural teeth cr implants "
ADVANTAGES: A. PT eS bone }( fvlr^x.
B- Still has p troJ'.rdit,,r - bon( lt:,
oN._f DL ?ffi:."rt
QIJESTIONS:
A. What is 'the ideal number of implants for implant-retained maxillary denturez *-G
B. What is the ideal number of implants for implant-retained mandibular denture? 4
C- What is the best over-retained tooth? l\A f"*- o Arti .\

PROBLEMS & COMPI,ATNTS

1- Burning sensation in mandibular ridge due to PRESSURE ON MENTAL FORAMEN
2. Burning sensation on the palatal area due to PR.ESSURE ON Ii{ClSIVE F

3. Clicking of denture teeth:

in opening the mouth.
BILABIAf-S are the most affected.
elain teeth
4. Cheek biting:
A. Not enough horizontal overlap of posterior teeth - n
B. Insufficient VDO
C. Posterior teeth in edge to edqe
5. Lip biting:
A. Re ed muscle tone

6. Mucosal changes
A" Vitamin C deficiency
B. Vitamins A. C, D, B-complex for oid patlenr
{ grudt\ Y\"t gY255or' c&*sl
"-
Dislodgiement: **^ad
&"1 \vu621 C''€''n't
A. l{axiflary - Posterior buccal space is firl v.rith "(
B. Ma-nd-ibular - Overextencied drstobuccai area "
* aq, ttL)v/{ 'r-.roJ} vor'non}n tur-r\t
0L rnrat) ' ['uVfoY*g1
1&7
 B. GAGING:
A. Maxillary - Overextension and too thick posterior border
B. Mandibular - Elange is too thick
9. SORE THROAT
A. Maxillary-
B. Mandibular-
TYPES OE PATTENT ',r
,_<t5* &A\
-
A. PHILOSOPHICAL - He accepts
B. EXACTING - Methodical and demanding, asks a lot of questions.
C. INDIFE:ERENT _ He doesn,T care about dental treatment.
D. HYSTERICAI . Emotionall unfit to wear dentures
\tasY fU rrt\
FORMS oE DEIiIIAI ARCE
CLASS I: Broad/seuare: BRACIIYCEPIIALIC
CLASS I] Long and narrow/taper DOLTCOCEPHAITC -l(q)r''< k^\ re
CI,ASS II I Averaqe/rounded: MESOCEPHALfC - rr.rz5+
"rka^\u{
DIRECTION OE' RIDGE RESORPTION

DIRECTION A}ITTRIOR POSTERIOR lTPE

IIN(rIJ,A Superj-or & Posterior Labial BuccaI CENTRIPETAI
l"IAlilDIBLE Inferior & Anterior Linqual Buccal CtrNTRIFUGAL

CLINICAL SIGNIFICA}iICE: Excessive resorption r s to Oidiine fracture of

the dentures.
DENTURE PROPERTIES
1. STABfLITY- It is the resistance of denture agai-nst
X2. SUPPoRT- It is the resistance of denture to foTces DI INST THE

250lbs which is found in MOLARS.

is only.@!fE
STRESS-BEARING ARE"A }B:(ILI..ARY }BI{DIBUI.AR
PRIT.{ARY dqe'{< 1. Bucca] shelf
2. Hard oal-ate
SECONDARY 1. Rugae 1. Residual ridqe
2. Tuberositv

NOTE: MAIN RETENTfON FORM of the denture is rn\n(rUt L'Yln' gt, \ Afg)
Saf-fV

EACTORS AEEECTING RETENTION:

A. ADHESION - Adhesion of saliva to
the ruucous merrlcrane anci denture is achieved through ionic forces between charqed
sa1 ivary glycoproteins and surface epithelium or acrylic resin.
L

() a that is present betvoeen the denture base and the mucosa.

