Prosthodontics
What this domain tests
This domain tests removable partial dentures, complete dentures, fixed prosthodontics, implant prosthodontics, occlusion, and maintenance. The exam emphasizes design rationale, load distribution, and the difference between retention and stability.
Core rules and concepts
- A removable partial denture uses rests, clasps, major and minor connectors, and indirect retainers. Rests direct load to abutments; major connectors distribute stress; indirect retainers resist rotation.
- Kennedy classification describes the edentulous space pattern. Applegate rules govern classification when teeth are missing or spaces are modified.
- Complete denture success depends on retention, stability, support, border seal, and neutral zone. Balanced occlusion helps distribute load in excursions.
- Fixed partial denture abutments need adequate ferrule, path of insertion, margin fit, and occlusal clearance. Cantilevers concentrate stress on the abutment.
- Implant osseointegration depends on primary stability, bone quality, heat control, and loading protocol. Peri-implant mucositis is reversible; peri-implantitis involves bone loss.
- Occlusal trauma can aggravate periodontal injury but does not cause periodontitis.
Worked example
A Kennedy class III partially edentulous patient is missing premolars. The reasoning is to use rests on adjacent teeth, a major connector that avoids soft tissue impingement, and an indirect retainer to limit rotation. The design should distribute load and maintain hygiene access; simply adding clasps without rests can overload abutments and cause tissue damage.
Traps that cost marks
Do not confuse retention with stability. Not every RPD needs an indirect retainer. Overextended borders cause sore spots, not better seal. Ignoring path of insertion leads to nonseating castings. Also avoid saying occlusal trauma causes periodontitis; it can aggravate but not initiate it.