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DEN203 > A- C.Dentures > Flashcards

A- C.Dentures Flashcards

1
Q

4 stages of Denture construction?

A

1- Primary impressions
2- Secondary impressions
(Recording the shape of the ridges and supporting tissues)

3- Registration
4- Wax tryin
(Establish correct placement of the denture teeth, record inter-ridge relationships, make a wax template to be converted into a denture)

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2
Q

2 stages of denture provision?

A

1- Fit stage; aesthetic, funcitonal checks… check record?

2- Post-fit Review: sore areas, aesthetic and functional checks

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3
Q

Name some maxillary structures relevant to dentures

A
  • Fovea palatini
  • Hamular notch
  • Sulcus
  • Fraena (midline? buccal)
  • Incisive papilla
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4
Q

Name some mandibular structures relevant to denture making

A
  • Retromolar pad
  • External-oblique ridge (outside)
  • Mylohyoid ridge (inside)
  • Sulcus
  • Lingual gingival remnant
  • Mental foramen
  • Genial tubercles
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5
Q

Purpose of primary impressions?

A
  • Record anatomy
  • Permit primary models to be cast
  • construction of special trays to record working 2ndary imps
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6
Q

What imp material is used to take primary imps?

A

STiff viscous mix of alginate
- Displaces soft tissues (lips, tongue, cheeks) of denture bearing area

Bonding agent must be applied to tray as mechanical retention via perforations is insufficient.

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7
Q

Where and what height/ angle is mandibular primary imps taken?

A

In front of px.
Mandible= elbow height
Px sat at 60 degrees.

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8
Q

Where and what height/ angle is maxillary primary imps taken?

A

BEHIND, px right shoulder.
Px head= diaphragm level,
maxilla= elbow height

60??

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9
Q

How to take a primary imp

A
  • Take impression
  • Trim excess alginate (overextended, bulky periphery, undercuts)
  • Wash impression with low-visc alginate “runny mix”= for resolution
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10
Q

What kindof tray should be requested from primary imps (by the lab)

A
  • Close fitting
  • Non perforated
  • for ZoE imp
  • Made 1.5mm short of functional depth of sulcus
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11
Q

What resorbs more- Max or Mand and by how much?

A

Mandibular resorps 4x MORE than max.!!

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12
Q

Describe the site and pattern of bone resorption in max and mand.

A

Max- (buccal resorbs) Palatal movement (in)

Mand- in at front, out at back

Ant.- lingual movement
Post- Buccal movement.

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13
Q

Name 3 influencing factors of bone resorption

A

1- systemic; osteoporosis
2- Local; retained roots preserve alveolar bone
3- denture-induced; denture wearing can contribute to resorption

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14
Q

Name some problems that can occur with dentures

A
  • Insecurity
  • occlusal problems
  • pain
  • appearance
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15
Q

Cause of denture insecurity?

by bone resorp

A
  • ill fitting

- outside neutral zone

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16
Q

Causes of occlusal problems?(by bone resorp)

A
  • Crossbite

- Resorption

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17
Q

Causes of pain ? (by bone resorp)

A
  • Sharp, resorbed bony ridges
  • Relative movement of mental foramen puts pressure on nerve
  • irreg. resorp, mucosa becomes sandwiched between bone and denture
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18
Q

For secondary imps, if ridge has large undercuts what to use?

A
  • Elastic imp material

- Spaced special tray

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19
Q

What are flabby/fibrous ridges?

A
  • Due to fibrous tissue deposition
  • Common in upper anterior region
  • Can occur when natural teeth oppose edentulous ridge
  • use a window box for imps
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20
Q

Aim of secondary imps?

  • use close fitting trays with ZoE paste (can use alginate or silicone as well)
A

Accurately record denture bearing areas and functional sulcus.

  • Muscle insertions
  • Anatomy
  • Border moulding
  • Clear frenal attachments

For stability and retention of dentures…

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21
Q

Problems that imps can have :

A
  • air blows
  • tray showing through at periphery
  • tray showing through fitting surface
  • material pulling away from tray and sticking to ridges
  • knife edge ant. peripheral recorded
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22
Q

Vertical and Horizontal measurements for wax registration rims

A
  • Alma gauge readings for the old dentures

Standard: V22 upper V18lower

23
Q

Name 2 vertical jaw relations

Measured between 2 marked points,

  • condyles in retruded positon
A
  • Rest face height
  • Occlusal fh

RFH and OFH

“2 definable, reproducible, inter-maxillary positions”

24
Q

What is the FWS?

A

Difference between RFH- OFH

25
Q

Ideal FWS?

A

2-4mm

26
Q

Name 2 horizontal jaw relations

A

1- Intercuspal position

2- Retruded contact position

27
Q

What is ICP?

A

Max and man. teeth are in maximum intercuspation (centric occlusion)

28
Q

What is RCP?

A
  • Heads of condyles are in most superior part of glenoid fossa
  • First point of contact
  • when mandible rotates around hinge axis
29
Q

What is the interpupillary line?

A

IPP- imaginary line passing thorugh pupil- guide for parallel

30
Q

What is the Alar-tragus line?