I

188
t
C. INEEREACIAL FORCES - It is the resistance of separation of two surfaces that
is imparted by a film of liquid between them

sufficiently close acts like a capillary tube in which the saliva tends to
maximize contract and aid in retentio
tk frya - ept,lt*gn$<n\rf {"ov n""r*.\\"9
ry
. It's due to the pressure of atmospheric on the earth surface.
REMO\ABLE PARTIAI DENTURES
PROPERTIES:
A. Y is the most important property of p dentures.
B. ION is the most important property of any co s of the RPD

KENIIEDY CI,AS S IFICE TION

f)!-rn9.t^t c\c.(( -f,$ - txk.ql& tD p.7-,r.rQt1^
CI.ASS T Bil-ateral distal extension
CI,ASS II Unil-ateral distaf extension + \9a91!1\- r^ojy Jc,*t^tntJ
CI.ASS III Tooth-bound '16
P{'trD&r6rnia
CLASS r\/ Anterior crossinq the midline ^ o |^\o&q r.,(,rho n
DISADVANTAGE: It doesn't measure the lenqth of edentulous area.
CLINICAL STGNIFICAI{CE: BefoTe, they used STRESS-BREjNGR DEVICE in a n
distal extension to reduce the actinq on the abutment but it is
OT used anvmore because it causes ION

is the most difficult to design a

FEATURES:
A. Anterior lower teeth are the only natural.
B- Enlarged m.axillary tuberosity.
C- Resorbed maxillary anterior area.
D. Resorbed mandibufar posterior area. / \t"1 a o.\ s, {,t

STRVEY - The procedure of I of posltion of the

abutment teeth & associated structures before designing a partial denture.

assocj-ated with the fabrication of a prosthesi-s.

SURVEYOR - An instrument used in the construction of a removable partlaf denture

OBJECTIVES:
A. To aid in placement of the intra- and extra-coronal retainers.
B. To check the contour, if there will be poor clasp design-
C. Block-out a master cast
D. To measure a specific depth of undercuts.

s
Thi s i s done to en,s r-r rc- reproducible orientation of the cast to determine t-he
11'Of Efl-r,i_.rr1'r.,
189
COMPONENTS OF RPD
1" ltArTOR CONNECTOR - It connects the components of the two sides of the arch
together
I"IAIN PROPERTY: D <,-b6n\k U\rbrnr,uf^ - r"(k\\
MANDIBULAR
The borders of mandibular malor connecter must 4mm away from the gingival margin.
A. LINGUAL BAR-II is the simplest and most commonmandibufar major connector wj-th
at least 4 mm of the heiqht of the bar. This major connector is NOT used if there
is torus mandibularls & lingualIy tilted anterior teeth.
CLINfCAL SfGNIFfCAIiICE: If it interferes phonetics, place it the lowest
mucol insual foId.
B. LINGUAI PLAIE - This design requires a 7-mm deptht less of lingual vestibule.
Lingual plate over lingual bar if there's no space in the floor of the mouth. But
this major connector is ors.
C. LABIAL BAR - Rarely used because of esthetic concern
D. KENNEDY BAR ( ) It is the major connector when there is lingual
bar with another bar in the cinqulum of anterior teeth for additj-onal retention.
MAXILLARY
The borders of the maxj-Ilary major connector must be 6mm away from the gingival
margin.
A. PALAIAI, STRiAP This major connector requires a minimum of B-mm widestrap to
provide rigidity.
INDICATION: Used in Kennedy Class III (Tooth-borne)

B. AIITERO-POSTERfOR PALATAL CONNECTOR (APPC) - Thls is the most commonly used

maxillary major connector. A1I straps have approximately 6-8rmn tlfDE.
ANTERIOR STRAP 8-10 nrn
LATERAL STRAP 7-9 mn
POSTERIOR STRAP 5-7 mn
WINDOW ) 15 nrn
NOTE: The posterior strap must be placed anterior to the ;unction of movable and
non-movable of the soft oalate.
C. PALATAI PLATE It is the rna;o:: connector used ',vhen all- postericr teeth are
missing bilatera11y.
D. U-SEAPE (HORSE-SHOE)- This is the Ieast rigid major connector.
2.I"IINOR CONNECTORS - This component connects af l- the remaining components of the
RPD to the malor connector

3. DIRECT RETAINER - This component engages an abutment tooth to resist

displa.cement of the denture from the basal seaI tissue.
I4AIN FUNCTION: It prevents R.PD from mcvlnE awa)- from the hard tissues"

190
 MAXIMUM: 2 per quadrant.
NOTE: GUIDE PLANE is a device used to assure predictable clasp retention.
TYPES:
A. INTRA-COROIIIAI- It is located within the contours of the crown. This is the
most esthetic form in RPD.
B. EXTRA-COROIIIAI-It is f ocated outside the coniour of the crown. This is the
most common. It has two (2) types which are SUPRABULGE & INFRABULGE.

