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BDS - Module 9 > 6. Removable Prosthetics > Flashcards

6. Removable Prosthetics Flashcards

1
Q

What are the 5 components of history taking before construction of new dentures?

A
  1. Complaints
  2. Denture history
  3. Dental history
  4. Medical history
  5. Social history
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2
Q

What are 5 medical history points that can impact denture wearing?

A

Neuromuscular problems
Tremors
Strokes
Dementia
Dry mouth

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3
Q

What are the areas that should be assessed when assessing dentures?

A

Extra Oral - TMJ, asymmetry, facial fullness
Intra Oral - soft tissues, hard tissues, occlusion, aesthetics

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4
Q

What are the 6 clinical stages of partial denture construction?

A
  1. First impressions
  2. Occlusion
  3. Second impressions
  4. Try in
  5. Fit
  6. Review
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5
Q

What are the 6 steps of designing a partial denture?

A
  1. Note: teeth being replaced
  2. Chose: saddles
  3. Chose: connector
  4. Chose: support
  5. Chose: retention
  6. Select: materials
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6
Q

What is a denture saddle?

A

Part of denture that holds artificial teeth

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7
Q

What is a connector?

A

The component that connects saddles together

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8
Q

What is a denture support?

A

The area of a denture that resists vertical load via teeth or bone

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9
Q

What is denture retention?

A

Resistance of vertical movement away from tissues via clasps

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10
Q

What is a bounded saddle?

A

When there is teeth on either side of a saddle

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11
Q

What is a free end saddle?

A

When there is no teeth distal to a saddle

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12
Q

What are the two types of saddles?

A

Bounded
Free end

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13
Q

What are 5 examples of lower connectors?

A

Lingual plate
Dental bar (requires 9mm crown height to accommodate 5mm bar)
Lingual bar (requires 7mm lingual sulcus as bar is 3.5mm plus clearance)
Split lingual plate
Swing lock denture

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14
Q

What are the 3 upper connectors for PMMA dentures?

A

Full coverage
Spoon
T denture

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15
Q

What are the 5 connectors for CoCr dentures?

A

Full coverage
Anterior palatal bar
Horseshoe
Mid palatal bar
Posterior palatal bar

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16
Q

What are the 2 types of support for dentures?

A

Teeth
Mucoperiosteum

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17
Q

How is retention achieved in dentures?

A

Saliva and suction
Muscle activity
Clasps

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18
Q

List 3 clasp types?

A

Occlusal approaching
Gingival approching
Ring

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19
Q

When would you use an occlusal approaching clasp?

A

If diagonal survey line

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20
Q

When would you use a gingival approaching clasp?

A

If high or low survey line

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21
Q

What are 4 materials used for clasps?

A

CoCr
Stainless steel
Gold
Copolymer

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22
Q

CoCr Clasps can engage undercuts up to a depth of:

A

0.25mm

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23
Q

Stainless steel clasps can engage undercuts to a depth of:

A

0.5mm

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24
Q

Gold clasps can engage undercuts up to a depth of:

A

0.75mm

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25
Q

Copolymers can engage undercuts of:

A

Any depth

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26
Q

What is the equation for recording occlusion?

A

FWS = RVD - OVD

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27
Q

FWS means?
FWS should be?

A

Freeway space
2-4mm

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28
Q

RVD meaning:

A

Rest vertical dimension

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29
Q

OVD meaning:

A

Occlusal vertical dimension

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30
Q

What is an index tooth?

A

A tooth that is in occlusion reproducibly

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31
Q

How is occlusion recorded if there is SUFFICIENT index teeth?

A

In ICP using bite reg paste

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32
Q

How is occlusion recorded if INSUFFICIENT index teeth?

A

ICP if bite reproducible
RCP if not

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33
Q

How do you get a patient into RCP?

A

Tongue to back of palate and guide closed

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34
Q

What are the 2 ways you can make new full dentures?

A

Conventional technique - start from scratch
Replica technique - replicate previous denture

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35
Q

What are the 6 stages of conventional full denture construction?

A
  1. First imps
  2. 2nd Imps
  3. Occlusion
  4. Try in
  5. Fit
  6. Review
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36
Q

Recording Occlusion for F/F dentures:
1. What are the 7 steps to recording with the upper block?
2. What are the 2 steps to recording with the lower block?

A
  1. Check stability, extension and retention
    Check lip support
    Check incisal level
    Check anterior plane with interpapillary line
    Check posterior plane with ala tragus line
    Check posterior border
    Mark centre line
  2. Ensure even contacts with upper block
    Ensure correct OVD with sufficent FWS
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37
Q

What are the 5 clinical stages for replica full denture construction?

