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69 Cards in this Set
- Front
- Back
definition- complete denture prosthodontics
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1) the replacement of the natural teeth in the arch and their assoc. parts by artificial substitutes 2) the art and science of the restoration of the edentulous mouth
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types- complete denture prosthodontics
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1. conventional complete dentures 2. overdentures 3. immediate dentures 4. implant supported dentures
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major causes of tooth loss
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1. perio disease 2. caries 3. trauma 4. planned extractions 5. congenital absence
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the # of edentulous patients will _____ eventhough the % of edentulous patients w/in the population is ______
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increase, decreasing
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purposes of complete dentures
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1.esthetics 2.mastication 3.speech 4. oral health
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important aspects of treatment for dentist
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1.technical ability 2.interpersonal management skills 3.understanding of denture function and limitations
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tooth loss results in
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1.residual ridge resorption 2.changes in intraoral structures 3.dec. masticatory function 4.loss of facial support and muscle tone 5.psycho-social effects
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changes in appearance caused by tooth loss
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1.premature aging 2.nose closer to chin 3.cheeks fall in 4.narrowing of lips(loss of vermillion border) 5.inc. facial creasing
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reduced masticatory efficiency caused by tooth loss
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1. range and type of food is dec. 2.max. biting force is 5-6 x's less 3.dec. area of mucosa available to recieve load
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maxillary mean denture-bearing area
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22.96cm^2
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mandibular mean denture-bearing area
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12.25cm^2
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normal dental arch PDL area
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45cm^2
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problems due to wearing dentures
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1.denture stomatitis 2.flabby ridge 3.irritation hyperplasia 4.ulcers 5.oral cancer 6.burning mouth syndrome 7.gagging 8.ridge reduction 9.caries(overdentures) 10.atrophy of muscles 11.nutritional deficiencies
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control problems by
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1.retain some teeth if possible 2.yearly regular follow-ups 3.implant supports
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1st appointment
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patient exam>>history, intra&extra oral exam, radiographs, prelim. impressions, diagnostic casts, psychological aspects
Lab work: custom tray |
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2nd apptmnt
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border molding and final impressions, Lab work: master casts, record base w/ occlusal rim
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3rd apptmnt
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jaw relation record, teeth selection, Lab work: mount casts, set teeth
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4th apptmnt
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try-in, verification, Lab work: prepare casts for flasking
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5th apptmnt
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denture placement
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6th, 7th, 8th apptmnt
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follow up, clinical remount
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purpose- preliminary impression
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diagnosis or construction of a tray
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purpose- final impression
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constructing master cast
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impression objectives
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1.preservation 2.support 3.stability 4.esthetics 5.retention
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preservation
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stimulation of alveolar ridge prevents resorption
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support
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maximum coverage provides snowshoe effect> distributes forces over widest area possible
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stability
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close adaptation is important; resistance to horizontal movement decreases 1.w/ loss of vertical height of ridges and 2.w/ inc. in flabby tissue
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esthetics
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vestibular fornix should be filled to restore facial contour
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retention
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depends on: 1.atm pressure (peripheral seal) 2.adhesion (saliva to denture) 3.cohesion (saliva to saliva) 4.mechanical locks 5. muscle control and patient tolerance
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features for maximum resistance
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1.optimum extension of denture base 2.close adaptation to mucosa 3.effective peripheral seal 4.polished surfaces 5.teeth placed in neutral zone 6.balanced neutrocentric occlusion
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primary impression should reproduce
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1. sulcus depth 2.sulcus width 3.landmarks which indicate correct extension of custom tray
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impression materials
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1.gypsum 2.ZOE paste 3.reversible hydrocolloid 4.irreversible hydrocolloid 5.rubber material 6. modeling compound 7.waxes
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reasons for inaccurate casts
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1.alginate dehydrates-shrinkage 2. alginate absorbs H2O- expansion 3.poor pouring technique 4.incorrect trimming
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dimensions-preliminary casts
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base-15-16mm
land area-3-4mm |
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factors affecting treatment plan
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1. patients mental attitude 2.patients systemic status 3.past dental history 4.local oral conditions
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psycho-social effects
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1.philosophical 2.exacting 3.indifferent 4.hysterical
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philosophical
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rational; expectations are real; prognosis good
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exacting
