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Dentures Flashcards

1
Q

Describe Non-Soluble Denture Adhesives…

A
  • Pads and wafers
  • Sodium alginate, ethylene oxide polymer
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2
Q

What are some different materials for final impressions for dentures?

A
  • Plaster
  • ZOE
  • Polysulfide
  • Silicones
  • Polyether
  • Waxes
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3
Q

What are some Advantages of Immediate Complete Dentures?

A
  • Prevent embarrassment
  • Promote health
  • Provide optimal esthetics
  • Provide guide for occluding vertical dimension
  • Promote healing
  • Promote better ridge form
  • Prevent collapse of facial musculature
  • Hasten patient adaptation
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4
Q

To increase denture support, would you want distribution of applied forces over wide or short area?

What does this help with?

A
  • For support, you want distribution of applied forces over as wide an area as possible
  • Helps with ridge preservation, prosthesis stability, and retention
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5
Q

What is the purpose of a Post Palatal Seal?

A
  • Close tissue contact during speech and swallowing
  • Seal adaptation/increased retention
  • Compensate for polymerization shrinkage
  • “Sunken” border less conspicuous to tongue
  • Less gagging
  • Cross sectional strength
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6
Q

What are 3 Overdenture Types?

A
  • Immediate
  • Transitional
  • Remote
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7
Q

What is the prevalence of Combination Syndrome among denture patients?

A

24%

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8
Q

Describe the patient spectrum regading youth and elderly for neuromuscular control…

A
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9
Q

What 5 things contribute to good denture stability?

A
  1. Good retention
  2. Non-interfering occlusion
  3. Prper tooth arrangement
  4. Proper tooth form and contour of polished surface
  5. Good control and coordination of the patient’s musculature
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10
Q

Regarding the Neutrocentric Technique, what is the Condylar Inclination, Incisal Guidance, and Tooth Form set at?

A

0°

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11
Q

What are the 2 types of Lingualized Articulation?

A
  1. Balanced concept
  2. Nonbalanced concept
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12
Q

Which ridge experiences more loss of bone in denture patients, mandible or maxilla?

A

Mandible

4x greater loss of bone over first seven years

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13
Q

What are 2 components of Chemically Activated Resins?

A
  1. Liquid: Methylmethacrylate + chemical activator (tertiary amine)
  2. Powder: prepolymerized spheres of polymethylmethacrylate + benzoyl peroxide (initiator)
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14
Q

What do you do if the posterior palatal seal is too short?

A
  • Define border and PPS
  • Reline
  • Chemical cure addition
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15
Q

What are some advanced treatment options for edentulous patients?

A
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16
Q

What is a Soft Liner?

A

A liner, whether hard or soft, should be used as a simple tool to improve clinically acceptable prostheses

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17
Q

What are some advantages of Overdentures?

A
  • Stable record bases
  • Reversible
  • Convertible
  • Prevent Combination Syndrome
  • Decreased tissue trauma
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18
Q

How do you record the Neutrocentric Technique?

A
  • No facebow transfer
  • No protrusive or lateral records
  • Just OVD + CR
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19
Q

During a chairside remount for a balanced occlusal scheme, what do you adjust regarding Protrusive Movements?

A
  • Adjust M inclines of mandibular cusps and D inclines of max cusps
  • Centric: re-adjust as needed
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20
Q

What is the rationale for Nonanatomic Occlusion?

A
  • Nonanatomic teeth set with a compensating curve
  • Balance provided by anterior-posterior and lateral curves
  • Rationale is to eliminate lateral forces and preserve residual ridges
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21
Q

What are some important anatomical landmarks for a maxillary denture?

A
  • Hamular notch: between pterygoid hamulus and tuberosity
  • Tuberosity will resist movement in anterior direction
  • Posterior border of denture
  • Post palatal seal
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22
Q

Describe Light-Activated Denture Base Resins…

A
  • Urethane dimethacrylate matrix
  • Micro fine silica
  • High MW acrylic resin monomers
  • Filler: acrylic resin beads
  • Activator: visible light
  • Initiator: comphoroquinone
  • High-intensity visible light cure
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23
Q

What is a Remote Overdenture?