A
  1. First imps via replica technique outwith the mouth
  2. Second imps and occlusion
  3. Try in
  4. Fit
  5. Review
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38
Q

How do you record occlusion for replica dentures if:
1. No changes required?
2. Change required?

A
  1. Bite reg paste
  2. Add/remove wax
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39
Q

What is the aim and use of first impressions?

A

To record all anatomical landmarks to construct models to allow:
Tx planning
Special tray construction
Occlusion examination
Design of denture

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40
Q

What should 1st imps record?

A

Natural teeth and denture bearing area

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41
Q

What are the 3 checks following first impressions?

A

Are all edentulous areas included
Are sulci included?
Are all teeth included?

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42
Q

List 4 ways to improve 1st impressions:

A

Modify tray
Use more or less material
Border mould
Pre pack palate/tuberosity

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43
Q

What is the aim and use of second impressions?

A

Aim: to record the tissues of the denture bearing area, the teeth and the sulci in a special made tray
Used to: construct a cast which represents the fitting surface of the finished denture

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44
Q

When should 2nd imps be done?

A

After denture is designed and any tooth modifications are completed

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45
Q

What is the requirement of spacing required for special trays if alginate is the impression material?

46
Q

What materials are special trays made of?

A

PMMA
shellac

47
Q

What checks should you do at TRY IN stage?

A

I/O:
Wax extension
Rest seats
Occlusion
Tooth position
Tooth aesthetics
E/O:
Lip support
Incisal level
Occlusal planes
Speech
Aesthetics

48
Q

What checks should you do at the FIT stage?

A

I/O:
Comfort
Retention
Stability
Extensions
Occlusion
E/O:
Aesthetics
Speech

49
Q

What should you check at a REVIEW stage?

A

I/O
Soft tissues
E/O
Function
Aesthetics
Soeech

50
Q

List the 5 denture care instructions that should be given to all denture wearers:

A
  1. Rinse mouth after every meal
  2. Remove denture every night
  3. Brush denture with soap and soft brush
  4. Store in cold water overnight
  5. Continue to brush and clean natural teeth
51
Q

Denture hyperplasia signs and management:

A

Gum blanching
Management: denture ease

52
Q

Denture stomatitis signs and management:

A

Redness and sloughing of denture bearing area
Management:
Denture hygiene
Mouthwash
Antifungals

53
Q

Kennedy Classification I

A

Bilateral free end saddle

54
Q

Kennedy Class II

A

Unilateral free end saddle

55
Q

Kennedy class III

A

Single bounded saddle that DOES NOT cross midline

56
Q

Kennedy class IV

A

Single bounded saddle crossing the midline

57
Q

What are the 2 steps of surveying casts?

A
  1. Determine POI with surveyed and analysing rod
  2. Draw survey lines with graphite marker to determine undercuts
58
Q

What is a POI?

A

Path of insertion
The path followed by a P/P denture on insertion

59
Q

What is an undercut?

A

Portion of tooth between the survey line and gingiva

60
Q

What is the RPI system?

A

A specific design for abutment teeth adjacent to free end saddles that aims to avoid torque on abutment teeth

61
Q

What does RPI stand for?

A

R = medial rest
P = distal plate
I = I bar

62
Q

List 3 metals used for clasps

A

CoCr
NiCr
Stainless Steel

63
Q

Components of CoCr

A

Cobalt
Chromium
Nickel

64
Q

Components of NiCr

A

Nickel
Cobalt
Chromium

65
Q

Components of stainless steel

A

Steel
Chromium
Nickel

66
Q

List the 2 denture base materials:

67
Q

What is PMMA

A

Polymethyl Methacrylate

68
Q

What is CoCr and what is it composed of?

A

Cobalt chromium
Cobalt
Chromium
Molybdenum
Nickel

69
Q

What are the 2 materials used for artificial teeth?

A

Acrylic
Porcelain

70
Q

What are the 4 stages of IR denture construction?

A
  1. First imps
  2. Second imps and occlusion
  3. Try in
  4. XLA and fit
71
Q

What are the 3 post XLA and fit instructions that should be given?

A

Keep denture in for 24 hours
After 24 hours:
Salty mouthwash
Begin Denture cleaning regime

72
Q

When should IR dentures be reviewed?

A

1 day
1 week
1 month
Then,
6 month recall for either reline or new dentures now full healing occurred

73
Q

What is the aim of a denture reline?

A

To add new base material to the fit surface of an ill fitting denture to fill the gap between the denture and mucosa

74
Q

What are the 3 types of reline and the materials for each?

