DENTURES4 Flashcards
What is the try in stage?
Dress rehearsal where denture is in wax mock-up with teeth mounted
What does a trial stage allow?
Assessment of function and aesthetics by dentist/patient
Technical work to be checked
What should be checked before patient arrives?
Dentures are for correct patient
Denture fit models
Models are not damaged
What are the 3 surfaces of a denture?
Fit/impression surface
Polished surface
Occlusal surface
What can be checked the day prior to patient arriving?
Will work be ready- is correct date/instructions on card
Check if mould, shade, individualisation is correct
Are trial bases stable on models
Are borders smooth (no sharp edges)
Is extension of border shape to width/depth of functional sulcus
What should be checked before insertion of dentures from coronal view?
Articulator- pin is on table
Check if wax is distorted
Check occlusion of anteriors and contacts
Check that centre lines coincident
What should be checked before insertion of trial from a lateral view?
That overbite and overjet are not excessive
Occlusion on molars- contacts should be even
What should be checked from a vertical view?
Teeth are set over ridge
If last molar or premolar is required- more space for tongue and improved stability
If position may affect stability
Why is a shellac base used?
Wax base distort easily
How are trial dentures assessed?
Each denture is done independently then together
Moisten beforehand
Allow time to settle
Why should the lower try-in be inserted first?
As due to lower retention in trial denture the upper denture is easily dislodged when the lower is inserted afterward
What in mouth checks should be done in try-in? (upper and lower separately)
Extension- adjust if required
Retention- hold tissues out of way and see if it drops
Stability- is there any rocking
What can cause lack of retention in the try-in phase?
Under extension
Poor adaption
*can be caused by poor ridge and dry mouth
What can be added to denture to improve very poor retention in trial?
Denture fix
What issues with extension can cause denture to drop?
Under- seen when holding tissues away from denture
Over- seen when manipulating tissues/patient moves tissues
Too much lip support
What can be used to alter extension on trials?
Wax knife- not done on fitting surface
What are the occlusal checks during a trial?
Incisal plane- matched with inter pupillary line
Occlusal plane- parallel to ala-tragus line
Lower occlusal plane- incised edge is level with lower lip at corner of mouth
Resting face height, OVD, FWS
What happens if lower occlusal plane is too high?
Tongue will not have enough space- won’t rest on occlusal surfaces and keep denture in position
Instability
How is OVD checked?
Using dividers or willis bite gauge with both dentures in
What happens if the OVD is increased?
Teeth need to be removed from one (preferably lower) or both dentures and replaced with wax rim
What are the stages when taking another registration following increased OVD?
Remove teeth
Replace with wax
Re-record registration
Prescribe another wax trial (2 trials is common)
What is checked if OVD is ok?
Balanced occlusion- teeth in contact in all areas
Balanced articulation- contact on both working AND non working sides in lateral movements
Centric relation- should be natural (check multiple times)
What should you check with the patient when they are wearing dentures?
Comfort- do they feel overly loose
Appearance- ask opinion of others
Speech
** don’t keep in too long as wax melts
How can speech be checked?
Count from 60-70
Say days of week
Get patient to say fricatives- assesses contact between incisors and lower lip
What are signs in speech that OVD is increased or decreased?
INC- clicks when speaking
DEC- whistling sound when saying ‘s’
What is a post dam?
Lip on denture which helps with peripheral seal
How should post dam be marked?
Draw on cast where you want it and get technician to cut it (1-2cm anterior to vibrating line)
Why may it be wise to ask for double post dam?
Incase the patient feels that the posterior of the denture is too far back, so you can move to the post dam further forwards and not compromise seal
What is written in the prescription card if you and patient are happy?
Prepare post dam
Process try-ins in heat cure acrylic and provide upper and Lower dentures
Special instructions
What instructions are given to the lab in the case of a retrial?
Rearticulate models to re-recorded registration
Any other changes
What are the factors to be constantly aware of when carrying out denture work?
Extension
Retention
Stability
Occlusion
Appearance
What are the factors to be constantly aware of when carrying out denture work?
Extension
Retention
Stability
Occlusion
Appearance
What should be double checked at the end of the try-in?
That changes you wanted to make to the previous dentures have been incorporated and that there are no new errors