A
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24
Q

What is the position of the posterior teeth in the Neutrocentric Concept (Monoplane)?

A

Over the residual ridge as far lingually as possible

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25
Q

What are some disadvanges to the anatomic scheme?

A
  • Precise records required
  • Greater lateral forces on inclines
  • Technically demanding, results short lived
  • More difficult in class II, III, and crossbite situations
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26
Q

What are some advantages to the anatomic scheme?

A
  • Esthetics
  • Bolus penetration
  • Decreased vertical stresses
  • Increased denture stability in parafunctional movements
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27
Q

What are some Disadvantages of Immediate Complete Dentures?

A
  • Increased complexity
  • Limited evaluation of trial denture
  • Increased patient discomfort
  • Increased maintenance
  • Increased patient visits
  • Increased treatment cost
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28
Q

What is the rationale for the Anatomic Scheme?

A
  • Better chewing efficiency
  • Better stability of articulation
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29
Q

What are some clinical uses for tissue conditioners?

A
  • Tissue conditioning before final impression (change every 3 days)
  • Diagnostic relining
  • Impression material
  • Immediate complete denture treatment
  • Post surgical and during implant therapy
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30
Q

What factors are involved in denture retention?

A
  • Adhesion
  • Cohesion
  • Interfacial viscous tension
  • Capillary attraction
  • Oral and facial musculature
  • Atmospheric pressure and peripheral seal
  • Mechanical locking
  • Gravity
  • Occlusion
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31
Q

What is the Form of teeth in the Neutrocentric Concept (Monoplane)?

A

Flat teeth with no deflecting inclines

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32
Q

What are 3 techniques for denture base resins?

A
  • Compression flask
  • Injection-molding
  • Pour techniques
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33
Q

During a chairside remount for a balanced occlusal scheme, what do you adjust regarding Working Cusps?

A
  • Adjust using BULL Rule (buccal UPPER, and lingual LOWER)
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34
Q

What are 4 things you can use to determine vertical dimension?

A
  • Physiologic rest
  • Phonetics and esthetics
  • PAtient-reported perception of comfort
  • Closest speaking space
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35
Q

What are some surgical treatments you can provide to enahance denture support?

A
  • Placement of osseointegrated implants
  • Hyperplastic tissue, epulis fissuratum, and papillomatosis
  • Frenular attachments and pendulous tuberosity
  • Bony prominences, tori
  • Discrepancies in jaw size
  • Pressure on mental foramen
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36
Q

What angles are set for teeth in Nonanatomic Occlusion?

A
  • Teeth with cuspal inclination of 0-19°
  • Anatoline: 10°
  • Monoline: 0°
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37
Q

How much monomer is left in a processed denture?

A
  • Chemically acticated resin: 3-5% residual monomer
  • Heat acticated resins 0.2-0.5% residual monomer
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38
Q

During the first year of dentures, how many mm of bone heigh is lost during the first year after extractions for immediate dentures?

A

4 mm

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39
Q

Describe the Occlusal Spectrum of denture teeth arrangements?

A
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40
Q

What are some advantages of Lingualized Articulation?

A
  • Esthetics
  • Better bolus penetration
  • Less vertical force
  • Simple technique
  • Parafunctional stability with balanced arrangement
  • Reduced lateral forces
  • Easier to adjust
  • Can be used in Class II, III, and crossbite situations
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41
Q

What is a pendulous tuberosity?

A

Enlarged maxillary tuberosity, may need surgical excision

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42
Q

What are some Disadvantages of the Neutrocentric Concept?

A
  • Less esthetic
  • May not be compatible with tongue, oral function
  • Poor bolus penetration
  • Class II patients may function forward of CR
  • Encourages lateral chewing component
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43
Q

What degrees are teeth setup regarding the Anatomic Scheme?

A

30° - 45°

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44
Q

What are some contraindications for denture adhesives?

A
  • Ill-fitting dentures
  • Fractured prosthesis
  • Obvious pathology or tissue hyperplasia
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45
Q

What are 2 categories of Denture Adhesives?

A
  1. Soluble
  2. Non-soluble
46
Q

What are some Disadvantages of Overdentures?

