Denture revision notes!

Question 1

Primary impression

Answer 1

prealse pour upper the upper and lower alginate impresions in 0:50 stone and provdie spical trays
upper - 3mm space non perforated llight cured acrylic resin trya with extra olral handles
lowers - close fitting light cured acrylic resin tray with extra oral handles

Question 2

master impressions

Answer 2

please pur up the scondary impressions in 100% dental stone
please provide wax record blocks on light cured bases

Question 3

Jaw reg

Answer 3

please mount the casts to the hreg providied
lease provide try in of wax teeth
mould and shade
detail in specal features

Question 4

Tooth trial

Answer 4

please wax up for finish in heat cured acrylic

Question 5

Denture hyg

Answer 5

please remove denture at night and soak in water
do not soak in boiling water as can distort denture
please clean over a bowel of water to prevent damage if dropped
clean denture after ever meal]may impinge on speech adn salivation
may get intial discomfort and pain
lceanwwith a soft bristle brush adn imild soap or denture cleaners not toothpaste
if yuing dental dhesvie then small amount and removed everyday
if denture becomes sore and can’t wear then wear 24hrs before appt to allow dentist to see sore aras
routine dental check ups 1year

Question 6

Denturec leaners

Answer 6

alkialine peroixe - sterodent - hardens soft linings
alkaline hypochloritres - milton -only use for 10mins
ezymes - proliners - expensive and bleaches acrylic
abrasive cleaners - denturecreme abrasive - smokers

Question 7

Attwood classification for boneresoprtion

Answer 7

class I - dentate - the area before xtraction of tooth from the socket
class II - post xla - tooth as just been removed from socket, bone deposition has started to form, edges sharpened
CLass III - broard avloear process - bone deposition continues and no reduction in height
Class IV - knife edge avleoar process - the alveolus shape starts to thicken into a knife edge appearance
Class V - flat ridge - resoprtption starts to occur creating a flat ridge
Class VI - submerge ridge - the alveolar bone starts to resprp into the basa lbone

Question 8

Primary impressions

Answer 8

supplies a negative impression of the tissues in the mouth
becomes a positive impression when cast in dental stone
uncercuts - alginate
no undercutes - use non elastic impression compound
chec for - perheral seal, voids, tears, air bubbbles, surface detaail, extension to post dam, flange depth adn sulucs captures, denture bearing areas

Question 9

MAster impressions

Answer 9

provedes a more accurate impression of the mouth
allows good functional depth adn width of sulcus to be captures with border modelling and muscle trimming to provide good perpiheral seal
occlusal stops - upper = canine and post dam, lower = retromolar pads and ridge of canine area

Question 10

Jaw reg

Answer 10

LIMBO
lips
incisal lvel
mid line
buccal corridor
occlusal plane
shade
moulde
special features
jaw red

Question 11

Tooth trial

Answer 11

check for extention retention, stability, aesthetics ,spreech, freeway space, denture bearing areas, present of post dam for retetnion, occlsuion, perpiher extentions

Question 12

Delivery

Answer 12

repeart same steps carried out at tooth trial
provide denture hyg insutrctions and review in 1week

Question 13

Why dentures fravture

Answer 13

trauma and impaction
thina crylic surface
work hardening on metal
bruxists pts
deep overbite
use of soft linings

Question 14

advatanges of acrylic

Answer 14

cheap
good aethetics
easy to use for technicina
can allow relines and rebases
ca`nall allowaddiotoin of teeth

Question 15

disadvatagnes of acrylic

Answer 15

allergy ot monomer
fracture resitance is decreased
denture whitening
can absorp wter easily
risk of caindial infecitons
impact strength reduced

Question 16

disadvatnages of immediate dentures

Answer 16

gross irregularties ofteeth make processing dififcult
requires good co-operation from pt as need review appts
alveolar bone resoprtion overtime
incrseased cost as need relines and rebases

Question 17

Review appts after imeedaite denture placement

Answer 17

24hrs - to check socket area and healing
1 week - to check the denture and healing status
1month - the socket will have healed check denture retention
3-6months potential for reline/rebase of denture
12 months - provide new denture for pt using the copy technique

Question 18

Reline

Answer 18

the addtion of a lining materia on the fitting surface of thre denture to fil the space between the denture and the new contoured tissue

Question 19

Rebase

Answer 19

the complete removal of the denture base and replaced with a new one

Question 20

uses for reline and rebases

Answer 20

only if the only issue is do with retetnion
pt happy to live without denture for period of time

Question 21

reline advantages

Answer 21

can be carried out at chairside
improves retetnion
can be permanent or temporary

Question 22

Rebases advatanges

Answer 22

does not alter the paaltal thickeness
allows the colour of denture bases to change if been bleached

Question 23

types of relines

Answer 23

temp - implant surgery, tissue conditioner
soft - used for cancer pts, bruxists, atrophic ridges
permanenent - acrylic - for immediate dentures, bad master imps, perpiheral seal

Question 24

replica dentures

Answer 24

replicated polished surface of the denture and can have some small changes e.g - occlulsion and adaptation

Question 25

why do copy dentures

Answer 25

if pt wants a second set - care home detoritation of the denture base immediate dentures requires retention is the only issue with the denture good occlusion and polished surface wear of occulsa surface

Question 26

contra indications for copy dentures

Answer 26

if there are more issues than just renttion - ovd, neutral zone, facial height pt has lost denture issue with polished surface of dentures

