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module 8 > removable pros > Flashcards

removable pros Flashcards

1
Q

what is an immediate denture

A

denture inserted at the same appt as XLA

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2
Q

can an immediate denture be a complete?

A

yes

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3
Q

name 5 advantages to immediate dentures

A
  • aesthetics
  • speech
  • maintain function/eating
  • avoid drifting of teeth
  • self esteem
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4
Q

what are the clinical stages of immediate dentures

A

the same as for partial dentures

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5
Q

what are the clinical stages of immediate dentures

A

the same as for partial dentures
- imps
- occlusion
- design
- 2nd imps
- try-in
- XLA and fit

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6
Q

what must you always do before taking out the tooth at an immediate denture fit

A

check its the correct tooth on the denture

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7
Q

what instructions have to be given to the lab for immediate dentures

A
  • which teeth for XLA
  • arrangement
  • shade
  • flange type
  • material
  • date for XLA
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8
Q

what is a full flange?

A

engages entire sulcus depth

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9
Q

what is a partial flange

A

engages only partially into the flange

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10
Q

what is flangless?

A

tooth directly onto the ridge

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11
Q

what material is most often used for immediate dentures

A

heat cured acrylic

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12
Q

on what occasion would you NOT use acrylic for an immediate denture

A

if the pt is allergic to the monomer in the acrylic

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13
Q

what will lab mark on the cast when making the immediate denture

A

angulation and incisal level

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14
Q

when should an immediate fit be reviewed

A

24 hrs after

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15
Q

what should the pt be told to do for the first 24 hrs after immediate denture fit

A

keep the denture in

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16
Q

why should the pt keep the immediate denture in for the first 24 hrs

A

swelling will prevent reinsertion

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17
Q

why is immediate denture reviewed 24 hrs later

A

pt wont be able to tell anything about fit at date of insertion due to LA

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18
Q

what should you do at the review appt of immediates 24 hrs later

A
  • remove dentures
  • examine for healthy clot
  • ease accordingly
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19
Q

what should the pt be advised after 24 hours of wear of immediate dentures

A
  • warm saline rinses from that appt
  • remove denture after mealtimes to rinse mouth and clean denture
  • use soft toothbrush and soap to clean denture
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20
Q

when should the 2nd review of an immediate denture be

A

1 week later

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21
Q

why is the immediate denture reviewed at 1 week

A

further adjustments

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22
Q

when is the 3rd review appt of an immediate denture

A

1 month

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23
Q

why are immediate dentures reviewed at 1 month

A

assess adaptation

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24
Q

what should be considered at the 1 month review appt of immediate dentures

A
  • self cure acrylic addition
  • temp reline
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25
Q

why do you need to be careful when placing self cure acrylic to immediate dentures

A

be careful not to engage undercuts in case they cant get the denture out

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26
Q

when should the dentist and pt decide whether to replace or keep an immediate denture

A

6 months post XLA

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27
Q

what may be a consideration at 6 months if the immediate denture is complete

A

rebase

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28
Q

what lies at the posterior junction between the hard and soft palate

A

palatine fovea

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29
Q

what lies just behind the maxiallry tuberosity that can be captured on an impression

A

hamular notch

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30
Q

what should primary imps record

A
  • clinically relevant landmarks without excessive tissue distortion
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31
Q

what are 2nd imps also called

A

working imps

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32
Q

what should 2nd imps record

A

entire functional denture bearing area

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33
Q

what is most crucial to capture in a denture imp

A

full extensions into the sulcus

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34
Q

what are primary imps used for

A

construction of special trays

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35
Q

what can primary imps be modified with

A

wax or putty

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36
Q

what should a primary imp never be used for

A

to construct a prosthesis

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37
Q

what does a special tray allow for

A

refining of tray to pts own anatomy

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38
Q

what can be used to modify a special tray

A

greenstick

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39
Q

where should a special tray be relieved around

A

frenum attachments

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40
Q

what should you consider for imps if the pt has a deep palate

A

pre-packing the palate

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41
Q

what should a working imp record

A

depth and width of functional sulcus

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42
Q

what can be done to indicate the sulcus depth to the technician

A

mark the imp with an indelible pencil

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43
Q

what else might be marked on an imp for the technician to see (apart from sulcus depth)

A

areas where relief may be required eg tori

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44
Q

what should be done to accurately record a flabby ridge in an imp

A

2 stage imp
- mucocompressive imp of the non-compressible areas
- mucostatic imp of the fibrous areas

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45
Q

what should be done if there are no suitable undercuts in denture design

A

modify the survey lines

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46
Q

how can the survey lines be modified when unfavourable

A

addition of composite to create an undercut

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47
Q

what does modifying the survey lines do when there are no suitable undercuts

A

improves denture retention

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48
Q

when combining removable and fix pros, what is done first, the denture design or crown prep?

A

denture design

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49
Q

what can be incorporated into fixed pros to aid in removable pros

A

rest seats prep, guide plane and undercuts

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50
Q

what might the dentist have to coordinate if combining fixed and removable pros

A

multiple technicians

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51
Q

what is made first, the denture or fixed pros?

