Complete Denture Flashcards
Component of the complete denture
- Denture base
- Artificial gum
- Denture teeth
Maybe additional retainer ( e.g. suction disc )
Definition of the denture base
That part of a removable dental prosthesis, which cover the oral mucosa of the maxilla and/or mandible and to which artificial teeth will be attached during the processing. It transmits the chewing forces to the oral tissues ( teeth, mucosa - fundaments ) and integrates the denture part into one unit. It can be extended, conventional and reduced.
Stabilizing factor of the complete denture
A. Physical : Adhesion Cohesion Vacuum, negative atmospherical pressure Border seal Gravity B. Biologic / clinical : Area of edentulous ridge and mucosal bony base Retentive areas Neuromuscular factors Occlusion of the denture C. Additional retentive devices Adhesive materials
Which stabilizing factor is the most important for the upper and lower denture
In the upper denture is the vacuum
In the lower denture is stabilizing effects of the surrounding muscles and in some degree occlusion
What do we mean under retention in complete dentures?
Complex effect created by forces with different directions, which helps to prevent the horizontal movements and dislocation of the denture away from the tissue-base. It means the maintenance of a dental prosthesis in proper position in the mouth, resistance to movement or displacement.
What is the meaning of support in complete dentures?
The osseous-mucous foundation, which is able to withstand the chewing force, that affects the complete denture. It means the transmission of the vertical component of the chewing load to the mucosal-bony base and resistance of these structures to the forces.
What do we mean under internal seal of complete dentures?
Border seal will occur when we close the denture border airless (creating vacuum). The internal seal can be reached, if this sealing is provided by sinking the border of the denture in the mucosa (e.g. between the anterior and posterior vibrating line).
What do we mean under facial seal in complete dentures?
Border seal will occur when we close the denture border airless. The facial seal can be reached, if the sealing is provided by the flat connection of the cheek and lip and the polished surface of the denture. (e.g. in the maxillary tuberosity –bucca area/tuber-cheek split)
Term mucostatic and mucodynamic.
Mucostatic: representing the mucosal tissues of the jaws as they are in state of rest. Mucostatic impression records the tissues in a particular position
Mucodynamic: taking the impression while the oral tissues, which are relevant to the
complete denture, are moving and changing their shape.
What do we mean under denture space?
A space in the edentulous mouth, bordered by the cheek, tongue and edentulous alveolar ridges, when the mandible would be in centric occlusion position, previously filled in with the teeth and their supporting tissues, capable to receive the denture. The space between the residual ridges which is available for dentures.
Write down which clinical-anatomical areas are important in the edentulous
mandible? (only listing)
Alveolar ridge Retromolar pad Paralingual space and Retromylohyoid area (Fish pocket) Sublingual area Accessory mandibular recess Mental area
What is mucosal resiliency?
Dimensional change of the mucosa between the rest state and the maximally compressed state. It could be:
Primary or immediate resiliency – reversible Delayed resiliency – mucosa becomes more compact (some days - week) –
reversible
Sinking due to bone resorption - irreversible
What is the vibrating line?
It is a line that helps us to determine the posterior extension of the upper base, in the
area of the soft palate. The familiar “junction of the hard and soft palate”. Ask the
patient to blow the nose, while the nostrils are kept closed, the soft palate moves
downward and anteriorly.
What is the flabby ridge?
The hypertrophy of connective tissue in the mucosa that is commonly caused by an
ill-fitting denture. It doesn’t have to be removed in most cases, it can improve the
vacuum. It can be a independent process or it can occur in conjunction with
resorption of the alveolar bone tissues.
Cause: inadequate denture, horizontal denture movement
The position and the borders of the retromolar pad (only listing)
After losing the third molar a pear-shape area (trigonum retromolare) develops
behind the former place of the wisdom tooth.
This area can be divided two parts:
Mesial part: retromolar papilla. Covered by attached or displaceable mucosa Distal part: retromolar pillow. Covered by loose movable mucosa
The position and the borders of the masseteric notch area (only listing)
Bordered by the lateral side of the alveolar tubercle and the mucosa of the cheek, when the mouth is opened, and the peak of the area is beside the orovestibular bisector of the alveolar tubercle.
