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BDS4 PP > Prosthodontics > Flashcards

Prosthodontics Flashcards

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1
Q

which denture reconstruction technique would be appropriate to give pt replacements dentures they can tolerate

A

replica dentures

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2
Q

other than replacement dentures, state 2 tx methods which can be used to improve retention and stability in loose complete dentures

A

relining
rebasing

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3
Q

what is the technique for replica dentures

A
  1. upper large dentate trays, vaseline and putty in the original denture
  2. capture impression of the occlusal surface, mould to 2mm of edge
  3. place vaseline and notches for removal and replacement
  4. capture impression with putty of the fitting surface of the denture tray, outer surface down
  5. ensure flanges of denture captures
  6. smooth edges and wait for set
  7. light bodies silicone for jaw registration

old dentures can be modified with greenstick before replica taken

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4
Q

what is relining a denture

A

adding a new base material tot issue of surface of existing denture in sufficient quantity to fill space which exists between original denture and altered tissue contour

improves stability and retention
usually chair side

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5
Q

3 types of relines and when done

A

temporary - tissue conditioning, post-immediate, after implant surgery

soft - parafunctional habits

permanent - peripheral seal problems, correction of errors after masters, immediate/post-immediate after lots of temporary relines

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6
Q

materials used for relines

A

heat-cured acrylic
self-cured acrylic [coe comfort]
heat-cured silicone
self-cured silicone

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7
Q

what is the technique for rebasing a denture

A
  1. undercuts removed
  2. wash impression taken using denture in closed mouth technique
  3. impression poured in stone with overcast
  4. denture removed to reveal new working model
  5. post dam carved
  6. remove fitting surface + palate
  7. denture placed back on overcast, gap between denture and model is filled with wax
  8. overcast removed as served purpose of maintaining denture position and OVD
  9. palate added back in wax
  10. flasked using Dundee injection method, wax removed and acrylic injected
  11. trimmed and polished
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8
Q

describe the 3 important features of complete dentures you would check in try-in stage

A
  • retention and stability
  • base extensions
  • lip support
  • incisal level
  • midline
  • buccal corridor
  • occlusal planes
  • position of teeth
  • vertical dimension, FWS
  • even contact in occlusion
  • speech
  • aesthetics
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9
Q

53 y/o presents with loose dentures and palate denture bearing area red.
which organsim is likely

A

Candida albicans

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10
Q

3 most likely contributing local factors to denture stomatitis

A

ill-fitting dentures, poor denture hygiene, wearing dentures overnight, reduced salivary flow, denture material

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11
Q

define support in RPD and what components do this

A

resistance to vertical movement of denture towards tissue via occlusal directed load

rest seats, abutments, connectors

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12
Q

define retention in RPD and what components do this

A

resistance to displacement of denture away from the tissue

clasps, minor connector

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13
Q

give types of connectors for maxilla and mandible

A

palatal bar/ring
mid palatal strap
plate
horseshoe

lingual bar
sublingual bar
plate

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14
Q

what is the advantage of lingual bars

A

minimal coverage of the gingival tissues and teeth
allows for better cleaning and salivary flow
reduced bulk in CoCr

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15
Q

how do you achieve retention in complete upper denture

A

post-dam
palatal coverage
adequate extension into buccal sulcus
adhesion-cohesion with acrylic
peripheral seal
neutral zone

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16
Q

biometric principles - where are denture teeth located on

A

upper - slightly buccal to ridge crest
lower - on the ridge crest

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17
Q

what is a shortened dental arch

A

reduced number of teeth in the dental arches, with reduced or absent molars/premolars
must be at least 20 teeth

do not replace them

generally 3-5 teeth each quadrant

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18
Q

why is the shortened dental arch acceptable

A

enough occluding pairs necessary for function, speech and aesthetics

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19
Q

indications for shortened dental arch

A

pt unwilling for complete dentures
good OH, no perio
extensive tooth loss
good prognosis remaining teeth
pt preference/motivation
medically compromised

