Exam, Diagnosis and Treatment Planning

Question 1

What are the 3 denture occlusion arrangments?

Answer 1

• Balanced
• Non-balanced
• lingualized (can be used on balanced and non-balanced)

Question 2

What is the definition of balanced occlusion?

Answer 2

the bilateral, simultaneous, anterior and posterior occlusal contact of teeth in centric and eccentric positions

Question 3

What type of denture occlusion did we use in lab?

Answer 3

non-balanced (lingualized on one side and not on the other)

Question 4

What do you need to use balanced occlusion?

Answer 4

• young, healthy alveolar ridges
• good neuromuscular control

Question 5

What is the only thing you cannot control when doing balanced occlusion?

Answer 5

condylar guidance (patient’s anatomy controls this)

Question 6

When should you use a monoplane occlusion?

Answer 6

• anything but a class I bite
• limited oral dexterity
• excessive inter-ridge distance
• successful previous F/F were monoplane
• severely resorbed ridges

Question 7

What are the patient psychological classification?

Answer 7

• philosophical
• exacting/critical
• hysterical
• indifferent

Question 8

What is a philosophical patient?

Answer 8

• rational, calm, sensible, confident
• the majorite of patients
• prognosis is good

Question 9

What is an exacting patient?

Answer 9

• methodical, precise
• somewhat difficult to please
• may try to dictate treatment
• may demand a written guarantee
• should make special effort to be neat and organized

Question 10

What is a hysterical patient?

Answer 10

• generally in poor health
• oral conditions neglected
• may blame the dentist
• don’t make promises to these patients

Question 11

What is an indifferent patient?

Answer 11

• unconcerned with apperance and chewing
• often persuaded by relatives to get treatment
• diet often poor
• prognosis poor unless education successful

Question 12

What should you do on the first visit with a denture patient pre extraction?

Answer 12

1. make impressions of the mouth as the patient presents
2. measure existing VDO
3. record tooth shade
4. dental history
5. medical history
6. radiographs

Question 13

What type of radiographs should you take on a denture patient pre extraction?

Answer 13

panoramic
- look for root tips, foreign bodies, impacted teeth

Question 14

What are the different classes from House?

Answer 14

Class I - ideal
Class II
Class III - unfavorable

Question 15

What class would a lot of space or too little space between the dentures be?

Answer 15

Class III

Question 16

What is the ideal ridge form?

Answer 16

square to gently rounded

Question 17

What is the unfavorable ridge form?

Answer 17

tall, thin, undercut

Question 18

What is the ideal space for the tuberosities?

Answer 18

5-6 mm (minimum of 4 mm)

Question 19

If you have bony undercuts is that alright or would you need surgical correction?

Answer 19

Depends!

• unilateral may be OK
• bilateral prolly needs surgical correction

Question 20

What is a palatal torus?

Answer 20

bony enlargement at midline of hard palate

Question 21

What percent of the population has palatal tori and who is it most prevalent in?

Answer 21

20-25% of population
more prevalent in women

Question 22

When is the palatal torus a problem with dentures?

Answer 22

• it is on the vibrating line
• it has many lobes or undercuts
• large and fillts palatal vault
• pnt is concerned about it (thinks it is cancer)

Question 23

What are the problems with mandibular tori?

Answer 23

• extremely susceptible to irritaiton from denture base
• best treatment is surgical removal

Question 24

What are mandibular tori?

Answer 24

• dense cortical bone covered by a very thin layer of mucous membrane

Question 25

What is the ideal palatal vault form?

Answer 25

medium depth with well-formed rugae

Question 26

What are the versions of poor palatal vault form?

Answer 26

• flat = poor resistance to horizontal movement
• high, narrow, deep = rapid break of peripheral seal and poor retention

Question 27

What are the different classes of soft palate?

Answer 27

Class I - ideal (5-12 mm)
Class II - (3-5 mm)
Class III - (less than 3 mm)

Question 28

What is the hardest soft palate class to work with?

Answer 28

class III

Question 29

What are the ideal border attachments?

Answer 29

muscle/ frenum attachments are 10 mm or more from crest of ridge

Question 30

What are the unfavorable border attachments?

Answer 30

attachments near crest of ridge and may interfere with peripheral seal

Question 31

What are the major impact areas with the tongue and dentures?

Answer 31

border seal
tooth placement
speech

Question 32

Where is the normal tongue position?

Answer 32

• Fills floor of mouth
• Lateral borders lie on post. alveolar ridge
• Apex approximates ant. alveolar ridge

Question 33

What is a retruded tongue?

Answer 33

• 25% of edentulous pnts
• border seal is absent

Question 34

Saliva plays an important role in denture…

Answer 34

retention

Question 35

What should you evaluate with existing dentures the patient has?

Answer 35

Phonetics, esthetics, stability, retention, lip support, OVD

Question 36

What is prosthodontic diagnostic index (PDI)?

Answer 36

a tool that every clinician can use to communicate to colleagues and patients the challenges each patient presents with their unique dental condition

Question 37

What is the prosthodontic diagnostic index (PDI) complete edentualism checklist?

Answer 37

Question 38

What are the PDI classification systems?

Answer 38

Class I - straightforward
Class II - denture-supporting anatomy degraded
Class III - anatomy degraded; surgical revision needed
Class IV - most debilitated edentulous condition