The position and the borders of the paralingual area (only listing)
Lingual side of the alveolar ridge, in the molar region, until the mylohyoid line. It extends from the first premolar to the mesial part of the retromolar pad.
The position and the borders of the retromylohyoid recess (only listing)
It is situated under and behind thealveolar tubercle on the lingual side of the mandible, an area posterior to mylohyoid muscle, between the mandible and the tounge, also called Fish pocket.
The position and the borders of the sublingual area (only listing)
A semilunar shape area in frontal part of the floor of the mouth, between the ridge and plica sublingualis. Distally it extends until the first molars. Two muscles (m. genioglossus and geniohyoid) split the region into two parts (left and right)
The position and the borders of the accessory mandibular recess (only listing)
Mandibular recess is a hollow between margo anterior and crista temporalis of the mandible, and its extension on the body of the jaw between the linea obliqua and the ridge is the accessory mandibular recess. dorsal border is a virtual line that runs from retromolar pad to linea obliqua mandibulae in 45º, frontal border is on the position of the second molar
The position and the borders of the buccal recess (only listing)
Frontal border: distal part of the M. depressor oris, in line with the second premolar.
Lingual border: vestibular part of the alveolar ridge – if it is well maintained Dorsal border: mesial line of the retromolar pad Lateral border: buccal mucosa – frontal part of the, m. buccinator and the distal fibers of
m. depressor anguli oris Upper border: virtual horizonal line between the vestibular surface of natural or artificial
teeth and the buccal mucosa.
The position and the borders of the tuber-cheek split (only listing).
It is the space between the vestibular surface of the maxillary tuberosity and the mucosa of the cheek.
Width is 3-10 mm.
Which parts of the removable denture has to be polished and why?
Those parts have to be polished, that are facing the oral cavity (not in touch with the mucosa). This must be done because of the irritating effect on the cheek and lips, and to provide facial seal.
Describe the primary/preliminary impression!
Mucostatic and overextended: representing the mucosal tissues of the jaws as they are in a state of rest. Overextended: it extends over the borders of the future denture, but it is not distorted. Tool: stock tray– for edentulous jaws
What is the definition of the definitive (functional) impression?
A step of the construction the complete denture, in which the extension of the future denture base and the width of its borders is determined during the functional activity of the surrounding soft tissues, to achieve maximal support, stability and retention and to determine the continuously changing form, position of the vestibular reflection, and the physiological path of its movements.
Describe the individual/special tray!
The individual tray is constructed on the primary cast made with casting the primary/anatomical impression. It’s borders almost reach the borders of the future denture. The impression taken with it can be used for functional cast production.
Borders:
Upper: it follows the borderline of the attached and loose mucosa, it will pass the line of
the attached mucosa about 1-2 mm. The palatal side the border is on the vibrating line.
Lower: the same as will be the borders of the denture
Why do we place a foil on the cast?
During mastication, the denture will tend to waggle on the most incompressible areas (e.g. torus palatinus), and may lose retention and cause ulcer. These effects can be reduced by placing tin foil or wax on those areas of the cast where incompressible tissue is present. This can also be done if the technician wants to correct the retentive areas of the denture.
List the methods used for determining the horizontal dimension of the mandibulo-maxillary relationship - centric relation! (only listing)
A, patient active : - graphic method ( extra – and intraoral gothic arch tracing)
- myodynamic method (linguomandibular homotropy, swallowing, mirror test)
B. with the manual help of dentist
Which complementary lines do we carv on the facial surface on the wax rims?
Median-sagittal line = midline Alar line/canine line Smile line/high lip line (Mouth corners line) (lower lip-line during smiling)
The sagittal Christensen phenomenon!
When the mandible is in protrusion, there is a wedge shape gap between upper and lower wax rims, if the wax rims were adjusted in centric relation position of the mandible.
When the mandible moves in protrusion without the influence of the incisor guidance a separation occurs between the posterior wax rims. The wedge is opened distally, and is bigger when the mandible moves more frontally. This is known as Christensen’s phenomen.
We can use it to check, if the wax rims were in centric relation during bite registration.
Inclination of symphysis sagittalis is 0° when we use the wax rims (there is no overbite) and the distal part of the mandible moves downward and forward during protrusion – this is the reason for the gap.