SUPRABULGE
1" SIMPLE AKERS (CLASPS) - This is the most coilrmon &shou]d provide 18O-deqree
encirclement.
EUNCTION: Stabilize the RPD by controlling occlusaf movement.
COMPONENTS:
A. RETENTNE ARM
A.1" RETENTION
A.2. RIGID except tip of the retentive arm
A.3. PASSilETY - It is the propertlz of a direct retainer wherern it doesn't
exert force when the denture is seated in p1ace.
B. RECIPROCAI, ARM
B.1. STABILITY- It providesharmonious occlusion
8.2. RECfPROCITY - It opposes the action of retainer in function.
B.3. BRJLCING -It resists HORIZONTAL fOrcCS
C. REST - It provides SUPPORT and RESISTS VERTfCA-T- forces
C.1. OCCLUSAI REST - A spoon- or triangular-shaped component of the RPD. It
requj-res at Ieast 1/3 of bucco-fingual width of the occl-usal of the tooth. The
topography of the occlusal rest should restore the naturaf contours cf the tooth.
2. IIALF-&-HALF - It utilizes a lingual undercut and can be used on PREMOLARS.
J. RING CLA.SP - It utilizes a linqual undercut and can be used on MOLARS.

INERABULGE:
1. RPI- It should provide 3-point contact.
COIvIPONENTS:
A. REST
A.1. CINGILITM- It is used usually on maxil-lary canines. It is a FTALF MOON-
D component of the RPD.

A.2. fNCISAL It is usually cn mandibular canines NoT on maxillary

incisors. It i-s the SAUCER-SHAPED component of the RPD.
de- PRoXTMAI PT.ATE -This component must cover upto above the survey line.
This provides BRACING in the RPI.
C. I-BAR - This component is a form of retenti.re arm. This is used to reduce
tooth contact of the retainer.
2. LoDIFIED RPI
COMPONENTS:
A" REST
B. PROXII{AL PI,ATE
1"91
 C" I-B,AR
D. RECIPROCAI, ARM

" INDfRECT RETAINER This component of RPD prevents DISTAL extension from
4
moving away from t-he underlying tissue during function. Thls is only added in the
design when there is needed for additional retention-
5" POSITilIE STOP - This component of RPD provides positive stop of the framework
and it is placed in RPD on1y.

6. FINISH LINES - This component of RPD serves as the interface where meets
to provide smooth transition.
5.1 EXTERTiTAL ETNISH LINE: <90 degrees
A. MAXILLARY RPD must be in hamufar notch.
6.2 fNTERNAL EINISH LINE: 90 degrees
DENTAI AII,oYS FOR RPD
1. GOLD ALLOYS- It is not used an\rmore because Type IV Gold exceed in numeric
va]ue of SPECIEIC GRAVITY.

with Cobalt-Chromium, manganese and silicone are added to INCREASE CASTABILITY.

3. WROUGHT H"IRE- It produces 25% qreater tensile strength and more flexible.
NOTE: COMBINATION CLASP is when the retentive arm uses C while
tip of the retentive arm uses
REDIEMBER:
A. When cleaning an RPD using NaOCI (sodium hypochlorite) it w-iII result I,o
CORROSION.
B. The most important mechanical- property when adjusting the clasp isELONGATION.

