PROS- Complete Dentures Flashcards
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Labial frenum
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The buccal suclus
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The Rugae area
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Hamular notch
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Palatine fovea
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The vibrating line
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Maxillary tuberosity
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The Palatine raphe
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The labial sulcus
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The incisive papilla.
What is the hamular notch used for in a denture?
This is the ideal site of the distal border of the denture- This helps with the posterior seal.
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The retromolar pad
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The Mylohyoid ridge.
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The lingual sulcus.
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The lingual frenulum.
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This is the buccal shelf.
What is the relevance of the retromolar pad for complete dentures?
This is a triangular soft pad of tissue used to provide support.
What is the retromylohyoid space?
The area at the distal end of the lingual sulcus posterior to the mylohyoid space.
What is the Cawood and howell classification used for ?
This is used to classify the type of ridge.
What is the ideal ridge classification for our denture patients?
Broad alveolar process.
What is the disadvantage of a knife edge ridge classification?
This is painful for the patient because the load goes on the knife edge.
How does resorption affect the alveolar ridge.
Upper width decreases.
Lower width widens.
Anterio-posterio - upper resorbs backwards .
Anterior-posterior lower resorbs more vertically.
Compare Support, Stability and Retention.
Support- Resistance to vertical movement towards the tissue
Stability- Resistance to horizontal movement
Retention- Resistance to displacement in a vertical direction .
What areas in the maxilla provide support for complete dentures?
Hard palate and residual ridge. (the alveolar ridge after bone resorption)
What areas in the mandible provide support for complete dentures.
Retromolar pad
Buccal shelf
Residual ridge.
How do we achieve a border seal for the denture?
Extension of the denture flanges & incorporation of the post dam.
How do you test the retention of a complete denture?
By pulling the anterior teeth away from the tissue.
How do we test the stability?
Placing your fingers on the occlusal surface and trying to rock the denture from side to side.
Why is a lower denture with dentate uppers unsatisfactory?
Due to the reduced retention of the lowers and the increased load from the upper natural teeth.
What is the stage on a prescription card?
This is what you want the technician to do and what you want back
What is the date on the prescription card?
This is when you want the work done for.
What determines the spacing in the special trays?
Depends on the material used for the master impression.
Alginate
3mm.
Silicone/polyether
upper 2mm.
Lower 0.5-1mm
What is border moulding?
This is adding a material to the outside periphery of the trays to fill the functional sulcus e.g. greenstick/ silicone/ wax
What are stops?
Used to ensure we have the correct thickness of impression material.
Using what materials can we make stops and compare the thickness of these materials?
Silicone- 1mm thick stops
Alginate- 3mm thick stops.
Where are stops located in the upper tray ?
In the canine and post dam regions.
Where are stops located in the lower tray?
Retromolar pad and the canine area of the ridge.
What can we use greenstick for and why?
- To border mould
- To temporarily modify the pt’s old denture to check that the modifications that we want to make will improve the denture (make it fit better)
When you try in the upper record block during the registration visit it doesn’t stay in place- What could be causing this?
If there is overextension of the peripheries
If there is too much lip support.
How do we adjust the upper record block?
Name and explain
Lip support- mark lip line
Incisal level- mark incisal edge
Midline- mark centre line
Buccal corridor- mark canine line
Occlusal plane-
Check occlusal plane & interpapillary line are parallel
Check occlusal plane and alatragal line are parallel.
LIMBO
Why do we mark the lip line?
So that we know how much of the tooth is shown in order to choose the correct height of teeth for the denture.
Where should the anterior teeth be positioned?
8-10mm anterior to the incisive papilla
What is the incisal plane and what should it be?
This is the level of the incisal edge.
This should be parallel with the interpupillary line.
Where does the buccal corridor start?
At the mid-canine line
To find the mid-canine line- Take floss from the inner corner of the eye and drop it down to the nose and then the canine.
Discuss the link between dental arch and buccal corridor.
The broader the dental arch, the smaller the buccal corridor.
The narrower the dental arch, the more obvious the buccal corridor.
How do we measure the occlusal plane?
Using fox’s biteplane and a wooden spatula.
What are we looking for when checking the occlusal plane?
The occlusal plane and interpapillary line are parallel.