A
  • Add tx time and $
  • More exacting
  • Caries and periodontal disease
  • Maintenance
  • May affect esthetics
  • Increase denture fracture
47
Q

What is Epulis Fissuratum?

A

Epulis fissuratum (also termed inflammatory fibrous hyperplasia, denture-induced fibrous inflammatory hyperplasia, denture injury tumor, denture epulis, denture induced granuloma, and granuloma fissuratum is a benign hyperplasia of fibrous connective tissue which develops as a reactive lesion to chronic mechanical irritation produced by the flange of a poorly fitting denture.

48
Q

What are the 2 components of Heat-Activated Denture Resins?

A
  1. Powder (Prepolymerized PMMA spheres/Benzoyl peroxide (initiator)
  2. Liquid
  • Unpolymerized methyl methylacrylate
  • Glycol dimethacrylate (corsslinking agent)
  • Hydroqinone (inhibitor)
49
Q

What is some important anatomy for a mandibular denture?

A
  • Retromolar pad (Mucous glands, temporalis tendon, buccinator, pterygomandibular raphe, superior constrictor)
  • Occlusal plane references
  • “Pear-shapped pad”: scar after 3rd removal
  • Rare resorption
50
Q

What are the 3 methods of making a post palatal seal?

A
  1. Empirical alteration
  2. Functional/direct: Korecta wax
  3. Semi-functional: T burnisher/reduce cast according to palpated amount of tissue depressibility
51
Q

What is the rationale for Semi-Anatomic Occlusal Scheme?

A
  • Technique same as anatomic
  • Rationale is to overcome the problems with anatomic occlusion
52
Q

What is Papillomatosis?

A

Papillomatosis is skin surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae. These papillary projections of the epidermis form an undulating surface under microscopic examination.

53
Q

What is another term for Combination Syndrome?

A

Anterior Hyperfunction Syndrome

54
Q

When does Combination Syndrome occur?

A

When an edentulous maxilla is opposed by natural mandibular anterior teeth

55
Q

What is a Contraindication for Immediate Complete Dentures?

A
  • Patients with certain systemic or mental conditions may necessitate minimal episodes of surgical correction
56
Q

Where is the Hamular Notch located?

A

Between pterygoid hamulus and tuberosity

57
Q

What does relining with a soft liner accomplish?

A

Offers short-term resolution to a patient’s problems

58
Q

What is the rationale for Overdentures?

A
  • Maintenance of alveolar bone
  • Proprioception
  • Increased masticatory efficiency
  • Increased stability and support
  • Psychological
59
Q

What are some indications for Overdenture Attachments?

A
  • More stability and retention needed
  • Xerostomia
  • Poor ridge form
  • Congenital deformity
  • Gain improved patient acceptance and function
  • Doubtful RDP abutment
60
Q

If you are looking for a durable soft liner that will help prevent growth of candida, what would you choose?

A
  • Silicone Liner
  • More durable
  • Silane heat polymerized silicone rubber
61
Q

During a chairside remount for a balanced occlusal scheme, what do you adjust regarding CO?

A
  • Correct vertical processing error and restore to CO
  • Adjust fossa and inclines first
62
Q

What is the sequence for occlusal adjustment during a chairside remount regarding a balanced occlusal scheme?

A
  1. Centric Occlusion
  2. Working
  3. Balancing
  4. Protrusive
63
Q

Describe neural control/feedback for Dentate Vs. Edentulism..

A
  • Dentate: Neural Control
  • Edentulism: Loss of PDL neural feedback
64
Q

What is teeth/cuspal inclination in Semi-Anatomic Occlusal Scheme?

65
Q

When treatment planning Immediate Complete Dentures, how many phases are there?

A
  • One phase
  • Two phase
66
Q

What do you do if the posterior palatal seal is too long?

A
  • Define border and judiciously remove
  • Re-establish PPS with wax
  • Chemical cure addition
67
Q

What are some different attachments/bars for Overdenture Abutments?

A
  • Stud
  • Bar
  • Magnets
68
Q

Describe the Tripodal Method of recording CR in a denture patient…

A
  • Stable relationship, minimum contact, maximum visibility
  • More accurate control of mandibular reocrd base
  • Minimum pressure
  • Easily verified in mouth
69
Q

What are some denture enlargement procedures?

