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Partial Dentures 6 Flashcards

1
Q

What are Free end saddles and want do they result in.

A
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2
Q

Why are lower free end saddle dentures problems

A

Frequently unsuccessful
Class I lower dentures
Uncomfortable - mucosa supported- transmit forces to the ridge below
Load on abutment teeth
Force transmitted to premolar
Tooth might start to become uncomfortable for a while
Lack of retention
I bar - retain 4 denture teeth
Rely on clasp on premolar to stop denture form lifting out

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3
Q
A

Discomfort on denture bearing area
Adverse forces on abutment teeth
If this is situation patients teeth apart - everything is fine
Arrow dentures force- patient put food in mouth and chewing on food
Denture pushed into tissue, because supported by toth at one end
Pushed into tissue more at the abc end of the denture
Force on premolar tooth

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4
Q

What is another issue fo not having tooth at the back of denture

A

Without having tooth at back of denture
May start to move side to side during function
Bracing - denture wraps around patients remaining ridge to prevent that from happening

Denture like a see saw
Bite down at the back , rock over top of rest
Anything in front of premolar will lift up

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5
Q

What are management strategies of lower free end saddle

A

5-5 upper and lower - function fine

½ premolar missing - may be able by resin retained bridges give resin retained premolars

Reline saddle- make pressure on ridge even

Narrower teeth - more effective than getting through food

RPI - design of denture that reduces torque or twisting forces of the abutment teeth
Revisit indirect retention - anterior saddles
Cant get retention form clasps at either end of saddle

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6
Q

What are the differential pressure impressions for free end saddles

A

Take pressure off the mucosa . denture sitting on in a compressed state
Special tray - closing fitting and adapted over edentulous area
Snugly fitting mucosa

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7
Q

Describe difference between mucostatic and mucocompressive techniques

A

1st - pressure concentrated at back of denture if denture was sitting in top of tissues

Even thickness of mucosa even if underlying bone is uneven

Biting pressure spread over much larger surface area

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8
Q

What 2 things do we need to consider for designing free end saddles

A

Normal processes
Lower free end saddles
Including rpi

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9
Q
A

Situation may find
Lower free end saddle
I bar
Rest where normally position it
Closest side of abutment tooth to free end saddle
Patient bites down - denture completed on that

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10
Q
A

Sink down
On the saddle area
Rest on bac edge of pre oalr
Dentures tend to rotate around hat rest
Clasp - i bar on opposite side of rest
Like a see saw
I bar tend to pushed more towards survey line
Survey lien - widest part of the tooth
Pushed upwards- digging in the surface of the tooth

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11
Q
A

Move rest to mesial tide of tooth than distal -
See saddle and I bar are same side of that fulcrum

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12
Q
A

When patients bites down
I bar has tendency to move downwards
I bar resting against tooth’s surface moving away from tooth surface
Not applying any stress or abutment tooth
Mesial rest - key part of design process for lower free end saddles

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13
Q

What is the RPI system

A
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14
Q
A
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15
Q

1st stage of denture design

A

First stage - outline saddles
Drawing these - little shape behind teeth - retromolar pad- free saddle drawn on

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16
Q

2nd stage of denture design

A

Put support in
Side where bounded saddle - sue closest size of tooth
RHS - opposite side of abutment tooth
Mesial rest - free end saddle
4th corner of support - retromolar pad
Survey and find undercuts
Use occlusally approaching clasp for molar
Gingivally approaching clasp for premolar

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17
Q

3rd stage of denture design

A

Lower left 7 surveyed
Undercut on buccal side where rest was
Ring clasp

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18
Q

What is indirect retention

A
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19
Q
A

Situation
Imagine sticky food chewed by patient
If sticky tooth on mo6lar - pull denture upwards when apitent opens mouth
Clasp grip on denture as much as it can but nothing to clasp the denture form back

20
Q

When do we use a sublingual bar

21
Q
A

Anything in font of clasp axis - move downwards

22
Q

Describe the saddle lifting in physics terms

A

Force to lift - effort
Effort needs to overcome resistance
Lifting source - effort
Keeping it in place- resistance
Physical weight of denture itsellf

Need to create resistance higher than normal effort hat is going to be encountered during this

23
Q
A

Looking diagramatically in a denture
RPI on premolar

Connector to anterior tooth ith something resting on the anterior tooth
Upward forces caused by food
Transferred to downwards forces on that tooth
Equal and opposite force back

24
Q
A

Rest would stay in place
If you career on lift the denture , eventually you’ll overcome force and resistance provided by the clasp
But denture much more difficult to remove because of the ret on the anterior tooth
Brought clasp right into the equation

25
Rest anteriorly is the fulcrum Force is provided by sticky food -effort to displace the denture Clasp is providing resistance to hat movement Equation Not expected to learn the equation Effort has to overcome resent to lift the abr Fitter the resistance form fulcrum the greater the effort to lift it Denture design terms- further indirect retention is form clasp More effective the indirect retention is
26
What are indirect retention
27
Denture design -draw clasp axis - clasp tips of two clasp closest form end of saddle Dotted line drawn between clasp tips of those Canine tooth- cingulum rest attached to minor retainer
28
2 clasps Denture will rotate around imaginary line between those clasp tips
29
Define something as major clasp axis Look where problem is Free end saddle on RHS Two clasp out of 3 closest o problem area LR premolar -clasps And clasp to LL molar Opposite where indirect retention is going to be
30
What distance is required to choose a lingual bar between gingival margin and bottom of sulcus
31
32
When do we use a lingual plate
In this case Covering gingival margins - instruction to keep it clean Help spread load Lots of denture teeth Helping spread the laid Indirect rentiton
33
In upper free end saddles what do we consider
Upper free end saddles Some similar challenges Bounded saddles Teeth retained - nicely Gravity and food sticky food 2 clasps - effective If patient loses backtooth and loses free end saddle denture - problem is very different Nothing retaining the denture in the back and nothing to drop down Soon as it drops down - drop out Unretentive retainer
34
what are the strategies of free end saddles
Plate design Wing connector or horse shoe Plate connector SA Plate and mucosa Sitka denture to the roof of the mouth Addition of post dam/pin dam Suction underneath plate Add to denture not dropping down Create indirect retention RHS - free end saddle on UL Anything other side of that line act as indirect retention
35
What is a wax try in
First ot those Wax try in After recorded occlusion Add denture teeth on Only into wax Replace them Purpose of try in Try out dentures with patient Opportunity to see how they look and how teeth meet together Alter things if need to
36
Wax try in
Shade Mould Size for the teeth Out those into patient's mouth and how well they fit in with patients own teeth Up to patient to decide whether they are happy with that
37
38
What happens when you fit finished partial dentures
39
What is required when you fit finished partial dentures
Bite together Same as it was Appearance same as it was as try in Patient walking away with them Make sure patients happy Honest opinion
40
What are the post insertion instructions advice to the patient to partial dentures
41
What are the post insertion instructions of dentures regarding cleaning, eating, wearing at night , pain
42
What do we do after giving the dentures to the patients
Review after one week
43
What do we do int he review appointment for dentures
44
How do we select patients
PATIENT - can manage good level of oral hygiene Stable peiro status No Denture with existing caries Motivated- dentures are difficult Abutment teeth -as strong enough to withstand extra forces Thorough perio assessment
45
What is good practice of using dentures
Overarching guide toward denture design Denture have adequate support Gingival clearance where possible Rigid - apart form a clasp tip So all aspects of denture acts as one

CSB (46 decks)

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