The lateral Christensen phenomenon!
During lateropulsion (working side movement of the mandible) the well adjusted wax rims have a contact only on the working side, there is a gap on the non-working side. The reason for this is that during lateral movement the head of the mandible makes only a rotation, but the other (balance side condyle) moves forwards, downwards and inwards; the distal part of the mandible sinks, the frontal part doesn’t, therefore a wedge shape gap is visible between the wax rims, which looks laterally. An indirect evidence of CR as a starting point of the mandibular movement. The split is opened to the non-working side from the working side.
What do we mean under the interalveolar line?
The interalveolar line is a line interconnecting the center lines of the upper and lower alveolar ridges in a particular frontal section.
When do we have to set up the posterior teeth in a cross bite?
When the inclination of the interalveolar line to the horizontal plane is less then 80°.
What is the stop-line?
Where the mandibular alveolar ridge begins steeply rising, the distal end of the occlusal surface.
What do we mean under the denture try-in?
A phase of the denture-construction, when we insert the try-in denture (artificial teeth set up in wax on the base plate) in the mouth and it is checked by the dentist and the patient
What do we mean under the inverted method in the process of flasking?
During the process of flasking the artificial teeth are in the upper part of the flask, while the master cast is in the lower part after setting the gypsum.
What is reocclusion?
A procedure, right after the processing of the dentures, which are still on the casts, and are resettled in the articulator, in which the teeth set-up was made. The objective is to correct occlusal errors resulting from imperfect processing (done by the technician).
What is remontage?
A procedure performed, after the insertion, at the end of the adaptation period (8-10 days) full dentures are remounted into an articulator (with face bow), in order to revise occlusion mistakes originated from the sinking and bite registration faults. Done by the dentist.
What do we mean under festooning?
Festooning is the process of carving the denture base to simulate the contour of the natural tissues which are being replaced by the denture, reproduce natural gum patterns around the teeth.
What do we mean under relining/rebasing a denture?
Dentures are rebased so as to improve the fit and retention of an otherwise satisfactory prosthesis, caused by bone atrophy.
Indications for making an immediate complete denture.
Removal of more teeth, especially anterior teeth, or in the case of removing a longer fixed partial denture, that may cause the patient to impede his work or social life. Psychological considerations. To make eating easier. It helps the extraction wound to heal quicker. Styptic effect after extraction. Slowing or preventing the bone loss on the ridges. Fixing and reproducing the habitual centric occlusion. Helping the patient to get used to the denture.
What is an immediate denture?
An immediate denture is a complete or partial denture inserted immediately, or a few hours later, following the removal of natural teeth.
Write the method for determining the vertical dimension of the mandibulo-maxillary relationship!
-related on CR
- measuring 5 times, using the Phonetic method: asking the patient to pronounce
sounds („m”, „e”)
-than we make an average
From which type of acrylic material can be the complete denture base made of?
HPP, injection molded and self-curing (for temporary)
From which material can be the artificial teeth made of?
The artificial teeth can be made of: acrylic, porcelain or metal.
In which cases and how do we extend the denture base on the maxillary tuberosity?
We always extend on in it, and it’s fully covered with the denture base.
In which cases and how do we extend the denture base on the tuberculum alveolare
mandibulae?
If there isn’t a big difference from the level of the alveolar ride, we extend it on the mesial part. If the difference is big in the levels (negative, or deeply negative formed ridge) we just support it, to reduce the horizontal movements of the denture.
Where is relief needed on the upper jaw?
papilla incisiva/incisive papilla raphe palati/palatal raph rugae palatini/palatal rugs sharp ridge torus palatinus/palatal torus
Where is relief needed on the lower jaw?
mylohyoid line sharp ridge mantal foramen mandibular torus resessus mandibulae accessorius ( negative and deep nagative ridge)
What materials can we use for functional impression?
- monophase silicone
- zinc oxid-eugenol
How can we take the functional impression in the case of flabby ridge?
- with perforated special tray, using light flow and monophase silicon in the same time
- with perforated special tray, using ZnOE and flowable impression gypsum in the same time
- with closed special tray using monophase and light flow silicon in two time (perforating the tray before the second phase)
picture of IKP and excentric contacts of CD in case of normal bite
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