Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS2 RPD > Clinical stages of RPD's > Flashcards

Clinical stages of RPD's Flashcards

1
Q

What are the 6 clinical stages of RPD’s?

A

Visit 1: Assessment and primary impressions

  • Visit 2: Master impressions
  • Visit 3: Framework trial (+/- record occlusion)
  • Visit 4: Tooth trial
  • Visit 5: Delivery (fit)
  • Visit 6: review
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What would you examine on visit 1? (2 points)

A

The patient

  • The previous denture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In the first visit you would look in the mouth of the patient. What would you be looking for? (4 points)

A

Ridge form (feel for displacement tissue)

  • Free end saddles
  • Bounded saddles
  • Undercuts (particularly when selecting impression material)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the difference between an dentate and edentate impression tray?

A

Edentate tray is shallower than dentate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which type of impression material would you typically use when there are no free end saddles?

A

Alginate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which type of impression material do you typically use for primary impressions?

A

Alginate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which type of impression material would you typically use for people with free end saddles? (2 points)

A

Compound (stock trays don’t always fit everyone so can use compound to modify this)

  • Alginate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Is alginate an elastic compound?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 2 examples of elastomers?

A

Silicone

  • Polyether
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is impression compound an elastic material?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the process of taking primary impressions? (4 points)

A

Select stock tray and modify peripheries/fit surface with wax or compound

  • Apple adhesive and use alginate or alginate/compound for impression. Border mould +++
  • Disinfect and place in sealed bag with wet cotton wool/paper towel
  • Label bag and write instructions to technician
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you decontaminate and disinfect primary impressions?

A

Put in perform for 10 mins

  • Then rinse and put in a bag
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens during visit 1?

A

Assessment and primary impressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

During the first visit, you need to record the occlusion. What does this mean?

A

Measure how the teeth meet

  • What is the comfortable bite?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When can study casts be hand articulated?

A

IF it is obvious where the teeth fit together - good occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Do you need to record the occlusion if you can hand articulate the cast?

A

No, you can move on without a primary record block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When you are unable to hand articulate the casts, what needs to be done?

A

Need to take a primary registration using a wax bite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can you use to take an inter occlusal record of a patient?

A

A wax wafer

  • Warm wax the patient bites on - not the most accurate if you make the wax really thick or really soft
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What clue on the articulator can indicate that the wax wafer for an inter-occlusal record is too thick?

A

The pin of the articulator is not on the table

  • Shows teeth are not meeting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

You are not able to hand articulate a cast with a free end saddle present. What would you use to record the occlusion?

A

A primary record block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why may you take primary record blocks? (4 points)

A

You can’t obviously see how the teeth meet

  • Use to mount casts accurately
  • Look for space to place rest seets and base plate
  • Plan for preparation of rests seats if no space is available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why is there an extra clinical stage (visit) when there are not enough teeth to hand articulate?

A

As need to record the occlusion before the primary models can be mounted on an articulator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When giving instructions to the technician you need to think about what material you are going to use for the master impression. What do you need to consider? (2 points)

A

How much spacing is required (The space required for the impression material)

  • Are there many undercuts (If got a lot of undercuts then would not use anything rigid - needs to be able to flex so needs to be elastic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What instructions would you give to the technician if the casts are going to be hand articulated? (2 points)

A

Pour primary casts

  • Special tray with spacer (1-2 sheets of wax depends on master impression material with handles/finger rests etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What instructions would you give to the technician if the casts are not going to be hand articulated? (3 points)

A

Pour primary casts

  • Special tray with spacer (1-2 sheets of wax depends on master impression material with handles/finger rests etc)
  • Construct primary record block for a preliminary jaw registration (base can be wax, shellac or light cure acrylic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Before visit 2 you need to design the denture. What do you need to do to be able to do this? (4 points)

A

Survey to decide the path of insertion

  • Survey to decide undercuts etc (so you know where to put clasps)
  • Do you need to modify teeth to produce rest seats, guide planes and undercuts
  • Draw the design on the laboratory work card
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Must the denture you are producing conform to the patients occlusion?

A

Yes, unless you are planning to change it for a valid reason

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If there is no inter-occlusal clearance for a rest on the denture what must you do?

