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BDS2 Clinical Dental Science > Prosthodontics > Flashcards

Prosthodontics Flashcards

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1
Q

what are some adv and disadv of RPD over other restorations

A

adv - cheaper, removal for hygiene, minimally invasive

disadv - may be bulky and less aesthetic, less retention and stability

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2
Q

what is an occlusal unit and how many should we aim to have

A

an opposing molar or premolar - should aim to have 3-5, molar is 2 units, premolar is 1

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3
Q

what are some anatomical consequences of missing teeth

A

mandibular and alveolar bone resorption, decreased chin to nose distance as chin protrudes, tooth movement - over eruption or drifting

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4
Q

what are some other consequences of missing teeth

A

aesthetics, functional - eating and speaking, may result in malabsorption and weight loss, psychological

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5
Q

what is the denture flange

A

where it extends into vestibular sulcus

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6
Q

what are the kennedy classifications

A 
class I - bilateral free end saddle
class II - unilateral free end saddle
class III - unilateral bounded saddle
class IV - bounded saddle crossing the midline
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7
Q

what are saddles classified on and when can they be modified

A

classified on most posterior saddle, any additional anterior saddles are a modification

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8
Q

what is denture support defined as

A

resistance of denture to occlusally directed load

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9
Q

how can support be classified

A

craddock classification

1 - tooth only, 2 - mucosa only, 3 - tooth and mucosa

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10
Q

how should the force be distributed if using rest seats on abutment teeth

A

down the long axis of the tooth, through periodontal ligament to alveolar bone, if bounded saddle adjacent to saddle, if free end, should be on the other side

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11
Q

what should be avoided when using abutment teeth for support

A

distal axial torque of the abutment tooth, when the force is not down the long axis

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12
Q

what determines the force a tooth can withstand

A

the surface area of the root - molars, canines, premolars then incisors in order of most force

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13
Q

why is mucosa borne support not ideal

A

transmits force directly through to alveolar bone, which can increase bone resorption, need a large area to reduce resorption. soft tissue is also more compressible so more movement of denture

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14
Q

how much occlusal space is required for a rest seat

A

0.5mm

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15
Q

what is blocking out

A

using wax to remove any unwanted or unused undercuts between high and low survey line

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16
Q

why do casts need to be blocked out

A

if undercuts are not removed, acrylic will be produced that goes into this undercut, the denture then wont be able to fit over the most bulbous part of the tooth, dentist will have problems trying to seat the denture

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17
Q

how are casts blocked out

A

wax put over cast then chisel on surveyor to remove excess wax, can also use plaster

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18
Q

why are casts duplicated

A

to have a working cast and a master cast

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19
Q

how are cast duplicated

A

use an investment material and place cast inside, either hydrocolloid or sillicone is poured into this investment material, basically takes another set of impressions. the cast is then removed, impression left and stone is poured in, produce another cast

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20
Q

what is the duplicated cast used for

A

for producing a wax design

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21
Q

why is a refractory cast required

A

when producing cocr in an investment material, a cast is required to withstand temperatures of 1000 degrees, stone and plaster cannot so another cast is required made of material that will

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22
Q

what is a post dam

A

adhesion at posterior periphery of upper denture in palate, before palatine fovea

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23
Q

what is a pin dam

A

anteriorly at gingival margin, ensures food and plaque cannot get underneath the denture - flush fitting

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24
Q

what is retention

A

resistance to vertical displacement of denture

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25
Q

what are the mechanisms of retention

A

mechanical - clasps around abutment teeth
physical - coverage of mucosa, saliva
muscular - buccinator, lips and tongue muscle keeping it in

26
Q

what are guide planes

A

proximal surface is parallel to path of insertion, no distortion on insertion and removal

27
Q

what are the dimensions for a cobalt chrome clasp

A

length - 50mm, in an undercut of 0.25mm, ensure undercut isnt 1mm within gingival margin

28
Q

where are undercuts commonly found on upper and lower molars

A

upper - buccal normally distal

lower - lingual normally mesial

29
Q

what is reciprocation

A

preventing horizontal displacement of tooth caused by clasps

30
Q

are there any dimensions for reciprocal arms

A

do not engage undercuts but must have sufficient space from occlusal surface without being in undercut

31
Q

what is the pattern of retention

A

should have 3 points of retention on 1 arch - the bigger the triangle the more stable the retention

32
Q

how can the path of insertion be altered for retention

A

if undercuts present anteriorly at common path of displacement, altering the path of insertion can remove these undercuts, allows for resin to flow into here and provide retention.

