Removable Test 4 (Final) Flashcards by Matthew Stringham

What are 3 basic types of temporary removable partial dentures?

Interim
Transitional
Treatment partial denture

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What RPD is indicated when age, health, or lack of time precludes more definitive treatment, often used in young patients who have lost one or more teeth, but to prep abutments could risk mechanical exposure of large pulp chambers?

Interim partial denture

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At what jaw position is an interim partial denture normally constructed?

MIP

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What are the normal components of interim RPDs?

Acrylic resin denture base

Acrylic resin artificial teeth

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What is optional for an interim RPD?

Retentive clasps in surveyed undercuts

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What is a consideration for an interim RPD design material when long wear is anticipated (e.g. a preadolescent patient)?

Cast metal denture base. Better fit and improved hygiene.

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What retentive clasp can be used if no undercuts can be surveyed?

Ball clasps…must have sufficient occlusal space

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What are the wire type and gauge used for retentive clasps in the interim RPD?

Wrought wire 20 gauge - lighter than that is used for conventional RPD

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What is the first component of the interim RPD to be formed?

Retentive clasps

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What is done to the cast to ensure intimate contact of the artificial tooth and base with the edentulous ridge?

LIghtly scrape ridge crest and labial portion of cast

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What thickness of baseplate wax is added to the master cast to fabricate the interim?

Double-thickness (2mm)

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What are placed in the ridge lap portions of the artificial teeth to provide mechanical retention?

Diatorics

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Why are slight undercuts in the cast not eliminated for the interim?

They provide some retention

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What is the outline for a maxillary interim RPD?

Horseshoe major connector with acrylic resin contacting lingual surfaces of remaining teeth

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What is the denture base form for a mandibular interim RPD?

Lingual plating extending as far inferiorly as possible without encroaching on movable tissues

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How far posteriorly should the interim RPD major connector extend when replacing anterior teeth?

At least the distolingual surface of the first molar

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What are 2 reasons to extend interim RPD to DL of first molar when replacing anterior teeth?

Distribute forces generated by the RPD stability against anterior tipping forces

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What is the polymerization time for the interim RPD denture base?

20psi for 20 minutes in a pressure pot. With no pressure pot, allow the base to cure in a monomer-saturated environment

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On interim RPD delivery, what is painted on the intanglio surface prior to the initial placement?

Pressure-indicating paste (PIP)

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What is a concern during interim RPD try-in and how do you avoid it?

Locking interim in as acrylic engages undercuts, therefore do not force the interim on

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What are the occlusal goals of an interim RPD when replacing anterior teeth?

Free from opposing contact in CR or MIP

Light contact in eccentric movements

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What will occur if occlusal overloading of the prosthesis is present?

Rapid alveolar bone resorption

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What can be incorporated into the interim RPD to avoid occlusal loading and what is the easiest method?

Occlusal rests. Bend the wrought wire to engage occlusal surfaces of at least 1 posterior tooth on each side of the arch with denture base end having many angles to engage denture resin

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What is required information for the patient when delivering the interim RPD?

Treatment is temporary and definitive treatment must be planned and completed. if long-term interim, must have increased recalls

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What is an interim that is planned when some or all of the remaining teeth are beyond the point of restoration but immediate extractions are not indicated for physical or physiological reasons?

Transitional partial denture

When a transitional partial denture is planned for an extended period of time, the design will be cast metal. What design is indicated to adapt this cast metal framework to acrylic teeth as natural teeth are lost?

Lingual plating of the teeth most likely to be lost

What is put on the lingual plate as a tooth is lost to facilitate the attachment of a denture tooth?

A retentive loop

How is an impression made to create a transitional partial denture?

If RPD exists, take alginate with RPD in, pick up the RPD in the alginate, block out the denture bas portion, pour up entire impression in stone, then recover the RPD

What preparation is done on the cast for a transitional partial denture for teeth to be removed?

