Complete Denture (Midterm Exam): Week 3

to preserve the peripheral borders/rolls of the patient

What is the purpose of boxing the final edentulous impressions?

dental plaster and pumice flour (50-50 mixture)

What materials do we use for the matrix for boxing the final impressions?

5mm

Place the maxillary tray/impression into the pumice/plaster mixture. Center it and push it all the way down. Work the mixture up toward the peripheral rolls. Work the mixture up toward the top of the rolls but only to the point where there will still be ____mm of the peripheral rolls above the crest of the mixture. Put it aside to set.

Parallel

Place the mandibular final impression into the middle of the mix and push it all the way down. Please note that the M.F.P. of the mandibular impression should be __________ to the bench top. The bending of the handle has make this possible.

the midline of the crest of the edentulous mandibular ridge

What is the anterior point for the Mean Foundation Plane (MFP) of the mandibular final edentulous impression?

the areas of the left and right ascending rami of the mandible

What are the posterior points for the Mean Foundation Plane (MFP) of the mandibular final edentulous impression?

FALSE!!

T/F: the Mean Foundation Plane (MFP) of the mandibular final edentulous impression is from the anterior crest of the ridge to the retromolar pads

Retromolar pad should be deeply imbedded into the mix but completely exposed (be sure that the retromolar pad areas have been cleared of all of the mix that is covering them)

How should the retromolar pads area of the boxing impression look?

10mm

On a model trimmer, after peeling off the paper bowl, reduce the excess outside walls of the matrix so that they are about ____ mm

5mm

Carefully trim the land area around the impression so that about ____mm of the impression's peripheral roll is showing.

True!

T/F: The matrix is very soft so you need to be super careful when trimming

- Sit flat on the bench top.

- Have their mean foundation planes parallel to the bench top.

- Have a matrix material land area, about 10 mm wide around the impression.

- Have the peripheral rolls of the impression extend up about 5 mm above the land area (don't forget the lingual rolls).

- Pay special attention to the retromolar pads.

What should the final maxillary and mandibular matrices be like before boxing the impression?

15 mm (usually the depth of the palatal vault on the maxillary cast and the depth of the lingual peripheral roll on the mandibular cast)

When pouring the impressions, think ahead! How thick should the final master cast be at the thinest area?

Type III

What type of stone is the following:

- Dental stone (microstone)

- Has 0.20% expansion Beta calcination, not refractory

- Processing of acrylic dentures

dental stone type III

What material do we use use to pour the final casts?

it is not strong enough

Why do we not use model/dental plaster to pour our master casts?

Die stone is so hard that it will be very difficult to separate the final cast from the processed denture.

Why do we not use die stone when pouring our master casts?

Dental stone is just right, strong enough to take the pressure yet not too difficult to separate from the processed dentures.

Why do we use dental stone to pour our master csats?

- 30 ml of water

- 100 g of powder

What is the proper mix for water and dental stone?

True (instant wetability)

T/F: Powder is always added to liquid for mixing

No! The land areas are flat and square all the way around the final edentulous casts.

Are there bevels on the final casts?

5mm

You will trim the final edentulous casts very carefully and precisely by making the land areas square, flat and about ____mm above the peripheral rolls.

5mm

The maxillary land area should be square and smooth, 3 to 5 mm above the peripheral rolls and about ____mm wide.

Land area

ID the area:

- Hamular notches

- Retromolar pads

- Full peripheral rolls

Assess the final casts for tissue detail and what three anatomical landmarks?

3-5 mm

Mandibular facial land areas are square, smooth, and 3 to 5 mm above the depths of the facial peripheral rolls. Be sure to also maintain a lingual peripheral roll that is ___-___mm below the level of the lingual land area.

- Palatal vault (max)

- Lingual peripheral rolls (mand)

Check the final casts and make sure that there are at least 15 mm thick at their thinnest portion which is between the base of the cast and the ___________ for the maxillary and the ___________ for the mandible

Under-trimmed

What do you think of this trimming cast?

Over-trimmed

What do you think of this trimming cast?

Ideal (180 degrees)

What do you think of this trimming cast?

Articulate your master casts

Between the second and third appointment, a record base is made on each cast and a wax rim is made on each record base. These are occlusal rims that will allow you to what?

To create guidelines for the proper placement of the denture teeth in a complete denture set-up

Why do we mark the final impression casts?

- Circle the incisive papilla

- Make the front edge of the ruler perpendicular to the mid-palatal suture. Draw lines on the left and right land areas, directly beneath the front edge of your ruler

What set of marks do we make as a guideline for positioning the facial surfaces of the maxillary central incisors?

to determine the height of the posterior occlusal plane in a complete denture set-up

Why do we mark the retromolar pads on the mandibular cast?

Place a dot anterior 2/3 of the height of each retromolar pad (make dots/reference points while holding cast at eye level and look at it from the facial aspect)

Where do you place a dot on each retromolar pad?

