RPD Insertion Flashcards
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OBJECTIVE OF THE INSERTION
APPOINTMENT
(4)
➢ TO FIT THE DENTURE BASE TO THE EDENTOLOUS RIDGE
➢ TO CORRECT THE OCCLUSAL DISCREPANCIES
➢ TO ADJUST RETENTIVE CLASPS IN NECESSARY
➢ TO INSTRUCT THE PATIENT IN HOME CARE
CORRECTING THE FIT OF THE DENTURE BASE
➢ THE DENTURE BASE WILL USUALLY EXHIBIT HEAVY CONTACT WITH THE
(3)
LATERAL WALLS, BOTH BUCCAL AND LINGUAL OR PAPATAL, OF THE RIDGE
AND LIGHT OR NO CONTACT WITH THE RIDGE CREST.
THE MOST FREQUENTLY
OBSERVED AREAS
(3)
➢UNDERCUTS BUCCAL TO THE EDENTULOUS RIDGE IN THE
MANDIBULAR PREMOLAR
➢MAXILLARY TUBEROSITY AREA
➢MYLOHYOID AREA
MODIFYING THE PERIPHERAL
EXTENSION OF THE DENTURE BASE
➢DENTURE BASE FLANGE LENGTH CONTRIBUTES TO
(2)
- RESISTANCE TO HORIZONTAL OR LATERAL
DISPLACEMENT OF THE DENTURE - A MAJOR SHARE OF VERTICAL SUPPORT FOR THE
PARTIAL DENTURE
CORRECTING OCCLUSAL DISCREPANCIES
➢ALL TOOTH-BORNE RPD:
➢ALL TOOTH-TISSUE BORNE RPD:
MAY BE EVALUATED AND
OCCLUSION ADJUSTED INTRA-ORALLY.
WILL REQUIRE THE
COMPLETION OF A CLINICAL REMOUNTING
PROCEDURE.
INTRAORAL DETECTION OF
OCCLUSAL DISCREPANCIES AND
THEIR CORRECTION
➢IT IS IMPORTANT THAT TEETH WHICH CONTACT
WITHOUT THE PROSTHESIS IN PLACE
CONTINUE
TO DO SO WITH THE PROSTHESIS IN PLACE.
SELECTIVE GRINDING
➢THE CUSP TIPS SHOULD NOT BE RELIEVED…
(1)
ARBITRARY.
➢BY ALTERING THE INCLINE OF A CUSP, INTERFERENCES
CAN BE ELIMINATED WITHOUT BASICALLY CHANGING
THE CUSP HEIGHT.
DJUSTING THE RETENTIVE CLASP
➢ AS A GENERAL RULE, AT THE TIME OF INSERTION SLIGHTLY
LESS THAN MAXIMUM RETENTION SHOULD BE USED.
➢ ONLY THE NO. — PLIER SHOULD BE USED WHEN
ADJUSTING A HALF-ROUND, CAST CIRCUMFERENTIAL
CLASP
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Clasps should be adjusted in small
increments. Excessively bending a
clasp in one direction only will lead
to
accelerated fatigue and failure of
the clasp.
HOME CARE INSTRUCTION
➢ADVISE PATIENTS TO
BRUSH THE RPD USING SOAP
AND A DENTURE BRUSH.
THE PROSTHESIS MUST BE REMOVED FOR — HOURS
EACH DAY AND ALWAYS SOAKED UPON REMOVAL TO
PREVENT DISTORTION OF THE ACRYLIC RESIN.
EIGHT
ADVISE THE PATIENT TO NEVER SOAK THE RPD IN ANY
CLEANER CONTAINING CHROLINE (BLEACH) THIS WILL
CAUSE
THE METAL TO CORRODE AND MAKE THE
FRAMEWORK MORE BRITTLE.
Patient should grasp — and carefully withdraw the removable
partial denture from the mouth.
acrylic resin denture bases on each
side of the arch
DJUSTMENTS
➢PATIENTS WILL BE SEEN AT — HOURS AND — AFTER
INSERTION.
➢THE PROSTHESIS SHOULD BE INSERTED —
BEFORE THE APPOINTMENT SO THAT PROBLEM AREAS CAN
BE VISUALIZED.
➢USE — TO AID IN LOCATING OVEREXTENSION OR
PRESSURE AREA.
