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BDS4 CDS Restorative, Pros & Endo > Pros: All Tutorials > Flashcards

Pros: All Tutorials Flashcards

1
Q

RELINES AND REBASES

Describe a reline.

A

Adding new base material to tissue surface of existing denture in a qualtity sufficient to fill space that exists between original denture contour and altered tissue contour.
Mostly done chairside.

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2
Q

RELINES AND REBASES

Describe a rebase.

A

Replacing the entire denture base material of an existing denture.
Mostly done by the lab.

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3
Q

RELINES AND REBASES

What are the three types of relines ?

A

Temporary, soft, permanent.

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4
Q

RELINES AND REBASES

When would a temporary reline be appropriate ?

A

When grossly ill fitting denture - tissue conditioning prior to new defintive denture construction.
Post immediate dentures.
After implant surgery.

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5
Q

RELINES AND REBASES

Name a brand of temporary reline material.

A

Coe-Comfort.

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6
Q

RELINES AND REBASES

When are soft relines used ?

A

Parafunctional habits.
Very atrophic ridges.
Cancer/cleft patients for obturator construction.
Denture-related hyperplasia - settle condition until provision of new denture.

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7
Q

RELINES AND REBASES

What is the main problems with soft relines ?

A

Plasticizer leaches.
Deteriorates with time.
Harbours microorganisms.

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8
Q

RELINES AND REBASES

What are four types of soft lining materials ?

A

Heat cured acrylic.
Self cured acrylic.
Heat cured silicones.
Self cured silicones.

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9
Q

RELINES AND REBASES

What material is used for permanent relines ?

A

Hard acrylic.

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10
Q

RELINES AND REBASES

When might a permanent reline be suitable ?

A

Peripheral seal problems.
Correction of errors following inadequate master impressions.
Immediate/post-immediate dentures.
Prolonging life span of older dentures.

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11
Q

RELINES AND REBASES

Describe the clinical procedure for rebasing dentures prior to sending to the lab.

A
  1. Remove undercuts from denture.
  2. Wash impression taken using closed mouth technique.
  3. Denture taken to the lab.
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12
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

COMPLETE UPPER DENTURE WITH LOWER NATURAL TEETH
What are the consequences of this ?

A

High forces developed against upper maxillary edentulous ridge.

Leads to trauma (ulceration, discomfort), instability of denture, alveolar resorption and fibrous tissue replacement (flabby ridge).

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13
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

Describe a fibrous ridge. And what are the problems associated with it in denture design ?

A

Alveolar ridge resorption and fibrous tissue replacement, where lower anteriors have been the last teeth to be lost.

Fibrous tissue can be displaced, can compromise retention/support of the denture - causing tipping of prosthesis.

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14
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

Describe ‘combination syndrome’ features (Kelly 1972).

A

Accelerated maxillary anterior alveolar bone loss.
Fibrous tissue replacement i.e. papillary hyperplasia.
Appearance of hypertrophy of tuberosities.
Possible extrusion of mandibular anterior teeth.

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15
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

Describe some ways of reducing trauma to maxillary denture bearing area (avoid development of fibrous ridge where possible).

A

Maximise coverage of denture bearing area.
Ensure prosthesis covers the primary load bearing sites.
Use overdenture abutment roots to maintain alveolar bone level.

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16
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

In what 4 ways can you improve the stability of a maxillary denture if opposing natural teeth ?

A

Optimal border seal

Effective post dam

encourage patient to wear lower RPD and correct irregular occlusal plane

Manage incisal overbite.

Articulation in eccentric movements of mandible - even contacts on both sides of the arch.

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17
Q
A
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18
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

At what clinical stage of denture design, can you achieve the best border seal possible ?

A

Master impression stage with border moulding.

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19
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

What is the benefit of encouraging a patient to wear a lower RPD with their complete maxillary denture ?

A

Prevent breaking posterior border seal, better occlusal plane and better stability. Prevents denture from falling down at the back.

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20
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

Why always ask for two post dams to be placed on upper complete dentures ?

A

Put two - on vibrating line between hard and soft palate and one further forward, if patient cannot tolderate without retching, can be cut back.

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21
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

Where does posterior post dam sit ?

