Dental Prosthesis II (27242 code) is a compulsory annual subject, belonging to module IV (Dental Pathology and Therapeutics), which is taught in Spanish and Basque in the third year of the Master's Degree in Dentistry.

It consists of 12 ECTS credits, with a total dedication by the student of 300 hours, divided into 136 on-site hours and 164 off-site hours.

PREVIOUS COMPETENCES

A dental student must have some prior knowledge or skills in several fundamental disciplines that provide the theoretical and practical bases necessary to understand and carry out the procedures related to prostheses.

It is essential to have a solid knowledge of the anatomy and physiology of the stomatognathic system, skills that are acquired in the first years of the Master's Degree. Knowledge of dental anatomy and the study of occlusion are fundamental for the design of removable prostheses. A correct occlusal relationship is vital for the functionality of the prosthesis. These competencies are acquired in Dental Prosthetics 1 which is taught in the second year of the Master's Degree in Dentistry. Dental Biomaterials is another essential subject, as it provides knowledge of the physical and chemical properties of materials used in the manufacture of prostheses, such as acrylic resins, metals and polymers.

It is advisable to have computer skills, as well as a good command of presentation software and technical English, as the scientific literature used is mainly in English.

RELATED SUBJECTS

Removable prosthodontics is closely related to various subjects of the degree in dentistry, as its study and application require an integration of theoretical knowledge and practical skills from multiple disciplines. Not only anatomy, physiology and dental prosthetics 1 but others such as periodontology are closely related to removable prosthetics, as the health of the periodontal tissues directly affects the viability of the prosthesis. Knowledge in periodontology allows the dentist to properly assess and treat the supporting structures prior to the placement of a prosthesis. Restorative dentistry and fixed prosthodontics (Prosthodontics III) are related to removable prosthodontics in the context of comprehensive rehabilitation. Knowledge in these areas allows for planning combined treatments, offering complex prosthetic solutions that integrate different types of prostheses to improve the patient's dental function and aesthetics.

The study of removable dental prostheses, both complete and partial, is essential for dental students as it relates to clinical practice, technical knowledge and a comprehensive understanding of the patient's oral health.

Firstly, removable complete and partial dentures are a common and effective solution for oral rehabilitation in patients with complete or partial edentulism. The ability to design, fabricate and fit these prostheses allows the dentist to restore masticatory function, improve dental aesthetics and, consequently, the patient's self-esteem and quality of life. Dentists must be well versed in these techniques to offer appropriate treatment to a wide range of patients, especially those who cannot afford more expensive options.

In addition, the study of removable dental prostheses involves a thorough understanding of oral and maxillofacial anatomy, as well as occlusal dynamics and the forces acting on the supporting structures. In the customisation of a complete removable prosthesis, all concepts of dental aesthetics are studied and applied to harmonise with the patient's facial features, achieving a natural and attractive appearance.

Another important aspect is the technical skill required for the elaboration and adaptation of prostheses. This includes knowledge of dental materials, impression techniques, analogue and digital techniques as well as dental laboratory procedures. Accuracy in these processes is vital to ensure the comfort and functionality of the prosthesis, as well as patient satisfaction.

Finally, studying removable dental prosthetics encourages students to take a holistic and multidisciplinary approach to dentistry. Dentists must work closely with dental technicians, hygienists and other specialists to provide holistic and effective treatment. This collaborative approach and understanding of the different aspects of prosthodontic treatment contributes to the development of professional competencies that are essential in modern dental practice.

PDII1. Identify the patient for whom the best treatment to achieve aesthetics and function is a full denture, immediate denture or overdenture.

-PDII2. Correctly handle all the materials necessary for the fabrication of a complete prosthesis and an overdenture on teeth or implants.

-PDII3. Plan and carry out in a sequential and reasoned manner each of the steps necessary to fabricate a complete prosthesis and an overdenture on teeth or implants.

