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_complete removable pros > 1 - 3/4: The Trial Placement > Flashcards

1 - 3/4: The Trial Placement Flashcards

1
Q

What relationship must the denture function in?

A

Harmonious relationship between the mechanical and the biologic

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2
Q

What stage is a critical phase of complete denture care when evaluating the relationship between mechanical and biologic?

A

The wax trial denture stage

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3
Q

What is a significant appointment for successful complete denture treatment?

A

Trial placement

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4
Q

What attitude should a dentist approach the trial placement appointment?

A

Errors may exist in all areas

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5
Q

The steps that convert dentures to acrylic resin may do what?

A

Limit the possibility of further corrections

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6
Q

What is the trial denture?

A

A preliminary arrangement of denture teeth that has been prepared for placement into the patient’s mouth to evaluate esthetics and maxillomandibular relationships

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7
Q

What is trial placement?

A

process of placing a trial denture into the patient’s mouth for evaluation

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8
Q

What are waxs occlusion rims?

A

Crude approximations of positions of artificial teeth

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9
Q

What are contours?

A

Arbitrary

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10
Q

How are shapes and size of teeth selected?

A

Based on anatomic averages (are estimates)

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11
Q

What is important to patient and dentist?

A

Trial denture evaluation

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12
Q

What question does the trial denture evaluation help answer?

A

“Do we have the correct teeth in the correct locations?”

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13
Q

What might be necessary during a clinical evaluation?

A

A checklist for the steps

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14
Q

What should you use inside the trial bases?

A

Denture adhesive powder

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15
Q

What should you clinically evaluate in trial dentures?

A
  • occlusal vertical dimension
  • centric occlusion
  • midline, vertical and horizontal overlap
  • occlusal plane
  • buccal corridor
  • phonetics
  • overall esthetics
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16
Q

How should you assess occlusal vertical dimension?

A
  • numerous methods suggested
  • all methods are unscientific
  • should assess using a combination of methods for more accuracy
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17
Q

What is the OVD assessment in physiologic rest position?

A

Normally 2-4mm space between teeth when mandible is in physiologic rest position

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18
Q

What is the OVD assessment in stretch-relax method?

A
  • dot on nose and chin. Open wide and hold for 20 seconds
  • slowly close until lips first touch. Measure distance between dots
  • after 10-15 more seconds, close until teeth touch. Measure dots again
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19
Q

What are the difference in measurements in OVD during the stretch-relax method?

A

“interocclusal distance”
2-4mm average

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20
Q

What is the swallow relax method in OVD assessment?

A
  • Pnt is asked to swallow then relax. Teeth contact while swallowing, then separate upon relaxing
    Note: teeth should not be in contact at physiologic rest position
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21
Q

How to determine the closest speaking space?

A
  • rapid speech of sibilant sounds “sixty six, san francisco, kansas city chiefs, salt lake city, cincinnati”
  • should be no contact of max. and mandib. teeth when speaking
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22
Q

How should you perform the OVD assessment?

A

“Just look at it”

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23
Q

What should you verify to determine centric occlusion?

A

Must verify that the casts are mounted correctly on the articulator

24
Q

How should you verify centric relation mounting?

A
  • make new interocclusal record in mouth and check it on the articulator
  • remember: either record base can move on soft tissue and the resulting occlusion may seem acceptable when its not
  • REMOUNT CAST IF NEEDED
25
Q

How should you check centric position contacts?

A
  • with articulating paper
  • stabilize the mandibular denture
  • new centric relation record
  • minimal amount of recording medium
26
Q

What does accurate mounting entail?

A
  • teeth interdigitate perfectly (no space around the cusps)
  • condylar ball should contact fossae wall
  • if either criteria not met, remake record
27
Q

What is used to confirm inaccurate mounting?

A
  • second record
  • mandibular cast removed from mounting ring
  • mounting plaster ground thinner
  • cast remounted, using the new record
28
Q

What is the level of occlusal plane in the anterior determined by?

