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growth, development, ageing, nutrition > anatomical considerations - primary impressions > Flashcards

anatomical considerations - primary impressions Flashcards

1
Q

How are complete dentures made?

A

Denture construction

Denture provision

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2
Q

How are dentures constructed?

A

Primary and secondary impressions during visits 1 and 2

Registration and wax try-in during visits 3 and 4

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3
Q

What happens during denture construction?

A

Shape of edentulous ridges recorded
Correct placement of teeth established - inter-ridge relationships
Wax template made
Template converted to acrylic denture

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5
Q

How is the correct placement of teeth established?

A

Occlusal registration blocks are placed in situ

They are mounted in centric relation on articulator

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6
Q

How are dentures provided?

A

Fit stage and review during visits 5 and 6

6-12 months post fit review

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7
Q

Where should the dentures extend to?

A

1-2mm in front of the fovae palatini

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8
Q

What are the fovae palatini?

A

Two small indentations at the junction at the hard and soft palate

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9
Q

What is denture candidiasis?

A

Red and speckled palate often due to wearing dentures at night

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10
Q

What are the hamular notches?

A

Formed at junction of maxilla and hamular process of the sphenoid bone

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11
Q

Where should the back of the maxillary dentures go on the lateral sides?

A

Hamular notches

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12
Q

What happens if you don’t mold the hamular notches properly?

A

May lead to soreness and loss of retention

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13
Q

What structures need to be molded properly?

A

Hamular notches
Prominent frenae
Full depth of labial and buccal sulci

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14
Q

What is the relevance of the middle frenum?

A

Key reference point for impression taking

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15
Q

What impact would a shallower sulcus have on a denture?

A

More lateral movement

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16
Q

What is the relevance of the large frenae in the canine region?

A

Insertion into crest of ridge may reduce retention of maxillary denture

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17
Q

What is the relevance of the incisive papilla?

A

Key reference point for maxillary incisors

Mean distance between IP and incisor is ~12mm

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18
Q

What is the relevance of the retromolar pads?

A

Key reference point for posterior border of mandibular border
Denture should cover just over half of this

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19
Q

What is the relevance of the mylohyoid ridge?

A

Key reference point for lingual border of mandibular denture

20
Q

What is the relevance of the external oblique ridge?

A

Key reference point for buccal border of mandibular denture

21
Q

What is the relevance of the lingual gingival remnant?

A

Usually on newly edentulous patients

Indicates where to place teeth

22
Q

What is the relevance of the lingual frenum?

A

Key reference point

Move tongue side to side and forward during impressions

23
Q

What is the relevance of the genial tubercles?

A

Bony extentions

If denture rocks on this as jaw resorbs and ridge gets smaller may be traumatic

24
Q

What is the relevance of the insertion of mentalis?

A

May be uncomfortable for dentures to rock on as jaw resorbs and ridge gets smaller

25
Q

What is the relevance of the mental foramen?

A

Mental nerve may get trapped as the jaw resorbs and ridge gets smaller
Shooting pains

26
Q

How is informed consent gained?

A 
Explain who you are
Carry out initial assessment for notes
Diagnosis and prognosis
Explain no of visits and treatment 
Propose changes, benefits and risks
Ask if they understand and if any Qs
Clearly document
27
Q

What is the initial assessment?

A

Reason for attending
Med/social/dental history
Observations from oral examination

28
Q

What should be said on subsequent visits?

A

Explain today’s treatment
Ask if understood and any Qs
Reestablish objectives of treatment
Write up notes

29
Q

What are the ideal properties of impression materials?

A

Accuracy
Resolution
Dimensional stability
Rigid or elastic

30
Q

Why do we use alginate?

A

Simple, cheap, bonded to tray with adhesive, viscous during placement, elastic when set
HOWEVER, unstable if not cast up quickly

31
Q

What is the problem with stock trays?

A

Impression material may debond if large undercuts present

32
Q

How do you select your stock tray?

A

If the medium tray doesn’t fit, use a small or large

Use callipers to take inter hamular notch width of patients old dentures

33
Q

Why might a greenstick be used?

A

If the stock tray doesn’t fit properly, they can be adapted with this

34
Q

How do you use greenstick?

A

Very hot water softens this and it’s good to add to retromolar pads and palate

35
Q

Why and how do you apply adhesive to the tray?

A

To hold the material in the tray when removing

Apply copiously and leave for 5 mins before impression

36
Q

Where do you stand when taking an upper impression?

A

Behind right shoulder

Maxilla at your elbow

37
Q

Where do you stand when taking a lower impression?

A

In front

Mandible at your elbow

38
Q

What should be happening as the impression material is setting?

A

Apply traction to the cheeks

Get the patient to do functional movements with lips and cheeks

39
Q

How do you get finer detail on the impression?

A

Trim peripheral excess so 1-2mm short of functional sulcus depth
Relieve frenae

40
Q

What should you do if the alginate debonds?

A

Retake

41
Q

How do you mark your impression as an indication for the special trays?

A

Use an indelible pencil to mark 1-2mm inside the depth of the periphery

42
Q

Why might old good dentures be useful?

A

Provide an alginate for lab to cast up
Gives indication of how denture looks
Helps to select mold of teeth
Shows diastimer or crossover of teeth

43
Q

What instructions should you give to the lab?

A 
What material for second impression 
What tray is needed
Eg. Non perforated close fitting special tray for zinc oxide
Patient sticker
Date and signature
44
Q

How do you reduce the risk of cross infection?

A

Immerse the impressions in perform for 10 mins

Must be clearly documented

45
Q

How are the impressions made?

A

Stock tray for an alginate primary

Special tray for zinc oxide-eugenol secondary

growth, development, ageing, nutrition (40 decks)

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