Week 3 PP

Question 1

What are removable prosthodontics for?

Answer 1

Removable prosthodontics are used to replace missing teeth and can be taken in and out of the mouth freely.

Question 2

The two major types of removable prosthodontics are:

Answer 2

1. Partial denture
2. Full denture

Question 3

Dental Assistant’s Role for Removable Prosthodontics

Answer 3

-prepare materials
-record measurements and details for fabrication of the denture
-patient education
-ensuring case is back from the lab prior to appointments

Question 4

What are Partial Dentures?

Answer 4

Partial dentures replace the missing teeth in a quadrant or arch. The partial recieves its support from the underlying tissues and remaining teeth.

Question 5

Partial Dentures Components

Answer 5

Framework
Connectors
Retainer
Rest (Occlusal & Lingual)

Question 6

What is the purpose of the framework for partial denture?

Answer 6

Provides strength - the metal substructure

Question 7

What is the purpose of the connectors on a partial denture?

Answer 7

Join the various parts of the partial together to help distribute the stress evenly

Unite the parts of the partial denture into a single unit, holding the working parts in the proper position an distribute the stress

Question 8

What is the purpose of the retainer on a partial denture?

Answer 8

Also referred to as the clasp, directly supports and provies stability

Question 9

What is the purpose of a rest on a partial denture?

Answer 9

metal projection designed to control the seating of the prosthesis, distributes the retention load and food passage between the abutment tooth and reatiner. Rests are designed to lay within a prepared recess on the occlusal or lingual surface of the tooth.

Question 10

What is the purpose of an occlusal rest?

Answer 10

Minimizes trauma to the tooth by transmitting stress along the long axis of the tooth

Question 11

What is the purpose of the lingual rest?

Answer 11

Placed on the cingulum of the lingua lsurface of the tooth, where support is good, but away from visibility

Question 12

What is the major connector on a partial denture?

Answer 12

Connect the left and right sides of the partial

• mandibular is often a lingual bar or plate
  -max is a palatal bar or strap or complete palatal plate

Question 13

What is the minor connector on a partial denture?

Answer 13

connect the major connectors
with the other units of the partial (clasps and rests)
and maintain the integrity of the arch by anteriorposterior bracing action.

Question 14

Circumfrential-type retainer for partial denture

Answer 14

encircles and adapts to the contours of the abutment tooth

Question 15

Bar-type retainer for partial denture

Answer 15

extend from the gingiva to the occlusal

Question 16

What is the Denture Base? on Partial

Answer 16

Typically made of acrylic resin to provide a natural appearance.

Rest son the tissue providing coverage and stability

The denture teeth are held into the denture base

Sometimes referred to as the saddle

Question 17

What are the artificial teeth on a denture constructed from?

Answer 17

Acrylic resin or porcelain

Question 18

Partial Denture Considerations - Extra Oral

Answer 18

physical health - poor health may affect how well the partial is tolerated

mental health - patients with poor mental health may become agitated, concerned with or may be unable to keep the denture clean

patient motivation - is it for esthetic purposes? Are there other treatment options available?

age - in younger children may need to consider eruption patterns, older people may have unrealistic goals to maintain teeth that are no longer structurally sound

Dietary Habits – poor nutrition may lead to poor tissues which can affect overall tolerance

Social and Economic Factors – how important is it to the patient to replace the lost teeth

Occupation – people who need to speak or meet in public could be concerned about the change in appearance. Consider how surgery appointments are scheduled

Question 19

Partial Denture Considerations - Intra Oral

Answer 19

Musculature - strong muscle attachment is important, however, habits or a strong tongue may lead to difficulty with the prosthesis

Salivary Flow - may increase salivary flow, however too little saliva can make the prosthesis uncomfortable

Residual Alveolar Ridge - Support is provided by the alveolar ridge, without adequate support “sore spots” are created

Oral Habits - Clenching, grinding or mouth breathing can cause stress on the partial or affect retention