A
  1. Temporary
  2. Soft: acrylics or silicones
  3. Permanent: hard acrylic
75
Q

What is the aim of a rebase?

A

To replace the entire denture base material of an existing denture

76
Q

What are the 4 stages of rebase of a denture?

A
  1. Removal of undercuts from the fit surface of denture
  2. Light body imp taken of fit surface in the mouth
  3. Send to lab
  4. Fit of denture
77
Q

How is a denture repaired if pieces can be put back together?

A

In the lab or chairside

78
Q

How is a denture repaired if part of the denture has been lost?

A

Take impressions of denture in the mouth and send to lab

79
Q

List 2 chairside methods of denture repair:

A

Self cure acrylic
Cyanoacrylate glue

80
Q

What are the two methods of denture additions?

A

Tooth additions
Clasp additions

81
Q

What are the 5 steps to add a tooth to an existing denture?

A
  1. Take impression with denture in place
  2. Send to lab
  3. New tooth added to denture
  4. XLA of natural tooth
  5. Fit of denture
82
Q

What are the 3 steps of clasp additions to an existing denture?

A
  1. Take impression with denture in place
  2. Send to lab
  3. Fit denture
83
Q

What are 3 advantages of over dentures?

A

Can correct occlusion
Preserves ridge
Maintains proprioception

84
Q

List 3 disadvantages of overdentures:

A

Good OH required
Increases caries and perio risk
Potential for more traumatic extractions

85
Q

What 2 things must be detailed in a lab card for 2nd imp and occlusion stage:

A

Special tray: material, spacer required, handle
Record block: material

86
Q

What must you include on lab card for try in stage?

A

Tooth: shade, mould

87
Q

What should you include in lab prescription at fit stage?

A

Denture details: post dam, relief areas, linings

88
Q

List 6 common mucosal issues associated with dentures:

A

Ulcers
Denture stomatitis
Angular chelitis
Denture hyperplasia
Flabby ridges
Allergy

89
Q

Ulcers signs and management in dentures wearing patients:

A

Pain, yellow/white/red lesion, redness surrounding
Identify, ease, review

90
Q

Denture Stomatitis signs and management

A

Redness, swelling
Denture hygiene, chlorohexidine mouthwash, antifungals

91
Q

Angular chelitis signs and management

A

Sores at corners of mouth
Miconazole

92
Q

Denture hyperplasia signs and management

A

Enlargement of tissues
Ease denture or make new one, tissue conditioner

93
Q

Flabby ridges signs and management

A

Bone resorption that is replaced with fibrous tissue due to trauma
New dentures

94
Q

Denture allergy signs and management

A

Redness under denture bearing area
Change denture base material

95
Q

List 5 denture design ideas for difficult cases:

A

Modify survey lines
Combine fixed and removable pros
Use precision attachments
Two part dentures
Swing lock dentures

96
Q

What sort of connector would be used for lingual tilted teeth?

A

Buccal connector

97
Q

List 5 ideas for dentures for bruxists:

A

Metal backing on teeth
CoCr or high impact acrylic
Metal occlusal surfaces
Cross linked teeth
Acrylic post dam

98
Q

How would you manage problems with extension at try in:

A

Overextended - trim wax
Under extended- mark extension on casts

99
Q

How would you manage problems with adaptation at try in?

A

Take new impression

100
Q

How would you manage problems with CoCr framework at try in?

A

Take new inpression

101
Q

How would you manage too little FWS at try in stage?

A

Add wax to correct FWS
Re-record occlusion
Retry appointment

102
Q

How would you manage too much FWS at try in stage?

A

Remove occlusion teeth and replace with wax
Record occlusion
Retry appointment

103
Q

How do you manage pain at an ease appointment?

A

Ease denture

104
Q

How would you manage movement of denture at ease appointment?

A

Assess extensions and oral dryness
Reline denture

105
Q

How would you manage jaw pain at an ease appointment?

A

Check the FWS

106
Q

How would you manage occlusal complaints at an ease appointment?

A

Check there is no sliding
Check occlusion with articulating paper
Grind down any high areas

107
Q

What should be checked at and IR denture ease appintment and when should this be?

A

Sockets, any signs of trauma, if pt can insert and remove denture
Should be 24 hours after XLA

108
Q

When should an IR denture be reviewed?

A

After 1, 3 and 6 months

109
Q

When is fully healing complete after XLA and fit of an IR Denture?

A

6 months post XLA

110
Q

What are the options after 6 months of an IR denture?

A

Reline
New denture

111
Q

When should Full Dentures be reviewed?

112
Q

When should partial dentures be reviewed?

A

As per oral health needs

BDS - Module 9 (16 decks)

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