Complete dentures - Try in stage

Question 1

What checks must you do before putting the denture In the patients mouth? (4)

Answer 1

ensure the denture match the patient details

ensure the denture match the design

Is it damaged/of acceptable quality - are the borders smooth and rounded?

place on the models on the articulator and inspect

Question 2

Before insertion, What do you inspect with the try in on the articulator? (6)

Answer 2

Pin contacts the table

assess centre line

stability - does the denture rock on the models

extension - into the depth & width of the functional sulcus

assess the occlusal contacts

assess the overbite/overjet

Question 3

what do we do once the try in is ready for insertion? (3)

Answer 3

Place denture in perform for 10 mins and rinse

Moisten the try ins and insert one at a time into the mouth

• mandibular before maxillary

Question 4

List the 5 checks we do once the denture is In the mouth.

Answer 4

Extension

retention

stability

occlusion

appearance
(& speech)

Question 5

How do we check upper and lower extension during a try in? (4)

Answer 5

Upper:
Assess extension to the vibrating line and hamular notches

Lower: assess extension 2/3rds on to retromolar pads and the retromylohyoid space (as patient to move tongue from side to side)

• Assess frenal relief
• assess depth and width flanges into the functional sulcus

Question 6

How do we alter overextension?

Answer 6

Use a wax. knife and a hot plate to reduce

- don’t adjust the fitting surface

Question 7

How do we check retention during a try in? (4)

Answer 7

insert the denture and place a finger in the palate to allow a seal of saliva to form

pull down on the central incisors or premolars

remove all tissues and see if denture drops = underextension

manipulate tissues and see if denture drops = overextension

Question 8

How do we alter retention?

Answer 8

Alter the extension since retention is a result of extension

Question 9

what can cause a lack of retention? (1)

Answer 9

Over/under extension

Question 10

How do we check stability during a try in? (1)

Answer 10

place fingers on the occlusal surface of premolars and rock from side to side

Question 11

what causes a lack of stability? (2)

Answer 11

underextension

Unbalanced occlusion

Question 12

How do we check the occlusion during a try in? (5)

Answer 12

Assess upper incisor plane - using a foxes bite plane ensure its parallel to inter pupillary line
Assess lower incisor plane - edge is level with corner of mouth

assess mandibular plane - is it parallel to the ala-tragal line (use foxes bite plane)

canine line - with foxes bite plane use a spatula vertically down side of face

assess OVD

assess occlusal contacts:

• are there even contacts in static occlusion
• are there both working and non-working contacts when patient moves lower jaw from side to side

Question 13

how do we alter the OVD? (1)

Answer 13

Remove teeth of preferably the lower denture add a wax rim and re-record the occlusion

Question 14

How do we check appearance during a try in? (6)

Answer 14

Assess nasiolabial angle = 90 degrees

assess support of corners of the mouth

Assess position = centreline and canine line

assess tooth colour, shape, size

Ask patient what they think of the appearance - at rest and smile
Ask patient how denture feels in the mouth

Question 15

How do we check speech during a try in? (3)

Answer 15

ask patient to say;
60 & 70 numbers
Days of the week
fricative sounds

Question 16

What has gone wrong if the patients teeth click when speaking? How do we fix this?

Answer 16

OVD is too high, there is too much interocclusal space

= the OVD has to be reduced

Question 17

What has gone wrong if the patients whistles when speaking? How do we fix this?

Answer 17

OVD is reduced

= increase OVD

Question 18

Apart from assessing the try-in denture in the mouth what else should be noted at the try in stage?

Answer 18

Draw on cast the post dam position

what is post dam?
a lip at the posterior border of the denture that aids peripheral seal

Question 19

How do we know if we are ready to take the denture to the finishing stage? (2)

Answer 19

The problems listed during patient assessment have been addressed

no problems identified during the try in - assess design principles

Question 20

What do we note on the lab prescription if the denture is ready to go to finish? (2)

Answer 20

Please wax up the denture for finish in heat cured acrylic PMMA to produce a complete upper denture

please prepare post dam to…

Question 21

What do we note on the lab prescription if the denture is has to go for a re-trial?

Answer 21

Please remount the cast with [ add changes] for a re-trial