Denture Napoleon Dynamite Part III Flashcards
Exam, Preliminary Impression, Preliminary Cast, Custom Tray:
Visit 1
How long does it take to make a denture?
5-6 weeks
*avg
Border molding, final impression master casts, record base and wax rims:
Visit 2
Adjust wax rims, Facebow, VDR, VDO, CR, Mount
Visit 3
Mount the Mx cast using…
Mount the Mn cast using…
Facebow
CR
The smile line of the teeth mirrors what?
Lower lip line
Evaluate Esthetics/phonetics, check VDO/VDR, confirm CR, Protrusive Record, Posterior Palatal Seal:
Visit 4
*esthetic Try In
Looking at the articulator from a frontal view and a gradually rising occlusal plane gives the impression of…
distance
If teeth set too buccally it can give the appearance of…
straight or reverse curve smile line
F and V are made at the incisal edge to wet/dry line called…
Fricative
S and Z called ____ sounds
Sibilant
What are the 5 steps to Visit 4?
Esthetics/Phonetics
VDO/VDR
CR
Protrusive Record
Posterior Palatal Seal
VDR - VDO =
2-3mm
Physiologic rest position
Phonetics and esthetics
Swallowing
Comparison with old denture
Are all methods of assessing…
VDO
Closest Speaking Space determines if a pt can say…
S
How to take CR:
AluWax
pt puts tongue on roof of mouth
when 1st contact = CR
If there is a ___mm discrepancy between the CR and the MI you need to ReMount
1 mm
T/F
Use the bimanual technique for the CR
True
T/F
Rehearse and have the pt Gently close onto the compound just short of tooth contact for CR
True
CR record is taken and put into Articulator, if closes the _____ was correct originally
CR
Where do you re-set the patient’s teeth (if needed)?
Never…
Articulator
In the Mouth
If the pts teeth fit in the Articulator but NOT in the mouth, what 2 things might have happened?
CR taken incorrectly
Mounting in Lab was wrong
2 things the Posterior Palatal Seal compensates for:
Polymerization Shrinkage
Minor denture base movements during function
If “ah” doesn’t work to find the Vibrating Line, pinch pts nose and have them…
Blow through nose
The junction of the mobile and non-mobile portion of the Soft Palate:
Vibrating Line
3 effects if Palatal Seal is too far back:
Gag
Dislodge
Soreness
Mark the Vibrating Line with what?
Indelible Marking Stick
Posterior extent of the Mx denture baxe ends at or just _______ to the Vibrating Line
Anterior
Once Vibrating Line determined, transfer it where?
Then where?
Record Base
Master Cast
Posterior Palatal Seal will be represented as a ______ on the palatal portion of the denture base.
This is represented as ____ space on the Master Cast
Elevation (positive)
negative
The attached gingiva should be finished to look like and “orange peel.” This is called…
Stippling
The interdental paplilla must be _____
Convex
Mx Cuspid eminence raises the _____ and corner of the ____
lip
mouth
Mb cuspid supports lip and gives contour
True
Proper contours will minimize biting of the lips and cheeks
True
What is in the periphery of the denture in the posterior region?
Along with Gingival Role, does what?
Slight Concavity
Displaces buccal mucosa away from the biting zone
What prevents tongue biting on the Lingual side of the Mn denture?
Lingual Concavity
Flanges help hold denture in place between boundaries of force from tongue = force from cheeks/lips =
Neutral Zone
The Palate of a denture is smooth and ___ mm thick
Because promotes proper speech and prevents ____
3 mm
gagging
Final Step to Try-In appointment:
Pt Approval/Acceptance
Denture Wax Ups are sealed to the periphery after festooning and ____ is separated
Next step:
cast/mounting
flasking
3 Reasons for a Lab ReMount:
Occlusion
VDO
Balanced occlusion
If contacts are premature, adjust:
Cusps tip to tip:
Upper teeth too buccal:
Fossae deepened (not Tips!)
shorten
Broaden fossae of lower and move
*Only shorten tips in tip-tip cases
When is a Lab ReMount done?
