Removable Midterm Exam

Front 1

Four types of patients according to M.M. House

Back 1

Philosophical, Exacting, Indifferent, Hysterical

Front 2

What type of trays are used for preliminary impressions?

Back 2

Stock metal trays

Front 3

What material is used for preliminary impressions?

Back 3

A highly viscous irreversible hydrocoloid

Front 4

List the steps to final impression completion following making of the preliminary impression

Back 4

Outline custom tray borders, fabricate custom trays, complete border molding for final impression, make final impression with custom trays, bead and box the complete denture final impression

Front 5

What is another name for physiologic rest position?

Back 5

Vertical Dimension of Rest (VDR)

Front 6

What is VDR?

Back 6

Vertical dimension of rest/physiologic rest position. The habitual postural position of the mandible when the patient is resting comfortably in the upright position and the condyles are in a neutral unstrained position in the glenoid fossae.

Front 7

What are synonyms for Interocclusal distance?

Back 7

Free way space, interocclusal clearance, interocclusal gap, interocclusal rest space

Front 8

Define interocclusal distance

Back 8

The distance between occluding surfaces of hte maxillary and mandibular teeth when the mandible is in its physiologic rest position

Front 9

What is the vertical dimension of occlusion (VDO)?

Back 9

The vertical dimension (length) of the face when the teeth or occlusal rim are in contact and the mandible is in centric relation

Front 10

What procedures are done with delivery of the dentures?

Back 10

Tissue side adjustment with PIP, new centric jaw relation record, clinical remount, adjustments of occlusion in centric relation, eccentric, and protrusive jaw relations, home care instructions

Front 11

Home care instructions for complete dentures

Back 11

1. Chew bilaterally
2. Carefully and thoroughly brush teeth, tongue, and edentulous ridges after each meal
3. Dentures must be taken out at night
4. Periodic recalls

Front 12

What are the recall appointments following denture delivery?

Back 12

24 hours, 48 hours, one week, six months

Front 13

This type of patient understands the limitations of dentures. They are easy-going and intelligent

Back 13

Philosophical

Front 14

This type of patient has high expectations and expects you to do exactly what they have in mind. They are still a favorable patient

Back 14

Exacting

Front 15

This type of patient can live without a denture. They are often younger and are pressured by others to get a denture. They don't receive a satisfying feeling on completing treatment and do not like the final outcome as they never really understood the procedure

Back 15

Indifferent

Front 16

This type of patient is emotionally unstable. They are older or more mature, more sensitive and less positive. They often blame other problems (ie: headaches) on the denture. You must spend more time working with these patients and listening to complaints

Back 16

Hysterical

Front 17

What are two preprosthetic surgeries that may need to be completed before denture fabrication?

Back 17

Frenectomy in cases of a high frenum attachment or alveolplasty in patients with maxillary tori, buccal exostoses, sharp alveolar ridges, or bony undercuts.

Front 18

What does border molding do?

Back 18

"fills in the space between the red and blue lines on a custom tray cast"

Front 19

What is a typical VDO distance?

Back 19

3 mm
The length of the face when the teeth or occlusal rims are in contact and mandible is at rest.

Front 20

What are you looking for in the initial patient evaluation?

Back 20

Smooth edentulous curve, well-defined vestibule, no maxillary tori or tuberosities.

Front 21

What are most of today's dentures made of?

Back 21

Heat-activated PMMA and copolymers

Front 22

What is the effect on crosslinking of polymers on material properties?

Back 22

1. Reduces water absorption
2. Prevents crazing of polymers
3. increases elasticity and decreases viscosity
(Increases rigidity and resistance and decreases crazing)

Front 23

What is the ratio of polymer to monomer in PMMA?

Back 23

3:1

Front 24

What are the stages that occur in setting of a PMMA?

Back 24

1. Wet, sandlike stage
2. Tacky fibrous stage
3. Smooth doughlike stage
4. Stiff, rubberlike stage

Front 25

At what stage is the PMMA packed into a gypsum mold and put into a time-temp controlled water bath (74C for 8 hrs) to initiate resin polymerization?

Back 25

Smooth doughlike stage

Front 26

What type of reaction is PMMA polymerization?

Back 26

Exothermic

Front 27

Why are denture flasks cooled slowly after polymerization?

Back 27

To allow for adequate release of internal stresses to minimize warpage

Front 28

What degree of shrinkage occurs in PMMA polymerization?

Back 28

7%

Front 29

Why should dentures be stored in water when outside the mouth?

