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Removable -ALL > Revision > Flashcards

Revision Flashcards

1
Q

When do patients seek new complete dentures (CDs)?

A
  1. to replace an existing set of CDs
  2. if they are about to become edentulous
  3. prior to implant treatment
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2
Q

Replacing existing complete dentures

Treatment options: previous dentures were successful

A
  1. Do nothing
  2. Repair or modify existing dentures
  3. New CDs
  4. Copy dentures
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3
Q

Replacing existing complete dentures

Treatment options: previous dentures were not successful

A
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4
Q

Replacing existing complete dentures

Treatment options: previous dentures were not successful
If no problem can be identified, the options are:

A
  1. repeat the interview and clinical examination
  2. do nothing
  3. refer to specialist (not an option if you are the specialist!)
  4. consider implant treatment
  5. palliative care and/or psychological support
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5
Q

Complete Denture Prosthodontics

Clinical and laboratory stages

A
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6
Q

Complete Denture Prosthodontics

Primary impressions

A
  • stock edentulous tray selection & modification
  • material of choice: alginate wash over silicone putty
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7
Q

Complete Denture Prosthodontics

Secondary impressions

A
  • border moulding (greenstick wax)
  • material of choice: zinc oxide & eugenol paste
  • deep undercuts: polyether or polysulfide
  • must be beaded & boxed
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8
Q

Complete Denture Prosthodontics

Jaw relationship registration

A
  • heat polymerized polymethyl methacrylate permanent bases
  • ensure comfort, retention, support and stability
  • pressure indicating paste for adjustments
  • maxillary lip support: based on appearance
  • occlusal plane level: showing 1-2mm of wax at rest
  • occlusal plane orientation: parallel to interpupillary line and ala-tragal line
  • freeway space = rest vertical dimension (RVD) – occlusal vertical dimension (OVD)
  • establish 2-4mm freeway space
  • record retruded position of the mandible (at the selected OVD)
  • mark midline, high smile line and canine tips
  • perhaps the most challenging clinical stage!
  • ok to use 2 sessions
  • tooth mould and shade selection
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9
Q

Complete Denture Prosthodontics

Tooth setup / Trial insertion

A
  • set up: as close as possible to the positions of the natural teeth
  • best chance to confirm the JRR!
  • maximum intercuspation position (ICP) must coincide with retruded contact position (RCP)
  • if not: repeat the JRR
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10
Q

Complete Denture Prosthodontics

Occlusal adjustment

A
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11
Q

Complete Denture Prosthodontics

Trial insertion

A
  • all aspects of the trial prostheses must be correct
  • aesthetics: most important!
  • confirm the freeway space
  • phonetic tests
  • acquire patient consent to proceed to finish
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12
Q

Complete Denture Prosthodontics

Placement

A
  • focus on: occlusion (check record necessary!) & instructions of use and hygiene
  • review: 1 week post-insertion; repeat check record if needed
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13
Q

Partial Denture Prosthodontics

Clinical and laboratory stages

A
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14
Q

Partial Denture Prosthodontics

Primary impressions

A
  • stock tray selection and modification
  • material of choice: alginate over silicone putty
  • ensure correct extension to capture all the anatomy
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15
Q

Partial Denture Prosthodontics

Preliminary jaw relationship registration
do we always need record bases and wax occlusion rims?

A
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16
Q

Partial Denture Prosthodontics

Tooth preparations

A
  • protect abutment teeth and ensure correct function of the RPD
  • detailed instructions and illustrations for each type of tooth preparation
17
Q

Partial Denture Prosthodontics

Secondary impressions

A
  • do not proceed unless there is surveyed cast and approved design!
  • material of choice: monophase polyvinyl siloxane
  • deep undercuts: consider alginate
18
Q

Partial Denture Prosthodontics

Metal frame trial insertion and definitive JRR

A
  • assess frame on the cast first
  • only minimal or no adjustments should be required
  • ensure no occlusal interferences
  • wax rims may be attached to the frame at the chairside
  • ICP cases: ensure natural tooth/tooth contacts
  • non-ICP cases: ensure freeway space
  • tooth shade selection
19
Q

Partial Denture Prosthodontics

Tooth setup / Trial insertion

A
  • most cases: conform to existing occlusion
  • ensure all aspects of the prosthesis are correct
  • determine flange extension for support and aesthetics
  • acquire patient consent prior to finishing
20
Q

Partial Denture Prosthodontics

Placement

A
  • usually only minor adjustments of the acrylic parts
  • beware: soft tissue undercuts and acrylic / natural tooth contacts
  • check the occlusion, aesthetics and phonetics
  • ensure the patient can place and remove the prosthesis!
  • hygiene instructions
21
Q

Immediate Denture Prosthodontics

First priority?
Not a predictable tx option because:

A
22
Q

Immediate Denture Prosthodontics

Alternatives:

A
  • modify existing RPD (e.g. tooth additions and flange extension)
  • accept posterior edentulous spaces
  • consider a temporary bridge (e.g resin bonded bridge) for small anterior edentulous spaces
  • delayed placement of transitional denture after initial healing phase
23
Q

Immediate Denture Prosthodontics

Staged approach

A
  • posterior extractions first
  • denture construction after initial healing
  • immediate placement after anterior extractions
  • dilemma: surgical management of residual alveolar ridge to eliminate deep undercuts?
24
Q

Urgent Denture Repairs

What is a real denture emergency?

A
  • anything that renders our patient unable to use their denture
  • mostly: denture base fractures; addition, replacement or repair of a tooth or retentive clasp
  • consider chairside repair if possible
25
Q

Urgent Denture Repairs

Do we need to record impressions?

A

Removable -ALL (28 decks)

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