After Flasking
*done AFTER separating master cast
Fabrication of the ______ is necessary prior to Denture Delivery
Facebow Remount Jig
Prior to the insertion appointment the old dentures must be left out of the mouth for ______
24 hours
The Facebow jig only includes the occlusal/incisal surfaces
True
Take the final Facebow Record ____ the ReMount
after
Deflask, Remount, Fb jig
True
5 steps in preparing dentures for Deliver:
Fb jig
remove dentures from Master Casts
Finish/Polish
Fabrication of Clinical ReMount Casts
Mount Mx Remount, preserve Fb record
T/F
Do not overpolish the denture
True
Prior to delivery the finished dentures must be soaked in water for _______
72 hours
Flask Mx/Mn Wax rims:
DeFlask
Lab Remount:
Fb remount Jig
Finish/Polish
Remount Cast:
Mount Mx
Mount Mn
gets you MC, impressions, teeth
8-10 min.
on articulator
plaster, close, incisal edge
block undercuts
Upper/Lower
Use Fb jig
Pt must come in for CR
3 steps to Visit 5:
Denture Placement
Clinical Procedures
Pt education
2 steps to Visit 6:
Post-placement Examination
Post placemnt probs/solutions
Prior to seating the CD (Visit 5: delivery), 2 steps to clean:
Wash soap/water
Disinfect w/ Birex for 10 minuets
Wash CD w/ soap/water and disinfect w/ Birex for ____ minutes
10
4 Clinical Steps (evaluations) when Placing Dentures (Visit 5: initial placement)
PIP - pressure indicating paste
border extension
esthetic/phonetic
vertical, horizontal, occlusion
PIP should be painted on the intaglio and pt should close mouth for ____ minutes
*Visit 5: Delivery
2
Check the Border Extension w/ paste stuff (?) for ____
*Visit 5: Delivery
1 minute
Cheek and tongue biting caused by
lack of overlap
Upon Deliver (Visit 5), if 1st touch is the same as MIP…
If slide…
done
ReMount
If you need a Clinical Remount at Delivery (Visit 5), you have to…
Grind teeth
*can’t move the teeth
If you need a Clinical Remount at Delivery (Visit 5) you should 1st do…
CR
*AluWax
Occlusal Refinement is done when?
Visit 5
*delivery
2 Times a Clinical ReMount can be done:
Lab ReMount done when?
Esthetic Try-In, Delivery (whenever Occlusion off)
After De-Flasking (lab step Visit 4)
OI for CD delivery: fullness, difficulty speaking/ reading aloud for ____
chew food bilaterally and keep tongue _____
2 weeks
forward
Daily care of CD: soak in bleach, use soft brush with _______
remove for several (____) hours at night
No Toothpaste
8 hrs
If can’t swallow, ____ might be too long
VDO
Examine the pt ___ hours after initial placement of CD
24 hours
At Visit 6 (Post-Placement Exam), if you polish, you must…
If Lesion, pt shouldn’t use denture for ___ hours
disinfect
6-24
Visit 6 happens ____ hrs after initial placement: \
Reappoint in ____ months
48-72 hours
6-12 months
CD should get a hard re-line after ______
Replace denture after…
2 years
5-7 years
4 advantages of Immediate Denture:
*also prevents embarrassment, promotes health, provides guide for esthetics, VDO
Better healing
better ridge form
prevents facial mm. collapse
hastens adaptation
Before the 1st Clinical Appointment in an Immediate Denture, you must…
Remove Posterior Teeth, preserve 1 PM
*wait 6-8 weeks before clinical appt
1st Clinical appointment Immediate Dentures:
2nd:
3rd:
Exam/prelim impressions
Master impressions (MC, record base, wax rim)
Mx/Mn relation records, tooth selection
4th Clinical appointment Immediate Dentures:
5th:
6th:
Try-In (Lab processes dentures)
Extraction/Denture insertion
24 hr Post insertion
6th Clinical appointment Immediate Dentures:
7th:
8th:
24 hr Post insertion
72 hr
1 week
Where should you not put Border Molding on a Preliminary Cast (immediate dentures)?
