FINAL IMPRESSION TECHNIQUE:
No custom tray needed | Mucocompressive technique |
CLINICAL VISIT 1 | Communication, preliminary impression |
CLINICAL VISIT 2 | boarder molding, final impression |
CLINICAL VISIT 3 | jaw relation registration |
CLINICAL VISIT 4 | try in |
CLINICAL VISIT 5 | try in |
CLINICAL VISIT 6 | delivery, adjustment, instruction; recall |
LABORATORY STEP 1 | pouring of cast, custom tray |
LABORATORY STEP 2 | master cast, record base, occlusion rim |
LABORATORY STEP 3 | articulation, setting of anterior pontics |
LABORATORY STEP 4 | setting of posterior pontics, festooning |
LABORATORY STEP 5 | processing; finishing and polishing |
objectives of complete denture | to restore masticatory function; to restore contour and dimension; to correct speech defect; to preserve the remaining tissue; to provide patient comfort |
what steps are included in communication | interview, clinical exam, evaluation of available diagnostic records, treatment planning, presentation of treatment plan |
COMMON FAULTS AND SOLUTIONS FOR IMPRESSION: Shortage impression of the palate due to insufficient material or failure to seat the impression completely. | adding stick compound or remake the impression |
COMMON FAULTS AND SOLUTIONS FOR IMPRESSION:Under-extended in tuberosity regions | adding stick compound |
COMMON FAULTS AND SOLUTIONS FOR IMPRESSION:Excess impression material | Remove with sharp knife;Heat and reshape impression material |
COMMON FAULTS AND SOLUTIONS FOR IMPRESSION:Insufficient impression material. | Remake impression or correct with stick compound |
COMMON FAULTS AND SOLUTIONS FOR IMPRESSION:Deficiency in the labial sulcus because the lip was not lifted forward to allow the compound to flow into the sulcus | Soften the impression compound |
COMMON FAULTS AND SOLUTIONS FOR IMPRESSION:Too large tray | folding or cutting excess border |
Process by which the shape of the border of the tray is made to conform accurately to the contours of the buccal and labial vestibules; done on real patients | Border Molding |
BORDER MOLDING:The tray is tried into the patient's mouth and the borders are reduced ___ short of the depth of the vestibules and the frenuli attachments | 2mm |
BORDER MOLDING: how to determine that there is sufficient room for bording molding | pulling the lip outward and having the patient raise the tongue |
do you move the tongue during border molding? | yes w/in functional limit |
BORDER - MOLDING MATERIALS | Modeling compound sticks (Green Stick Compound); Elastomeric Materials (Polyether) |
BORDER MOLDING:fusion temperature of that compound (green) | 140° |
used to support the record rim material for recording maxillomandibular records | RECORD BASE |
Occluding surfaces fabricated on interim or final denture bases for the purpose of making maxillomandibular relation records and arranging teeth | OCCLUSION RIM |
To establish the neutral zone or arch form | OCCLUSAL CONTOUR RIM (OCR) |
To establish the level of the occlusal plane | OCCLUSAL CONTOUR RIM (OCR) |
Related to the activity of the lips, cheeks, and tongue and includes preliminary circumoral and facial support | NEUTRAL ZONE |
area with balance/ equilibrium about the movement of the tongue and lips/chee | NEUTRAL ZONE |
determines arch form | NEUTRAL ZONE |
PATTERN OF RESORPTION (mandibular):Anterior/labial - Crest of the ridge migrates toward | lingual |
PATTERN OF RESORPTION (mandibular):Premolar area = buccal and lingual | crest remains the same |
PATTERN OF RESORPTION (mandibular):Molar area/ lingual - Arch in molar region becomes __ kasi bawas ng bawas sa lingual | wider |
PATTERN OF RESORPTION (maxillary): facial and buccal surfaces - mx arch becomes | smaller |
if you just make dentures without considering pattern of resorbtion, you end up with a denture that has | crossbite |
To establish the preliminary maxillomandibular relation records | OCCLUSAL CONTOUR RIM (OCR) |
Mouth is closed but teeth are not in contact and mandible is in relaxed position | INTEROCCLUSAL DISTANCE SPACE/IOD (freeway space) |
