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BDS4 EXAM STUDY > Prosthodontics > Flashcards

Prosthodontics Flashcards

1
Q

What is meant by the term “saddle” in RPDs?

A

the teeth being replaced

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2
Q

What is a Kennedy Class I?

A

Bilateral free end saddles

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3
Q

What is a Kennedy Class II?

A

Unilateral free end saddle

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4
Q

What is a Kennedy Class III?

A

Bounded saddle

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5
Q

What is a Kennedy Class IV?

A

Anterior bounded saddle that crosses the midline

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6
Q

How do you determine what Kennedy Class an arch falls under if there is multiple saddle areas?

A

Most posterior saddle determines Kennedy Classification

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7
Q

What is meant by the term “support” in RPDs?

A

the resistance of the denture to occlusally directed load

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8
Q

What support classification is used in RPDs?

A

Craddocks Classifications
- Class 1 = tooth borne
- Class 2 = mucosa borne
- Class 3 = tooth & mucosa borne

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9
Q

What is meant by the term “retention” in RPDs?

A

resistance of the denture to vertical displacement (lifting away from tissues)

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10
Q

What are some methods of retention used in RPD design?

A
  • clasps
  • soft tissue undercuts
  • adhesion (eg maxillary plates over hard palate)
  • path of insertion
  • precision attachments/implants
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11
Q

What is meant by the term “indirect retention” in RPDs?

A

Resistance of a denture to rotational displacement

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12
Q

What is meant by the term “reciprocation” in RPDs?

A

Prevention of a clasp arm moving the clasped tooth (eg tilting/tipping)

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13
Q

What is meant by the term “major connector” in RPDs?

A

Part of denture that connects all the components together

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14
Q

What is meant by the term “minor connector” in RPDs?

A

Connects rests, clasps and bracing arms to major connector

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15
Q

What connector design is this?

A

Palatal strap

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16
Q

What connector design is this?

A

plate design

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17
Q

What can you use to record the inter-occlusal record during a jaw-reg?

A
  • bite registration paste (usually polyvinyl siloxane)
  • wax wafer
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18
Q

Why is bite registration paste sometimes a better option for recording inter-occlusal record compared to wax wafer technique?

A

Wax wafer can sometimes prop occlusion open

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19
Q

What area of a treatment plan does construction of RPDs fall under?

A

Reconstructive phase

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20
Q

What are the clinical stages in RPD construction?

A
  • primary impressions
  • mount & survey study casts
  • design denture
  • tooth prep if required
  • master impressions
  • jaw registration
  • tooth trial
  • delivery
  • review
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21
Q

What can be involved in “mouth preparation” prior to creation of RPD?

A
  • pre-prosthetic surgery
  • periodontal treatment
  • orthodontic treatment
  • tooth preparation
  • fixed pros
  • endodontics
    ETC
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22
Q

When preparing pt mouth for a new RPD, what may be involved as a part of pre-prosthetic surgery?

A
  • remove retained roots/unerupted teeth
  • remove any pathology
  • reduction of bony prominences
  • eliminate prominent frenal attachments
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23
Q

Why is tooth preparation sometimes required before taking master impressions?

A
  • provide rest seats
  • establish guide surfaces
  • create undercuts / retentive areas
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24
Q

Why might rest seats need to be prepared?

A
  • prevent interference with occlusion
  • reduce prominence of the rest
  • produce favourable tooth surface for support
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25
Q

How deep should rest seats ideally be?

A

Deep enough to allow a rest of at least 1mm thick

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26
Q

What are guide planes?

A

2 or more parallel axial surfaces on abutment teeth, which limit the path of insertion of a denture

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27
Q

What are the pros of guide planes?

A
  • increased stability
  • reciprocation
  • prevention of clasp formation
  • improved appearance
28
Q

How can undercuts/retentive areas be created on abutment teeth?

A
  • addition of composite
  • tooth surface reduction
29
Q

Give a brand name of PVS:

A

Extrude

30
Q

In which patients is polyether unsuitable to use for impression taking?

A

Pt with severe undercuts
- polyether sets rigidly

31
Q

Give example of a brand name of polyether material?

A

Impregum

32
Q

In which patients is impression compound a good option to use for impressions?

A

Edentulous pts

33
Q

List the procedural steps involved at the master impression stage of RPD production:

A
  • try in special tray & trim peripheries if overextended
  • modify peripheries with greenstick
  • modify free end saddles with green stick
  • apply adhesive & use alginate/polyether/PVS for impression
  • border mould when impression seated
  • disinfect & place in sealed back
34
Q

What has likely happened if you receive framework trial from lab, the framework fits the cast BUT does not fit the patient?

A

impression error

35
Q

What is the technique used to create a cobalt chromium RPD base?

A

LOST WAX TECHNIQUE
- base design created on cast in wax
- cast placed in mould & put into furnace
- wax melts away and is replaced by molten CoCr
- mould allowed to cool & is removed
- metal base casting is now sandblasted with aluminium

36
Q

At what temperature does Cobalt Chromium alloy melt at?