A
  • Vestibuloplasty
  • Ridge Augmentation
70
Q

What are some different Overdenture Abutment restoration options?

A
  • Amalgam restoration
  • Dome (gold coping)
  • Attachments/bars
71
Q

What is the Proportion of teeth in the Neutrocentric Concept (Monoplane)?

A

Reduced the tooth 40% to reduce vertical stress on the ridge

72
Q

What is the difference between short term and long term liners?

A
  • Short term liners: < 30 days (tissue conditioners)
  • Long term liners: > 30 days
73
Q

What are some criteria to consider when choosing Overdenture abutments?

A
  • Sound perio/endo
  • Bilateral, symmetrical
  • Canines
  • Single rooted vs. multirooted
  • No opposing/adjacent teeth
74
Q

Compare support structures for Dentate Vs. Edentulism…

A
  • Dentate: Tension and Alveolar Bone
  • Edentulism: Residual ridges exhibit continued resorption
75
Q

What do soft liners enhance in regards to force distribution?

A
  • Allows uniform distribution of stress at the mucosa/lining interface
  • Energy absorbed by liner material
76
Q

What are some risks in using denture adhesives?

A
  • Mask underlying condition (tumor, etc.)
  • Ill-fitting denture will be more ill-fitting
77
Q

What are 2 general categories of Soft Liners?

A
  1. Acrylic
  2. Silicone
78
Q

What is Modiolus?

A
  • Point in the corner of the mouth where multiple muscles meet
  • Muscles of facial expression
  • Zygomaticus Major
  • Zygomaticus Minor
  • Levator Angulii Superioris
  • Incisivus Labii Superioris
  • Buccinator
  • Depressor Anguli Oris
  • Depressor Labii Inferioris
  • Incisivus Labii Inferioris
  • Mentalis
  • Obicularis Oris
  • Risorius
79
Q

Describe Soluble denture adhesives…

A
  • Paste, powders, creams
  • Hydrated (swelling) polyvinylether metyl cellulose or carboxymethylcellulose
80
Q

What can you do to prevent Combination Syndrome?

A
  1. Overdenture
  2. Routine Maintenance (Check Posterior Occlusion/Reline)
81
Q

When can a Posterior Palatal Seal be made?

A
  • At impression phase
  • Before packing
  • After fabrication
82
Q

What are Chemically Activated Resins also known as?

A

Self-curing, cold-curing, autopolymerizing resins

83
Q

What are some non-surgical procedures that can enhance denture support?

A
  • Rest: 48-72 hours (Tissue conditioners + 24 hours)
  • Occlusal and vertical dimension correction in existing dentures
  • Nutrition
  • Good oral hygiene: Candida
  • Massage
84
Q

What is Hanau’s Quint/Theilmann’s Formula?

A

B= Condylar Inclination X Incisal Guidance

_________________________________

OccPlane X Cuspal Inclination X CompCurve

85
Q

What is some general diagnostic data that is good to gather for a denture patient?

A
  1. Denal history (denture history)
  2. Mental attitude
  • House Classification
  1. Systemic status (neurologic)
  2. Local factors
  • Factors affecting retention, stability and support
86
Q

What is the Lingualized Occlusal Scheme?

A
  • Articulates the maxillary lingual cusps with the mandibular occlusal surfaces in centric, working and nonworking mandibular positions
87
Q

What is your goal when making a final impression for dentures regarding anatomy?

A

Capture optimum extension and refined borders

88
Q

What are some Advantages of the Neutrocentric Concept?

A
  • Simple technique, less precise records
  • Decreased lateral forces
  • Easier to adjust
  • Good stability (forces centralized)
  • Good for Class II, III, crossbites
89
Q

What are the 3 objectives you want to achieve for denture patients?

A
  1. Stability
  2. Retention
  3. Support
90
Q

What are the characteristics of combination syndrome?

A
  1. Maxillary anterior ridge resorption
  2. Pendulous tuberosity
  3. Maxillary papillary hyperplasia
  4. Mandibular anterior extrusion
  5. Mandibular posterior ridge resorption
  6. Overclosure of OVD
91
Q

How is a Triad Denture Base activated?

