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BDS4 PP > Prosthodontics > Flashcards

Prosthodontics Flashcards

1
Q

which denture reconstruction technique would be appropriate to give pt replacements dentures they can tolerate

A

replica dentures

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2
Q

other than replacement dentures, state 2 tx methods which can be used to improve retention and stability in loose complete dentures

A

relining
rebasing

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3
Q

what is the technique for replica dentures

A
  1. upper large dentate trays, vaseline and putty in the original denture
  2. capture impression of the occlusal surface, mould to 2mm of edge
  3. place vaseline and notches for removal and replacement
  4. capture impression with putty of the fitting surface of the denture tray, outer surface down
  5. ensure flanges of denture captures
  6. smooth edges and wait for set
  7. light bodies silicone for jaw registration

old dentures can be modified with greenstick before replica taken

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4
Q

what is relining a denture

A

adding a new base material tot issue of surface of existing denture in sufficient quantity to fill space which exists between original denture and altered tissue contour

improves stability and retention
usually chair side

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5
Q

3 types of relines and when done

A

temporary - tissue conditioning, post-immediate, after implant surgery

soft - parafunctional habits

permanent - peripheral seal problems, correction of errors after masters, immediate/post-immediate after lots of temporary relines

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6
Q

materials used for relines

A

heat-cured acrylic
self-cured acrylic [coe comfort]
heat-cured silicone
self-cured silicone

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7
Q

what is the technique for rebasing a denture

A
  1. undercuts removed
  2. wash impression taken using denture in closed mouth technique
  3. impression poured in stone with overcast
  4. denture removed to reveal new working model
  5. post dam carved
  6. remove fitting surface + palate
  7. denture placed back on overcast, gap between denture and model is filled with wax
  8. overcast removed as served purpose of maintaining denture position and OVD
  9. palate added back in wax
  10. flasked using Dundee injection method, wax removed and acrylic injected
  11. trimmed and polished
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8
Q

describe the 3 important features of complete dentures you would check in try-in stage

A
  • retention and stability
  • base extensions
  • lip support
  • incisal level
  • midline
  • buccal corridor
  • occlusal planes
  • position of teeth
  • vertical dimension, FWS
  • even contact in occlusion
  • speech
  • aesthetics
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9
Q

53 y/o presents with loose dentures and palate denture bearing area red.
which organsim is likely

A

Candida albicans

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10
Q

3 most likely contributing local factors to denture stomatitis

A

ill-fitting dentures, poor denture hygiene, wearing dentures overnight, reduced salivary flow, denture material

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11
Q

define support in RPD and what components do this

A

resistance to vertical movement of denture towards tissue via occlusal directed load

rest seats, abutments, connectors

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12
Q

define retention in RPD and what components do this

A

resistance to displacement of denture away from the tissue

clasps, minor connector

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13
Q

give types of connectors for maxilla and mandible

A

palatal bar/ring
mid palatal strap
plate
horseshoe

lingual bar
sublingual bar
plate

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14
Q

what is the advantage of lingual bars

A

minimal coverage of the gingival tissues and teeth
allows for better cleaning and salivary flow
reduced bulk in CoCr

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15
Q

how do you achieve retention in complete upper denture

A

post-dam
palatal coverage
adequate extension into buccal sulcus
adhesion-cohesion with acrylic
peripheral seal
neutral zone

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16
Q

biometric principles - where are denture teeth located on

A

upper - slightly buccal to ridge crest
lower - on the ridge crest

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17
Q

what is a shortened dental arch

A

reduced number of teeth in the dental arches, with reduced or absent molars/premolars
must be at least 20 teeth

do not replace them

generally 3-5 teeth each quadrant

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18
Q

why is the shortened dental arch acceptable

A

enough occluding pairs necessary for function, speech and aesthetics

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19
Q

indications for shortened dental arch

A

pt unwilling for complete dentures
good OH, no perio
extensive tooth loss
good prognosis remaining teeth
pt preference/motivation
medically compromised

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20
Q

contraindications for shortened dental arch

A

pathological tooth wear
poor prognosis remaining teeth
parafunctional habits
young pt
periodontitis
malocclusion

