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D1 Spring - Complete Removable Pros > 3 - 3/18: Complete Denture Insertion > Flashcards

3 - 3/18: Complete Denture Insertion Flashcards

1
Q

What two things does the patient think before the insertion appointment?

A

Anticipation
Apprehension

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1
Q

When do you do a lab remount?

A

After processing

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2
Q

What is the process of eliminating errors?

A

The insertion appointment

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3
Q

How long should the patient leave dentures our prior to the insertion appointment?

A

24 hours - to let the tissue relax

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4
Q

What should you do to the dentures before the insertion appointment

A

Inspect dentures, put in denture cup/H2O

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5
Q

What should you look at on the dentures before the insertion appointment?

A
  • no imperfections on surfaces
  • borders are round/no sharp angles
  • cameo surfaces are smooth
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6
Q

What should you do to the casts before the insertion appointment?

A

Mandibular remount cast is prepared for clinical remount

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7
Q

Where should the maxillary remount cast be before the insertion appointment?

A

Already attached to articulator

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8
Q

What should you put on the intaglio surface?

A

Pressure indicator paste

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9
Q

What is the function of the pressure indicator paste?

A

Undercut areas
Accuracy of tissue contact

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10
Q

What is zinc oxide paste used as?

A

A pressure indicating paste (PIP) to detect improper adaptation

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11
Q

What patients is PIP used in?

A

Patients with xerostomia in order to prevent the PIP from sticking to the mucosa

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12
Q

What is the PIP sequence?

A
  1. dry denture surface
  2. brush a thin even layer of PIP onto the surface of the denture
  3. seat the denture with pressure in the first molar region
  4. remove immediately
  5. inspect and adjust bearing surface as necessary
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13
Q

How should you apply the pressure indicator paste?

A

Brush on thin coat
Brush strokes visible

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14
Q

What should you remove on the cast after applying paste?

A

islands of pink
- the area is adjusted with an acrylic burr
- when completed the brush marks are mostly absent and the posterior palatal seal bead is showing

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15
Q

What should you ensure regarding the displaced paste?

A

Reflects a pressure area before relieving the denture base
Mark again, if not sure

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16
Q

How should you evaluate the borders?

A

Are dentures stable during speech and swallowing?
Are borders and contours compatible with available space in vestibules?
Borders properly relieved at frenal attachments?

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17
Q

How should you disclose the wax and adjust the borders?

A
  • adjust denture flange as necessary
  • reapply, border mold, and adjust until areas of overextension are eliminated
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18
Q

How should you check the phonetics?

A
  • check the thickness of the maxillary palatal portion (a common problem is excessive thickness)
  • reevaluate the position of the maxillary anterior teeth
  • if everything appears normal it nay be a matter of time for the patient to adapt
  • open vertical dimension of occlusion
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19
Q

Why does a patient gag?

A
  • palate excessively thick
  • palatal extension too long
  • lack of tongue space (teeth set too far to the lingual)
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20
Q

What are sources of occlusion errors?

A
  • Resin shrinkage when processed
  • Ill-fitting temporary record bases
  • Change of OVD on the articulator
  • Inaccurate max-mand. records by dentist
  • Incorrect arrangement of teeth
  • Overheated when polished
  • Water absorption (expands 1-3%)
21
Q

Since numerous sources of occ. errors exist, what should the dentist assume?

A

Errors exist and work to find it

22
Q

What does technique for cheking occlusal errors require?

A

A willingness to see the error

23
Q

What happens if you simply tell patient to close the jaw and observe contacts?

A

The error is unlikely to be detected

24
Q

What is occlusal harmony?

A

Patient comfort
“efficient” function (20% of natural teeth)
Preserve supporting tissues

25
Q

How should you occlude the completed dentures first?

A

Hand occlude

26
Q

What should you look for beyond the tooth contacts?

A

Posterior flange contacts

27
Q

What should you do prior to making the record?

A
  • seat the posterior paltal seal
  • place two cotton rolls between the posterior teeth and have the patient bite down for 5 min
28
Q

How do you make the clinical remount?

A
  • make interocclusal record
  • remount dentures on articulator
  • refine occlusion on articulator
29
Q

When is clinical remount and occlusal refinement done?

A

Before final delivery of the dentures

30
Q

What do occlusal errors deform?

A

The supporting tissues and conceal the errors if postponed

31
Q

What allows the dentures to move?

A

Resiliency of tissues
Misleading articulating paper markings result

32
Q

What interferes with paper markings?

A

Salive on teeth

33
Q

What does intraoral occlusal “adjustment” require?

A

Reoeated patient cooperation
- some can cooperate, others cannot

34
Q

What should you use as extra security during the intraoral occlusal adjustement?

A

Denture adhesive powder

35
Q

What are advantages for clinical remount?

A
  • reduce patient participation
  • dentist sees better what to do
  • stable working foundation; bases not shifting on resilient tissues
36
Q

What does absence of saliva create?

A

More accurate marks with articulating paper

37
Q

Where should grinding be done?

A

Away from patient. This prevents patient objections to “mutilating my new teeth”

38
Q

What is desired occlusion?

A

Simultaneous contact of all posterior teeth in the retruded mandibular position (CR)

39
Q

What should be absent in desired occlusion?

A
  • contact on anterior teeth
  • deflective interferences in eccentric movements
40
Q

How should you evaluate the cameo surface acrylic thickness?

A
  • observe intraorally and extraorally
  • use pressure indicator paste
  • make measurements
  • seek patient feedback
41
Q

What should you do for the patient at each appointment?

A

Educate

42
Q

What is the difference between an explanation and an excuse?

A

The time they are provided
- explain the limitations of dentures as mechanical substances for living tissues

43
Q

What is an explanation

A

Before the problem

44
Q

What is an excuse

A

After the problem

45
Q

What are instructions given to patients after denture delivery?

A
  • strange feeling of fullness in lips and cheeks for a few days
  • mandibular denture more difficult to use than maxillary CD
  • increased flow of saliva first few days
  • speaking approves with practice – read newspaper aloud everyday
  • expect sore spots during break in period
  • return to clinic for adjustements. Don’t adjust dentures at home
  • remove dentures at night and store in water
46
Q

What are instructions to give regarding chewing?

A
  • normal chewing takes about 2 months
  • begin with softer foods that are cut into smaller pieces
47
Q

How is control of the dentures accomplished by?

A

Manipulation with the tongue, lips, and cheeks

48
Q

How should you teach the patient to position the tip of their tongue?

A

Next to the lingual surfaces mandibular anterior teeth (have the patient say “e”)

49
Q

What should the patient use for extra security?

A

Denture adhesive powder AS NEEDED, during the first month

50
Q

What is care of the prosthesis?

A

Brushing (over a sink with water or a washcloth in it), soaking in a container, remove any adhesive

51
Q

What is care of the mouth?

A

Gingival massage, tongue brushing with a soft toothbrush

D1 Spring - Complete Removable Pros (18 decks)

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