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Prosthodontics > Pros Tutorials > Flashcards

Pros Tutorials Flashcards

1
Q

What are the differnt types of additions we can have to a denture

A

Immediate
Post immediate
Retention

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2
Q

What do we use to retain the acrylic onto cobalt chrome

A

4 META

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3
Q

What of dentures can be used when a paitent has a PMMA allergy and what are some clincal issues with this

A

Nylon based
They are virtually impossible to add to due to weak bonding between the nylon and tooth
They are porous which leads to them absorbing bacteria and saris

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4
Q

What is the initiator in PMMA

A

Benzoyl peroxide

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5
Q

What 5 stages does PMMA go through as it set

A

Sandy - stringy - dough-rubbery - hard

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6
Q

What are 4 advantages of acrylic dentures

A

Cheap
Easy to add to
Technically easier to make
Pink - aesthetic

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7
Q

What are 5 disadvantages of acrylic dentures

A

Low impact resistance
Poor resistance to fracture
Water absorption and candida growth
Allergy to residual monomer
Denture whitening

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8
Q

What are two difficulties of having completes opposed by natural dentition

A

Breaks the seal
High occlusal load and force when its natural uppers and a lower denture - not as much bony support

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9
Q

What is a flabby ridge

A

Following loss of the upper dentition the alveolar bone gets resorbed and is replaced with fibrous tissues

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10
Q

What kind of impression do we want when we have a flabby ridge

A

Mucostatic impression - use a material that isnt going to push against the tissues i.e. light bodied silicone

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11
Q

What are the two kinds of trauma to maxillary denture bearing area when there is a complete upper and natural lower

A

Abuse of soft tissue
- mucous membrane damage
- ulceration and discomfort

Alveolar respotion and fibrous tissue replacement - formation of a flabby ridge

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12
Q

In complete uppers with natural lowers - how can we reduce trauma to the maxillary denture bearing aera

A

Maximise coverage of the denture being area
Ensure the prosthetics covers the primary load bearing sites
Use over over dentures - tooth born support iwll help

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13
Q

When there is complete uppers and natural lowers the stability of the upper denture is comprised
What are ways to improve this

A

Optimal border seal is compromised - so an effective post dam for retention

Try to get a lower denture introduced early so not all force is located on the anteriors and load gets distributed more evently

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14
Q

If we have a knife edge ridge what can be added to the denture and why

A

A soft liner could be added to act as a shock absorber

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15
Q

What are 2 problems with soft linings

A

After 12-18 months they need to be replaced as they loose their plasticity
They are much more porous than PMMA - so they absorb bacteria and stains

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16
Q

What is peri-implant mucositis

A

Inflammation of the peri-implant mucosa with no evidence of crestal bone loss, the tissues will appear red and swollen and may bleed on gentle probing

Reversible condition

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17
Q

What is peri-implantitis

A

Infection with suppuration and inflammation of the soft tissues surrounding an implant - significant loss of peri-implant crestal bone.

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18
Q

What is retching

A

This is an involuntary contraction of the muscle of the soft palate or pharynx modfied by higher centres in the medulla oblongata

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19
Q

There are two types of retching what’s are they

A

Psychogenic ; retching may occur by sight smell or sound of the dental surgery

Somatic ; touching of trigger zones

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20
Q

How do we manage paitents that retch

A

Identification of the problem
Identify trigger zones
Anxiety reduction
Patience and empathy

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21
Q

When would you review an immediate denture

A

A day a week and then a month
Then three months post extraction

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22
Q

How might we change a denture for a patient that is a bruxist 4 things

A

Metal backings to the teeth - Co/Cr reduces fracture
Metal on occlusal surfaces of posterior
Use of cross linked teeth as they have bettter wear resistance
Acrylic post dam increases retention

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23
Q

Three steps in dealing with an ulcer in a denture patient

A

Identify - pressure indicating paste - articulating paper
Ease - occlusal adjustment - trim and polish base
Review

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24
Q

You are making a denture for a patient with advanced periodontal disease - what things do you want to tell them to ensure informed consent

A

Prognosis of remaining dentition - especially if using some of the advanced perio teeth as abutments
Risk of denture vs no denture
Benefit of denture vs no denture

Record all conversations in notes

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25
Q

What is a reline

A

Adding new base material to the tissue surface of an existing denture in a quantity sufficient to fill the space which exists between the original denture contour and alter tissue contour

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26
Q

What are two situations that you might use a reline in a denture

A

Immediate dentures or a very old denture which isnt in great condition

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27
Q

What is a rebase

A

Replacing the entire denture base of an existing denture

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28
Q

What situation would you use a rebase in

A

The denture is loose fitting - the teeth are not worn and are in good condition

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29
Q

What impression technique is used when doing a rebase

A

Closed mouth impression technique

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30
Q

What is the purpose of an overcast during the rebase of a denture

A

To maintain the tooth position of the denture in relation to the model and maintain the vertical dimension

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31
Q

If you have added a temporary reline to a patients denture what would you warm them not to do

A

Not to use sterodent
This is because it will de nature the plasticisers
Instead use a dilute solution of Milton

32
Q

What is the initiator in self cure acrylic

A

Tertiary amine

33
Q

What is an indication for a permanent reline of a denture

A

To prolong the life span of a denture
Patient has worn the denture for years and the teeth arent too worn

34
Q

What is the problem with chair side relines

A

The materials used are more pourous than what is used in the lab so it is more likely to take up colour and bacteria

35
Q

What are 5 reasons that a denture might not fit

A

Over/under extension
Not adapting to the tissues
Processing fault
Occlusal imbalance will break the posteior seal
Poor master impression

