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Prostho > 12. Remount procedure > Flashcards

12. Remount procedure Flashcards

1
Q

Desired articulation for complete dentures?

A

Balanced articulation

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2
Q

During flasking there is a contraction of..

A

3-14 % in the acrylic resin

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3
Q

When does deformation of the denture occur in the process of constructing it? What deforms?

A
  • Flasking and deflasking

- changes in teeth positions

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4
Q

Accurate occlusal adjustments are difficult to achieve if…

A

preformed in the patient’s mouth

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5
Q

What cast is used for the remount procedure?

A

When taking a denture out of the flask, cast usually breaks. We make a new cast from the complete denture by putting the plaster into it directly

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6
Q

Remount procedure: To achieve balanced articulation extraorally, dentures must be transferred and mounted in a semi-adjustable articulator with…? (2)

A
  • Facebow transfer

- Centric relation occlusal records

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7
Q

Remount procedure: PCPI?

A

Must be customized

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8
Q

How many times must casts be mounted in the articulator for CDs?

A
  1. Teeth arrangement

2. Remounting procedure

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9
Q

Who makes the remount casts?

A

Dental lab

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10
Q

What happens to the working cast during manufacturing?

A

Usually destroyed while deflasking dentures

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11
Q

Final dentures have a VD that is…

A

Increased by 0.5-1mm because the cast is not in the fossa directly

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12
Q

Inadequate occlusal contacts lead to…? (2)

A
  • Unsuitable load transfer to supporting tissues
    (gingiva sores and bone resorption).
  • Reduction in retention and stability.
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13
Q

Remounting: Back cuts/ retentitve areas of the inner surface of both dentures should..

A

Be blocked ( with wax or other materials )

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14
Q

Remounting: _____ shaped wax plate is placed _____

A
  • U shaped

- At lingual area

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15
Q

What is poured on top of dentures for the remounting ? (2)

A
  • Separating fluid is laid over inner surface.

* Type IV plaster is poured into the inner surface of the dentures.

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16
Q

How do we get casts from dentures? (2)

A
  • Dentures are centered in the base formers

- Before plaster fully sets: notches to ease removal of denture from plaster.

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17
Q

Remount facebow transfer: PCPI/Bennet/Incisal pin?

A
  • PCPI of 45o.
  • Bennet angle of 15o.
  • Incisal pin at 0 mm.
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18
Q

Remount: facebow? (2)

A
  • Ideally with a kinematic facebow.

* It’s difficult with edentulous patients, so arbitrary facebows are the ones most commonly used.

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19
Q

Remount intermaxillary transfer: How is the aluwax heated?

A

45 degrees for 30s

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20
Q

Remount intermaxilarry transfer: how thick is the aluwax?

A

1mm

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21
Q

Remount intermaxillary transfer: Incisal pin? why?

A

+2mm to compensate the increased VD while flasking and aluwax

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22
Q

Remount intermaxillary trasnfer: records must be taken at what VD?

A

almost the final occlusal VD

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23
Q

Remount PCPI customization: wax record?

A

3mm thick hard wax

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24
Q

Remount PCPI customization: steps? (6)

A

• At the articulator, make a protrusion of 3mm or
until front teeth are at edge-to-edge relation.
• Guide the patient to reach that position with his/ her dentures on.
• Heat the record, put it in place at take the PCPI record.
• Cool it down.
• Take it to the articulator to adjust PCPI value.
• Fix value for Bennet angle at 15 degrees

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25
Q

What are the occlusal equilibration goals? (2)

A
  • MI at CR

- Balanced articulation

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26
Q

Occlusal equilibration MI @ CR (3)

A
  • MI happens at the desired OVD and with the condyles at centric relation.
  • Simultaneous and equally intense occlusal contacts between all active cusps and their corresponding fossae.
  • No occlusal contacts at the anterior teeth.
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27
Q

Occlusal equilibration Balanced articulation: at lateral mandibular position?

A
  • Simultaneous contacts at both working and non-working sides.
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28
Q

Occlusal equilibration Balanced articulation: at lateral mandibular position WORKING SIDE? (2)

A
  • Working side: contacts between homonymous cusps:

◦ Upper buccal against lower & same with linguals

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29
Q

Occlusal equilibration Balanced articulation: at lateral mandibular position NON WORKING SIDE? (2)

A

◦ Upper palatal cusps against lower buccal cusps

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30
Q

Occlusal equilibration: cusps engage … (2)

A

Fossae or marginal ridges

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31
Q

Occlusal equilibration: cusps engagement should not be …

A
  • not strong - freedom to allow eccentric movements

- Should not be flat occlusal surfaces to preserve masticatory efficiency

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32
Q

Ideal occlusal relationships: Upper palatal cusps contact?

A

corresponding lower fossae or marginal ridges (upper functional cusps)

33
Q

Ideal occlusal relationships: Upper buccal cusps inclination?

