Lecture 1-Intro and Anatomical Landmarks Flashcards by Austin Shackelford

What happens in the first visit? (2 clinical & 2 lab)

Clinical: Exam & impressions Lab: Diagnostic Casts and Custom Trays

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What happens in the 2nd visit? (2 clinical, 2 lab)

Clinical: Boarder Molding & Final Impression with custom trays Lab: Master Casts and Record bases

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When doing the occlusal wax rim, what is the height of the maxillary rim from vestibule to rim?

22mm

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When doing the occlusal wax rim, what is the height of the mandibular rim from vestibule to rim?

15-18mm

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Which facial landmark can give us the occlusal plain?

Inter pupillary line

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What is the purpose of a face bow? What relationship does it give us?

To mount the maxillary cast to the articulator…..relationship of the maxillary arch to the TMJ

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What information do we use to mount the mandibular cast?

Centric Relation

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What happens in the 3rd visit? (3 clinical, 1 lab)

Clinical: Adjust record base, take face bow, and get CR record. Lab:mount master cast using record bases

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What happens in the 4th visit? (1 clinical, 1 lab)

Clinical: Esthetic try-in Lab:Remount if needed

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What happens in the 5th visit? (2 clinical, 1 lab)

Clinical: Clinical Remount and delivery lab: remount

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What happens in the 6th visit? (1 clinical, 1 possible lab)

Clinical: adjustment where sore spots exist…lab:remount if needed

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When examining the tonsilar region, the soft palate, and the oropharynx what are the two key landmarks to evaluate for retention of the denture?

hamular notch and the tuberosities

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The first sign of cancer is often a palpable _______ in the neck.

lymph node

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What is a highly compressible and

displaceable soft tissue seen in the ant. residual ridge of the max. or the mand?

Denture FIBROMA

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What is a massive roll of hyperplastic

tissue which extend from the ant. residual ridge to the oral vestibule in the maxilla?

EPILUS Fissuratum

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The 􏰀_________􏰁 is caused when an edentulous maxilla is opposed by a partially dentate mandible (anterior dentition).

Combination Syndrome

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WHERE does bone resorption mainly occur in combination syndrome?

the “premaxillary” area (canine to canine)

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What are the 3 consequences of combination syndrome?

1.Resorption of the pre maxilla 2.hypertrophy of the maxillary tuberosity and 3.Occlusal plane problems

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If there is a widespread INFLAMMATION over the denture-bearing mucosa, it will recover quickly by removal of the denture for __-__ days or by the use of a tissue conditioning material.

2-3 days

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PAPILLARY HYPERPLASIA is secondary to ill-fitting _______ dentures and is sometimes complicated by chronic ________.

maxillary….candidiasis

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Therapy of papillary hyperplasia?

Topical anti fungal and possible surgery

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Is papillary hyperplasia pre-cancerous?

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______ hyperplasia begins as a traumatic ulcer secondary to an ill-fitted denture flange.

Fibrous

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Chronic irritation leads to inflammatory fibrous hyperplasia (__________).

epulis fissuratum

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How long does tissue conditioning material last?

2-3 weeks (do not soak them!)

What drug do we use to Tx Chronic Candidiasis?

Clot-Rim-Azole TROCHES

How long should dentures be out of the Pt mouth EACH day?

6-8 continuous hours

Where is a common place to see Lichen Planus manifested?

buccal shelf area

Which type of Diabetes results in compromised support and impaired tolerance of complete dentures?

Type I Diabetes

What type of LESIONS are chronic ulcerations with subsequent scarring of the oral mucosa?

Pemphigoid lesions

Without physiological levels of tension in the opposing dentition and WITH non-physiologic compression of the ridge: the result is:

RRR-Residual Ridge Resorption

***Maxillary RRR loss is in the _______ and ______ direction***

VERTICAL and PALATAL

***Mandibular RRR loss is in the _______ and oriented along the _______ shape of the mandible***

vertical and cross-sectional shape of the mandible

About how much RRR is happening on the maxillary? (___mm/year)

0.1mm/year

***Mandibular bone resorption is __x the amount of maxillary bone resorption***

_______ is Resistance to VERTICAL displacement of the denture away from the denture bearing surface during function.

RETENTION

________ is Resistance to LATERAL displacement of the denture during function.

STABILITY

________ is Resistance to vertical forces of OCCLUSION. Factors of the bearing surface that resist or absorb occlusal loads during function.

SUPPORT

The more ________ attached mucosa available on the denture bearing surfaces, the better the support.

keratinized

What is the impact of Residual Ridge Resorption on retention, stability, and support?

All three are negatively impacted.

What are the three ways we can prevent or mahhginally disrupt resorption?

1.well adapted dentures w/ correct occlusion 2.retention of residual tooth roots in key locations 3.use of IMPLANTS

What are the two material choices we can use to take preliminary impressions?

1.Modeling Compound 2.Alginate

What color modeling compound is used for taking edentulous impressions?