Tori - can affect partial fit, and may need to be surgically removed before fabrication

Question 20

Partial Denture Indications

Answer 20

-To replace several teeth in the same quadrant or same arch
-Serve as temporary replacement for missing teeth in a child as necessary
-To avoid additional reduction of tooth structure
-Replace missing teeth for a patient who cannot tolerate longer appointments or extensive preparation
-To allow the patient to maintain good oral hygiene
-To serve as a splint to support periodontally involved teeth

Question 21

Partial Denture Contraindications

Answer 21

• A lack of suitable teeth in the arch to support, stabilize and retain the denture
  -Rampant caries or severe periodontal conditions that threaten the remaining teeth in the arch
  -Lack of patient acceptance for esthetic reasons
  -Chronic poor oral hygiene

Question 22

Partial Denture Appointment Sequencing

Answer 22

1. Records - medical history, impressions, xrays and photographs (sent to lab as well)
2. Preparation - shade taken, preparation of teeth (rests), final impression, bite registration, creating lab rx
3. Try in - initial try in of framework with the teeth set in wax. Fit, comfort, shade and function are evaluated
4. Delivery - verify case has returned from the lab. only requires 20-3 min for insert
5. Post Delivery Check - completed a few days after delivery. DDS checks for sore spots and overall function

Question 23

Home Care Instructions for Partial Dentures

Answer 23

• After eating, remove the appliance from the mouth and rinse the partial to remove food debris.
• Handle the partial carefully, place a towel on the counter/sink or fill the sink partially with water to prevent damage if dropped.
• Do not bend the plastic or clasp portion of the partial.
• Don’t adjust the partial denture. Contact the DDS. If there are any issues.
• Carefully brush the abutment teeth and remaining natural teeth at least once per day. Use a soft toothbrush to clean the artificial teeth, tissues and in and around the clasps.
• Brush and floss the rest of your mouth.
• When not wearing, store the prosthesis in water or a moist air-tight container.
• The DDS will check the fit of the denture at regular check-up appointments.

Question 24

What are full dentures for?

Answer 24

Full dentures restore the function and esthetics of the natural dentition when all the natural teeth are missing.

Question 25

What supports a full denture?

Answer 25

The underlying tissues, alveolar ridge, hard and soft palate and mucosa support and retain the denture

Question 26

Full Denture Components

Answer 26

Base Flange Post Dam Artificial Teeth

Question 27

What is the Base on a Full Denture?

Answer 27

Made from acrylic to fit over the patient's alveolar ridge and tissue. If additional strength is required, it may be reinforced with metal mesh

Question 28

What is the Flange on a Full Denture?

Answer 28

the part of the base that extends from the attached gingiva to the surrounding gingival area

Question 29

What is the Post Dam on a Full Denture?

Answer 29

– Is the ”suction seal” which is created between the posterior of the base and the hard palate

Question 30

Full Denture Indications

Answer 30

* The patient is totally edentulous * Any remaining teeth cannot be saved * Remaining teeth cannot support a removable partial denture (or other alternatives) * The patient refuses alternative treatment options

Question 31

Full Denture Contraindications

Answer 31

-Another acceptable alternative is available -Physical or mental illness reduces patient cooperation -Patient is hypersensitive to the denture -Patient is not interested in replacing missing teeth

Question 32

Appointment Sequencing for Full/Complete Dentures

Answer 32

1. Records - Medical/dental history, radiographs, photographs, impressions (for custom tray fabrication) 2. Final Impressions - Impressions are taking using custom trays using final impression materials 3. Baseplate and Occlusal Rim Try-in - Try in is to check vertical dimension, occlusal relationship, smile line and canine eminence Baseplate is returned to the lab for fabrication: Artificial Teeth ◦ The mold, shade and material of the artificial teeth are selected and placed into the denture Occlusal Registration ◦ Occlusion is determined by using the patient's centric relation, protrusion, retrusion and lateral excursion. 4. Try In ◦ Try in consists of the baseplate with the artificial teeth set in wax (that resembles tissue). The occlusion is checked and returned to the lab on an articulator 5. Delivery ◦ Dentures are disinfected and delivered to the patient 6. Post delivery ◦ Scheduled 2-3 days after delivery, the dds removes the denture and checks for sore spots or pressure points. Minor adjustments are made if necessary.

