Prosthodontics1 Flashcards
The shape and amount of
• the distobuccal extension of a complete mandibular edentulous impression is determined during border molding by the ?
• The distolingual extension is limited by the action of ?
- position and action of the masseter muscle
* the superior constrictor muscle
The most important consideration in checking custom trays for accurate border molding is ?
stability and lack of displacement
The primary reasons for obtaining the most extensive areal coverage for a mandibular complete denture are:
• to increase the capacity of underlying structures to withstand the stress due to biting force and to improve appearance
• to provide balanced occlusion and to increase tongue space
• to increase the capacity of the underlying structures to withstand the stress due to biting force and to increase the effectiveness of the seal
• to improve retention and to increase tongue space
to increase the capacity of underlying structures to withstand the stress due to biting force and to increase the effectiveness of the seal (underextension of the peripheral border of a complete mandibular denture decreases tissue-bearing surfaces, thereby affecting denture stability. Marked ridge resorption will occur if a mandibular complete denture base terminates short of the retromolar pad)
Mandibular dentures do not rely on suction from a peripheral seal for retention (as do maxillary dentures) but rather on denture stability in ?
covering as much basal bone as possible without impinging on the muscle attachments
? in mandibular border molding is often the most difficult area to manage.
Retromylohyoid area
Immediate dentures should be scheduled for relines at: • 1 month and 3 months post extraction • 4 months and 7 months post extraction • 5 months and 10 months post extraction • 1 year and 2 years post extraction
5 months and 10 months post extraction (Recontouring of the healing ridge progresses rapidly from four to six months and does not become stable in form until 10 -12 months post extraction)
When a patient wears a complete maxillary denture against the six mandibular anterior teeth, it is very common to have to do a reline every so often due to ?
the loss of bone structure in the anterior maxillary arch
All new dentures should be evaluated: • 3 hours after delivery • 12 hours after delivery • 24 hours after delivery • 48 hours after delivery
24 hours after delivery (done for the purpose of correcting undetected errors and adjusting areas that are causing tissue trauma)
Posterior teeth that are set edge to edge may cause: • gagging • cheek biting • reduced taste • speech aberrations
cheek biting
Lip biting may be due to ?
reduced muscle tone and/or a large anterior horizontal overlap
Tongue biting may be caused by having ?
posterior teeth too far lingually
Maxillary anterior teeth in a complete denture are usually arranged:
• facial to the ridge
• lingual to the ridge
• exactly over the ridge
facial to the ridge (Setting anterior teeth directly over the ridge usually causes poor esthetics of dentures)
For most patients, the labial surface of the central incisor should be approximately ? mm anterior to the center of the incisive papilla
8
? should support the lower lip when the teeth are in occlusion.
The labioincisal one-third of the maxillary central incisors
A patient who wears a complete maxillary denture complains of a burning sensation in the palatal area of his/her mouth. This is indicative of too much pressure being exerted by the denture on the: • incisive foramen • palatal mucosa • hamular notch • posterior palatal seal
incisive foramen
A burning sensation in the mandibular anterior area is caused by ?
pressure on the mental foramen
A patient having trouble swallowing may have ?
insufficient interocclusal space — decreased freeway space caused by excessive vertical dimension of occlusion
The best dietary advice for an elderly denture patient is to eat foods rich in ?
protein and vitamins A, C, D, and B complex
Learning to chew satisfactorily with new dentures requires at least ? weeks. This time is spent on establishing new memory patterns for both facial and masticatory muscles.
6-8
? can be ruined by the use of denture adhesives and home-reliners. These agents can modify the position of the denture on the ridge and as a result, change both vertical and centric relations.