24, 1 WEEK
4-5 HOURS
PIP
COMPLAINTS
(5)
➢PROBLEMS WITH PHONETICS
➢CHEEK OR TONGUE BITING
➢DIFFICULTY IN CHEWING
➢LOOSE DENTURE
➢GAGGING
PROBLEMS WITH PHONETICS
➢ IMPROPER PLACEMENT OF
(2)
THE PROSTHETIC ANTERIOR TEETH OR CHANGES
IN THE CONTOUR OF THE ANTERIOR PALATE
MAXILLARY AND MANDIBULAR PREMOLARS
IF POSITIONED TOO FAR LINGUALLY
➢ IMPROPER PLACEMENT OF MAXILLARY AND MANDIBULAR PREMOLARS
IF POSITIONED TOO FAR LINGUALLY:
THE ACTION OF THE TONGUE MAY
BE LIMITED AND SPEECH MAY BE AFFECTED
PROBLEMS WITH PHONETICS
IF POSITIONED TOO FAR BUCCALLY:
✓WHISTLING OR SLURRING OF THE SPEECH MAY OCCUR. IF
THIS ERROR HAPPENS, SOFT UTILITY WAX ADAPTED TO
THE LINGUAL SURFACES OF THE PREMOLAR TEETH
SHOULD DECREASE THE ESCAPE OF AIR AND THE
WHISTLING OR SLURRING EFFECT.
CHEEK BITING:
➢ IS CAUSED BY
INSUFFICIENT HORIZONTAL OVERLAP
BETWEEN MAXILLARY AND MANDIBULAR TEETH.
IF ARTIFICIAL TEETH ARE CORRECTLY POSITIONED:
ROUND THE
BUCCAL CUSPS OF THE MANDIBULAR POSTERIOR TEETH. THIS ACTION
WILL MOVE THE BUCCAL CUSPS SLIGHTLY LINGUAL, THEREBY
CREATING A GREATER HORIZONTAL OVERLAP.
IF ARTIFICIAL TEETH ARE INCORRECTLY POSITIONED OR THE ABOVE
PROCEDURE OF ROUNDING DOES NOT HELP:
REMOVE ARTIFICIAL
TEETH AND RESET THEM.
TONGUE BITING
CAUSED BY
THE ARTIFICIAL TEETH BEING POSITIONED TOO FAR LINGUALLY AND
THERE IS A DECREASE IN THE TONGUE SPACE.
TONGUE BITING
I. GENTLE “ROUNDING OR ROLLING” THE LINGUAL CUSPS
AND RECONTOURING OF THE LINGUAL SURFACES OF
THE MANDIBULAR TEETH.
II. IF TONGUE BITING CONTINUES AFTER THE TEETH HAVE
BEEN RESHAPED,
THE ARTIFICIAL TEETH HAVE TO BE
REMOVED AND RESET.
DIFFICULTY IN CHEWING
➢IF PATIENTS HAVE BEEN MISSING TEETH FOR SEVERAL
YEARS, THEY HAVE LOST THE NEUROMUSCULAR SKILLS
REQUIRED TO INCISE AND GRIND FOOD.
(2)
➢REASSURE THE PATIENT THAT THE CHEWING PATTERN
WILL EVENTUALLY BE REESTABLISHED.
➢DURING THE EARLY PERIOD OF ADJUSTMENT, PATIENT IS
TO AVOID EXTREMELY TOUGH, STRINGY, OR STICKY
FOOD.
DIFFICULTY IN CHEWING
➢EXAMINE THE OCCLUSAL SURFACES OF THE DENTURE
TEETH: IF THE OCCLUSAL ANATOMY OF THE ACRYLIC RESIN
IS NOT ADEQUATE, THE TOOTH WILL BE
INEFFICIENT.
ADDITIONAL SLUICEWAYS AND GROOVES SHOULD BE
ADDED TO THE OCCLUSAL SURFACE TO INCREASE THE
CUTTING EFFICIENCY.
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GAGGING
(4)
➢POOR ADAPTATION OF A MAXILLARY RPD TO THE TISSUES
OF THE HARD PALATE- DUE TO FAULTY IMPRESSION
➢IF MAXILLARY RPD IS OVEREXTENDED POSTERIORLY-
TRIM THE POSTERIOR BORDER OF THE MAJOR CONNECTOR
➢INCREASE/DECREASE IN OCCLUSAL VERTICAL DIMENSION
➢OVEREXTENSION BOTH IN LENGTH AND BULK OF THE
DENTURE BASE FLANGES AT THE DISTAL EXTENSION
AREAS.