- Crest of the residual ridge

- Determine the bucco-lingual placement of posterior teeth

- The central fossae of the premolar and molar denture teeth are placed directly over the crests of the mandibular residual ridges

After marking the retromolar pads, what are the second markings on the mandibular casts?

Teeth/denture will lean outward and cause cheek biting

It is important that we mark the crest of the mandibular ridge correctly because, if we set teeth too buccally, what would happen?

Teeth/denture will tip too lingual and reduce space for tongue

It is important that we mark the crest of the mandibular ridge correctly because, if we set teeth too lingually, what would happen?

Crest of the residual ridge

What do the red dots represent?

Height of the occlusal plane

What does the blue dot represent?

Where the ascending rami begin

What does this marking represent?

ascending rami

Where the __________ begin, draw vertical lines on the left and right sides of the cast. No tooth will be set completely distal to this line

Where the ascending rami begin

What line marks where no tooth will be set completely distal to the line?

Crest of the anterior aspect of the ridge

What do these markings represent?

18

How many total markings are there between the maxillary and mandibular casts?

- Height

- Width

- Contour

Ideal border molder determines the proper ________, ________, and ________ of the final complete denture

Peripheral rolls

For this project, we will assume that our impression are perfect. The triad material should completely fill the entire __________ of your final edentulous casts.

Hamular notch

When fabricating the maxillary record paces, be sure that the material completely fills the ___________ areas and is straight across the posterior aspect of the cast.

The thinned down area at the posterior of the hard palate should be about 10 m, wide anterior posteriorly. This will minimize the acrylic shrinkage that will occur during the triad curing process

When making the record bases, why do we thin down the posterior hard palate?

A new record base will be required

Check the posterior area of the maxillary rim and be sure that you do not have more than a 2 mm space. What happens if you have more than 2 mm space?

Thinning makes the tooth arrangement easier as it provides a little more room for the denture teeth set-up - this should be done before adding wax

Why do we thin the anterior aspect of record bases?

anterior

For the fabrication of the maxillary wax rim, there is a slight _______ inclination

22mm

For the fabrication of the maxillary wax rim, it should have a smooth and flat facial surface which is _____ mm high at the lateral incisors (black arrows)

3mm

For the fabrication of the maxillary wax rim, it should have a flat and smooth incisal plane which is __ mm wide (blue arrows)

Buccal

For the fabrication of the maxillary wax rim, the ________ surface is smooth and sloping towards the peripheral roll

Lingual

For the fabrication of the maxillary wax rim, the _________ surface is smooth and sloping towards the palate

smooth and sloping

For the fabrication of the maxillary wax rim, it should have a lingual surface which is _________ and _________ toward the palate

Over the crest of the maxillary ridges

Where should the posterior maxillary wax rim be located over?

parallel

the posterior maxillary wax rim should be _______ to the maxillary mean foundation plane

5mm (bicuspids), 10mm (molar)

the posterior maxillary wax rim should have a flat and smooth occlusal plane that is __ mm wide in the bicuspid areas and __ mm wide in the molar areas

Midline

For the fabrication of the maxillary posterior wax rim, it should have a lingual wax smooth and sloping towards the ________

Where you expect the junction of the first and second molars to be - put about a 45 degree angle on this cut

Where should you cut the posterior ends of the maxillary wax rim?

18mm (height), 3mm (width)

For the mandibular wax rim, the anterior wax is __ mm high and __ mm wide

5mm (bicuspids), 10mm (molar)

For the mandibular wax rim, the widths of the occlusal surfaces of the wax rim at __ mm in the bicuspid and __ mm in the molar areas. Keep all these features in mind as you are working

Parallel

The occlusal plane of the mandibular wax rim is _________ to the mandibular mean foundation plane

Peripheral rolls

The facial and lingual walls of the mandibular wax rim are flat with a slight flare as they feather toward the _________

No

Is there a buccal inclination of the mandibular wax rim?

3, 5, 10 mm

What are the varying widths of the mandibular wax rim?

5mm

The rim former features a __mm hamular fence

perpendicular

Note that the incisal portion of wax rim is ________ to occlusal plane

First visit

Consider the sequence of treatment for making complete dentures:

When do you take preliminary impressions?

Second visit

Consider the sequence of treatment for making complete dentures:

When do you do border molding and final impressions?

Third visit

Consider the sequence of treatment for making complete dentures:

When do you do the maxilla-mandibular relationships?

Fourth visit

Consider the sequence of treatment for making complete dentures:

When do you do the denture try in?

Fifth visit

Consider the sequence of treatment for making complete dentures:

When do you do insertion?

Between first and second visit

Consider the sequence of treatment for making complete dentures:

When do you pour/trim preliminary casts and use those to fabricate the custom trays?

Between second and third visit

Consider the sequence of treatment for making complete dentures:

When do you pour/trim final casts and use those to fabricate the record bases and wax rims?

Between the third and fourth visit

Consider the sequence of treatment for making complete dentures:

When do you articulate the casts and set up the teeth?