A

On vibrating line - junction between soft and hard palate - compressible tissue.
Helps with retention.

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22
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

How can an irregular occlusal plane on natural teeth be managed ?

A

No adjustments - accept problems.
Minimal localised occlusal grinding.
Radical occlusal adjustment.
Extraction of teeth.
Overlay appliances.

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23
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

Complete lowers with upper naturals OR complete upper with lower naturals - what is more complex ?

A

Complete lowers with upper natural teeth - more significant trauma to lower ridge is seen.

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24
Q

COMPLETE DENTURES OPPOSED BY NATURAL TEETH

For complete lowers opposed by natural uppers, what can be done to prevent trauma and resoprtion of lower ridge ?

A

Soft linings.
Implant retained dentures.

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25
# REPAIRS AND ADDITIONS OF DENTURES What are some reasons for denture fracture ?
Impact. Acrylic thin in section. Work hardening of metal. Parafunctional habits. Deep overbite. Soft linings. Porosity in denture processing. Bonding between tooth and acrylic.
26
# REPAIRS AND ADDITIONS OF DENTURES SIMPLE REPAIR - your patient comes into the practice with denture midline fracture and the two pieces can be relocated together - how would you manage this situation ?
Send both parts to lab. No impression required. Cast poured. Fractured area removed. New acrylic processed.
27
# REPAIRS AND ADDITIONS OF DENTURES PIECE OF DENTURE MISSING - patient comes into the practice with part of acrylic flange lost - how would you manage this situation ?
Take impression with fracture denture in mouth. Disinfect. Cast poured. New acrylic processed into defect.
28
# REPAIRS AND ADDITIONS OF DENTURES Your patient comes into your practice with loss of an acrylic tooth from their denture - how would you manage this situation ?
If patient has tooth - it can be rebonded with self cure acrylic. If patient does not - might need to match shape and mould and cut denture down for tooth to fit. Is there repeat failures ? Ask why ? Is occlusion wrong or failure in tooth to acrylic bond - might have to redesign denture.
29
# REPAIRS AND ADDITIONS OF DENTURES What two materials can be used for temporary repairs ?
Self cure acrylic. Cyanoacrylate glue.
30
# REPAIRS AND ADDITIONS OF DENTURES What are some strengtheners which can be used in denture repair ?
Wire mesh. Glass fibre mesh. SS wire.
31
# PATHOLOGY RELATED TO DENTURES What are the three causes of pathology related to dentures ?
Acute or chronic reactions to microbial denture plaque due to poor denture hygiene. A reaction to consisituents of denture base material - due to allergy. Mechanical denture injury due to ill-fitting dentures.
32
# PATHOLOGY RELATED TO DENTURES Give some examples of pathological changes associated with dentures.
Ulcers. Denture stomatitis. Angular chelitis. Denture irritation hyperplasia. Flabby ridges. MRONJ/ORN. Allergic reactions.
33
# PATHOLOGY RELATED TO DENTURES What are the signs/symptoms of denture stomatitis ?
Erythema and oedema of denture bearing area.
34
# PATHOLOGY RELATED TO DENTURES What microbe is the cause of denture stomatitis ?
Candida albicans.
35
# PATHOLOGY RELATED TO DENTURES How should denture stomatitis be managed ?
Take denture out at night. Clean with soft brush. Steep denture 1-2 weekly. Use nystatin or antifungal on denture base. Can use chlorhexidine. Might be appropriate to give new denture.
36
# PATHOLOGY RELATED TO DENTURES What are the possible causes of denture stomatitis ?
Poor denture hygiene. Underlying issues - diabetes, folate, B12, ferritin.
37
# PATHOLOGY RELATED TO DENTURES What is the cause of angular chelitis in denture patients ?
Loss of OVD or excessive freeway space. Related to old worn dentures. Consider underlying problems - diabetes, folate, ferritin, B12, xerostomia, polypharmacy.
