Denture (Napoleon) Dynamite Q1 Flashcards
How many visits for a Denture?
6
Edentulism, in terms of raw numbers, is increasing in the US
True
*37.9 million by 2020
Percentage of denture users that will have at least 1 problem with the denture
60%
T/F
Most edentulous patients are quite satisfied with their dentures
True
What % of pts are NOT satisfied with their dentures
5-20%
Visit 1 Clinical Procedure:
Visit 1 Lab Procedure:
Exam and Preliminary Impression
Diagnostic Casts and Custom Trays
Visit 2 Clinical Procedure:
Visit 2 Lab Procedure:
Border Molding/Final Impression (w/ Custom Trays)
Master Casts/Record Bases
Visit 3 Clinical Procedure:
Visit 3 Lab Procedure:
Adjust Record Bases/Facebow (CR)
Mount Master Casts using Record Bases
Visit 4 Clinical Procedure:
Visit 4 Lab Procedure:
Esthetic Try-In
Remount if needed
Visit 5 Clinical Procedure:
Visit 5 Lab Procedure:
Clinical remount/Delivery
Remount
Visit 6 Clinical Procedure:
Visit 6 Lab Procedure:
Denture adjustment
Remount if needed
Highly compressible and displaceable soft tissue seen in the anterior residual ridge of the Mx or Mn
Denture Fibroma
Massive roll of hyperplastic tissue which extends from the anterior residual ridge to the oral vestibule in the Mx
Epulis Fissuratum
*aka Inflammatory Fibrous Hyperplasia
If Denture fractures w/in the first year, it is usually b/c…
If fracture happens after 4 years, it is usually b/c…
Frenae
Maxillary resorption
T/F
A Pendulous Mx Tuberosity must be removed prior to denture
True
Combination Syndrome is Edentulous _______
Partially dentate _______
This leads to Resorption occurring where?
Hypertrophy (fibrous hyperplasia) occurring where?
Mx
Mn
Premaxilla (opposed by Mn anteriors) and Mn posterior
Mx Tuberosity
T/F
There is a type of reverse Combination Syndrome in which we never make full Mn denture opposing partially edentulous Mx b/c of Jaw Resorption
True
If there is widespread inflammation over denture-bearing mucosa it will recover in ______ days upon removal of denture
2-3 days
*or use tissue conditioning matl
T/F
Inflammatory Papillary Hyperplasia is a premalignant condition
False
Where does Inflammatory Papillary Hyperplasia occur?
secondary to…
Tx:
Mx
- secondary to ill fitting dentures
- AF or surgery
What condition begins as an Ulcer secondary to ill fitting dentures
Inflammatory Fibrous Hyperplasia
Tx for Inflammatory Fibrous Hyperplasia (Epulis Fissuratum)
Re-Fit
OS (most)
T/F
Tissue Conditioning involves adding matl to the denture to give tissue a break
True
Tissue Conditioning matl will last how long
2-3 weeks
Tx Chronic Candidiasis Rx Clotrimazole _____ 10 mg
Troches
*to suck on
Tx Chronic Candidiasis by soaking the denture for ___min in solution of __% bleach (Na hypochlorite), thoroughly rinse
30
1%
Tx Chronic Candidiasis Apply thin film of _____ ointment to inner surface of the denture after each meal
Nystatin
Describe epithelium in Diabetes Type I (lont-term insulin dependent)
This produced what for dentures?
thin, less keratinized
impaired tolerance
Oral Lichen Planus can decrease tolerance for Dentures
True
Pemphigoid lesions is a chronic _____ with scarring that can limit denture _____
ulceration
extensions
2 lesions that can transform into Squamous Cell Carcinoma
Leukoplakia
Erythroplakia
Unless detected early most pts with Squamous Carcinoma have a survival of less than _____%
50%
Early cancers are difficult to detect, advanced have low cure rates, so we must Detect when small, localized, and treatable
True
if Edentulous, Mx loss in what pattern?
Mn?
Vertical and Palatal
Vertical
Mn resorption occurs at ___x the rate of Mx resorption
4x
4 types of Pts we’ll run in to:
Philosophical
Exacting
Indifferent
Hysterical
Retention is resistance to _______ displacement
Stability is resistance to ______ displacement
Support is resistance to ______ displacement
Vertical
Lateral
Vertical Occlusion
T/F
The more keratinized the tissue, the better the support
true
RRR (residual ridge resorption) negatively impacts what 3 things?