Question 27

Loose denture

Answer 27

polished surface - over or under extended occulsal surface - high occulsal plane, new jaw reg required impression surface - lack of adhesvice, mandibular atrophic rdige, flabby rdie, bony deposits, warping denture base

Question 28

neatural zone

Answer 28

the teeth on the denture base are plasced in an area to ensure maximum avoidance of muscles extra and intra orally

Question 29

complaints of dentures

Answer 29

ulcers dry mouth angular chelitis denture stomatitis denture induced hyperlpasia speech and speaking diificults pain on cheek and tongue pain on one side teeth meet too soon localised pain to premolar region lack of chewing, collapse in face poor mastication

Question 30

flappy ridge

Answer 30

where bone resoprtion and loss has occrued and replaced with fbirous tissue support weak and leads to insibility

Question 31

netural zone

Answer 31

the teeth ares et on the denture base to ensure maximum reduced interfence with the exntra and oral muscles the tongue and the lips and cheeks are at equilibrium with oe another

Question 32

over dentures

Answer 32

gains support by covering one or more teeth, the roots of teeth been treated or implans

Question 33

indcations for over dentures

Answer 33

pt transitioning from partial to complete dentures elederly pts with few remaiining teeth and mucosal born denture support attrtion/erosion/abrasion hypodontia cleft palatle

Question 34

not to sue overdentures when

Answer 34

poor oh caries risk high erio status poor

Question 35

retention

Answer 35

rethe resitance to vertical movment of the dentures away from the tissues

Question 36

what provides retetnion

Answer 36

muscular - the lips, tongue, cheeks, mom physical - adhesion/cohesion with salvia between denture and mucosa, surface thension, viscotiy

Question 37

how to acheive retetnion

Answer 37

large impression surface accruace of fit - thin acrylic on fitting surface denture fixatives sft linings post dam placmeent extended flanges and good border seal

Question 38

Support

Answer 38

the resitance of the denture to occulsal y directed loards towards th etissues acheived by soft tisses and the alvolar ridge manidble - buucal shelf, retromolar pads, alveolar mucosa maxialla - hard paalte, alevolar mucosa, zygomatic butress, resudal shelf

Question 39

Stability

Answer 39

resitance of denture to horizontal and rotational forces use a light denture to help with gravity ensure netural zone manintaed good occulusion upper muscles - buccinator, oris, levator anguli lower muscles - buccinator, superior constrictor, depressor labii iferorisis

Question 40

crietiera for a denture base

Answer 40

dimensianally stable radiopaque non irritant non toxic insoluble inexpensive long shlef light high softening temp good asethetics insoluble in water high elastic limit high thermal conductivity high abrasion resisitance high impact strength

Question 41

PMMA

Answer 41

advatanges - high softening temp, dimesinally stable. good aethetics disadvatnages - radiolucent, low theraml conductivity

Question 42

PMMA issues

Answer 42

poroosity - gaseous due to monomer boiling away, contraction insuffiecnt pressure granuiliaty - insufficent mixing ratio crazing - due to the differnce in coeffeicnts between the acrylic base and porcelain teeeth residual monomer - can casue irritation

Question 43

Mandible

Answer 43

suppport - buccal shelf, alevolar residular ridge limign - buccal and lingual sulcus and frenum, retromolar pads relief - genia ltubercles, tori, mylohyoid rdige

Question 44

Maxialla

Answer 44

support - ruguae, hard palate relief - plataine fovea, incisal papille, palatine fovea liminting - buccal and lingual frenum and sulucus, hamular notch

Question 45

Static occlusion

Answer 45

contact ebtween the teeth when the madnible is not moving

Question 46

Dynamic occlusion

Answer 46

contacts made betweenthe teeth when the mandible s moving

Question 47

ICP

Answer 47

occlusion the person makes with theri teeth when they bite down in mainmum intercuspation - centric occlsuion

Question 48

Kennedy classes

Answer 48

class 1 - unilateral free end class II - biltaeral feee end class III - bilateral bounded class IV - anterior bonunded

Question 49

craddock classes

Answer 49

claa 1 - tooth borne class ii - mucosa borne class III - tooth and mucosa borne

Question 50

Aims of dental surverying

Answer 50

to determine the path of insertion to determine the presence of guide planes to provide survery lines to check for preence of undercuts adn depth/position

Question 51

Guide planes

Answer 51

an extra area of retention close to the base and parallel to the path of insertion

Question 52

Clasps

Answer 52

0.155mm ot engage a 0.25mm undercut

Question 53

undercut guages

Answer 53

0.25mm - cocr 0.5mm - gold 0.75mm - wrought S.S

Question 54

Reciprocation

Answer 54

an opposing element to the clasp arm which prvents too much pressure of the classp on the tooth

Question 55

Guide planes provine

Answer 55

incrases stability and appearance reciprocation prevent of clasp deformation

Question 56

Aims of rests

Answer 56

to prevent overuption of unopposed teeth to allow even distrubution of occlulsal forces indirect retention reciprocation to determine the axis of rotation in free end saddles prevent movment of RPD towards mucosa

Question 57

issues with rest seats

Answer 57

can remove tooth tissue can expose dentine loss of occlusal stops when denture not worn

Question 58

Path of displacement

Answer 58

direction in which the denture dislodges during function and perpendicular to occlusal placne

Question 59

RPI

Answer 59

r = mesial rest p- distal proximal guiding plate I = i bar clasp the denture saddle compresses on the oral mucosa and rotates around the mesial rest. the distal plate and the i bar move down and disengage from the tooth to avoid torque it relieves stressts on the abutment tooth cclose to the free end saddle