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BDS - Module 9 > 6. Removable Prosthetics > Flashcards

6. Removable Prosthetics Flashcards

(112 cards)

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1
Q

What are the 5 components of history taking before construction of new dentures?

A
  1. Complaints
  2. Denture history
  3. Dental history
  4. Medical history
  5. Social history
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2
Q

What are 5 medical history points that can impact denture wearing?

A

Neuromuscular problems
Tremors
Strokes
Dementia
Dry mouth

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3
Q

What are the areas that should be assessed when assessing dentures?

A

Extra Oral - TMJ, asymmetry, facial fullness
Intra Oral - soft tissues, hard tissues, occlusion, aesthetics

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4
Q

What are the 6 clinical stages of partial denture construction?

A
  1. First impressions
  2. Occlusion
  3. Second impressions
  4. Try in
  5. Fit
  6. Review
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5
Q

What are the 6 steps of designing a partial denture?

A
  1. Note: teeth being replaced
  2. Chose: saddles
  3. Chose: connector
  4. Chose: support
  5. Chose: retention
  6. Select: materials
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6
Q

What is a denture saddle?

A

Part of denture that holds artificial teeth

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7
Q

What is a connector?

A

The component that connects saddles together

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8
Q

What is a denture support?

A

The area of a denture that resists vertical load via teeth or bone

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9
Q

What is denture retention?

A

Resistance of vertical movement away from tissues via clasps

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10
Q

What is a bounded saddle?

A

When there is teeth on either side of a saddle

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11
Q

What is a free end saddle?

A

When there is no teeth distal to a saddle

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12
Q

What are the two types of saddles?

A

Bounded
Free end

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13
Q

What are 5 examples of lower connectors?

A

Lingual plate
Dental bar (requires 9mm crown height to accommodate 5mm bar)
Lingual bar (requires 7mm lingual sulcus as bar is 3.5mm plus clearance)
Split lingual plate
Swing lock denture

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14
Q

What are the 3 upper connectors for PMMA dentures?

A

Full coverage
Spoon
T denture

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15
Q

What are the 5 connectors for CoCr dentures?

A

Full coverage
Anterior palatal bar
Horseshoe
Mid palatal bar
Posterior palatal bar

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16
Q

What are the 2 types of support for dentures?

A

Teeth
Mucoperiosteum

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17
Q

How is retention achieved in dentures?

A

Saliva and suction
Muscle activity
Clasps

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18
Q

List 3 clasp types?

A

Occlusal approaching
Gingival approching
Ring

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19
Q

When would you use an occlusal approaching clasp?

A

If diagonal survey line

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20
Q

When would you use a gingival approaching clasp?

A

If high or low survey line

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21
Q

What are 4 materials used for clasps?

A

CoCr
Stainless steel
Gold
Copolymer

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22
Q

CoCr Clasps can engage undercuts up to a depth of:

A

0.25mm

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23
Q

Stainless steel clasps can engage undercuts to a depth of:

A

0.5mm

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24
Q

Gold clasps can engage undercuts up to a depth of:

