insertion, checks and maintenance Flashcards
What are patient related faults?
Systemic disease
~Parkinson’s, dyskinesia, hormonal
Local pathology
~atrophy, fibrous replacement, undercuts, anomalies, torus palatini
What are lab related faults?
Tech faults
~investment- weak plaster=tooth movement
~processing- ‘flash’ excess acrylic, shrinkage at post dam, air bubbles=surface defects
Careless damage to model
What are clinician related faults?
Debonding at primary impressions
Full sulcus depth not recorded
Inaccurate registrations
How do you inspect the fitting surface for rough surfaces?
Visually Gloved hand ~if sharp Cotton wool test ~if sticks or dislodged when brushed against
How should the dentures be placed?
- Inspect fitting surface
- Insert- correct faults
- Check occlusion- correct faults
- Fitting surface- remove pressure spots
- Security- correct faults
How do you check the occlusion?
Maybe use articulating paper
Manipulate into centric relation
If ICP is not = RCP, problems can occur
How do you transfer a pre-centric check record to the lab?
Put a small amount of wax or silicone on the molar teeth
Manipulate into centric relation just before the first contact of any teeth
Records an indentation
How might the dentures be modified to increase the occlusal contacts?
Deepen the fossae, don’t reduce the cusp height
How do you adjust lateral excursive movements?
BULL rule
~buccal upper cusps and lingual lower cusps
How do you check for pressure spots on the fitting surface?
Coltene PSI paste
Quadrant at a time, 4cm length
Equal lengths of green and white=pale green
Mix quickly and applied evenly
Inserted, pressed firmly and border moulding
Where the denture shows through=pressure spots and overextensions
Mark w PSI pencil
Use a correct denture bur to reduce
How do you check for overextensions?
Press a finger on the denture in the mouth
Pull on the cheeks and lips
If denture moves=overextended
How do you correct an inadequate post dam?
Autopolymerising acrylic resin to create functional post dam
What should you do if the patient has pain when wearing the dentures?
Reassure- normal in the first week
Make an appt for the following week
They should wear it all the time
If they have to take it out, they must wear for 24hr prior to appt
Under promise and over deliver
May have a common mouth ulcer in post dam region- be sympathetic as v painful
How does the patient clean the dentures?
Mechanical and chemical
Bring to review appt to ensure they’re following instructions
Vital to prevent denture stomatitis
Don’t excessively soak or use bleach either
Should a patient use denture fixatives?
Yes, keep denture still during function and prevent food stagnation
