Trial Placement Flashcards
What is another name for the trial placement?
wax try-in
Why are esthetics important for a trial placement?
it needs to be neat since it is going into the mouth and the patient is going to see it
What is a wax trial placement?
denture stage becomes a critical phase of complete denture care in evaluating this relationship
The dentist should approach the appointment with the attitude that…
errors may exist in all areas
What is a trial denture?
a preliminary arragement of denture teeth that has been prepared for placement into the patient’s mouth to evaluate esthetics and maxillomandibular relationships
Shapes and sizes of teeth selected are based on…
anatomic averages
Why should you not overlook problems?
- difficult/impossible to change after processing
- may require removal, restting and re-prossessing
- can be costly and time consuming
What are the parts of a checklist for the steps of clinical evaluation for trial placement?
- CO = CR
- occlusal vertical dimension
- midline
- horizontal and vertical overlap
- lip support
- occlusal plane
- buccal corridor
- esthetics
- phonetics
- maxillary posterior limit
- protrusive record and articulator settings
What should you use inside the trial bases when trying them on?
denture adhesive powder
What should you check during the trial denture clinical evaluation?
How can you assess occlusal vertical dimesion?
- numerous methods suggested
- all methods are unscientific
- should access using a combo of methods for more accuracy
What should you check when considering the OVD?
2-4 mm space between teeth when mandible is in PRP
How do you do a OVD assessment? (stretch-relax method)
- dot on nose and chin; open wide (hold for 20 seconds)
- slowly close until lips first touch and measure that distance
- hold for 15 seconds and then close until teeth touch; measure again
- difference in measurements is “interocclusal distance” (about 2-4 mm)
How do you do a OVD assessment? (swallow-relax method)
- patient is asked to swallow and then relax
- teeth contact while swallowing and the separate when relaxing
What should the closest speaking space be?
- rapid speech of sibilant sounds (S, Ch, “sixty six, san francisco, kansas city, chiefs”)
- should be no contact of max and mand teeth when speaking
What should you verify about the casts during the trial placement?
make sure the casts are mounted correctly in CR on the articulator
How do you check if your casts are mounted correctly in CR?
- check with articulating paper
- stablize the mandibular denture
- new CR record
- make new interocclusal record in mouth and check on articulator
- use a small amount of recording material
- remount if needed…
How do you know if you have an accurate mounting?
- teeth interdigitate perfectly
- condylar ball should contact fossae wall
How do you determine the level of occlusal plane anterior?
- anterior determined by esthetics/phonetics
- resting upper lip: 1-2 mm incisor teeth visible
- smiling: displays most of teeth length but minimal amount of base
Maxillary incisors should have positive contact with lower lip when ________ sounds are made.
fricative sounds (F, V, “very funny”)
How do you determine the level of occlusal plane posterior?
- molars should be 2/3 up the retromolar pad
- plane should be 2-3 mm below dorsal surface of resting tongue
- planes should parallel the two residual ridges and bisect the space between the ridges
Maxillary posterior teeth generally parallel to what plane?
ala-tragus plane (Camper’s plane)
Maxillary posterior teeth should do what on the occlusal plane?
should not appear to descend posteriorly
What are sibilant sound?
S, Ch
(occulsal vertical dimensions)
What are fricative sounds?
F, V
(incisors hit wet/dry line of lip)
If teeth touch when speaking S sounds, occlusal vertical dimension is…
too far open
If the patient whistles on sibilant sounds then what is wrong with the contour of anterior palate?
too narrow
If the patient lisps on sibilant sounds then what is wrong with the anterior palate?
too broad
What can cause lisping?
- non-uniform overjet of the anterior teeth
- diastemas between teeth
- palatal contours
- diamond-shaped openings between incisors
What should the incisal plane be in relation to interpupillary line?
parallel to it
Where shoudl the posterior tooth positions be?
mediolaterally centered over denture-bearing area
What should you check during the trial placement?
What is one of the most important parts of the trial placement?
- patient approval (friends and family as well)
- leave the patient alone for a few mintues to look in a mirror
What should the denture base be: convex or concave?
should NOT be convex
What will happen if the denture base is too thick? Too thin?
Too thick - impair comfort
Too thin - weakened
What should the laboratory prescription be?
- processing, finishing, and polishing
- laboratory remount of the dentures
- adjustment of occlusion to compensate for processing changes