FIXED PROSTHODONTICS
AIL EPDs are contraindicated in patients with hygiene & high caries
rate.
1. INLAY - It is an indirect restoration which has been constructed out of the
mouth & then cemented
INDICATION: Carles
)k
CI,ASS II GOLD CI"ASS II AI'ALGAI'f
INITIAL DEPTH 1.5mm - 2mm L-5mm
DEPTH INTO DENTIN 0.5mm 0.5mm
A>(IAL TItsI.L REDUCTION 1.0mm - 1.5mm 1.0mm - 1.5mm
ISTHMUS I{IDTH 2.0 mm 2.0 m-m
PRII"IAR.Y RETENTION EORM Height of walls Converg-ing Wa11s
POINI AI{D LINE ANGI,ES Sharp Rounded
INCLtrNATION OE' WAILS Dive::ginq -^--.^*-l
UU!r v =!Vf ^^
1tv
RETENTION OF' PROXIMAL BOX Reduce taper Retention grooves
Reverse be-rel
BEVEL:
r ao
a . L-riv Lrb uis. -Er
,
4r/
l,]
-)(.r
B. PROXTMO-FACIAL
C. PROXIMO-LINGUAI 400
D. GINGIVAI YTAIL 30"
E. COITNTER BEVEL (Onl-ays only) 300

TYPES OF USED:
1. TYPE GOIJ) It must be beveled occlusal- cavosurface marqin. The
principal reason for a beveled CSM t^
ID to
2" PORCEI,AIN - NO bevel-
3- COMPOSITE - No bevel b.lr- i"ovg\ ,

- ''';t yylt \
11t''t f^
^\ 1'a
2. ONLAY It is an indirect restoration that invofves one or more cusp but not
AIL. Ctallg'rr{i - t.lJ\i t'rrt"r) ':F S,r,",y\a^-at 1,,tlP
OCCLUSAI REDUCTIONS:
5 \I,e/r,,4 " txvtnng ,€ !tod\- h,tnO[tanotl
^Y
WORKING CUSPS NON-WORKING CUSPS
(CENTRIC/SUPPORTING) ( NON-CENTR] C / BALANC IN

eI.aLGeM 2.5mm-3 - Omm 2-Omm

PORCEI,AIN 1.5mm-2.Omm 1.5mm-2.Omm
PEM 1.5mm-2.Omm 1.5mm-2. Omm
@LDlMETAL 1,5mm l.Omm

REMEMBER:
A. The most effective means for verifying occfusal cfearance is
C. Onlay gaincd most of its rotcntion from EXTILA coronal portion.
D. are indicated to add AUXILIARY (SECONDARY) retention.
E. PAF,AILEL A-XI.AI WALL contributcs thc grcatcet amount of rctcntion.
NOTES: fNLAYS & ONLAYS are the l-east retentive amonrT fixed prosthesis.
INLAYS & ONLAYS are the most conservative among fixed prosthesis&can
rmanentlv restore and relnforce a tooth conservational.
3. cRow!{s *
3.1
TEMPORARY CROT|NS- are designed TO MEET THE NEEDS OE A PERMANENT
RESTORATION, but still with DURABILITY. Usually, it is made up of acrylic& done
by Lhe clenl:isl-s 1n the clinic.
DURATION: Eew days to 3 weeks

NOTE: DURABILITY is the abilitv of the material to withstand the force.

3.2 PERT'A{ENT CROWNS-II is usually done in the laboratory or off-site.
DURATION: 5-15 years with proper care.

3.3 TELESCOPIC CROI{NS It is a modified complete crown indicated for

brokendown crown.
PARTIAL \r'ENEER CROTIN Ax extra-coronal- metal restoration that covers only
retention is placing pins.
INDICATION: damaged ot- teeth.
CONTRAINDICATION: H h

TYPES:
A. FOR ANTERIOR TEETH

193
 1. 3/4 ( CROT{N - rt is
restores the incisal edge & three axial
surface rs preserved.
2 - PINLEDGE RESTORATfON - It is a technique that employs paralleJ- long pins
order to increase
retention of the res

the in dge, the mesiaf surface & a portion of the labial or lingual
surfaces.
INDICATION: Mesially tilted tooth
B. EOR POSTERIOR TEETH
- It ls a partial coverage of restoration that
1. 3/4 (THREE QUARTER) CRoIIN
restores the occlusal surface & three axial surfaces of the clinical. The
surface is preserved.
REVERSED 3/4 CROIIN - It is a partial
a
L. coverage of restoration that
restores the occlusal surface & three axial surfaces of the clinical. The
surface is preserved.
3. 7/8 CRorYu- rt is a partial coverage restoration that restores the all
surface of the clinical crown except the MESIOBUCCAL CUSP remains intact.
INDICATION: Maxill-ary fj-rst mo.Iar