SOFT TISSUE IRRITATION
➢LACERATION OR ULCERATION OF THE SOFT TISSUES
SURROUNDING THE DENTURE BASE IS PRODUCED BY AN
OVEREXTENDED DENTURE BASE.
A CAREFUL VISUAL EXAMINATION OF THE BORDER TISSUES
SHOULD BE MADE. ANY AREA DISPLAYING INCREASED
(2) SHOULD AROUSE SUSPICION
OF OVEREXTENSION.
REDNESS OR TRANSLUCENCY
THE TRANSLUCENT APPEARANCE BECOMES EVIDENT JUST
BEFORE ACTUAL — OCCURS. IT MAY OR MAY NOT
BE ACCOMPANIED BY NOTICEABLE DISCOMFORT.
ULCERATION
ERYTHEMA:
OR REDNESS, OF THE SOFT TISSUES IS
GENERALLY CAUSED EITHER BY ROUGHNESS OF THE
DENTURE BASE OR BY A SLIGHT RUBBING MOVEMENT OF
THE DENTURE BASE AGAINST THE SOFT TISSUES
AN EXCELLENT METHOD OF IDENTIFYING IRREGULARITIES
ON THE INTAGLIO SURFACE IS TO
PASS A FINGERTIP OR
GAUZE PAD OVER THE INTAGLIO SURFACE OF THE RESIN.
CONFIRM THE ROUGHNESS APPLYING —
✓THEN, USE A LABORATORY BUR IN A LOW-SPEED
HANDPIECE TO ADJUST AND ANOTHER TRIAL WITH
PIP SHOULD BE MADE TO VERIFY THAT THE
PRESSURE HAS BEEN RELIEVED.
PRESSURE-
INDICATING PASTE (PIP).
THE SECOND FACTOR THAT MAY CAUSE
ERYTHEMA OF THE SOFT TISSUES UNDERLYING A
DENTURE BASE IS THE PRESENCE OF
OCCLUSAL
DISCREPANCIES OR PREMATURITIES.
A GREAT DEAL OF EMPHASIS MUST BE PLACED
UPON
OCCLUSAL FACTORS IN PATIENTS WHO ARE
HAVING DIFFICULTY ADJUSTING TO RPDS.
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RRITATION TO TEETH
WHEN SOFT TISSUE IRRITATION HAS BEEN
ELIMINATED, EVALUATE ALL TEETH THAT ARE IN
CONTACT WITH THE PROSTHESIS:
-WITH THE PROSTHESIS OUT OF THE MOUTH, MESIAL,
DISTAL, BUCCAL, AND LINGUAL PRESSURE SHOULD
BE APPLIED TO THE REMAINING NATURAL TEETH.
PRESSURE CAN BEST BE APPLIED USING INDEX
FINGERS OF EACH HAND..
IRRITATION TO TEETH
CAUSED BY
PRESSURE FROM THE PARTIAL DENTURE
SUCH AS PRESSURE FROM THE METAL OR RESIN OF THE
PROSTHESIS ON THE ABUTMENT TEETH UPON WHICH THE
PROSTHESIS IS SEATED.
IRRITATION TO TEETH
* CAN BE EVALUATED BY PRODUCING AN AREA OF
SHOW-THROUGH IN THE
DISCLOSING WAX AS SEEN IN THE FIGURE.
- CAN BE EVALUATED BY PRODUCING AN AREA OF SHOW-THROUGH IN THE
DISCLOSING WAX AS SEEN IN THE FIGURE. - IF THIS IS NOT THE CAUSE, THEN THE MOST LOGICAL REASON FOR PAIN IS
OCCLUSAL TRAUMA CAUSED BY THE OCCLUSAL INTERFERENCE BETWEEN A
NATURAL TOOTH IN ONE ARCH AND THE METAL OF THE PROSTHESIS IN THE
OPPOSITE ARCH.
INSTABILITY OF THE RPD
➢ CONSIDER ADJUSTING ONE OR MORE OF THE
RETENTIVE CLASPS AND IF THIS DID NOT TAKE
CARE OF THE EXISTING INSTABILITY, CONSIDER
REMAKE OF THE PROSTHESIS.
