Rem Pros

Question 1

give an alternative to making a pt edentulous

Answer 1

over dentures - retaining and restoring roots to support an overlying denture

Question 2

define resistance and stability

Answer 2

resistance = resistance of a denture to vertical movement away from the tissues
stability = resistance of denture displacement by functional forces (moreso lateral movement)

Question 3

what is interfacial surface tension?

Answer 3

thin layer of fluid between 2 parallel planes of rigid material

Question 4

what is interfacial viscous tension?

Answer 4

force holding 2 parallel plates together that is due to viscosity of the liquid in between

Question 5

how does viscosity of the interposed liquid affect interfacial viscous tension?

Answer 5

as thickness of the liquid increases interfacial viscous tension falls

thinner saliva is better for tension

Question 6

explain the difference between adhesion and cohesion

Answer 6

adhesion = the physical attraction of unlike molecules for each other i.e. saliva to mucous membranes
cohesion = they physical attraction of similar molecules i.e. salivary film

Question 7

what does the post dam provide? where is it placed?

Answer 7

adequate seal for the maxillary denture
it is placed behind the hard palate border and in front of the palatine fovea & vibrating line on the soft palate

Question 8

what ensures optimal adaptation of denture to mucosa?

Answer 8

good surface detail of impressions

Question 9

what structure does adequate extension of the impression into the lingual pouch ensure you reach?

Answer 9

retromylohyoid fossa

Question 10

how should teeth be positioned over mandible and maxilla?

Answer 10

over central aspect of mandible
bucally positioned on maxilla

Question 11

what can be added to denture to ensure good base fit? what do these allow?

Answer 11

valves - they suck out the air from under the denture and act like suction cups

Question 12

what else can be placed to aid denture retention?

Answer 12

anchors - implants placed into bone
minimum of 2 implants required to retain prosthesis

Question 13

give 3 consequences of natural teeth opposing an edentulous ridge

Answer 13

trauma
inc resoption - especially anterior maxilla
lack of denture stability

Question 14

explain combination syndrome - who is it commonly seen in?

Answer 14

commonly seen in pts w/ completely edentulous maxilla and partially edentulous mandible but preserved teeth in anterior mandible

leads to severe anterior maxillary resorption w/ hypertrophic and atrophic changes in diff quadrants of maxilla and mandible
overgrowth of tuberosities
papillary hyperplasia of mucosa of hard palate
extrusion of mandibular anterior teeth - over erupt
loss of alveolar ridge height from below denture

Question 15

how will a fibrous ridge present?

Answer 15

flabby & blanches/moves w/ pressure

Question 16

what impression taking technique should be used for fibrous ridges? explain 2 ways this can be done.

Answer 16

mucostatic - can by done via:
1. perforations in impression tray - prevents distorting of flabby ridge during impression taking

2. 2 stage impression - 1st putty impression, remove excess putty around fibrous area then use light bodied silicone around fibrous ridge

Question 17

where should denture finish?

Answer 17

at junction between hard and soft palate

Question 18

how should borders of impressions be?

Answer 18

well rounded border - not knife edge

Question 19

how will absent lower posterior teeth affect stability of upper denture?

Answer 19

upper denture will tip backwards

Question 20

what is meant by a balanced occlusion?

Answer 20

opposing teeth contact evenly on both sides

Question 21

explain what is meant by reline & rebase? only what kind of dentures are rebased?

Answer 21

reline = adding new material to tissue surface of an existing denture - fills space between original denture controur and altered tissue contour

rebase = replaced entire denture base material of an existing denture - only rebase completes, not partials

Question 22

list 3 types of reline materials

Answer 22

1. temporary - not resilient and only last for short period
2. soft - cushioning
3. permanent - resilient

Question 23

where can relines be fabricated? which is better?

Answer 23

chairside or lab - lab tend to be more reilient

Question 24

temporary relines - also known as? good for? when are they used?

Answer 24

“tissue conditioners”
good for inflamed ridges
can improve denture fit whilst allowing tissues to heal preventing further trauma
used post immediate dentures and after implant surgery

Question 25

when are soft relines useful?

Answer 25

parafunctional habits atrophic ridges cancer/cleft pits

Question 26

what is likely to happen w/ soft linings? why?

Answer 26

candida infections plasticiser in soft linings leaches and deteriorates - can harbour mircoorganisms

Question 27

list 4 materials used for soft linings - what kind is molloblast b?

Answer 27

heat cured acrylic self-cured acrylics heat cured silicones (molloblast B) self-cured silicones

Question 28

permanent relines - usually what material? useful when/for? (3) prolongs? often created where?

Answer 28

hard acrylic useful when: 1. issue w/ peripheral seal 2. correcting errors following inadequate master impression 3. immediate or post immediate denture prolongs lifespan of old dentures often lab based

Question 29

when does appearance of denture suggest worn surface? what does this suggest?