4. MESIAL t/2 CROI{N It is a partial coverage restoration that restores

the occlusa1 surface, the mesial surface & a portion of the facial or lingual
surfaces -

INDICATION: Mesially tilted tooth

5. EULL VENEER cRorYNs ,/ 6\1 Surfo*L
INDICATION: damage of teeth.

TOOTH PREPARAT]ON:
1. @CLUSAI. REDUCTION: SAME with the ONLAY REDUCTION tAb].C.
2. FACIAI AT{D LINGUAL R"EDUCTTON: T.25_1.5 Mm
3. PROXIIAL REDUCTfON: 1.25 mm
6. BRIDGES
TYPES:
t A. ErXED PARTIAL DENTT RE - It is a fixed dental prosthesis with replace &

restore the function & esthetic of one or more missing natural teeth.
t COMPONENTS:
1. RETAINER - It is the part of the bridge which is cemented to the
abutment teeth. ft could be ful-l metal, fuII veneer, partial veneer, etc.
I 7linouth
2- PONffC - It is the part of the bridge which represents the missj-nq tooth
& it connects to the retainer by a connector.Pontic design gives SUCCESS OR
t l^ r^ r. Jot.J

194
I
CLII{ICAI SIGNIEICA}ICE: Pontic with rough, poorly-polished areas may cause:
A. Halitosis
B. Discomfort
C. Chronic inflammation of the ridqe ti-ssue
TYPES OF PONTICS:
1. RIDGE LAP (SADDLE) - It is esthetically good, but not hygienic.
1.1 O\IATE - A substitute to ridqe lap but difficuft to achieve without ridge
augmentation procedures or GTR

1.2 IiODIEIED RIDGE LAP - A combination of ridge lap on the buccal surface and
bull-et on the lingual surface- This ls used d.
2- SAIIIIARY - ft has a clearance of for HYGIENE but has poor esthetics.
3- BTLLET (EGg ) - It is similar to sanitary but shaped like a t with tip
against the ridge.
3. CONNECTOR - It is the part of the bridge which connects the pontic and
the retainer. It may be rigid (solid joint) or movable joint (precision
attachment key).
4. ABUIMENT This is the most important component of fixed partial
denture. It supports the bridge and on which the retainer is cemented.
MOST IDEAI ABUTMENT (ROOT): D oot
MOST IDEAL ABUTMENT (CROWN): Squarish with average lenqth and bulk
LEAST IDEAI ABUTMENT: Short, tapered root with long clinj-cal crown.
CONTRAINDICATION: Tooth tipped more than 244 is not used as ahutment.

CLfNICAL SfGA{fE'fCAIICE: In choosing the abutment, the CROWN-ROOT ratio must be

checked. CROWN-ROOT RATIO is Lhe measurement of the length of the tooth occlusal to
the alveolar crest of the bone compare with the length of the root embeddecl in the
bone.

The most ideal crown root ratio for a tooth to be used as brldge abutment is
The minimum ratio acceptable for abutment under normal- circumstances is 1:1.
The most commonlv encountered crown root ration is 2:3

A}ITE'S I,AW It states that the surface area of the roots of the abutment teeth
shouldrc or D the surface area of the roots of the teeth to be replaced- It
indicates P area.
ABUTMENT TOOTH PREPARAT]ON:
** Before doing the tooth preparation, CHECK E]RST THE GINGIVAL CREVICE.
Eor adult patients, it is ruore than 1.Omm I .r tr
Eor young patients, it is shal]ower. .+r.,ptr Eu ltv
{. rnc,xi ft1 \,rn
1. TAPER - This is the nrain retention form of an abutment. The most ideal is 2 -5!
2. HEIGHT - The ta preparatron tne Detter RE_SISTANCE.
3- BOXES & GROOVES - To improve resistance and retention form

A. CHAMEER This makes an OBTUIE angJ-e between the axial wafl of the tooth &

the prepared rnargin.