  • Can be determined with Fox-bite plane guide
A

imaginary line passing thorugh ala of nose and tragus of ear.

31
Q

List the 8 steps of registration

A

1- Mark fixed reference points on nose and chain

2- Measure and record RFH and OFH of old dentures ( determine what the OFH of new d. should be)

3- Upper wax rim: Add lip support, adjsut occlusal plane to IPL and ATL

4- Insert lower rim: guide into Retruded position, add wax until even contact; then remove evenly ti pre-determined OFH level.

5- Mark centre and canine lines and cut finger notches in premolar region of LOW. rim

6- Record the retruded jaw relationship with occlusal registration paste (silicone)

7- Select tooth mould and shade

8- Disinfect and lab prescription: Describe any variations in tooth arrangement etc.

32
Q

Purpose of wax try-in?

A

Check elements vital to success of complete dentures prior to final processing

33
Q

Things to check at wax try-in stage

A
  • Aesthetics (size, shade, arrangement)
  • OVD
  • Desired FWS
  • Occlusion; ICP= RCP?
  • Border extensions
  • Border thickness
  • Neutral zone issues- tongue not constricted and lower teeth not out of NZ
  • Lip support, centre and horizontal lines
  • No undercuts!
34
Q

What else to do at wax try-in stage?

A

Mark post-dam on cast

Ball burnisher to palpate hard/soft palate junction- find compressible areas.

35
Q

How to achieve balanced articulation with dentures?

A

Desirable to have multiple contacts on both sides of the denture (in lateral and protrusive movements)

  • prevents denture tipping
36
Q

What is curve of spee?

A

Antero-posterior movement curve

  • Steep cusps posteriorly
  • Shallow cusps anteriorly

(to maintain contact)

37
Q

What is curve of Mason

A

Lateral movements

  • Rotating around working condyle
  • Shallow cusps on rotating side
  • Steep cusps on translating side

(to maintain contact)

38
Q

What soft-tissue relationships should be checked?

A

Visibility- should have 0.5-0.66 of incisors showing

Lower lip line should coincide with incisors “tooth-lip harmony)

39
Q

What is the post-dam?

A

the ridge on tissue along post. border of upper denture is used to make air-tight peripheral seal with soft palate to hold denture in place

40
Q

What happens at denture-fit stage

A

1- Cotton wool test for rough areas on fitting surface
2- Insert and correct obvious faults of pain and undercuts

3- Check occlusion and correct- DEEPEN fossae

4- Check articulation- reduce CUSPAL HEIGHTs (BULL rule)

Precentric check record for more major defects

41
Q

What is a pre-centric check record?

A

Used when there is obvious gap between opposing teeth/ obvious slide between ICP and RCP

“method of re-registering coincidence of ICP and RCP”

  • Mount on articulator?
  • Identify contacts
  • Deepen fossae
  • Articulating paper? Silicone registration paste?
42
Q

Post-fit review stage

A
  • Listen to complaints
  • Pain correction
  • Check occlusion
  • Pressure spots with PSI paste
  • Overextensions
  • Steradent to clean dentures
43
Q

How to identify small painful areas?

A

Can put small amount of ZnO paste on dry sore area in mouth, insert denture and it will transfer onto it.

44
Q

What can cause painful dentures?

A
  • Overextensions, peripheral pain
  • Bony areas, central pain pressure/ undercuts
  • sore ridge over diffuse area= lack of FWS/ Occlusal problems
45
Q

Common ulcer sites

A
  • mylohyoid region
  • hamular notch
  • post dam
  • around frenal attachments
  • genial tubercles (atrophic mandibles)
46
Q

Causes of numbness/shooting pain?

A

Superficial mental nerve

47
Q

What might cause speech problems?

A
  • teeth position
  • shape of base
  • lack of FWS
48
Q

What might cause insecurit when eating?

A

Occlusal interference

  • occlusal error
  • locked occlusion?
  • premature contact on RHS (lack of left contact)
49
Q

Cause of nauseau from dentures?

A
  • Insecurity
  • Thick posterior margin (should be knife edge)
  • Intolerance of thick margins
50
Q

Causes of loose dentures?

A
  • Peripheral/muscle insertions
  • Polished surfaces and tooth position reasons:
  • food gets trapped underneath when eating… occlusal problem
51
Q

What are the Polished surfaces and tooth position reasons that might lead to lower denture instability?

A
  • if denture rises when mouth opens:
  • anterior teeth set too far forward (labial)
  • Bulky labial surface
  • Polished buccal surfaces
52
Q

Why might it hurt when swallowing?

A

Overextension in hamular region (maxillary) or sublingually (RMP?)- reduce accordingly

53
Q

How to resolve tongue cramping?

A

Eased by:
- reducing palatal cusps of upper denture to increase tongue space

  • thinning polished palatal surfaces of cusps
54
Q

How to resolve cheek biting problems?

A
  • Reassure
  • Check occlusion for obvious gaps where cheek falls in to
  • Remove 7s?? - often not in occlusion and results in cheek biting

DEN203 (11 decks)

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