Retention
Stability
Support
Implants minimize compression of the _______ and prevent resorption of underlying bone
mucoperiosteum
Preliminary impressions can be taken with what 2 matls?
Which is correctable? Greater accuracy?
Impression (modeling) compound - correctable
Irreversible hydrocolloid (Alginate) - greater accuracy
Anatomical feature that can prevent denture from rotating:
Denture should be relieved over what area?
Canine eminence
Incisive papilla
Distal to the hard and soft palate at the vibrating line:
Posterior palatal seal area
Capturing the ____ in the impression is critical to the retention of the Mx denture
Hamular Notch
Lateral movements capture what in the Mx?
Coronoid process
2 small pits in the posterior palate, one on each side of the midline at soft/hard palate interface
*will be posterior to the denture
Fovea palatina
Posterior 1/3 of the hard palate glandular tissue
*may produce irregular impression surface
Minor Salivary Glands
Ideal Mx ridge has a Square Arch and U shaped, with moderate palatal vault and well defined Hamular Notches
True
Center of Palate:
Hamular Notch:
Median Palatal Raphe
Pterygomaxillary Notch
The Alveolar Ridge is used for primary support
False
*secondary support area
Muscle at the bottom of the Vestibule in the Mn:
Metalis
Primary stress bearing area of the Mn arch:
Buccal Shelf
*external oblique ridge/slope of residual ridge
***parallel to the occlusal plane and very dense
External Oblique Line and Crest of the Alveolar Ridge:
Buccal Shelf
T/F
The Buccal Shelf is a primary support area
True
T/F
The Retromolar pad is a primary support area and does NOT resorb
True
3 Mn support areas:
Retromolar Pad
Buccal Shelf
Alveolar Process
Distal and Lateral Groove:
Masseter Groove
Formed by surface of sublingual gland surface and ducts:
Sublingual Folds
Interior Mn ridge
Mylohyoid Ridge
Distal end of the Alveolingual Sulcus:
*important for retention
Retromylohyoid Space
Mx Tray Handle ____mm thick
____mm wide
labial flange to incisal edge:
3-5 mm
10-15 mm
22mm
Mn Tray Handles - Laterals width
Middle width:
20 mm (5-7 mm)
10-15 mm (3-5mm)
How far away should the Custom Tray be to the Vestibule?
2-3 mm
What are the only 2 matls you can use to make a Border Mold?
PVS
green stick compound
The occlusal wax rim is how high?
22 mm
3 Final Impression Techniques:
Selective Pressure
Mucostatic
Functional
Posterior Palatal Extension should go ___mm beyond the ______
2 mm
Vibrating Line
3 Final Impression Matls:
Zinc Oxide Eugenol
Polysulfides (rubber)
Polyether/PVS
3 Advantages to using Zinc Oxide Eugenol for final impressions:
3 disadvantages:
Accuracy, Stability, Inexpensive
messy, can’t disinfect, irritating, fractures
Final impression matl that is low cost, high flex, long working time
but, bad taste, low viscosity
Polysulfide
What Impression matl is recommended for Mx?
What can also be used?
Polysulfide
PVS
Light body Polysulfide matl takes how long to Polymerize?
7-8 minutes
After the Final Impression is made what must be done to it?
Disinfect
If kept dry, ______ have good dimensional stability for up to 1 week
*final impression matl
Polyethers
Polyethers are stable for 1 week but have ___ cost and bad taste
high
PVS can have excessive flow, isn’t as hydrophilic, and is _______
Expensive
The Land Area must be ____mm wide
4-5 mm
In setting the Stone (after boxing), what can be left overnight?
What can’t?
PVS or Polyether
Alginate
The Master Cast Should be how thick?
15 mm
*with 4-5 mm Land Area
Trim the height of the Land Area so the depth of the peripheral roll is ___ mm throughout
1-3 mm
Temporary device representing the base of a denture and used for making JRR/teeth arrangement
Record Base
The top 1/3 of the Ascending Ramus represents what?
Occlusal Plane
The average distance between the deepest portion of the vestibule and the incisal edge:
22 mm
Occlusal rim dimensions _____ mm wide in the front
___ mm in the PMs
____mm in the Ms
3- 5 mm
5-7 mm
8-10 mm
The facial surface to the Papilla (when making Wax Rims) should be how wide?
*wax thickness…
7 mm (5-7)
*wax thickness 3-5mm
What undercuts should be blocked out?