A

fixed pros

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52
Q

if making denture and crown at the same time, what should be fitted when and why?

A

crown 24 hrs before denture to ensure that cement is fully set

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53
Q

what should be done at the try-in stage of denture if also making a fixed prosthesis

A

try them both in together to ensure fit and function

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54
Q

what do you have to be really careful of when fitting a fixed prosthesis before a removable one

A

ensure crown is fully seated as this could offset the fit of the denture

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55
Q

what can precision attachments be used for

A
  • on retained roots for overdentures
  • on crown/inaly for dentrues
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56
Q

where are precision attachments more often found if on a fixed prosthesis

A

premolar

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57
Q

name 2 types of precision attachements

A
  • ball and post
  • tubelock
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58
Q

what type of precision attachment is used for overdentures

A

ball and post

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59
Q

what type of precision attachement is used for fixed pros

A

tubelock

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60
Q

what are 2 downfalls of precision attachments

A
  • technically demanding
  • difficult to repair if break
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61
Q

when would a two part denture be useful

A

gross tissue loss and different paths of insertion –> eg trauma pts

62
Q

what are used in two part CoCr dentures

A

split pins

63
Q

how does the acrylic part fit into the CoCr two part denture

A

acrylic fits into the pins on the different POI

64
Q

how does a swinglock denture work

A

engages bone and tissue undercuts for retention

65
Q

what is essential to ensure before constructing a swinglock denture

A

pt has good OH

66
Q

what type of denture would a swinglock usually be constructed for

A

lower partial kennedy class 1

67
Q

what type of denture would a swinglock usually be constructed for

A

lower partial kennedy class 1

67
Q

what type of denture would a swinglock usually be constructed for

A

lower partial kennedy class 1

67
Q

what type of denture would a swinglock usually be constructed for

A

lower partial kennedy class 1

67
Q

what type of denture would a swinglock usually be constructed for

A

lower partial kennedy class 1

68
Q

what type of connector might be constructed for lower lingually tilted teeth

A

buccal bar

69
Q

what may be added to dentures for bruxists

A

metal backing to teeth to stop anteriors dislodging

70
Q

what type of teeth may be added to dentures for bruxists

A

cross linked

71
Q

what will you receive from the lab for the try-in stage if doing a replica denture

A

teeth in wax with shellac base

72
Q

what does the try in base being in wax give us the opportunity to do at try in

A

move teeth as required

73
Q

what might changes needed at finish result in

A

remake

74
Q

what should stress and request from the pt at try in

A

this is their opportunity to change things shade etc - request honest opinon

75
Q

what should you check the teeth for at try in stage

A
  • postion
  • aesthetics
  • occlusion
76
Q

what should you check for try in of CoCr denture

A
  • fit
  • rest seats flush to teeth
  • index teeth occlude
  • clasps engage
77
Q

what should you do initially if the CoCr denture is not fitting at try in

A

remove the teeth and wax and try in the framework alone

78
Q

what might be the reason for a try in CoCr denture not fitting if the framework fits fine

A

posterior occlusion

79
Q

what should be the first three try in checks

A
  • lip support
  • incisal level
  • occlusal planes
80
Q

what are 2nd three try in checks

A
  • retention/ stability
  • position of teeth in relation to ridge
  • base extensions
81
Q

what are the 3rd two try- in checks

A
  • vertical dimension
  • even occlusal contact
82
Q

what are the last two try in checks

A
  • speech
  • aesthetics
83
Q

how to you assess lip support at try in

A

look at pt from the side

84
Q

how do you check incisal level at try in

A

check where it sits in relation to the upper lip and the pt is showing the correct amount of teeth when smiling

85
Q

how do you check occlusal plane at try in

A

foxes guide plane

86
Q

why might there be poor adaptation at try in

A

poor imps

87
Q

how do you check the vertical dimension of a denture at try in

A
  • index teeth meeting
  • adequate FWS
  • no sliding on occlusion
88
Q

what should you do if the vertical dimension is off at try in

A

compare on the articulator to in the pts mouth

89
Q

what are you trying to figure out if the vertical dimension is off at try in

A

is the problem with articulation or master imp

90
Q

what should you advise the pt to do when seeing the denture at try in

A

hold the mirror at arms length to see how others will see them

91
Q

what should you do at the end of the try in appt before going to finish

A

get the pts permission

92
Q

how can you fix an aesthetic issue at try in appt

A

clinical photographs to show lab issue

93
Q

what can you do if the denture is overextended at try in

A

trim until happy

94
Q

what can you do if the denture is underextended at try in

A

draw on cast where you want the extensions to finish then retry appt

95
Q

what should you do if the imp doesnt record full sulcus depth and the denture is underextended at try in appt