most labial of incisor placement on occlusal rim is ___ from the incisive papilla (filipinos) | 6-8mm |
most labial of incisor placement on occlusal rim is ___ from the incisive papilla (caucasions/book) | 8-10mm |
height of mn occlusion rim | 2/3 of retromolar pad |
what area of the arch has equal resorption on both buccal and lingual | premolar area |
PPS for type I | 4-5mm |
PPS for type II | 3-4mm |
PPS for type III | 1-2mm |
the level of occlusal plane is usually ___ when installed in the px | too high |
When the OCR is placed in the px, it is expected that there are ____ | openings |
the maxillary ocr should be ___ below the upper lip when they slightly open their mouth | 2-3mm |
when fitting the mx ocr on the patient we follow the ___ | campers line/ ala-tragus line |
when fitting the mn ocr the anterior level is guided by ___ | angle of the mouth/vermilllion border of lower lip |
when fitting the mn ocr the posterior level is guided by ___ | retromolar pad |
MAXILLARY OCCLUSION RIM ADJUSTMENT: mediolaterally, the occlusal plane parallels the ___ | pupils |
what do we use to measure he occlusal plane of MX OCR | fox plane |
MANDIBULAR OCCLUSION RIM ADJUSTMENT: Anterior height even with the corners of the mouth when the lip is relaxed ___horizontal overjet in anterior and posterior in centric position | 2mm |
WAX RIM (ADJUSTED WITH LIP LENGTH):10-20mm | 3-4mm |
WAX RIM (ADJUSTED WITH LIP LENGTH):20-21mm | 2mm |
WAX RIM (ADJUSTED WITH LIP LENGTH): 26-30mm | 1mm |
WAX RIM (ADJUSTED WITH LIP LENGTH:>30mm | 0 |
WAX RIM (ADJUSTED WITH Sex and Age): young female | 2 |
WAX RIM (ADJUSTED WITH Sex and Age):middle female | 1 |
WAX RIM (ADJUSTED WITH Sex and Age): old female | 0 |
WAX RIM (ADJUSTED WITH Sex and Age):young male | 1 |
WAX RIM (ADJUSTED WITH Sex and Age): middle male | 0 |
WAX RIM (ADJUSTED WITH Sex and Age): old male | -1 |
____ should touch upper rim during frivatives | Lower lip |
phonetics test: too compressive "f" | excessive height of Mx OR= reduce |
phonetics test: If no contact | too low vertical height of the maxillary occlusion rim = add more |
Lips should be unrestrained:Thin lips | more than 90 degrees |
Lips should be unrestrained: thick lips | less than 90 degrees |
if the patient cannot close their mouth during OCR try in | the OCR is too long/ too thick |
Modiolus should not sag lateral to the corner of the mouth. If sagging, what do you do | add more wax in facial surface |
Distance between maxilla and mandible when teeth or wax rims contact in centric position; w/o any muscles contracting | OCCLUSAL VERTICAL DIMENSION (OVD) |
At rest, lips barely touching; OCR should not touch here; w/o evident contraction of muscles | PHYSIOLOGIC REST POSITION (PRP) |
Dimension get when the px is in PRP | VERTICAL DIMENSION OF REST (VDR) |
The difference between OVD and RVD is congruent to the height of ____ | Free-way space |
is the distance or gap existing between the upper and the lower teeth when the mandible is in the physiological rest position | Free-way space |
Free-way space is usually ___ | 2-4mm |
PRE-EXTRACTION RECORDS | radiograph, cast, previous denture |
Incisive Papilla to Mandibular Incisors | RIDGE RELATIONS |
RIDGE RELATIONS: Distance of the papilla from the incisal edges of the mandibular anterior teeth on diagnostic casts averages approximately ___in the natural dentition | 4mm |
Closest speaking space | sibilants (H,S,Z) |
SIBILANTS: If it touches, | VD is too high so reduce |
Patient should be siiting ____ | bolt upright |
MEASUREMENTS (OVD & PRP): Small dots under ______ | columella and mid-symphysis |
The position assumed by the mandible when the head is in an upright position, the muscles are in equilibrium | PHYSIOLOGIC REST POSITION |
if you cannot feel the interocclusal distance, what do you do to the ocr | reduce |
why do you look away when establishing OVD | concentrate senses |
nearest relationship of the occlusal surfaces and incisal edges of the mandibular teeth to the maxillary teeth during the function and rapid speech | closest speaking space |
what test do you use to evaluate the closest speaking space | phonetics test |
