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BDS3 Prosthodontics Removable > Theory of dentures 3 > Flashcards

Theory of dentures 3 Flashcards

1
Q

equipment needed for trimming wax blocks

A
  • Bunsen/ induction heater
  • Foxen bite plane
  • Wax knife
  • Willis bite gauge
  • palate knife or iron (handy)
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2
Q

step 1 of adjusting upper wax block

A

adjust the upper wax rim to maximise retention

  • Try it in, it will be bulky warn pt
    • It has to stay in place (fixative can be of use)
  • Use the wax knife and hot plate/spatula to make adjustments
  • Too much lip support and it will drop
  • You may need to adjust the rim labially/buccallyAny overextension of the peripheries and it will drop - manipulate
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3
Q

step 2 of adjusting the upper wax block

A

adjust the upper record blck for tooth position

  • Look at previous denture
    • How much tooth do they show
    • What changes did you want to make
  • Consider the patients age
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4
Q

acronym for tooth positioning

A

LIMBO

Lip Support

Incisal Level

Midline

Buccal corridor

Occlusal plane

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5
Q

Lip support and nasolabial angle

A

Approx. 90 degree correct but depends on individual

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6
Q

how to determine incisal plane level

A
  • Look
  • “F” – fricative (lower lip touches upper lip)
  • Old photos (caution)
  • Variable – age; lip level

get pt involved

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7
Q

steps in to aid in positioning anterior teeth

A
  • Lick lips
  • Relax
  • Fricatives
  • Trim block so showing the right height – compare with old denture, take in and out and check incisal position
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8
Q

upper tooth position anteriors

A

up to 1cm anterior to incisive papilla

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9
Q

upper tooth position canines

A

below nose

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10
Q

incisal plane orientation determined with

A

Use fox’s bite plane

  • If level with interpupillary – then true

Want incisal plane and interpupillary parallel - adjust

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11
Q

2 techniques for tooth position

A

replica technique

conventional technique

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12
Q

replica technique for tooth position

A

Easy – look at treatment plan (as teeth already in wax so just look for changes needed)

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13
Q

conventional technique for tooth position

A

Standard values

  • Journal of Oral Rehabilitation 2004 31; 554–561
  • International Journal of Oral Science (2013) 5, 155–161
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14
Q

what mark is this

A

high lip line

helps when selecting tooth so can consider height

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15
Q

what mark is this

A

centreline

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16
Q

tools to make marks in wax rims

A

wax knife or le cron carver

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17
Q

how to test if centre line mark is correct

A

mirror and check from behind the pt to check it looks correct

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18
Q

buccal corridor

A

difficult, subjective

Mid-canine line in relation to buccal corridor – indication of where the start of the buccal corridor is

Use floss from the tear duct of eye down to nose and mouth

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19
Q

impact of buccal corridors

A

How much tooth seen in different buccal corridors

  • Narrow arch with obvious buccal corridor to broad arch with small buccal corridor

https://www.realself.com/question/toronto-ks-correct-my-large-buccal-corridor-dark-spaces-the-edge-my-smile

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20
Q

how to determine occlusal plane

A

alar tragal line with fox’s bite plane – want parallel, or fox’s bite plane angled up v slightly

  • Remember don’t alter incisors you have done that already
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21
Q

how to decide if happy with upper record block adjustments before occlusal reg?

A

Clue does it look denture shaped

Yes -> move onto lower

No -> complete upper

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22
Q

3 steps in adjusting upper record block

A

Step 1: Adjust the upper record block for retention

Step 2: Adjust the upper record block for tooth position

Step 3: Adjust the upper record block for occlusal plane

23
Q

2 steps in adjusting lower record block before occlusal reg?

A

Step 4: Measure vertical dimension and establish face height

Step 5: Lower tooth position

24
Q

lower tooth position importance

A

Critical to lower denture – can be loose if tooth not in neutral zone (area with minimum force acting on denture)

Look where residual ridge is

  • molar is largely lingual so denture will be unstable
  • too buccal – cheek impinge

want narrow teeth right over ridge

25
Q

why do we need to adjust lower record block

A

want to adjust it so tongue helps keep denture in place rather than displace it

26
Q

neutral zone for lower tooth position is

A

area with miimum force acting on denture

over ridge

27
Q

anterior lower tooth position

A

over ridge (or v slightly forward)

28
Q

posterior lower tooth postion

A

over ridge

29
Q

lower polished surface aim

A

Aim to direct forces of tongue in favour of denture stability

  • triangle make denture base wider than top so tongue push on denture down (unlike if flat like rectangle)
30
Q

consider relationship between upper and lower teeth when deciding postion of lower teeth

