RPD Insertion Flashcards
what is the objective of the insertion appointment
- to fit the denture base to the edentulous ridge
- to correct the occlusal discrepancies
- to adjust retentive clasps if necessary
- ton instruct the patient in home care
the denture base will usually exhibit heavy contact with the:
lateral walls, both buccal and lingual or palatal of the ridge
the denture base will exhibit light or no contact with:
the ridge crest
what are the most frequently observed undercutareas
- undercuts buccal to the edentulous ridge in the mandibular premolar
- maxillary tuberosity area
- mylohyoid ridge
denture base flange length contributes to:
- resistance to horizontal or lateral displacement of the denture
- a major share of vertical support for the partial denture
where are tooth-borne RPD evaluated and adjusted for occlusion
intra orally
how do you correct occlusal discrepancies in tooth tissue borne RPD
clinical remount
how should natural teeth contact
teeth which contact without the prosthesis in place continue to do so with the prosthesis in place
what are the steps in the clinical remounting procedure
- facebow
-pick- up impression
-block out undercuts
-remount cast and intra occlusal record - articulation
what does selective grinding do
- by altering the incline of a cusp, intereferences can be eliminate without changing cusp height
- the cusp tips should not be relieved arbitrarily
how should you adjust the retentive clasp
- at time of insertion use slightly less than maximum retention
- clasps should be adjusted in small increments
what tool should be used to adjust the half round, cast circumferential retentive clasp
- No. 139 plier
what is the home care instructions
- brush the RPD using soap and a denture brush
- prosthesis should be removed for 8 hours each day and soaked upon removal
what does soaking denture do
prevents distortion of the acrylic resin
why should the patient not soak in RPD in bleach
it will cause the metal to corrode and make the framework more brittle
how should the patient remove the RPD from the mouth
grasp acrylic resin denture bases on each side of the arch and carefully withdraw the removable partial denture from the mouth
when are adjustments done
- 24 hours after delivery and 1 week after insertion
- prosthesis should be inserted 4-5 hours before the appointment so that problem areas can be visualized
- use PIP to aid in locating overextension or pressure area
what are common complaints
- problems with phonetics
- cheek or tongue biting
- difficulty in chewing
- loose denture
- gagging
what causes problems with phonetics
- improper placement of the prosthetic anterior teeth or changes in the contour of the anterior palate
what happens if there is 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
how are phonetics affected if positioned too far buccally
whistling or slurring of speech
how can you correct an RPD positioned too far buccaly
soft utility wax adapted to the lingual surfaces of the premolar teeth to decrease the escape of air and the whistling or slurring effect
what is cheek biting caused by
insufficient horizontal overlap between maxillary and mandibular teeth
how can horizontal overlap be increased to stop cheek biting
- if artificial teeth are correctly positioned- round the buccal cusps of mandibular posterior teeth to move cusps slightly lingual
- if artifical teeeth are incorrectly positioned reset teeth
what is tongue biting caused by
the artifical teeth being positioned too far lingually and there is a decrease in the tongue space
how do you fix tongue biting
- gentle rounding or rolling the lingual cusps and recontouring of the lingual surfaces of the mandibular teeth
- if tongue biting continues after the teeth have been reshaped the artificial teeth need to be reset
when would the patient have difficulty chewing
if the patient has been missing teeth for several years they have lost neuromuscular skills required to incise and grind food
- chewing pattern will be reestablished
during early period of adjustment to RPD patient should avoid:
extremely tough, stringy, or sticky food
how can difficulty chewing be affected by occlusal surfaces of teeth
- if the occlusal anatomy is not adequate the tooth will be inefficient in chewing
how can occlusal surfaces be modified to help with chewing difficulties
- additional sluiceways and grooves should be added to the occlusal surface to increase the cutting efficiency
what is gagging caused by and how is it fixed
- 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
- overextension both in length and bulk of the denture base flanges at the distal extension areas
- increase/decrease in occlusal vertical dimension
what is soft tissue laceration or ulceration of the soft tissues caused by
an overextended denture base
what should cause suspiscion of over extension
increased redness or translucency
when does translucent appearance of soft tissue appear
just before actual ulceration occurs
what is erythema and what is it caused by
- redness of soft tissues
- roughness of the denture base or a slightly rubbing movement of the denture base against soft tissues
- occlusal discrepancies or prematurities
how can you identify irregularities on the intaglio surface
to pass a fingertip or gauze pad over the intaglio surface of the resin
how do you confirm the roughness of the RPD causing soft tissue irritation
PIP
when soft tissue irritation has been eliminated, evaluate:
all teeth that are in contact with the prosthesis
how should natural teeth be evaluated
with prosthesis out of the mouth, mesial, distal, buccal and lingual pressure should be applied
what is 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
how can irritation to teeth be evaluated
producing an area of show through in the disclosing wax
if there is no show through in disclosing wax and teeth are irritated what should you suspect
occlusal trauma caused by interference between a natural tooth in one arch and the metal of the prosthesis in the opposite arch
if the RPD exhibits instability what should you do
adjust one or more of the retentive clasps and if this does not work remake the RPD
what do you need to be careful of when adjusting posterior extension of RPD major connector in maxillary
dont remove the beads
- if you do food will trap there
