Removable Test 1 Flashcards
(208 cards)
1
Q
How many appointments required for Diagnostic Exam for prosth?
A
2 appointments
2
Q
What 5 things are accomplished in the first prosth appointment?
A
- Thorough health history
- Preliminary oral cavity exam
- Dental prophylaxis
- Radiographic survey
- Accurate max and mand impressions
3
Q
What are the 4 major patient psychological categories by Dr. MM House?
A
- Philosophical
- Hysterical
- Exacting
- Indifferent
4
Q
Patient’s with Systolic pressure exceeding ____ or diastolic exceeding _____ should be considered to have a potentially serious medical condition indicating a medical consult?
A
130mmHg systolic
90mmHg diastolic
5
Q
What are 2 oral conditions seen in uncontrolled diabetes?
A
- Small oral abscesses
2. Poor tissue tone
6
Q
Diabetic patients can have what oral condition that can make prosthesis wear difficult as well as increase caries risk?
A
Reduced salivary output
7
Q
Where can Paget’s disease can cause enlargements that can change fit of a prosthesis?
A
Maxillary tuberosities
8
Q
Patient with this disease will show enlargement of the mandible which can change fit of prosthesis?
A
Acromegaly
9
Q
What neurological disease causing rhythmic muscle contractions making prosthesis planning as well as wear difficult?
A
Parkinson’s disease
10
Q
What is a disease with oral bullae showing first then moving onto the skin?
A
Pemphigus vulgaris
11
Q
What is a consideration for material use when making a RPD for an epileptic patient?
A
All material should be radiopaque in case swallowed or aspirated during seizure
12
Q
What 2 things are usually indicated with increasing age?
A
- Need for some type of prosthesis
2. Need for prescription or OTC meds that can affect dental treatment
13
Q
What is the most significant side effect of antihypertensive drugs?
A
Orthostatic hypertension
14
Q
What usually initiates bruxism?
A
Interceptive occlusal cotacts/occlusal permaturities
15
Q
What are some physical characteristics to note during the interview?
A
- Neuromuscular/neuromotor deficits
- Length and mobility of lips
- Decreased vertical dimension of occlusion (VDO)
- Speech problems
16
Q
What is the most important measure to minimize disease transmission between patients and dental care providers?
A
The routine use of gloves
17
Q
Must custom trays, record bases, and occlusion rims be disinfected after construction?
A
Yes. Stewart’s says 2 minutes of sodium hypochlorite application
18
Q
Impressions should be loosely wrapped in plastic and set aside for how many minutes after rinsing with water and disinfecting?
A
No less than 2 min
19
Q
Casts should be poured no more than _____mins after removal of alginate from mouth?
A
12 mins
20
Q
What are 3 responsibilities of the dentist to explain for patient oral hygiene?
A
- Signs and symptoms of disease
- Materials and techniques for proper home care
- Patient’s responsibility to prevent further dental disease
21
Q
Which radiograph is essential for determining the crown-to-root ratio and the condition of the periodontal tissues?
A
Periapical
22
Q
What radiograph helpful to identify interproximal caries on the remaining teeth?
A
Bitewing
23
Q
Which radiograph is ideal for screening for pathologic conditions?
A
Panoramic
24
Q
Is a panoramic radiograph adequate for the definitive examination of a RPD patient?
A
No
25
An RPD exam is considered incomplete unless it includes what?
Evaluation of accurate diagnostic casts
26
What items serve as blueprints for placements of restorations, recontouring of teeth, and the preparation of rest seats?
Surveyed and marked diagnostic casts
27
Casts are normally mounted and evaluated during which diagnostic appointment: first or second?
Second (get facebow record at second app)
28
What is the material of choice for diagnostic impressions?
Irreversible hydrocolloid/alginate
29
Is the accuracy of irreversible hydrocolloid affected by changes in the water-powder ratio?
No, will only change consistency and setting time
30
What type of measurement performed using a scoop, and is inaccurate because the powder can be loose or tightly packed within the scoop?
Volumetric measurement
31
What measurement technique is the preferred method for alginate powder?
