mouth prepartion and master cast Flashcards
(39 cards)
phase 1 pt tx
relief of?
collection of?
what is cast is made? used for?
develop what plan?
what to do with pt?
occlusion?
– Relief of pain & infection= priority
– Collection of diagnostic data= Diagnostic cast, Diagnostic mounting
– Develop treatment plan= Design RPD
– Patient education & motivation
– Occlusal equilibration
phase 2 pt tx
removal of?
extraction of?
surgery?
perio? plaque?
interim prothesis? why?
occlusion?
– Removal of deep caries, temporary restorations
– Extraction of non-retainable teeth
– Preprosthetic surgery: tuberosity reduction, etc.
– Periodontal treatment, Plaque control
– Interim prosthesis: function, esthetics
– Occlusal equilibration, may need changes after extractions
phase 3 pt care
endo?
restorative?
occlusion?
– Definitive endodontic treatment
– Definitive restorative treatment: Surveyed crowns, if needed and Fixed partial dentures, if appropriate
– Occlusal plane correction
phase 4 of pt tx
– Construction RPD
phase 5 tx
– Post-insertion care
– Periodic recall
– Continued plaque control
goals of mouth preparation
pain/infection?
caries?
extractions? surgery?
perio/plaque?
occlusion?
endo?
definitive restorations?
enameloplasty?
• Relief of pain & infection
• Caries removal
• Extractions, Preposthetic surgery
• Periodontal treatment, plaque control
• Occlusal equilibration
• Endodontics
• Definitive Restorative Treatment:– Amalgams, composites– FPDs, crowns, surveyed crowns
• Occlusal plane correction
• Enameloplasty for RPD GP
Diagnostic Casts roles
• Preliminary design of RPD
• Identify tooth modification areas
performing tooth mods?
– according to RPD diagnostic cast design
– QA Worksheet
possible enameloplasty in order
- develop guide planes
- enlarge embrasure for minor connectors
- lower HOC
- create undercuts if needed
- rest seats
developing guide planes
proximal
ML
L
– Proximal: adjacent to edentulous areas
– ML: stress-release clasps ML minor connector
– Lingual: reciprocal clasp
considerations of lowering the HOC
– Proximal 2/3 Circumferential retentive clasp
– Reciprocal clasp
– Lingual Guide Plate
confirming mouth preparations
• Alginate Impression(s)/Snapstone Cast(s)
• Survey interim casts
• Confirm that preparations are parallel to path of insertion in the following sequence:
1. Prepare guiding planes
2. Enlarge embrasures for minor connectors
3. Reposition the survey line to reduce interferences to framework placement and enable most ideal clasp placement
• Confirm that survey line lowered enough
Undercut Preparation
• Used when slightly insufficient retentive undercut
• Sloped buccal &/or lingual surface, procedure contraindicated: reconsider other areas for undercut or surveyed crown
when is placing an undercut prep indicated
slightly insufficient retentive undercut with vertical buccal & lingual surfaces
how is the retentive undercut prepped
Preparation with round-ended tapered diamond
when are rest seats made
After adequate preparation for GP, Survey line alterations
Checking the adequacy of occlusal/embrasure rest seats:
– Patient close into beading wax
– Measure thickness of wax (Caliper)
• At least 1mm
what if yu cannot obtains adequate depth in enamel of the tooth for the rest seat
• Remove small amount of opposing tooth structure
– Be sure to remake impression of opposing arch
Master Cast: Class III RPD impression techniques
does the ridge provide support in these cases?
• Residual ridge not provide RPD support
• Alginate/stock tray
• Alginate/custom tray
• Custom tray/elastomeric material
– Preferred technique UMKC
– Not border molded
– Medium-bodied PVS
Master Cast: Distal Extension RPD Impression
ridge support?
captures? why?
how should force be distributed?
allows increased?
less frequent?
• Residual ridge important source of RPD support
• Important to accurately record maximum tissue support area– Broad-stress distribution concept
• Distribute occlusal forces over as many teeth & as much soft tissue as possible
• Not overload teeth or tissue
• Increased stability & retention
• Less frequent reline
The Problem with Tooth-Tissue Supported RPDs:
•The periodontal membrane allows for 0.25 +/- 0.1 mm and the muco-periosteum allows for 2.0 + mm movement
•Due to the lever effect of the distal extension base, occlusal pressure is concentrated on the distal end of the base
The Solution for Tooth/Tissue Supported RPDs
equalize support from?
distributing load?
base movement?
• Equalize support derived from tissue and teeth
• To distribute load to both the natural and artificial dentition & minimize base movement
Master Cast: Extension RPD Impression techniques
• Custom tray/elastomeric material
• Corrected (Altered) Cast technique
Custom tray/elastomeric material technique for master casts
border molded tray, one step
