Removable- ABGD Flashcards
What is the greatest rate of resorption in a edentulous patient?
1st 12 months
between the maxilla and mandible which experience greater resorption? and by how much
mandible 4x greater
What anatomic structure is #1?
retromolar pad
How does the retromolar pad develop
scar from 3rd molar removal
What comprises the retromolar pad?
buccinator,
mucous glands,
temporalis tendon
pterygoidmandibular raphe
superior constrictor
What is the primary support area for a mandibular complete denture?
buccal shelf
Submandibular fossa
What anatomical structure is located in the submandibular fossa?
submandibular gland
What is the primary support area for a maxillary complete denture.
post alveolar ridge
What anatomical structure identifies the distal end of a max complete denture?
Hamular Notch - aka Pterygomaxillary notch
What does the post palatal seal accomplish on a complete denture?
- creates a post seal against the soft palate
- increased the cross sectional strength
- compensates for polymerization shrinkage
- increases retention
- decreases the gag reflex
- less food under the denture
Where do you place the posterior palatal seal?
at approximately the vibrating line (Ahh) which is near the fovea palatine ~ 2mm post
creating:
empirical alteration
functional/direct: add wax to your trial base
semi-functional: adjust the cast according to the palpated amount of tissue depressability
***Ahhh and valsalva lines
For denture patients, what are some factors causing candida-associated denture stomatitis?
Systemic:
DM, age, steroid, poor nutrition
Local: trauma, xerostomia, ABX, amoking, high carb diet
How much space do you need for a lingual bar? What is the minimum height for one?
7mm for L bar
min 4mm bar height
3mm from ging margin
What are the requirements for an all on 4 denture?
no para-function
standard mouth opening
Adequate ridge size:
- MAX: W-5mm, H-10mm
- Mand: W-5mm, H-8mm
Min 10mm implant
Tilt of implant 45 degrees maximally on post (reduces cantilever)
A-P spread: 1.5
10-12 teeth as fixed, with max 1-2 teeth cantilever
Achieve primary stability during surgery (35Ncm)
Whats the minimum space for a denture locator
8-10mm
Locator: 3-3.5mm
Acrylic: 2mm
Abutment cuff/tissue to implant platforms: 2mm
How are kennedy classifications modified when dental implants are considered?
McDermott- “OD” over denture
Schneid & Mattie: “I” implant
Ie: Class 1- I (19,30)
When would you consider a reline/rebase?
Immediate dentures, 3-6 months after initial fabrication
alveolar ridge resorption, but occlusion still stable
pt can’t afford a new denture
When making a new set would cause the pt undue stress
How do you do a clinical remount and why?
can fully ID post processing occlusal issues
ID problems in lab, which saves chair time, and patient isnt watching
How do you perform a clinical remount
save the remount index and mx/mand remount jigs
make an intraoral centric max occ x2
mount the mandibular denture using the pre-process remount jig on the articulator
mount the max to the mand using the intraoral centric bite registration
set condylar guidance/process side shift to previous settings
Set/verify occlusion: centric contact
- Working: BULL RULE
Balancing: L inclines of mand B cusps
Protrusive: mesial inclines of mand cusp and D incline of max cusp
just look at these and know them
What are the different impression techniques?
Mucostatic
- pressureless, tissues at rest
Functional
- impression made while tissues are under load
Selected Pressure
-distribute pressure to areas that are best capable of withstanding load
Mucostatic: hese impressions will generally lead to a denture which has a good fit during rest, but during chewing, the denture will tend to pivot around incompressible areas (e.g. torus palatinus) and dig into compressible area
What are 2 critical measurements to collect at the records appointment?
Facebow- stimulate jaw movements, assessment of tooth arrangement
Jaw relation at proposed OVD
- minor changes in vertical can be made at try in
What is the importance of vertical dimension determination?
physiological rest
phonetics and esthetics
patient perception
closest speaking space
What are two common occlusal schemes?
Lingualized
-esthetic compromise
- articulates max lingual to man occlusal
-easier occlusal adjustment
-class 2, 3, articulators
Monoplane
- nonanatomic teeth set on compensating curve
- goal is to eliminate lateral forces
- patients with poor coordination and neuromuscular control
What is hanau’s quin or thielmann’s formula
5 factors that affect occlusal balance
CGxIG / OPxCAxCC
= balanced occlusion
CG= condylar guidance (unchange)
IG: incisal guidance
OP: occlusal plane
CA: cusp angle
CC: compensating curve
How is an articulator programed?
Condylar inclination- protrusive angle
Bennet angle= H/8 +12
H= horizontal condylar inclination degree
What is kelley’s combination syndrome?
Natural mandibular anterior teeth opposing edentulous maxillary teeth
Seen:
-maxillary ant ridge resorption
-pendulous tuberosity
-maxillary papillary hyperplasia
-mand anter extrusion
-mand post ridge resorption
-overclosure of OVD
What are the 3 lever classes in RPDs?
Class 1: see saw- fulcrum between resistance and applied force
Class 2: wheel barrow - fulcrum at the edge with force and resistance on the same side
Class 3: fishing pole- fulcrum and resistance at ends with effort in the middle
What are the RPD classifications?
Class I: bilateral edentulous
Class II unilateral post edentulous
Class III: tooth borne
Class IV- anterior tooth born
What are 3 criteria for distal extension of a denture base?
adequate support for distal extension
denture base
flexible direct retainer
indirect retainer
