Prosthodontics Flashcards
The incisive papilla provides a guide for the
anteroposterior placement of maxillary anterior
denture teeth. The labial surfaces of natural
teeth are generally 8 to 10 mm anterior to this
structure.
A. Both statements are true.
B. The first statement is true, and the second
statement is false.
C. The first statement is false, and the second
statement is true.
D. Both statements are false.
A. The incisive papilla provides a guide for the antero-
posterior position of the maxillary anterior teeth. The
labial surfaces of the central incisors are usually 8 to
10 mm in front of the papilla. This distance varies
depending of the amount of resorption of the
residual ridge, the size of the teeth, and the labio-
lingual thickness of the alveolar process.
Which of the following statements is true con-
cerning vertical dimension of rest (VDR)?
A. VDR = physiologic rest position.
B. VDR = position of the mandible when opening
and closing muscles are at rest.
C. VDR is a postural relationship of the mandible to
maxilla.
D. VDR = the amount of jaw separation controlled
by jaw muscles when they are in a relaxed state.
E. All of the above.
E. All of the above statements are correct. Vertical
dimension of rest (VDR) is a physiologic rest
position; it is the position of the mandible when
the muscles are in their minimum state of
tonicity, which occurs when a patient is relaxed
with the trunk upright and the head
unsupported. In this position, the interocclusal
distance is usually 2 to 4 mm when observed at
the first premolar area.
The following are characteristics of a post-
palatal seal of complete dentures, except which
one?
A. Compensates for shrinkage of the acrylic resin
caused by its processing.
B. May reduce the gag reflex.
C. Improves the stability of the maxillary denture.
D. It is most shallow in the midpalatal suture area.
C. Stability is resistance to movement toward the
residual ridge. The function of the posterior
palatal seal is to improve retention, not stability.
Stability is determined by the size, height, or
shape of the ridge.
Which of the following is the most likely cause
of an occlusal rest fracture?
A. Inadequate rest-seat preparation
B. Improper rest location
C. Structural metal defects
D. Occluding against the antagonist tooth
A. In McCracken’s Removable Partial Prosthodontics,
ed 11 (St Louis, Mosby, 2005), McCracken states,
“Failure of an occlusal rest rarely results from a
structural defect in the metal and rarely if ever is
caused by distortion. Therefore the blame for such
failure must often be assumed by the dentist for not
having provided sufficient space for the rest during
mouth preparations.”
The primary purpose of a maxillary denture
occlusal index is to _____.
A. Maintain the patient’s vertical dimension
B. Maintain both the correct centric and vertical
relation records
C. Maintain the patient’s centric relation
D. Preserve the facebow record
- D. In order to preserve the mounting relationship
in the articulator of the maxillary cast (facebow
record) after processing a denture, an
occlusal index of the maxillary denture is made
after occlusal adjustments, and before de-
casting the denture. This procedure has nothing
to do with the mandible’s relationship to the
maxilla.
An edentulous patient with a diminished verti-
cal dimension of occlusion is predisposed to
suffer from which of the following conditions? A. Epulis fissuratum B. Pemphigus vulgaris C. Papillary hyperplasia D. Angular chelosis
D. Angular chelosis is described as inflamed and
cracked corners of the mouth that can become
infected with bacteria and fungal organisms. It is
commonly seen in denture patients with dimin-
ished vertical dimension of occlusion. It is best
treated with antifungal creams and correcting the
vertical dimension of occlusion.
When performing a diagnostic occlusal adjust-
ment on diagnostic casts, the mandibular cast
should be mounted to the maxillary cast in an
articulator using which of the following?
A. A centric relation interocclusal record
B. A hinge articulator
C. A maximum intercuspation wax record
D. A facebow transfer
A. When performing an occlusal adjustment, the
goal is to make CR and MI to coincide. None of
the other choices allows one to reliably mount
the casts in CR or allows one to accurately per-
form this procedure.
When border molding a mandibular complete
denture, the extension of the lingual right and
left flanges are best molded by having the
patient _____.
A. Purse the lips
B. Wet the lips with the tongue
C. Open wide
D. Swallow
E. Count from 50 to 55
B. The main purpose is to capture the influence of the
mylohyoid muscle. The extent of this flange is
determined by the elevation of the floor of the
mouth when the patient wets the lips with the tip
of tongue. Pursing the lips will form the extension
of the buccal vestibule. The buccal vestibule is
influenced by the buccinator muscle, which
extends from the modiolus anteriorly to the
pterygomandibular raphe posteriorly and has its
lower fibers attached to the buccal shelf and the
external oblique ridge.
The main function of the direct retainer of a removable partial denture is \_\_\_\_\_. A. Stabilization B. Retention C. Support D. Add strength to the major connector
B. The direct retainer’s function is to retain the RPD
by means of the abutments. Stabilization is pro-
vided by the minor connector. Support is provi-
ded by the rest. The indirect retainers improve
the efficiency of the direct retainers. Direct
retainers do not add strength to the major
connector.
Lack of reciprocation of a removable partial
denture (RPD) clasp is likely to cause _____.
A. Tissue recession due to displacement of the
RPD
B. Insufficient resistance to displacement
C. Fracture of the retentive clasp
D. Abutment tooth displacement during removal
and insertion
D. Tooth mobility is prevented or diminished during
function by the reciprocating clasp. The recipro- cating clasp should contact the tooth on or above
the height of contour of the tooth, allowing for
insertion and removal with passive force.
Displacement of the RPD toward the tissue,
causing tissue recession, is a function of the lack
of occlusal rests.
Centric relation is the maxillomandibular rela-
tionship in which the condyles are in their
most _____.
A. Posterior position with the disc interposed at its
thickest avascular location
B. Posterior position with the disc interposed at its
thinnest locale
C. Superior position with the disc in its most
anterior position
D. Superior-anterior position with the disc
interposed at its thinnest location
D. This meets the definition of centric relation and
the normal anatomic relationships of the tem-
poromandibular discs to the condyles. Centric
relation is a clinically repeatable mandibular
position primarily defined by the temporo-
mandibular joints, not the teeth.
