Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
63 Cards in this Set
- Front
- Back
|
Remote Denture
|
A removable prosthesis, complete or partial, inserted some time after the patient as been rendered edentulous
|
|
|
Immediate denture
|
Removable complete or partial denture inserted at the time the patient is rendered edentulous
|
|
|
Transitional denture
|
Remote, immediate, complete, or partial denture that is used temporarily to ease the transition to another denture type
|
|
|
Denture base
|
Flanges: Labial, Buccal, Lingual
Palate |
|
|
Denture base & arch materials
|
Base:
Vulcanite Metals Polymethyl acralate Other plastics Ceramics Arch: Porcelain Acrylic Composite |
|
|
Golden proportion
|
.618:1
|
|
|
Functions of oral structures & least easily disturbed function
|
Mastication
Deglutition Communication Respiration Support of facial musculatures Swallowing is least easily disturbed function |
|
|
Resonance & Articulation
|
Resonance is intensification and prolongation of sound - essentially the vowels
Articulation - Modification of laryngeal tones to create new sounds - Consonants |
|
|
Limitations of complete dentures
|
Transitory:
Alteration in speech patterns Feeling of fullness in mouth Increased salivation Permanent: Changes in appearance Function is 1/3 that of natural teeth Changes in eating habits: Bilateral chewing, food selection, Dislodging forces & use of tongue, lips and cheeks to retain dentures |
|
|
Surface area of roots and denture bases
|
Attachment mechanism of periodontal membrane is twice as much as maxillary & 3x that of mandible
|
|
|
Radiographic mandible distance relationship
|
Distance from inferior border of mandible to occlusal plane is 3x that of inferior border of mandible to the mental foramen
|
|
|
Resorption pattern
|
Maxillary is from back to front
Mandibular is front to back starting with lingual down |
|
|
Rate of residual ridge reduction
|
3 to 4 times higher in mandible which has less than half the surface area of maxilla
3 times higher in women Most happens 6months to 2yrs post extraction |
|
|
Systemic factors of resorption
|
Osteoporosis:
Postmenopausal Estrogen deficiency Calcium deficiency Idiopathic |
|
|
Effects of bone overloading
|
Compressive forces decrease vascularity, tensile forces increase vascularity
Piezoelectrical effect Stimulation of osteoclasts Postsurgical cicatrical mucoperiosteum seeks reduced area |
|
|
Diabetes & Dentures
|
Epithelium is thinner & less keratinized
Compromises support and impairs tolerance of complete dentures Xerostomia also decreases tissue's tolerance of dentures |
|
|
Dietary disturbances
|
Soft diet, usually low on proteins and complex carbs
|
|
|
Testing denture stability, support, retention
|
Maxillary
- Apply tipping force in attempt to break the seal for retention - Apply unilateral vertical force in posterior occlusal surface to test Support, push horizontally to test stability Mandibular - Alternately apply unilateral force on occlusal surfaces |
|
|
Treatment of Candidiasis
|
Nystatin Powder - Apply to undersurface of denture 3 times a day for 3-4wks
Nystatin cream - Best for lesions on corner of mouth Reline or remake denture Nystatin rinse is generally ineffective Nystatin oral lozenges are reserved for fungal infestations that extend beyond the denture bearing surface |
|
|
Inflammatory Fibrous Hyperplasia
|
Aka Epulis Fissuratum
Fibrous hyperplasia begins as a trauma ulcer secondary to an ill fitted denture flange. Continued wear & irritation results in inflammatory fibrous hyperplasia & treatment is by surgical excision |
|
|
Inflammatory Papillary hyperplasia
|
Secondary to ill fitting maxillary dentures & sometimes complicated by Candidiasis
Treatment with antifungal medication or surgical excision in extreme cases * This is not a premalignant lesion |
|
|
Premalignant lesions
|
Leukoplakia
Erythroplakia |
|
|
Evaluation of existing dentures sounds
|
F sound on wet & dry line
S sound is closest speaking space Thus evaluate & avoid drastic changes to existing dentures |
|
|
Effect of alteration of VDO
|
Vertical Dimension of Occlusion
- Pseudo class III |
|
|
Quality of oral mucosa & support
|
The more keratinized attached mucosa the better the support. Especially in the mandible
Abundance in maxilla covering palate & alveolar ridges Mandible has only narrow zone of keratinized gingiva confined to alveolar ridges |
|
|
key teeth for partial or overdenture
|
Cuspids & Posterior abutments
|
|
|
Less favorable combinations
|
Complete maxillary & mandibular dentures or overdentures
Complete dentures with no previous denture experience Complete mandibular denture against natural maxillary teeth |
|
|
Mandibular support areas
|
Retromolar pad - Due to many muscles, does not resorb
Buccal Shelf Alveolar process - Most affected by bone resorption |
|
|
Buccal shelf boundaries
|
Extrenal oblique line & crest of the alveolar ridge form boundaries.
|
|
|
Mandible resorption pattern
|
Initiall Buccal-lingual dimension of mandibular alveolar ridge is narrowed, compromising support
Then height is affected compromising support, stability and retension Continued calcification of mylohyoid attachment leaves sharp bony projection to lingual causing irritation and perforation from complete dentures |
|
|
Maxillary resorption trend
|
Initial resorption is buccal-labial towards lingual resulting in some compromise of stability and support
Continued vertical resorption results in pseudo class III jaw relation, significant stability compromise resulting in secondary retention compromise. |
|
|
Anterior Hyperfunction syndrome
|
Caused by edentulous maxilla or mandible opposing a dentate anterior arch.
