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Prosthodontics > Complete dentures > Flashcards

Complete dentures Flashcards

1
Q

What is a complete denture?

A
  • Removable dental prosthesis that replaces entire dentition and associated structure of maxilla and mandible
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2
Q

What are complete dentures made of?

A
  • PMMA acrylic
  • Cobalt/chromium
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3
Q

What are some effects of edentulism?

A
  • Loss of masticatory function
  • Appearance
  • Self esteem
  • Soft tissue changes to lip and chin
  • Reduction in face height
  • Ridge resorption
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4
Q

When does post-extraction resorption most rapidly occur?

A
  • Occurs rapidly after XLA in 1st 6 months
  • Occurs throughout life as well
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5
Q

What are the Cawood and Howell’s classifications of alveolar ridge?

A

Class I - Dentate
Class II - Immediately post extraction
Class III - Well rounded ridge form, adequate in height and width
Class IV - Knife-edged ridge form, adequate in height, inadequate in width
Class V - Flat ridge form, inadequate in height and width
Class VI - Depressed ridge form

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6
Q

Why do we render patients edentulous and make complete dentures?

A
  • Rampant caries
  • Periodontal disease advanced with unrestorable teeth
  • Severe and debilitating toothwear
  • Occlusal collapse
  • Appearance
  • Head and neck cancer
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7
Q

Why use a replica denture?

A
  • AKA copy dentures
  • Maintains existing aesthetics
  • Keeps existing design easier to adapt
  • Major mods difficult tho
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8
Q

What is included in denture history?

A
  • Age of dentures
  • Matched set
  • Most recent worn
  • How many
  • How often worn
    etc
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9
Q

Social history you need to be cautious of for denture?

A
  • Mobility
  • Barriers to treatment
  • Alcohol/smoking
  • Capacity to consent
  • Support needed
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10
Q

What do is included in assessment of mouth and facial tissues?

A
  • Tissues healthy
  • Do they require management before new denture
  • Angular cheilitis
  • Denture stomatitis
  • Denture hyperplasia
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11
Q

What intra-oral are you looking for?

A
  • Support in edentulous areas upper and lower
  • Mouth opening (trismus)
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12
Q

How do you calculate freeway space?

A

Vertical height - RVD - OVD

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13
Q

What are the key concepts you are examining when denture is in mouth?

A
  • Anterior and posterior occlusal planes
  • Freeway space
  • Occlusion recorded correctly
  • Lip support
  • Overextension or underextension
  • Retention, stability, adaptation
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14
Q

In upper jaw what are the support areas we look for in impressions?

A

Primary = Hard palate
Secondary = Ridge crest
Denture border does not contribute

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15
Q

In lower jaw what are the support areas we look for in impressions?

A

1ry = Buccal shelf and pear shaped pad
2ry = ridge crest and genial tubercles
N/C = labial ridge incline
Relief area = lingual ridge and mylohyoid ridge

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16
Q

What is ICP?

A
  • Intercuspal position
  • Complete intercuspation of opposing teeth independent of condylar position
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17
Q

What is RCP?

A
  • Retruded contact position
  • Guided occlusal relationship occurring at most retruded position of condylars in joint cavities
  • Most reproducible position and use in complete not ICP
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18
Q

What is retention?

A
  • Resistance to displacement of denture away from ridge
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19
Q

What is stability?

A
  • Ability of denture to resist displacement by functional stresses
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20
Q

What is adaptation?

A
  • Degree of fit between prosthesis and supporting structures
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21
Q

What is involved in pre-treatment phase?

A
  • Get tissues healthy prior to prosthesis
  • Referral for investigation or further opinion if concerns about mucosa
22
Q

What are primary impressions used for?

A
  • Construct model casts
  • Treatment planning
  • Construction of special trays
23
Q

How can stock trays be modified to fit denture bearing area?

A
  • Reduced with acrylic bur
  • Soft red wax
  • Greenstick
  • Putty
  • Composition
24
Q

Benefits and cons of putty?

A
  • Expensive
  • Short setting time
25
Q

Benefits and cons of soft red wax?

A
  • Cheap
  • Can manipulate easily in hands
  • Poor dimensional stability
26
Q

Benefits and cons of red composition?

A
  • Cheap
  • Requires boiling water
  • Less available in practice
  • Very short working time
27
Q

Benefits and cons of greenstick?

A
  • Cheap
  • Rarely used in stock trays
  • Requires intense heat
  • Tricky to manipulate
  • Runny so suited for smaller additions on special trays
28
Q

What materials are used for denture impressions?

