Try in Flashcards
why a trial stage?
Dress rehearsal
- Dentist
- Function
- Aesthetics
- Patient
- function
- Aesthetics
- Check technical work
imp Qs before pt arraives
- Are they the correct dentures?
- Do they fit the models?
- Are the models damaged?
- Is the work ready – did you put the correct date on the card (check the day before)
- Check instructions on lab card before the patient arrives- day before preferably.
- Distance travelled by patient/ work not ready / problem
Is the mould and shade what you requested.
Arrangement of teeth. Did you request a diastema/imbrications.
3 things to check when first pick up dentures before pt arrives
- The trial bases are stable on the models (rocking)
- The borders of the trial bases are smooth, rounded and no sharp edges
- Extension of the border is shaped to the depth and width of the functional sulcus
before you insert the dentures check
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- Trial on articulator
- Is the wax distorted or well adapted
- Check the occlusion.
- Satisfactory occlusal contacts
- Is there an anterior open bite or good contact
- Are centre lines coincident
- Examine the dentures in lateral profile.
- Look at the overbite and overjet.
- Is it excessive
- Look at the occlusion on the molars.
- Are there even contacts
- Are the teeth set over the ridge – esp lowers
- Is the position of the teeth likely to affect the denture stability
- Do you need to include the last molar or would it be better to give increased space for the tongue. Each case is different.
- Check the position of the anterior teeth.
- Check the shade and mould.
what to say to the pt when they arrive for trial appointment
Tell pt trying them in today and if all well nice short appointment but gives us time to adjust them if needed
how to insert the trial dentures
Assess each denture independently & then together.
- Allow time to settle
- Insert one denture at a time (moisten)
If maxillary denture is inserted first it can be dislodged when the mandibular denture is inserted.
3 key things to check when trial denture in the mouth
- Extension (& adjust if necessary)
- Retention
- Stability
NB. Retention is not as good with trial as it is with finished denture
how to assess extension
- Hold tissues away from denture – does it drop? If yes – possible underextension
- Any overextension of the peripheries and it will drop when you manipulate tissues
- Too much lip support and it will drop
- Use the wax knife to make adjustments (not fitting surface)
resistance
Resistance to VERTICAL movement (away from occlusal surface)
stability
Resistance to HORIZONTAL movement (Rocking)
what to check about occlusal plane and appearance
- can do this for individual upper or lower before together
Incisal plane orientation – with interpupillary (parallel)
occlusal plane orientation -with alar tragal line
how to assess lower occlusal plane and why imp
For most patients the level of the incisal edge is at the level of the lower lip at corner of the mouth
- If the occlusal plane is too high the tongue will be cramped and the denture will be unstable
tongue should rest on the occlusal surfaces of the teeth to help hold the denture in position
what needs done if OVD is increased
teeth need to be removed from one or both dentures and replaced with a wax rim
if OVD on upper is correct but lower is wrong
- remove the lower teeth
- replace with wax
- Re-Record the registration
- Prescribe another wax trial – order another retrial
Try prevent altering the upper unless needed
check occlusion on wax trial
- Balanced Occlusion
- Balanced Articulation – contact on both working and non working sides on sliding (complete want both unlike dentate)
- Centric relation (RCP) = centric occlusion in edentulous cases
ask if comfortable bite or too high