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20
Q

contraindications for shortened dental arch

A

pathological tooth wear
poor prognosis remaining teeth
parafunctional habits
young pt
periodontitis
malocclusion

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21
Q

how could you extend a shortened dental arch

A

bridges
RPD
implant

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22
Q

5 requirements of occlusal stability

A

1 - stable occlusal contact all all teeth in centric relation/ICP
2 - anterior guidance in harmony with envelope of function
3 - all posterior teeth disclude in mandibular protrusive movement
4 - all posterior teeth disclude on non working side on lateral movement/excursion
5 - all posterior teeth disclude on working side on lateral movement/excursion

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23
Q

signs of occlusal trauma

A

mobility, pain, wear facets, fractured teeth, widening PDL, scalloping, pronounced linea alba, NCTSL

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24
Q

what are the ideal properties of a denture base

A

Dimensionally accurate, high softening temperature, high hardness/abrasion resistance, thermal expansion equal to abutment teeth, low density, high thermal conductivity, biocompatible, high YM, high elastic limit, high fatigue strength, inexpensive

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25
what are the constituents of PMMA
- Powder = PMMA beads, benzoyl peroxide initiator, pigments, fillers Liquid = MMA monomer, hydroquinone inhibitor, cross-linking agent ethylene glycol dimethacrylate, plasticisers
26
give 4 faults of denture base production and how they can occur
contraction porosity = too much monomer, insufficient pressure, insufficient excess material gaseous porosity = monomer boiling in bulkier parts of denture granularity = not enough monomer crazing = internal stresses due to fast cooling rate
27
advantages as CoCr as a denture base
high YM - rigid high strength high impact resistance high thermal conductivity thin, lightweight high softening temperature corrosion resistant excellent retention
28
disadvantages of CoCr as a denture base
cost difficult to add teeth to aesthetics
29
what undercuts are required for CoCr, SS + Au clasps
0.25mm CoCr 0.5mm SS 0.75mm Au
30
ideal properties of an impression material
high surface reproduction/ accuracy high tear strength 100% elastic recovery biocompatible no dimensional change ease of use
31
name 2 non-elastic impression materials
impression compound impression paste [ZOE]
32
name 4 elastomers
polyether [impregum] silicone; - addition silicone [PVS] - condensation silicone [lab putty] polysulphide
33
name 2 hydrocolloids
alginate agar
34
what are the constituents of alginate
sodium alginate calcium sulphate trisodium phosphate filler
35
what is the setting reaction of alginate
sodium alginate + calcium sulphate = calcium alginate + sodium sulphate
36
2 advantages of alginate
ok accuracy easy to use acceptable taste/smell no toxic cheap
37
2 disadvantages of alginate
poor tear strength sensitive to environmental factors e.g. temperature needs stored properly limited shelf life
38
uses of alginate
primary impressions master impressions study model impressions
39
3 advantages of elastomeric impression materials over alginate
better accuracy better tear strength better surface detail reproduction better shelf life as doesn't dry out
40
what does RPI stand for
rest on mesial surface proximal plate on distal surface I-bar, gingival approaching
41
RPI MOA
rest mesially acts as an axis of rotation as proximal plate and I-bar rotates downwards and medially [respectively], around the axis of rotation during occlusal load the I-bar and proximal plate disengage from tooth/undercuts potential traumatic torque avoided
42
what are the measurements required for a lingual bar in RPD
3-4mm from gingival margin, height 4mm minimum of bar, clearance 3mm from floor of mouth >7/8mm needed
43
aetiology of denture stomatitis
growth of bacteria e.g. Candida albicans primarily denture bearing area poor denture hygiene, wearing dentures overnight, smoking, immunocompromised, HIV, inhaler use
44
how is denture stomatitis managed
denture hygiene instructions tissue conditioner manage predisposing factors OHI antifungals - miconazole to fitting surface
45
how do you restore freeway space in very worn dentures