Steep anterior guidance results in denture tipping anteriorly compressing mucoperiosteum of premaxilla leading to bone resorption in premaxillary area. |
|
|
Measures to prevent or slow resorption
|
Well adapted & properly extended dentures with properly designed & executed occlusion
Use of residual tooth roots & osseointegrated implants |
|
|
Tongue position in stability & retention of mandibular denture
|
Position anteriorly to get prominent lingual flange to enhance stability and retention
|
|
|
Solutions to retruded tongue position and unfavorable alveolingual sulcus
|
Can be retained with osseointegrated implants to improve retention, stability, and support
Skin graft vestibuloplasty - Lower muscle attachment in floor of mouth & skin graft to widen keratinized tissue. Increased stability and retension b/c lingual flange is lengthened, improved support because zone of attached keratinized gingiva is widened. |
|
|
Posterior palatine salivary glands & Denture retention
|
Presence of these glands permits compression of tissues to overcome acrylic shrinkage during processing & helps maintain peripheral seal
|
|
|
Soft Palate House classification & Hard palate shape & character
|
Class 1 is most anterior to Class 3 most posterior
Flat, medium & high |
|
|
Methods for determining size of anterior teeth
|
Based on space available for placement of teeth
Based on proportion of facial size to tooth size |
|
|
Space available method
|
Vertical length of maxillary central incisors between high lip ling & wet line using F and V sounds.
Line at right angle to midline bisecting incisive papilla will indicate tip of cuspids Corner of closed mouth will indicate distal of cuspids Line from corner of eye past ala of nose will indicate tip of cuspids |
|
|
Proportion to face size method
|
Width of face measured at zygomas
Height from chin to top of forehead Central incisor is 1/16 the size of face in height and width |
|
|
Tooth molds
|
Square molds - Central incisor dominant & moderate curvature. Square shape offers max light reflection & creates bold effect
Tapering - Rounded contours with large triangular incisor slightly triangular in shape Ovoid - Pronounced gingivo incisal curvature to cause softened appearance |
|
|
Soft characteristics
|
Rounded arch form & tooth corners
Anteriors follow lower lip Laterals overlap centrals Smaller laterals & cuspids Sharp canines |
|
|
Bold characteristics
|
Angular outlines
Square arch form Large laterals & canines Centrals overlap laterals Blunt canines |
|
|
Choosing shade
|
Look for harmony with skin color because hair color changes with age & cosmetics.
Eye color covers too small of an area to be a major factor |
|
|
Horizontal relationships
|
To lie in a neutral zone between lips and tongue
Neutral zone is are where forces by lips, cheek and tongue are balanced |
|
|
PDL and Surface area
|
PDL has 2x surface area in maxilla and 4x that of mandible
|
|
|
Masticatory mucosa & parts
|
Well keratinized tissue firmly adherent to bony base
Covers residual ridges & hard palate. Lamina propria blends directly with periosteum - Raphe area, Gingival area, |
|
|
Basal mucosa in anterolateral & posterolateral areas
|
Anterolateral has submucosa made of adipose
Posterolateral has submucosa made of salivary glands |
|
|
LIning mucosa
|
Mucous membrane that comes into contact with denture borders
Thick, non keratinized stratified squamous epitheliium with thick lamina propria and loosely attached submucosa |
|
|
Retromolar papilla
|
Pear shaped area of gingiva attached to the scar tissue left by the extraction of the last molar
Firm & pale, so distinguish from retromolar pad which is red, soft and displaceable |
|
|
Denture stomatitis
|
Chronic irritation or inflammation associated with dentures
|
|
|
Clicking
|
Insufficient freeway space, excessive vertical dimension, teeth are too long
|
|
|
Angular chelitis cause and treatment
|
Candidiasis, or overclosure when teeth are too short causing saliva leakage at corners of mouth
Treat with Nyastin & Triamcinolone acetate ointment |
|
|
Gaging or vomiting
|
Posterior border of denture must be at vibrating line
|
|
|
Burning tongue and palate
|
Tough diagnosis. Check for candida or may be due to injury of taste buds
|
|
|
Treatment of oral candadiasis
|
Reline denture & decontaminate daily with sodium hypochlorite
Nystatin oral suspensin swish and rinse 4 times a day Clotrimazole torches If Nystatin does not work, use Fluconazole |
|
|
Tissue recovery procedures
|
Pressure indicator paste & dye marking sticks
|
|
|
Anterior Hyperfunction syndrome six manifestations
|
Loss of bone in premaxillar from mucoperiosteal hypertrophy
Loss of posterior palatal seal Reorientation of occlusal plane due to mandibular resorption and maxillary tuberosity hypertrophy Shift into protrusion of mandible Loss of face height Problem with removable partial denture due to rotation around fulcrum axis |
|
|
Types of implants
|
Subperiosteal
Osseointegrated |
|
|
Types of impression material
|
Regular body Elastomers - Firm and do not flow easily used for firm non-displaceable ridges preferred for mandibular impressions. Use 1 thickness of baseplate wax for spacer
Light body Elastomers - Thin and runny, used for thin mobile ridges & preferred for Maxillary CD impressions. Use 1 thickness of base plate wax for spacer. |
|
|
Land area & Cast base
|
Land area should be 2mm thick
Thinnest portion of cast should be .5 to .75 inches thick |
|
|
Flat occlusal template
|
Centering guide lines
Anterior reference line Anterior reference point Midline |
|
|
Three landmarks used to determine the plane of occlusion
|
Midpoint of retromolar pads bilaterally
Incisal edge of maxillary central incisors |
