Pros Tutorials Flashcards by Erin Murphy

What are the differnt types of additions we can have to a denture

Immediate
Post immediate
Retention

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What do we use to retain the acrylic onto cobalt chrome

4 META

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What of dentures can be used when a paitent has a PMMA allergy and what are some clincal issues with this

Nylon based
They are virtually impossible to add to due to weak bonding between the nylon and tooth
They are porous which leads to them absorbing bacteria and saris

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What is the initiator in PMMA

Benzoyl peroxide

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What 5 stages does PMMA go through as it set

Sandy - stringy - dough-rubbery - hard

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What are 4 advantages of acrylic dentures

Cheap
Easy to add to
Technically easier to make
Pink - aesthetic

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What are 5 disadvantages of acrylic dentures

Low impact resistance
Poor resistance to fracture
Water absorption and candida growth
Allergy to residual monomer
Denture whitening

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What are two difficulties of having completes opposed by natural dentition

Breaks the seal
High occlusal load and force when its natural uppers and a lower denture - not as much bony support

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What is a flabby ridge

Following loss of the upper dentition the alveolar bone gets resorbed and is replaced with fibrous tissues

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What kind of impression do we want when we have a flabby ridge

Mucostatic impression - use a material that isnt going to push against the tissues i.e. light bodied silicone

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What are the two kinds of trauma to maxillary denture bearing area when there is a complete upper and natural lower

Abuse of soft tissue
- mucous membrane damage
- ulceration and discomfort

Alveolar respotion and fibrous tissue replacement - formation of a flabby ridge

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In complete uppers with natural lowers - how can we reduce trauma to the maxillary denture bearing aera

Maximise coverage of the denture being area
Ensure the prosthetics covers the primary load bearing sites
Use over over dentures - tooth born support iwll help

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When there is complete uppers and natural lowers the stability of the upper denture is comprised
What are ways to improve this

Optimal border seal is compromised - so an effective post dam for retention

Try to get a lower denture introduced early so not all force is located on the anteriors and load gets distributed more evently

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If we have a knife edge ridge what can be added to the denture and why

A soft liner could be added to act as a shock absorber

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What are 2 problems with soft linings

After 12-18 months they need to be replaced as they loose their plasticity
They are much more porous than PMMA - so they absorb bacteria and stains

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What is peri-implant mucositis

Inflammation of the peri-implant mucosa with no evidence of crestal bone loss, the tissues will appear red and swollen and may bleed on gentle probing

Reversible condition

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What is peri-implantitis

Infection with suppuration and inflammation of the soft tissues surrounding an implant - significant loss of peri-implant crestal bone.

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What is retching

This is an involuntary contraction of the muscle of the soft palate or pharynx modfied by higher centres in the medulla oblongata

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There are two types of retching what’s are they

Psychogenic ; retching may occur by sight smell or sound of the dental surgery

Somatic ; touching of trigger zones

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How do we manage paitents that retch

Identification of the problem
Identify trigger zones
Anxiety reduction
Patience and empathy

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When would you review an immediate denture

A day a week and then a month
Then three months post extraction

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How might we change a denture for a patient that is a bruxist 4 things

Metal backings to the teeth - Co/Cr reduces fracture
Metal on occlusal surfaces of posterior
Use of cross linked teeth as they have bettter wear resistance
Acrylic post dam increases retention

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Three steps in dealing with an ulcer in a denture patient

Identify - pressure indicating paste - articulating paper
Ease - occlusal adjustment - trim and polish base
Review

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You are making a denture for a patient with advanced periodontal disease - what things do you want to tell them to ensure informed consent

Prognosis of remaining dentition - especially if using some of the advanced perio teeth as abutments
Risk of denture vs no denture
Benefit of denture vs no denture

Record all conversations in notes

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What is a reline

Adding new base material to the tissue surface of an existing denture in a quantity sufficient to fill the space which exists between the original denture contour and alter tissue contour

What are two situations that you might use a reline in a denture

Immediate dentures or a very old denture which isnt in great condition

What is a rebase

Replacing the entire denture base of an existing denture

What situation would you use a rebase in

The denture is loose fitting - the teeth are not worn and are in good condition

What impression technique is used when doing a rebase

Closed mouth impression technique

What is the purpose of an overcast during the rebase of a denture

To maintain the tooth position of the denture in relation to the model and maintain the vertical dimension

If you have added a temporary reline to a patients denture what would you warm them not to do

Not to use sterodent This is because it will de nature the plasticisers Instead use a dilute solution of Milton

What is the initiator in self cure acrylic

Tertiary amine

What is an indication for a permanent reline of a denture

To prolong the life span of a denture Patient has worn the denture for years and the teeth arent too worn

What is the problem with chair side relines

The materials used are more pourous than what is used in the lab so it is more likely to take up colour and bacteria

