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Partial Dentures > Framework > Flashcards

Framework Flashcards

1
Q

4 types of tissue blockout

A
  1. parallel blockout
  2. arbitrary blockout
  3. ledges
  4. 22 and 30 gauge relief
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2
Q

who is responsible for the design of the partial denture

A

YOU - the dentist

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3
Q

purpose of parallel block-out relief wax

A

protects the path

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4
Q

purpose of the arbitrary block-out relief wax

A

protects the TISSUE

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5
Q

purpose of the ledges block-out relief wax

A

for clasp location

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6
Q

purpose of the 22 and 30 gauge block-out relief wax

A

for ACRYLIC – (under mesh-work), approach arms and lingual major connectors

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7
Q

ledges are placed where for C clasp?

A

DIRECTLY UNDER the drawings - because when duplicated to refractory cast we do NOT have the drawings anymore so ledges will guide us to where they need to be

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8
Q

ledges are placed where for RPI clasp?

A

placed along SIDE of the drawing

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9
Q

tissue stop does what two major things

A
  1. only part of the distal extension meshwork that contacts the tissue
  2. the only part of the denture that predicts how accurately the acrylic will contact the tissue
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10
Q

position of the tissue stop?

A

always forward of the RMP

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11
Q

what do you use to make tissue stops

A

created with the 30 gauge wax

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12
Q

refractory cast?

A

DUPLICATE of the final cast

*final cast is duplicated in investment –> refractory cast

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13
Q

where is the wax up done on?

A

refractory cast

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14
Q

after wax up is done, next step?

A

the wax up is sprued, invested and cast

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15
Q

what is done and what is the order of these tasks prior to duplicating the final cast?

A
  1. DRAW design and frame-work on the final cast
  2. Parallel and arbitrary block-out is completed
    (parallel = guide planes so PROTECTS PATH)
    (Arbitrary = protects TISSUE)
  3. ledges for clasps are waxed in
  4. relief for acrylic and metal is done
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16
Q

what is needed to make a tissue stop

A

a whole in the relief wax

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17
Q

what happens to whole in relief wax for tissue stop?

A

after casting –> converts this space into a POSITIVE metal stop in the framework

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18
Q

how you know partial is sitting well on mandible and maxilla?

A

Maxilla - Major connector *** because it also seats on the tissue + the TISSUE STOP

Mandible

  • ONLY TISSUE STOP
  • because major connector is not touching tissue like it does on the palate of the maxilla
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19
Q

where do you place maxillary tissue stops?

A

also placed in distal extension areas

- can decrease canteliver effects

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20
Q

altered cast impression technique cannot be used where?

A

NOT POSSIBLE on MAXILLARY frameworks

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21
Q

material used for final cast

A

poured with STONE

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22
Q

material used for refractory cast

A

poured in CASTING investment

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23
Q

describe the creation of the refractory cast

A

comprised of INVESTMENT

it is a DUPLICATE of the final cast with RELIEF WAX ADDED

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24
Q

sprue pin?

A

creates a pathway for the molten alloy to go into

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25
Q

minor connectors need which wax?

A

parallel blockout

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26
Q

arbitrary block-out placed where?

A

near the free gingival margin

protecting the tissue - so where we think metal may come into contact and want to protect the tissue

like on the palate if we have some irregular rugae

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27
Q

ledges guide us for what?

A

where we will place the clasp

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28
Q

set up of approach arm where do you place 30 gauge and where do you place 22 gauge?

A

30 –> right before undercut of approach arm
(creates SPACE between approach arm and tissue)

22–> right distal to the approach arm contacts meshwork

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29
Q

tissue stop uses what relief wax? purpose?

A

30 gauge – room for acrylic

acrylicc- mesh-work–acrylic

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30
Q

if tissue stop is off what else is off?

A

OCCLUSION

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31
Q

where is hole placed when making tissue stop?

A

hole is placed in the relief wax on the RIDGE so the position of the tissue stop is just forward of the rise of the retro-molar pad

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32
Q

parallel blockout position in relation to the guide plane?

A

ends JUST BELOW the guide plane

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33
Q

need tissue stops on both maxilla and mandible?

A

MAXILLA
- optional here because of the major connector contacting the palate – depends on the size and rigidty of the maxillary major connector (probably in large distal extensions they are necessary)

MANDIBLE
- REQUIRED – because the mandibular major connector is relieved from mandibular tissue

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34
Q

importance in the junction between waxes

A

must remain SHARP to maintain the FINISH LINE

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35
Q

relief wax gives rise to what?

A

internal finish line

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36
Q

where do you see tooth to fold and where do you see tooth to notch?