The denture base of a mandibular distal exten-
sion RPD should cover _____.
A. The retromolar pads B. All undercut areas and engage them for retention C. The hamular notch D. The pterygomandibular raphe
A. The retromolar pad should always be covered for
support of the mandibular denture base. The
retromolar pads and the buccal shelf are consi-
dered primary areas of support for a mandibular
distal extension removal partial denture or com-
plete denture.
A good landmark for the anteroposterior posi-
tioning of the anterior maxillary teeth in a com-
plete denture is the _____.
A. Residual ridge
B. Incisive papilla
C. Incisal foramen
D. Mandibular wax rim+
B. Anatomic guidelines to be used as guides in
arranging the anterior teeth are the incisive
papilla, the midsagittal suture, and the ala of the
nose (canine lines).
The incisive papilla is a good guide for the
anteroposterior positioning of the maxillary ante-
rior teeth. The labial surfaces of the central inci-
sors are usually 8 to 10 mm in front of the papillae.
This distance varies depending on the size of the
teeth and the labiolingual thickness of the alveolar
process, so it is not an absolute relationship.
Which is one of the purposes or characteristics
of the postpalatal seal?
A. Provide a seal against air being forced under the
denture.
B. Usually should extend posterior to the fovea
palatinae.
C. Improves the stability of the maxillary denture.
D. It is carved deeper in the midpalatal suture area.
A. The vibrating line is located by finding the ptery-
gomaxillary (hamular) notches, and continues to
the median line of the anterior part of the soft
palate slightly anterior to the foveae palatinae.
A V-shaped groove 1 to 1.5 mm deep and 1.5 mm
broad at its base is carved into the cast at the
vibrating line. The narrow and sharp bead will sink
easily into the soft tissue to provide a seal against air
being forced under the denture. Stability is
resistance to movement toward the residual ridge.
The post-dam improves retention, not stability. It is
carved shallow in the midpalatal suture area.
Stability is determined by the size, height, or shape
of the ridge.
The \_\_\_\_\_ is used as a guide to verify the occlusal plane. A. Ala-tragus line B. Interpupillary line C. Camper’s line or plane D. All of the above
D. The ala-tragus line posteriorly and the interpu-
pillary line anteriorly are used as a guide to align
the occlusal plane for complete dentures.
The Camper’s line is also known as the ala-tragus
line.
Balanced occlusion is less important during
chewing than during nonchewing events. This
difference occurs because the time teeth are in
contact during nonchewing events is much
greater than the time teeth are in contact dur-
ing chewing.
A. Both statements are true.
B. The first statement is true, and the second
statement is false.
C. The second statement is true, and the first
statement is false.
D. Both statements are false.
A. Teeth come together every time a patient swal-
lows. This can dislodge dentures due to breaking
the denture seal.
Which of the following conditions can be caused in an edentulous patient by an ill-fitting denture flange? A. Papillary hyperplasia B. Epulis fissuratum C. Candidiasis D. Fibrous tuberosity
B. Epulis fissuratum is a reactive growth to an
overextended or ill-fitting denture flange. It is best
removed surgically. Papillary hyperplasia is found
in the palatal vault. It is caused by local irritation,
poor-fitting dentures, poor oral hygiene, or leaving
dentures in 24 hours a day. Candidiasis is
associated with papillary hyperplasia. Fibrous tuberosity is commonly seen with large tubero-
sities.
Inadequate rest-seat preparation for a remov-
able partial prosthesis can cause _____.
A. Tooth mobility
B. Ligament widening
C. Occlusal rest fracture
D. Occlusal rest distortion
C. In McCracken’s Removable Partial Pros-
thodontics, ed 11 (St Louis, Mosby, 2005),
McCracken states, “Failure of an occlusal rest
rarely results from a structural defect in the metal
and rarely if ever is caused by accidental
distortion. Therefore the blame for such failure
must often be assumed by the dentist for not
having provided sufficient space for the rest
during mouth preparations.”
Which of the following is the main disadvan-
tage of resin-modified glass ionomer compared
to conventional glass ionomer? A. Reduced fluoride release B. Increased expansion C. Reduced adhesion D. Cost
B. Resin-modified glass ionomers combine some of
the advantages of glass-ionomer cements, such
as fluoride release and adhesion, but provide
higher strength and low solubility. These materi-
als are less susceptible to early moisture expo-
sure than are glass-ionomer cements but, due to
the addition of resin, they exhibit increased ther-
mal expansion.
You are planning to replace a maxillary cen-
tral incisor with a fixed prosthetic device
(FPD). The edentulous space is slightly wider
than the contralateral tooth. In order to
achieve acceptable esthetics, you should
ensure that _____.
A. The line angles of the pontic are placed in the
same relationship as the contralateral tooth
B. The pontic should be made smoother than the
contralateral tooth
C. The pontic should have a higher value than the
contralateral tooth
D. The line angles should be shaped to converge
incisally on the pontic
A. The width of an anterior tooth is usually identified
by the mesiofacial and distofacial position of the
line angles, the shape of the surface contour, and
light reflection between these line angles. The
contralateral tooth features should closely be
duplicated in the pontic, and the space discrep-
ancy can be compensated by modifying the
shape of the proximal areas.
Polycarboxylate cement achieves a chemical
bond to tooth structure. The mechanism for
this bond is _____.
A. Ionic bond to phosphate.
B. Covalent bond to the collagen.
C. Chelation to calcium.
D. These cements do not form a chemical bond.
C. The carboxylate groups in the polymer molecule
chelates to calcium.
Which of the following properties of a gold
alloy exceeds a base metal alloy in numerical
value?