A

have an antero-posterior inclination of 33 degrees

34
Q

Ideal occlusal relationships: lower buccal cusps?

A

contact corresponding upper fossae or marginal ridges (lower functional cusps)

35
Q

Ideal occlusal relationships: distance between cusps?

A

decreases from front to back

36
Q

Occlusal reshaping: transversely at working side? (2)

A
  • Upper teeth: the opposing tooth moves buccally. - Lower teeth: the opposing tooth moves lingually.
37
Q

Occlusal reshaping: diagonally at non-working side? (2)

A
  • Upper teeth: mesio-palatal direction.

- Lower teeth: disto-buccal direction.

38
Q

Occlusal equilibration: location of grinding for eccentric movements? (2)

A
  • Always at cusp inclines.

- Never at cusp tips.

39
Q

Occlusal equilibration: which denture do we prefer to grind?

A

Lower to preserve esthetics

40
Q

Occlusal equilibriation: Contacts with eccentric movements?

A

Must get maximum number of contacts

41
Q

Occlusal equilibriation: Contacts with eccentric movements- working side? (3)

A

(homonymous cusps):

  • Buccal cusps: upper inner inclines against lower external inclines.
  • Lingual cusps: upper external inclines against lower inner inclines.
42
Q

Occlusal equilibriation: Contacts with eccentric movements- nonworking side? (2)

A
  • Upper palatal cusps: inner
    inclines.
  • Lower buccal cusps: inner inclines.
43
Q

Occlusal equilibriation: Contacts with eccentric movements- protrusion? (2)

A
  • Upper cusps: distal inclines.

- Lower cusps: mesial inclines.

44
Q

Occlusal equilibration: VD and grinding?

A
  • Must be preserved

- Grinding done preferably at nonfunctional cusps

45
Q

Occlusal equilibration: preserving VD grinding exception?

A

Grinding must be done preferably at non- functional cusps (except for non-working side contacts and some CR contacts)

46
Q

Occlusal equilibration: preserving VD- adjusting CR?

A

its better to grind bottom of fossae or marginal ridges than tip of cusps

47
Q

Occlusal equilibration: preserving VD - prematurities in sagittal plane? (2)

A

◦ Upper cusps: mesial inclines.

◦ Lower cusps: distal inclines.

48
Q

Occlusal equilibration: preserving VD - prematurities in frontal plane? (3)

A

◦ Between inner inclines of upper palatal and inner inclines of lower buccal.
◦ Between inner inclines of upper buccal and external inclines of lower buccal .
◦ Less likely between external inclines of upper palatal cusps and inner inclines of lower lingual cusps.

49
Q

Occlusal equilibration procedure: steps? (3)

A
  1. Lateral movements.
  2. Protrusion.
  3. Maximal intercuspation/centric relation.
50
Q

What is the occlusal equilibration procedure with an atriculator with micrometrical screws?

A

equilibration is performed at condylar movements of 1, 2 and 3 mm

51
Q

What is the occlusal equilibration procedure with an atriculator without micrometrical screws?

A

(like Artex/Kavo), the whole movement from CR to

maximal lateral position or maximal protrusion is performed

52
Q

What type of articulating paper do we use to assess if there are prematurities?

A

Thin articulating paper (4-8 μm)

53
Q

What tools do we use to reduce pre maturities?

A

With high speed handpiece (turbine) or contra- angled handpiece with rugby ball burs (fine grit size – red band).

54
Q

What colors do we use for lateral movements occlusal equilibration? (2)

A
  • Blue articulating paper for working side.

- Red articulating paper for non-working side.

55
Q

lateral movements occlusal equilibration working side: There are only NWS contacts, that prevent WS
teeth to contact? (4)

A 
◦ Least common possibility.
◦ Trim until getting contacts at WS.
◦ Diagonal trimming (mesially at upper/distally at
lower).
◦ Inner inclines of functional cusps.
56
Q

Lateral movements occlusal equilibration working side: There are only anterior WS contacts (2)

A

◦ Canine guidance impedes posterior WS contacts.

◦ Trim labial surface of lower canine or incisors.

57
Q

Lateral movements occlusal equilibration working side: There are only posterior WS contacts - general? (4)

A

◦ They impede NWS contacts.
◦ Most frequent possibility.
◦ Trim non-functional cusps transversely.
◦ Usually inner inclines buccal upper cusps are the ones that have to be trimmed. - inner inclines of buccal cusps

58
Q

Lateral movements occlusal equilibration working side: There are only posterior WS contacts - buccal cusp contacts?

A

◦ Inner inclines of upper buccal cusps

◦ Or external inclines of lower buccal cusps, because of esthetics (even being functional cusps)

59
Q

Lateral movements occlusal equilibration working side: There are only posterior WS contacts - Contact between upper palatal and lower lingual cusps?

