Pros Flashcards

1
Q

What does RPI stand for

A

Rest on mesial surface
Proximal plate distally
Gingivally approaching I bar Clasp

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2
Q

Mechanism of action for RPI

A

Mesial rest acts as axis of rotation.
Proximal plate rotates downwards, I bar clasp rotates mesially around axis of rotation.
During occlusal loadplate and clasp disengage from tooth/ undercuts .:. preventing potentially traumatic torque.

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3
Q

How would you assess the position of an unknown unerupted tooth?

A

would use separate radiographic views

opt and PA/ occlusal

Use SLOB rule w/ parallax technique
same lingual, opposite buccal
wherein if the object moves same way as tube shift is lingually placed

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4
Q

XLA Risks pt with osteoporosis (6)

A
pain
swelling
bruising
infection
mandibular fracture 
MRONJ
Dry socket
Nerve damage
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5
Q

Outline your approach for an overdenture with a partially erupted tooth (12)

A
retention
stability
support
occlusion- fws, ovd, rvd
extension
appearance - shade and mould
neutral zone
relief for p.e tooth
soft lining
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6
Q

Measurements required for lingual bar

A

8mm

4mm height
3mm from gingival margin
1mm from base of functional sulcus of FoM

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7
Q

Name the method of producing dentures of same specs to old dentures

A

Replica technique

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8
Q

Methods of adjusting fit of current dentures

A

Reline
Rebase
Remake

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9
Q

Factors needing checked at try in stage

A
midline
occlusion
shade + mould of teeth
position of teeth
lip support 
extension 
canine line
incisal line
buccal corridors
pt opinion
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10
Q

Define retention

A

Resistance to vertical displacing forces

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11
Q

Define stability

A

Resistance to horizontal displacement

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12
Q

Name 3 ways in which an upper complete denture is retained

A

Muscular
Adhesion/Cohesion
Peripheral/ marginal seal, post dam

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13
Q

What is meant by biometric guidance of tooth placement

A

Teeth to be placed in pre-extraction sites
Maxillary teeth placed buccally to ridge
Mandibular teeth placed on ridge - .:. palatal cusps of U teeth occlude with fossa of L teeth
- allows appr. force displacement
- reduces tongue restriction for lowers when placed on ridge

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14
Q

aetiology of denture stomatitis (3)

tx (6)

A

poor denture hygiene- .:. fungal infection + plaque accumulation
leaving dentures in at night
immunocompromised pt

denture hygiene instruction
tissue conditioner
CHX MW
antifungal agent prescribed
new dentures when health restored
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15
Q

How do you restore freeway space in worn dentures?

A

occlusal pivots

restore occlusal surface with autopolymerising acrylic resin

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16
Q

What problem can occur with a complete upper denture occluding with partial lower denture?

why does this occur

A

combination syndrome resulting in flabby ridge

forces direct on upper anterior region leading to excessive and rapid alveolar bone loss in region, this is replaced by excess FIBROUS tissue

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17
Q

How would you fabricate dentures for a pt with flabby ridge? (2 techniques)

A

need mucostatic impression techniques to record ridge at rest

  1. 2 stage impression technique
    1st imp taken in medium body PVS, cut out material around area of FR. 2nd imp taken in light bodied PVS
  2. window technique- window cut out of impression tray to allow for flow of impression material0 leaving ridge undisplaced
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18
Q

Define Kennedy Class 2 Mod 1

A

Unlateral free-end saddle, with one bounded saddle

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19
Q

Define Kennedy Class 4

A

bounded saddle crossing midline

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20
Q

Define Kennedy Class 1 Mod 2

A

Bilateral free-end saddles, with one bounded saddle

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21
Q

Define Kennedy Class 3 Mod 1

A

two bounded saddles

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22
Q

System of design for partial dentures

A
outline saddle areas 
support
retention
stability
reciprocation 
connector

OSRSRC

23
Q

Give 2 max and 2 mand connectors, with pros and cons

A

maxillary plate/strap :) thin :( large palatal coverage
maxillary bar :) less mucosal coverage :( thick

lingual bar :) away from gingiva :( not well tolerated
lingual plate :) thin- better tolerated :( difficult to keep clean

24
Q

Define support

A

Resistance to occlusally directed loads

25
Q

Define indirect retention

how is it provided

A

Resistance to rotational displacement forces.

provided by supporting components
e.g a rest used to prevent distovertical rotational displacement forces. usually placed 90 degree from axis of rotation. Used in cases of free end saddles.

26
Q

Give 3 types and examples of retentive factors

A

Mechanical - clasps/ guide planes

Muscular - buccinator, obicularis oris

Physical - cohesion/ adhesion

27
Q

Name and describe classification for ridges.