What are 5 reasons that a denture might not fit

Over/under extension Not adapting to the tissues Processing fault Occlusal imbalance will break the posteior seal Poor master impression

Name 5 reasons a denture might fracture

Impact Work harnidng of the material Para-functional habit Occlusion - deep OB more likely to fracture Soft lining weaking the denture Denture processing problem

Patient presents to you with a midline fracture of the complete denture - the pieces can be located together Wjat do u do

Disinfect and send to lab No impression needed Cast poured and fracture area removed New acrylic processed

Paitent presents with a fractured denture and a piece is missing what do u do

Impression taken WITH FRACTURED DENTURE IN MOUTH Disinfect Cast poured New acrylic process

How do u bond acrylic to Co/cr

4 meta

What is a disadvantage of using a wire Strenghtener in a denture

Need to increase denture base thickness

If when taking a master impression there are areas of shine through - what may the patient complain of during delivery

That those areas are causing pressure on the mucOSA

What does a foxes bite plane measure

Measures the occlusal plane

What 2 reasons would you use cuspless teeth for complete dentures

If you are having difficulty fgetting patient into RCP use these - so they are able to slide over each other If the patient has a knife edge ridge

What devices can be used to measure OVD and RVD

Willus bite gauges Dividers

What must we be careful of when using dividers to measure OVD and RVD

Be wary where marking the dots on the patient if they have mobility in thier chin

What may happen to the incisive papillae in flabby ridge

It may migrate labiallyu

Where does the buccinator insert

Buccal frenum

What is the minimum sulcus depth required for a lingual bar connector

7mm

What disadvantage does a lingual bar have

Very difficult to add to Need sufficient sulcus depth

What would you do if you tried a cobalt chrome frame into the paitents mouth and it did not fit

- check it first onto the model - look and see if there are any modifications on the cast - use occlude spray on the area you dont think is seating - where the occlude has been wiped off is the area that isnt seating - can also use articulating paper for this Only do this if you think it is one thing that is preventing it from seating if lots of areas a new impression needs to be taken

What is the undercut a CoCr clasp engages

0.25mm

What is the undercut a gold clasp engages

0.75,,

What is the undercut a SS clasp engages

0.5mm

Why is gold a larger undercut than CoCr and SS

This is because it has a greater young modulus of elasticity so it can flex more without breaking

What must you warn your patient of when adjusting their CoCr clasp Where should you adjust it?

Always warn the patient that it may fracture when adjusting it Adjust at the head as it is least likely to break here

There is normally a 2-3mm spacer on trays - what is a clincal situation you might not do this

When a pateint has resorbed ridges you may instead choose to do a close fitting tray - with no spacer

Name 4 diadvantages of partial dentures

Increase in plaque accumulation Increased risk of periodontal disease Damage to underlying soft tissues Gingival stripping - due to movement of the denture §

What is the aim of a partial denture

Replace lost teeth and tissues to Restore function speech and aesthetics

What is Kennedy class 1

Bilateral free end saddles

What us Kennedy class 2

Unilateral free end saddle

What is Kennedy class 3

Unlilateral bounded saddle

What is Kennedy class 4

Anterior crosses midline

What is the purpose of surveying

To determine the path of insertion To determine the position and depth of the undercuts

What is the path of displacement

The direction in which the prosthesis tends to be dislodge during function and is assumed to be perpendicular to the occlusal plane

How does an RPI system work

As the saddle presses into the denture bearing mucosa, it rotates around the mesial rest Distal plate and I bar move down and away from the tooth thus avoiding torque on the abutment tooth

Give 5 denture hygiene pieces of advice for a denture patient

Remove the dentures at night Mechanical cleaning with soap and water - not toothpaste After chemical cleaning - store in cold water Soft brush to clean In partials stress the importanace of cleaning natural teeth with the dentures out

How does a clasp provide rentetion

The tip of the clasp flexes as the patient is inserting and removing the denture - the clasp deforms over the bulbosity of the tooth and comes to rest in the undercut When it is in the undercut is is passive and applying no pressure to the tooth

What is the purpose of the reciprocating arm in a clasp

It is an opposing element to the retentive clasp arm to prevent pressure from the clasp acring on the tooth

What part of the clasp engages in the undercut

The terminal third of the clasp with only the tip engaging to full depth

Name 2 disadvantages of an RPI

Creating windows Not limiting the loading on the free end saddle then we could be accelerating bone resorption on free end saddle

What is the tool used to determine the path of insertion and identify undercut areas during surerying

Analysing rod

What tooth is used to indetify a useable undercut for a clasp

Undercut gauge

What is the purpose of the graphite marker during surveying

Marks the survey lines on the cast

What kind of material is impregunm

Polyether

What is the most common cause of a framework fitting an undamged cast but not the patient

Faulty/ distorted impression

What is the recommend casting thickness for cobalt chrome framework

0.5mm

Pros Tutorials Flashcards

(76 cards)