Denture Manual 1-51 Flashcards
Mandibular arch
- Areas of primary support
- Areas of secondary support
Primary: Buccal shelves, posterior ridge, retromolar pad
Secondary: Anterior ridge
Maxillary arch
- Areas of primary support
- Areas of secondary support
Primary: Posterior ridge, palate, and tuberosities
Secondary: Anterior ridge
House’s Palatal Classification - Class I
The junction between mobile and immobile soft palate is 5-13 mm distal to the line formed between the two pterygomaxillary notches
House’s Palatal Classification - Class II and III
The junction between mobile and immobile soft palate is 1-5 mm distal to the line formed between the two pterygomaxillary notches.
Class III: The junction between mobile and immobile soft palate is 1-5 mm anterior to the line formed between the two pterygomaxillary notches.
Five methods to improve the support of a denture (pg 7)
- Tissue conditioning
- Surgical removal of pendulous tissue
- Surgical removal of a sharp or spiny ridge
- Surgical enlargement of the ridge (bone graft, skin graft, vestibuloplasties)
- Implants
Five requirements for denture stability (pg 7)
- Good retention
- Non-interfering occlusion
- Proper tooth arrangement
- Proper form and contour of the polished surfaces
- Good control and coordination of the patient’s musculature
Five manners of denture retention (pg 7)
- Adhesion (between unlike)
- Cohesion (between like)
- Interfacial surface tension (a thin film of saliva)
- Mechanical locking into undercuts
- Peripheral seal and atmospheric pressure
Purpose of the posterior palatal seal and who wrote about this (pg 8)
- Compensates for dimensional changes of denture acrylic
- Retention of a maxillary denture (peripheral seal)
- Reduces gag reflex
- Reduces food accumulation
- Posterior denture border becomes less noticeable to the dorsum of the tongue
- Strength of denture
Millsap wrote about this
Retromolar pad (pg 29)
- Comprised of what?
- Bounded laterally, posteriorly, and medially by what?
Soft elevation of mucosa tissue comprising of loose connective tissue and mucous glands
- Bounded laterally by the buccinator
- Posteriorly by the temporalis tendons
- Medially by pterygomandibular raphe and superior constrictor
Pear-shaped pad versus retromolar pad (pg 29)
- What is the pear-shaped pad?
- How are they positioned against each other
- Who coined the phrase pear-shaped pad?
The pear-shaped pad is residual scar of the third molar
The pear-shaped pad is anterior to the retromolar pad
Coined by Craddock
Which frenum has more “vertical” area of activity leading to a narrow notch in the denture - Labial or buccal frenum? (pg 29)
Labial = Narrow - usually just a single narrow band due to primarily vertical movements
Buccal = Wider due to horizontal as well as vertical movements
Frenum’s (pg 29)
- What kind of tissue do they consist mainly of?
- What is their purpose in relation to the tongue, lips, and muscles of the cheeks?
- Buccal frenum may have some musculature
- Fibrous connective tissue
2. They are accessory limiting structures as they do not contract or expand like muscles
Mandibular Labial vestibule (pg 29)
- Where is it?
- What is the major muscle in this area for border molding?
Sulcus area between the buccal freni
Orbicularis oris. Mentalis may be very active for some patients as well
An active masseter will create what kind of shape in the denture?
Active masseter will create a concavity in the outline of the distobuccal border. Less active a convex border.
Lingual vestibule - describe the three regions and what muscles are found in each
- Anterior lingual vestibule (genioglossus)
- Middle lingual vestibule (mylohyoid)
- The posterior lingual vestibule or lateral throat form (. Bounded anteriorly by the mylohyoid, laterally by the pear-shaped pad, posterolaterally by the superior constrictor, posteromedially by the palatoglossus, laterally by the tongue
What determines the posterior limit of a mandibular denture (pg 30)
Primarily the palatoglossus and somewhat by the superior constrictor
What muscles influence the buccal vestibule? (pg 31)
Influenced mainly by the modiolus and buccinator muscle
Ptyergomandibular raphe (pg 31) - Originates from where and attaches to the distal end of what?
Originates from the pterygoid hamulus of the medial lamina and attaches to the distal end of the mylohyoid ridge.
Palatine aponeurosis (pg 31) - What is it and is it okay to put a heavy seal on the area?
Tendon-like band in the midline which attaches to the posterior nasal spine and supports palatal tissue.
Do not put a heavy seal in this area!
Parotid gland (pg 31) - Located in what fossa? - The salivary output is what type and via what duct?
Located in the retromandibular fossa
The salivary output is mixed but predominantly serous via Stenson’s duct
Submandibular gland (pg 31) - Located in what triangle? - The salivary output is what type and via what duct?
Submandibular triangle
Mixed but predominately serous via Wharton’s duct
Sublingual gland (pg 31) - Located in what fossa? - The salivary output is what type and via what duct?