Residual ridges
The treatment plan for a patient indicates that both mandibular and maxillary immediate dentures are to be fabricated. The ideal way to do this is:
• fabricate the maxillary immediate denture first
• fabricate the mandibular immediate denture first
• fabricate the maxillary and mandibular immediate dentures at the same time
fabricate the maxillary and mandibular immediate dentures at the same time
The duplication of the master cast used for the construction of the surgical template to be used at the time of immediate denture insertion is best made after ?
wax elimination and after the cast is trimmed
A major advantage with immediate dentures is being able to ?
duplicate the position of the natural teeth
The first step in the treatment of abused tissues in a patient with existing dentures is to: • fabricate a new set of dentures • reline the dentures • educate the patient • excise the abused tissues
educate the patient (The patient should understand both the cause of the tissue deterioration and the eventual outcome if the process is not arrested) then we should remove the dentures
The most important benefit of an overdenture (root-retained denture) is:
• the psychological comfort of avoiding the loss of all teeth
• the continuous functional feedback for the neuromuscular system from proprioceptors in the periodontal membrane
• the preservation of the alveolar ridge
• the improved support and stability for the denture
• the increased retention of the denture
the preservation of the alveolar ridge
The incisal edges of the maxillary anterior teeth should just touch the wet/dry line of the lower lip when enunciating which sound(s):
• linguoalveolar sounds or sibilants (such as s, z, sh, and ch)
• fricatives or labiodental sounds (such as f, v, or ph)
• b, p, and m sounds
• linguodental sounds (such as this, that, or those)
• fricatives or labiodental sounds (such as f, v, or ph)
A whistling sound with dentures is indicative of having ?
a posterior dental arch form that is too narrow or high.
The b, p, and m sounds: are made by contact of the lips. Note: ? can affect the production of these sounds
Insufficient lip support by the teeth or the labial flange
Note: The two most probable causes of a patient complaining that whenever he/she tries to make an “s” sound, it sounds like “th” are ?
- Incisor teeth are set too far palatally
* Palate is made too thick
To evaluate vertical dimension, have the patient pronounce the s sound; the interincisal separation should be ?. This is known as ?
- 1 to 1.5 mm.
* the closest speaking space
• If the teeth are positioned too far ?, the “t” will tend to sound like a “d.”
If the teeth are positioned too far ?, the “d” will sound more like a “t.”
- lingually
* labially
? can result in clicking of teeth
An increased occlusal vertical dimension
The primary role of anterior teeth on a denture is: • to incise food • occlusion • esthetics • stability of the denture
esthetics
Whistling when a patient speaks with dentures (complete or partial which replaces the incisors) may be caused by any of the following:
- Vertical overlap is not enough
- Horizontal overlap is too much
- The area palatal to the incisors is improperly contoured (too high or too narrow)
Do not set mandibular molars over the ascending area of the mandible because ?
the occlusal forces in the area will dislodge the mandibular denture
A patient has worn a complete maxillary denture for 8 years against mandibular anterior teeth (the remainder of the mandibular teeth are missing). She complains of looseness of the denture. Examination of the mouth shows an excessive amount of hyperplastic tissue at the anterior part of the maxillary ridge. The maxillary denture teeth do not show below the upper lip. Radiographs show poor bone structure in the anterior part of the maxillae. The principal cause of difficulty with her maxillary denture is:
• fibrous tuberosities
• too great a vertical dimension of occlusion
• a lack of posterior occlusion
• the maxillary denture teeth that were used are too short
a lack of posterior occlusion (The patient’s chief complaint will be looseness of the maxillary denture. They will also state that they can no longer sec their upper teeth on the denture. These signs and symptoms are caused by a lack of posterior occlusion)
- Denture ? is necessary to resist dislodgement of a denture in the horizontal direction
- Denture ? is the ability of the denture to withstand dislodging forces exerted in the vertical plane.
- stability
* retention
The primary indicator of the accuracy of border molding is:
• adequate coverage of tray borders with the material used for border molding
• contours of the periphery similar to the final form of the denture
• stability and lack of displacement of the tray in the mouth
• uniformly thick borders of the periphery
stability and lack of displacement of the tray in the mouth
After border molding is completed, some areas of the modeling compound should be relieved because the tissues are extremely displaceable and have probably been distorted during the border molding process. These areas include ?
around the maxillary labial frenum and over the retromolar pad areas
You are in the process of making a complete maxillary denture for a patient. Which of the following structure(s) will be the secondary support area (s): • residual ridges • palatal rugae • incisive papilla • maxillary tuberosity • buccal vestibule
palatal rugae
The primary support areas of the maxillary complete denture are the residual ridges (the maxillary and palatine bones).