A

Esthetics/phonetics

29
Q

How much of the incisor teeth are visible when the upper lip is resting?

A

1-2mm

30
Q

What is displayed when smiling?

A

Most of teeth length, but minimal amount of denture base
“The white things look better than the pink stuff”

31
Q

What contact must the maxillary incisors have?

A

Positive contact with lower lip when fricative sounds “F, V, “very funny”, are made

32
Q

What should be visible at the lower lip?

A

Mandibular incisors, slightly

33
Q

What should the occlusal plane be like in the posterior?

A
  • mandibular molars at height 2/3 up RM pads
  • plane should be 2-3mm below dorsal surface of resting tongue
  • plane should parallel the two residual ridges and (usually) bisects the space between the ridges
34
Q

What are the maxillary posterior teeth parallel to?

A

Ala-tragus plane (camper’s plane)
- should not appear to descend posteriorly

35
Q

What are phonetics?

A

-easier to assess (Teeth have replaced bulky rims)
- crowded tongue space can adversely affect phonetics

36
Q

How do specific sounds affect phonetics?

A

Sibilant sounds - “S”, “CH” –OVD
Fricative sounds - “F”, “V” – incisors hit wet/dry line of lip

37
Q

What are fricative sounds?

A

F, V, ‘fifty five’
Ask patient to count from 50-60
Maxillary incisal edges should just touch the posterior one third of the lower lip

38
Q

What are the five components of speech?

A

Respiration - lungs
Phonation - vocal cords
Resonance - pharynx, mouth, nasal cavity
Articulation
Neurologic integration - a learned activity

39
Q

What converts sound into meaningful speech?

A

Mandible, tongue, lips, soft and hard palates, alveolar ridge and teeth convert sound

40
Q

What happens if teeth touch when speaking “S” sounds?

A

OVD is too far open

41
Q

What happens if the speaking space is excessive?

A

More than approx. 3mm - OVD likely overclosed

42
Q

What does it mean if a pnt whistles or lisps on sibilant sounds?

A

Whistles - contour of anterior palate may be too narrow
Lisps - anterior palate may be too braod

43
Q

What should the incisors approach in sibilant sounds?

A

End to end relationship

44
Q

What is lisping?

A
  • non uniform overjet of the anterior teeth
  • diastemas between teeth
  • palatal contours
  • diamond shaped openings between incisors
45
Q

What should the incisal plane parallel?

A

Interpupillary line

46
Q

What should you evaluate when assessing esthetics/appearance?

A

Various harmonies of tooth size, form, position, arrangement, shade

47
Q

Where should posterior teeth be centered?

A

Mesiolaterally centered over denture-bearing area

48
Q

What is the checklist when evaluating how dentures fit on a patient?

A
  • centric record verified with recording medium
  • vertical dimension verified:
    a. 2-3mm between lip closure and teeth touching
    b. phonetics tests “50s-60s” or “mississippi” - space between rims
    c. lips appear and feel unstrained
  • tooth form, arrangement and shade verified
  • phonetics verified “S”, “F”, and “M” sounds
49
Q

What does a protrusive record record?

A

Condylar inclinations of pnt

50
Q

What is a protrusive record used to adjust?

A

Articulator condylar angles
- recird is made approx. 6mm protruded

51
Q

What schemes should a protrusive record be used for?

A

Balanced occlusion schemes only
- is not needed for non-balanced schemes

52
Q

What is VERY IMPORTANT?

A

Patient approval
- pt, family, friends
- look in a large mirror, alone for a few minutes

53
Q

What do denture base contours affect?

A

Phonetics, comfort, and retention
Should not be slightly convex in shape

54
Q

What do denture base contours ensure?

A

That the denture base is not unduly thick or thin
- excess bulk impair comfort (feel between index finger and thumb)
- base that is too thin will be weakened (should not be able to see through

55
Q

What should you request in a labaratory prescription?

A
  • processing, finishing and polishing
  • lab remount of the dentures
  • adjustment of occlusion to compensate for processing changes

_complete removable pros (18 decks)

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