Denture Try-in, Insertion and Review Flashcards
What are the parts of the try-in checklist?
Retention and stability
Base extensions
Lip support
Incisal level
Midline
Buccal corridor
Occlusal planes
Position of teeth compared with soft tissues
Vertical dimension FWS
Even contact in occlusion
Speech
Aesthetics
How should base extension be assessed?
Hold tissues away from the denture - does it drop, if yes then possible underextension
Any overextension of the peripheries and it will drop when you manipulate tissues
Too much lip support and it will drop
How should speech be assessed in a try-in?
Test fricativas: count from 60-70, days of week, Mississippi, Forfar, 5 East Fife 4
Not too much whistling on s sounds
Look - teeth should be slightly apart
How should aesthetics be assessed in a try-in?
Allow patient to view in mirror
Give time and freedom to comment
Patient consent to finish
Record consent in records
If patient wants to alter, get specifics
Warn patient try-in gum colour is redder
Actively seek patient views on all aspects of try-in - comfort, speech etc
How can you fix a speech problem if teeth don’t make contact at try-in?
Often insufficient FWS so OVD needs to be reduced - re-register at new OVD
How can you fix a speech problem if there are whistling sounds during s sounds?
Air is escaping so OVD needs to be increased or the anterior tooth position changed
Re-register new OVD
How can overextension problems be fixed?
Minor - modify wax and mark on master cast - give lab specific instuctions for insertion
Major - usually need to go back to the master imp stage
How can underextension problems be fixed?
Minor - either wash imp in try-in and send to lab for casting/mounting and re try-in or proceed to insertion stage but do not insert instead reline denture
Major - usually need to go back to master imp stage
How can a vertical dimension error be fixed?
This always triggers a re try-in
If OVD is increased teeth need to be removed from one or both dentures and replaced with a wax rim
If OVD is decreased a wax rim can be added to the teeth on one or both dentures or teeth removed and replaced with a bigger wax rim
How are occlusal errors fixed if the OVD is correct?
If uneven contact some or all teeth need to be removed and replaced with wax rim, re-register, remount, reset and re try-in
How are occlusal errors fixed if the OVD is incorrect?
Correct OVD by removing teeth from one or both dentures and replace with wax rim, re-register occlusion to eliminate occlusal error, remount, reset and re try-in
How can minor occlusal errors be fixed?
Selective grinding at either try-in or insertion
Using articulating paper
Buccal upper and lingual lower - adjust the contacting surfaces rather than the tips of the cusps
