DENTURES4

Question 1

What is the try in stage?

Answer 1

Dress rehearsal where denture is in wax mock-up with teeth mounted

Question 2

What does a trial stage allow?

Answer 2

Assessment of function and aesthetics by dentist/patient

Technical work to be checked

Question 3

What should be checked before patient arrives?

Answer 3

Dentures are for correct patient

Denture fit models

Models are not damaged

Question 4

What are the 3 surfaces of a denture?

Answer 4

Fit/impression surface

Polished surface

Occlusal surface

Question 5

What can be checked the day prior to patient arriving?

Answer 5

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

Question 6

What should be checked before insertion of dentures from coronal view?

Answer 6

Articulator- pin is on table

Check if wax is distorted

Check occlusion of anteriors and contacts

Check that centre lines coincident

Question 7

What should be checked before insertion of trial from a lateral view?

Answer 7

That overbite and overjet are not excessive

Occlusion on molars- contacts should be even

Question 8

What should be checked from a vertical view?

Answer 8

Teeth are set over ridge

If last molar or premolar is required- more space for tongue and improved stability

If position may affect stability

Question 9

Why is a shellac base used?

Answer 9

Wax base distort easily

Question 10

How are trial dentures assessed?

Answer 10

Each denture is done independently then together

Moisten beforehand

Allow time to settle

Question 11

Why should the lower try-in be inserted first?

Answer 11

As due to lower retention in trial denture the upper denture is easily dislodged when the lower is inserted afterward

Question 12

What in mouth checks should be done in try-in? (upper and lower separately)

Answer 12

Extension- adjust if required

Retention- hold tissues out of way and see if it drops

Stability- is there any rocking

Question 13

What can cause lack of retention in the try-in phase?

Answer 13

Under extension

Poor adaption

*can be caused by poor ridge and dry mouth

Question 14

What can be added to denture to improve very poor retention in trial?

Answer 14

Denture fix

Question 15

What issues with extension can cause denture to drop?

Answer 15

Under- seen when holding tissues away from denture

Over- seen when manipulating tissues/patient moves tissues

Too much lip support

Question 16

What can be used to alter extension on trials?

Answer 16

Wax knife- not done on fitting surface

Question 17

What are the occlusal checks during a trial?

Answer 17

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

Question 18

What happens if lower occlusal plane is too high?

Answer 18

Tongue will not have enough space- won’t rest on occlusal surfaces and keep denture in position

Instability

Question 19

How is OVD checked?

Answer 19

Using dividers or willis bite gauge with both dentures in

Question 20

What happens if the OVD is increased?

Answer 20

Teeth need to be removed from one (preferably lower) or both dentures and replaced with wax rim

Question 21

What are the stages when taking another registration following increased OVD?

Answer 21

Remove teeth

Replace with wax

Re-record registration

Prescribe another wax trial (2 trials is common)

Question 22

What is checked if OVD is ok?

Answer 22

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)

Question 23

What should you check with the patient when they are wearing dentures?

Answer 23

Comfort- do they feel overly loose

Appearance- ask opinion of others

Speech

** don’t keep in too long as wax melts

Question 24

How can speech be checked?

Answer 24

Count from 60-70

Say days of week

Get patient to say fricatives- assesses contact between incisors and lower lip

Question 25

What are signs in speech that OVD is increased or decreased?

Answer 25

INC- clicks when speaking

DEC- whistling sound when saying ‘s’

Question 26

What is a post dam?

Answer 26

Lip on denture which helps with peripheral seal

Question 27

How should post dam be marked?

Answer 27

Draw on cast where you want it and get technician to cut it (1-2cm anterior to vibrating line)

Question 28

Why may it be wise to ask for double post dam?

Answer 28

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

Question 29

What is written in the prescription card if you and patient are happy?

Answer 29

Prepare post dam

Process try-ins in heat cure acrylic and provide upper and Lower dentures

Special instructions

Question 30

What instructions are given to the lab in the case of a retrial?

Answer 30

Rearticulate models to re-recorded registration

Any other changes

Question 31

What are the factors to be constantly aware of when carrying out denture work?

Answer 31

Extension

Retention

Stability

Occlusion

Appearance

Question 32

What are the factors to be constantly aware of when carrying out denture work?

Answer 32

Extension

Retention

Stability

Occlusion

Appearance

Question 33

What should be double checked at the end of the try-in?

Answer 33

That changes you wanted to make to the previous dentures have been incorporated and that there are no new errors