Question 33

What is the Jaw relationship?

Answer 33

A detailed accurate recorrding of the patient's occlusion

Question 34

What is the vertical dimension?

Answer 34

A vertical measurement of the face between two points at the midline. One located above the mouth and one located below the mouth (nose and chin)

Question 35

What does the baseplate rims help the DDS determine?

Answer 35

With baseplate rims in place the DDS also determines the esthetic lip drape for the patient. If rims are too large the patient will struggle to close their lips and if too small the patient will appear to be pouting.

Question 36

What is centric relation?

Answer 36

position of the mandible when the condyles are positioned postsuperiorly in an unstrained position. Independent of tooth contact.

Question 37

What is intercuspation?

Answer 37

Cusp to fossa relationship of the upper and lower posterior teeth

Question 38

What is a smile line?

Answer 38

A line representing the area of the teeth that is visible when the patient is smiling

Question 39

What is Canine Eminence?

Answer 39

Vertical line that indicates the location of the canines.

Question 40

Home Care Instructions for Full Dentures

Answer 40

* Remove the denture and thoroughly rinse the mouth at least 1 x per day. * Thoroughly clean all surfaces of the denture; a special denture brush can be used. Avoid harsh abrasives like toothpaste. * Carefully hold the denture over a sink half filled with cool water. * Do not soak the denture in hot water or a strong solution (bleach) as these will damage the denture. * When not wearing the denture; store in a moist, airtight container to prevent drying and warping. The container will keep the denture from being accidently knocked to the floor, stepped on or broken. * Do not wear the denture at night.

Question 41

Post Op Instructions for Full Dentures

Answer 41

Day 1 – eat soft foods while you adjust to wearing your dentures Day 2-14 – it is normal to have increased salivation. Sore spots can be normal, rinse with saltwater rinses. The DDS can make minor adjustments to the denture if necessary. Day 15-29 – You may need to talk and eat all over again. You can begin to use a denture adhesive to increase fit and comfort Day 30 – remember to come in for regular denture check ups. New dentures are required every 5-10 years.

Question 42

What are Immediate Dentures?

Answer 42

Immediate dentures are placed immediately after the extraction of the patients remaining teeth. The immediate denture: * Serves as a compression device to healing tissues * Provides esthetics and function during the healing time * Must be replaced or relined in 3-6 months

Question 43

What is Relining?

Answer 43

Over time changes in the alveolar ridge and surrounding tissues may make is necessary to reline the partial denture Relining is accomplished by placing a new layer of denture resin over the tissue surface of the appliance.

Question 44

What is a rebase?

Answer 44

Replaces the entire denture base material on an existing prosthesis without changing the occlusal relationship of the teeth

Question 45

Indications for Relining or Rebasing

Answer 45

* Dentures are loose or ill fitting * A loss of vertical dimension occurs * Inflammatory hyperplasia is present. * Traumatic ulcers appear after long periods of comfortable wear.

Question 46

What is a Tissue Conditioner?

Answer 46

* Relining a denture must be done accurately * Patient’s supporting tissue must be healthy. * If the tissue is unhealthy a tissue conditioning material is placed for 3-4 days. * This material is a soft elastomer and is placed in the prosthesis and adapts to the supporting tissue and ridge, providing a conditioning effect on unhealthy tissues.

Question 47

What is an Overdenture?

Answer 47

Is a full denture that is supported by the bony ridge, oral mucosa and two or more remaining natural teeth (usually canines) or implants. -Retention and stability are increased which improves patient satisfaction -Fabrication steps are similar to those of a complete denture. *more expensive option but better option if patient can afford it