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Dentures > Dentures > Flashcards

Dentures Flashcards

1
Q

4 Shapes of Hard Palate

A

Flat
Round
U
V

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2
Q

House’s Palatal Throat Form

A

Class I: 5-13mm distal
Class II: 3-5mm distal
Class III: 3-5 anterior

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3
Q

Neil’s Lateral Throat Form

A

Class I: mirror not displaced
Class II: mirror half displaced
Class III: mirror entirely dispalced

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4
Q

Primary Support Areas of the Maxilla

A

Palate

Ridge

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5
Q

Primary Support Areas of the Maxilla

A

Palate

Alveolar Ridge

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6
Q

Primary Support Areas of the Mandible

A

Buccal Shelf

Retromolar Pad

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7
Q

6 Factors of Denture Retention

A
  1. Adhesion
  2. Cohesion
  3. Surface tension
  4. Atmospheric pressure and peripheral seal
  5. Undercuts
  6. Musculature (neutral zone)
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8
Q

Posterior Palatal Seal

A

Application of pressure in the soft palate to form a seal of the denture

  1. Retention
  2. Firm contact with tissue reduces gag reflex
  3. Reduces food accumulation
  4. Distal border less noticeable to tongue
  5. Dimensional change compensation
  6. Increase thickness = strength

Valsalva line = junction of hard and soft
Vibrating line = junction of movable and nonmovable soft palate

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8
Q

Posterior Palatal Seal

A

Application of pressure in the soft palate to form a seal of the denture

  1. Retention
  2. Firm contact with tissue reduces gag reflex
  3. Reduces food accumulation
  4. Distal border less noticeable to tongue
  5. Dimensional change compensation
  6. Increase thickness = strength

Valsalva line = junction of hard and soft
Vibrating line = junction of movable and nonmovable soft palate

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9
Q

Retromolar Pad

A

Posterior boundary: Temporalis tendon
Medial: Superior constrictor and pterygomandibular raphe
Distal: Buccinator

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9
Q

Retromolar Pad

A

Posterior boundary: Temporalis tendon
Medial: Superior constrictor and pterygomandibular raphe
Distal: Buccinator

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10
Q

Buccal Shelf

A

Anterior: Buccal frenum
Posterior: Anterior edge of masseter
Lateral: Oblique ridge
Mesial: Alveolar ridge

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11
Q

Pterygomandibular Raphe Origin and Insertion

A

Hamular notch to distal end of mylohyoid ridge

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12
Q

Retromylohyoid Area

A
  • anterior: mylohyoid muscle
  • lateral: pear-shaped pad
  • posterolaterally: superior constrictor muscle
  • posteromedially: palatoglossus muscle
  • medially: the tongue
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13
Q

Purpose of a custom tray

A
  1. Minimize impression material distortion
  2. Prevent tissue distortion
  3. Reduce costs
  4. Allow for border molding
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14
Q

Functional Impression

A

Using the same amount of pressure in the impression as during chewing

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15
Q

Selective Pressure

A

The non-stress bearing areas are recorded with the least amount of pressure, and selective pressure is applied to certain areas of the max and mand that are capable of withstanding the forces of occlusion. The trays are selectively relieved, therefore, providing more space in some areas while at the same time, having areas in the tray that have less space.

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16
Q

Mucostatic (Page)

A

Impression should be an absolute accurate negative of the ridge tissues at rest, there is no border molding. Retention is mainly due to interfacial surface tension and has poor peripheral seal.

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17
Q

Maxillary Anatomic Landmarks

A
  • Labial frenum : fold of mucous mb. at the median line, no muscle att.
  • Labial vestibule: major muscle in this area is orbicularis oris
  • Buccal frenum: sometime is single fold of mucous membrane, sometimes double, and in some mouths, board and fan shaped. Associated muscles are: buccinators, levator anguli oris and orbicularis oris.
  • Buccal vestibule: It is influenced by the buccinators and the modiolus.
  • Hamular notch
  • Posterior palatal seal area
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18
Q