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severe demands; must reach agreement before treatment; prognosis fair
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indifferent
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uninterested; fair prognosis
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hysterical
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emotionally unstable, demanding; psychiatric eval?; poor prognosis
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systemic diseases affecting dentures
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1.debilitating(diabetes, blood dyscrasias)2.joints (osteoarthritis) 3.CV disease 4.skin(pemphigus) 5.neuro(bells palsy, parkinson's) 6.oral malignancies (radiation) 7.menopause(osteoporosis)
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local factors affecting dentures
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1.broad square ridges, no undercuts 2.cuspid eminence, alveolar tubercles,broad palate(maxillary) 3.broad buccal shelf,firm retromolar pad(mandibular) 4. definite vestibular fornix 5.frenum attachments, high in max. and low in mand. 6.definite lingual sulcus 7.lateral throat form allows extension into retromylohyoid space 8.firm mucosal covering 9.gradually sloping palate w/ passive reflection at junct. of hard and soft palate 10.adequate inter-ridge space
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extra-oral exam
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proportion of face, palpation of lymph nodes, skeletal base relationship, TMJ
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intra-oral exam
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mucosal membranes, tongue, alveolar ridge, saliva, existing dentures
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the rate of resorption is ___ x's higher in the mandible compared to the maxilla
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4
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resorption occurs from
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buccal to labial, towards the lingual
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resorption results in
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denture instability, pseudo-class III jaw relation, secondary- dec. retention
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purposes- impression tray
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1.carry impression material to mouth 2.confine material in apposition to surface to be recorded 3.control impression material while it sets
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impression tray materials
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1.autopolymerizing acrylic resin 2.thermoplastic resin (vacuum formed) 3.thermoplastic shellac baseplate 4.light cure resin material by pressure adapting
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dimensions- custom tray
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2-3mm thick
2mm short of vestibule 2mm distal to fovea palatina tissue stops- 4mm wide, 15mm length, 2mm from tray border margin handle- labial tilt, 5-6mm depth, 18-20mm width, 12-15mm height |
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definition- border molding
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shaping of the border areas of an impression tray by functional or manual manipulation of the tissue adjacent to the borders to duplicate the contour and size of the vestibule
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techniques- border molding
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1. incremental- stick tracing compound 2.one-step- rubbery material such as polyether
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3 M's of successful dentures
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mold, method, material
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stress bearing areas
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max- residual ridge, rugae
mand- buccal shelf, residual ridge |
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buccal shelf
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cover w/ dense cortical bone, wide area perpendicular to direction to occlusal load, bound medially by alveolar crest, ant by buccal frenum, laterally by ext oblique, distally by retromolar pad; extent influenced by buccinator
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rubber impression material
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adv: accurate, stable for 1 hr, do not affect stone hardness, easy to handle, records undercuts accurately; disadv: long setting time, technique sensitive
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ZOE impression material
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adv: fluidity-inc detail, fast, easy handling, dimensionally stable, can be used as a refining material; disadv: temp, humidity, diff to control
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final impression techniques
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1.functional position-closed mouth 2.rest position-open mouth
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window tray impression technique
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used to record highly mobile or hypertrophic tissue w/ minimum displacement; normal impression w/ ZOE covering mobile tissue
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vibrating line
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imaginary line b/w moveable and immovable tissues of the soft palate
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valsalva maneuver
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patient holds nose and blows through it; accentuates vibrating line and fovea palatinae
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postpalatal seal area
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soft tissue at or beyond the junction of the hard and soft palates on which pressure can be applied to inc retention; extends 3mm buccal to both hamular notches; post. border is vibrating line
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purpose-postpalatal seal
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1.provide close tissue contact during speech and swallowing 2.enhance retention and stability 3.compensate for processing shrinkage of resin
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purpose-vent hole
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1.permit proper seating of loaded tray while taking impression 2.relieve pressure over the incisive papilla and the rugae 3.prevent trapping of air bubbles
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purpose-boxing an impression
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produce a dense, accurate master cast of predetermined thickness
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wax boxing method is used for
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1.ZOE paste 2.rubber base 3.silicone
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purpose-record base
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1.act as carriers for occlusal rims on which jaw relations are recorded 2.hold teeth in wax set up for try in 3.check accuracy of previously recorded records
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record base materials
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1.shellac 2.reinforced shellac 3.processed acrylic resin 4.chemical activated or self-curing acrylic resin 5.light cure resin
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thickness of record base
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2mm
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anatomic guides for facial lip contour
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nasolabial and mentolabial sulci, philtrum, commisure of the lips
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