The occlusal plane and ala tragal line are parallel.
What is the neutral zone and discuss it’s importance.
Neutral zone- the area with minimum force acting on the tooth.
The denture will be loose if the teeth are not positioned in this neutral zone.
What is the ideal denture width and why?
The base of the denture should be wider than the top
This means that the tongue can help push the denture down into position.
How do we measure the vertical dimension?
We can use:
Dividers- and select two points in the midline of the face (sites of minimal influence from the muscles of facial expression)
Willis bite gauge- Fixed metal arm should be placed under the nose. The flexible arm should rest below the chin.
Compare the RVD and the OVD
How do we position the patient in these.
How does a previous denture affect the positioning?
RVD- the vertical dimension at rest
OVD- the vertical dimension in occlusion.
RVD- get the patient to lick their lips and say m.
OVD- get the patient to place their tounge at the roof of their mouth and bite together. (RCP)
If they have a previous denture- they should wear the upper for RVD measurement and wear both the upper and lower for OVD measurement.
What is the freeway space?
The RVD-OVD.
What size is the freeway space normally and what can cause an increase in the freeway space?
Normally 2-4mm.
Tooth wear can increase the freeway space
What is this and what do we use it for?
The alma gauge.
Used to determine the vertical and horizontal position of the anterior teeth relative to a point in the denture base (incisive papilla)
What is the data transfer line A-A on the cast?
The centre line.
What is the data transfer line B-B on the cast?
The central incisor plane.
What is the data transfer line C-C on the cast ?
This is the residual alveolar ridge contour.
What is the data transfer line D on the cast?
This is the canine line.
Why do we limit the time the denture sits in the mouth during the try in stage?
Because we are using a denture made of wax- which can melt if left in the mouth for too long.
How do we know if the denture is overextended?
It will drop if you move the lips or manipulate the tissues around the denture.
This is because it requires too much lip support.
How do we know if the denture is underextended?
It will drop if you hold the tissues away from the denture.
How does a high occlusal plane impact the denture?
The tongue will be cramped, making the denture unstable.
Describe the contacts of a complete denture?
There should be working side and non-working side contacts.
*We are aiming for the same as a normal occlusion*
What do the clicking noises mean when the patient is trying in the wax denture?
There is tooth contact- which is caused by too high an OVD creating too small a freeway space?
During the try in stage, you have asked the patient to make an sss sound and you hear whistling. What does this mean?
The OVD is too small.
What is the Post Dam?
A lip on the back of the denture used to provide a better peripheral seal.
Why is it beneficial to cut a double post dam?
This means you will still get a good seal even if you need to reduce the denture size.
Label A, B and C.
A-Fit or impression surface.
B- Polishing surface
C-occlusal surface.
How can we adjust occlusal interferences?
We can use selective grinding where you adjust the contacting surfaces using articulating paper
*
Remember contacts= BULL (BUCCAL upper and LINGUAL lower)
or we can re-measure the occlusion.
What is the difference between a wax rim and a record block?
Wax rims and record blocks are the same thing.
How do you test a patient’s neuromuscular control?
Put your finger in their mouth and ask the patient to bite down.
Look at the movement of the tongue.
The posterior part should elevate to hold the upper teeth in place.
The lateral border of the tongue should try and prevent the lower denture slipping.
Summarise the visits for a complete denture patient
- Assessment
- Impressions
- Master impressions.
- adjustment of Record block
- Tooth trial
- delivery
Compare the two types of compound.
Red compound is used for saddle areas when taking primary impressions.
Greenstick compound is used for border moulding and adjustments at the retromolar area.
What is a soft lining material?
How does it work?
Why do we need it?
This is material applied to the inner surface of the denture which has similar features to the mucosa.
It absorbs energy by deformation to reduce the energy absorbed by the surrounding tissues.
Alveolar bone loss results in a reduction of the mucosal thickness. This Diminishes the shock absorption effect.
What is a tissue conditioner?
A short term soft lining material e.g. Coe Comfort/ Visco-Gel.
How do we adjust the record block for OVD?
Insert the upper and lower record blocks.
Check that the heels are not in contact in the mouth.
Reduce the lower wax rim in height until it contacts the upper rim evenly (in occlusion at the planned OVD)
Describe what happens in the registration visit?