A. Hardness
B. Specific gravity
C. Casting shrinkage
D. Fusion temperature
B. Gold alloys are heavier for a given volume. Gold
alloys are softer. Base metals are cast at higher
temperatures, leading to greater shrinkage.
Which of the following impression materials has the highest tear strength? A. Polyether B. Polysulfide C. Addition silicone D. Condensation silicone
B. Polysulfide has the highest tear strength of all
elastomeric impression materials.
Chroma is that aspect of color that indicates \_\_\_\_\_. A. The degree of translucency B. The degree of saturation of the hue C. Combined effect of hue and value D. How dark or light is a shade
B. Chroma is the saturation or intensity of the color
or shade. Value is the relative lightness or darkness
of a color. Opalescence is the light effect of a
translucent material.
In order for an alloy to be considered noble metal, it should \_\_\_\_\_. A. Contain at least 25% Ag B. Contain at least 25% Pt or Pd C. Contain 40% Au D. Contain at least 80% gold
B. Noble metals are gold (Au), platinum (Pt), and
palladium (Pd) [silver (Ag) is not considered
noble; it is reactive, but improves castability].
Noble alloys (old term was semiprecious metal)
have a noble metal content ≥25%. (To be classi-
fied as noble, Pd-Cu, Pd-Ag, Pd-Co alloys have no
stipulation for gold.)
High noble alloys have a high content of gold
(more than 60%).
The purpose of fabricating a provisional restoration with correct contours and marginal integrity is \_\_\_\_\_. A. For protection B. To supervise the patient’s dental hygiene and give them feedback during this stage C. To preserve periodontal health D. All of the above
D. All these reasons are correct. The provisional is
placed to protect the tooth and preserve healthy
tissues if proper contours and marginal integrity
are present. This is an excellent time to evaluate
and give feedback to the patient on how well they
are brushing and flossing.
A compomer cement _____.
1. Is indicated for cementation of metal-ceramic
crowns.
2. Is indicated for cementation of all-ceramic
restorations.
3. Is indicated for some all-ceramic crowns, inlays,
and veneers with some contraindications.
4. Has low solubility and sustained release of
fluoride.
A. All are correct.
B. 1, 2, and 3 are correct.
C. 1, 3, and 4 are correct.
D. 2, 3, and 4 are correct.
C. Compomer cements (also known as resin-modified
glass ionomer cements) have low solubility, low
adhesion, and low microleakage. They are not
recommended to be used with all-ceramic
restorations because they have been associated
with fracture, which is probably due to their
water absorption and expansion.
Heating the metal structure in a furnace prior to opaque application in a metal-ceramic crown is necessary to \_\_\_\_\_. 1. Harden the metal. 2. Oxidize trace elements in the metal. 3. Eliminate oxidation. A. 1 only B. 1 and 2 C. 1 and 3 D. 2 only E. 3 only
D. An important factor that affects the metal–ceramic
bond is the surface treatment of the alloy before
firing porcelain. Air-abrasion of the cast alloy is typi-
cally performed before the oxidation step to help
remove surface contaminants that remain from
devesting, and to help clean the casting and provide
microscopic surface irregularities for mechanical
retention of the ceramic. The oxidation step for the
alloy can be performed in air or by using the
reduced atmospheric pressure (approximately 0.1
atm) available in dental porcelain furnaces.
Which of the following are probably not clini-
cally significant in terms of influencing the
retention of a cemented restoration? 1. Tooth preparation 2. Surface textur 3. Casting alloy 4. Tooth taper 5. Luting agent A. 1, 3, and 4 B. 1, 2, 3 C. 1, 2, 3, 5 D. 3 and 5
D. The casting and luting agent have been shown to
have a minimal effect in the retention of a crown.
The geometry of the preparation, parallelism
between the walls (taper), and surface texture of
the preparation have an effect on the retention of
a crown.
Which articulator is capable of duplicating the
border mandibular movements of a patient?
A. Nonadjustable
B. Arcon-type
C. Nonarcon-type
D. Fully adjustable
B. The arcon-type is capable of duplicating a wide
range of mandibular movements, but is generally
set to follow the patient’s border movements.
The terminal hinge axis is located and a panto-
graph is used to record the mandibular move-
ments. These mandibular movement tracings or
recordings are used to set the articulator.
Tooth #30 is endodontically treated after a con-
servative access cavity was made through a
typical MO amalgam restoration. The restora-
tion of choice is a _____.
A. Chamber-retained amalgam foundation
B. Custom cast post and core
C. Wire post and core
D. Parallel-sided prefabricated post with cast core
A. If there is an existing pulp chamber and
remaining sound tooth structure, there is no
need to place a post. Placement of a post tends
to require taking additional tooth structure,
which weakens a tooth.
Potential problems in connecting implants to
natural teeth include all of the following except
_____.
A. Stress is concentrated at the superior portion of
the implant
B. Breakdown of osseointegration
C. Cement failure on the natural abutment
D. Screw or abutment loosening
E. Fracture in the connector area of the prosthesis
E. A tooth moves within the limits of its periodontal
ligament during function. The relative immobility
of the osseointegrated implant compared to the
functional mobility of a natural tooth can create
stresses at the neck of the implant up to two
times the implied load on the prosthesis.
Potential problems when connecting an implant
with a tooth include (1) breakdown of the
osseointegration; (2) cement failure on the natu-
ral abutment; (3) screw or abutment loosening;
and (4) failure of the implant prosthetic compo-
nent. Fracture in the connector area is rarely
seen in this situation.
Which is true of a minor connector of an RPD?
A. Should be thin to not interfere with the tongue
B. Should be located on a convex embrasure surface
C. Should conform to the interdental embrasure
D. All of the above
E. A and C only
C. The minor connector must have sufficient bulk to
be rigid so that it transfers functional stresses
effectively to the abutment or supporting teeth and
tissues. It should be located in the interden-
tal embrasure where it doesn’t disturb the
tongue, and should be thickest in the lingual sur-
face, tapering toward the contact area but not
located on a convex surface.