INDICATION: C_€_t rneL3l_gle-trirs e full melal_crowns
195
 B. SHOITLDER (BUTT-JOINT) - It allows room for PORCELAIN. It is recommended for
FACIAI, part of the METAI CERAMIC CROT|N.
8.1 SEOULDER WrTH BE\ruT,- It rs the best CFL under PEM.
C. BEVEL - A margin, under circumstances, is more suitable for CAST
RESTORATION particularly if a ledge or shoulder already exlsts.

D. FEATHER-EDGE (SHOULDERLESS/KNIFE EDGE) - It is with conservation of tooth

structure
INDICATION: ly.
CLINICAI SIGNEICAI{CE: SPLINTING the abutment rs done to stribu the occfusa-1
I Maximum of J abutment teeth.

*-A. O.8t EPfNEPHRINE causes n.

' 8. POTAssrtM AIIMINIM S slightly Iess effective than
epi ne
*.c . ATt MTNUM CIILoRTDE- rf it exceeded more than 10, it causes
n
D. 408 ZINC CHLORIDE- It causes t s
E - 13 - 3t IERRIC SITLFATE- It is statrc agent but it discolors the
tissue
DOITBLE CORD TECHNIQT E
1sr CORD - A smafler cord for controfLing the M

B. CAI{TILEVER - A type of bridge that uses one abutment only. It can be mesial
or distal. The most destructive in periodontium is when you use LATERIAL INCISOR
abutment and CENTRAL fNCISOR is the pontic.
C. I"ARYLAND BRIDGE- It is conservative form of brlcige chat aifects the LIi$GIl:Al
surfaces of the abutment using RESIN.
D. Ir'.IRGINIA BRIDGE- It uses I.Oti!liALT TECHNIQUE tc fabricate the bridge.
E. ROCHETTE BRIDGE - It is type of bridge that uses a ring-like retainers with

PORCEI,AIN
It is classified as AMORPHOUS solid materials
CI,ASSIEICATION OE SOLID MATERIA]-S
1. CRYSIALLINE - A solid ls said to be crystalline of the various constituent
particles are arranged in definite g'eometric patterns.
2. AIIIORPI{OUS - A solid is said to be amorphous if the various constituent
particl-es are NOT arranged in any regular fashion-
NOfE: Their basic differerrce is cr:yst allrne have -1. er
and wel-f -defr t cr range "

10fi
l_

COMPONENTS:
1" FET.DSPAR- It acts as matrix. This is the greatest ingredient of porcelain by

2. QUARTZ- It provides skel-eton & gth-

3. KAOLIN- It serves as a clay that acts as a r
4" ELIIX - It is rrsed to decrease sinte g temperature.
,.F

COIIPRESSIVE STRENIGTH is of porcefain.

2 - LOW PLASTfC DEEORI,A,TION - Porcelain has inability to be deformed overtime -

CLASSIFCAT]ON OE DENTAI CERAMICS BY OE E]RING (SINTERING) OF DENTAI PORCEI.AIN

x UI,TRA LOI{ BISQUE FIRING:
APPLICATfON: Crown e bridges veneer ceramic
LOII B]SQIJE FIRING: oC
APPLICATION: Crown & brldges veneer ceramic

MEDTUM BISQUE: C
APPLICATION: De resented Zirconia
HIGH BISQT'E: C
APPLfCATTON: teeth. Zj-rconia ceramics
GI,AZED PORCEI,ATN:
It provides:
A. Non-porous
B- Resistance against abrasion
C. Esthetic ability "naturafness"
D. V[eff-tolerated by the gingiva
TYPES OE CROWNS:
1 . MErAr CERAI'IIC ( PORCELAIN EUSED TO METAL) - This is the most commonly used with
and advantage of being esthetic S well as adequate strength. When porcelain is
baked with metal- ), it LES ENS linear co-ef Lcient of thermal ex
than of the metal. fl=
CLINfCAI SIGIIfEICANCE: Repeated fracture of PFM is due to AN INADEQUATELY DESIGNED
ERAMEVIORK

between the surface oxide faver of the alloy & and the porcelain.
2. AIL-CER'AMTC (PORCE],AIN ) This is best for anterlor as they can be
matched to your teeth that Iooks exactly naturally.
CLTNICAI SIGIIIEICANCE: Esthetics is the concern when cementing the crown. The
POWDER OE THE CEMENT musT be mlxed with GLYCERI}T_WATER SOLUTION.

