Exam, Diagnosis and Treatment Planning Flashcards
What are the 3 denture occlusion arrangments?
- Balanced
- Non-balanced
- lingualized (can be used on balanced and non-balanced)
What is the definition of balanced occlusion?
the bilateral, simultaneous, anterior and posterior occlusal contact of teeth in centric and eccentric positions
What type of denture occlusion did we use in lab?
non-balanced (lingualized on one side and not on the other)
What do you need to use balanced occlusion?
- young, healthy alveolar ridges
- good neuromuscular control
What is the only thing you cannot control when doing balanced occlusion?
condylar guidance (patient’s anatomy controls this)
When should you use a monoplane occlusion?
- anything but a class I bite
- limited oral dexterity
- excessive inter-ridge distance
- successful previous F/F were monoplane
- severely resorbed ridges
What are the patient psychological classification?
- philosophical
- exacting/critical
- hysterical
- indifferent
What is a philosophical patient?
- rational, calm, sensible, confident
- the majorite of patients
- prognosis is good
What is an exacting patient?
- 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
What is a hysterical patient?
- generally in poor health
- oral conditions neglected
- may blame the dentist
- don’t make promises to these patients
What is an indifferent patient?
- unconcerned with apperance and chewing
- often persuaded by relatives to get treatment
- diet often poor
- prognosis poor unless education successful
What should you do on the first visit with a denture patient pre extraction?
- make impressions of the mouth as the patient presents
- measure existing VDO
- record tooth shade
- dental history
- medical history
- radiographs
What type of radiographs should you take on a denture patient pre extraction?
panoramic
- look for root tips, foreign bodies, impacted teeth
What are the different classes from House?
Class I - ideal
Class II
Class III - unfavorable
What class would a lot of space or too little space between the dentures be?
Class III
What is the ideal ridge form?
square to gently rounded
What is the unfavorable ridge form?
tall, thin, undercut
What is the ideal space for the tuberosities?
5-6 mm (minimum of 4 mm)
If you have bony undercuts is that alright or would you need surgical correction?
Depends!
- unilateral may be OK
- bilateral prolly needs surgical correction
What is a palatal torus?
bony enlargement at midline of hard palate
What percent of the population has palatal tori and who is it most prevalent in?
20-25% of population
more prevalent in women
When is the palatal torus a problem with dentures?
- 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)
What are the problems with mandibular tori?
- extremely susceptible to irritaiton from denture base
- best treatment is surgical removal
What are mandibular tori?
- dense cortical bone covered by a very thin layer of mucous membrane
What is the ideal palatal vault form?
medium depth with well-formed rugae
What are the versions of poor palatal vault form?
- flat = poor resistance to horizontal movement
- high, narrow, deep = rapid break of peripheral seal and poor retention
What are the different classes of soft palate?
Class I - ideal (5-12 mm)
Class II - (3-5 mm)
Class III - (less than 3 mm)
What is the hardest soft palate class to work with?
class III
What are the ideal border attachments?
muscle/ frenum attachments are 10 mm or more from crest of ridge
What are the unfavorable border attachments?
attachments near crest of ridge and may interfere with peripheral seal
What are the major impact areas with the tongue and dentures?
border seal
tooth placement
speech
Where is the normal tongue position?
- Fills floor of mouth
- Lateral borders lie on post. alveolar ridge
- Apex approximates ant. alveolar ridge
What is a retruded tongue?
- 25% of edentulous pnts
- border seal is absent
Saliva plays an important role in denture…
retention
What should you evaluate with existing dentures the patient has?
Phonetics, esthetics, stability, retention, lip support, OVD
What is prosthodontic diagnostic index (PDI)?
a tool that every clinician can use to communicate to colleagues and patients the challenges each patient presents with their unique dental condition
What is the prosthodontic diagnostic index (PDI) complete edentualism checklist?
What are the PDI classification systems?
Class I - straightforward
Class II - denture-supporting anatomy degraded
Class III - anatomy degraded; surgical revision needed
Class IV - most debilitated edentulous condition