Weight measurement
32
What alginate weight is used for most impressions?
28g
33
What amount of water mixed with the 28g of alginate powder?
68-72 mL
34
What is the manufacturer recommended temperature of water for alginate impressions?
22°C/72°C
35
What can increase the working time of alginate?
Refrigerate mixing bowl and water
36
What are 2 primary mechanisms of distortion of alginate impressions resulting in inaccurate diagnostic casts?
1. Evaporation
| 2. Absorption of liquids/imbibitions
37
Evaporation does what to the alginate impression?
It causes it to shrink
38
What results in localized expansion of the completed impression?
Imbibitions
39
Should alginate impressions ever be wrapped in wet paper towel or immersed in a liquid and why?
No, such things carry a risk of imbibitions
40
What are 3 factors contributing to alginate sticking to teeth?
1. Impression done after thorough polishing
2. Teeth dry
3. Repeated impressions
41
What are the impression trays of choice for RPD impressions?
Nonperforated metal trays
42
What is the most important factor in determining impression tray size?
Width of dental arch
43
There should be clearance of ___mm to ___mm between inner flange of tray and the facial surfaces of the remaining teeth and soft tissue?
5mm-7mm
44
What are 3 techniques to prevent gagging during impression making?
1. Patient sits upright
2. Max tray modified posterior to stop alginate flow down throat
3. Use astringent mouthwash or cold water rinse immediately prior to making impression
45
When mixing alginate: should you add water to powder or powder to water?
Powder to water (water in bowl first, add preweighed powder to it)
46
What is the minimum time to spatulate alginate?
45 sec
47
What is the most consistent method for alginate spatulation?
Mechanical under vacuum (20lbs for 15 sec)
48
Stewart’s suggests making which impression first and why?
Mandibular. Less discomfort, increases patient confidence
49
The gelation of alginate impression material is complete within ___ min?
2-3 min
50
When should an impression be repeated?
When there are voids in critical areas
51
Stewart’s says to leave an alginate impression in the mouth how long after the loss of surface tackiness to allow development of additional strength?
2-3 min
52
The gel strength of alginate does what during the first 4 minutes after initial gelation?
It doubles
53
To ensure an alginate is ready to remove, what can be used to verify?
Small mound or original mix fractures cleanly with finger pressure
54
Should an impression be removed from the mouth with a rapid tug directed along the long axes of the teeth or with a slow rocking motion?
Rapid tug along long axes teeth
55
What is essential in all phases of RPD design and construction?
Cast with dense, abrasion-resistant surface
56
Surface hardness of a stone cast is directly related to what?
Compressive strength
57
Compressive strength of a stone cast is directly affected by what?
Water-powder ratio when cast is made
58
All gympsum products (both plaster and stone) require what water-powder ration?
18.61 mL to 100g powder
59
What is formed when water is added to powder for dental plaster or stone?
Calcium sulfate dehydrate
60
All gypsum products should be measured by ____ rather than by ______?
Weight rather than volume
61
Gypsum mixed how: water to powder or powder to water?
Powder to water (water in bowl first, then add preweighed powder to it)
62
What is adequate gypsum mixing time?
60-90 sec
63
What dental stone is indicated for diagnostic and master casts?
Minimal expansion. ADA type II or type IV stone
64
What is the pour technique for alginate impressions resulting in casts in which teeth and soft tissue areas are densest and most abrasion resistant?
2 stage pour technique
65
Why not do a single stage/inversion pour technique?
Water will rise to the surface. In this case it would be the teeth, making them brittle
66
In 2 stage pour, the initial pour is allowed to go to initial set, which is ____ min?
12-15 min
67
What is done with the initial pour cast after initial set, before putting on second pour?
Soak in clear slurry water for 4-5 min
68
What is a supersaturated solution of calcium sulfate made by placing chips of dental stone in water for 48 hrs?
Clear Slurry
69
What is the benefit of clear slurry soak of first pour?
Allows wetting of 1st pour without dissolution of stone
70
How is the 1st pour placed on the 2nd pour?
