PROSTHODONTICS - American College of Prosthodontists

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Figure 17. Class IV patient. (4) Panoramic radiograph. (B) Facial tiew at the approximate occlusal vertical dimension.(C) Occlusal view: maxillary arch. (0) Occlusal view: mandibular arch. (E) Facial view: tongue in resting position. (F) Facialview: tongue elevated. (G) Lateral view of mandible: patient right. (H) Larcral view of mandible: patient left.2010 CDEL Re-recognition of the Specialty Report 156 of 279
38 Clm$cation of Cumllete EdClass 11 (Fig 15 A-H)This classification level distinguishes itself by thecontinued physical degradation of the denturesupportinganatomy, and, in addition, is characterizedby the early onset of systemic disease interactions,patient management, and/or lifestyleconsiderations.0 Residual bone height of 16 to 20 mrn measured atthe least vertical height of the mandible on apanoramic radiograph.0 Residual ridge morphology that resists horizontaland vertical movement of the denture base; TypeA or B maxilla.Location of muscle attachments with limited influenceon denture base stability and retention; TypeA or B mandible.Class I maxillomandibular relationship.Minor modifiers, psychosocial considerations,mild systemic disease with oral manifestation#Class 111 (Fig 16 A-N)This classification level is characterized by the needfor surgical revision of supporting structures to allowfor adequate prosthodontic function. Additional factorsnow play a significant role in treatment outcomes.Residual alveolar bone height of 11 to 15 mmmeasured at the least vertical height of the mandibleon a panoramic radiograph.Residual ridge morphology has minimum influenceto resist horizontal or vertical movement ofthe denture base; Type C maxilla.Location of muscle attachments with moderateinfluence on denture base stability and retention;Type C mandible.Class I, II, or III maxillomandibular relationship.0 Conditions requiring preprosthetic surgery'3:1) minor soft tissue procedures;2) minor hard tissue procedures including alveoloplastyI8;3) simple implant placement, no augmentationrequired;4) multiple extractions leading to complete edentulismfor immediate denture placement.Limited interarch space (18-20 mm).Moderate psychosocial consideration^'^^^^ andormoderatc oral manifestations of systemic diseasesor conditions such as xerostomia?l0 TMD symptoms present.140 Large tongue (occludes interdental space)** withor without hyperactivity.0 Hyperactive gagClass N (Fig 17)This classification level depicts the most debilitatededentulous condition. Surgical reconstruction is almostalways indicated but cannot always be accomplishedbecause of the patient's health, preferences,dental history, and financial considerations. Whensurgical revision is not an option, prosthodontictechniques of a specialized nature must be used toachieve an adequate treatment outcome.0 Kesidual vertical bone height of 10 mm or lessmeasured at the least vertical height of the mandibleon a panoramic radiograph.0 Residual ridge offers no resistance to horizontal orvertical movement; Type D maxilla.Muscle attachment location that can be expectedto have significant influence on denture basestability and retention; Type D or E mandible.0 Class I, 11, or 111 maxillomandibular relationships.0 Major conditions requiring preprosthetic surgery:I) complex implant placement,25 augmentationrequired;2) surgical correction of dentofacial deformities;3) hard tissue augmentation required;4) major soft tissue revision required, ie, vestibularextensions with or without soft tissue grafting.0 History of paresthesia or dysesthesia.Insufficient interarch space with surgical correc-tion required.Acquired or congenital maxillofacial defects.Severe oral manifestation of systemic disease orconditions such as sequelae from oncological treatment.Maxillo-mandibular ataxia (incoordination).Hyperactivity of tongue that can be associatedwith a retracted tongue position and/or its associatedmorphology.Hyperactive gag reflex managed with medication.Refractory patient (a patient who presents withchronic complaints following appropriate therapy).These patients may continue to have difficultyachieving their treatment expectations despite thethoroughness or frequency of the treatments provided.0 Psychosocial conditions warranting professionalintervention2010 CDEL Re-recognition of the Specialty Report 157 of 279
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COUNCIL ON DENTAL EDUCATION AND LIC
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A. General InformationThe American
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The American College of Prosthodont
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Changes in Scope of PracticeThe Ame
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ReferencesThe American College of P
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ENVISIONED FUTURE~ 10-30 YEAR HORIZ
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Prosthodontists will provide prosth
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GOALS AND OBJECTIVES~ 3-5 YEAR PLAN
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E4. Create effective linkages to fu
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Journal of ProsthodonticsImplant, E
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December 2005, Supplement, Volume 1
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Page 105 and 106: December 2005, Supplement, Volume 1
Page 145 and 146: COUNCIL ON DENTAL EDUCATION AND LIC
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thinningorperforationofthecortices,
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lymphoma)andprimarycarcinomas,areen
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Figure4EffectsonadjacentstructuresW
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fromaprimarylesioninboneorthesoftti
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THEORALCANCERSCREENINGEXAMINATIONTh
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Society’sABCDERule:lookforAsymmet
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Function:Paraesthesia,paralysis,pai
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Examinetheentireheadandneckincludin
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Figure11IntraoralexaminationTheintr
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Figure13Thesoftpalate,uvula,andtons
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Figure15Examinationofthetongueisthe
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Figure18Finally,thefloorofthemouthn
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MANAGEMENTOFSUSPICIOUSORALLESIONSIn
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Tables1through10ThoseatriskTable1 4
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Table3 512010 CDEL Re-recognition o
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Table6 532010 CDEL Re-recognition o
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Table9Table10 552010 CDEL Re-recogn
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CPE Course History From 2000-2010Da
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Accreditation Standards forAdvanced
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Document Revision History (continue
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Mission Statement of theCommission
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PrefaceMaintaining and improving th
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Definitions of Terms Used in Prosth
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Educationally Qualified: An individ
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Intent: Major changes have a direct
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STANDARD 2 - PROGRAM DIRECTOR AND T
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STANDARD 3 - FACILITIES AND RESOURC
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STANDARD 4 - CURRICULUM AND PROGRAM
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Intent: Students will have in depth
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4-18 Students/Residents must be exp
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STANDARD 5 - ADVANCED EDUCATION STU
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STANDARD 6 - RESEARCHAdvanced speci
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PROSTHODONTICS - American College of Prosthodontists

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