Classification of defects of sets of teeth

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Classification of defects of sets of
teethaccording to their topography and
size

• Martin Tvrdon
• Teaching Hospital and Policlinic
• of the Academician L. Dérer, Bratislava, Slovakia

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Introduction

• In dental prosthetics there exists an unfortunate
  situation as since the end of the 19 century many
  different diagnostic classification systems of
  defects in sets of teeth have been formulated. We
  have collected almost 40 systems from the schools
  of the world.

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Review of the different ciassifications of
defects of dentition by Soviar et all./1986/
Andrik and all./1984/ and added data 1. Group
- Localization and extension of defects Kennedy
(1928), Koller (1928), Wild (1933), Martin
(1939), Fäldvári a Lärinczi (1951), Betelmann a
Bynin (1951), Ga1asinska-Langsbergerova (1952),
Rouot (1959), Lejoyeux (1957), Applegate (1960),
Gabri10v (1966), Korber (1966), Soviar, Bilý,
Pokorný (1980), Fiset (1973), Fabián (1979),
Skinner (1959), Steffe1 (1973) Koller (1943,
1954), Vo1dfich (1950), Andrik (1986), Graber a
kol. (1984), Geering (1986). 2. Group Types
of dentures Cummer (1920), Bai1yn (1928), Balters
(1935), E1brecht (1936), Beckett (1953), Takác
(1981), Vacek (1982), Knowles (1963), McCracken
(1963), Andrik (1986), Pasankiewicz (1972) 3.
Group Frequency of defects of sets of teeth
4. Group Intermaxillary relationship of
defects Mathé (1950), Steinhardt (1965), Rehm
(1956), Eichner (1955), Wajs (1984), Skinner
(1959)
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Korber /1966/
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Eichner /1955/
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Kennedy /1928/
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Consequences /at least two/

• 1. Exchange of the experiences of the prosthetic
  treatment among the experts is more or less
  complicated
• 2. It is an obstacle at the development of
  Prosthodontics as a science

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Worlwide try of unification

• The World Dental Cogress 1966 in Wurzburg
  /Germany/ which was devoted to the problem of
  Classification of defects of sets of teeth. There
  was not achieved the aggreement about the unified
  classification /diagnosis/ of defects of sets of
  teeth

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• Where is a problem?

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• Cummer, 1912
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• In one jaw is possible 2 65.536 cases
• of ideal teeth /idealy sound/
• If there is taken into the consideration only one
  real property of the tooth e.g. caries- it is
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• 43,046.721 cases
• If combination of maxilla and mandible
  /intermaxillary relationship/
• practically the infinite number of cases

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Our proposal of classification of the defects in
sets of dentition

• is based on the principle
• - that the absence of one,two or all teeth is a
  functional and morphological disease with health
• 1.local consequences /integration of dental
  arch,intermaxillary relationship,TMJ, speach,
  processing of the food, esthetics-psychic
  condition etc/
• 2.and general diseases consequences /GIT,
• focal infection etc./

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The main criteria for distinquishing the classes

• 1. the functional topography in sets of teeth
  /objective cr./
• 2. the gradual enlargement of defective
  regions during the life of the man /objectve
  individual criterion/
• 3. transmission of masticatory pressure of
  prosthetic dentures tooth, tooth-tissue,
  tissue-tooth and tissue /objective criterion/
• 4. distance and mutual location between the
  remaining teeth possibility of mutual
  splinting/objective criterion/
• 5. classes of abutment teeth /objective
  criterion/
• 6. the biological factor of the tooth
  including surrounding periodontal tissue
  /objective individual criterion/
• 7. and other objective criteria

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1.Functional areas of dentition and main
functional forces
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2.Gradual enlargement of defective regions

• Gradual enlargement of defective regions
• is individual. The progressive loss of the
• teeth depends on the genetic factors and
• the personal attitude to the oral health during
  the life - but
• special situation e.g. traumatism, neoplasms
• etc.

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3. Mutual position between the remaining teeth

• A single or group of remaining teeth which are in
  linear relationship. It is recommended to be
  splinted
• The remaining teeth are located in one functional
  area /incisal, canine, molar/. It is recommended
  to be mutualy splinted
• 1. If two teeth are present - between them is
  a linear relationship
• 2. if three and more teeth are present
• 2.1. linear relationship - recomm.to be
  splinted
• 2.2 areal relationship recomm.to be
  splinted
• The distance between the remaining teeth is
  too large - there is no possibility to be
  mutually connected

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• Why splint?

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Linear and areal anchorage
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4. Classes of abutment teeth
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5.Biological factor of a tooth
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• and now classes,designs
• and treatment

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Class I.A.
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Some examples
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• Some examples

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Class II.A.
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• Some examples

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New solutions at II class A free end saddle
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Fixed-fixed bridges with tissue supported glass
pad abutment at Class II A free end saddle
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• Cantilever pontic at the II.class A free end
  saddle

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Fixed-fixed bridge with posterior cantilever
pontic of Class II A free end saddle
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Class II.B.
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Majority of the alveolar ridge is edentulous
its relevance for stability and retentiom of the
denture increases
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• Some examples

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Class III.A.
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Class III.B.
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Class III.C.
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Conclusions

• 1. The classes are generate according to the
  objective and firm criteria which would be
  understable to both contemporary as well as
  future experts
• 2. The natural regions are represented by
  forces of specific directions and intensities
• and they are respected in the diagnose and
  the treatment as well
• 3. Easy to be applied by dental surgeons
• 4. Availability for easy computer programming

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• Thank you for your attention!