-PDII4. Identify, analyse, present, discuss, debate, understand and solve each of the problems that arise both in the fabrication and in the patient's use of a complete prosthesis, an immediate complete prosthesis or an overdenture on teeth or implants.

-PDII5. Obtain and analyse, using the scientific method, the updated information necessary for the realisation of a complete prosthesis and an overdenture.

-PDII6. Identify the patient in whom the best treatment to achieve aesthetics and function is the use of a removable partial denture

-PDII7. Correctly handle all materials necessary for the fabrication of a removable partial denture.

-PDII8. Plan and carry out in a sequential and reasoned manner each of the steps necessary to fabricate a removable partial prosthesis.

-PDII9. Identify, analyse, present, discuss, debate, understand and solve each of the problems that arise both in the fabrication and patient use of a removable partial prosthesis.

PDII10. Obtain and analyse, using the scientific method, the updated information necessary for the creation of a removable partial prosthesis.

-PDII 11. New technologies. Know how to interpret CBCT images and have skills in taking impressions using intraoral scanners.



BASIC AND GENERAL COMPETENCES

G003.Know how to identify patient concerns and expectations, as well as communicate effectively and clearly, both orally and in writing, with patients, relatives, the media and other professionals.

G005.Know how to apply the principles of anxiety and stress management to oneself, patients and other professionals.

G005.Know how to apply the principles of anxiety and stress management to oneself, patients and other members of the dental team.

G016.Understand the bases of action, indications and efficacy of drugs and other therapeutic interventions, knowing their contraindications, interactions, systemic effects and interactions on other organs, based on the available scientific evidence.

G017.Understand and recognise the principles of ergonomics and safety at work (including cross-infection control, radiological protection and occupational and biological diseases).

G018.Know, critically appraise and know how to use sources of clinical and biomedical

G018.Know, critically assess and know how to use clinical and biomedical information sources to obtain, organise, interpret and communicate scientific and health information.

G020.Obtain and prepare a clinical record containing all relevant information.

relevant information.

G021.Know how to carry out a complete oral examination, including the appropriate radiographic and complementary exploratory tests, as well as obtaining appropriate clinical references.

G022.Be able to make an initial diagnostic judgement and establish a reasoned diagnostic strategy, being competent in recognising situations requiring urgent dental care.

G023.Establish diagnosis, prognosis and appropriate therapeutic planning in all clinical areas of dentistry,

G024.Recognise life-threatening situations and know how to perform basic life support manoeuvres.

G025.Know and apply the basic treatment of the most common oral and dental pathology in patients of all ages.

G025.Know and apply the basic treatment of the most common oral and dental pathology in patients of all ages. Therapeutic procedures

be based on the concept of minimal invasiveness and a comprehensive and integrated approach to oral

integrated approach to oral health care.

G026.Know how to plan and carry out multidisciplinary dental treatments,

sequential and integrated dental treatments of limited complexity for patients of all ages and

G026.Know how to plan and perform multidisciplinary, sequential and integrated dental treatment of limited complexity for patients of all ages and conditions and for patients requiring special care.

SPECIFIC COMPETENCES

M04CM01.Perform basic treatment of oral-dental pathology in patients of all ages. Therapeutic procedures should be based on the concept of minimal invasiveness and a global and integrated approach to oral-dental treatment.

M04CM02.Diagnose, plan and carry out, in general terms, multidisciplinary, sequential and integrated treatment of limited complexity in patients of all ages and conditions and in patients with special needs (diabetics, hypertensive, oncological, transplanted, immunodepressed, anticoagulated, among others) or disabled patients.

M04CM03.In order to establish such a diagnosis and treatment plan, the dentist must acquire the following competencies: take and interpret radiographs and other image-based procedures.

Topic 1 History and clinical examination of the totally edentulous patient. Radigraphic examination. Prognosis and treatment plan. PDI (Prosthetic index of the totally edentulous).

Topic 2. Characteristics of complete dentures. Retention. Support. Stability.

Topic 3 Preliminary impressions. Definitive impressions. Aim. Technique and assessment. Diagnostic models. Master model. Mercaptans as definitive impression materials.