A

tooth to fold = lingual

tooth to notch = maxillary

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37
Q

butt joint?

A

90 degrees and is a junction of metal and acrylic where major connector meets denture base preventing leakage at their interface

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38
Q

where is frameowrk high finished and polished?

A

mandibular major connector (tissueside)

approach arms (tissue side)

Tongue side of anything

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39
Q

where is frameowrk medium finished and polished?

A

clasps - tooth side

rests – tooth side

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40
Q

where is frameowrk low finished and polished?

A

meshwork

max major connector (tissue side)

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41
Q

framework accuracy =??

A

fit of RESTS and rest seats

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42
Q

definitive determinate of if partial is fitting

A

if rests seats sit

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43
Q

first five things you check for fitting of frameowrk on cast

A
  1. RESTS
  2. Abrasion
  3. fractures
  4. relief
  5. tissue stops
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44
Q

internal bead check? location implication

A

care should be taken to avoid placing a bead in a non-compressible tissue such as the median palatal raphe or the anterior rugae areas

  • this will prevent rebound of the framework against non-compressible tissues during try-in
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45
Q

purpose and dimension of the internal bead

A

metal margin or bead is .5mm deep

provides intimate tissue contact preventing food from easily dislodging the prosthesis

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46
Q

external finish line dimesnsion

A

90 degrees to crest of ridge and depth of 1mm

butt joint between acrylic and meshwork

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47
Q

tooth to fold internal finish line dimensions and location

A

perpendicular to the crest of ridge (NOT at an oblique angle) it is 1mm deep and at a butt joint

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48
Q

all meshwork ends at?

A

ridge crest

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49
Q

meshwork is required where?

A

only where teeth will be

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50
Q

tooth to notch finish line ends and extends?

A

extends into hamular notch but meshwork and teeth end at tuberosity

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51
Q

tooth to fold meshwork ends?

A

before retromolar pad

52
Q

T/F tooth to notch finish line extends into hamular notch

A

TRUE

- but meshwork and teeth end at the tuberosity

53
Q

all meshwork ends where?

A

at ridge crest

54
Q

T/F guide plane should be contacting tooth

A

YES - with slight space below

55
Q

how to evaluate/ what to look at with clasps

A
  1. position of arms
  2. taper of tips
  3. degree of undercuts
56
Q

where is a good location for the clasp to originate from in combo / or C?

A

middle 1/3 of the tooth from the minor connector

  • dont want it in the occlusal 1/3 as the survey line was likely too high
57
Q

partial denture clasp adjuster

A

used to make minor adjustments to framework CLASPS

enables one to slightly tweak or bend the clasp tip TOWARD tooth only

C-C is brittle (fragile) and can break so do not bend multiple times

wire arms can be adjusted multiple times in multiple directions

58
Q

are you tightening or loosening with the clasp adjuster

A

tightening

59
Q

direction you bend with clasp adjuster

A

tweak or slightly bend the clasp tip TOWARD THE TOOTH ONLY

60
Q

if see that the clasp tip is not touching the tooth what is next step?

A

do NOT tighten it until pt. tries it in…could hit the patient’s tooth and so make sure it needs to be tightened before you do it

so must see this CLINICALLY

61
Q

if cast clasp CLINICALLY touches tooth too tightly what is next step?

A

disk/ rubber wheel the inner aspect of clasp tip and do not bend

62
Q

if one clasp is too tight and one too loose what is next step?

A

disk inside / rubber wheel the tighter one before tightening the other loose clasp

63
Q

where can you NOT bend the arm of any cast clasp

A

from the base/ origin of the clasp

64
Q

T/F you can bend wrought wire toward or away from the tooth

A

TRUE

65
Q

is abrasion seen on cast a problem? where?

A

YES - depends where though

problem at guide plane – may indicate that it is excessively binding in these area and need to be careful when place into patients mouth

NOT a problaem if on facial surface or CLASP TIP (like the 1/3 closest to tip) where clasp is engaging and actively crossing bulge

66
Q

important to have a clas arm taper?

A

YES (if not it is possible for clinician to make this correction)

67
Q

usual cause of a non-tapered clasp tip

A

small wax which was placed to secure wax pattern during casting

68
Q

importance of checking framework on cast against opposing cast

A

to ensure ALL RESTS are NOT overly thick or no bulky solder or weld joints which can interfere with occlusion and increase VDO

69
Q

if survey correct but excessive block out was done? result? what type of error?

A

then the arm will be too far from the tissue and NEED TO RECAST

lab error

70
Q

if survey correct but insufficient block out was done? result? what type of error?

