DENTURES 1

Question 1

What is the labial Frenum

Answer 1

Part where lip is attached to alveolar process

Question 2

What is the vibrating line?

Answer 2

Junction of hard and soft palate

Question 3

How does the maxillary tuboristy appear in the edentulous patient?

Answer 3

Larger

Question 4

What is the purpose of the lingual frenum?

Answer 4

Attaches tongue to alveolar process

Question 5

Where is the Hamular Notch located?

Answer 5

Between distal surface of tuberosity and the hamular process of the medial pterygoid plate.

Question 6

Why is the hamular notch the ideal site for the distal border of denture?

Answer 6

Helps with posterior seal.

Question 7

What can over and under extension of upper denture beyond hamular notch cause?

Answer 7

Over- pain or looseness

Under- poor retention

Question 8

What is the issue with the lower arch when supporting a denture ?

Answer 8

Offers less support- but good height and width helps!

Question 9

What is the issue with a narrow ridge on the lower?

Answer 9

Offers less support as soft tissue can be mobile and unstable

Question 10

What is the retromolar pad?

Answer 10

Triangular pad of soft tissue on the posterior end of edentulous ridge

Question 11

How much of the retromolar pad should we aim to cover with denture?

Answer 11

Two-thirds (provides support)

Question 12

Where is the retromylohyoid space?

Answer 12

distal end of lingual sulcus (posterior to mylohyoid muscle)

Question 13

How does the retromylohyoid space aid retention and stability?

Answer 13

Retention- has small undercut

Stability- Impinges on ramus to prevent sideways movement

Question 14

What are the different ridge types as per Cawood and Howell’s Classification?

Answer 14

1. Dentate
2. Post extraction
3. Broad alveolar process
4. Knife edge
5. Flat ridge (no alveolar process)
6. Submerged/ inverted ridge (loss of basal bone)

Question 15

What is the ideal ridge form in edentulous patients?

Answer 15

Broad

Question 16

What is the issue with knife edge ridges?

Answer 16

Pain on loading

Question 17

What are the intra-oral changes when all teeth are lost`?

Answer 17

No remaining periodontium, so bone is not retained around teeth and bone loss continues throughout lifetime

Question 18

When is bone loss at its max following loss of teeth?

Answer 18

First 3 months

So dentures may need to be remade or relined following extraction after this period

Question 19

How does the alveolar ridge resorb in Uppers?

Answer 19

Ant/Post- backwards and upwards

Coronal- Inwards and upwards

Question 20

How does the Lower alveolar ridge resorb ridge?

Answer 20

Ant/Post- downwards and slightly forwards (more vertical)

Coronal- outwards and downwards

Question 21

Why are dentures sometimes created with a crossbite?

Answer 21

As the lower ridge often widens, so it helps deal with difference in resorption with uppers

Question 22

How does the ridge appear shortly after extraction?

Answer 22

Bulbous and irregular

Question 23

What extra oral changes occur in edentulous patients?

Answer 23

Loss of upper lip support

Lower lip can disappear

Reduced lower facial height (change in profile)

Nasiolabial angle increase

Question 24

Why do edentulous patients appear class III?

Answer 24

Further rotation of the mandible

Question 25

What physiological issues can edentulism cause?

Answer 25

Loss of proprioception

Decreased masticatory efficiency

Decreased incising efficiency

Decreased swallowing efficiency

Problems with speech

Question 26

What psychological issues can be caused by edentulism?

Answer 26

Lost limb syndrome

Embarrassment

Depression

Denial

Question 27

How are dentures retained in mouth?

Answer 27

Combination of support, retention and stability (in harmony with oral musculature)

Question 28

What is support?

Answer 28

Resistance to vertical movement of the denture towards the tissues

Question 29

What aspects of the maxilla provide support?

Answer 29

Hard palate

Residual ridge

Question 30

What aspects of the mandible provide support?

Answer 30

Buccal shelf
Residual ridge
Retromolar pad

Question 31

What is retention?

Answer 31

Resistance to displacement in vertical direction away form tissues

Question 32

What aspects provide retention for a denture?

Answer 32

Accurate fit- smallest possible space between denture and mucosa

Border seal- extension of flanges to depth of functional sulcus or post dams.

Question 33

What should the borders of dentures never interfere with?

Answer 33

Borders of muscles or frenal attachments

Question 34

How can retention of a denture be tested?

Answer 34

Pulling vertically on anterior teeth

Question 35

What is stability?

Answer 35

Resistance to horizontal movements

Question 36

How can stability of a denture be tested?

Answer 36

Place fingers on the occlusal surface and trying to rock the denture side to side

Question 37

In what instances would stability be reduced?

Answer 37

If denture is underextended or occlusion not balanced.

Question 38

What are the treatment options for patient with edentulism?

Answer 38

Complete uppers AND lowers

Complete uppers or lowers

Implant supported removable (good for lowers)

Implant supported fixed

Replica

Question 39

What are the steps in constructing complete dentures?

Answer 39

1. Assessment of patient
2. Primary impressions
3. Master impressions
4. Registration
5. Trial Insertion- tooth trial
6. Delivery
7. Maintenance/review
8. Aftercare

Question 40

What do master impressions allow?

Answer 40

Construction of record blocks so we can test occlusion

Question 41

Why are there less steps when making replica dentures

Answer 41

Uses old denture as template

Master impressions and occlusion recorded at same visit

Question 42

What are the stages in replica denture construction?

Answer 42

1. Assessment of patient and dentures
2. Replica impressions
3. 2nd imps and occlusion
4. Try-in (re-try)
5. Finish
6. Maintenance
7. Aftercare