Clinical Steps in RPD's (1)

Question 1

Approximately how many visits will a patient make to you for a RPD and what will happen at these visits?

Answer 1

6

1 - assessment and primary impressions

2 - master impressions

3 - framework trail (+/- record occlusion)

4 - tooth trial

5 - delivery (fit)

6 - review

Question 2

What are the 9 steps from the start of the RPD process to the review stage?

Answer 2

1 - select tray

2 - primary impressions

3 - hand articulate and survey

4 - master impressions

5 - framework trial

6 - record occlusions

7 - tooth trial on framework

8 - delivery and insructions

9 - review

Question 3

What happens at the first patient visit?

Answer 3

Examination of the patient and a previous denture if present Primary impression taking

Question 4

What sorts of things are you looking for in the mouth in an examination for a RPD?

Answer 4

• Ridge form - is there any displaceable tissue?
• Free end saddles
• Bounded saddles
• Undercuts (both tooth and soft tissue undercuts)

Question 5

What is the main difference between and edentate tray and a dentate tray?

Answer 5

Edentate trays have a lesser depth than a dentate tray

Question 6

What primary impression material would you use for a patient with free-end saddles?

Answer 6

Alginate and Compound

Question 7

Where would you use compound when taking an impression?

Answer 7

On free end saddle areas - NOT where there are teeth as it is not elastic

Question 8

Why cant alginate always be used for free-end saddles?

Answer 8

Alginate might not catch the full extent of the free-end saddle (retromolar pad not recorded in the pic shown)

Question 9

How is compound used for impressions with free-end saddles?

Answer 9

Compound material heated up and added to the impression tray - impression of saddle areas taken. This stabilises the tray.

Adhesive suitable for alginate put on the composite

Alginate added to the tray and impression taken

Are left with an alginate impression supported by compound

Question 10

What impression material would you use in a patient who didn’t have any free-end saddles?

Answer 10

Alginate

Question 11

What are the steps for taking primary impressions?

Answer 11

1 - select stock tray and modify peripheries/fit surface with wax or compound

2 - apply adhesive and use alginate or alginate/compound for impression. Border mould +++

3 - disinfect and place in selaed bag with wet cotton wool/paper towel

4 - label bag and write instructions to technician

Question 12

How long do you disinfect the impressions for? Why this amount of time?

Answer 12

10 mins If you leave it for longer than this then the alginate will absorb too much liquid and not be accurate

Question 13

Why do you put the alginate in a bag with wet cotton wool/paper towels?

Answer 13

Because it is likely to dry out otherwise

Question 14

What should be thought about next after study casts have been made of the impressions?

Answer 14

Recording occlusion

Question 15

At the point of the study casts, when would you record the occlusion?

Answer 15

If the casts cant be hand articulated

Question 16

Do you need to record occlusion or have a primary record block if you can hand articulate the cast? Why?

Answer 16

no -can get casts mounted on an articulator with a wax wafer or nothing at all

Question 17

What is done after the casts are mounted onto an articulator?

Answer 17

-occlusion examined on the articulator -look for space to place rest seats -plan for prep of rest seats if no space available

Question 18

What is used to get an inter-occlusal record?

Answer 18

wax wafer (warm wax the patient bites on)

Question 19

What needs to be done if the cant be hand articulated?

Answer 19

-need a primary record block from the lab -record the occlusion using the primary record block -ask the technician to mount the primary casts using your registration