DENTURES3 Flashcards by Zach Geddes

What are the objectives of the registration stage?

Define shape of maxillary rim

Determine occlusal plane

Define position of the lower teeth

Determine jaw relationship

Select shade and mould

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What equipment is used to trim adjust wax block?

Willis bite gauge

Pallet knife

Hot plate

Bunsen

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What are the steps in adjusting the upper record block?

Adjust upper block for retention, then tooth position, then occlusal plane

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What are the steps in adjusting the record block to maximise retention?

Try it in- usually bulky

Any overextension of peripheries or too much lip support will cause it to drop

Use tools to make adjustments (sometimes requires labial/buccal adjustments)

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What should you use and consider when adjusting the upper block for tooth position?

Old dentures- how much tooth they show

Patients age

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What should be checked when adjusting upper record blocks for tooth position?

Lip Support
Incisal Level
Midline
Buccal corridor
Occlusal plane

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How is lip support ascertained?

Looking at the nasiolabial angle from side on- should be around 90 degrees

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What can be done to check the incised plane level?

Look at where it is with current denture

Old photos (caution)

Ask patient to say fricatives

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What factors can cause incised plane level to vary?

Age

Lip level

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What is the issue with showing more tooth?

Can compromise stability of denture

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What should be done before trimming the block to finalise position of anteriors?

Get patient to lick lips and relax

Saying fricatives

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What should be done before trimming the block to finalise position of anteriors?

Get patient to lick lips and relax

Saying fricatives

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What should the incisal bite plane be parallel to ideally?

Interpupillary line

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Where should the upper anterior teeth be positioned?

Incisors- up to 1cm anterior to incisive papilla

Canines- below nose

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What is used to prescribe tooth position in different types of dentures?

Replica- look at treatment plan

Conventional- standard values

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What does marking the lip line on the block help decide?

Height of teeth

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How should the midline be marked on a record block?

Use mirror and stand behind patient

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What is the starting point of the buccal corridor?

Mid-canine line (canthus of eye to canine area)

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What arch has a narrow buccal corridor?

Broad arch

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What does the width of the buccal corridor determine?

How much tooth fills space

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What should the occlusal plane be parallel to?

Ala-tragus line (or angled slightly up)

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What are the steps in adjusting the lower record block?

Measure vertical dimension and establish face height

Lower tooth position

Registration

Why is lower teeth position critical?

Prevents loose feeling

What is the neutral zone?

Area with minimum force acting upon denture

What can happen if teeth are too lingually placed?

Can impact tongue

Where should lower teeth be positioned?

Anterior- on ridge (or slightly further forward) Posterior teeth- on ridge

Why should the tongue be utilised in lower denture retention?

To hold denture down (Triangular shape of polished surface aids this)

What are the options for relationship of the upper and lower anteriors in a denture?

Shallow overbite Overjet- anywhere from edge to edge to class 2

What are the options for relationship between upper and lower posteriors in a denture?

Normal Crossbite

Why are cross bite relationships often chosen for posteriors in dentures?

This occurs when teeth are set on the ridges, means that posteriors don't impinge on buccal corridor

What instruments are used to measure OVD and face height?

Willis bite gauge Dividers

How is resting vertical dimension measured?

Place dots on point of nose and chin Ask patient to moisten lips, say 'm' and bring them into light contact with adjusted rims in situ

How is OVD measured

Insert upper and lower blocks Reduce the LOWER wax rim in height until it contacts upper rim evenly

What should the difference between RVD and OVD be?

OVD should be 2-4mm less than RVD (often greater with worn teeth) Avoid negative FWS

What teeth are usually used in complete dentures and why?

Hybrid- cusp incline allows some articulation *cusped have too much inclination

What is the RCP?

Guided occlusal relationship at most retruded position of condyles in joint cavity

Why is RCP used in edentulous patients

It is a reproducible maxillomandibular relationship

How can RCP be measured?

Get patient to close mouth and put tongue as far back as possible

Which position may be considered more comfortable for the patient when measuring occlusion?

ICP- condyles in fossa

What can be done to help you reposition blocks when measuring occlusion?

Add notches to allow yourself to reposition if required

Why is wax not used to measure occlusion?

Once recorded it is set and record blocks cannot be taken apart Means that you cannot double check occlusion

What is used to record occlusion?

Bite recording paste

Which articulators are used in the production of complete dentures?

Average Value

What can be used to help you pick the mould for teeth in denture?

Previous dentures Photos Facial Profile- square, ovoid, tapered

What are the 3 numbers on the mould cards?

Top- distance between distal of canines (not mid canine line) Mid- Height of central incisor Low- Width of central incisor

How do you choose the width of anterior teeth?

Use old denture Using a transparent rule (remember that marks at placed at mid canine- line and mould value is from distal)

What can be used to choose height of anterior teeth?

Previous denture High smile line marked on blocks

Why may teeth appear shorter in denture than they look on moulds?

As some of the neck will be hidden by acrylic

What are the different types of posterior teeth?

Cuspless- HO/HU Hybrid- FO/FU (12 degrees) Cusped (33 degrees)

When may cusp less teeth be a good option?

If there is no good reproducible bite (teeth tend to slide around side to side)

How do you select a shade?

Shade guide Patient preference Previous denture Skin colour -> select natural shade and note down if you disagree

How should teeth be arranged?

Can be perfect alignment Personalised- with diastema and imbrications set in

What should be written on the prescription card for next visit (try-in)?

Articulate casts to registration provided Try-in- with shade and mould Any special instructions- adjustments, different alignments

What is the freeway space

RVD-OVD