2019 EP Final Exam

Question 1

What are the 3 requirements for a good CR record? (3 marks)

Answer 1

1. Make sure mandible is in most retruded position
2. keep record in an indistorted state until the mounting is complete
3. apply equal vertical pressure to the tissues when making the record

Question 2

What are the tissues that make up the residual ridge? (3 marks)

Answer 2

1. Mucosa: epithelium and connective tissue
2. submucosa and periosteum
3. residual alveolar bone

Question 3

What are the 3 types of articulators? (3 marks)

Answer 3

1. DENAR
2. IVOCLAR
3. HANAU

Question 4

What are the advantages of monoplane occlusion? (5 marks)

Answer 4

1. reduces horizontal forces
2. CR can be developed as an area rather than a point
3. freedom of movement (lack of interdigitation)
4. can develop good occlusion despite an arch alignment discrepancy
5. easily adapt to situations prone to denture base shifting
6. easy to set and adjust teeth

Question 5

What delineates the posterior border of the mandibular denture? (1 mark)

Answer 5

retromolar pad

Question 6

What delineates the posterior border of the maxillary denture? (2 marks)

Answer 6

Hamular Notch

Vibrating Line

Question 7

What is the name of our articulator? (1 mark)

Answer 7

Hanau

Question 8

What is the significance of the incisive papilla? (3 marks)

Answer 8

helps orient where the place the anterior teeth because the incisive papilla does not move even after all teeth are lost

Question 9

Your patient has a lingual Tori. What do you do when planning a denture for this patient? (2 marks)

Answer 9

Shorter lingual flanges

Monoplane teeth should be used to provide balanced occlusion and to distribute forces over a larger area.

Question 10

Your patient has severe maxillary and mandibular ridge resorption. What problems might you have planning a complete denture? (5 marks)

Answer 10

Reduced retention, support, and stability
Resorption on the mandible can result in trauma on tissue over mylohyoid bone due to poor keratinization of mucosa
Resorption of the alveolus will cause poor peripheral seal of the denture because of little resistance to lateral displacement of denture during function
Denture placement could impinge on the inferior alveolar nerve on the mandible which can cause pain

Question 11

What is the name for the polymer used for denture base?

Answer 11

TruTriad VLC

Question 12

What is Christensens phenomenon?

Answer 12

When the mandible is protruded there is a naturally occurring gap in the posterior teeth. In dentures, this may cause reduced stability of the dentures, therefore compensating curves must be introduced in the dentures to counteract this.

Question 13

What is the purpose of making a diagnostic impression? (2 marks)

Answer 13

To make the final impression tray and to aid in diagnosis and treatment planning

Question 14

methods and anatomical methods of orienting the occlusal plane? (6 points)

Answer 14

1. parallel to the interpupillary line
2. parallel to the ala-tragus line (campers line)
3. max anterior teeth should be seen 1-2mm below the upper lip line and the posterior teeth should be at the level of stensens duct
4. mand anteriors should be at the height of the lower lip and mand posteriors should be level with the top 1/2 of the retromolar pad
5. Orient labio-lingually over the lower residual ridge
6. inclination should be at the height of the residual ridge

Cephalometrics
pre-extraction records
comparison to existing denture

Question 15

Why is it important to know the dental history for an edentulous patient when treatment options are severely limited?

Answer 15

Skeletal class of the jaw will determine what type of occlusal pattern will be chosen
Bruxism and grinders will determine the type of occlusion pattern that is most suitable (monoplane)
Poor neuromuscular control will affects patients control of the denture and occlusion
A previous denture can help with the occlusion choice
if patient has resorbed ridges, this will affect stability and retention

Question 16

5 key factors of the selective pressure technique?

Answer 16

1. Custom tray. Must be perfect size
2. Borders of tray are reduced to allow space for border molding but still support impression material
3. Space must be provided using wax spacer and/or relief holes to allow material to escape.
4. Proper placement and alignment of tray over arch
5. Minimal operator pressure while holding tray during impression.

Question 17

8 steps in fabricating a complete denture

Answer 17

1. patient history and examination
2. diagnosis, treatment plan, prognosis
3. edentulous impressions, diagnostic and final impression
4. maxillomandibular relationship records (VDO, facebow, CR)
5. selection and arrangement of artificial teeth
6. waxing and processing of trial dentures
7. denture insertion procedures
8. patient education and maintenance procedures

Question 18

What significant factors are affected by gingival contours? (5 points)

Answer 18

1. Improved esthetics for patients with a high smile line
2. Provides appropriate support and contour of lip and cheek.
3. Improved tolerance and comfort
4. Facilitates stability and control
5. Prevents chronic biting of the lip and cheek.

Question 19

What is the purpose of a remount jig?

Answer 19

Purpose is to reposition the teeth of an upper denture into their original position and to preserve the facebow record.

Question 20

Purpose and steps for a patient remount?

Answer 20

Purpose of the patient remount is to adjust denture bases to seat more accurately than record bases by correcting errors made during the making of CR records.

The steps are:
A new centric relation record is made and verified
Mandibular cast is remounted and verified.
Cautious adjustments are made until the occlusion on the articulator is the same as in the patient

Question 21

Why do we take a protrusive record?

Answer 21

to adjust the condylar elements and inclination of the incisal guidance on the articulator

Question 22

What is the purpose of the facebow? (3 points)

Answer 22

Allows for some alteration in the VDO once the dentures are mounted without causing errors in the occlusion

Maintains the maxillary cast in the correct relationship to the upper member of the articulator during mounting of the cast

Permits the semi-adjustable articulator to be used to the full extent of its capabilities

Question 23

What is the effect of incisal guidance on occlusal scheme? (1 point)

Answer 23

Incisal guidance discludes posterior teeth. The more incisal guidance is increased, the more the posteriors disclude.

Question 24

What are the 3 types of articulators used?

Answer 24

1. non-adjustable
2. semi-adjustable
3. fully-adjustable

Question 25

List the key benefits of lingualized occlusion (6 points)?

Answer 25

1. good esthetics
2. freedom of non-anatomic teeth
3. potential for bilateral balance
4. centralizes vertical forces
5. minimizes tipping forces
6. facilitates bolus penetration.

Question 26

Patient complains about lower denture lifting off from mandibular ridge, what are the possible problems? (3 points)

Answer 26

1. poor neuromuscular control
2. anterior contacts in centric
3. poor balanced occlusion in excursion and protrusion.

Question 27

What are the advantages to bilateral balanced occlusion?

Answer 27

Increased retention and stability
Better chewing ability
Reduced resorption
Centralizes forces
Balanced forces