Answer 29

if denture fit surface looks glossy/shiny denture no longer well adapted

Question 30

give clinical technique for rebase/reline - what impression material & technique is used?

Answer 30

1. use acrylic bur to remove undercuts of denture on fitting surface 2. use close fitting tray to record new impression 3. take wash impression with zinc oxide eugenol light bodied material and using closed mouth technique 4. send denture and impression off to lab and request rebase/reline

Question 31

what will lab then do to denture for reline/rebase?

Answer 31

1. overcast denture in plaster - maintains position and OVD of denture 2. denture removed from cast and post dam carved 3. fitting surface and palate of denture cut away 4. denture placed back over cast all parts put back together using sticky wax 5. palate added in wax and flasked using injection method 6. wax removed and acrylic injected into mould

Question 32

how would you repair a midline fracture in complete denture?

Answer 32

locate fractured pieces, disinfect and send to lab, no impression required

Question 33

how would you repair as lost acrylic flange?

Answer 33

impression taken w/ fractured denture in mouth and send to lab

Question 34

how would you repair debond between acrylic and Co/Cr? what materials can be used to retain Co/Cr to acrylic?

Answer 34

add retentive tags - solder on and use 4-META or silicoat Co/Cr to retain Co/Cr to acrylic

Question 35

what materials could you use to repair temporary denture? (2) where can this be done?

Answer 35

use self cure acrylic or cyanoacrylate glue can be done chairside

Question 36

how would you repair denture smashed into multiple pieces?

Answer 36

unrepairable

Question 37

list 3 types of denture additions

Answer 37

immediate - when tooth added on day of XLA post-immediate - tooth added onto denture 2-3 weeks after XLA retention - clasp added to improve retention

Question 38

only what kind of dentures can additions be done on?

Answer 38

only on partial - not complete

Question 39

what kind of impression technique do additions require?

Answer 39

denture in mouth during impression

Question 40

what denture material is harder to add to?

Answer 40

Co/Cr

Question 41

what is an overdenture?

Answer 41

any removable prosthesis that covers and rests on one or more natural teeth, roots or implants

Question 42

what precision attachments are used in overdentures? how can they be replaced?

Answer 42

Zest Anker male and female components (ball and socket) replaced by cold curing into new denture

Question 43

when are immediate replacement dentures used/not used?

Answer 43

used for straight forward XLA not if many XLAs at once - as lots of resorption will occur

Question 44

give 3 designs for immediate replacement dentures

Answer 44

flanged part flanged open face

Question 45

what does open face design lack? when is it useful?

Answer 45

lacks an upper labial flange good when bulky upper anterior alveolar ridge - doesn't add to bulk, avoids fat lip

Question 46

what is a disadvantage of open face design?

Answer 46

resorption can cause gap between denture and ridge - part flange may be useful here

Question 47

immediate denture replacement after care - how long must be kept in for? when to review? what should be examined on review? what should pt do after 24hrs?

Answer 47

1. must be kept in for 24 hrs 2. review appointment day after insertion 3. on review remove denture and examine for healthy clots, assess for inflamed areas 4. after 24hrs - warm saline mouthwash, remove and clean denture after meals

Question 48

when is one stage immediate denture used? how is this done?

Answer 48

to replace 1 or 2 anterior teeth in an otherwise intact arch 1. upper/lower imps taken 2. wax squash bite to confirm occlusion 3. choose shade and prescribe to lab including design 4. XLA and insertion of denture at next visit

Question 49

list order steps for construction of immediate replacement denture - what is this order the same as?

Answer 49

1. exam 2. primary imps 3. occlusion 4. design 5. second imps 6. try-in 7. XLA & finish order same for partial denture construction

Question 50

what disease can occur around implants (instead of periodontitis)?

Answer 50

periimplantitis

Question 51

what radiograph technique is good for implant planning and placement?

Answer 51

CBCT

Question 52

give 2 ways implants replacing multiple teeth can be retained advantages & disadvantages of each?

Answer 52

cement or screw retained cement - no screw hole, excess cement can cause inflammation/bone loss, may be too retentive screw - easily replaced, screw hole present

Question 53

give 3 structures on implants to secure denture firmly

Answer 53

1. ball and socket 2. gold bar - prevents anti-rotation more so than ball and socket 3. CAD CAM titanium bars - stronger than gold bar

Question 54

what do SDCEP guidelines say about role of GDP in implants/overdentures

Answer 54

1. baseline PA to be taken 1 yr after connection 2. OH TIPPS important 3. probe gently around implant - assess for cement, submucosal plaque, cement 4. assess inflamm, BOP, suppuration 5. BPE not necessary

Question 55

what is peri-implant mucositis?

Answer 55

inflammation of the peri-implant mucosa no evidence of crestal bone loss tissues red and swollen may have BOP

Question 56

what is peri-implantitis

Answer 56

infection and suppuration/inflammation oft soft tissues around implant significant crestal bone loss around implant after adaptive phase tissues red and swollen may have BOP suppuration