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partial removable > mouth prepartion and master cast > Flashcards

mouth prepartion and master cast Flashcards

1
Q

phase 1 pt tx
relief of?
collection of?
what is cast is made? used for?
develop what plan?
what to do with pt?
occlusion?

A

– Relief of pain & infection= priority
– Collection of diagnostic data= Diagnostic cast, Diagnostic mounting
– Develop treatment plan= Design RPD
– Patient education & motivation
– Occlusal equilibration

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2
Q

phase 2 pt tx
removal of?
extraction of?
surgery?
perio? plaque?
interim prothesis? why?
occlusion?

A

– Removal of deep caries, temporary restorations
– Extraction of non-retainable teeth
– Preprosthetic surgery: tuberosity reduction, etc.
– Periodontal treatment, Plaque control
– Interim prosthesis: function, esthetics
– Occlusal equilibration, may need changes after extractions

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3
Q

phase 3 pt care
endo?
restorative?
occlusion?

A

– Definitive endodontic treatment
– Definitive restorative treatment: Surveyed crowns, if needed and Fixed partial dentures, if appropriate
– Occlusal plane correction

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4
Q

phase 4 of pt tx

A

– Construction RPD

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5
Q

phase 5 tx

A

– Post-insertion care
– Periodic recall
– Continued plaque control

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6
Q

goals of mouth preparation
pain/infection?
caries?
extractions? surgery?
perio/plaque?
occlusion?
endo?
definitive restorations?
enameloplasty?

A

• Relief of pain & infection
• Caries removal
• Extractions, Preposthetic surgery
• Periodontal treatment, plaque control
• Occlusal equilibration
• Endodontics
• Definitive Restorative Treatment:– Amalgams, composites– FPDs, crowns, surveyed crowns
• Occlusal plane correction
• Enameloplasty for RPD GP

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7
Q

Diagnostic Casts roles

A

• Preliminary design of RPD
• Identify tooth modification areas

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8
Q

performing tooth mods?

A

– according to RPD diagnostic cast design
– QA Worksheet

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9
Q

possible enameloplasty in order

A
  1. develop guide planes
  2. enlarge embrasure for minor connectors
  3. lower HOC
  4. create undercuts if needed
  5. rest seats
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10
Q

developing guide planes
proximal
ML
L

A

– Proximal: adjacent to edentulous areas
– ML: stress-release clasps ML minor connector
– Lingual: reciprocal clasp

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11
Q

considerations of lowering the HOC

A

– Proximal 2/3 Circumferential retentive clasp
– Reciprocal clasp
– Lingual Guide Plate

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12
Q

confirming mouth preparations

A

• Alginate Impression(s)/Snapstone Cast(s)
• Survey interim casts
• Confirm that preparations are parallel to path of insertion in the following sequence:
1. Prepare guiding planes
2. Enlarge embrasures for minor connectors
3. Reposition the survey line to reduce interferences to framework placement and enable most ideal clasp placement
• Confirm that survey line lowered enough

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13
Q

Undercut Preparation

A

• Used when slightly insufficient retentive undercut
• Sloped buccal &/or lingual surface, procedure contraindicated: reconsider other areas for undercut or surveyed crown

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14
Q

when is placing an undercut prep indicated

A

slightly insufficient retentive undercut with vertical buccal & lingual surfaces

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15
Q

how is the retentive undercut prepped

A

Preparation with round-ended tapered diamond

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16
Q

when are rest seats made

A

After adequate preparation for GP, Survey line alterations

17
Q

Checking the adequacy of occlusal/embrasure rest seats:

A

– Patient close into beading wax
– Measure thickness of wax (Caliper)
• At least 1mm

18
Q

what if yu cannot obtains adequate depth in enamel of the tooth for the rest seat

A

• Remove small amount of opposing tooth structure
– Be sure to remake impression of opposing arch

19
Q

Master Cast: Class III RPD impression techniques
does the ridge provide support in these cases?

A

• Residual ridge not provide RPD support

• Alginate/stock tray

• Alginate/custom tray

• Custom tray/elastomeric material
– Preferred technique UMKC
– Not border molded
– Medium-bodied PVS

20
Q

Master Cast: Distal Extension RPD Impression
ridge support?
captures? why?
how should force be distributed?
allows increased?
less frequent?

