Bite Registration: Stage 1 Creating And Outlining The Form Of The Upper Denture

Question 1

What is the clinical stage following the visit where definitive impressions are recorded?

Answer 1

The bite or occlusal reg stage

Question 2

What are 3 component parts of the bite reg stage

Answer 2

Creating and outlining the form of the upper denture
Recording of intermaxillwry relations
Selecting teeth

Question 3

What is the purpose of the bite reg stage

Answer 3

Customise upper rim to create a replacement prosthesis which conforms to the facial. Contours and dental peri denture constraints taking into account pts age and expectations

Question 4

What is the upper wax rim?

Answer 4

What the lab makes following primary and secondary impressions
In clinical roaxtuce dentists receive upper wax rims that are duly moulded into the form of the upper denture at the chairside. The precise form of the upper wax rim or block depends essentially on how the technicians were taught in essence considerable variation probably exists among technicians with regards to the positioning of the labia face of the rim. The consequence of this is that it is often a matter of chance that wax has to be removed or added to the upper rim.

Question 5

How can you save clinical time in adjusting the upper wax rim whilst making sure there is appropriate form for each pt?

Answer 5

There are two techniques to adjust the upper wax rim
Biometric
And swissedent

Question 6

What is the Biometric technique for adjustment of the upper wax rim

Answer 6

Watt and macgreggor
Developed Biometric guidelines to compensate for facial changes following
Tooth loss predominantly in the maxilla

The replacement upper teeth should be placed in mean pre extraction positions

Fixed point of reference was taken as an average from edentulous pts, measurements taken from remnants of the lingual gingival margin

Question 7

What is the Biometric principle

Answer 7

Principle that helps to compensate for post extraction bone loss by placement of the de tyre teeth in perceived pre extraction positions

Question 8

What is the advantage of the biologic principle

Answer 8

Placing the maxillary denture teeth labial/buccal to the residual ridge is tha this promotes lower denture stability

Question 9

Why place the upper posterior denture teeth buccal to the maxillary ridge

Answer 9

In addition to compensating for the resorption pattern of the maxilla using this biologic principle also means that their palatal cusps will therefore occlusde into the central fossae of the lower posterior teeth
Thereby directing occlusal forces onto the ridge

Question 10

What is the advantage of placing the lower denture teeth using the biologic principle

Answer 10

Placing the lower teeth over the lower ridge tends to avoid constriction of the tongue space

Question 11

What is the disadvantage of using the biologic principle

Answer 11

It doesn’t necessarily customise the denture form for each pt or take into account biological ageing
Also, anatomical features not disimilar in the remnants of the lingual gingival margin have been observed in pts suffering from anodontia

Question 12

What is the other technique used to customise the upper rim?

Answer 12

Swissedent

Question 13

How can the upper lip form be communicated with the lab technician

Answer 13

1. Photographs and previous Dentures favoured by the pt
2. Use a papillameter
3. Use alma gauge

Question 14

What is a papillameter

Answer 14

Papillameter is a simple gauge with a step on its inner aspect; this step rests on the incisive papilla and the graduated column rests between the labial aspect of the ridge and the lip. The graduation commences at the level of the incisive papilla and the clinician determines where the incisal tips of the max incisors will lie in relation to the resting lip level and records the reading appropriately from the graduated scale

Question 15

How is the papillameter used?

Answer 15

Place the papillameter inside the pts upper lip and let it rest on the incisive papilla
Add addition cured polyvinyl siloxane PVS putty to the papillameter and mould the upper lip to restore the vermillion border. In younger patients, the philttrym may be restored but this may not be possible in older patients
Determine how much of the upper incisors will be shown under the upper resting lip length
Level the pvs at the incisal level and record the reading from the graduated scale on the papillameter
The customised papillameter is sent to the lab and this enables the technician to have sufficient information to prepare an upper rim that provides upper lip support

Question 16

What is the alma gauge

?

Answer 16

It’s a graduated table and a spring loaded pointer that is also graduated. The denture being templates is placed on the graduated table and the pointer placed in the graduated table and the pointer placed in the impression surface of the denture in the middle of the area occupied by the incisive papilla the distance from the pointer to the incisal tip of the central incisors may be read off the horizontal graduated scale on the table.

The vertical distance from the pointer tip to the ucjuwal tips is them read off the graduated scale giving a 3d reading from the incisive papilla to the incisal tips or the central incisors

Question 17

What two measurements are needed to customise the upper rim for each patient?

Answer 17

1. The upper lip dimensions

2. Anterior width of the upper rim

Question 18

What is the ‘aesthetic control base’ ACB?

Answer 18

Upper rim

Question 19

What is the alameter?

Answer 19

Calliper like deviceused to measure the width of the anterior upper rim

Question 20

The use of the alameter is based on what principle?

Answer 20

The width ie horizontal distance between the alar cartilages in a smiling pt is broadly speaking comparable to that of the canine tips