PROS- Clinical stages of RPD

Question 1

What are the visits required for a denture patient?

Answer 1

Assessment and primary impressions

Master impression

Framework trial

Tooth trial

Fit

review

Question 2

What are you looking for in an examination of the patient’s mouth?

Answer 2

Ridge form (can tissue be displaced)

free end saddles

bounded saddles

Undercuts

Question 3

Compare edentate trays to dentate trays.

Answer 3

Edentate trays are shallower than dentate trays for patients without teeth

Question 4

What material(s) are used for an impression with free end saddles?

Answer 4

Alginate and compound

Question 5

What material(s) are used for an impression without free end saddles?

Answer 5

alginate

Question 6

How do we take a compound impression?

Answer 6

The compound takes an impression of the saddle areas.

Any compound impressions containing teeth should be cut away.

Question 7

What is the alginate wash?

Answer 7

This is a thin layer of alginate that is applied over the compound to take the full impression.

We use an adhesive to attach the compound to the alginate.

Question 8

How do we prepare an impression for the lab?

Answer 8

The impression is disinfected in perform for 10 minutes.

It is then placed in a bag with wet cotton wool to prevent the alginate from drying out.

Question 9

Summarise what happens in visit 1?

Answer 9

We examine the patients mouth

Take the primary impression

Measure the occlusion.

Question 10

What do you do once the lab produces the primary cast?

Answer 10

You check if you can hand articulate the primary cast or not.

If you can hand articulate the cast, then you can begin the denture design & request the special tray design.

If you cannot hand articulate the cast then we need primary record blocks to record the patient’s jaw registration .

Question 11

What do you need to do before the second visit?

Answer 11

Survey the cast- find undercuts and alter path of insertion

Decide if any modifications are needed (rest seats/ guideplanes/ undercuts)

Draw the design.

Question 12

Compare the different choices for impression materials:

Answer 12

Medium bodied silicone (do not want the patient swallowing this)

Polyether (very rigid so you don’t want to use it with undercuts)

Alginate (good with undercuts)

Impression compound (used for saddle areas)

Question 13

How do we take the master impression?

Answer 13

1. Try in the special tray and trim it if the tray is over extended
2. Modify the tray with compound for the free end saddles
3. Apply adhesive to the special tray and use chosen material to create the impressions.
4. Disinfect the impression material.

Question 14

What instructions should you give the technician if you are producing a cobalt chrome denture?

Answer 14

The model should be poured in improved stone.

Chrome framework should be produced.

Question 15

What instructions should you give the technician if you are producing an acrylic denture?

Answer 15

The model should be poured in stone

A record block with an arylic base should be produced.

Question 16

Describe the 3rd visit

Answer 16

This is a framework trial.

You check the framework

You record the patient’s occlusion using record blocks.

Question 17

What do you check with the framework?

Answer 17

Does the framework fit the cast?

Does it seat correctly?

Is the cast damaged at all?

Does the framework interfere with occlusion?

Question 18

Why do we record the occlusion?

Answer 18

To help design the denture

To help the technician set up the teeth

To ensure stability of the denture and patient comfort

Ensure loading forces are correctly applied to the teeth.

Question 19

What instructions and information do you give the technician after visit 3?

Answer 19

Instructions: To articulate your casts to registration so you can complete a tooth trial

Information:

• The type of articulator you want your cast aligned on.
• To articulate your casts to registration so you can complete a tooth trial.
• where you want the artifical teeth to be positioned.
• The shade of artificial teeth needed.
• How the teeth occlude.

Question 20

What happens in visit 4?

Answer 20

We check that the denture and false teeth are up to scratch. If not, the denture is sent back to the lab.

Question 21

What are you checking for in the tooth trial?

Answer 21

Does the framework fit?

Are there any occlusal contacts?

Is the denture aesthetic?

Question 22

What happens in visit 5 ?

Answer 22

The finished denture is delivered by the lab.

You check the denture on the articulator and in the patient.

You instruct the patients about the denture.

Question 23

What are you looking for in the denture on the articulator?

Answer 23

Is the design as requested?

Is there any roughness or bubbles on the denture?

Does the denture seat properly?

Are there any broken teeth on the cast (this would provide undercuts )

Is the pin on the table of the articulator?

Does the occlusion look correct?

Question 24

What are you looking for in the denture on the patient?

Answer 24

Stability- Does the denture seat properly? (Don’t force it)

support-Are the rests and flanges sitting accurately?

Retention- do the clasps need adjusted?

Aesthetic- what does the patient think?

Occlusion- do the teeth meet in the prescribed occlusion and are there any heavy contacts?

Question 25

What instructions do you give a denture patient?

Answer 25

• That the denture will need to be worn in
• That it will affect speech and eating
• How to clean the denture
• Refer the patient to the clinic patient leaflet.

Question 26

What happens in visit 6?

Answer 26

The patient is reviewed in order to find out how their denture is.

You take a pain history of the denture and examine it before adjusting if neccesary.

Question 27

What is the difference between impression compound and greenstick?

Answer 27

Impression compound is used for modification of the trays during the first impressions- if there are free end saddles.

Greenstick compound is used to modify the special trays.