The design of a restored occlusal surface is
dependent upon the _____.
1. Contour of the articular eminence.
2. Position of the tooth in the arch.
3. Amount of lateral shift in the rotating condyle.
4. Amount of vertical overlap of anterior teeth.
A. 1 and 3
B. 2, 3, and 4
C. 2 and 4 only
D. 3 and 4 only
E. All of the above
E. The posterior and anterior factors, position in the
mouth, and side shift have influence on the
occlusal anatomy of a restoration.
Which is a main function of a guide plane sur-
face contacted by a minor connector of an RPD?
A. Provides a positive path of placement and removal for an RPD B. Can provide additional retention C. Aids in preventing cervical movement D. All of the above E. Only A and B
E. The contact of the framework with parallel tooth
surfaces acting as guide planes provides a positive
path of placement and removal for a remov-able partial denture. In addition, guide planes can
provide retention by limiting the movement of the
framework. The rest on a removable partial
denture prevents vertical or cervical movement.
From the following list of components of an
RPD, which must be rigid?
A. Major connector, minor connector, and retentive
clasp
B. Wrought wire clasp, rests, and minor connector
C. Minor connector, rest, and major connector
C. The clasps are meant to be flexible in order to
engage in undercut. The rest of the components
of an RPD should be rigid.
Which type of clasps are generally used on a tooth-supported removable denture? A. Circumferential cast clasp B. Combination clasp C. Wrought wire clasp
A. Circumferential cast clasps are more rigid than
combination clasps or wrought wire clasps. Since
there is good stability of the prosthesis when the
tooth is supported, there is no need for the added
flexibility in a normal situation.
Which of the following disinfectants can be used with alginate impressions? A. Alcohol B. Iodophor C. Glutaraldehyde D. All of the above E. B and C only
E. The impression should be rinsed and disinfected
with glutaraldehyde or iodophor and should be
poured within 15 minutes from the time the
impression was removed from the mouth.
A dentist replaces an amalgam on tooth #5 and
notices a small pulpal exposure. He elects to
use a direct pulp cap procedure. Which of the
following best predicts success?
A. Size of the lesion
B. Isolation of the lesion
C. Use of calcium hydroxide
D. Age of the patient
B. Isolation is the most important factor since it pre-
vents bacterial contamination, increasing the
success of the pulp cap procedure.
In a tooth-supported RPD with a circumferen-
tial cast clasp assembly, there is _____.
A. More than 180 degrees of encirclement in the
greatest circumference of the tooth
B. A distal rest on the tooth anterior to the
edentulous area
C. A mesial rest on the tooth posterior to the
edentulous area
D. Only B and C
E. All of the above
E. On a tooth-supported RPD with a circumferential
cast clasp assembly, there should be more than
180 degrees of encirclement by the clasp in the
greatest circumference of the tooth (that passes
from diverging axial surfaces to converging axial
surfaces). Mesial and distal rests anterior and
posterior to the edentulous areas, respectively, are
generally used.
What is a nonrigid connector?
A. An appliance composed of a key and keyway
that is used to connect one piece of a prosthesis
to another
B. An appliance that is used to connect two
crowns rigidly fixed
C. A bar appliance that is used to maintain a space
for a tooth that has not erupted
D. None of the above
A. Nonrigid connectors are used when it is not pos-
sible to prepare two abutments for a fixed partial
denture (FPD) with a common path of place-
ment or to segment a large or complex FPD into
shorter components. Nonrigid connectors can be
prefabricated plastic patterns (female or keyway
portion, and male or key portion) that are
embedded in the waxed crown and pon-
tic patterns or custom-milled in the cast crown.
The second part is then custom-fitted to the
milled retainer and cast.
The distance between the major connector on a
maxillary RPD framework and the gingival mar-
gins should be at least _____.
A. 3 mm
B. 2 mm
C. 6 mm
D. 15 mm
C. The recommended space or distance between
the border of the framework and the marginal
gingiva should be at least 6 mm.
The component that is responsible for connect-
ing the major connector with the rest and clamp
assembly is: A. The bar B. The minor connector C. The proximal plate D. The guide plane
B. The minor connectors are the components that
serve as the part of the removable partial denture
that connect the major connector and other
components such as the clasp assembly, indirect
retainers, occlusal rests, or cingulum rests.
The three dimensions of the Munsell Color
Order System, the basis for shade guides such
as Vita LuminTM, are _____.
A. Absorption, scattering and translucency
B. Color, translucency, and gloss
C. Size, shape, and interactions with light
D. Hue, value, chroma
D. The Munsell Color System, which is the basis of
shade guides such as Vita Lumin®, is divided into
three dimensions: hue is the shade or color of an
object; chroma is the saturation or intensity of the
color or shade; and value is the relative lightness
or darkness of a color.
The purpose of applying a layer of opaque
porcelain in a metal-ceramic restoration is to
_____.
A. Create a bond between the metal and porcelain
B. Mask the metal oxide layer as well as provide a
porcelain–metal bond
C. Create the main color for the restoration
D. A and B are correct
E. All of the above
D. The opaque porcelain is used for masking the
oxide layer of the metal and provides the porce-
lain–metal bond. The minimum thickness of the
opaque is about 0.1 mm.
The impression material that is mainly composed of sodium or potassium salts of alginic acid is \_\_\_\_\_. A. Polyether B. Irreversible hydrocolloid C. Polyvinyl siloxane D. Polysulfide
B. Irreversible hydrocolloid (IH) or alginate is the
material of choice to produce diagnostic casts. Its
composition is mainly sodium or potassium salts
of alginic acid. They react chemically with
calcium sulfate to produce insoluble calcium
alginate.
A complete denture patient presents with angular
cheilitis. A review of recent medical examination
revealed that vitamin deficiency is not a factor.
A possible predisposing factor is _____.