A

then clasp arm will be too close to tissue and need to recast or grind if possible

lab error

71
Q

if survery incorrect (HOC too high/ bulky what is result? what type of error?

A

need to redesign/ re-survey

Clinician error

72
Q

use of wide minor connector

A

if pre-molar has drifted and we want to re-establish proximal contact
- so can use pre-molar as primary abutment AS LONG AS SPACE TO BE CLOSED IS NOT MORE THAN 1-2MM

73
Q

if framework does not seat clinically what are potential reasons

A

binding on a vertical metal component

  • guide plane or
  • minor connector contacting an abutment

excessive bead on maxillary major connector causing rebound

74
Q

use of fit checker

A

used to adjust guide planes and minor connectors and placed where ever metal may be binding

  • where you think it is not seating
75
Q

before you make any adjustments on partial what should you do?

A

check with iwanson gauge and then grind accordingly using heatless stones and finishing carbides

*so always checking the thickness

76
Q

after framework fits what do we check next?

A

check the tissue stops

77
Q

what does the altered cast impression enable for?

A

re-establish relationship of soft tissue of MANDIBULAR distal extensions to framework

*using the tissue stop as the reference
ask if the relationship to the soft tissue really still there

78
Q

space underneath the tissue stop (sits above ridge) likely result of? what do you do?

A

means we probably over compressed the tissue

place compound underneath until get contact and then have to make it permanent

79
Q

if tissue stop is impinging on the ridge? what do you do first?

A

blanching the tissue now
now have to grind the tissue stop until we dont see the blanching anymore

first grind it with a diamond bur

80
Q

if tissue stop not fitting?

A

make trey on meshwork and border mold

  • making new final impression
81
Q

describe Final impression of distal extension

A

getting a new final mucostatic soft tissue impression

cut away the old part of the cast – so removing the distal extensions from the original cast because the new altered cast impression will not fit back on original cast

82
Q

why do you remove the original cast distal extensions

A

cut away with dovetails to increase mechanical retention with beading and boxing

enhances the mechanical retention and altered cast impression will not fit back on original cast

83
Q

altered cast impression can only be done on which arch?

A

MANDIBLE

  • can be done unilaterally or bi-laterally
  • only done on distal extensions
84
Q

outcome of an altered cast impression technique is most predictable when?

A

when there are multiple rest seats present for stability

85
Q

T/F guide plane can be a little off the tissue and stop on the tissue

A

true - because want the guide plane to slide down when patient bites down

86
Q

describe the sequence of problems if tissue stop above the tissue

A

tissue stop above –> acrylic above –> CANTILEVER –> trauma/ tooth loss

87
Q

describe the sequence of problems if tissue stop in the tissue

A

tissue stop blanching –> denture base REBOUND –> HYPER-OCCLUSION –> bone loss

88
Q

if cast fits framework but not patient likely cause? what should you compare?

A

probably a poor impression

compare the final cast with diagnostic cast for more clarity

89
Q

tissue stops must always be visible when?

A

during try in

after processing

90
Q

wax rims added to?

A

framework

91
Q

maxilla height of wax rims

A

anterior to tuberosity and height depends

  • level off to teeth if present
  • parallel to posterior ridge then make adjustments accordingly
92
Q

mandible height of wax rims

A

1/2 to 2/3 height of retromolar pad and anterior to the retro-pad
- based upon the use of flat or curved occlusal plane

93
Q

how do we determine VDO if no posterior contact exists in PD?

A

same way you do for complete dentures

VDR-VDO= freeway space (inter-occlusal rest distance)

sibilants and fricatives

retromolar pad

closest speaking space

esthetics

94
Q

freeway space deterimined by / definition

A

-VDR-VDO= freeway space (inter-occlusal rest distance)

95
Q

use of CR vs MIP in making partial dentures?

A

no posterior contact –> we use CR

stable MIP? –> we use this because it is REPRODUCIBLE

only using MIP if there is a reproducible posterior occlusion

96
Q

MIP is…

A

a REPEATABLE position DEPENDENT on TOOTH CONTACT

97
Q

recording method if no posterior occlusion

A

uses bases and rims with notch vs. aluwax

98
Q

recording method if posterior teeth present but no posterior occlusion

A

use bases and rims with TEETH vs. aluwax

99
Q

recording method if posterior occlusion is good

A

use baseplate wax or hand articulate

100
Q

shorthand

A

shorthand reflects teeth present/absent, not what rules of occlusion are being applied

