Lecture 2: Complete Denture Insertion

Question 1

When is a lab remount completed?

Answer 1

After processing, before they are removed from the master casts to check for processing errors →

Sometimes teeth can move during processing. You’ll need to correct occlusion when mounted with a handpiece.

Question 2

What is the purpose of an insertion appointment?

Answer 2

It is to eliminate errors and correct any mistakes

Question 3

How long should a patient leave out old dentures prior to an insertion appointment?

Answer 3

For at least 24 hours prior to the appointment, so the tissues are at rest

Question 4

Prior to delivery, what must happen to the dentures?

Answer 4

They must be soaked in water for at least 72 hours

Question 5

What is pressure indicator paste and what is it used for?

Answer 5

It is a zinc oxide paste→

It is used to see if there are any premature contacts from the intaglio surface of the denture in the patient’s mouth

Question 6

What does the PIP paste help measure?

Answer 6

It helps to measure:
- Accuracy of tissue contact
- Detect improper adaptation

Question 7

Do you want to remove the islands of pink in the sea of white?

Answer 7

YES! ☺

Question 8

What form of PIP can be used in patients with xerostomia?

Answer 8

The PIP spray→
This helps to prevent the PIP from sticking to the mucosa

Question 9

What is the sequence for how to use PIP?

Answer 9

1. Dry the denture surface
2. Brush a thin layer of PIP onto the denture
3. Seat the denture with pressure in the first
   molar region
4. Remove immediately
5. Inspect and adjust bearing surfaces as
   necessary

Question 10

Phonetics, or a variation in speech, can be due to what?

Answer 10

• The thickness of the maxillary cast - Extra saliva in the mouth

Question 11

If there is not enough interocclusal space, will the teeth touch or not?

Answer 11

They will touch

Question 12

If there is too much interocclusal space, will the teeth touch or not?

Answer 12

They will NOT touch

Question 13

When evaluating the borders of a denture, what should you consider?

Answer 13

• Are borders and contours compatible with the available space in vestibules?
• Are borders relieved at frenal attachments?
• Are the dentures stable during speech and
  swallowing?

Question 14

What material can be used to adjust the border of a denture?

Answer 14

Disclosing wax

Question 15

What three things can cause gagging?

Answer 15

1. Excessively thick palate
2. The palatal extension is too long/ too short
3. There is a lack of tongue space

Question 16

What else can cause gagging?

Answer 16

• Loose dentures
• Poor occlusion
• Incorrect extension of contour
• Incorrect teeth positions
• Excessive OVD
• Psychogenic factors

Question 17

Denture wearer’s will have __________ efficient function of natural teeth in order to preserve supporting tissues.

Answer 17

20%

Question 18

Biting force of the natural dentition is _______ that of denture wearers

Answer 18

5X

Question 19

What is the desired occlusion for denture wearers?

Answer 19

Balanced occlusion→

• Want simultaneous contact of all posterior teeth in
  retruded mandibular position
• Want absence of contact for anterior teeth
• Want absence of deflective interferences in
  eccentric movements

Question 20

What can be common sources of occlusion errors?

Answer 20

▪ Resin shrinkage when processing
▪ Ill-fitting temporary record bases
▪ Changes in OVD on articulator
▪ Inaccurate max-mand record by dentist ▪ Incorrect arrangement of teeth
▪ Acrylic overheated when polished ▪ Water absorption

Question 21

What is one way to look for posterior flange contacts beyond the tooth contacts?

Answer 21

Look at the dentures when hand occluding them

Question 22

When do you perform a clinical remount?

Answer 22

After all adjustments have been made and polished

Question 23

What is the purpose of a clinical remount?

Answer 23

It is to make sure the occlusion is correct outside of the mouth.

• They are done before the final delivery of dentures
• You will need to deprogram the musculature to get
  into CR, then take interocclusal record and remount

Question 24

What are the advantages of a clinical remount?

Answer 24

▪ Absence of saliva (more accurate marks with articulating paper)
▪ Reduces patient participation (dentist can see better, grinding done away from patient)
▪ Has a stable working foundation

Question 25

What is the alternative to a clinical remount?

Answer 25

An intraoral occlusal adjustment

Question 26

Are intraoral occlusal adjustments accurate?

Answer 26

Not as accurate as a clinical remount→

• The resiliency of the tissues allows dentures to
  move
• There can be misleading articulating paper
  markings
• Saliva on teeth interferes with paper markings
• Requires repeated patient cooperation

Question 27

What proper instructions should you give your patients about their new dentures?

Answer 27

1. They will have a strange feeling of fullness in lips and cheeks for a few days
2. Mandibular dentures are more difficult to use than the maxillary dentures
3. Teach them how to clean their dentures
4. Expect an increase in flow of saliva for a few
   days
5. Speaking will improve with practice
6. Learning how to chew normally will take about
   2 months
7. Teach patient how to position the tip of their
   tongue to the lingual surfaces of their
   mandibular anterior teeth
8. Remove dentures at night and give tissues time
   to breathe.

** use denture adhesive powder as needed **

Question 28

Control of the dentures is accomplished by manipulation with the ________ , _______ ,

Answer 28

Lips, tongue, cheeks

Question 29

What is the best way to take care of dentures?

Answer 29

• Over a sink/ with a washcloth
• Soaking in a container
• Remove any adhesive

Question 30

What is the best way to take care of the mouth?

Answer 30

• Give gingival massages
• Brush tongue with a soft toothbrush

Question 31

What is this an image of?

Answer 31

Lab remount

Question 32

What is this an image of?

Answer 32

Clinical remount