rims should be __ apart in phonetics test | 1mm |
if wax rims are too high, there is ___ ovd | insufficient |
critical characteristic of occlusal rim | flat even contact |
how many lines do you scribe to mark that the patient is in centric relation | 3 |
VERTICAL DIMENSION: Sore muscles | EXCESSIVE OCCLUSAL VERTICAL DIMENSION |
VERTICAL DIMENSION: Soft tissue sore spots | EXCESSIVE OCCLUSAL VERTICAL DIMENSION |
VERTICAL DIMENSION: Rapid bone resorption | EXCESSIVE OCCLUSAL VERTICAL DIMENSION |
VERTICAL DIMENSION: Dentures click during speech | EXCESSIVE OCCLUSAL VERTICAL DIMENSION |
VERTICAL DIMENSION: Difficulty of swallowing | EXCESSIVE OCCLUSAL VERTICAL DIMENSION |
VERTICAL DIMENSION: Collapsed Appearance | INADEQUATE OCCLUSAL VERTICAL DIMENSION |
VERTICAL DIMENSION: Fatigue when chewing | INADEQUATE OCCLUSAL VERTICAL DIMENSION |
VERTICAL DIMENSION: Sore muscles or joints | INADEQUATE OCCLUSAL VERTICAL DIMENSION |
VERTICAL DIMENSION: Mentolabial sulcus will be deep | INADEQUATE OCCLUSAL VERTICAL DIMENSION |
The maxillomandibular relationship in which the condyles articulate with the thinnest avascular portion of their respective disks with the complex in the anterior superior position against the slopes of the articular eminences. | Centric Relations |
TRUE OR FALSE: centric relation is dependent on tooth contact | false |
Centric Relations:This position is clinically discernible when the mandible is directed ________. | superiorly and anteriorly |
Centric Relations:It is restricted to a purely ___ movement about the transverse horizontal axis. | rotary |
TRUE OR FALSE: Centric Relation occurs on translatory axis | false |
The most retruded relation of the mandible to the maxillae when the condyles are in the most posterior unstrained position in the glenoid fossae from which lateral movement can be made, at any given degree of jaw separation | Centric Relations |
Any relation of the mandible to the maxillae other than centric relation | Eccentric Relation |
Is the relation of the mandible to the maxillae when the mandible is thrust forward | Protrusive Relation |
Are the relations of the mandible to the maxillae when the mandible is moved either to the right or left side | Right and Left Maxillomandibular Relation |
Is the occlusion of opposing teeth when the mandible is in centric relation | Centric Occlusion |
TRUE OR FALSE: in CD, the path of the mandible follows CGA | TRUE |
Jaw manipulation about the posterior border of movement in the initial ____ of opening is about the terminal hinge axis | 20-26mm |
more than 26mm the condyle moves into ___ | translatory movement |
Is repeatable when the condyles are maximally seated in Centric Relation | Hinge Axis |
Advantages of polyether technique in border molding | Reduced overextension, quick |
Polyether technique(border moldimg): __ shy of fornix;__thick | 2mm;2mm |
FINAL IMPRESSION TECHNIQUES: Should use flowy impression material; although these materials should be poured quickly to avoid deformation | Mucostatic technique |
FINAL IMPRESSION TECHNIQUE: Obtain an impression of tissues in resting stage | Mucostatic technique |
FINAL IMPRESSION TECHNIQUE: Uses a less viscous material with minimal application of pressure in the impression tray | Mucostatic technique |
FINAL IMPRESSION TECHNIQUE: Denture bearing tissues are compressed during impression taking | Mucocompressive technique |
FINAL IMPRESSION TECHNIQUE: Denture has maximal retention during mastication when using this technique; may be uncomfortable for some patients when not masticating | Mucocompressive technique |
FINAL IMPRESSION TECHNIQUE: Retention is less when not under load | Mucocompressive technique |
FINAL IMPRESSION TECHNIQUE:
No custom tray needed | Mucocompressive technique |
FINAL IMPRESSION TECHNIQUE:
Used in cases of flabby ridges | Selective Mucocompressive |
FINAL IMPRESSION TECHNIQUE: Only selected areas of the residual ridge are subjected to compressive stress | Selective Mucocompressive |
FINAL IMPRESSION TECHNIQUE: Plaster impression material is applied on areas to not be compressed | Selective Mucocompressive |