101
Q

rules if natural anterior teeth and denture posterior teeth

A

Pt. can have incisal guidance and canine guidance and anterior contact in centric

however … posterior must use/ have to mount the case in CR

102
Q

rules if natural anterior on lower only and denture posterior teeth

A

anterior

  • no anterior contact in centric
  • no incisal guidance
  • no canine guidance

posterior
- use CR

103
Q

rules if natural anterior teeth on lower only and natural posterior teeth in occlusion

A

you have to use denture rules in the anterior but may mount the case in MIP in the posterior

**if not stable enough to hand articulate you have to use record bases and occlusion rims

104
Q

what do you use if case not stable enough to hand articulate

A

need to use record bases and occlusion rims (even if you can mount in MIP)

105
Q

treatment of choice for single tooth spaces

A
  1. fixed/implant
  2. facing
  3. tube
106
Q

using facing if

A

severe overbite

severe tissue undercut

minimum resorption / flange not desired

minimum surface area

107
Q

using tube tooth if

A

small space and large tooth

108
Q

other applications for steele’s facing

A

where bone has no resorbed

flange is not wanted

insufficient occlusal clearance

*can use multiple facings for severe overlap and bone sufficient

109
Q

guidelines for choosing tooth size

A

MATCH remaining teeth if possible or select LARGER teeth if the match not possible

110
Q

guidelines for choosing tooth shape anterior and posterior

A

anterior
- match shape of remaining teeth or shape of FACE

posterior

  • match opposing cusp height
  • match shape of remaining teeth or amount of remaining ridge
111
Q

acrylic may oppose what type of denture tooth material

A

can oppose acrylic
can oppose enamel

CANNOT oppose porcelain

112
Q

rules with porcelain as denture tooth material

A

must NEVER OPPOSE ENAMEL

**porcelain anteriors must NEVER be used with acrylic posteriors

***acrylic anteriors may be used with porcelain posteriors if ridge is not resorbed

113
Q

only combination of porcelain and acrylic denture tooth material that is acceptable

A

if ridge is NOT RESORBED … then acrylic anteriors may be used with porcelain posteriors

114
Q

porcelain crown vs porcelaine denture teeth when opposite enamel

A

CROWN
- will have a final glaze following occlusal adjustments which PROTECT ENAMEL

DENTURE TEETH
- cannot be re-glazed following occlusal adjustments and will ABRADE THE ENAMEL

115
Q

major difference of processing in complete and partial dentures

A

entire framework gets embedded into the flask along with the final cast

*in complete there is no frame in the lower 1/2 with the final cast

116
Q

insertion sequence (5)

A
  1. adjust acrylic
  2. adjust occlusion
  3. teach patient ‘path’
  4. give homecare instructions
  5. reappoint for adjustment (Toothe borne vs distal extension–> will need more time )
117
Q

insertion problems regarding metal corrected when?

A

at frame and tooth try in appointment (4th appointment)

118
Q

insertion problems regarding acrylic corrected when? where?

A

WHERE

  • in guide plane undercuts
  • around clasps causing decrease in flexibility
  • in tissue undercuts
119
Q

sequence of adjustments in tissue undercuts

A
  1. posterior first
  2. posterior - evenly
  3. then anterior last
120
Q

what do you use to check tissue undercuts and acrylic against tissue surfaces

A

PIP and sorens paste which is brushed on the intaglio surface
- acrlyic around the clasps, in tissue undercuts, and in the guide plane undercuts then the denture borders

121
Q

when using PIP and seating the denture …rests not in seat.. why?

A

problem is in the acrlyic do not grind the metal

122
Q

if one side of partial seats first what does this mean for removal?

A

seats first – then it comes out last

123
Q

path of insertion implication on placing in patients mouth

A

if had to make adjustments on cast keep this in mind when inserting it in patient

  • fingers underneath the clasps when removing
124
Q

homecare maintenance

A

brush for cleaning

NO TABLETS WITH CHLORINE BLEACH – IT WILL OXIDIZE THE FRAMEWORK

125
Q

if patient has symptoms of pain, sensitivity, and occlusion problem what is the likely reason?

A

tooth changes

  • hyperocclusion
  • malocclusion
  • clasp design or position
  • bracing is less than 180
126
Q

if patient has symptoms of occlusion, borders, internal surfaces, white sores (more new), and red sores (more older) what is the likely reason?

A

tissue changes

  • hyperocclusion
  • malocclusion
  • resorption
  • reline, rebase?
127
Q

during recall appt. for pt. with DE RPD what must you evaluate?

A

ridge resorption, rocking/fulcruming, and a potential need for reline/rebase

Partial Dentures (9 decks)

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