11 RPD Delivery

Question 1

Three stages to RPD delivery

Answer 1

1. Initial adjustment (intaglio surfaces and periphery, occlusion)
2. Patient education
3. Follow-up adjustments/maintenance

Question 2

Steps for initial adjustment

Answer 2

1. Try to seat RPD (watch for acrylic flange undercuts)
2. PIP intaglio, moisten surface with Mizzy spray
3. Place RPD, but do not let patient bite down
4. Apply firm vertical pressure with fingers
5. Remove and inspect for thinned/rubbed areas
6. Make minimal adjustments with small rounded acrylic bur for small access or pear shape acrylic bur for larger areas
7. Repeat PIP until desired PIP pattern

Question 3

Occlusal adjustments for Class I, II, III, IV - which can you do intraorally and which require clinical remount?

Answer 3

Class I or II - Clinical remount

Class III/IV - Intraorally

Question 4

Tools needed for initial adjustment (4)

Answer 4

1. Accufilm
2. Green indicator wax
3. Shim stock
4. Round burs and/or stones

Question 5

Occlusal adjustment for opposing RPD or CD - Which do you select as the “intact” arch?

• Tooth borne vs distal extension
• Both tooth borne
• Both distal extension

Answer 5

1. Tooth borne
2. One with the most natural teeth
3. Maxillary arch (since it’s more stable)

Question 6

Instructions to Patient

Answer 6

1. Sore spot development
2. May have feeling of fullness
3. Salivary activity increased
4. May have initial change in speech
5. Potential for tooth soreness
6. RPD may slightly loosen
7. Gagging

Question 7

Instructions to Patient - Gagging advice (5)

Answer 7

1. If not too severe, pt may adapt
2. May have overextended borders
3. May be insufficient polish
4. May be excessive salary flow
5. Light contact in post dam area

Question 8

Home care instructions

Answer 8

1. Do not drop RPD
2. Rinse under running water after eating & rinse mouth
3. Remove and brush at end of day over basin of water (w/ non-abrasive dentrifice)
4. Home denture cleaning solutions is okay (no bleach)
5. Do not wear RPD at night
6. Keep in container with water
7. Review hygiene (to maintain remaining teeth)
8. Don’t place in napkin when eating
9. Keep out of reach of dogs

Question 9

What are the criteria for a successful RPD?

Answer 9

1. Adequate patient education
   1a. what to expect from RPD
   1b. Limitations of RPD
   1c. Materials used to make RPD
   1d. How to care for RPD
2. Confidence in dentist
3. Adequate recall and maintenance