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1 - BDS4 finals - big topics > Prosthodontics > Flashcards

Prosthodontics Flashcards

(70 cards)

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1
Q

common types of denture fracture

A

midline
tooth detaches from denture base
loss of flange
acrylic saddle detaches from Co/Cr baseplate
clasp fracture/bent

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2
Q

give reasons why a denture may fracture?

A

impact
acrylic in thin section
work hardening of metal
parafunctional habits
occlusion - deep overbites
soft linings
denture processing problem - porosity
bonding between tooth and base acrylic, or acrylic and CoCr

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3
Q

Give an example of a situation when you could carry out a simple denture repair

A

if the fractured pieces can be located together
- e.g. midline fracture of complete denture

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4
Q

how would you carry out a simple denture repair

A

disinfect fractured pieces
send to lab;
- cast poured
- fractured area removed
- new acrylic processed

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5
Q

how would you repair a denture fracture where a piece of the denture is missing?

A

take an impression with the fractured denture in the mouth
disinfect and send to lab
- cast poured
- new acrylic processed into defect

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6
Q

name 3 strengtheners that can be used in denture repairs

A

wire mesh
glass-fibre mesh
stainless steel wire

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7
Q

Reasons why patients may be dissatisfied with dentures

A

related to denture retention and stability
- usually lower denture
Patient may not be aware of limitations
aesthetic expectations unmet
decreased chewing efficiency
change in facial aesthetics due to tooth loss

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8
Q

Examination of denture bearing area - things to look our for

A

severely resorbed ridges
flabby ridges
tori
prominent mentalis muscles, mylohyoid ridge, genial tubercles
high muscle attachments
pain on ridge palpation

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9
Q

retching patients - management

A

identify problems
identify trigger zones
reduce anxiety
patience and empathy

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10
Q

distraction techniques for impression taking

A

talking to patient
get patient to concentrate on keeping their leg raised/wiggle toes
get patient to press or tap on their temple
salt on patients tongue
ask patient to close eyes
rinse mouth with very cold water just before treatment

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11
Q

desensitisation techniques for retching patient

A

repeated brushing or stroking anterior palate or tongue with finger or toothbrush
“homework” of bushing/stroking for patient pre-treatment
swallowing with mouth open
hypnosis
CBT

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12
Q

What is the MAGIC technique?

A

main amelioration of gagging indoctrination by communication
- patient fills their lungs completely with air
- sends a strong message form lung stretch receptors to medulla oblongata that there is plenty or air and no risk of choking
- psychogenic gag reflex is subverted

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13
Q

how to modify impression taking for retching patient

A

modify stock trays
lower trays in upper arch
palatal reduction on special tray
rapid setting materials
- e.g. alginate with warmer water = reduced exposure time

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14
Q

securing an implant denture firmly - options

A

locator abutments
ball abutments
gold bar
CAD-CAM titanium bar

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15
Q

common post implant treatment complications

A

peri-implant mucositis
peri-implantitis
loose/fractured components
late implant failure

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16
Q

2002 McGill consensus conclusion

A

a 2 implant over denture should be the first choice of treatment for the restoration of the edentulous mandible over the conventional denture

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17
Q

Complete upper denture opposing lower natural teeth - effects

A

presence of natural teeth mean that high levels of force can be developed against the upper mandibular alveolar ridge
leads to
- trauma to maxillary denture bearing area
- instability of denture
- fibrous ridge

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18
Q

How is a a fibrous ridge formed?

A

as a result of alveolar resorption and fibrous tissue replacement

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19
Q

Fibrous ridge - problems

A

tissue easily displaced
tipping of prosthesis

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20
Q

give examples of pathological changes related to dentures

A

ulcers
denture stomatitis
angular chelitis
denture irritation hyperplasia
flabby ridges
MRONJ/ORN
allergic reactions

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21
Q

causes of ulcers (denture related)

A

overextension; sharp bits on denture, pressing too hard, occlusal trauma

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22
Q

denture related ulcers - management

A

identify
- pressure indicating paste
- articulating paper
ease
- occlusal adjustment
- trim and polish base

review

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23
Q

denture stomatitis management

A

denture hygiene instructions
- take denture out at night
- clean with soft brush
- chlorhexidine mouthwash
- antifungals e.g. nystatin

consider underlying issues
- diabetes
- b12, folate

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24
Q

angular chelitis causes and features

A

often co-exists with denture stomatitis
result of overclosure
- loss of OVD/excessive free way space , old worn dentures