Back 29

High degree of shrinkage. Material undergoes water absorption which results in linear expansion, offsetting the thermal shrinkage

Front 30

What is the deformation of denture base resins over time called?

Back 30

Creep

Front 31

The Triad material which we use in lab is what type of denture base material?

Back 31

VLC - light activated resin base

Front 32

How is Triad VLC polymerized?

Back 32

Visible light of 400-500nm for 10 minutes

Front 33

Is Bis-GMA a polymer or monomer?

Back 33

Monomer

Front 34

What are the biocompatible properties of denture base resins?

Back 34

Not allergenic, not carcinogenic, not chemical toxic, non-tooth-wearing, non-estrogenic

Front 35

If Modulus of a material increases, what is the effect on strength, elasticity, and wear resistance?

Back 35

Strength increases
Elasticity decreases
Wear resistance increases

Front 36

Polymers can be classified into three categories in terms of reaction type:

Back 36

1. Chemical (Self-cure)
2. Visible light cure
3. Heat cured

Front 37

What is the inhibitor added to resin to increase shelf life?

Back 37

Hydroquinone

Front 38

Termination of polymerization reaction does what to molecular weight and strength?

Back 38

lowers molecular weight and decreases strength

Front 39

How does the strength of a polymer relate to the number of monomers/molecular weight?

Back 39

Direct correlation (as one increases, so does the other)

Front 40

The longer the SIDE CHAINS on a monomer, the more ... a polymer and ... the strength

Back 40

The more flexible the polymer and the lower the strength

Front 41

What type of reaction creates polymers through the linking of monomers and free radicals?

Back 41

Addition reaction

Front 42

What are five ways to reduce polymerization shrinkage?

Back 42

1. Use larger monomer molecules
2. Use 3 parts polymer powder to 1 part monomer as polymer powder has already shrunk
3. Add glass filler to composites (50-70% glass by volume)
4. Overfill and mold under pressure (Denture dough packing)
5. Add VLC in increments: makes up for some of the volume shrinkage of previous increment

Front 43

What are the differences between a thermoset and thermoplastic denture material?

Back 43

Thermoset: brittle, not softened by temperature, chars on heating/does not melt, HIGHLY crosslinked (>50%)

Thermoplastic: softened by temperature, becomes ductile as temperature increases, melts, little or no crosslinking

Front 44

How does the anatomy of a frenum notch affect stability of denture?

Back 44

Frenum notch is a stress concentrator that can cause a fatigue crack to create a midline fracture. It should be rounded or blunt, not thin.

Front 45

PMMA Properties

Back 45

Tissue-like appearance (NOT with auto-cured)
High flexure strength to resist midline fracture
Low impact resistance - brittle at room temp
Creep resistance - tell patients to NOT put into hot water or it will warp
However, keep in water to avoid shrinkage
Can use in monomer-allergic patients
Low % free monomer

Front 46

Why should you soak a PMMA in water for four days before delivery?

Back 46

Reduce monomer exposure as unreacted MMA leaches out

Front 47

What is the catalyst for VLC?

Back 47

Camphorquinone

Front 48

What are the properties of VLC?

Back 48

Low shrinkage
Residual monomer at surface only (inhibited layer)
Color stability is good
15% silica putty
highest elastic modulus

Front 49

Sources of voids in denture base

Back 49

1. Poorly mixed polymer powder and monomer
2. excess polymer powder
3. water in flask
4. heating too soon (monomer boils at 100 C
5. under-packing
6. air trapped while mixing

Front 50

Record base

Back 50

A temporary form representing the base of a denture base, which is used for making jaw relation records and for the arrangement of teeth

Front 51

A record base is used for:

Back 51

1. Carrying occlusal rim
2. Supporting materials used to record jaw relation records
3. Providing support when making facebow record
4. Support teeth during try-in
5. Locating the position of the posterior border of the maxillary denture

Front 52

Steps for record base fabrication

Back 52

1. Index casts
2. Posterior palatal seal
3. Soak casts for five minutes
4. Alcote casts
5. Block-out undercuts with baseplate wax
6. Apply MRA to cast
7. Place triad material over cast
8. Cure for 8 minutes total
9. Smooth borders with acylic bur
10. Establish midline

Front 53

Occlusal Rim

Back 53

An occluding surface attached to a record base onto which jaw relation records are made and maxillary/mandibular teeth are arranged

Front 54

An occlusal rim is used for:

Back 54

1. Guide for maxillary anterior teeth arrangement
2. establish maxillary occlusal plane laterally and AP until casts are mounted
3. support jaw relation records
4. establish midline

Front 55

What is the freeway space and what is its average distance?