38
# PATHOLOGY RELATED TO DENTURES How should denture related angular chelitis be managed ?
Replace denture with correct OVD. Use topical miconazole.
39
# PATHOLOGY RELATED TO DENTURES What microbes are related to angular chelitis ?
Candida albicans. S. Aureus. Beta-haemolytic streps.
40
# PATHOLOGY RELATED TO DENTURES What is the cause of denture irritation hyperplasia ?
Very old ill-fitting dentures causing chronic trauma. Causing hyperplastic response.
41
# PATHOLOGY RELATED TO DENTURES How should denture hyperplasia be managed ?
Ease of denture. Tissue conditioner (Coe Comfort). Review and repeat if requires. Make new denture. OR removal of hyperplastic tissue if excessive by OS and make new denture.
42
# PATHOLOGY RELATED TO DENTURES What is the cause of flabby/fibrous ridges ?
Trauma of denture of anterior ridge opposed by lower anteriors with no posterior support and no lower denture.
43
# PATHOLOGY RELATED TO DENTURES What is the solution to managing a flabby/fibrous ridge ?
Produce new denture covering whole denture bearing area with good peripheral seal - double post-dam. AND Opposing arch denture with posterior support. Perforated tray or tray with anterior window - reduces displacement of tissues - to get more accurate impression.
44
# PATHOLOGY RELATED TO DENTURES What is the causes of denture-related MRONJ/ORN ?
Continual irritation of ill fitting denture on mucosa in patient with history or currently taking anti-resorptive drugs or having previous radiotherapy.
45
# PATHOLOGY RELATED TO DENTURES How should potential MRONJ/ORN patients be managed who wear dentures ?
Regular oral health checks. Prevention by creating well fitting dentures. Immediate referral to Max-Fax if MRONJ or ORN is suspected (SDCEP guidelines).
46
# PATHOLOGY RELATED TO DENTURES What denture constituents are most likely to cause allergic reactions ?
Nickel. PMMA.
47
# PATHOLOGY RELATED TO DENTURES Patient presents with erythema and oedema of denture bearing area (following outline of denture) - what is the possible differential diagnoses ?
Allergic reaction. Denture stomatitis.
48
# PATHOLOGY RELATED TO DENTURES What sites of the mouth are most commonly affected by denture-related traumatic ulceration ?
Lingual frenum. Mylohyoid ridge. Undercuts.
49
# PATHOLOGY RELATED TO DENTURES What are the possible causes of denture-related traumatic ulceration ?
* Overextension. * Sharp edges. * Occlusal trauma.
50
# COMBINING DENTURES AND CROWNS AND BRIDGEWORK How can crowns/bridgework be modified to aid denture design ?
Precision attachments. Survery lines. Rest seats. Anterior bridges to avoid single tooth saddle.
51
# COMBINING DENTURES AND CROWNS AND BRIDGEWORK What are the main benefits/disadvantages of precision attachments ?
Better retention and stability. OH harder to maintain. Technical difficulties. Difficult to repair/replace.
52
# MEDICAL PROBLEMS RELATED TO DENTURES What is the consequences of xerostomia ?
Caries. Retention difficulty. Pain. Discomfort. Associated mucosal disease.
53
# MEDICAL PROBLEMS RELATED TO DENTURES What are the potential causes of xerostomia ?
Polypharmacy. Anti-depressants. Sjorgens syndrome.
54
# MEDICAL PROBLEMS RELATED TO DENTURES What is the consequences of anaemia related to dentures ?
Increased risk of candida and angular chelitis. Pain and discomfort.
55
# MEDICAL PROBLEMS RELATED TO DENTURES What are some causes of tremors ?
Parkinsons. CVA. Huntington's disease.
56
# MEDICAL PROBLEMS RELATED TO DENTURES What are the denture-related consequences of treating a patient with a tremor ?
Stages of denture construction can be difficult. Jaw registration. Aim for simple treatment plan. Insertion and removal.
57
# MEDICAL PROBLEMS RELATED TO DENTURES Name some anti-resorptive agents.
Bisphosphonates - alendronic acid. RANKL inhibitors - denusomab. Anti-angiogenic - bevacizumab.
58
# MEDICAL PROBLEMS RELATED TO DENTURES Define frailty.
State of increased vulnerability to poor resoltuion of homoeostasis after stressor event (NICE). Examples - low energy, slow walking speed, reduced strength.
