Pros Tutorials Flashcards
What is ICP?
The complete intercuspation of the opposing teeth independent of condylar position.
What is RCP?
Guided occlusal relationship occurring at the most retruded position of the condyles in the joint cavities
What is retruded axis position?
The axis the mandible rotates around when the condyles are in their most posterior position.
What are index teeth?
Contacting facets of teeth in ICP
How does ICP differ from RCP?
Requires index teeth
Stable occlusion
May vary through life
Depends on tooth relationships
Typically more anterior than RCP
How does RCP differ from ICP?
Insufficient index teeth
Unstable occlusion
Most reproducible position
Is a condylar position
Typically more posterior than ICP
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.
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.
When are record blocks indicated?
When there are insufficient index teeth to record the bite
What methods are there for obtaining an interocclusal record in a patient with sufficient index teeth?
Bite registration paste
Wax wafer
Modified wax wafer
What forms can record blocks come in?
Wax
Wire strengthener
Co/Cr
Shellac base
What can be used to register occlusion with record blocks?
Melted wax
Bite registration paste
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
How do you get a patient their resting face height?
Get them to lick their lips and say the letter ‘‘M’’.
How do you measure FWS?
RVD - OVD
What should the ideal FWS be?
2-4mm
What is meant by the term OVD?
The superior-inferior relationship of the mandible-maxilla, when in maximum intercuspation.
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