A

new imps and retry

96
Q

what does poor adaptation in the mouth but good fit to cast indicate

A

error in imp or casting

97
Q

what should you do if theres a problem with adaptation at try in

A

new imp, wax up, retry

98
Q

what should do if theres a small error with CoCr framework at try in

A

if small then attempt adjustment

99
Q

what should you do if theres a large error with CoCr framework at try in

A

new imp, cast and try in

100
Q

what is the problem with retrying a CoCr framework

A

expensive mistake

101
Q

what should you do if theres an issue with occlusion at try in

A
  • if one tooth then reset it
  • if multiple then retake occlusion
  • then retry both
102
Q

what should you do if the FWS is correct but the teeth dont occlude properly at try in

A

add wax until teeth meet
rerecord occlusion
retry

103
Q

what should you do if theres inadequate FWS at try in

A
  • remove occluding teeth
  • replace with wax
  • establish correct OVD
  • record occlusion
  • retry
104
Q

what do you request from the lab when you take a denture to finish

A

post dam placement and size

105
Q

what are the 3 types of acrylic that you can prescribe a denture for

A
  • heat cure
  • cold cure
  • high impact
106
Q

what is the first step at a fit appt before trying the denture in

A

check its the correct work

107
Q

what do you check at a fit appt

A
  • comfort
  • retention and stability
  • base extensions
  • appearance
  • speech
  • occlusion
  • vertical dimensions
108
Q

what do you do if a clasp isnt engaging at the fit appt

A

adjust with adams pliers

109
Q

how might you tell the denture is overextended just by looking at it in the mouth

A

the tissues blanch

110
Q

when does an overextended denture need to be adjusted by the lab

A

if significant changes

111
Q

what should you do if on review the pt is struggling with the palatal extension of a new denture

A

ask them to persevere one more week to try and adjust to the new changes

112
Q

what appearance changes to the denture can be made on review

A
  • shortened
  • single tooth replaced
113
Q

what will be required if the pt wants to change the shade or shape of the teeth at the final fit of a denture

A

remake

114
Q

what changes to the teeth will cause changes to the pts speech

A
  • changes to OVD
  • anterior tooth position
115
Q

will a change in speech settle over time with a new denture?

A

yes

116
Q

what should you do if there is premature contact of occlusion

A

indentify with articulating paper and adjust with bur

117
Q

what might the pt struggle to do if there have been changed made to the occlusion

A

bite in a consistent way

118
Q

what should you ALWAYS remind a pt at the fit of a denture

A

they need to persevere in wearing it

119
Q

when should a review be made after a denture fit

A

1 week

120
Q

what should new denture wearers be advised at the fit appt

A

they will salivate more than normal

121
Q

when would you arrange an ease appt earlier than normal

A

if the pt is new to wearing dentures

122
Q

how often should ease appts be made after fitting a new denture

A

1-2 weeks subsequently

123
Q

when should you stress is important for the pt to wear their denture before an ease appt

A

24 hrs before

124
Q

why do we want the pt to wear the denture consistently before an ease appt

A

makes areas causing trauma easier to identify

125
Q

what areas commonly hurt after the fit of a new denture

A
  • frenum
  • tuberosity
  • sulcus’
126
Q

what would the pt complaining of a denture moving indicate

A

poor adaptation

127
Q

how do you assess adaptation of a denture

A

apply vertical forces to see if it rocks

128
Q

what can you do for a denture with poor adaptation

A

reline

129
Q

what oral med condition may affect the retention of a denture

A

dry mouth

130
Q

can you help movement of a denture due to flabby ridge

A

not really - counsil pt

131
Q

what might cause a pts jaw to hurt after the fit of a new denture

A

OVD adjustments

132
Q

will pain in the jaw resolve after a new denture fit

A

not always

133
Q

if pain in the jaw doesnt resolve after having a new denture fitted what can you do

A

remake

134
Q

what should you check if the pt is complaining of a sore jaw after having a new denture fitted

A

check sifficient FWS

135
Q

what should you advise the pt if they are complaining of their bite feeling wrong with their new denture, but O/E its all good

A

may take some time for them to adapt and muscles to retrain

136
Q

what do anterior aesthetic complaints about dentures often require

A

remake

137
Q

what appearance can dentures with an incisal level thats too low give

A

horse like

138
Q

when should the initial ease appt for an IR be

A

24 hrs after fit

139
Q

what should you check at IR ease appt

A
  • any areas hurting
  • flanges extending into the undercuts
140
Q

what should you check the pt is able to do at an IR ease appt

A

take the denture in and out

141
Q

where can a reline be done

A

chairside or in lab

142
Q

why should you not reline an IR too quickly

A

further healing and gapping may occur

143
Q

when should a ridge be fully healed after XLA

A

6 months

144
Q

what should you do if there are significant changes to the fit of an IR 6 months after XLA

A

new denture

145
Q

what factors may affect a reline/rebase

A
  • is pt willing to be without denture while changes are being made
  • financial
146
Q

how often are pts with complete dentures recalled

A

annually

147
Q

what might you also want to do if having to tighten clasps on a loose denture

A

teach pt correct way to take it in and out

148
Q

what may cause discolouration of a denture

A
  • calculus
  • bleached by cleaning agent

module 8 (9 decks)

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