1. Cut out teeth even with surrounding gingival tissue 2. Make stimulated socket with center 2mm deeper than periphery 3. Scrape labial surface of cast slightly

What are 2 ways to aide retention of denture teeth in the lingual plating of transitional partial dentures?

1. Wire loops soldered to framework | 2. Perforations through the framework plating

If a denture flange is not planned on a transitional partial denture, how are the denture teeth to be arranged?

Butted to the ridge, which is why the labial surface is scraped

How soon after placing the transitional partial denture immediately after extractions should the patient be seen?

Within 24 hours

What is the recall for patients with a transitional partial denture?

Not greater than 3 months

What is frequently present in a transitional partial denture patient indicating the need for increased recalls to avoid periodontal abscesses?

Deep periodontal pockets

Pathology that may result from prolonged interim or transitional denture wear in conjunction with inadequate oral hygiene?

Marginal gingivitis

What tissues are frequent sites of inflammatory hyperplasia associated with interim or transitional partial denture wear?

Palatal tissues

What pathology is associated with "ill-fitting major connectors and poor oral hygiene"?

Papillary hyperplasia

What is commonly used "to carry tissue conditioner to abused oral tissues"?

Treatment partial dentures

Prolonged marginal gingivitis can lead to what?

Chronic periodontal disease

What are 2 ways oral soft tissues will react to chronic irritation?

1. Hyperplasia | 2. Recession

What are 2 common factors for hyperplastic tissues?

1. Continuous prosthesis wear with no tissue rest period | 2. Poor oral and prosthesis hygiene habits

What pathology can be described as a hyperplastic response to the overextended border of a denture base?

Epulis fissuratum

What is the term for a soft material applied to intaglio of complete or partial dentures to allow better distribution of forces over the dental arch?

Tissue conditioner

How long will tissue conditioner last before it hardens and becomes itself an irritant?

Approximately 1 week. Must be changed every 3-5 days

What are 2 components of tissue conditioner?

1. Powdered acrylic polymer (ethyl methacrylate) | 2. Liquid ethyl alcohol and aromatic ester

What is the mechanism of action for tissue conditioner?

1. Improved force distribution | 2. Short-term cushioning

if constructing a treatment partial denture, what is placed on the cast in the areas requiring conditioning?

Single layer of baseplate wax in area to be conditioned, then fabricate the rest of the denture as you would an interim

Which surface of the treatment partial denture is polished to prevent plaque and debris accumulation?

Cameo surface

What is the definition of "cameo surface"?

The viewable portion of a removable denture prosthesis

What is the definition of "intanglio surface"?

The portion of the denture or other restoration that has its contour determined by the impression, the interior or reversal

What is done with the treatment partial denture when the tissue conditioner is intitially placed and the treatment denture is initially seated in the patient's mouth?

Light pressure to cause conditioner to flow and perform border molding movements

How long should the patient sit quietly to allow for the gel stage of the conditioner to be reached?

4-5 minutes

What is placed on the cameo surface of the treatment partial denture to avoid tissue conditioner adhering to it?

Separator

What is done if areas of the denture base are exposed through the tissue conditioner material?

Relieve those areas and add new conditioner

What is the best method to relieve show-through areas of a denture base in the presence of surrounding tissue conditioner and why?

Coat tissue material with liquid soap. Relieve the show through. Soap prevents cutting fragments from adhering to the tissue conditioner

Is it permissible for the tissue conditioner to be allowed to dry?

No. The patient must be instructed that when the denture is not in the mouth it must be submerged in water.

What are RPD wearers at increased risk for due to the requirement to keep the prosthesis out of the mouth for some time each day?

Distortion and drainage

What are 2 special maintenance considerations for tooth-tissue supported proshteses?

Relining and rebasing

What is the term for adding new denture base material to the existing resin to make up for loss of tissue (and can be done in either the lab or chairside)?

Relining

What is the method of choice for relines?

Laboratory reline

What is a lab technique in which the bulk of the denture base is removed and replaced using new resin?

Rebasing

What is the easiest means of evaluating the space under the denture base and its need for a reline?

