RPD Flashcards
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
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)
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
what trays do we use for RPD primary impressions?
Red, yellow or blue tray for dentate patients
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)
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
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
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.
once we get our primary casts back what do we then establish?
if the casts can be hand articulated
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
what are the next steps if the primary casts cannot be hand articulated?
request a primary record block (extra stage)
request special trays
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
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
what steps must we do before visit 2?
you must survey the casts and establish;
- Undercuts
- Path of insertion
- Tooth modifications
- Design the denture
when do we make tooth modifications for our RPD?
Before taking the master impressions
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)?
- 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 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