A

Must either make space by cutting a rest seat or do not place the rest in that position

  • If you don’t make space the occlusion will not be correct
  • IF there is no space the rest will simply open the bite
29
Q

What is the system for design of a RPD? (6 points)

A

Outline saddles

  • Support
  • Retention
  • Bracing
  • Connectors (minor and major)
  • Review design
30
Q

What happens during visit 2?

A

Master impressions are taken

31
Q

When trying in a special tray for master impressions what may you need to do?

A

Trim peripheries if overextended

  • Modify peripheries with greenstick and fit surface for free end edentulous saddles
32
Q

Why are handles on special trays orientated in a specific way?

A

To avoid disturbing the lip

33
Q

What are the options for impression materials at the dental hospital? (4 points)

A

Poly vinyl Siloxane (medium bodied silicone)

  • Polyether (sets more rigid than PVS)
  • Alginate
  • Impression compound (to modify the tray)
  • Use specific tray adhesive for the material you are going to use
34
Q

What is an example of a medium bodies silicone (poly vinyl siloxane) used as an impression material?

A

Brand name: Extrude

  • Comes in 3 different bits
  • Don’t need a lot as you have a custom tray that has a very narrow spacing - only need enough to cover the surface you are trying to record
  • Does not biodegrade so do not want the patient swallowing a big lump of it
35
Q

What is an example of a polyether used as an impression material?

A

Brand name: Impregum

  • Very accurate, will give nice impression
  • Very rigid, do not use with undercuts
  • Be careful with people with periodontal disease
36
Q

What are a few positives and negatives of alginate? (4 points)

A

WEll mixed (smooth mix)

  • Poured up as soon as possible
  • Good if undercuts present
  • Careful for air blows
37
Q

What is the process of taking master impressions? (4 points)

A

Try in special tray and trim peripheries if over extended

  • Modify peripheries with greenstick and fit surface for free end saddles
  • Apply adhesive and use alginate/polyether/PVS for impression. Border mould+++
  • Disinfect, place in sealed bag and write instructions to technician
38
Q

Do you need to decontaminate and disinfect a master impression?

A

Yes

39
Q

What instructions would you give the technician with master impressions for a cobalt chrome denture? (3 points)

A

Pour model in improved stone

  • Construct a chrome framework per design (clear design signed by the clinician)
  • (remember to prepare occlusal rests/guide planes before taking impression)
40
Q

What instructions would you give the technician with master impressions for an acrylic denture? (2 points)

A

Pour model in stone

  • Construct record block with shellac base
41
Q

What do you do during visit 3?

A

Framework trial (+/- recording the occlusion)

42
Q

For the framework trial what do you need to consider? (4 points)

A

Does it fit the cast (if it looks like it does not fit the cast then it will probably not fit the patient)

  • Does it seat correctly in the mouth?
  • Is the cast damaged (might mean undercut is too big)
  • Is the framework interfering with occlusion?
  • If happy with the above checks then register the occlusion
43
Q

Why do we need to record the occlusion? (5 points)

A

To help design the denture

  • To help the technici an set up the teeth
  • (to ensure the denture is stable and not dislodged in function)
  • Patient comfort
  • Ensuring loading forces are applied correctly to teeth
44
Q

What is meant by a ‘conformist approach’ when recording the occlusion?

A

Want to keep the occlusion the same as it currently is

  • Need to know the position of teeth in relation to each other
45
Q

What is a ‘reorganised approach’ when recording occlusion?

A

Can reorganise the bite

  • Do this by altering the occlusion
  • May need to be done because of tooth wear or if there are not enough teeth to meet
46
Q

What is the aim of visit 3 in regards to recording the occlusion? (4 points)

A

Want to establish:

  • Inter-occlusal relationships to articulate casts
  • Occlusal vertical dimension
  • Tooth shade and mould

Extended edentulous spaces:

  • Buccal/labial contours of wax record block
  • Lip support
  • Incisal plane
  • Posterior plane
47
Q

IF there are no index teeth, you need to measure the OVD And FWS. What do these terms mean and what do you use to do this?