A

Alwood and Howell’s

I. Dentate
II. Post- XLA
III. Broad
IV. Knife edge
V. Flat
VI. Submerged
28
Q

What is a knife edge ridge

A

where rapid resorption of the buccal and lingual alveolar bone has resulted in hard bony presentation with thin layer of gingiva overlying

29
Q

Give 3 reasons for a knife edge ridge

A

immediate dentures
periodontitis pre XLA
traumatic surgery to XLA

30
Q

How to manage a knife edge ridge in dentures

A

soft liner

SURGICAL REMOVAL of bony prominences

31
Q

What is the difference between soft liner and tissue conditioner?

A

soft liner- used for healthy gingiva as cushioning/shock absorber in relines or in cases of knife edge ridge/bony prominences

tissue conditioner- used in unhealthy/ulcerated gingiva to aid healing and dissipate load

32
Q

What is a functional impression?

A

where tissue conditioner applied to denture, pt to wear denture 24 hours in function. brings back and sent to lab for reline

33
Q

how to check retention clinically

A

pull on premolar region to see if displacement

push on anteriors to test post dam

34
Q

how to improve retention of dentures (not remaking)

A

reline
rebase
implant retention
precision attachments (if partials)

35
Q

Describe process of making copy denture

A

consent & explain
clean & sterilise dentures
need 2x large stock trays per denture
apply adhesive to inside surface of one tray, outside of other.
mix lab putty. apply to inside of first tray and lay denture occlusally down onto putty. mould putty up within 2mm of denture edge
place VASELINE AND LOCATION NOTCHES to aid removal
apply putty to fitting surface of denture and place 2nd stock tray outside surface down onto this
bind and allow to set
remove dentures, clean, return to pt
send to lab for wax copies
can use as master impressions, take with light bodied PVS, take jaw reg here too.
carry on as normal after

36
Q

label features of mand and max

A

in onenote doc ‘important’

37
Q

Signs and symptoms of an incorrect OVD (5)

A

tmd aggravation
pain mandibular muscles
clicking when eating
occlusal wear in RPD

38
Q

Microbe involved in denture stomatitis

give 5 virulence factors of this microbe

A

candida albicans

germ tube formation
extracellular enzymes
adhesion
acidic 
phenotype switching
39
Q

Tx plan for denture stomatitis

A

denture hygiene advice: remove at night, clean with toothbrush over sink of water, soak for 20mins in alkaline peroxide/sterodent, then store in water overnight

antifungal meds:

topical: miconazole, nystatin, CHX
systemic: fluconazole, itraconazole

40
Q

Where should your post dam be?

A

hamular notch to hamular notch
along vibrating line - junction of hard and soft palate
1-2mm in front of palatine fovea

41
Q

What is the distal extension of a lower complete denture?

A

2/3rd RETROMOLAR PAD

42
Q

Why is the buccal shelf used for support?

A

non-resorbable

43
Q

What anatomical features can you use to set the incisors?

A

incisive papilla- 1cm anterior to
philtrum- use as midline
lip line at rest - incisal edge should show 1-2mm when lip at rest

44
Q

What 4 variables make up the shade?

A

value
chroma
hue
translucency

45
Q

Give the average horizontal bone loss for

a) incisors
b) canines
c) premolars
d) molars

A

6
9
10
13

46
Q

Advantages of immediate dentures?

A
pt aesthetics and psychological benefit
maintain face height
provide lip support 
prevent soft tissue collapse
transitional aid
haemorrhage control
47
Q

Disadvantages of immediate dentures?

A

fit poor due to resorption
need relining or rebasing
no trial stage
difficult with surgical xla

48
Q

Write a prescription for special trays for U and L complete dentures

A

Please construct U and L special trays in light cure acrylic. Upper with 2mm spacer and extraoral handle. Lower with 1mm spacer and intraoral handle and finger rests in premolar region.

49
Q

define: reciprocation

A

a plate or non-engaging clasp arm that can resist the force placed on tooth during seating of denture.
resisiting tip action of clasp moving over bulbosity during seating motion.

rpd is passive once seated but active during seating

50
Q

3 possible disadvantages of giving a pt an RPD

A

plaque trap - > enhanced prevention
clasps impinge on aesthetic zone - > need sensitive denture design
denture stomatitis - > denture hygiene advice

51
Q

ideal craddock classification and why?

any negatives of this classification

A

tooth borne

occlusal load transmitted through pdl
protects mucosa from trauma
greater support
greater retention
more comfortable
improved stability

:( expensive + difficult to modify

52
Q

effects of loss of teeth

A

function -

- mastication difficult as loss of teeth affects posselts envelope, icp lost
- speech  - sibilant sounds rely on tooth contact

dentition

  • drifting
  • loss of lip support
  • loss of alveolar bone

general

  • eating
  • aesthetics
  • psychological impact
53
Q

indications for tooth and mucosa bourne

A
  • free end saddles - reduced number of teeth

- 3+ missing teeth in one area- large saddles