Sublingual fossa
Mixed but predominately mucous via Bartholin’s ducts
Palatal glands (pg 31) - Located where? - The salivary output is what type?
Located in the hard and soft palate
Exclusively mucous
Non-surgical treatment methods for management of abused oral tissues
- Rest for denture supporting tissues 48-72 hours - Advocated by Lytle
- Vertical dimension correct via repair/lining
- Occlusal correction - distributing forces - Probably most important factor
- Good nutrition
- Oral hygiene
- Oral massage (technique by Morrow)- Large bolus of bubble gum to massage basal seat area
- Tissue conditioner (advocated by Lytle)
Tissue conditioners - What powder acrylic, liquid, plasticizer, and initiator?
Acrylic - polyethyl methacrylic
Liquid - aromatic esters and ethyl alcohol
Plasticizer - Dibutyl phthalate
Initiator - Usually a peroxide
Why is the biocompatibility of tissue conditioners / soft liners of interest? (pg 38)
It’s been demonstrated that both materials leach out significant amounts of alcohol and phthalate esters
Ideal properties of a resilient denture base material? (pg 39)
- Permanent resiliency
- Dimensional stability
- Adherence to the denture base
- Colour stability
- Biocompatibility
- Inertness to fungus and bacteria
- Absence of odour, taste, irritation, and toxicity
- Ease of processing, adjustment, and repair
- Wettability
- Low fluid absorption
- Abrasion resistance
- Long shelf life
- Moderate price
Indications for processed soft liners (pg 39)
- Bothersome resorbed areas (mental foramina)
- Undercut areas where surgical reduction is contraindicated
- Parafunction (chronic soreness due to heavy bruxism or poor health)
- Relief of painful raphe area or rugae
- Restoration of oral defects
Greenstick compound (pg 41)
- Introduced by the Green brothers and great success reported by Fournet and Tuller
- The working temperature of Greenstick compound?
122-124 degrees Fahrenheit
What various materials can be used for border moulding (5) - pg 40)?
- Modelling compound (greenstick)
- Autopolymerizing acrylic resins (Rimseal)
- Elastomerics (PVS)
- Impression waxes (Adaptol by Dr. Kaye)
- Thermoplastic materials (Tak)
What are the three pressure techniques for final impressions?
- Definite pressure (Jacobson, Krol)
- Selective pressure (Pleasure, Boucher, Frank))
- Non-pressure or mucostatic (Page)
Nonpressure or Mucostatic final impression technique (pg 40)
- Advocated by who?
- He wrote that what method of retention was the best way to retain dentures?
- This technique sacrifices what two important concepts of denture retention?
- Page, Jacobson, and Krol
- Interfacial surface tension
- Maximum ridge coverage and peripheral border seal
Advantages and disadvantages of definite pressure final impression technique
- Advocates employed open or closed mouth impressions?
ADV: Denture retention is severely tested during mastication, so it seems logical to use the same amount of pressure as during chewing. Presumes occlusal loading during impression making will be the same as occlusal loading
DADV: Dentures are only in actual occlusal contact during a short period of time and the constant pressure may overstress the tissue. Good initial retention, but eventual bone resorption and loose dentures
Closed mouth impression
Selective pressure final impression technique - Who advocated for it? (pg 43)
Frank 1970
Composition of baseplate wax (5 components) pg 46)
80% Ceresin (Increases melting temp) 12% beeswax 3% Resin 2.5% Carnauba (high hardness, brittleness, and melting temp) 2.5% Microcrystalline wax
Definition of Centric Relation
Maxillomandibular relationship, independent of tooth contact, in which the condyles articulate in the anterior superior position against the posterior slopes of the articular eminence. In this position, the mandible is restricted to purely rotational movement. From this unstrained, physiologic maxillomandibular relationship, the patient can make vertical, lateral, or protrusive movements. It is a clinically useful, repeatable reference position.
Methods of determining OVD (5)
- Boos Bimeter
- Silverman: Closest speaking space
- Pound: Phonetics and Esthetics:
- Lytle: Neuromuscular perception
- Pleasure: Pleasure points (tip of nose/chin)
What is Beyron’s point? (pg 49)
Point to mark arbitrary hinge axis - It is a point 13 mm on a link between the tragus of the ear and the outer cantus of the eye
What is Swenson’s Formula and what is it used for?
CA = IG + 1/2 (CG-IG)
Used to select proper posterior tooth mold to allow enough tooth stock to obtain a balanced occlusion
Mandibular protrusive movements depend upon and must follow the contour of what anatomic structure?
The glenoid fossa
Lateral interocclusal records - What is Hanau’s formula
L = H/8 + 12
So if horizontal guidance is 30 degrees, then 30/8 + 12 = 16 degrees of lateral condylar inclination
Greenstick compound composition (5)
- Rosin
- Resin
- Carnauba
- Talc
- Rouge