RED

______- folds of mucous membrane and do not contain significant muscle fibers. ______ attachments (closer to the crest of the ridge) will compromise denture retention and may require surgical excision.

Frenum..HIGH

Labial _______ - when it is properly filled with the denture flange greatly enhances stability and retention.

vestibule

_________ - This bony eminence provides denture support, prevents a denture from rotating and improves denture stability.

Canine eminence

________ - Is a pad of fibrous connective tissue overlying the orifice of the nasopalatine canal. Pressure in this area will cause a disruption of blood flow and impingement on the nerve, causing the patient to complain of pain or a burning sensation. The denture should be relieved over this area.

Incisive papilla

****_______ - is an important primary denture support area. It also provides resistance to HORIZONTAL movements of the denture.****

TUBEROSITY

****Posterior _____ ______ area - distal to the junction of the hard and soft palate at the vibrating line.****

palatal seal

______ - raised areas of dense connective tissue in the anterior 1/3 of the palate. This area resists ANTERIOR displacement of the denture and is a SECONDARY support area.

RUGAE

***CRITICAL***_______ - this narrow cleft extends from the tuberosity to the pterygoid muscles. The pterygomandibular ligament attaches to the pterygoid _____ which is a thin curved process at the terminal end of the medial pterygoid plate of the sphenoid bone.

Hauler Notch...hamulus

_________ - the patient is instructed to open wide, protrude and go into lateral movements. The width of the distobuccal flange will then be contoured by the anterior border of this.

Coronoid process

________ – two small pits or depressions in the posterior aspect of the palate, one on each side of the midline, at or near the attachment of the soft palate to the hard palate and slightly posterior to the termination of the denture.

Fovea palatina

____________ - located in the posterior third of the hard palate the tissue is very glandular and displaceable. The impression surface may appear irregular as the glandular secretions displace the impression material.

Minor salivary glands

Ideal Maxillary Ridge- "_____" arch and the palate is "__" shaped in cross section

square arch...U shaped (not V!)

_________ - limited inferiorly by the MENTALIS muscle, internally by the residual ridge and labially by the lip.

Labial vestibule

________ - elevates the skin of the chin and turns the lower lip outward. Dictates the length and thickness of the labial flange extension of the lower denture.

MENTALIS muscle

**_______ - is a SECONDARY support area. High rate of resorption when excessive pressure is applied to this area.

Alveolar ridge

*******________- bordered externally by the external oblique line and internally by the slope of the residual ridge. This region is a PRIMARYYYYYYY stress bearing area in the mandibular arch.******

BUCCAL SHELF

The ________ line and the crest of the ________ form the boundaries of the buccal shelf

external oblique....alveolar ridge

Access to the BUCCAL SHELF is determined by the attachment of the _______ muscle.

buccinator!

******One constant, relatively unchanging structure on the mandibular denture bearing surface is the pear shaped _________ ...A PRIMARY SUPPORT AREA!!!!*****

Retromolar PAD

The bone beneath this pear shaped landmark does not resorb secondary to the pressure associated with denture use!!!

RETROMOLAR PAD

WHAT ARE THE 3 MAIN Mandibular Support areas? Which is MOST susceptible to bone resorption?

1.Retromolar Pad 2.Buccal Shelf 3.Alveolar process...the alveolar process...DUH!

________- a ridge of dense bone from the mental foramen, coursing superiorly and distally to become continuous with the anterior region of the ramus. This line is the attachment site of the buccinator muscle and an anatomic guide for the lateral termination of the buccal flange of the mandibular denture.

external oblique line

___________ the anterior exit of the mandibular canal and the inferior alveolar nerve. In cases of severe residual ridge resorption, the foramen occupies a more superior position and the denture base must be relieved to prevent nerve compression and pain.

MENTAL FORAMEN

_________ - the action of the masseter muscle reflects the buccinator muscle in a superior and medial direction. The distobuccal flange of the denture should be contoured to allow freedom for this action otherwise the denture will be displaced or the patient will experience soreness in this area.

Masseter Groove

____________ - present on the anterior surface of the mandible and serve as the attachment sites of the genioglossus and geniohyoid muscles. In patients􏰂 with severe ridge resorption the geniotubercles may cause discomfort if they are exposed to the denture base.

Geniotubercle (Mental Spines)

_________ - overlies the genioglossus muscle, which takes origin from the superior genial spine.

Lingual frenum

_________ - formed by the superior surface of the sublingual glands and the ducts of the submandibular glands.

Sublingual Folds

_________ Function in elevation of the hyoid bone and the larynx and depression of the mandible.

Suprahyoid Muscles

________ muscle - forms the muscular floor of the mouth. Arises from the mylohyoid ridge of the mandible. *****Determines the lingual flange extension of the denture.

Mylohyoid muscle

On the mandible....Palpate the ______ ridge to determine its contour, sharpness and degree of undercut!!

mylohyoid

***The ________ (lies at the distal end of the alveolingual sulcus) is very important for denture stability and retention on the mandible****

retromylohyoid space

How long do you wait to separate your cast from your impressions?

45min-1hour