A

OVD = occlusal vertical dimension

  • FWS = Freeway space
  • Do this using a Willis bite guage
  • Measure the OVD and the resting occlusal dimension - 2-3mm called the freeway space
48
Q

If adjusting the framework on chairside what would you use to adjust the clasps?

A

Adam’s pliers

49
Q

What is the process of trimming blocks for recording the occlusion? (7 points)

A

Try it in, it will be bulky

  • It has to stay in place
  • Any overextension of the peripheries as it will drop/displace
  • Too much lip support and it will drop
  • Use the wax knife and hot plate/spatula to make adjustments
  • Adjust the upper rim first
  • You may need to adjust the rim labially/buccally
50
Q

How do you prescribe the position of anterior teeth? (4 points)

A
  1. Make sure index teeth are in occlusion
  2. Mark Centreline
  3. Correct incisal plane
  4. Correct antero-posterior position
51
Q

What are reference points for placing anterior teeth in RPD’s? (8 points)

A
  • Teeth present
  • Dento-facial midline
  • Inter-pupillary line
  • Ala-tragus line
  • Curvature of lower lip
  • Smile line
  • Gingival margins of existing anterior teeth
  • Previous dentures
52
Q

What factors would influence the shade in tooth selection? (3 points)

A

Existing teeth

  • Previous denture
  • Patient preference
53
Q

What factors would influence the mould in tooth selection for RPD’s? (3 points)

A

Existing teeth

  • Previous denture
  • Measure
54
Q

After visit 3 what instructions should you give the technician in relation to articulators?

A

Need to tell them which articulator you want them on

  • Usually want an average value articulator
55
Q

After visit 3 if you need a wax record block what would your instructions to the technician be?

A

Construct wax record blocks on chrome framework

  • (Additional visit required)
56
Q

After visit 3 if a wax record block is not needed what would your instructions to the technician be? (2 points)

A

Articulate casts to registration

  • Set teeth for wax trial (shade and mould provided)
57
Q

What happens during visit 4?

A

Tooth trial

58
Q

Visit 4 is usually the framework tooth trial. What is included in this? (4 points)

A

Framework fit

  • Occlusion
  • Aesthetics
  • Extension
59
Q

If there are problems with the framework tooth trial what do you need to do?

A

Need to agree with the patient what you want and then have a re-trial

60
Q

What instructions would you give to the technician after visit 4: the tooth trial

A

Please take to finish in acrylic

  • (all the wax will be burned out and acrylic will be put in)
61
Q

What happens during visit 5?

A

Delivery

  • Dentures will be on articulator
  • Need to check everything is okay e.g. pin is on the table
62
Q

After visit 5, What should you look for when examining the denture on the articulator? (6 points)

A

Check design again as requested

  • Examine dentures for roughness/blebs
  • Check it seats properly
  • Undercuts - are any teeth in the cast broken?
  • Is the pin on the table?
  • Does the occlusion look correct?
63
Q

After visit 5, what should you look for when looking at the denture in the patients mouth? (6 points)

A

Does it seat properly?

  • Don’t force it in (check undercuts)
  • Check:
  • Stability (does it rock?)
  • Support (are the rests/flanges seating correctly?)
  • Retention (adjust clasps with adams pliers)
  • Aesthetics (carry out the above checks first, last thing you do is show the patient
64
Q

At visit 5 you need to check the occlusion. What are you looking for?

A

Do the teeth meet in the prescribed occlusal scheme per the wax up? (check with articulating paper for heavy/early defective contacts)

  • Is something propping over the bite?:
  • (small change adjust with acrylic bur chairside)
  • (large change may require removal of teeth and re-set in wax)
65
Q

What instructions would you give the patient when they re cieve the complete denture? (7 points)

A

Insertion/removal (make sure patient is able to get it in and remove it themselves)

  • Coping with new dentures (going to be uncomfortable at first but will adjust)
  • Pain
  • Denture cleansing
  • Speech
  • Eating
  • Refer to clinic patient info booklet
66
Q

What happens during visit 6?

A

Review (can be most difficult appointment of the whole process)

67
Q

What must be included in the review visit? (3 points)

A

History

  • Examination
  • Adjustments
68
Q

What are index teeth?

A

Teeth that you can reproduce if the patient bites together

BDS2 RPD (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions