Complete Denture Definitions

Question 1

1) Components of the complete denture

Answer 1

Denture base, artificial gum, denture teeth, maybe additional retainers (e.g. suction disc – now not used)

Question 2

2) Definition of the denture base

Answer 2

That part of a removable dental prosthesis, which covers 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-bone fundaments) and integrates the denture parts into one unit. It can be extended, conventional and reduced.

Question 3

3) Stabilizing factors of the complete denture

Answer 3

Physical: adhesion, gravity, vacuum
Biological: stabilizing effects of the surrounding soft tissues, muscles, mucosa and the neuro- muscular reflex-activity
Optimal occlusion

Question 4

4) Which stabilizing factor is the most important for the upper and the lower denture?

Answer 4

In upper denture is the vacuum, in the lower is stabilizing effects of the surrounding muscles, and in some degree occlusion.

Question 5

5) What do we mean under retention in complete dentures?

Answer 5

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.

Question 6

6) What is the meaning of support in complete dentures?

Answer 6

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.

Question 7

7) What do we mean under internal seal of complete dentures?

Answer 7

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).

Question 8

8) What do we mean under facial seal in complete dentures?

Answer 8

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)

Question 9

10) Term mucostatic and mucodynamic.

Answer 9

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.

Question 10

11) What do we mean under denture space?

Answer 10

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.

Question 11

12) Write down which clinical-anatomical areas are important in the edentulous mandible? (only listing)

Answer 11

Alveolar ridge
Retromolar pad
Paralingual space and Retromylohyoid area (Fish pocket)
Sublingual area
Accessory mandibular recess
Mental area

Question 12

13) What is mucosal resiliency?

Answer 12

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

Question 13

14) What is the „Aah”/posterior vibrating line?

Answer 13

When the patient says “Ah” the soft palate moves upward. The limit of posterior extension of the upper base.

Question 14

15) What is the anterior vibrating line?

Answer 14

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.

Question 15

16) What is the flabby ridge?

Answer 15

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

Question 16

17) The position and the borders of the retromolar pad (only listing)

Answer 16

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

Question 17

18) The position and the borders of the masseteric notch area (only listing)

Answer 17

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.

Question 18

19) The position and the borders of the paralingual area (only listing)

Answer 18

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.

Question 19

20) The position and the borders of the retromylohyoid recess (only listing)

Answer 19

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.

Question 20

21) The position and the borders of the sublingual area (only listing)

Answer 20

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)

Question 21

22) The position and the borders of the accessory mandibular recess (only listing)

Answer 21

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 ont he position of the second molar

Question 22

23) The position and the borders of the buccal recess (only listing)

Answer 22

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.

Question 23

24) The position and the borders of the tuber-cheek split (only listing).

Answer 23

It is the space between the vestibular surface of the maxillary tuberosity and the mucosa of the cheek.
Width is 3-10 mm.

Question 24

25) Which muscle is called the Jüde-muscle?

Answer 24

The m. myloglossus.

Question 25

26) Which parts of the removable denture has to be polished and why?

Answer 25

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.

Question 26

27) Describe the primary/preliminary impression!

Answer 26

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

Question 27

28) What is the definition of the definitive (functional) impression?

Answer 27

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.

Question 28

29) Describe the individual/special tray!

Answer 28

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 will be 2-3 mm longer than the border of the planned denture.
Lower: the same as will be the borders of the denture

Question 29

30) Describe the special tray!

Answer 29

Material: 1. Self curing acrylic resin, 2. Heat cured acrylic resin,
3. Shellack base plate,
4. Vacuum preformed tray, 5. Light cured resin
Handles
Aims: 1. Insertion, removal
2. Holding,
3. Evaluation
After adaptive modification of the individual tray we will get the functional tray.

Question 30

31) Why do we place a foil on the cast?

Answer 30

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 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.

Question 31

32) List the methods used for determining the horizontal and vertical dimension of the mandibulo-maxillary relationship - centric relation! (only listing)

Answer 31

Extraoral arrowhead tracing, according to Gysi
Intraoral gothic arch tracing according to Gerber
Method based on the linguomandibular homotrophic theory
Walkhoff method
Lamellar method according to Kemény
Hromatka method
Pantographic method
EMG
Radiographic cephalometry
Lauritzen method

Question 32

33) Which complementary lines do we carv on the facial surface on the wax rims?

Answer 32

Median-sagittal line = midline
Alar line/canine line
Smile line/high lip line
(Mouth corners line)
(lower lip-line during smiling)

Question 33

34) The sagittal Christensen phenomenon!

Answer 33

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.

Question 34

35) The lateral Christensen phenomenon!

Answer 34

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.

Question 35

36) What do we mean under the interalveolar line?

Answer 35

The interalveolar line is a line interconnecting the center lines of the upper and lower alveolar ridges in a particular frontal section.

Question 36

37) When do we have to set up the posterior teeth in a cross bite?

Answer 36

When the inclination of the interalveolar line to the horizontal plane is less then 80°.

Question 37

38) What is the stop-line?

Answer 37

Where the mandibular alveolar ridge begins steeply rising, the distal end of the occlusal surface.

Question 38

39) What do we mean under the denture try-in?

Answer 38

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

Question 39

40) What do we mean under the inverted method in the process of flasking?

Answer 39

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.

Question 40

41) What is reocclusion?

Answer 40

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).

Question 41

42) What is remontage?

Answer 41

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.

Question 42

43) What do we mean under festooning?

Answer 42

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.

Question 43

44) What do we mean under relining/rebasing a denture?

Answer 43

Dentures are rebased so as to improve the fit and retention of an otherwise satisfactory prosthesis, caused by bone atrophy.

Question 44

45) Indications for making an immediate complete denture.

Answer 44

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.

Question 45

47) Write 4 methods for determining the vertical dimension of the mandibulo-maxillary relationship!

Answer 45

Phonetic method: asking the patient to pronounce sounds („m”, „e”)
Methods based on harmonic proportions of the face, golden section
EMG method
Kemény – Rehák method
Appropriate former denture
Records made before the extraction of the natural teeth

Question 46

48) Which consonants pronounciation is disturbed in the state of edentulousness?

Answer 46

Dental, alveolar consonants: d,t,n,z and the labiodental consonants: v, f are impaired.

Question 47

49) Which physiognomic changes can be observed in the state of edentulousness?

Answer 47

1) ”hag” face: circumoral muscles loose their support -> depths of nasolabial, mental folds increase chin becomes prominent – pseudo class III appearance
2) the nose virtually becomes longer, its base seemingly wider
3) the chin tends to appear closer to the tip of the nose -> vertical dimension of the face decreases
4) the tongue functions partly like the former dentition, becomes stronger and wider,
5) Joint: condyle and tuberculum become flattened -> possibility luxation,
6) Hyperfunction of lat. pterygod. m. -> propulsive position of the mandible -> even more prominent progen character (bulldog bite).
7) Hyperactivity and hypertrophy of m. depressor anguli oris -> corners of the mouth hang down -> melancholic appearance
8) The lips become narrower, fold into the oral cavity -> cheilitis angularis

Question 48

50) From which material can be the complete denture base made of?

Answer 48

Acrylic, rarely metal.

Question 49

51) From which material can be the artificial teeth made of?

Answer 49

The artificial teeth can be made of: acrylic, porcelain or metal.