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69 Cards in this Set

  • Front
  • Back
definition- complete denture prosthodontics
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
types- complete denture prosthodontics
1. conventional complete dentures 2. overdentures 3. immediate dentures 4. implant supported dentures
major causes of tooth loss
1. perio disease 2. caries 3. trauma 4. planned extractions 5. congenital absence
the # of edentulous patients will _____ eventhough the % of edentulous patients w/in the population is ______
increase, decreasing
purposes of complete dentures
1.esthetics 2.mastication 3.speech 4. oral health
important aspects of treatment for dentist
1.technical ability 2.interpersonal management skills 3.understanding of denture function and limitations
tooth loss results in
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
changes in appearance caused by tooth loss
1.premature aging 2.nose closer to chin 3.cheeks fall in 4.narrowing of lips(loss of vermillion border) facial creasing
reduced masticatory efficiency caused by tooth loss
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
maxillary mean denture-bearing area
mandibular mean denture-bearing area
normal dental arch PDL area
problems due to wearing dentures
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
control problems by
1.retain some teeth if possible 2.yearly regular follow-ups 3.implant supports
1st appointment
patient exam>>history, intra&extra oral exam, radiographs, prelim. impressions, diagnostic casts, psychological aspects
Lab work: custom tray
2nd apptmnt
border molding and final impressions, Lab work: master casts, record base w/ occlusal rim
3rd apptmnt
jaw relation record, teeth selection, Lab work: mount casts, set teeth
4th apptmnt
try-in, verification, Lab work: prepare casts for flasking
5th apptmnt
denture placement
6th, 7th, 8th apptmnt
follow up, clinical remount
purpose- preliminary impression
diagnosis or construction of a tray
purpose- final impression
constructing master cast
impression objectives
1.preservation 3.stability 4.esthetics 5.retention
stimulation of alveolar ridge prevents resorption
maximum coverage provides snowshoe effect> distributes forces over widest area possible
close adaptation is important; resistance to horizontal movement decreases 1.w/ loss of vertical height of ridges and 2.w/ inc. in flabby tissue
vestibular fornix should be filled to restore facial contour
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
features for maximum resistance
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
primary impression should reproduce
1. sulcus depth 2.sulcus width 3.landmarks which indicate correct extension of custom tray
impression materials
1.gypsum 2.ZOE paste 3.reversible hydrocolloid 4.irreversible hydrocolloid 5.rubber material 6. modeling compound 7.waxes
reasons for inaccurate casts
1.alginate dehydrates-shrinkage 2. alginate absorbs H2O- expansion 3.poor pouring technique 4.incorrect trimming
dimensions-preliminary casts
land area-3-4mm
factors affecting treatment plan
1. patients mental attitude 2.patients systemic status 3.past dental history 4.local oral conditions
psycho-social effects
1.philosophical 2.exacting 3.indifferent 4.hysterical
rational; expectations are real; prognosis good
severe demands; must reach agreement before treatment; prognosis fair
uninterested; fair prognosis
emotionally unstable, demanding; psychiatric eval?; poor prognosis
systemic diseases affecting dentures
1.debilitating(diabetes, blood dyscrasias)2.joints (osteoarthritis) 3.CV disease 5.neuro(bells palsy, parkinson's) 6.oral malignancies (radiation) 7.menopause(osteoporosis)
local factors affecting dentures
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
extra-oral exam
proportion of face, palpation of lymph nodes, skeletal base relationship, TMJ
intra-oral exam
mucosal membranes, tongue, alveolar ridge, saliva, existing dentures
the rate of resorption is ___ x's higher in the mandible compared to the maxilla
resorption occurs from
buccal to labial, towards the lingual
resorption results in
denture instability, pseudo-class III jaw relation, secondary- dec. retention
purposes- impression tray
1.carry impression material to mouth 2.confine material in apposition to surface to be recorded 3.control impression material while it sets
impression tray materials
1.autopolymerizing acrylic resin 2.thermoplastic resin (vacuum formed) 3.thermoplastic shellac baseplate 4.light cure resin material by pressure adapting
dimensions- custom tray
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
definition- border molding
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
techniques- border molding
1. incremental- stick tracing compound rubbery material such as polyether
3 M's of successful dentures
mold, method, material
stress bearing areas
max- residual ridge, rugae
mand- buccal shelf, residual ridge
buccal shelf
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
rubber impression material
adv: accurate, stable for 1 hr, do not affect stone hardness, easy to handle, records undercuts accurately; disadv: long setting time, technique sensitive
ZOE impression material
adv: fluidity-inc detail, fast, easy handling, dimensionally stable, can be used as a refining material; disadv: temp, humidity, diff to control
final impression techniques
1.functional position-closed mouth position-open mouth
window tray impression technique
used to record highly mobile or hypertrophic tissue w/ minimum displacement; normal impression w/ ZOE covering mobile tissue
vibrating line
imaginary line b/w moveable and immovable tissues of the soft palate
valsalva maneuver
patient holds nose and blows through it; accentuates vibrating line and fovea palatinae
postpalatal seal area
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
purpose-postpalatal seal
1.provide close tissue contact during speech and swallowing 2.enhance retention and stability 3.compensate for processing shrinkage of resin
purpose-vent hole
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
purpose-boxing an impression
produce a dense, accurate master cast of predetermined thickness
wax boxing method is used for
1.ZOE paste 2.rubber base 3.silicone
purpose-record base
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
record base materials
1.shellac 2.reinforced shellac 3.processed acrylic resin 4.chemical activated or self-curing acrylic resin 5.light cure resin
thickness of record base
anatomic guides for facial lip contour
nasolabial and mentolabial sulci, philtrum, commisure of the lips