RPD insertion Flashcards
OBJECTIVE OF THE INSERTION
APPOINTMENT
➢ TO FIT?
➢ TO CORRECT?
➢ TO ADJUST?
➢ TO INSTRUCT?
➢ 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
➢ THE DENTURE BASE WILL USUALLY EXHIBIT HEAVY CONTACT WITH:
AND LIGHT OR NO CONTACT WITH THE:
➢ THE DENTURE BASE WILL USUALLY EXHIBIT HEAVY CONTACT WITH THE
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 of improper fit
➢UNDERCUTS BUCCAL TO THE EDENTULOUS RIDGE IN THE
MANDIBULAR PREMOLAR
➢MAXILLARY TUBEROSITY AREA
➢MYLOHYOID AREA
what can we use to look for interferences
PIP
➢DENTURE BASE FLANGE LENGTH CONTRIBUTES TO
* RESISTANCE TO:
* A MAJOR SHARE OF:
- RESISTANCE TO HORIZONTAL OR LATERAL DISPLACEMENT OF THE DENTURE
- A MAJOR SHARE OF VERTICAL SUPPORT FOR THE PARTIAL DENTURE
when to clinically remount and when not to for occ discrepancies
in class 3 you can correct intraorally and for any distal ext case or long spane class 4 req clinical remount
natural tooth contacts maintained?
IT IS IMPORTANT THAT TEETH WHICH CONTACT WITHOUT THE PROSTHESIS IN PLACE CONTINUE TO DO SO WITH THE PROSTHESIS IN PLACE.
clinical remount procedure
- facebow preservation
- pick up impression
- block out undercuts
- remount with intraocc record
selective grinding of cusps
➢THE CUSP TIPS SHOULD NOT BE RELIEVED ARBITRARY.
➢BY ALTERING THE INCLINE OF A CUSP, INTERFERENCES
CAN BE ELIMINATED WITHOUT BASICALLY CHANGING
THE CUSP HEIGHT.
retention level at appt? tool for half round? increments?
adjusting the retentive clasp
➢ AS A GENERAL RULE, AT THE TIME OF INSERTION SLIGHTLY LESS THAN MAXIMUM RETENTION SHOULD BE USED.
➢ ONLY THE NO. 139 PLIER SHOULD BE USED WHEN ADJUSTING A HALF-ROUND, CAST CIRCUMFERENTIAL
CLASP
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 for pts
brush denture with soap after eating
how long should RPD be removed per day? placed where?
8hrs, soaked to prevent distortion
pts should never place RPD in solutions containing:
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.
pt removal of rpd technique
Patient should grasp acrylic resin denture bases on each side of the arch and carefully withdraw the removable
partial denture from the mouth.
adjustment appt time frame
➢PATIENTS WILL BE SEEN AT 24 HOURS AND 1 WEEK AFTER INSERTION.
umkc is 1 and 3 days
RPD insertion before adjjustment appt
should be inserted for 4-5 hrs prior to visualize problem
common pt complaints
➢PROBLEMS WITH PHONETICS
➢CHEEK OR TONGUE BITING
➢DIFFICULTY IN CHEWING
➢LOOSE DENTURE
➢GAGGING
potential causes of phonetic issues
IMPROPER PLACEMENT OF THE PROSTHETIC ANTERIOR TEETH OR CHANGES IN THE CONTOUR OF THE ANTERIOR PALATE
IMPROPER PLACEMENT OF MAXILLARY AND MANDIBULAR PREMOLARS
IF POSITIONED TOO FAR LINGUALLY:
THE ACTION OF THE TONGUE MAYBE LIMITED AND SPEECH MAY BE AFFECTED
problem and solution
teeth 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.
how does cheek biting occur
CAUSED BY INSUFFICIENT HORIZONTAL OVERLAP BETWEEN MAXILLARY AND MANDIBULAR TEETH.
solution to cheek biting if teeth correctly positioned
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.
solution to cheek biting if teeth improperly postioned
remove teeth and reset them
tongue biting caused by
CAUSED BY THE ARTIFICIAL TEETH BEING POSITIONED TOO FAR LINGUALLY AND THERE IS A DECREASE IN THE TONGUE SPACE.
solutions to 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.
avoid what foods?
pts and difficulty chewing
➢IF PATIENTS HAVE BEEN MISSING TEETH FOR SEVERAL YEARS, THEY HAVE LOST THE NEUROMUSCULAR SKILLS
REQUIRED TO INCISE AND GRIND FOOD.
➢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.
possible adjustment for diff 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.
solutions
possible causes of gagging
➢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.
LACERATION OR ULCERATION OF THE SOFT TISSUES
SURROUNDING THE DENTURE BASE IS PRODUCED BY AN
___________________ DENTURE BASE.
LACERATION OR ULCERATION OF THE SOFT TISSUES
SURROUNDING THE DENTURE BASE IS PRODUCED BY AN
OVEREXTENDED DENTURE BASE.
examining border tissues
CAREFUL VISUAL EXAMINATION OF THE BORDER TISSUES
SHOULD BE MADE. ANY AREA DISPLAYING INCREASED
REDNESS OR TRANSLUCENCY SHOULD AROUSE SUSPICION
OF OVEREXTENSION.
inital sign of tissue iritation
➢THE TRANSLUCENT APPEARANCE BECOMES EVIDENT JUST
BEFORE ACTUAL ULCERATION OCCURS. IT MAY OR MAY NOT
BE ACCOMPANIED BY NOTICEABLE DISCOMFORT.
generally caused by?
➢ERYTHEMA
➢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.
how can we ID intaglio irregularities
EXCELLENT METHOD OF IDENTIFYING IRREGULARITIES
ON THE INTAGLIO SURFACE IS TO PASS A FINGERTIP OR
GAUZE PAD OVER THE INTAGLIO SURFACE OF THE RESIN.
how to confirm roughness of intaglio
PIP
correcting intaglio surface tool
low speed with lab bur
additonal factor that can cause erythema
occ discrepancies
what is examined once all soft tissue discrepancies have been examined
teeth in contact with RPD
how to examine irritation to the teeth
-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 the teeth is caused by
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.
how can irritation to teeth be evaluated
show through with disclosing wax
tooth pain without irritaton from RPD
- 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.
examining occ of RPD metal surfaces
roughen metal surface and use articulating paper
RPD instability, solutions
➢ 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.