Topic 4. Base plates and occlusal rollers. Design. Dimensions. Clinical utility.

Topic 5. Vertical dimension. Determination. Adaptation of the articular rollers.

Topic 6 Horizontal intermaxillary relationship. Methods of registration.

Topic 7 Transfer of models to the articulator. Transfer with facebow.

Topic 8 Artificial teeth. Classification according to materials and occlusal morphology.

Topic 9 Aesthetics in total prosthesis. General factors. Mounting of anterior teeth.

Topic 10 Mounting of posterior teeth. Stability criteria. Model design. Sequence. Cross-over set-up. Other set-ups. Comparison with physiological occlusion of the dentition.

Topic 11 Aesthetic and functional try-in. Control of stability and occlusion. Wax-up.

Topic 12. Moulding and polymerisation. Concept, techniques.

Topic 13. Primary occlusal adjustment. Justification. Systematics.

Topic 14. Polishing and finishing of prostheses. Placement, revision and subsequent controls Relining and remounting.

Topic 15. Overdentures. Concept and indications. Immediate prostheses. Indications, technique.

Topic 16. Classifications referring to the partially edentulous. Kennedy classification. PDI. Prosthetic diagnostic index of the partially edentulous.

Topic 17. Removable partial denture planning. Anamnesis and examination. Radiographic examination.

Topic 18. Choice of abutments. Study models. Treatment plan.

Topic 19. Pre-prosthetic preparation. Re-evaluation of the case. Preparation of abutments.

Topic 20. Elements that make up the removable partial prosthesis. Concept and function. Parallelometry.

Topic 21. Major and minor connectors. Concept. Types. Design.

Topic 22. Direct pressure retainers. Types and indications. Determination of retention depth.

Topic 23. Direct friction retainers. Indirect retainers. Types. Indications.

Topic 24. Bases. Concept. Classification. Design.

Impressions in Removable Partial Prosthesis. Individual trays. Positivation of the impression.

Topic 26. Intermaxillary relations in partial edentulous patients. Transfer to the articulator.

Topic 27. Design of Removable Partial Prosthesis. Static and biodynamic aspects. Design of the different elements. Work order in the laboratory.

Topic 28. Laboratory procedure in Removable Partial Prosthesis.

Topic 29. Try-in of the metal framework. Selection of teeth. Definitive test.

Topic 30. Placement of the prosthesis. Adjustments. Revision and subsequent controls. Relining.

Topic 31. New technologies in removable prostheses.

The strategies that will be implemented for students to develop the competences and achieve the learning outcomes are as follows:

TEACHING CLASSES TO THE WHOLE GROUP: from week 1 to week 16 in this teaching modality, brief presentations will be given by the teacher, where the conceptual contents of the subject are presented in an expository manner, part of the classroom time will be dedicated to carrying out group activities, and to continuously assessing the theoretical learning outcomes PDII1. PDII5 PDII6. PDII10

PRECLINICAL OR LABORATORY PRACTICES From week 2 to 11 from 11 to 15h. Students will carry out in the laboratory under the supervision of the teacher: Complete prosthesis: Obtaining models of total edentulous. Preparation of individual trays. Manufacture of articulating plates and rollers. Transfer of the models to an articulator. Assembly of upper and lower teeth achieving a bilateral balanced occlusion. Practice of overdentures on implants. Removable Partial Prosthesis: Design of Removable Partial Prosthesis. Knowledge and skills are acquired in the techniques required for clinical development. Each practical will be evaluated for follow-up, feedback and improvement. Attendance at the laboratory practicals is compulsory. The competences PDII2. PDII7. PDII 11



CLINICAL PRACTICES From week 11 to week 30, from 9.00 a.m. to 12.00 noon. Clinical practicals will be carried out in pairs. Students will attend to patients and teachers will act as monitors. Students will have to carry out all those removable prosthesis treatments that are indicated, partial, complete, immediate, or overdentures. In the clinic the student acquires the following competences PDII1 PDII2. PDII3. PDII4 PDII6 PDII7 PDII8 PDII 11

Clinical internships are compulsory except in the specific cases provided for in the UPV/EHU Student Regulations published in the Official Gazette of the Basque Country on 30 November 2016. You must attend the internship, even if there is no patient, in which case you will practice on phantoms or you will help other colleagues until the internship timetable is completed. Absence prior to completion without the consent of the tutor will result in non-attendance for the whole day.