Back 55

The freeway space is the distance between VDR and VDO and is usually 2-4 mm at the position of the first premolars

Front 56

Class I articulators

Back 56

Simple holding instruments capable of accepting a single static registration

Front 57

Class II articulators

Back 57

Instruments that permit horizontal as well as vertical motion but do not orient motion to TMJ via facebow transfer

Front 58

Class III articulators

Back 58

Instruments that simulate condylar pathways by using an average or mechanical equivalent for all part of hte motion. Accept facebow records

Front 59

Class IV articulators

Back 59

Instruments that will accept three-dimensional dynamic registrations

Front 60

Minimal articulator requirements

Back 60

1- Must accurately maintain centric position
2- Casts must be easily removed without losing their correct horizontal and vertical relationship
3- Should have an incisal guide pin with a positive stop that is adjustable and calibrated
4- Should be able to open and close in a hinge-like fashion
5- Should accept a face-bow transfer record
6- Made out of rigid and noncorrosive material should resist wear
7- Not too bulky and heavy

Front 61

What are the four types of posterior teeth for selection?

Back 61

1. 20-30 degree cusped teeth for bilateral balanced occlusion
2. 0 degree flat teeth for monoplane occlusion
3. Flat teeth with compensating curve of second molar ramp
4. Combinations for lingualized occlusion

Front 62

What type of teeth have shown a slight advantage for chewing efficiency?

Back 62

Cusped teeth

Cuspal anatomy has nto been shown to have any significant effect on supporting tissues

Front 63

Advantages and Disadvantages of 20-30 degree cusped teeth

Back 63

Advantages - more efficient in chewing, posteriors appear more natural

Disadvantages - most time and complexity of records, limitations of anterior tooth position (0.5-1.0 mm overlap and 1-2 mm overjet), restriction of tooth position to that allowed by cuspal anatomy

Front 64

Advantages and Disadvantages of monoplane 0 degree teeth

Back 64

Advantages - simple recording, simple articulator, quick arrangement, wide range of posterior tooth positions, no lateral stresses on mucosa with parafunction, easier for patients with uncoordinated closures (ie: Parkinson's)

Disadvantages - Flat premolars may appear less esthetic, less efficient chewing, anterior esthetics require more overjet and NO overbite

Front 65

Advantages and Disadvantages of flat teeth with compensating curve or second molar ramp

Back 65

Advantages - Simple to set up, allows for more esthetic overlap, posterior point contact maintains denture base stability on excursions or parafunction

Disadvantages - slightly more laboratory setup time than flat teeth, premolars appear flat if visible

Front 66

Advantages and Disadvantages of combinations or lingualized occlusion

Back 66

Advantages - upper premolars appear natural, range of posterior tooth positions allowed, better chewing than monoplane

Disadvantages - some grinding needed to create upper cusp tip to lower fossa contacts

Front 67

A semiadjustable facebow is used to determine three jaw relations

Back 67

1. Relation of the jaws to the opening axis
2. Vertical separation of the jaws
3. Relation of the lower jaw to the upper jaw in protrusion (incisor edge to edge position)

Front 68

What is the preferred interocclusal record?

Back 68

Static because of ease of reproducibility and repeatability

Front 69

What is the average speaking space and how does it related to the interocclusal space?

Back 69

1-3 mm and is NOT related to the interocclusal space of rest position. When the s sound is enunciated, this shows the speaking space. During this, occlusal rims should come close together but should NOT contact.

Front 70

Which is more important in controlling movements of the mandible: incisal guidance or condylar paths and why?

Back 70

Incisal guidance because the condylar paths are farther away from the cusp inclines, which both the incisal angle and the condyle angle influence. Incisal guidance is influenced by the horizontal and vertical overlap of the anterior teeth

Front 71

Goals of complete denture occlusion

Back 71

1. Minimize trauma to supporting structures
2. Preserve remaining structures
3. Enhance stability of the dentures
4. Facilitate esthetics and speech
5. Restore mastication efficiency to a reasonable level

Front 72

Common features of denture occlusion

Back 72

1. Simultaneous, bilateral posterior contact in centric relation
2. Centralization of centric occlusal forces over the residual ridges

Front 73

If you are making a denture to oppose natural teeth, what occlusal scheme would you choose?

Back 73

Anatomic balanced

Front 74

What is the difference between anatomic balanced and semi-anatomic balanced occlusion?

Back 74

Semi-anatomic balanced decreases the cuspal inclines to 10-20 degrees. Cuspal inclines in anatomic balanced occlusion are 30 degrees.

