1. Prosthetic treatment in children
6 DM

2. Prosthodontics in childhood
Dental prosthetic treatment of children is planned with respect to the special conditions accompayning the absence of teeth
Dental prosthetic appliances has temporary function
Prostethetics: principal functions:
Rehabilitation of masticatory efficiency
Protection of dental pulp
Esthetic function

3. Prosthodontics in childhood
4 Prevention and correction of speech abnormalities
5. Support optimal development of teeth and their eruption
6. Support growth of dental arches
7. Support growth of facial bones
8. Prevention of harmful habits

4. Prosthodontics in childhood
9. Provision of space maintainance
10. Obturation of congenital defects of orofacial structures
11. To create conditions for prosthodontics in adult age
Other functions:
Stop bleeding (cover plate)
To keep developmental oppening following the surgery intervention (ocludor)
To fix the loosed teeth after trauma or osteomyelitis (splint)

5. Basic principles of prosthodontic treatment in children
non toxic materials to dental pulp
appliances must not irritate soft tissues
appliances must not irritate marginal gingiva
appliances must not extend to gingival sulcus
appliances must not inhibit development and growth of dental arches
appliances do not include active clasps (unless a combination with orthodontic appliance)

6. Prosthodontics dentures in children with deciduous dentition
Fixed dentures
Removable dentures
Fixed dentures:
protective temporary crown (protect vital pulp after dental trauma in vital teeth)
fixed space maintainers
fixed splint

7. Reconstruction of deciduos crowns:
Types of temporary crowns:
Protective celuloid crown
Metallic crown
Stainless steel crown for distal teeth prefabricated
Resin crowns for frontal teeth
Indications:
after trauma of frontal teeth
carious destruction of frontal teeth
carious destruction of lateral teeth
developmental anomalies

8. Indications for stainless steel crowns:

9. Stainless steel crown are manufactured by 3M ESPE, they come several sizes numbered from 2 to 7.
Step by step technique for fiting stainless steel crown:
Local analgesia
Reduction of occlusal height
Reduction of distal and mesial surfaces
Select a crown for trial fit
Crimp the crown margins (scissors, pliers)
Cement the crown on the tooth
Final check
Follow up

11. Prosthodontics dentures in children with deciduous dentition
B) fixed space mainterners
band with wire loop
keep the space for permanent tooth after premature extraction of deciduos tooth

12. Prosthodontics dentures in children with deciduous dentition
fixed splint
immobilize teeth after trauma
immobilize teeth in case of osteomyelitis
(wire and composite, fibre splint)

13. Removable dentures in deciduous dentition
Removable partial dentures (space maintainers)
Vestibular screen
Lingual bar
Removable partial dentures are designed to allow modifications when growth occurs and when teeth erupt and migrate.
Partial dentures are also indicated for long or widely distributed edentulous spans or when bone resorption and remodeling is anticipated immediately following extraction or traumatic tooth loss.

14. Removable dentures design
For patient with growing arches, maxillary dentures usually are designed with acrylic base.
Acrylic base is extended, covers the whole palate. Clasps are not used, but some orthodontic springs may be incorporated in the design to achieve simple tooth movement if necessary.

15. it shoud be construced with minimal damage to the tissues
it should allow hygienic and cosmetic demants
Retention is provided by:
extended body
90% inclination of deciduous teeth
RECALL
SHORTER LIFETIME

16. Prosthodontics treatment for children with permanent dentition
Indications:
dental caries
dental trauma
congenitaly missing teeth
malformed teeth
erosion by dietary habits
Goals of prosthodontics treatment
psychological rehabilitation
esthetic rehabilitation
to achieve complet root formation

17. Prosthodontics treatment of the adolescents
Fixed
Removable
Fixed crowns and bridges
1. All ceramic crowns
2. Metal- ceramic crowns
3. Resin crowns
Indications: dental caries, tooth trauma, malformed tooth, discolored tooth, developmental anomalies, premature loss of teeth

18. Prosthodontics treatment of the adolescents
Preparation of all ceramic crown:
required normal tooth preparation
smooth finish line is 0.8 mm in depth around the entire tooth
lingual reduction 1 mm
axial surfaces are reduce to a depth of 0,8 mm
an incisal edge reduction 1.5 – 2 mm

19. whenever possible, cervical margin shoud not be extended into gingival sulcus of an adolescent patient (subgingival margin can produce in case of inadequate hygiene accelerated gingival recession)

20. Prosthodontics treatment of the adolescents
Preparation of metal- ceramic crown:
smooth finish line is 1.0 mm in depth around the entire tooth
lingual reduction 1 mm
axial surfaces are reduce to a depth of 0,8 mm
an incisal edge reduction 2 mm
whenever possible, cervical margin shoud not be extended into gingival sulcus of an adolescent patient (subgingival margin can produce in case of inadequate hygiene accelerated gingival recession)

21. Fixed partial dentures
Indications:
tooth lost after trauma
congenital lack of tooth formation
extensive caries
Resin bonded retainers (dens pendens, Maryland bridge, Rochet bridge)
should be provided immediately after tooth lost to prevent tipping or rotation of the abutment teeth
retention and resistance form is achieved through tooth preparation

22. Fixed partial dentures
2. Complete crown retainers (dental bridge)
- when a resin bonded retainers cannot be used because of the tooth condition, crown form, crown lenght, axial alignment, occlusal forces or conditions requiring maximal retention and resistance form, use of complete – coverage retainer is indicated

23. Removable partial dentures
Indications:
excessive span lenght
the inability to achieve adequate retention for a fixed prosthesis
congenital malformation
injuries of multiple teeth

24. Removable partial dentures
Major objectives in construction of removable partial dentures:
The restoration of the functions of mastication and speech
The restoration of dental and facial esthetics
The preservation of the ramaining teeth and their supportive tissues