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25
angular chelitis - management
miconazole gel (interaction with coumarins) consider underlying issues - diabetes - folate - xerostomia - ferritin
26
denture irritation hyperplasia - cause
often very old, ill-fitting dentures chronic trauma resulting in hyperplastic response
27
denture irritation hyperplasia, management
major ease of denture tissue conditioner e.g. Coe comfort review and repeat if needed new denture?
28
flabby ridges - solution
new denture covering whole denture bearing area with good peripheral seal AND opposing arch denture giving posterior support may occasionally need special impression techniques
29
MRNJ/ORN cause (denture related)
and ill fitting denture in a patient on anti resorptive medication
30
MRONJ/ORN management
refer promptly to maxfax
31
when to conform to existing occlusion
stable occlusion sufficient index teeth usually use ICP
32
when to change existing occlusion
lack of sufficient index teeth often use RCP usually more challenging to record occlusion
33
what materials can be used to take an interocclusal record?
bite registration paste wax wafer modified wax wafer - e.g. alminax
34
What is the intercuspal position?
the complete intercuspation of the opposing teeth independent of condylar position
35
what is the retruded contact position?
guided occlusal relationship occurring at the most retruded position of the condyles in the joint cavities
36
When would a soft reline be appropriate?
parafunctional habits very atrophic ridges cancer/cleft patients (obturators)
37
Downsides of soft relines
plasticiser leaches deteriorate over time can habour microorganisms
38
name materials that can be used for soft linings
heat cured acrylics self cured acrylics heat cured silicones self cured silicones
39
denture rebase technique for upper denture
undercuts removed from denture wash impression taken with closed mouth technique - sent to lab
40
Name the Kennedy classifications
Class 1 bilateral free end saddle class 2 unilateral free end saddle class 3 unilateral bounded saddle class 4 anterior bounded saddle across the midline
41
aims of surveying casts for partial dentures
determine path of insertion determine position and depth of undercuts using survey lines
42
benefits of Co/Cr denture base material
stronger than acrylic thinner/less bulky usually better tolerated less destructive to periodontal tissues
43
disadvantages of CoCr denture base
more expensive difficult to add to
44
benefits of acrylic denture base material
cheaper easier to add to
45
downsides of acrylic denture base material
weaker thicker less well tolerated more destructive to periodontal tissues
46
components of the RPI system
R - mesial occlusal rest P - distal guiding plate I - I bar clasp
47
where would the RPI system be used?
in a free end saddle - Kennedy class 1 or 2
48
function of the RPI system
reduces stress on the abutment tooth
49
how does the RPI reduce stress on the abutment tooth?
when under load, the denture rotates towards the mucosa underlying the saddles without damaging the abutment as saddle presses into denture bearing area it rotates around the mesial rest distal plate and I-bar move down and away from tooth avoiding torque on the abutment tooth
50
care and maintenance of dentures - advice to give patients
remove dentures at night mechanical cleansing with soap and water - NOT toothpaste soft brush immersion in chemical cleaner - variable manufacturers guidelines - store overnight in cold water after chemical cleanser for partials - stress cleaning of natural teeth with dentures out
51
Complete dentures try in checks
OVD and free way space even contact in RCP lip support occlusal planes lower teeth over ridge speech retention and stability appearance base extensions
52
complete denture review checks
pain/redness/ulceration function speech aesthetics recheck occlusion and vertical dimension
53
benefits of replica dentures
keeps existing design maintains existing aesthetics only 1 impression in the mouth 1 less clinical stage
54
downsides of replica technique
major modifications difficult - can reproduce faults
55
space required for a lingual bar
8mm - 3mm from gingival margin - 4mm height of bar - 1mm clearance from functional floor of mouth
56
benefits of bar connectors
little coverage of gingival tissue wide relief of gingival margins to prevent food packing rigid
57
downsides of bar major connectors
posterior bar offers less support to free end saddle across hard palate greater cross sectional thickness number of edges - some pts may find uncomfortable
58
benefits of plate connectors
thinner cross section wide relief of gingival margins to prevent food impaction support across hard palate for free end saddle less edges - more comfortable
59
downsides of plate connectors
anterior plate has 3 small windows that could possibly cause food impaction
60
What is an immediate denture?
Any removable dental prosthesis fabricated for placement immediately following the removal of a natural tooth or teeth
61
Immediate denture advantages
- guide for aesthetics - speech - function - self esteem - avoid drifting/tilting or over eruption of remaining teeth - promotes health - better adaption to dentures - prevents collapse of facial musculature
62
immediate denture disadvantages
- temporary prosthesis due to resorption - poor adaptation to ridge very quickly - guesstimate as to how healing will proceed
63
immediate denture possible contraindications
- some MRONJ cases - pre-chemo/radiotherapy - pathology - fractures
64
Initial aftercare following immediate denture delivery
- dentures to be kept in for 24 hours - ideally review appt on day after insertion - after 24 hrs advise warm saline mouthwash and patient to remove dentures after mealtimes to rinse mouth and clean dentures
65
What are replica dentures?
a copying technique for replacement of complete dentures
66
stages in replica denture construction
assessment of patient and dentures replica impressions 2nd impressions and occlusion trial insertion visits/tooth trial delivery maintenance aftercare
67
complete dentures - common patient complaints
appearance eating pain/discomfort loose retching speech dislike wearing a denture
68
why is RCP used in complete dentures?
most reproducible position no opposing teeth so ICP cannot be used
69
define retention and stability, in relation to dentures
retention = resistance to vertical displacement stability = resistance to lateral displacement
70
When would you use a temporary reline?
post immediate dentures tissue conditioning - grossly ill fitting dentures after implant surgery

1 - BDS4 finals - big topics (17 decks)

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