Front 75

What is the main functioning occlusal element in lingualized occlusion?

Back 75

The maxillary lingual cusps

Front 76

What is the anatomy of the mandibular teeth in lingualized occlusion?

Back 76

Mandibular monoplane or shallow (10 degree) cusp teeth

Front 77

What are the indications for anatomic balance and semi-anatomic balanced schemes?

Back 77

Healthy patients with good ridges, good muscular control, and adequate dexterity

Front 78

What does lingualized occlusion avoid?

Back 78

Maxillary buccal cusp contact in centric relation or lateral excursion

Front 79

What are indications for lingualized occlusion?

Back 79

mandibular ridge atrophy, malocclusion (class II, III, crossbite), esthetic demands.

In general: versatile, can be used in most patients

Front 80

What are the five elements of neutrocentric occlusion?

Back 80

Position, proportion, pitch, form, and number

Front 81

Describe the position element of neutrocentric occlusion

Back 81

Posterior teeth are positioned as far lingually as the tongue will allow

Front 82

Describe the proportion element of neutrocentric occlusion

Back 82

A narrow BL tooth width reduces vertical stress on the ridge

Front 83

Describe the pitch element of neutrocentric occlusion

Back 83

Occlusal plane parallel to ridge, teeth set flat, no balance, patients instructed not to incise or protrude

Front 84

Describe the form element of neutrocentric occlusion

Back 84

Tooth form is flat with no inclines to reduce lateral forces

Front 85

Describe the number element of neutrocentric occlusion

Back 85

Three posterior teeth are used per quadrant instead of four

Front 86

What are the advantages of neutrocentric occlusion?

Back 86

Centric relation can be an area, not a point
Freedom of movement and reduction of lateral forces

Front 87

What are the disadvantages of neutrocentric occlusion?

Back 87

Unesthetic, poor bolus penetration, and
*Functioning forward or lateral to centric relation may unseat the dentures

Front 88

What are the indications for neutrocentric occlusion?

Back 88

Geriatric patient with limited oral dexterity, stroke or Parkinson's

Class II, III and cross-bite cases

Front 89

Describe the non-anatomic balanced occlusal scheme

Back 89

Monoplane teeth are set with a compensating curve or balancing ramp to provide lateral and protrusive balance.

Front 90

What are indications for the non-anatomic balanced occlusal scheme?

Back 90

Esthetically demanding patients with poor ridges in whom it may be possible to get reasonably accurate records (record taking is more difficult than a non-balanced occlusion). Also good for class II, III and crossbite.

Front 91

What is the single most important factor in successful manipulation of complete dentures under function?

Back 91

Neuromuscular control

Front 92

Which occlusal scheme has research deemed to be superior?

Back 92

None! No scheme has been shown to be more superior in function, safer in oral structures, or more acceptable to patients

Front 93

What are the dimensions to note in beading and boxing of a final impression?

Back 93

Land area to be (border) - 5 mm wide
Boxing was - 8-10 mm above highest point
Plaster/pumice 3-4 mm below border of impression
Plaster/pumice in mandibular posterior border - 2mm

Front 94

Match mandibular anatomy with occupying portion of denture : MANDIBULAR LABIAL FRENUM

Back 94

MANDIBULAR LABIAL NOTCH

Front 95

Match mandibular anatomy with occupying portion of denture : MANDIBULAR LABIAL VESTIBULE

Back 95

MANDIBULAR LABIAL FLANGE

Front 96

Match mandibular anatomy with occupying portion of denture : MANDIBULAR BUCCAL FRENUM

Back 96

MANDIBULAR BUCCAL NOTCH

Front 97

Where is the mandibular buccal frenum located and what muscle underlies it?

Back 97

Located in the region of the lower cuspid.
Triangularis muscle

Front 98

Match mandibular anatomy with occupying portion of denture : MANDIBUALR BUCCAL VESTIBULE

Back 98

MANDIBULAR BUCCAL FLANGE

Front 99

How does the location of the mental foramen change when teeth are lost?

Back 99

It lies closer to the crest of the ridge. If the ridge is extensively resorbed, the denture may impinge on the vessels and nerves and the area will require relief.

Front 100

Match mandibular anatomy with occupying portion of denture : EXTERNAL OBLIQUE LINE

Back 100

EXTERNAL OBLIQUE GROOVE

Front 101

What is the area that lies between the crest of the ridge and the external oblique ridge that provides good support for the mandibular denture?

Back 101

Buccal shelf

Front 102

The fibers of what muscle have origin in the region of the buccal shelf?

