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RPD > RPD insertion > Flashcards

RPD insertion Flashcards

1
Q

What are the objectives of the insertion appointment?

A
  • to fit the denture base to the edentulous ridge
  • to correct the occlusal discrepancies
  • to adjust retentive clasps if ncessary
  • to instruct the patient in home care
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2
Q

The denture base will usually exhibit heavy contact with the…

A

lateral walls, both buccal and lingual or palatal, of the ridge

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3
Q

The denture base will usually exhibit light or no contact with the…

A

ridge crest

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4
Q

What are the most frequently observed areas of contact (using PIP paste) that need adjusting?

A

➢ Undercuts buccal to the edentulous ridge in the mandibular premolar
➢ Maxillary Tuberosity area
➢ Mylohyoid area

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5
Q

Denture base flange length contributes to…

A
  • Resistance to horizontal or lateral displacement of the denture
  • A major share of vertical support
    for the partial denture
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6
Q

All __________ RPD may be evaluated and occlusion adjusted intra-orally.

A

tooth-borne

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7
Q

All ___________ borne RPD will require the completion of a clinical remounting procedure

A

tooth-tissue

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8
Q

What do you do to correct occlusal discrepancies?

A

➢All tooth-borne RPD may be evaluated and occlusion adjusted intra-orally.
➢All tooth-tissue borne RPD will require the completion of a clinical remounting procedure.

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9
Q

It is important that teeth which contact without the prosthesis in place continue to do so…

A

with the prosthesis in place

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10
Q

What is the procedure for clinical remounting?

A
  • facebow preservation
  • pick-up impression
  • block out undercuts
  • remount cast and intraocclusal record
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11
Q

What is selective grinding?

A

By altering the incline of a cusp, interferences can be eliminated without basically changing the cusp height.

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12
Q

With selective grinding the __________ should not be relieved arbitrary

A

cusp tips

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13
Q

As a general rule, at the time of insertion slightly _____ than maximum retention should be used.

A

less

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14
Q

The clasps should be adjusted
in _____ increments.

A

small

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15
Q

Excessively bending a clasp in
one direction only will lead to…

A

accelerated fatigue and failure
of the clasp

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16
Q

What are the home care instructions for an RPD?

A
  • Brush the RPD using soap and a denture brush.
  • The prosthesis must be removed for eight hours each day and always soaked upon removal to prevent distortion of the acrylic resin.
  • Never soak the RPD in any
    cleaner containing chlorine (bleach) This will cause the metal to corrode and make the framework more brittle.
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17
Q

How should a patient remove an RPD?

A

The patient should grasp acrylic resin denture bases on each side of the arch and carefully withdraw the removable partial denture from the mouth.

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18
Q

Patients will be seen at ___ hours and __ week after insertion.

A

24 hours
1 week

19
Q

The prosthesis should be inserted ____ hours before the appointment so that problem areas can be visualized.

A

4-5 hours

20
Q

Use _____ to aid in locating overextension or pressure area.

A

PIP

21
Q

What are possible complaints from the patient about their RPD?

A

➢ Problems with phonetics
➢ Cheek or tongue biting
➢ Difficulty in chewing
➢ Loose denture
➢ Gagging

22
Q

What could cause a problem with phonetics?

A

➢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 may be limited and speech may be affected

23
Q

What happens if the max/mand premolar are positioned too far lingually?

A

The action of the tongue may be limited and speech may be affected

24
Q

What happens if the max/mand premolar are positioned too far buccally?

A

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.

25
Q

What causes cheek biting?

A

Is caused by insufficient horizontal overlap between maxillary and mandibular teeth.

26
Q

How do you fix cheek biting if the teeth are correctly positioned?

A

Round the buccal cusps of the mandibular posterior teeth. This action will move the buccal cusps slightly lingual, thereby creating a greater horizontal overlap.

27
Q

How do you fix cheek biting if the teeth are incorrectly positioned?

A

Remove artificial teeth and reset them.

28
Q

What causes tongue biting?

A

Caused by the artificial teeth being positioned too far lingually and there is a decrease in the tongue space.

29
Q

How do you fix the RPD if their is tongue biting?

A

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 have to be removed and reset.
30
Q

If patients have been missing teeth for several years, they have lost the ___________ skills required to incise and grind food.

A

neuromuscular

31
Q

What do you tell the patient if they are having difficulty chewing?

A

➢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.

32
Q

What can you do to the RPD if the patient is having difficulty chewing?

A

➢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.

33
Q

What can cause gagging?

A
  • Poor adaptation of a maxillary RPD to the tissues of the hard palate- due to faulty impression
  • Overextension both in length and bulk of the denture base flanges at the distal extension areas.
34
Q

If maxillary RPD is overextended posteriorly and causes gagging what should you do?

A
  • trim the posterior border of the major connector
  • Increase/decrease in occlusal vertical dimension
35
Q

Laceration or ulceration of the soft tissues surrounding the denture base is produced by an…

A

overextended denture base

36
Q

How can you prevent soft tissue irritation?

A

A Careful visual examination of the border tissues should be made. Any area displaying increased redness or translucency should arouse suspicion of overextension.

37
Q

What is erythema?

A

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.

38
Q

An excellent method of identifying irregularities on the intaglio surface is to…

A
  • pass a fingertip or gauze pad o
  • confirm the roughness applying pressure indicating paste (PIP)
  • 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
39
Q

The second factor that may cause erythema of the soft tissues underlying a denture base is the…

A

presence of occlusal discrepancies or prematurities

40
Q

When soft tissue irritation has been eliminated, evaluate all teeth that are in contact with the prosthesis:

A

With the prosthesis out of the mouth, mesial, distal, buccal, and lingual pressure should be applied to the remaining natural teeth.

41
Q

What causes irritation to teeth?

A

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.

42
Q

How can you evaluate irritation to teeth?

A
  • 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.
43
Q

What can you do if the RPD is unstable?

A

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

RPD (25 decks)

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