A. Excessive vertical dimension of occlusion
B. A closed or insufficient vertical dimension of
occlusion
C. Improper balance of the occlusion
D. Poor contour of the denture base
B. A closed or insufficient vertical dimension of
occlusion is thought to be one predisposing con-
dition for angular cheilitis, which usually is asso-
ciated with Candida albicans. Improperly
balanced occlusion or poor contour of the den-
ture base are not predisposing conditions for
angular cheilitis.
Each of the following is a feature of papillary
hyperplasia except one. Which one is not true?
A. It is a proliferative bone disease
B. It can be caused by wearing the dentures at night
C. It can be caused by poor oral hygiene
D. It can be caused by an ill-fitting denture
A. Paget’s disease of bone is a bone disease char-
acterized by bone resorption followed by
attempts at bone repair involving proliferation
leading to bone deformities. Its etiology is
unknown and it occasionally involves the maxilla
and mandible. Papillary hyperplasia is character-
ized by multiple papillary projections of the
epithelium caused by local irritation, poor-fitting
denture, poor oral hygiene, and leaving dentures
in all day and night.
For optimum esthetics when setting maxillary
denture teeth, the incisal edges of the maxillary
incisors should follow the _____.
A. Lower lips during smiling
B. Upper lips during smiling
C. Lower lips when relaxed
D. Upper lips when relaxed
A. Maxillary teeth should contact the wet dry lip line
when fricative sounds f, v, and ph are made.
These sounds help to determine the position of
the incisal edges of the maxillary anterior teeth.
Excessive monomer added to acrylic resin will result in \_\_\_\_\_. A. Increased expansion B. Increased heat generation C. Increased shrinkage D. Increased strength
C. Using more monomer than needed will cause
increased shrinkage. The more monomer used,
the less expansion, less heat, and reduced
strength will be produced.
Which is the purpose of adjusting the occlusion in dentures? A. To obtain balanced occlusion. B. To stabilize dentures. C. To obtain even occlusal contacts. D. All of the above.
D. Occlusal adjustment of dentures should be done
with the premise of obtaining even occlusal
contacts with balanced occlusion in order to
stabilize the dentures during function.
Which may be a consequence of occlusal trauma
on implants?
A. Widening of the periodontal ligament.
B. Soft-tissue sore area around the tooth.
C. Bone loss.
D. All of the above.
C. Bone loss is usually seen on the most coronal
aspect of the implant in the form of a wedge.
There is no periodontal ligament on implants, so
there is no feeling of soreness.
Which of the following is true of an occlusal rest
for a removable partial denture?
1. One-third facial lingual width of the tooth
2. 1.5 mm deep for base metal
3. 2.0 mm labiolingual width of the tooth
4. Floor inclines apically toward the center of the
tooth
A. All of the above
B. 1, 3, and 4
C. 1, 2, and 4
D. 3 and 4
C. Rests are critical for the health of the soft tissues
underlying the denture resin basis and the minor
and major connectors. It should prevent tilting
action and should direct forces through the long
axis of the abutment tooth. In order to function as
specified, an occlusal rest should have a rounded
(semicircular) outline form, be one-third the
facial lingual width of the tooth, one-half the
width between cusps, and at least 1.5 mm deep
for base metal. The rest floor inclines apically
toward the center of the tooth and the angle
formed with the vertical minor connector should
be less than 90 degrees.
A patient is unhappy with the esthetics of an
anterior metal-ceramic crown, complaining that
it looks too opaque in the incisal third. The
reason for this is most likely _____.
A. Using the incorrect opaque porcelain shade.
B. Inadequate vacuum during porcelain firing.
C. Not masking the metal well enough with the
opaque.
D. The tooth was prepared in a single facial plane.
D. D is the best answer because generally it is the
dentist’s fault and not the technician’s. Incorrect
opaque may influence the resultant shade.
Inadequate vacuum will affect the esthetics. If the
opaque does not mask well, the metal result is a
grey appearance or lower value in the restoration.
An endodontically treated tooth was restored
with a cast post-and-core and a metal-ceramic
crown. Three months later, the patient complains
of pain, especially on biting. Radiographic
findings and tooth mobility tests are normal. The
most probable cause of pain is _____.
A. A loose crown
B. Psychosomatic
C. A vertical root fracture
D. A premature eccentric contact
C. Usually, vertical fractures will refer pain when bit-
ing. In this case, the patient had recent endodon-
tic treatment and there is no periapical lesion to
indicate that is due to inadequate root canal ther-
apy. There is no sign that the crown is loose, no
premature contact, and no mobility.
For an occlusal appliance used for muscle
relaxation to be effective, the condyles must be
located in their most stable position from a
musculoskeletal perspective. This is _____.
A. Centric occlusion
B. At the vertical dimension of rest
C. Centric relation
D. Maximum intercuspal position
C. The condyles should be in centric relation, which
is defined as “the maxillomandibular relationship
in which the condyles articulate with the thinnest
avascular portion of their respective disks with the
condyle–disk complex in the anterior-superior
position against the shapes of the articular emi-
nences.” (Glossary of Prosthodontic Terms,
J Prosthetic Dent 94(1):21-22, 2005.)
A diagnostic wax-up is indicated when _____.
A. Re-establishing anterior guidance
B. A provisional fixed prosthesis is to be fabricated
C. Uncertainty exists regarding esthetics
D. All of the above
D. It is recommended that any time there is a ques-
tion regarding the treatment outcome involving a
prosthetic device, or the need to produce tem-
plates for provisional restorations that reproduce
a desired form of teeth, a diagnostic wax-up
should be generated.
Which of the following is the single most
important predictor of clinical success of a cast
post and core?
A. Amount of remaining coronal tooth structure.
B. Post length.
C. Post diameter.
D. Positive horizontal stop.
A. The length, canal enlargement, and a finish line
for the post are unimportant if there is no sound
remaining coronal tooth structure to get a ferrule
of the final restoration.
