Revision Flashcards
When do patients seek new complete dentures (CDs)?
- to replace an existing set of CDs
- if they are about to become edentulous
- prior to implant treatment
Replacing existing complete dentures
Treatment options: previous dentures were successful
- Do nothing
- Repair or modify existing dentures
- New CDs
- Copy dentures
Replacing existing complete dentures
Treatment options: previous dentures were not successful
Replacing existing complete dentures
Treatment options: previous dentures were not successful
If no problem can be identified, the options are:
- repeat the interview and clinical examination
- do nothing
- refer to specialist (not an option if you are the specialist!)
- consider implant treatment
- palliative care and/or psychological support
Complete Denture Prosthodontics
Clinical and laboratory stages
Complete Denture Prosthodontics
Primary impressions
- stock edentulous tray selection & modification
- material of choice: alginate wash over silicone putty
Complete Denture Prosthodontics
Secondary impressions
- border moulding (greenstick wax)
- material of choice: zinc oxide & eugenol paste
- deep undercuts: polyether or polysulfide
- must be beaded & boxed
Complete Denture Prosthodontics
Jaw relationship registration
- 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
Complete Denture Prosthodontics
Tooth setup / Trial insertion
- 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
Complete Denture Prosthodontics
Occlusal adjustment
Complete Denture Prosthodontics
Trial insertion
- 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
Complete Denture Prosthodontics
Placement
- focus on: occlusion (check record necessary!) & instructions of use and hygiene
- review: 1 week post-insertion; repeat check record if needed
Partial Denture Prosthodontics
Clinical and laboratory stages
Partial Denture Prosthodontics
Primary impressions
- stock tray selection and modification
- material of choice: alginate over silicone putty
- ensure correct extension to capture all the anatomy
Partial Denture Prosthodontics
Preliminary jaw relationship registration
do we always need record bases and wax occlusion rims?