Exam 1 Flashcards
What does stability refer to when talking about CD?
-ability to overcome lateral displacement and rotation during function
What does retention refer to when talking about CD?
-ability to overcome vertical displacement during function
What does support refer to when talking about CD?
-ability to withstand vertical compression forces during function
What happens during the first appointment for an CD?
- examination, diagnosis, and preliminary impressions
- extractions if necessary
- make custom tray
What happens during the second appointment for CD?
-final impressions
What happens during the third appointment?
- maxillo-mandibular relations
- artificial tooth arrangment
What happens during the 4th appointment?
-wax trial denture try-in
What happens during the 5th appointment?
-insertion/delivery
What are the negative effects of antihypertensive meds on denture patients?
-can cause dryness and postural hypotension
What are the negative effects of corticosteroids and anti-parkinsons agents?
-dryness, confusion, and behavioral changes
What are the negative effects of diuretics, antihistamines and atropine?
-dryness
Fractured remains of extracted teeth may be left only if..?
-asymptomatic
Loss of vertical dimension usually leads to what soft tissue change?
- heavy wrinkles
- aged appearance
What are the main types of facial forms?
- square
- square-tapering
- tapering
- ovoid
How do you treat pathogenic mucosa before treatment?
-tissue conditioning
What anatomical structure is critical for a peripheral seal across the buccal flange?
-draping of cheeks over side of denture
What is the relationship between FOM and the issues with denture success?
- if near level of ridge crest, retention and stability are severely compromised
- hyperactive FOM also reduces these things
- significant resorption can bring crest close to FOM
What is the best ridge form for max CD?
-u-shaped
What is the worst ridge forms for max CD
- v-shaped
- knife-edged, shallow, resorbed ridges
What are the characteristics of viable maxillary tuberosities needed for a max CD?
- non-moveable tissue
- not overenlarged with fibrous tissue
What are the different forms of the soft palate and what are their relationships to the line drawn across the distal edges of tuberosities?
- Class I (best)- large, relatively immovable band of resilient tissues 5-12 mm distal to line
- Class II- medium size and 3-5mm distal to line
- Class III (worst)- curtain of soft tissue turns down abruptly 3-5mm anterior to line
What is the distal extent of the dentures?
-Hamular notches
What are the consequences of over-extension of CD?
-causes pain and inflammation
What are the consequences of under-extension?
-non-retentive denture
What anatomical feature forms the posterior palatal seal?
-vibrating line
Ridge form is more critical for which arch?
- mandibular ridge because there is less surface area for retention
- narrow zone of keratinized attached mucosa confined to alveolar ridge
- possible displacement for overextended denture
What bony feature is the primary stress bearing area for the mandibular denture?
- buccal shelf
- dense cortical bone that does not resorb due to muscle attachments
Which muscular attachment is most detrimental to the retention of the mandibular CD?
-lingual frenum
What is the anatomical feature that denotes the posterior extent of the mandibular CD?
- retromolar pad
- must be covered by denture to create seal
- retromylohyoid space determines posterior extension of lingual flange
- amount of available space affects stability and retention
Size of what major muscle affects mandibular stability?
- tongue
- hypertrophy
- hyperactive tongue
What type of stone is used to pour up the casts to make the custom trays?
-type 3 dental stone
What is the size of the land area for the casts?
-4-5mm
What is the purpose of custom trays?
- tray with borders approximating the outline of CD cast
- helps minimize distortion of impression material and tissue
- allows for accuracy of borders through border molding
How short does the land area need to be trimmed down?
-within 2-3mm of the vestibule
What is the thickness of the trays?
-2-3mm uniform tray thickness
What are the dimensions of the custom tray handle?
- 45*
- 9mm in height
- 10mm in width
Where are the finger rests placed on the mand custom tray?
- 1st molar/2nd premolar regions
- 20mm mesiodistally and 10mm wide anteriorly
The blue line is showing what part of the vestibule?
-fornix
The red line shows what part of the vestibule?
-2-3mm higher
What type of wax is used as a spacer for the custom tray?
-type 3 baseplate wax spacer
Before border molding, how long should the patient remove old CDs for?
- 24-72hrs
- this allows for recovery of tissue and keratinization of the edentulous mucosa
What kinds of materials can be used to border mold?
-heavy body PVS for border molding
What kind of material can be used to make the final impression?
- light body PVS (maybe poly ether)
- easy to mix and dispense
- good dimensional stability and accuracy
- great elastic recovery and dimensional accuracy
What are the 4 key actions to get a good max final impression?
- suction around finger
- pucker/pooch lips and produce maximal smile line
- open mouth and move mandible side to side to get condylar impression
- pinch patient nostrils down and attempt to blow air through nose while holding tongue down
- mark vibrating line
What are the 5 key actions to give a good mand final impression?
- suction around tray handle
- pucker/pooch, maximal smile line
- pronouce word Christmas and letter Q and U and pull lower lip and cheek over impression tray
- place fingers on the top of each side of the tray and ask patients to close using 1 second increments of force
- raise tongue to roof of mouth and stick tongue out and side to side
What is the ratio of the plaster/pumice base for the master cast pour?
-50/50
What are characteristics of successful record bases?
- slight retentive, stable, rigid and no rocking
- fill depth of vestibule
- trim excess, obtain smooth borders
- rims to establish VDO
What are the dimensions of the occlusion rims to be used?
- 8mm wide in molar region
- 6mm thick in premolar region
- 3mm thick in anterior region
How should the rim be positioned over the residual ridge for fabrication of the occlusion rims?
-centered over ridge exactly
How does the maxillary wax rim taper A-P in height?
- 22mm anteriorly
- 8mm posteriorly
How does the mandibular wax rim taper A-P in height?
- 18mm anteriorly
- 2/3 height of retromolar pad posteriorly
What is the occlusal plane parallel to?
-Camper’s plane
How much incisal length should show at rest?
- 0-1mm men
- 2-3mm women
Lip support generated by the maxillary CD should result in what angulation between the nose and upper lip?
- 95* ideal
- vermilion border must show
When making the fricative sounds, where should the edge of the wax rim touch the lower lip?
-wet-dry line
Ideally, how much horizontal and vertical overlap should there be?
- 1.0 mm vert.
- 1.5mm horizontal
From the frontal view, the anterior portion of the wax rim should appear parallel to which line?
-Interpupillary line
Interocclusal distance equals…?
VDR - VDO
~2-4mm
Which landmarks are used to determine the occlusal plane?
- midpoint of the retromolar pads
- incisal edges of maxillary central incisors
What is the description of the inclination of the maxillary incisors? This term especially applies to the canines…
- toed-in
- apically distal and incisally mesial
What is the purpose of overlap in CD?
- minimize forces applied to max and mand anterior ridges in CO (centric occlusion)
- create appropriate relationship for sibilant speech sounds
- more overlap for Class II, class III almost end to end
What are some common sources that can be used to select teeth for the denture?
- photos
- old radiographs
- existing dentures
- personality
What tooth form is more associated with men?
- square, large
- more wear
What tooth form is more associated with women?
- delicate
- curves
What are the two principle colors in teeth?
-yellow and gray
What material is denture dentition made out of?
- PMMA (polymethylmethacrylate)
- More resiliency
- will last ~7 years
- will last life of denture
Anterior teeth on the maxillary arch should be placed in what relationship to the residual ridge?
-just labial to avoid resorption
Anterior teeth on the mandibular arch should be placed in what relationship to the residual ridge?
-should not be labial to the center of the vestibule or will cause tipping forces on the mandibular denture
On average, the distance from the center of the incisive papilla to the labial surface of the central incisor is…
8-10mm