The practicals will be assessed each day jointly by the tutor and the student following the rubric presented in the student guide, always encouraging analysis, reflection and feedback.

Strict compliance with the protocol established in the Dental Clinic for the treatment of patients will be mandatory. Further information can be found in the student guide.



SEMINARS

From week 17 to week 26, from 8.00 a.m. to 9.00 a.m. students will present in pairs the planning, treatments and problems that have arisen in the clinical practicals. Individual and group reflection and open discussion will be encouraged in order to favour oral communication. The aim is to identify, analyse, present and discuss how to solve each of the problems that have arisen. Theoretical knowledge and the search for up-to-date information are used. The following competences are worked on - PDII4. PDII5. -PDII9. PDII10. Attendance is compulsory

• Continuous Assessment System
• Final Assessment System
• Tools and qualification percentages:
  • Written test to be taken (%): 50
  • Multiple-Choice Test (%): 15
  • Realization of Practical Work (exercises, cases or problems) (%): 20
  • Individual works (%): 5
  • Exhibition of works, readings ... (%): 10

The evaluation of this subject will be of a mixed type

I: Continuous assessment throughout the training period: 60% of the course grade. It will be carried out through:

Continuous assessment of theoretical knowledge (short question, problem solving, test) 15% of the course grade.

An individual daily report of the laboratory practices: 5% of the mark.

An individual written test, type development of basic concepts and necessary for the correct assistance of patients, is done before starting the clinical practice will consist of short questions maximum 10, it is mandatory to pass this evaluation 7/10 to be able to attend the dental clinic. The same evaluation criteria will be used to make up the exams. It represents 10%.

The clinical practices are evaluated by each monitor following the rubric attached in the student's guide: 20% The daily practice report must be signed and evaluated jointly by the tutor and the student. If during the course the student has not passed any of the practical activities, a practical test will be carried out in which the student must demonstrate that he/she has acquired the necessary skills to pass the practical part.

In the seminars, the development of the clinical case and active participation will be assessed. The rubric used evaluates the presentation, oral communication and reasoned defence 10%.

II It is complemented with a test on the official date established for the corresponding exams. A final individual test: 40% of the course grade. It will consist of a written test, a 25-question test with negative points and two problems to be solved.

In order to get the grade it will be necessary to pass both the theory and the practical.

Final assessment: Students will have the right to be assessed through the final assessment system, regardless of whether or not they have participated in the continuous assessment system. To do so, students must submit a written waiver of continuous assessment to the lecturer responsible for the subject, for which they will have a period of 9 weeks for four-monthly subjects and 18 weeks for annual subjects, starting from the beginning of the term or year respectively, in accordance with the academic calendar of the centre.

Students who cannot participate in the mixed assessment must justify their reasons to the Dean's Office at least one month before the start of the exam period, and may accredit the achievement of the learning outcomes of the subject through a final assessment consisting of:

1) A practical exam: 30%.

2) Carrying out a laboratory practical: 10%.

3) A final written test: It will consist of a 25-question test with negative points, two problems to be solved and 10 short questions 60%.

Waiver of the exam.

1.- If the student does not take the exam, he/she will be graded as not presented or not presented at all.

2.- In the case of continuous assessment, students may waive the exam within a period of at least one month before the end of the teaching period of the corresponding subject. This waiver must be presented in writing to the teaching staff.

Students who do not pass the subject in the ordinary call, regardless of the assessment system chosen, will have the right to sit the exams and assessment activities that make up the final assessment test in the extraordinary call.