Inverted on the second pour and edges cleaned up with a spatula
71
How long after the first pour should the cast and impression be separated?
45-60 min
72
What is the maximum time alginate should be allowed to stay in contact with stone cast?
60 min
73
Should a cast be trimmed if it is dry?
No, should soak in clear slurry first
74
The base of a cast should be trimmed to what thickness?
10-13 mm thick at the thinnest point with occlusal plane parallel to the deck
75
Where is a mandibular cast thinnest, and where is a maxillary cast thinnest?
Mandibular thinnest in lingual sulcus
| Maxillary thinnest at center of hard palate
76
How should the posterior surface of cast be related to midline of the palate?
Perpendicular to midline
77
Land area of ___ mm is trimmed around entire cast?
2-3 mm
78
Are anterior borders of max and mand casts trimmed the same?
No
79
How is the anterior max cast trimmed?
Angular, originates from canine area on each side and extends to a point anterior to central incisors
80
How is anterior mand cast trimmed?
Gently curves, originates from one canine curving around to the other canine
81
What is the most common cause of surface roughness of dental casts?
Adherence of alginate to enamel
82
Leaving alginate in contact with cast greater than 60 min after initial pour causes what?
Surface etching (soft, chalky surface)
83
What are the 3 phases of mounting a cast?
Orient maxillary cast to articulator condylar elements via facebow
Orient mandibular cast to maxillary cast via centric relation record
Verification
84
Most facebows rely on what hinge axis: true or arbitrary?
Arbitrary
85
The external auditory meatus is what relation to the true hinge axis and how is this corrected?
Superior and posterior corrected on the articulator by the manufacturer based on anatomic averages
86
What is one of the most commonly used points for the arbitrary hinge axis? (Hint: It is 13 mm anterior to the margin of the tragus on an imaginary line between the posterior margin of the tragus and the outer canthus of the eye)
Beyron's point
87
What is the plane established by the infraorbital notch and the external auditory meatus openings is approximately parallel to?
Frankfurt horizontal plane
88
What is the hysiologic relation of the mandible to the maxilla when both condyles are properly related to their articular discs, and the condyle-disc assemblies are stabilized against the posterior slopes of the articular eminences?
Centric relation
89
Centric relation is what type of relationship?
Bone-to-bone, and independent of tooth contact
90
Final stage jaw closure guided how?
Occlusal and incisal surfaces of teeth
91
What is the most common cause of bruxism, accelerated wear and TMD?
Interferences between Centric Relation and Maximum Intercuspation
92
What are the advantages of using metallic filler wax for centric relation records?
Uniform heating and cooling
| Extended work time as metal holds heat longer
93
What must be used to record CR when one or more distal extensions are present, or when the tooth bounded edentulous area is large, or when opposing teeth do not meet?
Record base with occlusal rim
94
When using an occlusal rim for CR records, it should be trimmed to allow how much clearance between the opposing teeth or other wax rim?
1-2 mm
95
When mounting the mandibular cast to the maxillary cast in CR, should the maxillary cast be left on the articulator or taken off?
Taken off (WTF?)
96
Will the articulator index pin stay at the neutral setting or must it be opened/ raised 2-3 mm when mounting the mandibular cast to the maxillary cast in CR?
Opened 2-3 mm
97
How do you verify correct CR mounting?
Remove incisal guide pin, release condylar locks. Place verification record. If all cusp tips engage and condylar balls are still in contact with their housing, then mounting is good
98
What are 2 ways to set the condylar elements of articulator?
1. Protrusive record
| 2. Relate wear facets on remaining teeth
99
Does preventive dentistry for a partially edentulous patient mean the retention of every retainable tooth?
No, sometimes better if they come out
100
What are 6 causes of tooth sensitivity?
1. Tooth moving due to traumatic occlusion or bad RPD
2. Restoration with traumatic occlusion
3. Periapical or pulpal abscesses
4. Acute pulpitis
5. Gingivitis or periodontitis
6. Cracked tooth
101
What are 3 reasons for tooth mobility?
