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_Complete Removable Pros > 2/19: Exam, Diagnosis and Treatment Planning for Edentulous Patients > Flashcards

2/19: Exam, Diagnosis and Treatment Planning for Edentulous Patients Flashcards

1
Q

What are the 3 types of denture occlusion arrangements?

A
  1. Balanced
  2. Non balanced
  3. Lingualized (can be used with 1,2)
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2
Q

What is balanced occlusion?

A

The bilateral, simultaneous, anterior and posterior occlusal contact of teeth in centric and eccentric positions

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3
Q

What is an indiciation of anatomic, balanced occlusion?

A

Young, healthy alveolar ridges
Good neuromuscular control

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4
Q

When you set balance occlusion, what is the only thing you cant control?

A

Incisal guidance

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5
Q

What is condylar guidance determined by?

A

Patient’s anatomy

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6
Q

What are monoplane occlusion indications?

A

Excessive inter-rdge distance
Skeletal class II, class III and crossbites
Successful previous F/F were monoplane
Limited oral dexterity
Severely resorbed ridges

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7
Q

What are the types of patient psychological classifications?

A

Philosophical
Exacting/critical
Hysterical
Indifferent

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8
Q

What makes up the philosophical patient?

A
  • rational, calm, sensible, confident
  • “you make them, ill wear them”
  • majority of the patients
  • prognosis good
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9
Q

What makes up the exacting/critical patient?

A
  • methodical, precise
  • somewhat difficult to please
  • may try to dictate treatment
  • may demand a written gurantee
  • should make a special effort to be neat and organized when treating
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10
Q

What makes up a hysterical patient?

A
  • in poor health
  • neglected oral conditions
  • may blame dentist for poor oral condition
  • “bet you can’t make teeth that i can wear”
  • dont make promises
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11
Q

What makes up the indifferent patient?

A
  • unconcerned with appearance and chewing
  • often persuaded by relatives to seek treatment
  • diet often poor
  • prognosis poor unless education successful
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12
Q

What are the main 3 things you should do with a edentulous patient?

A
  1. Make impressions of the mouth as the patient presents
  2. Measure existing VDO
  3. Record tooth shade
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13
Q

When taking the dental history, what should you record?

A
  • chief concerns or why pnt is in the chair
  • history of previous treatment
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14
Q

When taking the medical history, what should you record?

A
  • overall health and current medications
  • interactions causing xerostomia
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15
Q

What type of radiographic exam is preferred?

A

Panoramic

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16
Q

What should you evaluate in a radiographic exam on an edentulous patient?

A

pathosis: root tips, foreign bodies, impacted teeth
Mucosal thickness, foramen location

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17
Q

Describe the classes of occlusion from ideal to unfavorable

A

Ideal = Class I
Class II
unfavorable = class III

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18
Q

What is the ideal interarch space?

A

Space accomodates teeth and bases with esthetic result

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19
Q

What is the unfavorable interarch space?

A

Too little space or too much space (torque lever is applied to denture bases)

20
Q

What is the ideal ridge form?

A

Square to gently rounded

21
Q

What is the unfavorable ridge form?

A

Tall, thin, undercut

22
Q

What is the ideal mm of tuberosities?

A

ideal: 5-6mm
minimum: 4mm

23
Q

What happens if you have unilateral or bilateral undercuts?

A

Unilateral - may be ok
Bilalteral - may need surgical correction

24
Q

What happens if you have sharp area of ridge?

A

Surgery needed

25
Q

What is a palatal torus?

A

Bony enlargement at midline of hard palate

26
Q

What is the frequency of palatal torus?

A

20-25% of population
More prevalent in women
Maximum size in 3rd or 4th decade

27
Q

When should a palatal torus be removed?

A

Large and fills palatal vault
Is undercut
Encroaches on vibrating line
Pnt is concerned that its cancer

28
Q

What is mandibular tori?

A

Dense cortical bone covered by a very thin layer of mucous membrane

29
Q

What is mandibular tori susceptible to?

A

Irritation from denture base

30
Q

What is the best treatment for mandibular tori?

A

Surgical removal

31
Q

What is the ideal depth of the palatal vault?

A

Medium depth with well-formed rugae

32
Q

What happens to a flat palatal vault?

A

Poor resistance to horizontal movement of denture

33
Q

What happens to a high, narrow, deep palatal vault?

A

Rapid break of peripheral seal and poor retention

34
Q

What is an ideal border attachment?

A

Muscle/frenum attachments are 10mm or more from crest of ridge

35
Q

What is an unfavorable border attachment?

A

Attachments near crest of ridge and may interfere with peripheral seal

36
Q

What are major impact areas of the tongue and complete dentures?

A

Border seal
Tooth placement
Speech

37
Q

What is normal tongue position?

A

Fills floor of mouth
Lateral borders lie on post. alveolar ridge
Apex approximates ant. alveolar ridge

38
Q

25% of edentulous patients have…

A

Retruded tongue
- border seal is absent
- stabilizing influence of tongue is absent
- retention/function of mandib. CD difficult

39
Q

What does an enlarged tongue cause?

A

Constant dislodging force on mandibular denture
- adaptation to denture may require MONTHS of dedicated effort

40
Q

What plays an important role in denture retention?

A

Saliva

41
Q

What are some things we should know about a pts denture history?

A

Years edentulous?
Previous dentures/current dentures
Successful
Expectation? Attainable?
Multiple sets of dentures made in a short time - not a good sign

42
Q

What should you do with existing dentures?

A

Evaluate and make impressions

43
Q

What is the prosthodontic diagnostic index?

A

A tool that every clinican can use to communicate to colleagues and patients the challenges each patient present with his or her unique dental condition

44
Q

What are prosthodontic diagnostic index checklist items?

A
  1. Bone height mandibular
  2. Residual ridge morphology of maxilla
  3. Muscle attachments in mandible
  4. Maxillomandibular relationship
  5. Conditions requiring pre-prosthetic surgery
  6. Limited inter-arch space
  7. Tongue anatomy
  8. Modifiers
45
Q

Describe the PDI classifications for compelte edentulism

A

Class I — straightforward.
Class II – denture-supporting anatomy degraded.
Class III - anatomy degraded; surgical revision
needed; additional factors present.
Class IV – most debilitated edentulous condition

_Complete Removable Pros (18 decks)

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