A

Anterior teeth

  • overbite – shallow
    • too deep - when protrude, dentures will rock and one will be displaced
  • overjet – can be Class II (large) or edge to edge

Posterior teeth

  • Normal occlusion (push upper teeth out beyond the ridge – affect buccal corridor)
  • Cross bite (push upper teeth in?) 4:40

Group function often in C/C - but still getting contact of posterior teeth - imp

31
Q

resting vertical dimension and resting face height determined with

A
  • Two measuring points in the midline of the face
  • On sites of minimal influence from muscles of facial expression
  • Ask patient to moisten lips and bring them into relaxed light contact
  • Wearing adjusted rim

use willis bite gauge or dividers

32
Q

OVD

determined by

A

occlusal vertical dimension

(pt biting together)

  • Insert upper and lower record blocks
    • Dividers too wide if have free way space correct
  • Reduce the lower wax rim in height until it contacts the upper rim evenly
  • The OVD should be 2-4mm less than the RVD
33
Q

freeway space (FWS) =

A

RVD - OVD

resting vertical dimension - occlusal vertical dimension

34
Q

freeway space ideal

A

2-4mm

  • Often greater with worn teeth
    • Don’t change too much from original denture
  • Avoid -ve freeway space
    • Always space between dentures at rest

Facebow – NOT FOR COMPLETE DENTURES

OVD in old dentures if protruding teeth OVD not accurate

35
Q

textbook retruded contact position

A
  • The retruded contact position (RCP) is a reproducible maxillomandibular relationship in edentulous patient
  • Guided occlusal relationship at the most retruded position of the condyles in the joint cavities
  • It is used as a reference point for mounting casts on an articulator
36
Q

retruded contact position used in real life for occlusal registration

A
  • Is occlusion reproducible

ICP is more comfortable for pt – use if reproducible

37
Q

how to register occlusion

A

Line at far edge – to see if where you have recorded occlusion is where expected

Knotch is blocks so when bite recording paste comes apart or loose can replace accurately

38
Q

why use recording paste rather than wax when recording occlusion

A

Once recorded wax is set – cannot break the record blocks apart so cannot try them separately back in mouth to check if occlusion recorded is automatically what they go into

39
Q

benefit of bite recording paste

A

Bite recording paste sets quickly

Separate models and let pt bite with them back in

(do not use - wax cannot break apart)

40
Q

articulator to prescribe for C/C when got occlusal reg

A

Generally average value articulator (hinge not enough accuracy)

41
Q

how to select anterior teeth

A
  • Often come in matching moulds
  • Old denture – did they like?
42
Q

how to determine tooth mould size and shape (3)

A
  1. Frush and Fisher
    • Square
    • Ovoid
    • Tapering
  2. Previous dentures
  3. Photos (take care)
43
Q

numbers of tooth moulds indicate

A

width distal canine to distal canine

heigh central incisor

width central incisor

44
Q

how to choose length of anterior teeth?

A
  • High smile line
  • Previous denture
    • Measures on mould guides

Careful – many cases neck of tooth will be hidden under acrylic so get shorter height of tooth then moulds

45
Q

3 types of cuspal angle

A

cuspless

hybrid teeth (12o)

cusped teeth (13o)

46
Q

cuspless teeth used for

A

pts with poor reproducible bite, slide around lot

47
Q

hybrid teeth (12o)

A

used for complete, allows some articulation

48
Q

cusped teeth (33o) used for

A

too much articulation for complete

49
Q

how to determine posteiror tooth mould

A

Anterior tooth mould should correspond to posterior on chart

50
Q

how to select shade

A
  • Shade guide
  • Patient preference
  • Previous denture
  • Skin colour
  • Natural?
    • Right in notes if you inform them that they have chosen too white one

Not B1 – too white, remove before showing

51
Q

how should teeth be arranged

A
  • Personalise the denture
    • diastema
    • imbrication etc

class 2 div II, proclination etc

52
Q

additional things to consider to personal C/C when deciding tooth shape, position and shade

A

personalise

discuss with pt

restorations too make look like no change

gingival contour as smooth polished acrylic will reflect light

(special instructions)

53
Q

prescription card after occlusal reg

A

Stage – try in

Date – 2 weeks

Disinfected

Articulate the casts to registration provided

Try in of upper and lower teeth – with mould (spaces)

Special instructions – spacing between teeth, overlap etc

Any adjustments additional to record block (special instructions e.g. restorations, giniva etc)

BDS3 Prosthodontics Removable (10 decks)

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