A

Trim inner inclines of lower lingual cusps

60
Q

Lateral movements occlusal equilibration working side: What do you check when you’re done equilibrating? (3)

A
  • Check that there are NWS contacts when
    finishing with WS adjustment.
  • If there are NWS contacts, they must be at the inner inclines of functional cusps, up to the 2nd molar.
  • If not, continue trimming WS until there are NWS contacts up to the 2nd molar.
61
Q

Lateral movements occlusal equilibration non-working side: Where should there be contacts?

A

between inner inclines of functional cusps

62
Q

Lateral movements occlusal equilibration non-working side: If there aren’t contacts up to the 2nd molar, what are the two possibilities? (2)

A
  • Any NSW that implies a prematurity

- No NWS contact implies a prematurity

63
Q

Lateral movements occlusal equilibration non-working side: there aren’t contacts up to the 2nd molar: Any NSW contacts that implies a prematurity? (4)

A

Trim diagonally:

  • Distally for lower cusps
  • Mesially for upper cusps
  • Inner inclines of upper palatal cusps
  • Inner inclines of lower buccal cusps
64
Q

Lateral movements occlusal equilibration non-working side: there aren’t contacts up to the 2nd molar: No NSW contacts that implies a prematurity?

A

Trim diagonally:

  • Distally for lower cusps
  • Mesially for upper cusps
  • Inner inclines of buccal cusps only
65
Q

Occlusal equilibration protrusion: At the beginning of the movement (first 1-2mm) contacts should be… (4)

A

At both sides:

  • Between upper functional cusps and lower fossae/marginal ridge
  • Between lower functional cusps and upper fossae/marginal ridge
  • No contacts at the front teeth yet
66
Q

Occlusal equilibration protrusion: At 3mm contacts should be… (4)

A
  • At distal inclines of upper cusps.
  • At mesial inclines of lower cusps.
  • At palatal surface of upper front teeth.
  • At labial surface of lower front teeth.
67
Q

Occlusal equilibration protrusion: Undesired contacts between upper and lower buccal cusps?

A

Trim distal inclines of upper buccal cusps (mesially)

68
Q

Occlusal equilibration protrusion: Undesired contacts between upper palatal and lower lingual cusps?

A

Trim mesial inclines of lower lingual cusps (distally)

69
Q

Occlusal equilibration protrusion: Undesired contacts between functional cusps and opposing fossae/marginal ridges?

A

Trim at fossae/marginal ridges mesially at upper teeth and distally at lower teeth

70
Q

Occlusal equilibration protrusion: Undesired contacts at front teeth? (2)

A
  • Trim at labial surface of lower front teeth and palatal surface of upper front teeth.
  • Don’t trim incisal edges, especially upper ones.
71
Q

Occlusal equilibration protrusion: Undesired contacts at both anterior and
posterior teeth? (2)

A
  • Trim as previously stated if at 3 mm protrusion

- At 1-2 mm of protrusion there should be no anterior occlusal contact

72
Q

Occlusal equilibration centric relation?

A
  • While closing the articulator there should be maximum number of contacts (MI).
  • If there are only few contacts, one or both cusps can be trimmed.
73
Q

Occlusal equilibration centric relation: MIOP? (3)

A
  • Usually located at functional cusps.
  • Mesial inclines of upper palatal cusps.
  • Distal inclines of lower buccal cusps (better trimming place).
74
Q

Occlusal equilibration centric relation: LIOP possibile location 1? (2)

A

Between:
◦ Mesial inner inclines of upper buccal cusps
(choice trimming).
◦ Distal external inclines of lower buccal cusps

75
Q

Occlusal equilibration centric relation: LIOP possibile location 2? (2)

A

Between:
◦ Mesial inner inclines of upper palatal cusps
◦ Distal inner inclines of lower buccal cusps (better trimming place)

76
Q

Occlusal equilibration centric relation: achieving maximum number of contacts, what are the two possibilities?

A
  • There are only a few contacts at MI

- There are many occlusal contacts but not of the same intensity

77
Q

Occlusal equilibration centric relation: achieving maximum number of contacts - There are only a few contacts at MI (3)

A
  • Trim that contacts until getting contacts at all
    functional cusps/marginal ridges.
  • Deepening fossae or trimming marginal ridges.
  • Never trim tip of functional cusp.
78
Q

Occlusal equilibration centric relation: achieving maximum number of contacts - Many occlusal contacts but not same intensity? (3)

A
  • Trim stronger contacts until all have the same intensity.
  • Deepening fossae or trimming marginal ridges.
  • Never trim tip of functional cusp.
79
Q

Occlusal equilibration final evaluation? (3)

A

• Look at general occlusal anatomy.
- If occlusal surfaces are flat, reshape them deepening fossae and sulci without altering balanced articulation.
• When everything is correct, polish with stones and diamond paste.

Prostho (17 decks)

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