A

1400 degrees celcius

37
Q

WHY must we record the occlusion in the production of RPDs?

A

Must know the position of the teeth in relation to each other as:
- try to keep occlusion same for pt after denture fitted
- facilitates denture design (eg heavy contacts noted)
- ensure loading forces are directed in the correct direction

38
Q

What can be used to record the OVD?

A
  • Willis bite gauge
  • Dividers
39
Q

What problems may cause record block to be displaced when trying it in?

A
  • overextension into peripheries
  • too much lip support
40
Q

When reference points/lines are important to note at jaw reg stage?

A
  • midline
  • canine line
  • inter-pupillary line to guide incisal plane
  • ala-tragus line
  • smile line
  • incisal level
41
Q

What materials can artificial teeth for RPDs be composed of?

A
  • acrylic
  • porcelain
42
Q

How do acrylic / porcelain teeth on an RPD differ from each other?

A

Acrylic
- chemical bond with denture base
- silent during function
- easily trimmed/customised
- low abrasion resistance

Porcelain
- mechanical attachment with the denture base
- natural appearance
- noisy in function
- brittle
- high abrasion resistance

43
Q

What instructions might you provide to the patient at the RPD delivery stage?

A
  • how to insert/remove denture
  • denture cleaning instructions
  • wear instructions (eg take out overnight)
  • OHI of remaining teeth
44
Q

What information/warnings may you give to the patient at RPD delivery stage?

A
  • excess saliva initially
  • speech difficulties
  • eating discomfort initially
  • soreness, continue to wear denture if possible so at rv appt we can see where to reduce acrylic
45
Q

Pt comes back to see you for a RPD review appointment, they complain that they are experiencing pain over the entire denture bearing area, what is likely to be the problem?

A

None/not enough free way space
- pt may also complain of discomfort in MoM and TMJ

46
Q

Pt comes back to see you for a RPD review appointment, they complain that the denture becomes displaced easily when talking & protruding tongue, what is likely the problem?

A

Overextension into lingual sulcus

47
Q

Why is tooth support better than mucosal support for RPDs?

A

Tooth support
- transmits load via PDL
- feels more like natural dentition
- more comfortable
- protects soft tissues from trauma

Mucosa support
- may cause reduction of occlusal table
- allows denture base to move around

48
Q

Describe the method of an RPD achieving mechanical retention:

A

Engaging tooth undercuts via
- clasps
- guide surfaces

49
Q

Describe the method of an RPD achieving physical retention:

A

Via existing forces of:
- adhesion = surface forces of saliva on denture & mucosa
- cohesion = forces within saliva, viscosity
- atmospheric pressure

Determined by closeness of adaptation to tissues

50
Q

Describe the method of an RPD achieving muscular retention:

A

Dependent on the patients muscular control

51
Q

What is the difference between direct and indirect retention of an RPD?

A

Direct = resistance to vertical displacement of denture

Indirect = resistance to rotational displacement of denture

52
Q

What type of clasp is pictured here?

A

Gingivally approaching I-bar clasp

53
Q

What is the ideal “pattern of retention” ?

A

Triangular pattern of retention

54
Q

What makes a bar connector superior to a plate connector?

A

Less mucosal coverage with bar connection

55
Q

What should the minimum thickness of a lingual bar be?

A

2mm thick

56
Q

Name the mandibular connectors listed here:

A
  1. Lingual bar
  2. Lingual plate
  3. Dental bar
  4. Sublingual bar
  5. Labial bar (uncommon)
57
Q

Where should a lingual bar be positioned in relation to the gingival margin?

A

At least 3mm below gingival margin

58
Q

How much space is usually require on lingual mandibular surface for use of a lingual bar connector in RPD design?

A

8mm
- sits 3mm from gingival margin
- bar 4mm thick
- 1mm clearance to FoM

59
Q

When is an RPI system typically used?

A

Free-end saddle designs to prevent stress on the last abutment tooth

60
Q

What effects are associated with edentulism?

A
  • loss of masticatory function
  • appearance issues
  • self esteem issues
  • general health effects
  • poorer quality of life
  • speech problems
61
Q

What clinical effects are observed as a result of edentulism?

A
  • ridge resorption
  • soft tissues changes to lip & chin
  • reduction in face height
62
Q

Why might complete dentures not be a good option for parkinsons patients?

A

complete dentures require good neuro-muscular control

63
Q

What denture history is relevant to obtain when a pt attends your practise requiring new ones?

A
  • age of current dentures
  • what age did they start wearing dentures
  • how many denture sets have they had
  • what they like/dislike about their current dentures
  • how long have they had their current set of dentures
64
Q

What medical history may cause complete dentures to be contraindicated?

A
  • neuromuscular problems
  • strokes
  • dementia
  • epilepsy
  • polypharmacy may cause dry mouth
65
Q

A diabetic patient wears complete dentures, what condition are they more at risk of developing?

A

candida infections

66
Q
A

BDS4 EXAM STUDY (39 decks)

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