1. Trauma from occlusion
2. Inflammatory changes in PDL
3. Loss of osseous support
102
When is splinting with a fixed partial denture indicated?
First premolar and molars are lost and 2nd premolar is to be used as an abutment
103
What is the adequate tissue rest time?
The patient should remove the prostheses 6-8 hrs/day
104
What are 4 tissue reactions related to prostheses?
1. Papillary hyperplasia
2. Epulis fissuratum
3. Denture stomatitis
4. Soft Tissue displacement
105
What are the 3 most common undercut areas?
1. Maxillary tuberosities
2. Distolingual areas of mandible
3. Recent extraction sites
106
Lingual bar major connector must be minimum___ height
5mm
107
Superior margin of lingual bar major connector should be ____ from free gingival margins of mandibular teeth
3mm
108
Inferior border fo the lingual bar major connector should be ___ from the activated floor of the mouth
1mm
109
Can a tooth with a poor prognosis still provide support for an RPD?
Yes
110
What are 2 disorders where the Lamina dura is completely lost radiographically?
1. Paget’s Disease
| 2. Hyperparathyroidism
111
Other than Paget's Disease and Hyperparathyroidism, what may cause loss of the lamina dura?
Function
112
Pre-prosthetic surgery to remove a soft tissue maxillary tuberosity should have what healing time?
7-10 days
113
Pre-prosthetic surgery to remove a boney maxillary tuberosity should have what healing time?
2-3 weeks
114
What is the maximum amount of enamel that can be removed in enameloplasty to try and even an occlusal plane?
2mm
115
What percent of patients have a noticeable discrepancy between CR and MI?
90%
116
What are the 2 most common causes of bruxism?
1. Occlusal interferences b/w CR and MIP
| 2. Occlusal contacts on Non-working side
117
What are 5 indicators to construct RPD at CR?
1. Coincidence of CR and MIP
2. Absence of posterior tooth contacts
3. All posterior tooth contacts will be restored with fixed prosthodontics
4. Few remaining posterior contacts
5. Existing occlusion can be made acceptable with minor occlusal equilibration
6. Clinical symptoms of occlusal trauma
118
What are the 4 broad diagnostic categories for placing a patient in one of the 4 Prosthodontic Diagnostic Index (PDI) classes?
1. Location and extent of edentulous areas
2. Condition of abutments
3. Occlusion
4. Residual ridge characteristics
119
What are the 4 basic parts of every dental surveyor?
1. Level platform
2. Vertical column
3. Horizontal arm
4. Surveying arm
120
From which point of view is the tilt of the cast described?
Looking at posterior surface
121
What are 4 critical factors to consider when determining cast tilt?
1. Presence of suitable undercuts
2. Elimination of hard and soft tissue interferences
3. Create desirable esthetics
4. Guiding planes
122
What is the unchangeable rule when surveying diagnostic casts?
Retentive undercuts must be present on abutment teeth when cast is at horizontal tilt
123
Dislodging forces of an RPD are always directed in what relation to the occlusal plane?
Perpendicular
124
Each of the proposed abutments should display how much undercut at the most desirable location?
0.010-inch
125
If a wrought-wire clasp is planned the retentive undercut should be how much to allow for the greater flexibility of the wrought wire?
0.0150-inch
126
Where should the undercut be located?
Apical 1/3 of clinical crown
127
The retentive clasp should go no farther occlusally/incisally than what?
The junction of gingival and middle 1/3
128
What commonly interferes with the major connector of the maxillary RPD?
Palatal tori
129
What are common on the buccal surfaces of the maxillary arch?
Exostoses and undercuts
130
Maxillary posterior teeth tend to tip which direction?
Facially
131
Mandibular posterior teeth tend to tip which direction?
Lingually
132
Where are bony prominences often encountered?
Facial surfaces mandibular canines and premolars
133
What is the ideal position for a retentive clasp?
Gingival 1/3 of clinical crown
134
Which teeth are exceptions to the tendency towards drifting mesially to fill in edentulous spaces?