Back 102

Buccinator

Front 103

Match mandibular anatomy with occupying portion of denture : RESIDUAL RIDGE

Back 103

RESIDUAL FOSSA

Front 104

What is a PRIMARY area of support for the mandibular denture

Back 104

RESIDUAL RIDGE

Front 105

Match mandibular anatomy with occupying portion of denture : RETROMOLAR PAD

Back 105

RETROMOLAR FOSSA

Front 106

What structures does the retromolar pad contain?

Back 106

glands, pterygomandibular raphe, fibers of buccinator, temporal tendon. This area must be covered by the denture

Front 107

Match mandibular anatomy with occupying portion of denture : LINGUAL AREA

Back 107

LINGUAL FLANGE

Front 108

What is the shape of the lingual flange determined by?

Back 108

The mylohyoid muslce

Front 109

Match mandibular anatomy with occupying portion of denture : RETROMYLOHYOID SPACE

Back 109

RETROMYLOHYOID EMINENCE

Front 110

Where is the retromylohyoid space located?

Back 110

Behind the posterior border of the mylohyoid muscle

Front 111

Match mandibular anatomy with occupying portion of denture : MYLOHYOID LINE

Back 111

MYLOHYOID GROOVE

Front 112

Match mandibular anatomy with occupying portion of denture : LINGUAL TUBEROSITY

Back 112

LINGUAL TUBERCULAR FOSSA

Front 113

Match mandibular anatomy with occupying portion of denture : LINGUAL FRENUM

Back 113

LINGUAL NOTCH

Front 114

Match the maxillary anatomy with its occupying portion of the denture : MAXILLARY LABIAL VESTIBULE

Back 114

MAXILLARY FLANGE

Front 115

Term for the area that is the deepest part of the vestibule at which the labial mucous membrane is reflected onto the alveolar process

Back 115

VESTIBULAR FORNIX OR MUCOBUCCAL FOLD

Front 116

Match the maxillary anatomy with its occupying portion of the denture : MAXILLARY BUCCAL FRENUM

Back 116

MAXILLARY BUCCAL NOTCH

Front 117

The maxillary buccal flange narrows abruptly distally to allow clearance for WHAT during mandibular excursions?

Back 117

Coronoid process

Front 118

Match the maxillary anatomy with its occupying portion of the denture : MAXILLARY TUBEROSITY

Back 118

MAXILLARY TUBERCULAR FOSSA

Front 119

Match the maxillary anatomy with its occupying portion of the denture : HAMULAR NOTCH

Back 119

The posterior border of the maxillary denture extends through the center of the hamular notch, but not onto the pterygoid hamulus, which is the superior attachment of the pterygomandibular raphe

Front 120

Do the greater palatine foramen usually require relief?

Back 120

No. the foramen are covered by thick glandular tissues

Front 121

Match the maxillary anatomy with its occupying portion of the denture : VIBRATING LINE AND PALATINE FOVEAE

Back 121

POSTERIOR PALATAL SEAL

Front 122

What does the posterior palatal seal extend between?

Back 122

The two hamular notches

Front 123

T/F : the PALATINE RAPHE / MEDIAN PALATINE SUTURE of the hard palate require relief

Back 123

True. The tissues in this area are very thin.

Front 124

Match the maxillary anatomy with its occupying portion of the denture : RESIDUAL RIDGE

Back 124

RESIDUAL FOSSA

Front 125

What is the function of the palatine rugae?

Back 125

Aid in the formation of vocal sounds and also serve as secondary stress-bearing areas for teh denture

Front 126

Match the maxillary anatomy with its occupying portion of the denture : INCISIVE PAPILLA

Back 126

INCISIVE FOSSA

Front 127

Does the incisive fossa require relief?

Back 127

Yes. If not, the patient will experience a burning sensation.

Front 128

Inclined occlusal rim plane parallels what on patient?

Back 128

Camper's line = inferior border ala of the nose to the superior border of tragus of ear

Front 129

Define Frankfort Plane

Back 129

Plane passing through the lowest point in the margin of the orbit and the highest point in the margin of the auditory meatus (orbitale to tragion)

Front 130

Zero out setting for articulator

Back 130

horizontal guidance 30 deg. progressive side shift 15 deg. incisal guide table 0 deg. guide pin at thick black line (5 notches)

Front 131

What determines contour of labial surface of occlusal rim?

Back 131

esthetic requirements for support of upper lip

Front 132

What is done at denture delivery?

Back 132

Evaluate tissue with PIP (pressure indicator paste), new CR record, clinical remount, polish, deliver, home care instructions