A

0.75mm

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25
Copolymers can engage undercuts of:
Any depth
26
What is the equation for recording occlusion?
FWS = RVD - OVD
27
FWS means? FWS should be?
Freeway space 2-4mm
28
RVD meaning:
Rest vertical dimension
29
OVD meaning:
Occlusal vertical dimension
30
What is an index tooth?
A tooth that is in occlusion reproducibly
31
How is occlusion recorded if there is SUFFICIENT index teeth?
In ICP using bite reg paste
32
How is occlusion recorded if INSUFFICIENT index teeth?
ICP if bite reproducible RCP if not
33
How do you get a patient into RCP?
Tongue to back of palate and guide closed
34
What are the 2 ways you can make new full dentures?
Conventional technique - start from scratch Replica technique - replicate previous denture
35
What are the 6 stages of conventional full denture construction?
1. First imps 2. 2nd Imps 3. Occlusion 4. Try in 5. Fit 6. Review
36
Recording Occlusion for F/F dentures: 1. What are the 7 steps to recording with the upper block? 2. What are the 2 steps to recording with the lower block?
1. Check stability, extension and retention Check lip support Check incisal level Check anterior plane with interpapillary line Check posterior plane with ala tragus line Check posterior border Mark centre line 2. Ensure even contacts with upper block Ensure correct OVD with sufficent FWS
37
What are the 5 clinical stages for replica full denture construction?
1. First imps via replica technique outwith the mouth 2. Second imps and occlusion 3. Try in 4. Fit 5. Review
38
How do you record occlusion for replica dentures if: 1. No changes required? 2. Change required?
1. Bite reg paste 2. Add/remove wax
39
What is the aim and use of first impressions?
To record all anatomical landmarks to construct models to allow: Tx planning Special tray construction Occlusion examination Design of denture
40
What should 1st imps record?
Natural teeth and denture bearing area
41
What are the 3 checks following first impressions?
Are all edentulous areas included Are sulci included? Are all teeth included?
42
List 4 ways to improve 1st impressions:
Modify tray Use more or less material Border mould Pre pack palate/tuberosity
43
What is the aim and use of second impressions?
Aim: to record the tissues of the denture bearing area, the teeth and the sulci in a special made tray Used to: construct a cast which represents the fitting surface of the finished denture
44
When should 2nd imps be done?
After denture is designed and any tooth modifications are completed
45
What is the requirement of spacing required for special trays if alginate is the impression material?
3mm
46
What materials are special trays made of?
PMMA shellac
47
What checks should you do at TRY IN stage?
I/O: Wax extension Rest seats Occlusion Tooth position Tooth aesthetics E/O: Lip support Incisal level Occlusal planes Speech Aesthetics
48
What checks should you do at the FIT stage?
I/O: Comfort Retention Stability Extensions Occlusion E/O: Aesthetics Speech
49
What should you check at a REVIEW stage?
I/O Soft tissues E/O Function Aesthetics Soeech
50
List the 5 denture care instructions that should be given to all denture wearers:
1. Rinse mouth after every meal 2. Remove denture every night 3. Brush denture with soap and soft brush 4. Store in cold water overnight 5. Continue to brush and clean natural teeth
51
Denture hyperplasia signs and management:
Gum blanching Management: denture ease
52
Denture stomatitis signs and management:
Redness and sloughing of denture bearing area Management: Denture hygiene Mouthwash Antifungals
53
Kennedy Classification I
Bilateral free end saddle
54
Kennedy Class II
Unilateral free end saddle
55
Kennedy class III
Single bounded saddle that DOES NOT cross midline
56
Kennedy class IV
Single bounded saddle crossing the midline
57
What are the 2 steps of surveying casts?
1. Determine POI with surveyed and analysing rod 2. Draw survey lines with graphite marker to determine undercuts
58
What is a POI?
Path of insertion The path followed by a P/P denture on insertion
59
What is an undercut?
Portion of tooth between the survey line and gingiva
60
What is the RPI system?
A specific design for abutment teeth adjacent to free end saddles that aims to avoid torque on abutment teeth
61
What does RPI stand for?
R = medial rest P = distal plate I = I bar
62
List 3 metals used for clasps
CoCr NiCr Stainless Steel
63
Components of CoCr
Cobalt Chromium Nickel
64
Components of NiCr
Nickel Cobalt Chromium
65
Components of stainless steel
Steel Chromium Nickel
66
List the 2 denture base materials:
PMMA CoCr
67
What is PMMA
Polymethyl Methacrylate
68
What is CoCr and what is it composed of?
Cobalt chromium Cobalt Chromium Molybdenum Nickel
69
What are the 2 materials used for artificial teeth?
Acrylic Porcelain
70
What are the 4 stages of IR denture construction?
1. First imps 2. Second imps and occlusion 3. Try in 4. XLA and fit