temporary relines rebase occlusal pivots restore occlusal surface with auto-polymerising acrylic resin
46
what problem can occur with a complete upper denture occluding with partial lower
combination syndrome resulting in a flabby ridge
47
why does combination syndrome occur
bone loss maxillary ridge, hypertrophy of tuberosities and papillary hyperplasia in hard palate extrusion of mandibular anterior teeth which occlude with force against the anterior ridge causes bone to resorb with loose alveolar tissue
48
how to manage combination syndrome
reduce trauma = maximise coverage on denture bearing area [short post dam] optimise load = use over denture abutments to reduce alvoelar resorption stability = optimise border seal, effective post dam ensure good posterior support try to regularise occlusal plane reduce incisor teeth length??
49
define Kennedy class 1
bilateral free end saddle
50
define Kennedy class 2
unilateral free end saddle
51
define Kennedy class 3
bilateral bounded saddles
52
define Kennedy class 4
anterior bounded saddle crossing midline
53
define Kennedy class 2 mod 1
unilateral free end saddle with 1 bounded saddle
54
how to take impression with flabby ridge/combination syndrome
mucostatic impression so tissues are recorded at rest 2 stage impression with medium body then cut out impression material and make hole in tray over flabby ridge and take 2nd impression with light body OR window technique with relief holes cut in special tray to allow flow of material and leave tissues undisplaced use low viscosity impression material
55
what is a system of design used for designing PD
outline saddle areas support retention stability reciprocation connector
56
give 2 maxillary connectors with adv and disadvantages
plate/strap = - thin - BUT palate covered bar = - less coverage - BUT thicker
57
give 2 mandibular connectors with adv and disadvantages
lingual bar = - gingiva clear - less well tolerated lingual plate = - well tolerated as thin - hard to keep clean
58
define stability in in RPD and how it is done
resistance to horizontal/lateral movement of denture reciprocal arms of clasps
59
define indirect retention in RPD
resistance to rotational displacement e.g. rest seats opposite fulcrum line
60
what is the difference between a soft lining and tissue conditioner
soft lining used to improve retention, fit, cushioning conditioner used in unhealthy/ulcerated mucosa to aid healing dissipates forces but good short term option
61
what is a functional impression
can be used with tissue conditioner material applied and pt wears denture for 24hrs with movement and normal function this impression is sent to lab for reline
62
how to check retention clinically of complete denture
pull on premolars, push on anteriors to check post dam pull away lips to see if denture remains in situ ask pt to speak, chew etc
63
what problem can an incorrect OVD give
pain, movement of denture, instability, TMD aggravation, angular chieilitis, muscle strain and fatigue overclosed appearance reduced lip support cannot function properly - speaking, chewing, swallowing
64
where should the post dam be
just anterior to the vibrating line - junction between soft and hard palate
65
what is the distal extension of a lower complete denture
2/3 of the retromolar pads
66
why is the buccal shelf used for support
stable anatomy, not as prone to resorption, large surface area, adjacent to buccinator muscle for support, less muscles action impact
67
what anatomical features help set the incisors
1mm anterior to incisive papilla
68
what 4 things make up shade
value, hue, chroma, translucency
69
give average horizontal bone loss for incisors, canines, premolars, molars
incisors 6mm canine 9mm premolars 10mm molars 13mm
70
adv of immediate dentures
maintain soft tissue, prevent collapse haemorrhage control transition help uses existing occlusion pt aesthetics and psychology maintain muscle tone allow continuation of function, speech and aesthetics
71
disadvantages of immediate dentures
fit poor as resorption may require relining/rebase only temporary measure which will need replaced no trial stage need to pay for 2 dentures in short time span
72
write a prescription for special trays for U+L complete dentures
please construct upper and lower special trays in light cured acrylic non-perforated upper 2 mm spacer and EO handle lower 1mm spacer IO handle, finger rest premolar region
73

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