DPRP 712- Removable Complete Dentures I Exam 1 Lecture Material

Consequences of tooth loss

residual ridge resorption, changes in intraoral structures, decreased masticatory function, loss of facial support and muscle tones

A removable dental prosthesis that replaces the entire dentition and associated structures of maxillae or mandible

complete denture/ complete removable dental prothesis

residual ridge resorption

non physiologic compression (under dentures) results in resorption

which arch has a faster residual ridge resorption by 4x

mandibular

Maxillary loss is in a ____ direction

vertical and palatal

mandibular loss is in a ________ and oriented along _____

vertical direction; cross sectional shape of mandible

Maxilla gets ______, mandible gets _____

shorter and smaller; shorter and wider

Masticatory performance of complete dentures

59%

goal of complete denture treatment

minimize affect of functional, aesthetic, and psychological compromises

T/F dentures over the decades will have more problems due to bone loss, muscle tone loss, less neuromuscular control, reduced saliva, thinning tissues

T

T/F you can eat corn on the cob or an apple with dentures

F- this will accelerate RRR

T/F Patient education is an important part of the denture sucess

T

Retention

resistance to displacement of denture base away from ridge

Support

resistance to vertical movement of denture base toward ridge

Stability

Resistance to horizontal or rotational forces

Primary stress bearing areas of the maxilla

palate, residual ridge

Primary stress bearing areas of mandible

buccal shelf and retromolar pad

Step 1 Complete Denture Treatment

With Patient- treatment plan and prelim impressions

Lab- Prelim casts and custum tray

Step 2 Complete Denture Treatment

With Patient- Border molding and final impressions

Lab- Master cast, record base, wax rim

Step 3 Complete Denture Treatment

With patient- Ear Bow and MMR

Lab- cast mount and teeth set up

Step 4 Complete Denture Treatment

with patient- wax try in, adjustments, CR verification

lab- wax up and process dentures

Horizontal Jaw relation

centric relation

labial vestibule

2

Buccal vestibule

4

Residual Ridge

6

rugae

13

Buccal frenulum

3

tuberosities

7

Incisive papilla

12

posterior palatal seal

9

Junction of soft tissue over hard palate

14

fovea palatine

10

Hamular notch

8

Median palatine raphe

11

Labial notch

1

labial flange

2

Buccal notch

3

buccal flange

4

Alveolar groove

6

incisive fossa

12

Coronoid contour

5

Inadequate width or height of this flange area is a problem when developing seal to hold maxillary denture up

coronoid contour

area of posterior palatal seal

9

posterior palatal seal makes a _____ outline

butterfly

pterygomaxillary seal in area of hamular notch

8

Labial vestibule

2

residual alveolar ridge

5

pterygomandibular raphe

8

Buccal shelf

6

retromolar pad

7

sublingual caruncle

11

An additional secondary support area is necessary on the mandible if

there are genial tubercles

Buccal frenulum

3

Premylohyoid eminence

13

Relief zone for supporting a denture

premylohyoid eminence

retromylohyoid fossa

9

area critical to provide posterior retention of dentures on mandible

retromylohyoid fossa

Why does a mandibular denture gain retention in retromylohyoid fossa

the mandible has lingual bilateral undercuts

How do you insert a mandibular denture

initially more posterior to engage in retromylohyoid fossa and then sealing denture anteriorly last

labial notch

1

labial flange

2

buccal notch

3

buccal flange

4

alveolar groove

5

area of retromolar pad

7

pterygomandibular notch

8

lingual flange

10

lingual notch

12

area of premylohyoid eminence

13

extension helps retain posterior of mandibular denture

posterior lingual flange

Intaglio surfaces

surface of denture facing tissues

Cameo surfaces

surface of denture exposed, with teeth

How do you obtain an accurate impression

impress healthy tissue, use properly fitting custom tray, select correct impression method and materials for the circumstance

T/F Tissue management comes after impressions

False

what is the key to an accurate impression

custum tray

Custom tray requirements

stable, rigid, extended, properly relieved

Anterior flabby ridge

hypermobility made obvious with movement toward suction tip. movable, hyperplastic fibrous tissue on the maxillary ridge, often causing poor denture stability, retention, and a lost peripheral seal

Relief

reduction or elimination of undesirable pressure or force

Maxillary custom tray will be used with what technique

selective pressure impression technique

Where do you relieve

areas not well equipped to deal with pressures exerted by prosthesis

Selective pressure technique

relief wax for secondary stress areas, and no relief wax in primary stress bearing areas

Custom trays should be ____ short of vestibule depth

2-3 mm

T/F you can proceed with border molding without checking tray extension and adjusting as needed

false

If the tray border does not feel smooth to _____, then it is far too sharp for the patients mucosa

finger tip

Over extended tray

tissue distortion during impression leading to unstable denture

Under extended tray

insufficient extension to denture bearing areas leading to lack of retention

What is paramount about border molding to achieving a good outcome

ability to record necessary range of function

most difficult area to record clinically when border molding

mandibular posterior lingual vestibule of retromylohyoid fossa

border molding

shaping of border areas by functional or manual manipulation of tissue to duplicate contour and size of vestibule

Purpose of border molding

establish accurate flange length and border thickness, achieve retention through border seal (maxillary)

materials used for border molding

green stick compound

Overheating green stick will

vaporize volatile components

Prolonged immersion of green stick in hot water

leach out volatile or soluble components and alter physical properties

what increases flow of green stick

wet kneading

what results in distortion of tissues being recorded in border molding

not adequately softened compound

T/F excessive wet kneading can increase flow qualities of hardened material at mouth temperature to a point where distortion may occur upon removal

T

Where should you start border molding

buccal flange

Mucostatic impression

non pressure technique of recording tissue in passive state with mouth open

is it possible to have true mucostatic impressions

no, except scanning

what impression material would you use for mucostatic impression technique

low or extra low viscosity- ZOE and impression plaster