Excessive
Mx Custom Tray Handle _______mm mesiodistal
____ mm buccolingual
______ height from labial flange to incisal edge
10-15mm
3-5mm
22mm
Mn Custom Tray Handles ______mm mesiodistal Anterior
______mm mesiodistal Posterior
_____mm Height labial flange to Incisal edge
15
20
18
Basin water should be set at…
122
In the Mx, Border Molding in the Posterior should be where the Posterior Palatal ______ will be, ______ to the Vibrating Line
Seal
Anterior
Boxing, PVS adhesive is placed where?
Attach how many rope wax layers?
When boxing added around outside, keep in mind base to height of stone should be ____mm
External of impression past peripheral Roll
2
15mm
Mx Occlusal Wax Rim height:
Mn:
22 mm
18 mm
The original preliminary impression is done in what material?
Alginate
In the 2nd visit, border molding can be done with green wax or what kind of PVS?
Heavy body
T/F
A pendulous maxillary tuberosity doesn’t need to be removed
True
What begins as a traumatic ulcer secondary to an ill-fitten denture flange?
Fibrous Hyperplasia
Surgery is required for Inflammatory fibrous hyperplasia (Epulis Fissuratum)
True
Oral lichen planus is a _____ lesion that will cause compromised support/tolerance for the _____ denture
Erosive
Mandibular
RRR (residual ridge resorption) is often a consequence of what?
Tooth loss
T/F
Keratinized attached mucosa increases support and tolerance to occlusal load
True
With alginate, often recommended to use ____ water for a thicker mix, especially for the ______ arch
less
Mx
Be sure to capture the ______ notch on the Mx
and the _______ on the Mn
Hamular (pterygomaxillary)
Retromolar pad
T/F
The alveolar ridge (Mn) is considered a secondary support area b/c there is a high rate or resorption when excessive pressure is applied to the area
True
The Buccal Shelf is found on the _______ arch and is a ______ support area
Mn
Primary
Why is the Retromolar pad one of the Primary support areas of the Mn?
Does not resorb in response to pressure
3 Mn support areas:
Retromolar Pad
Buccal Shelf
Alveolar process (most affected by bone resorption)
Mx tray handle ____mm thick (B/L) and ____mm wide (M/D)
Mn trays handles thickness (B/L) ___ mm anterior and ____mm for posteriors
3-5mm 10-15mm
3-5mm 5-7mm
3 types of impression techniques:
Selective Pressure impression (specific area pressured)
Mucostatic impression (minimal/no pressure)
Functional impression (pressure entire - mostly w/ pt already has denture)
For a mucostatic impression, what type of material is used?
Light body
Leave the denture out ___hrs prior to the final impression appt
24 hrs
3 types of Final Impression materials:
Zinc Oxide-Eugenol (non-elastic) - can’t disinfect
Polysulfides (rubber, smells bad)
Polyether or PVS
Polysulfides are low cost but they smell bad (rubber)
*also high viscosity
True
Heavy material (PVS) is only used for what?
Border molding
What type of matl is recommended for Mx impressions?
light body polysulfide (rubber, smells bad)
*PVS also
Light body Polysulfide (rubber, smells bad) requires how long to polymerize?
7-8 minutes
Pour up Polysulfide impression w/in how much time to avoid distortion?
1 hr
If kept dry, what matl has good dimensional stability for up to 1 week?
Polyethers
Polyethers can be stored, have ___ cost, and ___ taste
high
bad
Why do you immerse the cast into hot water for 5 minutes after stone has set (for 1 hr)
soften compound (Border Molding)
The Land Area on Master casts should be how wide?
Height from vestibule depth?
4-5 mm
1-3 mm
The Mn wax occlusion rim fabrication should be ___mm high and go up ___ of the Retromolar pad
18 mm
2/3
3 Mx anatomical landmarks (prior to fabricating Record Base)
4 Mn anatomical landmarks (same):
incisive papila, posterior ridge, midline
retromolar pad, upper 2/3 retromolar pad, ascending ramus mandible, center posterior ridge
Wax Occlusal Rims (Mx), place rim former where?
Hamular Notch
Mx Wax Rim facial surface (of CI’s) to incisive papilla:
molar width:
PM width:
Anterior width:
Rim to depth of vestibule:
5-7mm
8-10mm
5-7mm
3-5mm
22mm
Mn Wax Rim depth of vestibule to incisal edge:
Retromolar pad height:
15-18mm
2/3
