Pros Tutorials Flashcards by Harry Wheeler

What is ICP?

The complete intercuspation of the opposing teeth independent of condylar position.

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What is RCP?

Guided occlusal relationship occurring at the most retruded position of the condyles in the joint cavities

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What is retruded axis position?

The axis the mandible rotates around when the condyles are in their most posterior position.

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What are index teeth?

Contacting facets of teeth in ICP

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How does ICP differ from RCP?

Requires index teeth
Stable occlusion
May vary through life
Depends on tooth relationships
Typically more anterior than RCP

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How does RCP differ from ICP?

Insufficient index teeth
Unstable occlusion
Most reproducible position
Is a condylar position
Typically more posterior than ICP

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What does the term conforming to occlusion mean?

Works best in a stable occlusion with sufficient index teeth.

We aren’t changing the current occlusion, and our prosthesis isn’t altering the occlusion.

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When is changing the occlusion indicated?

When there is a lack of sufficient index teeth

Often use RCP as its reproduceable.

Occlusion may be more challenging to record.

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When are record blocks indicated?

When there are insufficient index teeth to record the bite

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What methods are there for obtaining an interocclusal record in a patient with sufficient index teeth?

Bite registration paste
Wax wafer
Modified wax wafer

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What forms can record blocks come in?

Wax
Wire strengthener
Co/Cr
Shellac base

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What can be used to register occlusion with record blocks?

Melted wax
Bite registration paste

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What steps can be taken to guide the patient into a retruded axis position?

Get them to curl their tongue to the roof of their mouth as they close

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How do you get a patient their resting face height?

Get them to lick their lips and say the letter ‘‘M’’.

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How do you measure FWS?

RVD - OVD

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What should the ideal FWS be?

2-4mm

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What is meant by the term OVD?

The superior-inferior relationship of the mandible-maxilla, when in maximum intercuspation.

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What are the main modifications that can be made to dentures?

Modification of survey lines with composite

Precision attachments

Two-part denture/swinglock for altered path of insertion

Modifications for bruxsists

What are the benefits for two part dentures?

Useful for tissue loss and complex paths of insertion.

What modification can be made for teeth with a lingual tilt?

A buccal bar

What modifications can be made to dentures for patients with bruxism?

Metal backing to teeth
Metal occlusal surfaces
Acrylic post dam for retention

What are the main components of an implant?

Crown
Abutment
Titanium implant

What can dental implants restore?

A single tooth
Multiple teeth
Can secure a denture

Outline the road steps in implant placement.

Raise flap
Place implant
Place cover screw
Suture

Outline the broad steps for implant restoration?

Expose implant Place abutment Take imp with coping Choose colour Place temp Fit in final visit

How can a prosthesis be retained with an implant?

Cement Screws Locator abutments Ball abutments Gold bar CAD-CAM titanium bar

List FOUR common post implant treatment complications.

Peri-implant mucositis Peri-implantitis Loose/fractured components Late implant failure

What is the role of the GDP in managing implant patients?

OHI Triage and diagnosis of complications Referral to specialists

What is required for maintenance of dental implants?

Optimal plaque removal around implants Monitor peri-implant tissues Perform radiographs when clinically indicated.

Should implants be used for BPE?

No, however their own probing depths should be monitored.

What is peri-implant mucositis?

Inflammation around the implant with no crestal bone loss.

What is peri-implantitis?

Inflammation with suppuration around the implant, with significant crestal bone loss.

How can you perform PMPR on an implant?

Hand scaling Ultrasonic with specialised tips

What is the consequence of using standard ultrasonic tips on implants?

Can damage the coating of the implant Can cause cementation of crown to fail Can disturb osteointegration

What is retchinng?

Physiological mechanism Involuntary contraction of the soft palate or pharynx Modified by medulla oblongata

What are the main types of retching?

Psychogenic (Sight, smell, sound, thought) Somatic (Touching of trigger zones)

What problems does retching pose in pros?

Impression taking issues Jaw reg issues Toleration of dentures Denture retention issues

How do you manage retching?

Identification of problem Identify trigger zones Anxiety reduction Patients and empathy

Describe some distraction techniques for managing retching in a patient?

Talking to them Concentrate on raising leg/wiggling toes Tap their temple Close eyes Salt on tongue

Describe some desensitization techniques for managing a patient with retching?

Repeated stroking of anterior palate with finger Homework of brushing their palate Swallowing with mouth open

What aspects of denture design can be altered to help a patient who retches?

Thin palatal coverage Multiple post dams to cut back if needed Cusps can be rounded to not stimulate tongue Consider no 2nd molars Horseshoe plate

What is the rough proportion of people who are dissatisfied with their dentures?

10-30%

What are the main reasons a patient is dissatisfied with their denture?

Retention and stability Tends to be lowers more than uppers Tends to be partials more than completes

What aspects of a patients oral biology may impact denture success?

Severely resorbed ridges Flabby ridges Tori Prominent mentalist muscles High muscle attachments Pain on ridge palpations