Mandibular Anatomic Landmarks

A
  • Labial frenum : single narrow band but may consist of 2 or more bands
  • Labial vestibule: major muscle in this area is orbicularis oris
  • Buccal frenum
  • Buccal vestibule: extends from the buccal frenum posteriorly to the outside back corner of the retromolar pad and from the crest of the residual alveolar ridge to the check.
  • Lingual frenum
  • Alveololingual sulcus
  • Retromolar pads
  • Pterygomandibular raphe
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19
Q

Mucocompressive Impression (Jones)

A

The oral soft tissues are resilient and thus tend to return to their anatomical position once the forces are relived. Dentures made by this technique tend to get displaced due to the tissue rebound at rest. During function, the constant pressure exerted onto the soft tissues limit the blood circulation leading to residual ridge resorption.

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20
Q

Combination Syndrome (5 symptoms)

A
  1. Loss of bone in the anterior maxilla
  2. Overgrowth of tuberosities
  3. Extrusion of mandibular anteriors (due to lack of periodontal stimulation)
  4. Loss of alveolar bone under a mandibular RPD
  5. Papillary hyperplasia of the hard palate (due to vacuum effect, especially in areas of incorrect relief)
21
Q

Combination Syndrome Added Symptoms

A

o Loss of the correct VDO
o Incorrect occlusal plane
o Patient’s poor adaptation to the dentures
o Occurrence of granuloma fissuratum
o Changes in the periodontium of existing natural teeth

22
Q

Types of Gypsum

A 
Type 1: Impression stone
Type 2: Plaster
Type 3: Dental stone
Type 4: High strength dental stone
Type 5: High strength high expansion (used for compensation of some alloys for casting)
23
Q

Factors to control gypsum set time:

A
  1. Changing w:p ratio
  2. Spatulation speed (fast = accelerated setting and expansion)
  3. Temperature
  4. Accelerators and retarders
24
Q

Records needed in complete dentures:

A
  • VDO
  • Hinge axis
  • Centric position
  • Protrusive relationship
25
Q

Excessive VDO Symptoms

A

Sore muscles
Sore spots
Bone resorption
Clicking of dentures during speech

26
Q

Inadequate VDO symptoms

A

Face looks collapsed
Protruded chin
Fatigue when chewing
Sore muscles or joints

27
Q

Interocclusal rest space for different jaw relations:

A

Class I: 3-5mm
Class II: > 5mm
Class III: < 3mm

28
Q

Normal FMA Value?

A

25 +/- 5 degrees

29
Q

Atwood Study on Rest Position

A

A longitudinal roentgenographic analysis of face height before and after extraction was performed on 42 subjects. This study demonstrated variability within a sitting, between sittings, and between readings with and without dentures. A decrease in the vertical dimension of mandibular rest position was clearly shown following the removal of opposing occlusal contacts.

30
Q

Methods of VDO (5)

A
    1. Boos: Bimeter (an oral meter that measures pressure)
    1. Silverman: closest speaking space- looked at bicuspid area
    1. Pound: phonetics and esthetics
    1. Lytle: neuromuscular perception
    1. Pleasure: pleasure points (tip of nose and chin)
31
Q

Hanau’s Formula

A 
L = H/8 + 12
H = horizontal condylar inclination
L = lateral condylar inclination
32
Q

Hanau’s Formula

A 
L = H/8 + 12
H = horizontal condylar inclination
L = lateral condylar inclination
33
Q

Theilman’s Formula

A

Balance = Incisal guidance x condylar guidance /

cusp height x occlusal plane x compensating curve

34
Q

Define Realeff

A

Resiliency and like effects = compensation of the tissues for the articulator

35
Q

Porcelain vs. Acrylic Denture Teeth

A

Porcelain

  • Wear less
  • More translucent
  • Brittle - fracture easily if dropped
  • Don’t bond to base (stain, fall out)
  • Difficult to adjust/set

Acrylic

  • New materials wear well
  • Layered for translucency
  • Resilient (act as shock absorber)
  • Chemical bond
  • Quieter
36
Q

Causes of Lisping

A
  • Too much horizontal overlap
  • Palatal contour too constricted
  • Anterior teeth too far labially
  • Broaden and thicken contour for tongue contact
  • Arch form too broad
37
Q