59
# MEDICAL PROBLEMS RELATED TO DENTURES What are the denture-related concerns about treating a frail person ?
* Falls. * Hospital/care home admission. * Attending appointments. * Maintaining good denture hygiene. * Lost dentures. * Losing weight resulting in poor denture retention. * Reduced neuromuscular control.
60
# DENTURES AND PERIODONTITIS PATIENTS What are the benefits of treating a periodontitis patient with a denture ?
Good transition to edentulism - easy to add to.
61
# MANAGEMENT OF RETCHING PATIENT What is retching ?
* Physiological mechanism. * Involuntary contraction of muscles of soft palate or pharynx. * Involuntary reaction to foreign objects in going into airway.
62
# MANAGEMENT OF RETCHING PATIENT What part of the brain controls retching ?
Medulla oblongata.
63
# MANAGEMENT OF RETCHING PATIENT What are the two types of retching ?
Psychogenic. Somatic.
64
# MANAGEMENT OF RETCHING PATIENT Describe psychogenic retching.
Sight, smell or sound of dental surgery or thought of impression.
65
# MANAGEMENT OF RETCHING PATIENT Describe somatic retching.
Touching trigger zones. Common trigger zones - palatoglossal and palatolpharyngeal folds, base of tongue, palate, uvula, posterior pharyngeal wall.
66
# MANAGEMENT OF RETCHING PATIENT What aspects of denture construction does retching interfere with ?
Impression taking. Jaw registration. Tolerating dentures. Retention.
67
# MANAGEMENT OF RETCHING PATIENT How can a retching patient be managed in the dental surgery ?
Identify problem. Identify trigger zones. Anxiety reduction - relaxation. Patience and empathy.
68
# MANAGEMENT OF RETCHING PATIENT What distraction methods can be used in management of retching patient ?
Wiggle their toes. Talk to patient. Raise their leg. Press on temple. Close eyes. Rinse mouth with water before impression.
69
# MANAGEMENT OF RETCHING PATIENT What densensitiation techniques can be used in management of retching patient ?
Homework of touching trigger points in their mouth. Swallowing with mouth open.
70
# MANAGEMENT OF RETCHING PATIENT Impression taking stage - how can this be modifyed for the retching patient ?
Modify stock trays. Lower trays in upper arch. Rapid setting impression materials for reduced exposure time.
71
# MANAGEMENT OF RETCHING PATIENT Denture design - what considerations should you give to this stage where managing a retching patient ?
Do they really require a denture - do they have a SDA ? Can bridges/implants be used ? Horse shoe palate design. Shortening palatal extension. Use of double post dam. Consider no second molars on prosthesis.
72
# MANAGEMENT OF PATIENT EXPECTATIONS Effective communication - what % of communication is body language, tone of voice and words ?
Body language 55%. Tone of voice 38%. Words 7%.
73
# OCCLUSION FOR PARTIAL DENTURES Describe ICP.
Tooth position. Complete intercuspation of opposing teeth independent of condylar position.
74
# OCCLUSION FOR PARTIAL DENTURES Describe RCP.
Guided occlusal relationship occuring at most retruded position of condyles in mandibular fossa. Most reproducible mandibular position.
75
# OCCLUSION FOR PARTIAL DENTURES Define index teeth.
Contacting facets of teeth in ICP.
76
# OCCLUSION FOR PARTIAL DENTURES When do you record in ICP ?
Need sufficient index teeth. Stable occlusion. Conforming occlusion. Can vary through life. Depends on tooth relationships. Sometimes more anterior than RCP (1-2mm).
77
# OCCLUSION FOR PARTIAL DENTURES When do you record in RCP ?
Insufficient index teeth. Unstable occlusion. Changing occlusion. Most reproducible position. Sometimes more posterior than ICP (1-2mm).
78
# OCCLUSION FOR PARTIAL DENTURES What three materials can be used for recording intercuspal record ?
Bite registration paste. Wax wafer with modelling wax. Modified wax wafer with Alminax.
79
# OCCLUSION FOR PARTIAL DENTURES When are record blocks required ?
When insufficient idex teeth, unstable occlusion.

BDS4 CDS Restorative, Pros & Endo (13 decks)

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