Complete Denture Insertion Flashcards
patient should leave out old dentures for at least — prior to appointment
24 hr
before appointment, inspect dentures, put in denture cup/h2o (3)
no imperfections on surfaces
borders are round/ no sharp angles
cameo surfaces are smooth
reexamine the tissue side of the dentures carefully remove any — present with a kingsley scraper or other sharp instrument
bubbles
prior to delivery the dentures must be
soaked in water for 72 hours
Before Insertion appointment (2)
Accurate maxillary remount cast already attached to articulator
Mandibular remount cast is prepared for clinical remount
Intaglio surface
Pressure Indicator Paste (2)
Undercut areas
Accuracy of tissue contact
zinc oxide paste is used as a
pressure indicating paste (PIP)
PIP detects
improper adaptation
pip spray
used for patients with xerostomia in order to prevent the pip from sticking to the mucosa
pip sequence (5)
dry denture surface
brush a thin even layer of pip into the surface of the denture
seat the denture with pressure in the first molar region
remove immediately
inspect and adjust bearing surface as necessary
Pressure Indicator Paste
Brush on — coat
Brush strokes —
thin
visible
Remove — in the
sea of white
islands of pink
Ensure that displaced paste reflects a pressure area before
relieving the
denture base. Mark again, if not sure.
Are dentures stable during
speech and swallowing?
Are borders and contours compatible with
available space in vestibules?
Borders properly relieved at
frenal attachments?
adjusting denture borders (2)
carefully adjust the denture flange as necessary
reapply, border mold and adjust until areas of overextension are eliminated
problems with phonetics (4)
check the thickness of the maxillary palatal portion. a common problem is excessive thickness
reevaluate the position of the maxillary anterior teeth
if everything appears normal it may be a matter of time for the patient to adapt
open vertical dimension of occlusion
gagging (3)
palate excessively thick
palatal extension too long
lack of tongue space (teeth set too far to the lingual)
Sources of Occlusion errors (7)
Resin shrinkage when processed Ill-fitting temporary record bases Change of OVD on the articulator Inaccurate max-mand. records by dentist Incorrect arrangement of teeth Overheated when polished Water absorption (expands 1-3%)
Since numerous sources of occ. errors exist, dentist should assume
error
exists and work to find it
Technique to check is not difficult, but it requires a
willingness to see
the error.
Simply telling patient to close their jaws, and observing contacts —→
errors are unlikely to be detected.
Occlusal harmony (3)
Patient comfort
“Efficient” function (20% of natural teeth)
Preserve supporting tissues
Look for posterior — contacts
beyond tooth contacts
flange
prior to making the record
seat the posterior palatal seal
place 2 cotton rolls between the posterior teeth and have the patient bite down for 5 min
Clinical Remount (3)
Make interocclusal record
Remount dentures on articulator
Refine occlusion on articulator
Clinical remount & Occ. refinement
(2)
Done before final delivery of the dentures
Occlusal errors will deform the supporting tissues & conceal the errors if
postponed
Intraoral Occlusal
“adjustment” (2)
Resiliency of tissues allows dentures to move
Misleading articulating paper markings result
Saliva on teeth interferes with
paper markings
Intraoral Occlusal
“adjustment”
Requires — patient cooperation
repeated
Some can cooperate. Some cannot.
Intraoral Occlusal
“adjustment”
Use — for extra security during this procedure
denture adhesive powder
Clinical Remount
Advantages (7)
Reduces patient participation
Dentist sees better what to do
Stable working foundation; bases not shifting on resilient tissues.
Absence of saliva = more accurate marks with articulating paper.
Grinding may be done away from patient. This prevents patient
objections to “mutilating my new teeth.”
Occlusion desired (3)
Simultaneous contact of all posterior teeth in retruded mand. position
Absence of contact on anterior teeth
Absence of deflective interferences in eccentric movements
Evaluate the cameo surface acrylic thickness (4)
Observe intraorally and extraorally
Use pressure indicator paste
Make measurements
Seek patient feedback
the difference between and explanation and an excuse is the
time they are provided
before the problem=
explanation
after the problem=
excuse
explain the limitations of dentures as
mechanical substitutes for living tissues
instructions to patients
oral and written (2)
strange feelings of fullness in lips and cheeks for a few days
mandibular denture more difficult to use than maxillary CD
instructions to patient
expect
speaking
expect increased flow of saliva first few days
speaking improves with practice. read aloud the daily newspaper, etc
Learning to chew normally takes about
2 months
Begin with
softer foods that are cut into small pieces
Control of the dentures is accomplished by manipulation with the (3)
tongue, lips, and cheeks
Teach the patient to position the tip of their tongue next to the
lingual
surfaces mandibular anterior teeth (have the patient say “e”)
Use — for extra security , as needed, during the
first month
denture adhesive powder
Expect — during “break-in period”
sore spots
Return to — for adjustments. Do not adjust dentures at home.
clinic
Remove dentures at night and store in —.
water
Care of the prosthesis-
brushing (over a sink with water or a washcloth
in it), soaking in a container, remove any adhesive
Care of the mouth-
gingival massage, tongue brushing with a soft
toothbrush
provide — as well as verbal instructions
printed