Mandibular canines and premolars, which move distally
135
How many paths of insertion will an RPD have it there is one or more missing anterior teeth?
One
136
Parallel surfaces of abutment that direct the insertion and removal of a partial denture are called what?
Guiding planes
137
Guiding planes contact what part of an RPD?
Minor connector
138
Guiding planes are always parallel to ____ and are ____ in height?
Path of insertion
| 2-4 mm high
139
What is the purpose of guiding planes?
Stabilize prosthesis against lateral forces
140
Which of the four factors for determining tilt of cast is the most easily compromised?
Guiding planes
141
What is the most influential factor for determining whether prosthesis will have one or more paths of insertion?
Whether or not edentulous spaces are tooth bounded
142
What are the components of the RPD that govern the path of insertion?
Minor connectors
143
What is the term for placing crossmarks at 3 widely spaced points on the dental cast while the vertical arm of the surveyor is held at a fixed vertical position?
Tripoding
144
What is the term for lines representing the most prominent contours of individual teeth at a chosen orientation?
Survey lines
145
What are 4 things dentist does during the surveying process for RPD?
1. Determine most favorable tilt
2. Tripod
3. Survey lines
4. Mark desirable undercuts
146
Is RPD a form of treatment or a cure?
Treatment only
147
Is direct retention the primary objective of RPD design?
No. Main objective are restoration to function and appearance. Preserve remaining oral structure.
148
What is the consideration when choosing clasps for an RPD?
Use simplest clasp to satisfy design objectives
149
A class I prosthesis (Bilateral posterior edentulous spaces) require how many clasp assemblies?
2
150
What clasp material should be used to engage a mesiobuccal undercut in a Class I prosthesis?
Wrought wire
151
A class II prosthesis (Unilateral posterior edentulous space) requires how many clasp assemblies?
3
152
What should be the placement of the clasps on the dentate portion of a Class II prosthesis?
One as far posterior and one as far anterior as contours and esthetics permit
153
What is the purpose of indirect retention?
Neutralize unseating forces
154
What is the limit for indirect retainer placement?
No more anterior than canines
155
A class I prosthesis (bilateral posterior edentulous spaces) should have how many indirect retainers?
2
156
How many indirect retainers are adequate for a Class II prosthesis (unilateral posterior edentulous space)?
One. Located on side opposite distal extension as far from fulcrum line as possible.
157
A lass III prosthesis (posterior tooth-bounded edentulous space) requires how many clasps?
4
158
Does a Class III prosthesis (posterior tooth- bounded edentulous space) require indirect retention?
No
159
What are the 2 most commonly cited causes for abutment loss?
1. Overloading
| 2. Periodontal disease
160
What are the elements of the I-Bar assembly?
I-bar
Mesial rest
Distal proximal plate
161
What provides vertical support against occlusal forces and control the vertical relationship between the prosthesis and the supporting structures?
Rests
162
What are the advantages of placing a rest more anteriorly?
Increased distance from denture base makes arc of rotation more linear and helps direct forces onto the residual ridge
163
How far should a maxillary major connector be positioned from tooth-tissue junctions?
6mm
164
What are 3 major advantages of the I-bar configuration?
1. Food accumulation minimized
2. Clasp terminus disengages when distal extension loaded
3. Minimized lateral forces
165
What is a common site for a maxillary indirect retainer?
Maxillary canine
166
What is a common site for a mandibular indirect retainer?
Mesial fossa of mandibular first premolar
167
Teeth that have been unopposed for a prolonged period tend to do what?
Supereruption
168
What is a side effect associated with maxillary supraeruption?
Downward migration
169
What is the first option to correct molar tipping or malalignments prior to RPD design?
Orthodontic correction
170
Splinting of posterior teeth provide additional resistance to what forces: A-P or Mediolateral?
Anterior-posterior
171
When splinting posterior teeth, what must be included to resist mediolateral forces?
One or more anterior teeth
172
What is the major drawback of fixed splinting periodontally involved teeth to support RPD?