71
What are the 3 post XLA and fit instructions that should be given?
Keep denture in for 24 hours After 24 hours: Salty mouthwash Begin Denture cleaning regime
72
When should IR dentures be reviewed?
1 day 1 week 1 month Then, 6 month recall for either reline or new dentures now full healing occurred
73
What is the aim of a denture reline?
To add new base material to the fit surface of an ill fitting denture to fill the gap between the denture and mucosa
74
What are the 3 types of reline and the materials for each?
1. Temporary 2. Soft: acrylics or silicones 3. Permanent: hard acrylic
75
What is the aim of a rebase?
To replace the entire denture base material of an existing denture
76
What are the 4 stages of rebase of a denture?
1. Removal of undercuts from the fit surface of denture 2. Light body imp taken of fit surface in the mouth 3. Send to lab 4. Fit of denture
77
How is a denture repaired if pieces can be put back together?
In the lab or chairside
78
How is a denture repaired if part of the denture has been lost?
Take impressions of denture in the mouth and send to lab
79
List 2 chairside methods of denture repair:
Self cure acrylic Cyanoacrylate glue
80
What are the two methods of denture additions?
Tooth additions Clasp additions
81
What are the 5 steps to add a tooth to an existing denture?
1. Take impression with denture in place 2. Send to lab 3. New tooth added to denture 4. XLA of natural tooth 5. Fit of denture
82
What are the 3 steps of clasp additions to an existing denture?
1. Take impression with denture in place 2. Send to lab 3. Fit denture
83
What are 3 advantages of over dentures?
Can correct occlusion Preserves ridge Maintains proprioception
84
List 3 disadvantages of overdentures:
Good OH required Increases caries and perio risk Potential for more traumatic extractions
85
What 2 things must be detailed in a lab card for 2nd imp and occlusion stage:
Special tray: material, spacer required, handle Record block: material
86
What must you include on lab card for try in stage?
Tooth: shade, mould
87
What should you include in lab prescription at fit stage?
Denture details: post dam, relief areas, linings
88
List 6 common mucosal issues associated with dentures:
Ulcers Denture stomatitis Angular chelitis Denture hyperplasia Flabby ridges Allergy
89
Ulcers signs and management in dentures wearing patients:
Pain, yellow/white/red lesion, redness surrounding Identify, ease, review
90
Denture Stomatitis signs and management
Redness, swelling Denture hygiene, chlorohexidine mouthwash, antifungals
91
Angular chelitis signs and management
Sores at corners of mouth Miconazole
92
Denture hyperplasia signs and management
Enlargement of tissues Ease denture or make new one, tissue conditioner
93
Flabby ridges signs and management
Bone resorption that is replaced with fibrous tissue due to trauma New dentures
94
Denture allergy signs and management
Redness under denture bearing area Change denture base material
95
List 5 denture design ideas for difficult cases:
Modify survey lines Combine fixed and removable pros Use precision attachments Two part dentures Swing lock dentures
96
What sort of connector would be used for lingual tilted teeth?
Buccal connector
97
List 5 ideas for dentures for bruxists:
Metal backing on teeth CoCr or high impact acrylic Metal occlusal surfaces Cross linked teeth Acrylic post dam
98
How would you manage problems with extension at try in:
Overextended - trim wax Under extended- mark extension on casts
99
How would you manage problems with adaptation at try in?
Take new impression
100
How would you manage problems with CoCr framework at try in?
Take new inpression
101
How would you manage too little FWS at try in stage?
Add wax to correct FWS Re-record occlusion Retry appointment
102
How would you manage too much FWS at try in stage?
Remove occlusion teeth and replace with wax Record occlusion Retry appointment
103
How do you manage pain at an ease appointment?
Ease denture
104
How would you manage movement of denture at ease appointment?
Assess extensions and oral dryness Reline denture
105
How would you manage jaw pain at an ease appointment?
Check the FWS
106
How would you manage occlusal complaints at an ease appointment?
Check there is no sliding Check occlusion with articulating paper Grind down any high areas
107
What should be checked at and IR denture ease appintment and when should this be?
Sockets, any signs of trauma, if pt can insert and remove denture Should be 24 hours after XLA
108
When should an IR denture be reviewed?
After 1, 3 and 6 months
109
When is fully healing complete after XLA and fit of an IR Denture?
6 months post XLA
110
What are the options after 6 months of an IR denture?
Reline New denture
111
When should Full Dentures be reviewed?
Annually
112
When should partial dentures be reviewed?
As per oral health needs

BDS - Module 9 (16 decks)

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