3 " .&,LL- TAJ" This crown type uses gold alloys, nickel, chroirii um. or .ny other:
metal-based aIIcy. This is ideal in non-esthetic zone.
'
" &.2,L* gI$
-
4 This -ls the c_hea;9st cror./n bui their: qualil-y & at-y -LS
POOP. as ihev are prone to cign-!4\[ractures & can easily t*reail dOirtt-i
--'- - 14"7
LJ .'
 x
CLINICAI SIGNfEICANCE: If there 1s " n" every time the teeth contact
tooether there is S CLUSION of the c

CEMENTS

The most characteristic of cement is ON.

THICKNESS : zO+fmicrons .fi
*
1 . zrNc PHoSPEATE cB{ENTs ( )- H rlt .o
A. ft is also known as ^d'
sphate & Bridge cement

C. Uses a "Erozen sfab technique"to j-ncreased WT and decreased ST.

too\ 9icl9 ltOU - \r're.,.t C '.^rO !Y", \Yna

J,qr.Poist sLtanul \n /t-
COMPONENTS:
A. POI{DER: I *,,^fl)
B. LIQUfD: thophoshoric acid) The pH is4.2 that needs cavity
varnish when placed on the tooth.
CHARACTERI STICS :
A. No chemical bonding
B. Pulpal irritant
THfN MfX is undesirable because il
A. Results in Iow solubility
B. Decreases its compressive STR
C. Makes cement very static
2. ZINC oxIDE-EueENoL (ADA 30) during' 1858 ,1"'\i..
A. It is used under ass slab
B. The most biocompatible cement.
C. The pH is 7.
COMPONENTS:
A. POTIDER:
B. LIQUID:
C. OTIIERS: ic acid increases
CHARACTERIST]CS :
1. Biocompatible - ph ? [,.g,r,h.rnt)
2. Baclericidaf
3. Inhibits rization of resins
\
TYPES: 6ff,trng yftudtr9

I Temporary cementation
II Permanent cementation
ITI Temporary filling fRrn
rv Cavitv l-j-ners

198
t_
3" POLYCARBO)rrr.ATE (ADA 61)
A" ErRST ano oul:G&t that bonds to tooth structure Y.
{. B- It can provide T RMAI INSULATION with 0-75mm thickness.
4" SILICATE (ADA 9 )
A. Thls i LETE in the market already
B. Eor patients with high caries rate -

C. The FIRST cement to have a f luoride-rel-ease "

D. The most soluble cement.
5. ZINC SILICOPEOSPHATE (ADA 21)
A. rt is also known as- NT

COMPOSITIONS:
A. PO?ilDER: Zinc Phosphate c Silicate
B. LIQUfD: Phosphoric acid
6. IONOMER
GI,ASS I
A. It is also known as Af,UMINOSILICATE CEMENT
B. The least soiuble cement
C. The best in not producing MICROLEAKAGE.
D- the most pulp irritating
E. It has a fluoride-releasing property via LEACHING process,
E. It has anANTICARIOGENIC property
DISADVANTAGES: Technique & moisture sensitive.

TYPES:

I Lutinq
II Restoration
III Liners and bases
IV Eissure sealants
v Orthodontic cem-ent
VI Core build up
VII Eluoride release
VIII ART jlartalltr r,rt i;rlr/\tD I E- \ra,d rn5vurh{rh
IX Pediatric purpose

1 . COMPOLTERS (RESTN)
A. It is also Known as RES]N MOD]EIED WITH G].ASS IONOMERS.
B. The objective is to provide rapid settingr time to minimize the acidity.
c. rHE r. ilq
REtr"IEMBER:
A. After cementation the bridgre must be examined 7-10 days.
B. Application of cocoa butter in GIC and silicates p tion
QUESTIONS:
A. What is the most common complaint after cementation?JdnJth vilT .yD C,ola L-V Coqj
B. What is the best method to check excess cement? rg&au\t"-Fh$
C. What is the least retentlve cement? StricaV

l"g9