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r&p 3 > saparano > Flashcards

saparano Flashcards

1
Q

what is a transitional denture

A

interim prosthesis to which TEETH WILL BE ADDED as natural teeth are lost that will be replaced after post extraction tissue changes have occurred

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2
Q

what is an interim prosthesis

A

prosthesis designed to enhance esthetics, stabilization and/or function for a limited period of time after which it will be REPLACED by definitive prosthesis

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3
Q

what is an immediate denture

A

any removable dental prosthesis fabricated for placement immediately following removal of teeth

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4
Q

indications for IMMEDIATE dentures

A

failing permanent dentition due to generalized caries

extensive periodontal dz or malocclusion

cooperative, philosophical and socially active pattients

pts who want to maintain appearances

patients who have available time and can afford tx cost

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5
Q

what are advantages of immediate dentures in terms of healing

A

acts as a bandage to control post op healing

splinting and compression PROMOTES RAPID healing bc protects blood clot and stimulates proper ridge contours

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6
Q

t/f: an immediate denture maintains circumoral support , muscle tone, VDO, jaw relationship, aids in swallowing, masticating and phonation

A

true

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7
Q

disadvantages of immediate dentures

A

lack of retention on day of insertion

constant need for relines

multiple post insertion adjustments

immediate denture cannot be fully assessed until it is seated

hard to get accurate impressions when you have remaining teeth in mouth

no esthetic try in possible

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8
Q

what can make recording interocclusal jaw relationships difficult when fabricating an immediate denture

A

if remaining teeth are mobile

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9
Q

contraindications for immediate dentures

A

poor overall general health

systemic conditions

exacting and/or indifferent patients

unrealistic expectations and time schedules

pts with restorable teeth

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10
Q

how to determine if OVD requires change at diagnosis appointment

A

use physiologic rest, interocclusal space measurements and evaluate continuous eruption of teeth and available restorative space

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11
Q

esthetic and functional evaluation

A

form and shape of teeth

positions of teeth

amount of tooth exposure in function

lip support

shade of natural teeth

high smile line?

buccal corridor

PATIENT EXPeCTIONS

angles class

midline

CR reliable?

sharp bony prominences?

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12
Q

pre surgical patient records

A

photographs

radiographs

diagnostic impressions

mould of teeth

shade of teeth

face bow

CR registration

accurate mounting

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13
Q

what does prognosis depend upon for denture patients

A

bearing surface anatomy

tongue position

floor of mouth posture

neuromuscular control

denture history

psychological state

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14
Q

what is rationale for taking out posterior teeth first and doing double stage surgeyr

A

posterior segment can heal and stabilize

leave one definite tooth contact on each side

can do pre-pros surgeries

maintains esthetics

healing is better

less ulcerations/sore spots

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15
Q

how long to wait for healing when doing double stage surgery (posterior teeth out first)

A

6-8 weeks

12 weeks ideal

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16
Q

disadvantages of two stage surgery

A

needs two surgeries

forces on anterior teeth impeded adequate function and may cause overloading

forces on anterior teeth may cause them to flare out

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17
Q

what are the three key for a good custom tray

A
  1. get a good primary impression
  2. make good custom tray (1-2 mm clearance for border molding, tray border must be 2 mm thick)
  3. maintain space for impression material during border molding (2 layers of baseplate wax)
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18
Q

the _____ are the key to successful impressions

A

borders

19
Q

four key border molding actions

A
  1. ask patient to create suction around a finger and impression tray handle
  2. ask patient to create suction around a finger, then pucker their lips and produce maximal smile line
  3. ask patient to open wide and move mandible side to side to stretch PT-mn raphe and allow coronoid impression to shape impression
  4. pinch patients nose and ask them to blow out to mark hard-soft palate junction, say aaah to mark vibrating line
20
Q

you see on your impression that the two posterior areas of the impression are different. what is this due to and what should you do

A

due to different impact of coronoid process movement

repeat to verify the differences

21
Q

five key actions for mandibular border molding

A
  1. suction around finger/tray handle
  2. pucker and create maximal smile line
  3. pronounce the word “christmas” and “q” and u” and pull lower lip and cheek up over tray
  4. place fingers on top of tray and ask pt to close against resistance
  5. raise tongue to roof of mouth and swallow
22
Q

why are wax rims important

A

establish facial contours

aid in tooth selection

establish and maintain VDO

needed for STABLE interocclusal records

arrangement of denture teeth

23
Q

what do you need for stable interocclusal records when pt is edentulous

A

good wax rims

24
Q

VDR =

A

VDO + interocclusal distance

25
Q

VDO =

A

VDR - Interocclusal distance

26
Q

what is optimal nasio-labial angle

A

90-115 deg

27
Q

what is optimal incisal display

A

4 mm

28
Q

three methods of recording CR

A

chin point guidance

bilateral manual manipulation

anterior deprogramming

29
Q

why CR instead of MI?

A

CR is consistent, repeatable, reproducible

CR is physiologic, orthopedic position

CR is the position from which all other positions originate

30
Q

_____ is the position to which the mandible returns at the end of chewing strokes and in swallowing

A

CR

31
Q

rule of thirds cast trimming for taking off teeth on casts

A
  1. remove tooth at gingival level
  2. recess socket 1 mm
  3. recess labial edge to gingival mark (top 1/3),
  4. flat cut across facial portion of ridge
  5. trim the lingual par of cast
  6. sharp end smooth surface
32
Q

patients with advanced perio disease and the rule of thirds for cast trimming

A

gingival third will be more recessed than middle third

amount of trimming covered by existing bone height

33
Q

what is the most important thing to remember when trimming a cast for immediate denture

A

no socket cavities on cast

34
Q

primary binding sites for complete dentures are on facial or lingual?

A

facial

35
Q

when to place tissue conditioner when seating immediate complete dentures

A

only if dentures are not retentive

36
Q

insertion of immediate complete dentures steps

A
  1. check retention and stability
  2. check VDO and CR (you are prob gonna have discrepancies)
  3. dismiss pt with home care instructions
37
Q

what is the purpose of tissue conditioner

A

improves retention of denture, acts a protective, resilient cushion, acts as a dressing post surgery, expedites healing

38
Q

what is lynal

A

tissue conditioner

39
Q

for a functional reline, where should you put lubricant

A

on palate and teeth (not on the denture)

40
Q

functional reline steps

A

place layer of material on intaglio, add roll on edges

initiate border molding

remove excess, trim,

41
Q

what should you do at 24 hour post insertion appt

A

check with PIP paste

42
Q

what should you do if the occlusion is just totally wrong

A

remount

43
Q

what do you need for a remount

A

remount casts

face bow

CR record

44
Q

what should you do at 48 hr/72 hr appointment

A

check for sore spots

check healing sites

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r&p 3 (7 decks)

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