Which of the following are factors associated with bone loss? A. Initial implant instability. B. Excessive occlusal force. C. Inadequate hygiene. D. Inadequate prosthesis fit. E. All of the above.
E. Bone resorption around dental implants can be
caused by inadequate oral hygiene, premature
loading, and repeated overloading. If an implant-
supported framework does not fit passively, the
implant is placed under constant force. If signifi-
cant compressive forces are placed on the inter-
facial bone, these can lead to implant failure.
Which of the following statements is(are) true
concerning the evaluation of the occlusion on a
cast restoration?
A. The restoration is in proper occlusion if it holds
shim stock.
B. The restoration is in proper occlusion if the
adjacent teeth hold shim stock.
C. The restoration is in proper occlusion when
articulating paper marks multiple points of
contact on the restoration.
D. A, B, and C.
E. None of the above.
D. When checking the occlusion of a cast restora-
tion, mylar paper or shim stock is a very accu-
rate method for testing occlusal contacts. The
procedure is to check with the mylar paper
before placing the restoration in the teeth adja-
cent to the tooth to be restored and the oppos-
ing side. Place the restoration and check
whether the same occlusal contacts are main-
tained on the tested teeth. When all teeth,
including the one being restored, hold the mylar
paper upon occluding and even, articulating
markings are present, then occlusion contacts
are correct.
In a Kennedy Class I arch in which all molars
and the first premolar are missing and the rest
of the teeth have good periodontal support, the
preferred choice of treatment is _____.
A. A removable partial denture replacing all missing
teeth
B. A fixed dental prosthesis replacing the missing
premolar and a removable partial denture
replacing the molars
C. Implant supported crowns replacing the first
premolars and a removable partial denture
replacing the molars
D. A and B are preferred choice of treatment over C.
E. B and C are preferred choice of treatment over A.
E. A fixed dental prosthesis replacing the first
bicuspids improves the prognosis of the second
bicuspids when placing a removable dental
prosthesis. Implants would also improve the
prognosis by not leaving the second bicuspid
standing alone and acting as a cantilever when
in function with the removable prosthesis.
Which of the following is(are) uses for the
surveyor?
A. To aid in the placement of an intracoronal
retainer.
B. To block out a master cast.
C. To measure a specific depth of an undercut.
D. All of the above.
E. Only A and B are correct.
D. The surveyor is used for surveying a diagnostic
cast and to measure a specific depth of undercut.
It also helps to determine the most desirable path
of placement for a removable partial denture. It
identifies bony areas that may need to be surgi-
cally removed because they interfere during
insertion of the RDP. It is also used to survey
crowns, place intracoronal retainers, machine or
mill cast restorations, and survey and block out a
master cast before constructing an RDP.
A dentist is preparing all maxillary anterior
teeth for metal-ceramic crowns. Which of the
following procedures is necessary in order to
preserve and restore anterior guidance?
A. Protrusive record.
B. Template for provisional restorations.
C. Custom incisal guide table.
D. Interocclusal record in centric relation.
C. Anterior guidance must be preserved by means of
construction of a custom incisal guide table, espe-
cially when restorative procedures change the
surfaces of anterior teeth that guide the mandible in excursive (lateral, protrusive) movements.
A radiolucency near the apex of tooth #28 is seen radiographically. The tooth is asymptomatic and does not have caries or periodontal problems. Which is most likely the cause of the radiolucency? A. Submandibular fossa. B. Periapical granuloma. C. Complex compound odontoma. D. Mental foramen.
D. The tooth does not exhibit any pathology to indi-
cate that the radiolucency is derived from the tooth.
The mental foramen can appear on the apex,
depending on the direction of the x-ray beam.
The minor connector for a mandibular distal
extension base should extend posteriorly about
_____.
A. Two-thirds the length of the edentulous ridge
B. Half the length of the edentulous ridge
C. One-third the length of the edentulous ridge
D. As long as possible
A. The minor connector for the mandibular distal
extension base should extend posteriorly about
two thirds the length of the edentulous ridge; this
adds strength to the denture base.
Which are characteristics of a major connector
that contribute to health and well-being?
A. It is rigid and provides unification of the arch
stability.
B. It does not substantially alter the natural contour
of the lingual surface of the mandibular alveolar
ridge or the palatal vault.
C. It contributes to the support of the prosthesis.
D. All of the above.
E. Only A and B.
D. Rigidity is provided by cross-arch stability through
the principle of broad distribution of stress. The
major connector should not alter dramatically the
contours of the supporting structures, and it
should contribute to the support of the prosthesis.
When does a fixed dental prosthesis (FDP),
which was cast in one piece, need to be
sectioned?
A. When a cantilever pontic is used.
B. When the fit cannot be achieved or verified with a
one-piece cast.
C. When single crowns are adjacent to the FDP.
D. Always, in order to achieve a good fit.
B. Common reasons for a FDP not to fit in one piece
are lack of parallelism between the abutments
and distortion of the wax pattern during removal
from the dies. In any of these cases, the frame-
work may not fit in the prepared abutment teeth
and must be sectioned between one of the con-
nectors between the pontic and retainer to fit the
two pieces individually, and a solder record must
be made to solder the pieces.
When soldering a fixed partial denture, what is
the effect of flux when heated on the area to be
soldered?
A. To remove oxides from the metal surface.
B. To displace metal ions from the area.
C. To change the composition of the alloy.
D. To reduce the surface tension of the metal.
A. The soldering flux used with gold alloys is usually
borax glass (Na2B4O7), because of its affinity for
copper oxides. Flux is applied to a metal surface
to remove or prevent oxide formation. With an
oxide-free surface, the solder wets the surface
freely and spreads over the metal surface.
The component of an RDP that is spoon-shaped
and slightly inclined apically from the marginal
ridge of a tooth is the _____.