Hard to floss, so decreased oral hygiene in patient with already compromised oral health
173
How is splinting accomplished with an RPD?
Lingual plating in conjunction with multiple facially positioned clasps
174
What is indicated on a pier abutment, e.g. a lone standing tooth at the distal aspect of Kennedy Class I or Class II partially edentulous areas: a clasp or a rest?
A rest
175
Of the 6 Phases of RPD treatment, during which phase is the mouth prepared for the RPD?
Phase II
176
When planning preparation of the mouth, what is planned first?
Worst first
177
When is an interference allowed in excursive movements with an RPD?
when C/RPD
178
When do abutment preparations for the RPD come in Phase 2?
At the end of Phase 2 after ODCT
179
What is the recall schedule Post RPD delivery?
24 hr recall then 7-14 days recall then 1 month recall
180
What are 3 questions to ask when evaluating dentures of a new patient?
1. Are the dentures good enough?
2. Do I need to fix them?
3. Should new ones be made
181
What is the interocclusal clearance in the premolar region for mandibular rest position?
2-4mm
182
How should the maxillary incisal edges relate to the contour of the lower lip when smiling?
Follow contour lower lip
183
What is the term for resistance to denture movement when occlusalward forces are applied?
Retention
184
What is the term for resistance to denture movement when tissueward forces are applied?
Stability
185
What are chewing instructions for dentures?
1. No incising
2. Chew bilaterally simultaneously
3. Vertical chewing strokes
186
The RPD framework must contact at least how many teeth?
3 teeth
187
If you stick your finger on the buccal surface of your posterior maxilla as far back as your 2nd molar, and then make lateral mandibular movements, what bumps into your finger?
Coronoid process of your mandible
188
Why is the proprioception in natural teeth important?
Help avoid prematurities during function
189
What is the vertical and horizontal displaceability of natural teeth?
0.03 mm
190
What is the vertical and horizontal displaceability of artificial teeth?
Vert 0.4mm, horizontal can be up to several mm
191
How are artificial teeth placed in the posterior: more lingually or buccally?
Lingually
192
What type of contacts are used to stabilize the dentures during function in the artificial dentition?
Balancing contacts
193
These forces can be adapted to in the natural dentition, but are not adapted to and can produce symptoms in the artificial dentition?
Non-vertical forces
194
What is not desirable in artificial dentition that will cause destabilizing forces on the maxillary complete denture?
Mutually protected occlusion
195
What is the envelope of function for artificial dentition?
Up and down versus the teardrop envelope of natural dentition
196
What is the difference in closing force between natural and artificial dentition?
5-175 lbs for natural vs 22-24 lbs artificial
197
What is the difference between malocclusion in natural vs artificial dentition?
Natural dentition malocclusion may be uneventful for years while artificial dentition malocclusion will have an immediate response
198
The ideal occlusal plane should be higher where: anterior or posterior?
Higher in the posterior
199
What is the width determination for a maxillary central incisor?
The patient’s bizygomatic width divided by 16
200
What are the 4 complete denture occlusal schemes?
1. Neutrocentric
2. Balanced w/ cusped teeth
3. Lingualized
4. Balanced with monoplane teeth set to curve
201
What are three occlusal schemes for the natural dentition?
1. Anterior guidance
2. Group function
3. Progressive disclusion
202
What is the anterior reference point for establishing the plane of occlusion?
Maxillary central incisal edge
203
What is the posterior reference point for establishing plane of occlusion?
1⁄2-2/3 up retromolar pad
204
What is the key to occlusion with artificial over natural dentition?
Bilateral occlusal contact of posterior teeth and prosthesis cannot hold opposing natural dentition apart
205
If the RPD is tooth-borne what occlusion is desirable?
As close to natural with mutually protected articulation
206
When should group function be used in a tooth-borne RPD occlusal scheme?
If group function was present before and did not contribute to tooth loss
207
What occlusion is desired for RPD opposing a complete denture?
Balanced
208
What is the term for bilateral, simultaneous contact of anterior and posterior teeth in centric and eccentric positions?
Balanced occlusion