36
Q

Name 5 reasons a denture might fracture

A

Impact
Work harnidng of the material
Para-functional habit
Occlusion - deep OB more likely to fracture
Soft lining weaking the denture
Denture processing problem

37
Q

Patient presents to you with a midline fracture of the complete denture - the pieces can be located together
Wjat do u do

A

Disinfect and send to lab
No impression needed
Cast poured and fracture area removed
New acrylic processed

38
Q

Paitent presents with a fractured denture and a piece is missing what do u do

A

Impression taken WITH FRACTURED DENTURE IN MOUTH
Disinfect
Cast poured
New acrylic process

39
Q

How do u bond acrylic to Co/cr

A

4 meta

40
Q

What is a disadvantage of using a wire Strenghtener in a denture

A

Need to increase denture base thickness

41
Q

If when taking a master impression there are areas of shine through - what may the patient complain of during delivery

A

That those areas are causing pressure on the mucOSA

42
Q

What does a foxes bite plane measure

A

Measures the occlusal plane

43
Q

What 2 reasons would you use cuspless teeth for complete dentures

A

If you are having difficulty fgetting patient into RCP use these - so they are able to slide over each other

If the patient has a knife edge ridge

44
Q

What devices can be used to measure OVD and RVD

A

Willus bite gauges
Dividers

45
Q

What must we be careful of when using dividers to measure OVD and RVD

A

Be wary where marking the dots on the patient if they have mobility in thier chin

46
Q

What may happen to the incisive papillae in flabby ridge

A

It may migrate labiallyu

47
Q

Where does the buccinator insert

A

Buccal frenum

48
Q

What is the minimum sulcus depth required for a lingual bar connector

A

7mm

49
Q

What disadvantage does a lingual bar have

A

Very difficult to add to
Need sufficient sulcus depth

50
Q

What would you do if you tried a cobalt chrome frame into the paitents mouth and it did not fit

A
  • check it first onto the model
  • look and see if there are any modifications on the cast
  • use occlude spray on the area you dont think is seating - where the occlude has been wiped off is the area that isnt seating
  • can also use articulating paper for this

Only do this if you think it is one thing that is preventing it from seating if lots of areas a new impression needs to be taken

51
Q

What is the undercut a CoCr clasp engages

A

0.25mm

52
Q

What is the undercut a gold clasp engages

A

0.75,,

53
Q

What is the undercut a SS clasp engages

A

0.5mm

54
Q

Why is gold a larger undercut than CoCr and SS

A

This is because it has a greater young modulus of elasticity so it can flex more without breaking

55
Q

What must you warn your patient of when adjusting their CoCr clasp
Where should you adjust it?

A

Always warn the patient that it may fracture when adjusting it

Adjust at the head as it is least likely to break here

56
Q

There is normally a 2-3mm spacer on trays - what is a clincal situation you might not do this

A

When a pateint has resorbed ridges you may instead choose to do a close fitting tray - with no spacer

57
Q

Name 4 diadvantages of partial dentures

A

Increase in plaque accumulation
Increased risk of periodontal disease
Damage to underlying soft tissues
Gingival stripping - due to movement of the denture
§

58
Q

What is the aim of a partial denture

A

Replace lost teeth and tissues to
Restore function speech and aesthetics

59
Q

What is Kennedy class 1

A

Bilateral free end saddles

60
Q

What us Kennedy class 2

A

Unilateral free end saddle

61
Q

What is Kennedy class 3

A

Unlilateral bounded saddle

62
Q

What is Kennedy class 4

A

Anterior crosses midline

63
Q

What is the purpose of surveying

A

To determine the path of insertion
To determine the position and depth of the undercuts

64
Q

What is the path of displacement

A

The direction in which the prosthesis tends to be dislodge during function and is assumed to be perpendicular to the occlusal plane

65
Q

How does an RPI system work

A

As the saddle presses into the denture bearing mucosa, it rotates around the mesial rest
Distal plate and I bar move down and away from the tooth thus avoiding torque on the abutment tooth

66
Q

Give 5 denture hygiene pieces of advice for a denture patient

A

Remove the dentures at night
Mechanical cleaning with soap and water - not toothpaste
After chemical cleaning - store in cold water
Soft brush to clean
In partials stress the importanace of cleaning natural teeth with the dentures out

67
Q

How does a clasp provide rentetion

A

The tip of the clasp flexes as the patient is inserting and removing the denture - the clasp deforms over the bulbosity of the tooth and comes to rest in the undercut
When it is in the undercut is is passive and applying no pressure to the tooth

68
Q

What is the purpose of the reciprocating arm in a clasp

A

It is an opposing element to the retentive clasp arm to prevent pressure from the clasp acring on the tooth

69
Q

What part of the clasp engages in the undercut

A

The terminal third of the clasp with only the tip engaging to full depth

70
Q

Name 2 disadvantages of an RPI

A

Creating windows
Not limiting the loading on the free end saddle then we could be accelerating bone resorption on free end saddle

71
Q

What is the tool used to determine the path of insertion and identify undercut areas during surerying

A

Analysing rod

72
Q

What tooth is used to indetify a useable undercut for a clasp

A

Undercut gauge

73
Q

What is the purpose of the graphite marker during surveying

A

Marks the survey lines on the cast

74
Q

What kind of material is impregunm

A

Polyether

75
Q

What is the most common cause of a framework fitting an undamged cast but not the patient

A

Faulty/ distorted impression

76
Q

What is the recommend casting thickness for cobalt chrome framework

A

0.5mm

Prosthodontics (2 decks)

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