COMPLETE DENTURES - CLINICAL PROBLEMS AND SOLUTIONS

Question 1

What is retching?

Answer 1

Making the sound of vomiting (occurs when patients feel like they cant wear denture because they gag (need to double check with patients who say this aren’t just saying it)

Question 2

What are the 2 materials used for special trays?

Answer 2

1.Alginate
2.Silicone

Question 3

What spaced tray would you use for alginates and elastomers (silicones)

Answer 3

If minimal undercuts will prescribe a trash for elastomer 1.5mm
If big bony undercuts will prescribe - 3mm acrylic for alginates

Question 4

Do you use pink stick or green stick and why?

Answer 4

Pink stick is better because it softens quicker and you will never burn fingers with it, but as it softens quicker you should handle it more carefully

Question 5

What is the retromolar pad/papillae?

Answer 5

It’s similar to what tuberosity is in the upper but its in the lower

Question 6

What is muscle trimming?

Answer 6

A term for border moulding

Question 7

Which things should you check when you receive a special tray?

Answer 7

Your should check if its the right fit, and correct design. And assure its the correct extension to the primary impression

Question 8

How would you record the full functional width and depth of the sulcus?

Answer 8

Using pink or green stick

Question 9

Why are stops added to the impressions?

Answer 9

In order to pick out the contours and thickness of mucosa. To help with a nice seal for the denture (dont get lab to do them with acrylic. Use pink stick in order to prevent any penetration to the impression)

Question 10

What should you ask for when you order record rims?

Answer 10

Ask for a post dam on record rims in order for the record rims to be fully seated

Question 11

What does an Alma Gauge do?

Answer 11

Measures the height of the denture and proclamation of teeth

Question 12

What is Dr natresses tip about alma gauge?

Answer 12

Last thing after special tray impressions is to get the alma gauge and measure the previous denture and give these dimension measurements on the slip to get them to make it at those measurements. Can you make me an upper record rim on these dimensions ( only if all dentures are pretty close dimensions, doesn’t work otherwise.

Question 13

Should the naso-labial angle be the first thing you trim on your record and what angle should it be?

Answer 13

Yes - because that will give the correct proclination of the incisors
90 - 110 degree angle

Question 14

What should you do after establishing naso-labial angle?

Answer 14

Record the occlusal height - Which is how much of the teeth we are allowing to be seen.

Question 15

What things are important when measuring occlusal height after naso-labial angle?

Answer 15

The height and rim should be parallel to the interpapillary line. In older people the level which of teeth should be at the resting lip for 70 years and above.
The amount of tooth shown depends on the age of the patient, younger patients we may show more teeth.

Question 16

What is the 3rd plane we should get right when doing record rims?

Answer 16

Anterior posterior plane (Ala-tragal plane)

Question 17

What level should the lower denture be?

Answer 17

At the level of the corner of the mouth dictates level of occlusal plane - tongue should sit on top beautifully

Question 18

What helps with retention and stability in lower?

Answer 18

The tongue and the buccinator. The denture is sat in neutral zone, minimal conflict with buccinator and tongue

Question 19

Which position should the teeth be in in the upper arch?

Answer 19

In front of the ridge for the buccal cusps and on the ridge for the palatal cusps so they don’t break off with force

Question 20

Where do you position the teeth on the lower denture?

Answer 20

Always on the ridge

Question 21

What are you trying to achieve when you record an occlusion in a complete denture?

Answer 21

Bilateral simultaneous contact in the retruded contact position (RCP) at the correct occlusal vertical dimension (OVD)

Question 22

How do you get a patient to relax their face?

Answer 22

Ask them to lick there lips and swallow

Question 23

What do you use to measure height?

Answer 23

Willis gauge

Question 24

How do you work out occlusal vertical height?

Answer 24

You take a few milllimitres off the measurement done using a Willis gauge measurement of resting face

Question 25

Do we reduce freeway space for older patients?

Answer 25

Yes with some up to 4-5mm

Question 26

When would a patients anterior be in contact before the posteriors are in contact?

Answer 26

This will occur if the heels of the rim were in contact when recording the occlusion

Question 27

What is the black corridor? And how is it done?

Answer 27

It’s a black triangle in the corner of the mouth when you smile
It is done by putting the canines at the right angle allowing space behind (lateral borders of nose)
Inner canthus of eye, lateral border of nose to the rim use a dental floss for inside of eye to border of nose to the rim which will allow us to know where it should go.

Question 28

What are the different methods used to increase aesthetics for patients?

Answer 28

Buccal corridors (black triangles in corner of mouth)
Smile Line level of incisors and canines to follow the natural contour of the lower lip
Tissue height and papillae length - The papillae height should be different for each teeth, e.g canines papilla height should be slightly lower than that of lateral
You can get lab to put that in to give a really good appearance.

Question 29

What is the purpose of a coy denture?

Answer 29

A denture that is a duplication with or without modifications of a patients existing denture

Question 30

How do you record occlusion of copy denture?

Answer 30

1st record impression of upper
2nd record impression of lower
Next visit
3rd record impression of occlusion

Question 31

Why do you sometimes do copy dentures?

Answer 31

The patients have been wearing these dentures for any years and they find them comfortable but now they have started to go loose. So you will only record a new fitting surface and new teeth