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21
Q

how could you extend a shortened dental arch

A

bridges
RPD
implant

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22
Q

5 requirements of occlusal stability

A

1 - stable occlusal contact all all teeth in centric relation/ICP
2 - anterior guidance in harmony with envelope of function
3 - all posterior teeth disclude in mandibular protrusive movement
4 - all posterior teeth disclude on non working side on lateral movement/excursion
5 - all posterior teeth disclude on working side on lateral movement/excursion

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23
Q

signs of occlusal trauma

A

mobility, pain, wear facets, fractured teeth, widening PDL, scalloping, pronounced linea alba, NCTSL

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24
Q

what are the ideal properties of a denture base

A

Dimensionally accurate, high softening temperature, high hardness/abrasion resistance, thermal expansion equal to abutment teeth, low density, high thermal conductivity, biocompatible, high YM, high elastic limit, high fatigue strength, inexpensive

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25
Q

what are the constituents of PMMA

A
  • Powder = PMMA beads, benzoyl peroxide initiator, pigments, fillers

Liquid = MMA monomer, hydroquinone inhibitor, cross-linking agent ethylene glycol dimethacrylate, plasticisers

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26
Q

give 4 faults of denture base production and how they can occur

A

contraction porosity = too much monomer, insufficient pressure, insufficient excess material

gaseous porosity = monomer boiling in bulkier parts of denture

granularity = not enough monomer

crazing = internal stresses due to fast cooling rate

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27
Q

advantages as CoCr as a denture base

A

high YM - rigid
high strength
high impact resistance
high thermal conductivity
thin, lightweight
high softening temperature
corrosion resistant
excellent retention

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28
Q

disadvantages of CoCr as a denture base

A

cost
difficult to add teeth to
aesthetics

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29
Q

what undercuts are required for CoCr, SS + Au clasps

A

0.25mm CoCr
0.5mm SS
0.75mm Au

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30
Q

ideal properties of an impression material

A

high surface reproduction/ accuracy
high tear strength
100% elastic recovery
biocompatible
no dimensional change
ease of use

31
Q

name 2 non-elastic impression materials

A

impression compound
impression paste [ZOE]

32
Q

name 4 elastomers

A

polyether [impregum]

silicone;
- addition silicone [PVS]
- condensation silicone [lab putty]

polysulphide

33
Q

name 2 hydrocolloids

A

alginate
agar

34
Q

what are the constituents of alginate

A

sodium alginate
calcium sulphate
trisodium phosphate
filler

35
Q

what is the setting reaction of alginate

A

sodium alginate + calcium sulphate

=

calcium alginate + sodium sulphate

36
Q

2 advantages of alginate

A

ok accuracy
easy to use
acceptable taste/smell
no toxic
cheap

37
Q

2 disadvantages of alginate

A

poor tear strength
sensitive to environmental factors e.g. temperature
needs stored properly
limited shelf life

38
Q

uses of alginate

A

primary impressions
master impressions
study model impressions

39
Q

3 advantages of elastomeric impression materials over alginate

A

better accuracy
better tear strength
better surface detail reproduction
better shelf life as doesn’t dry out

40
Q

what does RPI stand for

A

rest on mesial surface
proximal plate on distal surface
I-bar, gingival approaching

41
Q

RPI MOA

A

rest mesially acts as an axis of rotation
as proximal plate and I-bar rotates downwards and medially [respectively], around the axis of rotation during occlusal load
the I-bar and proximal plate disengage from tooth/undercuts

potential traumatic torque avoided

42
Q

what are the measurements required for a lingual bar in RPD

A

3-4mm from gingival margin, height 4mm minimum of bar, clearance 3mm from floor of mouth
>7/8mm needed

43
Q

aetiology of denture stomatitis

A

growth of bacteria e.g. Candida albicans
primarily denture bearing area

poor denture hygiene, wearing dentures overnight, smoking, immunocompromised, HIV, inhaler use

44
Q

how is denture stomatitis managed

A

denture hygiene instructions
tissue conditioner
manage predisposing factors
OHI

antifungals - miconazole to fitting surface

45
Q

how do you restore freeway space in very worn dentures

A

temporary relines
rebase
occlusal pivots
restore occlusal surface with auto-polymerising acrylic resin

46
Q

what problem can occur with a complete upper denture occluding with partial lower

A

combination syndrome resulting in a flabby ridge

47
Q

why does combination syndrome occur

A

bone loss maxillary ridge, hypertrophy of tuberosities and papillary hyperplasia in hard palate
extrusion of mandibular anterior teeth which occlude with force against the anterior ridge
causes bone to resorb with loose alveolar tissue

48
Q

how to manage combination syndrome

A

reduce trauma = maximise coverage on denture bearing area [short post dam]

optimise load = use over denture abutments to reduce alvoelar resorption

stability = optimise border seal, effective post dam
ensure good posterior support
try to regularise occlusal plane
reduce incisor teeth length??