A

Light activated

92
Q

Where is the Retromylohyoid Fossa?

93
Q

During a chairside remount for a balanced occlusal scheme, what do you adjust regarding Balancing Contacts?

A
  • Reduce the lingual incline of the mandibular buccal cusp only
  • Do not adjust cusp tip
94
Q

What are some indications for denture adhesives?

A
  • Trial bases
  • Immediate dentures
  • Reconstruction surgery
  • Psychological support
  • Compromised anatomy
  • Elderly patients
  • physically/mentally challenged patients
  • Xerostomia
  • New dentures: during adaptation to decrease anxiety
  • Osseointegrated implants: man implants make max feel loose
  • RDPs
95
Q

Describe an Acrylic Soft Liner…

A
  • Adheres to denture better
  • Polyethyl methacrylate powder and methacrylate ester and phthalated ester plasticizer
96
Q

What are some local factors that can affect retention, stability, and support of dentures?

A
  • Arch size (form)
  • Interarch space
  • Muscle tone, attachments
  • Saliva quality
  • Ridge relationships
  • Ridge size
  • Throat form
  • Palatal sensitivity
  • Tongue position
  • Soft tissue health
97
Q

Compare the cm2 support for Dentate Vs. Edentulism…

A
  • Dentate: 45 cm2 periodontal support/each arch
  • Edentulism: 23 cm2 max arch support, 12 cm2 man arch support
98
Q

How are PMMA Denture Base Resins activated?

A
  • Heat activated
  • Chemically activated
  • Microwave activated
99
Q

What are some methods to record CR in a denture patient?

A
  • Graphic recordings (Coble Balancer)
  • Functional recordings (FGP)
  • Direct recordings (tripodal method, regular CR record with “mush bite”
100
Q

What are some desirable properties for Soft Liners?

A
  • Resilience
  • Tear resistance
  • Biocompatibility
  • Lack of odor or taste
  • Adhesive bond strength
  • Ease of adjustability
  • Dimensional stability
  • Ease of cleaning
101
Q

For the 2 Phase plan for Immediate Complete Dentures, how long do you wait inbetween phases?

102
Q

What is the prognosis for the 4 House Classifications?

A
  • Philosphical - Excellent
  • Exacting - Good with education
  • Hysterical - Unfavorable
  • Indifferent - Unfavorable
103
Q

How much volumetric and linear shrinkage do you get in a processed denture?

A
  • Volumetric shrinkage: 7%
  • Linear shrinkage: 0.12% high-impact acrylic resin to 0.97% rapid heat cured
104
Q

What may cause denture base acrylic resin porosity?

A
  • Too much monomer
  • Not enough resin when packing flask
  • Insufficient packing pressure
  • Incorrect processing temperature/curing cycle (monomer boils)
105
Q

Describe Microwave Polymerization…

A
  • PMMA
  • Non-metallic flask
  • Conventional microwave oven
  • Good fit and physical properties
106
Q

Regarding cloest speaking space, what is the most frequently used sibilant?

How much clearance do you need for this sibilant?

A
  • “S”
  • 1 - 1.5 mm
107
Q

What are 2 different types of Denture Base Resins?

A
  1. PMMA
  2. Triad (Urethane Dimethacrylate)
108
Q

What is the Pitch (inclination) that is placed in the Neutrocentric Concept (Monoplane)?

A

Occlusal plane is parallel to the underlying ridges, midway between

109
Q

What % decrease in width of bone during first year of wearing dentures?

110
Q

What are 3 impression techniques for complete dentures?

A
  1. Pressure-less
  2. Functional
  3. Selecive pressure
111
Q

What are some factors to consider when considering occlusal schemes for complete dentures?

A
  • Oral conditions
  • Ridge relationships
  • Neuromuscular coordination
  • Esthetics
  • What works best in your hands
112
Q

What is denture stability?

A
  • Resistance to horizontal movement
  • Decreases with the loss of vertical height of the ridges
  • Decreases with flabby, moveable tissue
  • Close adaption to the undistorted mucosa is important

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