Lingualized occlusion

A
  • No anterior contacts present in centric
  • Anatomic maxillary teeth, flat mandibular teeth
  • In excursive movements, contact on both working and balancing
  • Pros: esthetic maxillary teeth, central forces on mandibular ridge
  • Needs repeatable centric record
37
Q

Lingualized occlusion

A
  • No anterior contacts present in centric
  • Anatomic maxillary teeth, flat mandibular teeth
  • In excursive movements, contact on both working and balancing
  • Pros: esthetic maxillary teeth, central forces on mandibular ridge
  • Needs repeatable centric record
38
Q

Monoplane Occlusion

A
  • Cuspless teeth
  • No overbite in anterior setup, 2mm overjet to create illusion of overbite
  • Balancing ramps needed to have balanced occlusion
  • Philosophy based on idea that no cusp = no lateral forces improving denture stability
39
Q

Incisive papilla

A
  • Canine incisal point

- 8-10mm in front is the central incisors

40
Q

Labiodental sounds (F, Ph, V)

A
  • incisors too short: V sounds like F
  • incisors too long: F sounds like V
  • if upper teeth touch labial side of lower lip, incisors too far facially
  • if lower lip drops away from lower teeth during speech, lower teeth are too far lingually.
  • if imprints of the labial surfaces of the mandibular anterior teeth are on lingual of lower lip, mand ant teeth are too far labial.
  • if max ant teeth are too far lingual, they’ll contact lingual side of mand lip with F & V sounds.
41
Q

Linguodental (Th)

A
  • if tongue does not protrude, max ant teeth too far labially.
  • if more than 6mm of tip of tongue protrudes, max ant teeth too lingual.
42
Q

Linguopalatal (T, D)

A
  • T sounds like D if max ant teeth are too far lingual

- D sounds like T if max ant teeth are too far labial

43
Q

Sibilant (Ch, J, S)

A

2 positions:

  • Tip of tongue against palate in the rugae area with a small space for the escape of air between tongue and palate
  • if opening is too small, a whistle develops
  • if space is too broad or thin, a lisp results
  • a whistle develops if posterior arch is too narrow
  • 1/3 of people with tip of tongue contacting lingual side of the mandibular anterior teeth and the tongue itself up against the palate to form desired shape of airway
  • whistle sound: mand ant teeth too far lingually
  • faulty S sounds: lingual flange of mand denture too thick
44
Q

Indications for monoplane occlusion (5)

A
    1. Class II or III malocclusion
    1. Severe residual ridge resorption
    1. Excessive interarch distance
    1. Poor neuromuscular skills
    1. Poor patient adaptability
45
Q

Neutrocentric Occlusion (DeVan)

A
  1. Neutralize inclines

2. Centralization of forces

46
Q

Clinical Remount

A

Take 2 bite registrations, mount the first and check the second

47
Q

BULL Rule (laterotrusive)

A

Reduce lingual inclines of buccal cusps of upper teeth

Reduce buccal inclines of lingual cusps of lower teeth

48
Q

Single Denture Adjustments

A
  1. Occlusal adjustment of natural teeth may be required to level the plane of occlusion by:
    A. reducing any severe curve of Spee
    B. leveling steps in the occlusal plane caused by supraeruptions
    C. alter the contour of rotated teeth to permit bilateral contacts on flat surfaces
  2. A diagnostic cast should be obtained to assess the occlusal plane. Mock adjustment can be performed on the diagnostic cast and a reduction template fabricated to aid intraoral adjustment
  3. Avoid a complete single denture against an opposing 6- 8 teeth in the anterior of an arch - it can lead to resorption, or loosening or fracture of the denture (consider RPD)
49
Q

Advantages of immediate dentures (6)

A
  1. Reduction of pain, bleeding, and swelling
  2. Pt. has teeth
  3. Improved pt. cooperation and emotional attitude
  4. Quicker adaptation
  5. VDO and occlusal plane easier to obtain
  6. Immediate dentures contour bone?
50
Q

Disadvantages of Immediate Dentures (5)

A
  1. Loss of proprioception
  2. Physiologically devastating
  3. Loss of function and efficiency
  4. Technically difficult
  5. No esthetic try-in

Dentures (2 decks)

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