A
  • Alginate
  • Red composition (useful if patient retches but have to be quick as rapid working time)
  • Silicone elastomers/polysulphides
29
Q

How many mm should be between tray flange and denture bearing area?

A
  • Approx 4mm
30
Q

What is the clinical procedure for primary impressions?

A
  • Thin layer adhesive over tray and putty/wax and let dry
  • Mix alginate and load tray
  • Set into mouth
  • Border mould muscles (cheeks and lips whilst supporting tray)
  • Once set remove with sharp movement
  • Assess
31
Q

What are you assessing for in an impression?

A
  • Are edentulous areas included
  • Are sulci areas included
  • Deficiencies due to air inclusion?
  • Fit for purpose
32
Q

Why are master impressions done?

A
  • Record denture bearing area, functional depth and width of sulci
  • Use special trays prescribed after primary
33
Q

What landmarks are we looking for in upper denture bearing area?

A
  • Labial sulcus
  • Labial and buccal frenum
  • Incisive papilla
  • Palatine rugae
  • Buccal sulcus
  • Hamular notch
  • Tuberosity
  • Vibrating line and palatine foveae
34
Q

What landmarks are we looking for in lower denture bearing area?

A
  • Labial, buccal, lingual sulcus
  • Labial and lingual frenum
  • Buccal shelf
  • Retromolar pad
35
Q

What can special trays be made of?

A
  • VLC resin PMMA (acrylic)
  • Self-cure PMMA (acrylic) (hard to roll even layer)
36
Q

Benefits and cons to VLC resin PMMA as special tray material?

A
  • Easy to mould
  • Pre rolled sheets
  • Very rigid and can be hard to remove from model
37
Q

What are some advantages of special trays?

A
  • Accurate peripheral extension
  • Uniform thickness of material
  • Reduces amount of material so less discomfort for pt
  • Records denture bearing area more accurate
38
Q

What are mould stops used for and with what?

A
  • Greenstick
  • Maintain spacing for material to allow consistent placing of tray
  • Because extension should be approx 2mm short of sulcus depth to allow border moulding
39
Q

What are the aims of master impressions?

A
  • Well rounded borders
  • Minimal air blows and none in important areas
  • All clinically relevant areas included
40
Q

What should you be careful of with master impressions?

A
  • Underextended tray leads to underextended impression
  • Incomplete tray seating
  • Sharp border to lingual pouch
  • Overextended tray leads to overextended impression
41
Q

How must alginate impressions be handled?

A
  • Kept moist and cast asap
  • V imp for masters
42
Q

How should elastomer impressions be handled?

A
  • More dimensionally stable so don’t need moist environment
  • Cast to avoid damage
43
Q

Disinfection of impressions?

A
  • Needed to prevent cross contamination of micro-organisms via blood or saliva
  • Rinse in running water to remove saliva, blood or debris
  • Disinfect for 10mins in disinfectant sol
  • Rinse thoroughly with clean gloves
  • Damp towel around them
  • Label and place in plastic lab bag
  • Lab prescription disinfected and take to lab asap for casting
44
Q

What is an impressions?

A
  • Reverse or negative form of the tissues
  • It is converted into positive model/cast using plaster or stone or mixture of both
45
Q

Where should you stand for impression taking?

A
  • Upper stand behind
  • Lower stand infront
  • Patient not flat
46
Q

What are tissue stops used for?

A
  • Used with spaced trays either primary or secondary
  • Ensure uniform thickness of impression material
  • Help localise tray during impression taking
  • Greenstick or incorporated into tray in acrylic
47
Q

Where are tissue stops placed?

A

Lower tray = canine region and over retromolar pad
Upper tray = Canine region and post dam area

48
Q

What are finger rests used for?

A
  • Lower special trays
  • Placed in 2nd premolar and 1st molar region
  • To support mandible and ensure even distribution of pressure to tissues
  • Help stabilise tray in mouth
49
Q

When are close fitting trays used?

A
  • Spacing up to 1mm
  • Resorbed ridges and replicas
  • Use light bodied elastomers like ZOE
50
Q

When are spaced trays used?

A
  • Most common
  • 3mm spacing
  • Alginate or heavy body elastomers
  • Most situations
51
Q

What is mucocompression?

A
  • Pressure applied to mucosa so shape of tissues under load is recorded
52
Q

What is mucostasis?

A
  • Minimum pressure applied to tissues to record shape at rest

Prosthodontics (10 decks)

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