Lecture 7-visits 5 and 6...delivery, checks, and remounts Flashcards
QUICK! What are the 8 steps after processing? (begin with processing)
1.processing 2.LAB remount 3.VDO 4.Facebow Jig 5.Separate from master casts 6.polish 7.make remount casts 8.articulate the maxillary remount cast using jigq
Objective of visit 5: To provide the patient with a complete denture prosthesis that is in physiologic ______ with the oral environment
HARMONY :)
Before seating CD
• Wash the prosthesis w/____ and water
• Disinfect the prosthesis (_____ for 10 minutes)
• Check for any _____ projections, blebs or rough areas that would injure the patient
• Check over/under extension and thickness
• External surfaces should be smooth and _______
soap…Birex…sharp…polished
What is the internal surface of the denture called?
IN-TAG-LI-O surface
What do you have the patient bite on when checking the Pressure Indicating Paste (PIP)? For how long?
cotton rolls for 2 min
How do you remove PIP?
EtOH gauze
Which area do you actually want some pressure on the mandible?
DL undercut…major retention area
What do you use AFTER PIP to check for over extensions?
disclosing wax
What do you take the CR with when doing a clinical remount?
AluWax or ZnOE paste (zinc oxide eugenol)
Can you adjust the dentures in the patient mouth if you see a occlusal hinderance when delivering the final denture?
NO NO NO NO
What are the two appointments when you can do a clinical remount?
Visit 4-Esthetic Try-In and Visit 5-Delivery
Pt Edu: Forewarn patient about fullness sensation, excessive _______/gradually subside
SALIVATION
Pt Edu: Difficulty in _______ ESPECIALLY the “__” sounds /Reading aloud
speaking…”s”
Pt Edu: _____ tongue position (to maintain the border seal and stability)
forward
Pt Edu: Make diet recommendations and suggest to cut food in small pieces/place it ______ and chew in an up and down motion
bilaterally
Pt Edu: Soak dentures in ______ solution ( HOW MUCH? sodium hypochlorite per ____ oz. of water)
bleach…0.5 TEASPOONS of NaClO per 8 oz h2o
Pt Edu: Brush the denture w/denture brush, do not use ________, ridges and palate should be brushed w/soft toothbrush
toothpaste (leaves denture grainy/sandy)
Pt Edu: Remove CD from mouth for _______ hours during the day/at night
6-8 hours
Pt Visit #6…“The ___ hour visit”
24 hour
Visit 6-Listen to patient’s complaints and ______ check referred areas…EVEN if Pt says they are OK :)
visually
Visit 6- use ___ paste and look for _______ on the soft tissue
PIP paste….erythemia (ulcerations)
If there are lots of hang ups on Visit 6- Instruct patient not to use denture(s) for ___ to ___ hours depending on severity of lesion(s)
6 to 24 hours
If lesions are present indicate patient to rinse his/her mouth with _______ or ______ solution (___ tsp. of it in ___ oz of warm water)
warm water OR saline…(0.5 tsp./8oz)
Visit 6- with sore spots Appoint in ___-___ hours after initial placement and reappoint in ___-___ months
48-72 hours…6-12 months
Is DEAFNESS a possible complication in Visit 6?
YES! WTF??
IMMEDIATE DENTURES!!! how long do you wait after EXT of posterior teeth?
4-8 wks
Immediate Denture Challenges Increased ________ of clinical procedures
complexity
Immediate Denture Challenges Limited ________ of trial denture
evaluation
Immediate Denture Challenges ________ patient DISCOMFORT
increased
Immediate Denture Challenges ________ denture maintenanc
increased
Immediate Denture Challenges _________ treatment cost
increased
Immediate Denture Advantages Promotes better _______ and _______ form
healing and ridge form
Immediate Denture Advantages Prevents _______ of facial musculature
collapse
Immediate Denture Advantages _______ patient adaptation to dentures
hastens
Immediate Denture Advantages ________ patient embarrassment
prevents
Immediate Denture Advantages ________ patient health
promotes
Immediate Denture Advantages Provides a guide for optimal individualized patient _______
esthetics
Immediate Denture Advantages Provides a guide for _____
VDO
Immediate Denture Treatment Sequence 1st Clinical Appointment
Exam & preliminary impressions..Lab procedures - custom tray fabrication
Immediate Denture Treatment Sequence 2nd Clinical Appointment
Master impressions…Lab procedures - master cast, record base & occlusion rim fabrication if indicated
Immediate Denture Treatment Sequence 3rd Clinical Appointment
Maxillomandibular relation records, and tooth selection…Lab procedures - wax trial denture fabrication if indicated
Immediate Denture Treatment Sequence 4th Clinical Appointment
Wax trial denture try- in (confirm mounting & esthetics) if indicated…..Lab procedures - process dentures
Immediate Denture Treatment Sequence 5th Clinical Appointment
Extractions & denture insertion, adjust tissue surface &
flanges, adjust occlusion & care instructions
Immediate Denture Treatment Sequence 6th Clinical Appointments
24 hour post-insertion checks, adjust dentures & reinforce care instructions
Immediate Denture Treatment Sequence 7th and 8th clinical appt..
72 hr and 1 week post-insertion checks, adjust dentures, clinical remount and reinforce care instructions
What is the key for making the custom tray around present teeth when doing immediate dentures?
2 layers of wax over the present teeth will give room in the tray for them
Why is it important to remove all the wax from your custom tray after fabrication?
the impression material will not adhere to it and will distort!
How long before the master impression do you make the custom trays?
24 hours
What is the most commonly used final impression material combination for immediate dentures?
modeling compound and rubber base
How can we make sure the impression doesnt pull the patient’s teeth during the final impression?
put wax in the embrasures!
BOXING-mark the impression __-__mm above the peripheral roll
3-4mm
WHAT IMPRESSION MATERIAL DO YOU USE when there is CONSIDERABLE tooth misalignment and mobility?
ALGINATE!!
What do you need to do to the tray when taking your final impression with alginate?
Punch hella holes in that bitch
What are the two PRECAUTIONS when using alginate for your final impression?
1.requires more VIGEROUS border movements 2.pour immediately
If the Pt has Inadequate teeth to support the bite registration material ________ and _______ is necessary for CR record
Record base and wax rim
Correction of lower anterior ________ involves marking a reasonable incisal position on the stone teeth.
supra eruption!
What do we make if the EXTs or tori need to be relieved by O.S.?
A surgical guide…
Do we need to clean the teeth before the immediate denture delivery?
YES…get rid of inflammation!
Do you need to do a clinical remount at the immediate denture delivery appt?
NO…can do this at 72/1wk check!!
Immediate denture instructions: Keep denture in for __hrs and ____ your patient in the evening!
24…call!!
When do you do a clinical remount of an immediate denture?
72hr-1wk appt
How long does soft liner last? How much space is needed?
2-4 weeks…1-2mm