Place a thin mix of alginate in the RPD denture base, place in the mouth and allow to set up

What is the ratio for the alginate mix used for a reline evaluation?

1 scoop of powder and 2 measures of warm water

What is another means of evaluating support loss on a distal extension RPD?

Apply a seating force on the most posterior aspect of the denture base and observe if indirect retainers unseat

What are the alginate measurements of indirect retainer lift-distances that indicate a reline?

2mm alginate under base | Indirect retainer lifts 2mm or more

What is indicated if the existing RPD is short of ideal coverage of the denture bearing area; a rebase or a reline?

Rebase

What are 2 reasons to remove uniform depth of denture base before taking a reline impression?

1. Space for impression material so it doesn't displace soft tissue 2. Eliminate potential contaminants and give good bonding surface

The more displaceable the tissue on the denture base area, the more or less space is required for impression material?

More space required

What impression material is indicated for mobile tissue on the crest of the ridge?

Zinc-oxide eugenol material

What impression materials are indicated for dense, firm, tissue on the crest of the ridge?

1. Polysulfide rubber base 2. Polyether 3. Polyvinylsiloxane 4. Mouth temperature was

Can tissue conditioning materials be used as impression materials for relining?

Yes but they may displace tissues more

What is the most critical step in the reline procedure?

Maintain tooth-framework relationship during impression

Once the impression material has set up during the reline impression, what should the operator do and why?

Rock the framework around its fulcrum to ensure desired support is restored

When flasking the denture, does the impression of the ridge as well as the RPD to be relined go in the same parts of the flask?

No they are in separate parts

What will occur if the denture flask for a reline is not compeltely closed before closing? -

The entire RPD will be supported solely by the denture base

During conventional construction, what would incomplete flask closure only result in?

Premature contact on denture teeth

What is a danger with deflasking an RPD reline?

Damage of RPD framework, especially clasp arms

When doing a chairside reline, what is critical when mixing the reline material?

Sift polymer into monomer without trapping air

What is done to the denture base and the denture teeth before the chairside reline material is placed?

Cover these areas with tape to avoid getting reline material on them

How long will it take for most chairside resin relines to completely polymerize?

12-15 minutes

What are 2 expectations for intraoral (chairside) reline material?

1. Porous | 2. Lack color stability

What is indicated when denture bases do not extend to cover all the denture-bearing tissues, when the denture base has fractured or the base is irreparably discolored?

Rebase

What is the first step of RPD rebasing?

Relieve and shorten resin. Cover borders with compound and do border molding.

What is done after border-molding is done for rebasing?

Take impression as done with reline

How should the cast be poured for a rebase: with the entire framework, or only the edentulous ridge area?

Only edentulous ridge area

How far is the old denture resin removed?

Stop short of denture teeth

What reduces having an observable demarcation line between the old resin and the rebase resin?

Shape old resin borders to 90 degrees to exernal surface

What should the junction of the new and old resin be in a rebase when esthetics are not a concern to reduce stress concentration and increase strength?

Rounded junction

What can be done if the framework still fits, but the teeth and denture base are shot?

Heat resin from tissue side and pry it from retentive framework

What is done with a framework that fits and has had its base and teeth removed?

Placed back in patient's mouth and take impression. Framework must come out with the impression.

What is done with a framework recovered from the cast once it is poured up?

Pry it off along the inferior border of the major connector

How is the denture base repaired if both pieces are present (only resin involved, no framework)?

1. Put pieces back together with wax 2. Pour dental stone against tissue side and let it set up 3. Open and dovetail base at the fracture line 4. Overbuild chemically activated resin on the opened fracture/dovetailed line 5. Complete polymerization in a pressure pot 6. Finish and polish

When replacing a denture tooth on an RPD, how much denture base is removed?

Enough to allow at least 2mm of repair resin beneath the denture tooth

Why is resin slightly overbuilt during repairs?

To account for polymerization shrinkage

Removable Test 4 (Final) Flashcards

(94 cards)