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Prosthetic treatment in children
6 DM
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:
1. Rehabilitation of masticatory efficiency
2. Protection of dental pulp
3. Esthetic function
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
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:
1. Stop bleeding (cover plate)
2. To keep developmental oppening following the
surgery intervention (ocludor)
3. To fix the loosed teeth after trauma or
osteomyelitis (splint)
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)
Prosthodontics dentures in children with deciduous
dentition
1. Fixed dentures
2. Removable dentures
Fixed dentures:
A) protective temporary crown (protect vital
pulp after dental trauma in vital teeth)
B) fixed space maintainers
C) fixed splint
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
Indications for stainless steel crowns:
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:
1. Local analgesia
2. Reduction of occlusal height
3. Reduction of distal and mesial surfaces
4. Select a crown for trial fit
5. Crimp the crown margins (scissors, pliers)
6. Cement the crown on the tooth
7. Final check
8. Follow up
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
Prosthodontics dentures in children with deciduous
dentition
C) fixed splint
-
immobilize teeth after trauma
-
immobilize teeth in case of osteomyelitis
(wire and composite, fibre splint)
Removable dentures in deciduous dentition
1. Removable partial dentures (space
maintainers)
2. Vestibular screen
3. 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.
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.
- 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
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
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
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
- 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)
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)
Fixed partial dentures
Indications:
-
tooth lost after trauma
-
congenital lack of tooth formation
-
extensive caries
1. 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
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
Removable partial dentures
Indications:
-
excessive span lenght
the inability to achieve adequate retention
for a fixed prosthesis
-
congenital malformation
-
injuries of multiple teeth
Removable partial dentures
Major objectives in construction of removable
partial dentures:
1. The restoration of the functions of
mastication and speech
2. The restoration of dental and facial
esthetics
3. The preservation of the ramaining teeth
and their supportive tissues