Dentistry and Restorative/Prosthodontic Considerations
Dentistry and Restorative/Prosthodontic Considerations
OMFS surgeons must integrate with restorative dentistry. This domain covers dental materials, implant prosthodontics, fixed and removable prostheses, and occlusion. You must understand the biomechanics of implants, the principles of crown and bridge, and the design of removable partial dentures. Also, know the occlusal concepts (balanced occlusion, mutually protected occlusion) and the management of edentulous patients (complete dentures, implant-supported overdentures).
Traps: Questions often test the ideal implant position (3 mm from adjacent teeth, 2 mm from buccal/lingual plates). Another trap is the retention and stability of complete dentures: retention is resistance to vertical displacement, stability is resistance to horizontal forces. Also, know that osseointegration requires primary stability and a biocompatible surface. For fixed partial dentures, the abutment teeth must have adequate crown-root ratio (at least 1:1).
Rule of thumb: For implant placement, ensure adequate bone volume; if not, consider grafting. For complete dentures, the posterior palatal seal improves retention. For occlusion, aim for mutually protected occlusion in natural dentition.
Worked example: A patient with a single missing tooth desires an implant. The space is 8 mm mesiodistally. Minimum implant diameter is 3.5 mm, leaving 2.25 mm on each side, which is acceptable. However, ensure at least 1.5 mm from adjacent roots.