Why?
Anteriors
Custom Trays will ge stuck
Custom Trays (immediates) should be ___ mm short of the vestibules
Cover the retromolar pads and _____
Provide extra clearance for any _______
2-3 mm
tuberosities
frenum
What requires Extra Relief in a Custom Tray (Immediates)?
Tooth portion
*allows easy insertion/removal
Final Impression (on the custom tray) for an Immediate Denture is done with ______ and ______
*most commonly used
Modeling compound
Rubber Base
T/F
The Interdental Embrasures should be blocked with wax for a Final Impression (Immediates)
True
(Immediates) When boxing, place the wax _____ mm above the peripheral roll
*mark there and apply sticky wax - then box
3-4 mm
What material can be used for a Final Impression (Immediates) if there is considerable tooth misalignment or great mobility present?
Alginate
2 reasons to use Alginate in a Final Impression (Immediates)
Tooth misalignment severe
Mobility
*alginate must be poured right away
Why would an Alginate never be used for a CD procedure (final impression)?
pushes tissues
Perforate the custom tray for ________ retention of Alginate
(Immediate Final Impressions - if Tooth Misalignment/Mobility)
mechanical
If using Alginate as a Final Impression material (Immediates), it requires more vigorous __________
And must be poured immediately
Border Movements
*pushes tissues
(Immediates) in In 3rd Appointment, if natural tooth arrangement is not esthetic, re-establish the correct _____ position, dental midline and esthetically ideal tooth alignment
Incisal Edge
When is the Surgical Guide for Immediate Denture made (appointment?)?
4th Appointment
*5th is extraction
4 procedures that must be done before the Surgical Appointment (5th clinical)
Scaling
Hydrate dentures
Clear Surgical Stent
Diagnostic Cast
After the teeth are removed (5th Appointment, Immediates), what must you do when delivering Denture?
PIP
- pressure indicating paste
- adjustments
5th Appointment (immediates) after surgical extraction, any hint of wide or long dentures requires analysis with _________
Disclosing Wax
T/F
You can ReMount at the 5th (surgical extraction) Appointment for Immediate Dentures
False
When is the only time you would tell a patient to keep the Denture in overnight?
After extractions
*will reduce swelling
T/F
Check Occlusion and Adjust Immediate Denture the day of delivery (surgical/5th appt)
False
How long should you wait before adjusting an Immediate Denture after delivery? (5th appt)
1 week
After 1 week Delivery of Immediate Denture, we can do a ______ and ________-
Clinical REmount
Occlusal Equilibration
Overview Immediate Denture
Remove Posterior teeth, wait ___ weeks
1. Take _____ impression and make _______
2. Use light body PVS or _____ for final impression
Box, Pour, and Fabricate _______
3. Adjust wax rims and do the ________
Then do the Facebow and ______
Before the 4th appointment you must set teeth, starting at the _______
4. Esthetic Try-In, check Occlusal, ____, color
Lab fabricates the Denture and the _______ using a Putty cast of the inside of the Denture
5. Surgery: before remove _______
then try on the Surgical Guide, if there is _____ on the soft tissue then do a _________
If surgical guide fits, suture and insert
At this point you have to use _____ on denture
Keep denture in for _____ hrs
Do not adjust _____ on this day
6-8 weeks Final Impression, Custom Tray Alginate Record Bases Bite Reg. CR Posterior VDO Surgical Guide calculus Pressure, Alveoplasty Denture PIP 24 Occlusion
At 72 hr to 1 week check for Immediate Dentures, use _________ to improve the fit of the dentures before the extraction healing is completed
Tissue Conditioning
Tissue Conditioning, done 72hrs to 1 week post-extraction/delivery of Immediate Denture is ____ mm space and requires replacement every ____ weeks
2 mm
2-4 weeks
