Try in, wax up, processing, insertion, clinical remounting, and post insertion care

Lecture given 10/8/2025

what are we looking for during the 4th appointment?

are the teeth acceptable in color and mold, is the articulator mounting of the models an accurate record of the patient’s jaw position, are the teeth in their best position, are we satisfied with th esthetic result, how is the lip support and tongue space

what is the sequence of events for the try in?

check CR

check VDO/VDR

check teeth position, midline, lip support, speech

check esthetics

how can you check CR?

set the incisal pin to the setting you had before the setup

mark that position on the incisal table

have your patient close into CR with the wax rims in and with bite registration material 

remove the wax rims and set them on the mandibular cast

loosen the latch and close the articulator

if the incisor pin is in the exact place as the mark, good job (won’t touch because of bite registration material)

what happens if your CR is off?

the incisal pin does not line up with the mark you previously made

you need to remount the mandibular cast on the articulator and re-set the teeth to the correct occlusal relationship

what should the difference between VDO and VDR be?

2-4 mm

if the posterior border of the maxillary denture is overextended, the k sound will become more of a ___ sound

ch

any error in the labiolingual inclination of the maxillary incisor teeth may cause an error in the pronunciation of what sound?

th

incorrect horizontal and vertical positioning of maxillary incisor teeth leads to mispronunciation of which sounds?

f, v

incorrect labiolingual incisor inclination will interfere with lip closure, affecting which sounds?

b, p, m

how is the s sound made?

the sides of the tongue are against the alveolar ridges and the gingival margins of the maxillary teeth and the middle of the tongue is lowered to create a groove

at the same time, the tip of the tongue contacts the palatal surfaces of the maxillary teeth or alveolar ridge

when are the 3 chances to determine tissue compressibility?

at the final impression appointment, at the maxillomandibular record, and at teeth try in

posterior palatal seal

the portion of the intaglio surface of a maxillary removable complete denture, located at its posterior border, which places pressure, within physiologic limits, on the posterior palatal seal area of the soft palate

this ensures intimate contact of the denture base to the soft palate and improves retention of the denture

posterior palatal seal AREA

the soft tissue area limited posteriorly by the distal demarcation of the moveable and non movable tissues of the soft palate and anteriorly by the junction of the hard and soft palates on which pressure, within physiologic limits, can be placed

this seal can be applied by a removable complete denture to aid in its retention

what are the benefits of posterior palatal seals?

compensates for polymerization shrinkage that occurs during denture processing, creates a seal preventing food entrapment between the denture base and the mucosa, decreases gagging, minimizes bulk

where is the posterior palatal seal usually located?

just buccal (~3mm) to one hamular notch area across the palate to just buccal to the opposite hamular notch

it is narrower to the midline to minimize pressure on a thinner mucosa layer

what are the clinical steps to identify the posterior palatal seal?

identify and located the pterygomaxillary fissures or notches (aka hamular notches) with the aid of a t ball burnisher

identify and locate the vibrating line by having the patient pronounce ahhh or cough or use the valsalva maneuver

identify and locate the hard palate-soft palate junction by using palpation with a ball burnisher

palpate the hard palate to identify and locate areas of compressible mucosa by using a ball burnisher

tissue compressibility location transferred to the maxillary impression- mark the areas

vibrating line

the junction of the moveable and immoveable tissues of the palate

the posterior aspect of the posterior palatal seal area over the soft palate

also represents the distal extent of the maxillary complete denture base over the soft palate

what are the 5 steps of denture insertion?

check denture extensions

check the tissue surface

check occlusion

check overall esthetics

patient education