A. Indirect retainer
B. Minor connector
C. Rest
D. Lingual bar
C. The rest should be spoon-shaped and is slightly
inclined apically from the marginal ridge of the
abutment tooth. It should restore the occlusal
morphology of the tooth and not interfere with
the normal existing occlusion.
Metamerism invariably involves _____.
A. A color difference between two objects under
one or more illuminant(s)
B. One object having a lower chroma than another
C. One object having a lower lightness than another
D. A significant color change of one object as it
moves from one illuminant to another
- A. Metamerism is the phenomenon where a color
match under a lighting condition appears differ-
ent under a different lighting condition.
Ante’s law
Effect on length of FPD
Root surface of abutment > root surface of Pontic
Longer FPDs less stable
QUESTION: Where do you attach a non-rigid retainer from a FPD?
Distal of mesial abutment & mesial of the distal abutment
- Keyway = lock & key for non-rigid retainers, is located on the mesial of the distal abutment to prevent stress on the distal tooth (most likely to fail)
Most immediate sign after high occlusion on a bridge?
Myofacial pain
fixed partial denture keeps breaking, why?
POOR FRAMEWORK
Most common reason for PFM bridge breakage? Firing schedule, high contact, inadequate design
inadequate design
FPD seats during framework try-in but when come back for final cementation, the FPD holds up/doesn’t seat. Why?
Interproximal (porcelain over contoured)
- Check proximal contacts first when cast that fits on die cannot be seated on the teeth in the mouth.
All ceramic FPD should cover how much of abutment?
360 degrees
What is the basis for classification of different FPD pontics:
Relation of the pontic to the supporting tissue
Modified ridge lap pontic has what kind of contact?
Minimal contact w/ residual ridge
modified pontic how should it touch the gum?
Barely touch it
MOST esthetic pontic: Saddle, steins, sanitary, conical ridge lap, Modified ridge lap
Modified ridge lap
Pontic of 3-unit FPD should rest
gently on the soft tissue & should not blanch tissues.
Anterior teeth, which pontic is best?
Ovate or modified ridge
Pontic length on a bridge, what’s most important?
AP dimension, MD dimension
Strength of abutment connection to pontic which is more important?
occlusogingival width
Most important dimension that ensures the metal connector between abutment and pontic is sufficient (in 3-unit fpd bridge)?
occlusal-gingival
QUESTION: A pontic in the bridge shows the metal, why?
Under-reduction
Framework was not done well
Framework was not done well (since is a pontic this is probably the answer)
QUESTION: Edentulous space is wider than adjacent anterior tooth, how to match them? Make pontic line angles farther apart and deeper interproximal embrasures
Make pontic line angles closer and deeper interproximal embrasures
Make pontic line angles farther and shallower interproximal embrasure
Make pontic line angles closer and shallow interproximal embrasures
Make pontic line angles closer and deeper interproximal embrasures
QUESTION: How do you decrease the width of an artificial tooth?
Deepen the facial line angle proximally and increase the interproximal embrasure
Deepen the facial line angle proximally and decrease interproximal embrasure
Take the facial line angle labially and increase the interproximal embrasure
Take the facial line angle labially and decrease the interproximal embrasure.
Take the facial line angle labially and increase the interproximal embrasure
How do you make a crown narrower?
Move line angles more facially (closer together)
Ante’s law: 3 abutments, one being lateral, with 2 pontics, prognosis is good, poor, excellent?
Poor
Which of the following is not ideal abutment-pontic connection?
Lateral Incisor-Central Incisor
Central Incisor- Lateral Incisor,
Canine-Lateral Incisor
worst cantilever
lateral abutment with central pontic
QUESTION: Which cantilever bridge would be most destructive of the abutment tooth:
lateral incisor as abutment with central incisor as
pontic (larger root surface of pontic than abutment, Ante’s Law)
strength of soldered connector of FPD in enhanced by? 1. Using higher carat solder
2. Increasing height
3. Increasing width
4. Increasing gap
Increasing height
When soldering, what is the most important factor?
Height
What system is best for soldering adjusted FPD framework?
Oxygen something, use a torch
Keyhole for post /core is to
prevent rotation
Cast post and core - you put extra slit - what is that for?
Prevent rotation (keyhole)
What is the advantage of a fiber post over a cast post
Fiber post has the same modulus of elasticity as dentin
How does a dowel post & core help prevent vertical fracture? Ferrule, Ventilating groove, bevel, vertical stop
Ferrule
What is the point of putting a dowel post on an RCT tooth?
Retain core, metal set into root canal to provide support to crown
How should prep an RCT for cast post?
Need at least 4 mm of GP to preserve apical seal
Hue, value, chroma
What’s most important in color matching
Hue - color - least important
Value - brightness - most important
Chroma - saturation
Metamerism
Color appears different under different light
QUESTION: Most important when selecting shade? Value, translucency, chroma, hue, color
Value
Least important in selecting shade? fluorescence, value, chroma, hue
hue - due to lack of variation in mouth
When you have color index of 100, which of the following is effected?
Value - Color value is 0 = black while 100 = white
dentist adjusts the shade of a restoration using a complementary color. This procedure will result in
A. increased value.
B. decreased value.
C. intensified color.
D. increased translucency.
decreased value.
Crown #9 and #10. One of the crowns looks very light (white). What did the dentist pick wrong? Hue
Chroma
Value
Value
What does staining do for ceramics?
Decreases value. Alters chroma
What can’t occur with the addition of stain? Increase value, decrease value, increase chroma, increase hue, decrease chroma
Increase value
What can’t you change? hue, increase value, decrease value, change chroma
Increase value
When you add a different color to a resin, you increase what?
Chroma
How to change hue?
Add orange to it (some sources says it changes chroma)
How do you lower value in a restoration?