33
Q

what can be a consequence of altering path of insertion

A

altering posterior undercuts, can make them larger

34
Q

what do the letters stand for in RPI

A

r - rest, normally an mesial occlusal rest seat
p - proximal plate
i - gingivally approaching i bar clasp

35
Q

what is indirect retention

A

preventing rotational displacement of the denture

36
Q

give an example of indirect retention

A

rest seats on more anterior teeth - e.g. cingulum on canine or on premolar, lingual plate or continuous clasp

37
Q

what happens at the first visit of denture patient

A

examine patient, establish relationship, examine denture - what did they like about it etc, primary impressions, wax waiver

38
Q

what material is normally used for primary impressions and what can be used in saddle areas

A

alginate normally used, free end saddles can have compound, better accuracy

39
Q

where should an impression tray extend to

A

retromolar pad

40
Q

what is used for recording occlusion

A

if casts can be hand articulated - wax waver

if casts cannot be hand articulated - jaw registration wax record blocks - separate visit prior to master impressions

41
Q

what must be done before master impressions are taken

A

decide on denture design, prepare rest seats, know what undercuts will be used and if any need prepared, decide on path of insertion

42
Q

how can special trays be altered if not the correct fit

A

under extended - at green stick or compound at the end, extend peripheries
over extended - trim with a bur

43
Q

what impression materials are used for master impressions

A

silicone - medium bodied, not too runny, good surface reproduction
polyether - not good for undercuts, alginate

44
Q

what happens at visit 3 or 4 (if wax record block)

A

framework trial and recording occlusion - first done separately then together once experienced

45
Q

what is done in framework trial

A

check good fit on framework, not too tight, can check cast for any marks or damage

46
Q

why is occlusion recorded at this later time

A

to ensure correct setting of teeth that it doesnt interfere with occlusion

47
Q

what instructions must be given to the lab after framework trial and recording occlusion

A

colour and shape of teeth

48
Q

what are some reference points for setting anterior teeth

A

midline, inter-pupillary line, ala-tragal line, curvature of lower lip, smile line

49
Q

what is done in the visit prior to delivery

A

tooth trial - wax of final denture, like a dress rehersal, need to make sure patient is fully happy with it before sending it to acrylic

50
Q

what instructions must be given to patient

A

how to put it in, how to clean it, make sure they know to expect some discomfort and will need to develop neuromuscular control

51
Q

if a patient isnt wearing denture at their review what should you do

A

tell them to not to perservere if too sore, but wear for a couple of days before their next visit so we can see where flanges might be digging in or any areas that are too tight

52
Q

what is the purpose of a minor connector

A

to connect all the design components to the major connector

53
Q

give some examples of a major connector used in upper arch

A

anterior posterior bar (ring design), mid palatal strap, horseshoe bar

54
Q

give some examples of major connectors used in lower arch

A

lingual bar, sublingual bar, lingual plate, dental bar, continuous clasp

55
Q

what are some adv and disadv of plates and bars

A

plates - can be thinner, 0.5mm, more comfortable but cover more mucosa so feels less like the patient
bars - have to be much thicker 2mm but covers less mucosa so patient has better sensation

56
Q

how much space is needed between gingival margin and connector

A

3-5mm

57
Q

how much space is required for a lingual bar

A

from gingival margin to floor of mouth - 8mm

3mm for gingival clearance, 4mm height of bar, 1mm from floor for muscle movement

58
Q

what stages are involved in restorative treatment plan

A

immediate - temporary dressing to stop the pain and discomfort, short term solution
hygienic - get the patient into good oral hygiene habits, assess patients motivation - determines treatment
corrective - long term solution, rpd, crown, bridge
maintenance - periodontal scaling, support, required for successful treatment

59
Q

what are the clinical stages of rpd design

A

primary impression, jaw registration (if required), tooth prep and master impressions, framework trial and secondary occlusion, tooth trial, delivery, review

60
Q

what treatments might be done prior to rpd design

A

periodontal treatment, surgery, orthodontic, endodontic if tooth in radiograph seen to have caries, might not be giving them problems but denture will fail, crowns or bridges, not done until design of rpd decided to encorporate it

61
Q

what have you got to look at before deciding whether to use an abutment tooth for support

A

periodontal condition, condition of mucosa, occlusal relationship, aesthetics

62
Q

briefly describe the lost wax technique

A

on refractory cast, wax up the cocr design. then place spruces to allow molten metal to flow into the mould, then cover with investment material. then heated up, wax melted, molten cocr introduced and allowed to produce mould

BDS2 Clinical Dental Science (6 decks)

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