A

• Residual ridge important source of RPD support
• Important to accurately record maximum tissue support area– Broad-stress distribution concept
• Distribute occlusal forces over as many teeth & as much soft tissue as possible
• Not overload teeth or tissue
• Increased stability & retention
• Less frequent reline

21
Q

The Problem with Tooth-Tissue Supported RPDs:

A

•The periodontal membrane allows for 0.25 +/- 0.1 mm and the muco-periosteum allows for 2.0 + mm movement

•Due to the lever effect of the distal extension base, occlusal pressure is concentrated on the distal end of the base

22
Q

The Solution for Tooth/Tissue Supported RPDs
equalize support from?
distributing load?
base movement?

A

• Equalize support derived from tissue and teeth
• To distribute load to both the natural and artificial dentition & minimize base movement

23
Q

Master Cast: Extension RPD Impression techniques

A

• Custom tray/elastomeric material
• Corrected (Altered) Cast technique

24
Q

Custom tray/elastomeric material technique for master casts

A

border molded tray, one step

25
Q

• Corrected (Altered) Cast technique for distal extended cases basic steps

A

– Two-step (Dual) impression
• Step one: Impression of teeth & residual ridge
• Step two: Impression of residual ridge areas using framework

26
Q

Master Cast: Altered Cast Impression step 1

A

• Step one: Impression of teeth & residual ridge
– Alginate/stock tray or Alginate/custom tray
– Framework fabricated on 1st cast
• Framework less precise than with elastomeric impression

27
Q

Master Cast: Altered Cast Impression step 2

A

• Step two: Impression of residual ridge areas only
– Sectional trays added to framework
– Border-molded
– Elastomeric material

28
Q

creation of the altered cast

A
29
Q

errors of the altered cast approach

A

•Lift of distal framework during residual ridge impression
•Framework on final cast not oriented the same as in the mouth

30
Q

one step and two step cast techniques compared

A

• Leupold, Flinton, & Pfeifer, JPD, 1992
–Compared one-step border-molded custom tray/elastomer impression & altered cast impression technique
– Concluded clinically insignificant difference in the vertical displacement of final RPD between the 2 techniques
– One-step technique less prone to operator error than altered cast procedure

31
Q

one step custom tray impression, making the tray
which cast is used?
method?

A

• Fabricate tray on working / diagnostic cast
• Apply separating medium to cast– Liquid foil (not vaseline)
• Tray extensions:– 2-3 mm coronal to vestibule depth in both dentate &
edentulous areas
• Wax spacer placed over tray outline
– ~3 mm over teeth (red rope wax)
– ~1.5 mm over residual ridge (baseplate wax

32
Q

tray stops in custom tray making (one-step technique)

A

– 3 widely spaced openings in wax spacer
• 3 mm openings
– Tripod support for tray
– Use teeth NOT contacted with rests
– Residual ridge stops similar to complete denture tray

33
Q

custom trays and aluminum foil

A

Aluminum foil over wax spacer (not vaseline)
• Triad tray material adapted over foil/spacer
• Polymerize

34
Q

finger rests of the custom tray, why?

A

Add finger rests to tray surface over edentulous areas
– Stability during impression
– Strengthen tray
• Distal tray areas prone to fracture
• Narrow, flat residual ridges
• Add handle

35
Q

when to determine final tray extension, how is this done?

A

• Determine final tray extension at impression appointment
– PIP tray flanges: extension & outer surface
– Do border molding movements
– Areas where PIP removed, shorten or thin tray

36
Q

border molding the custom tray
where?
materials?

A

• Border mold distal extension residual ridge areas
• Elastomeric impression material
– Polysulfide: High tear strength, pour within 1 hour
– PVS: Hydrophobic, adequate tissue detail

37
Q

making the master cast with second impressions

A

• Box impression
• Pour with improved dental stone

38
Q

surveying the master cast
determining Poi?
marking Hoc?
marking the undercut?
what to do once all this is done?

A

– Determine path of insertion
• Guide planes parallel, Equalize undercut

– Mark abutment height of contour
• Facial & Lingual

– Measure & mark retentive undercut
• RED line
• NOT red DOT
• Approximate inferior edge of clasp

• Tripod lateral sides of cast

39
Q

Lab Prescription
requires?

A

• Surveyed cast
• Work authorization– Lab RX
• Send to QA for approval
• Send to Lab
• Framework fabricated

partial removable (14 decks)

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