STAIN w/ Complement color or orange - when you add a complement color, the colors mix & turn grey, thus changing value
What complementary color to darken porcelain & decrease value? gray, orange, ochre, violet.
orange
If you add a complementary color yellow, what happens to the hue?
decrease red content of yellow red shade
- Side note: adding yellow stain = Inc chroma of basic yellow shade
- Pink purple makes yellow –> yellow red
Which represents position on the spectral wavelength?
Hue
Which color characteristic is dependent on spectral wavelength?
Hue
QUESTION: What is best way to determine value:
Open eye as wide as you can
Half close eyes (squint) to increase sensitivity to better select value.
Arrange the shade guide in increasing value (from light to dark)
Arrange the shade guide in increasing value (from light to dark)
More rods than cones so eyes are more sensitive to value
-
QUESTION: How to prevent metamerism –
look at shade under multiple light sources
Porcelain, look at it with different light sources (metamerism)
The phenomenon whereby various light sources produce different perceptions of color is called A. fluorescence.
B. incandescence.
C. opalescence.
D. translucency.
E. metamerism
metamerism
Upper molar crown has a wear facet in porcelain on the MB inclination of MB cusp. Most likely associated with?
Interference in protrusion & working interference
30 gold crown has wear located on the MB cusp of the MB incline, cause –
protrusive and working side movement
Contact on lingual portion of buccal cusp of mandibular molar, what kind of interference? Non-working, working, protrusive
Non-working
Contact on buccal portion of lingual cusp of maxillary molar, what kind of interference? Non-working lateral, working, protrusive
Non-working lateral
Wear facets on lingual incline of maxillary lingual cusp & facial incline of mandibular facial cusp on left side? pt has: left nonworking interference, protrusive interference, right nonworking interference, left working interference
left working interference
Working side interferences are seen on what surfaces?
palatal inclines of buccal cusp of upper and buccal incline of lingual cusp of lower; (the nonworking cusps on the final side are interfering)
- In MIP or CO, the buccal incline of palatal cusp of upper and lingual incline of buccal cusp of lower.
- Balanced side interferences are buccal incline of palatal cusp of upper and lingual incline of buccal cusp of lower (it’s the working cusps
interfering)
Wear on buccal of maxillary premolars due to, due to mandibular movement working or nonworking?
Working
When will the BULL rule be utilized with selective grinding?
Working side
QUESTION: The mesiobuccal incline on the mesiobuccal cusp of mand molar (with stainless steel crown) has wear. This is because of movement
in which direction(s):
working and protrusive movement
Max molar on mesial slope of mesial lingual cusp, where do you have wear on lower teeth? Mesial or distal incline of either mesial facial or mid facial cusp?
Distal incline of midfacial cusp
The mesial angle of the ML of max 2nd molar occludes with what on the man 2nd molar
a. Mesial MB cusp
b. Distal MB cusp
c. Mesial DB cusp
d. Distal DB cusp
Distal MB cusp
Mesial angle of the L of maxillary second molar occludes with what on the mand 2nd molar.?
Distal of MB CUSP
Pt bites down after cementing down and deviates to the right #30:
Lingual incline of the buccal cusp
Crown on number 30, pt tries to close, contact interference deviates to left, lingual incline of buccal cusp needs to be altered buccal incline of the lingual cusp
buccal incline of the lingual cusp
In restoring a canine protected occlusion, with anterior overbite of about 2mm. The buccal cusps of posterior teeth should be flat,
BECAUSE they will guide the protrusion.
a. both are true
b. only the second statement is true
c. both are false
d. only the first statement is true
d. only the first statement is true
What kind of occlusion if in right lateral movement all posterior teeth are not in occlusion:
canine guidance
Which of the following would result in inaccurate terminal hinge record? acutely apprehensive patient, severe skeletal cl III, tooth
contact, muscle pain, etc
tooth
contact,
You have a patient who wants an all porcelain on number 8 – the incisal edge keeps breaking off and u have to come in to repair,
why does it keep breaking off?
Because the anterior guidance and the protrusive movements/clearance space was not properly
calculated/maintained
What is Bennett angle?
a. it is the angle that is formed by the non-working condyle and the sagittal plane during lateral
movement
b. it is the angle that is formed by the condyle and the horizontal plane during protrusive
movements.
c. It is a difference in condylar inclination between protrusive and lateral movements
d. It is the difference between in the condylar and incisal inclinations.
a. it is the angle that is formed by the non-working condyle and the sagittal plane during lateral
movement
Bennett angle: formed between sagittal plane and average path of advancing condyle as viewed in the horizontal plane during lateral mandibular movements. Avg range: 7.5 - 12.8
Bennett shift mainly on:
lateral movement or working side
Most common form of internal TMJ derangement
anterior misalignment or displacement of the articular disk above the condyle.
disk displacement with reduction
disk returns
clicking and pain with chewing
disk displacement without reduction
remains displaced
no clicking, max opening < 30mm
capsulitis
TMD without clicking
no clicking no reduction
upper compartment of TMJ
tranlsation
lower compartment of TMJ
rotation
Where to the condyles go in CR?
Superio-anterio-Medial
Which anatomical components are responsible for rotation of the mandible?
Disc and condyle
If you both condyle break, what you get?
Posterior open bite
Dislocation of condyle-
mandible deviates opposite
Clicking in TMJ:
internal derangement with reduction
Patient always had internal derangement with clicking. All of a sudden, no noise and open max 30 mm. What happened?
Myofascial pain, Lockjaw, Internal derangement w/o reduction
Internal derangement w/o reduction
Which way is the articular most displaced?
Anterior-medially
Which artery supplies the TMJ? D
eep auricular, maxillary, superficial temporal…MADS
- MADS: Middle meningeal from maxillary, ascending pharyngeal, deep auricular, superficial temporal
Best imaging for TMD (soft tissue, disc & condyle of TMJ):
MRI
Best diagnostic eval for TMJ disc? MRI, CT, PA radiograph
MRI
Rotation involves what structures? Condyle, glenoid fossa, disc, TMJ
Condyle
