18. Insertion of the PRDP Flashcards
Adjusting your patient’s Psyche – a.k.a. Educate your Patient!
• Mechanical and ____ problems with denture wear
• Establish ____ of patient in you and prosthesis
• ____ care of RPD needed from patient
biological
confidence
detail
Educating your patient
• Done before anything else, and:
• ____ throughout your insertion visit
• Reinforces your ____ for wear and care
continues
instructions
Fitting the Denture Base
• Harmonizes bearing surface of RPD to supporting soft tissues of edentulous ridges
• Includes ____ surface and ____
intaglio
flanges
How do I Know if it’s fitting the ridge(s) properly?
• Intaglio surface of rpd:
• Use ____ (PIP) to evaluate
• “____” consistency
pressure indicating paste
hair gell
How ‘bout the Flanges?
• Evaluate the flanges using
• ____ wax
• ____ Paste
disclosing
sorensen’s
How do I use these?
• Apply ____ & ____ pressure in tissue-ward direction
• Adjust areas of pressure or overextension
• Repeat until excessive pressure areas are eliminated
vertical
horizontal
Common areas requiring adjustment - Mandible
• ____ slope of the mandibular ridge in the ____ area.
• ____ ridge.
• Border area extending into the ____ space.
• ____ border in the vicinity of the ascending ramus and the external oblique ridge.
• Any areas with underlying boney sharpness.
lingual premolar mylohyoid retromylohyoid distobuccal
Common areas requiring adjustment – Maxilla
• Inside of the buccal flange over the ____.
• Border of the denture lying on the ____ prominence.
• Area of the denture at the ____ notch where it may impinge on the pterygomandibular raphe and pterygoid hamulus.
• Any areas with underlying boney sharpness.
tuberosities
malar
pterygomaxillary
Amount of Relief Necessary
• Depends on accuracy of ____, master cast and denture base
• Dependent on ____, integrity and morphology of supporting tissues
• Takes time!
impression
health
Up Next – Verify Seating Rest Seats and Major Connector
• Repeat process from framework ____ appointment
• Use ____ wax, spray indicator or other indicators
try-in
disclosing
Verify:
• Rests are fully ____
• Guide plates contact guide planes
• Contact of ____ / bracing components with tooth surfaces
• That major connector has ____ (not excessive)
seated
reciprocating
contact
Framework seats, Now Re- evaluate fit of Denture Base
• Why?
• The fit of the denture base may change with adjustments to ____
• After again adjusting base, ____ framework
framework
re-check
Next Step – Correct Occlusal Discrepancies • Can be accomplished via: • \_\_\_\_ remount • \_\_\_\_ remount • \_\_\_\_ adjustmen
lab
clinical
intra-oral
Intra-oral adjustment of the RPD • Use: • \_\_\_\_ paper • \_\_\_\_ Sheets • \_\_\_\_ Stock
articulating
mylar
shim
Adjusting the Occlusion
• First: ____ interferences
• Second: ____ interferences
• LASTLY: ____ interferences
framework
denture base
denture tooth
Framework Interferences
• Should have been correct at ____ visit
• NO framework ____ are acceptable
• Use ____ to verify
try-in
interferences
articulating paper
Denture Base Interferences
• Eliminate ____ and excursive prematurities
• Eliminate excursive contacts, EXCEPT for ____
• Ensure adequate space between ____
-> avoids cheek bites!
centric
balancing ramps
bases
Denture Tooth Interferences
• Easily performed intra-orally for tooth supported RPD
• ____ remount preferred for muco- periosteal and tooth supported RPD
clinical
Trust but Verify.. • Occlusal Contacts:
• ____ or MIC
• ____ Contacts
• ____
CR
excursive
balance
Adjust Retentive Clasps
- Minimized through:
- Proper ____, including:
- Path of ____
- Proper ____
design
insertion
reciprocation
Adjust Retentive Clasps
• Correct Clincal Procedures:
• Proper ____ preparation
• Accurate ____ technique
rest seat
impression
Adjusting Retentive Clasps • Proper Laboratory Techniques: • \_\_\_\_ • \_\_\_\_ • \_\_\_\_/Decasting • \_\_\_\_
flasking
processing
deflasking
finishing
Lastly – Provide Home care & Insertion Instructions
• How to place/ remove
• ____ sore spots!
• Adjustment periods for phonetics, mastication & gagging
• OHI / prosthesis care
• Adhesive use?
expect
Follow-up Mandatory
• Similar to CD follow- up
• Can be modified for the dentate patient
• At SDM, no ____ = no soup for you!
follow-up
Remember This!!!!!!
Strive for Harmony with ____ and
____ Dentition in all ____ Positions
natural
artificial
manidbular
Denture Care • \_\_\_\_, careful removal of biofilm • How? • Denture Cleaners • Used \_\_\_\_ of mouth • Thorough rinsing before re-insertion
daily
outside
Denture Care
• ____ Ultrasonic cleaning by dentist recommended
• Good time to do edentulous recall / oral cancer screening
yearly
Don’ts of denture care
• Don’t soak / place in boiling water in boiling ____
• Don’t place in ____ (sodium hypochlorite) solutions longer than ____ minutes
water
bleach
10
Helpful Hints
• Dentures should be stored in ____ when not worn (avoids warping)
• ____ can improve the experience for the denture wearer
water
adhesives
A word on Adhesives
• Can help seal out ____ particles (in well fitting too)
• Improve patient’s ____ of retention, adaptation and stability
food particles
perception
Very important
• Avoid ____ based adhesives
• Patients requiring adhesives for more than ____ months at a time should be re- evaluated
zinc
six
More adhesives needed continuously... • Means: • Somethin’ ain’t right • \_\_\_\_ loss? • \_\_\_\_ Change? • \_\_\_\_ Condition?
bone
tissue
systemic
Recapping the Appropriate Sequence • Continuous \_\_\_\_ of the patient. • \_\_\_\_ the denture base. • \_\_\_\_ seating and fit of rest seats and major connector. • \_\_\_\_ occlusal discrepancies. • \_\_\_\_ retentive clasps if necessary. • Provide home care \_\_\_\_.
education fit verify correct adjust instruction