49
Q

define Kennedy class 1

A

bilateral free end saddle

50
Q

define Kennedy class 2

A

unilateral free end saddle

51
Q

define Kennedy class 3

A

bilateral bounded saddles

52
Q

define Kennedy class 4

A

anterior bounded saddle crossing midline

53
Q

define Kennedy class 2 mod 1

A

unilateral free end saddle with 1 bounded saddle

54
Q

how to take impression with flabby ridge/combination syndrome

A

mucostatic impression so tissues are recorded at rest
2 stage impression with medium body then cut out impression material and make hole in tray over flabby ridge and take 2nd impression with light body

OR

window technique with relief holes cut in special tray to allow flow of material and leave tissues undisplaced
use low viscosity impression material

55
Q

what is a system of design used for designing PD

A

outline saddle areas
support
retention
stability
reciprocation
connector

56
Q

give 2 maxillary connectors with adv and disadvantages

A

plate/strap =
- thin
- BUT palate covered

bar =
- less coverage
- BUT thicker

57
Q

give 2 mandibular connectors with adv and disadvantages

A

lingual bar =
- gingiva clear
- less well tolerated

lingual plate =
- well tolerated as thin
- hard to keep clean

58
Q

define stability in in RPD and how it is done

A

resistance to horizontal/lateral movement of denture

reciprocal arms of clasps

59
Q

define indirect retention in RPD

A

resistance to rotational displacement

e.g. rest seats opposite fulcrum line

60
Q

what is the difference between a soft lining and tissue conditioner

A

soft lining used to improve retention, fit, cushioning

conditioner used in unhealthy/ulcerated mucosa to aid healing
dissipates forces but good short term option

61
Q

what is a functional impression

A

can be used with tissue conditioner

material applied and pt wears denture for 24hrs with movement and normal function
this impression is sent to lab for reline

62
Q

how to check retention clinically of complete denture

A

pull on premolars, push on anteriors to check post dam
pull away lips to see if denture remains in situ
ask pt to speak, chew etc

63
Q

what problem can an incorrect OVD give

A

pain, movement of denture, instability, TMD aggravation, angular chieilitis,
muscle strain and fatigue
overclosed appearance
reduced lip support
cannot function properly - speaking, chewing, swallowing

64
Q

where should the post dam be

A

just anterior to the vibrating line - junction between soft and hard palate

65
Q

what is the distal extension of a lower complete denture

A

2/3 of the retromolar pads

66
Q

why is the buccal shelf used for support

A

stable anatomy, not as prone to resorption, large surface area, adjacent to buccinator muscle for support, less muscles action impact

67
Q

what anatomical features help set the incisors

A

1mm anterior to incisive papilla

68
Q

what 4 things make up shade

A

value, hue, chroma, translucency

69
Q

give average horizontal bone loss for
incisors, canines, premolars, molars

A

incisors 6mm
canine 9mm
premolars 10mm
molars 13mm

70
Q

adv of immediate dentures

A

maintain soft tissue, prevent collapse
haemorrhage control
transition help
uses existing occlusion
pt aesthetics and psychology
maintain muscle tone
allow continuation of function, speech and aesthetics

71
Q

disadvantages of immediate dentures

A

fit poor as resorption
may require relining/rebase
only temporary measure which will need replaced
no trial stage
need to pay for 2 dentures in short time span

72
Q

write a prescription for special trays for U+L complete dentures

A

please construct upper and lower special trays in light cured acrylic
non-perforated
upper 2 mm spacer and EO handle
lower 1mm spacer IO handle, finger rest premolar region

73
Q
A

BDS4 PP (1 decks)

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