The assessment of the subjects in the extraordinary exams will be carried out exclusively through the final assessment system which will consist of

1) A practical exam: 30%.

2) Carrying out a laboratory practical: 10%.

3) A final written test: It will consist of a 25-question test with negative points, two problems to be solved and 10 short questions 60%.

Positive results obtained by students during the course may be retained. In the case of having obtained negative results through the continuous assessment carried out during the course, these results may not be kept for the extraordinary exam, in which students may obtain 100% of the grade.

Non-compliance or failure to appear will automatically lead to failure in both ordinary and extraordinary exams.

Handpiece
Turbine
The rest of the material will be provided by the Department and the Dental Clinic.

Basic bibliography

COMPLETE DENTURES



Atlas of complete dentures and overdentures. Geering/Kundert: Ed.Masson Salvat. 1993. It is a book that teaches how to carry out, from the exploration to the placement in the mouth of a complete prosthesis. It uses more than 1000 images which helps to understand the text.



Treatment of the total edentulous. Casado, J.R. Ed. J:R:C:LL: Madrid. 1991. It is a complete and simple book that includes all the basic principles on which the making of a complete prosthesis is based.



REMOVABLE PARTIAL DENTURE PPR



McCracken . Removable partial dentures. Car AB, Brown AB. Ed. Mundi. 2006. It is the best book published so far to understand when and why a removable partial denture should be placed. It includes images of all clinical and laboratory procedures. It is a great reference book.



Removable partial dentures and overdentures. Mallat, E.: Ed. Labor. 2003. The author of this book is the father of PPR in Spain and has been the one who has trained us all with his courses, videos and books. This is his last and most complete work



Borel, Schittly, Exbrayat: Manual de prótesis parcial removible. Ed. Masson. 1985. It is a very simple manual on the design of the PPR. It uses basic but very useful diagrams.



DENTAL PROSTHESIS ON IMPLANTS:

Misch, Carl E. Elservier 2015



Translated with DeepL.com (free version)

In-depth bibliography

1. Venezia P, Lacasella P, Casucci A, Ielasi A, Calesisni G, Fradeani M, et al. Estética y función en las prótesis completas: Perspectivas Digitales. Zaragoza: Edra; 2022.

2. Abe J. Todos pueden lograr prótesis mandibular completa con técnica de succión (SEMCD). Valencia: Lisermed,cD.L. 2022.

3. Sakar O. Removable partial dentures: A practitioners’manual. Cham: Springer; 2016.

4. Mallat EM. Sobredentaduras sobre implantes: Manual Clínico. Valencia: Lisermed; 2020.

Prostodoncia dental completa Sharry, John J.:. Ed. Toray.1977
Prótesis completa. Llena, J.M.: Ed. Labor. 1988.

Tratamiento del desdentado total. Capusselli, Schvartz Ed. Mundi. 1980

Prótesis parcial removible. Conceptos actuales. Atlas de diseño. Rendon Yudice Ed Interamericana 2006

Prótesis Removible de resina. Fonollosa. Ed Elsevier Masson 2004

Tratamiento preventivo con prótesis parciales. Peter Prospiech Ed Interamericana 2004
Prótesis parcial. Graber.: Ed. Salvat. 1988.

Journals

nt J Prosthodont.
J Prosthetic Dentistry
Rev. Española de Prótesis Estomatológica
Int. Journal of Periodontics and Restorative Dentistry
The European Journal of Esthetic Dentistry
Quintessence Int.
Int J Oral Maxillofac Implants
J Am Dent Assoc

Protes Dent.

Dent Today

Int J Comput Dent.
Pract Odontol
Dent Cadmos
Minerva Stomatol.
Rev Fac Cien Med Univ Nac Cordoba.

Web addresses

http://www.cochrane.org/reviews/en/topics/84.html
http://www.nlm.nih.gov/
www.iadr.com
www.sepes.org/
www.facedental.es
www.infomed.es