RPD Flashcards by Abby Lindsay

List the stages of RPD construction.

Patient assessment and Primary impressions

Before visit 2 : Hand articulate the casts and survey casts

Master impressions
Framework trial
Record occlusion
Tooth trial and try in
Delivery and instructions

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during visit 1 what must you examine?

existing denture in the mouth
the denture bearing areas: free end saddles, alveolar ridge
the quality of teeth for support and retention etc (undercuts)

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what materials do we use for RPD primary impressions?

A. No free end saddles = alginate

B. Free end saddles = compound and alginate wash
no teeth recorded in compound

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what trays do we use for RPD primary impressions?

Red, yellow or blue tray for dentate patients

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how do we know the tray fits?

covers the alveolar ridges (2mm space between the tray wall and ridge)
extend into the sulcus (1mm short of the functional sulcus)

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how do we take impressions for an RPD?

Upper = behind 
Lower = Infront

Rotate tray into patient’s mouth
Use firm pressure to seat the tray from the back to the front
Soft tissue moulding
- Lower – pull cheeks around the impression tray and ask patient to stick their tongue out. Have two fingers on top of the tray and thumb under the mandible
- Upper - pull lips and cheeks around the impression tray
Ensure the handle is in the midline of the face
Place some alginate on back of hand to assess the setting process
Ask patient to breathe through nose
Remove tray by breaking the posterior seal and assess

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what do assess after taking our impression?

The denture bearing area being covered
Adequate surface detail
No air blows
Captured the depth and width of the sulcus and frenum

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what do we do after taking our impressions and before sending to the lab?

Place impression in perform for 10 mins, then place in a sealed bag with a wet paper towel.

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once we get our primary casts back what do we then establish?

if the casts can be hand articulated

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what are the next steps if the primary casts can be hand articulated?

record bite using a wax wafer and ask lab to mount the primary casts with this.

Request special trays for masters

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what are the next steps if the primary casts cannot be hand articulated?

request a primary record block (extra stage)

request special trays

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what is the lab prescription for primary casts that can be hand articulated?

Please pour the PI in 50:50 dental stone and plaster and construct a 2 mm spaced light cured acrylic resin tray.

Include handles and finger rests

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what is the lab prescription for primary casts that cannot be hand articulated?

Please pour the PI in 50:50 dental stone and plaster and construct a spaced light cured acrylic resin tray.

Include handles and finger rests

Also construct a primary record block for a preliminary jaw registration

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what steps must we do before visit 2?

you must survey the casts and establish;

Undercuts
Path of insertion
Tooth modifications
Design the denture

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when do we make tooth modifications for our RPD?

Before taking the master impressions

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with what trays do we take our master impressions?

special trays

what lab instructions do we give the lab for a master impression and a Co-Cr framework ?

Please pour the MI in 100% improved dental stone

Please construct the Co-Cr framework as per the design sheet (given to lab alongside the impressions)

what lab instructions do we give the lab for a master impression and an acrylic framework ?

Please pour the MI in 100% dental stone

Please construct a record block with shellac

what must we check before trying in the framework?

That the framework fits the cast
The framework matches the patients design
The framework isn’t damaged
the cast is not damaged

what must we check after seating the framework in the mouth?

Is it seated correctly

- Is it interfering with the occlusion

when do we record the occlusion for those casts that cannot be hand articulated?

during the framework trial - the record block is made on to the framework

what must you check during the registration stage?

Ensure the incisal plane is parallel to the inter-pupillary line
Ensure the ala-tragal line is parallel with the antero-postero plane (use fox’s bite plane and a wooden spatula)
Ensure midline of RPD matches the midline of the face (mid saggital plane??)

what must you check during the registration stage?

Ensure the incisal plane is parallel to the inter-pupillary line
Ensure the ala-tragal line is parallel with the antero-postero plane (use fox’s bite plane and a wooden spatula)
Ensure midline of RPD matches the midline of the face (mid saggital plane??)

at what stage do we chose the colour of the th and how do we achieve this?

registration stage

using previous denture, existing teeth and skin tone.

what lab instructions do we give before the try in/tooth trial stage?

Please mount the master casts on a hinge or average value articulator to the registration provided and set teeth for the wax trial with the shade and mould provided

when do we use a hinge articulator?

when there are only a few missing teeth

when do we use and average value articulator?

when there are many missing teeth

what do we assess during the tooth trial?

- The fit of the framework - The patient’s occlusion - The aesthetics – tooth shade and position and ask for patient opinion - Extension of the denture

During the delivery stage what must we assess before placing the RPD in the mouth (check on articulator)?

- Does the denture match the design - Is the denture sharp/rough - Does the denture seat properly - Does the RPD interfere with the occlusion - Assess that the undercuts are engaged and that none of the teeth on the cast are broken - Is the pin on the table

During the delivery stage what must we assess before placing the RPD in the mouth (check on articulator)?

During the delivery stage what must we assess with the RPD in the mouth?

- Does the denture seat properly - Assess that the undercuts are engaged - Stability: does the denture rock - Support: assess the tooth rests - Retention: assess the clasps - Aesthetics: ask for patient opinion - Occlusion: is the RPD interfering? Use articulating paper to observe early/heavy contacts.

what patient instructions do we give?

• Pain: - if denture gets too sore, take them out and use old dentures. - Remind patient to put new denture in 1 day before their appointment so it highlights the areas of concern for us. • Speech: - you may notice a lisp but speech and have difficulty controlling them but this Should return to normal over time • Eating: - Avoid eating hard foods initially. - cut food into smaller pieces • Removal at night: - Allows tissues to breathe and minimises thrush

what cleaning instructions do we give for RPD?

- always brush denture morning and night - always clean dentures after eating - always remove dentures at night - brush denture in a sink of water using a toothbrush and denture cream or non-perfumed soap

what soaking instructions do we give for RPD?

- soak once a day = milton for 10 minutes - rinse thoroughly after soaking - can soak in water overnight