List 5 key points about the ICP
- Need sufficient index teeth
- Stable occlusion
- May vary thru life
- Depends on tooth relationships
- Sometimes more anterior than RCP
List 5 key points about the RCP
- Insufficient index teeth
- Unstable occlusion
- Most reproducible position
- Is a condylar position
- Sometimes more post. than ICP
What are the depths of underucts req for a clasp to enage w/ 3 diff materials ( CoCr/SS/Au)
CoCr - 0.25mm
SS - 0.5mm
Au - 0.75mm
What is the definition of occlusion?
The static relationship between the incising or masticating surfaces of the maxillary or mandibular teeth or tooth analogues
What is the Definition of ICP?
The COMPLETE INTERCUSPATION of the opposing teeth independent of condylar position, ‘best fit of the teeth regardless of condylar position’
What is the definition of RCP?
Guided OCCLUSAL relationship occurring at the most retruded position of the condoles in the joint cavities
What are index teeeth?
Contacting facets of teeth in the ICP
What can be used to measure/look@ the interocclusal record?
- Bite reg paste - usually silicone paste
- Wax Wafer - modelling wax
- Modified wax wafer - eg alminax
What diff types of record blocks are there?
- Wax
- Wax w/ wire strengther
- CoCr base
- Shellac base
What is a swinglock denture?
A denture that engages bone and tissue undercuts for retention
Good oral hygiene is essential and is technically demanding
What sort of dentures can be used for bruxists? And what does the alteration do?
Metal backing dentures
CoCr reduces fracture likehood as metal is occulsal surfaces
What is retching?
Involuntary contraction of the muscles of the soft palate or npharynx - physical mechanism
aka gagging/boking/gypping
What are the 2 diff types of retching
Psychogenic
Somatic
What is Psychogenic Retching?
Occurs due to sight, smell and sound of a dental surgery or thought of it eg an impression
What is somatic Retching?
Touching ‘trigger’ zones common on palatoglossal and palatopharyngeal (back of palate) folds, the base of the tongue/palate and uvula and post pharyngeal wall
In what areas does a retching patient cause problems in?
- Jaw reg
- Impression taking
- Toleration of dentures
- Denture retention
What is the management of a retching denture patient?
- Identification of the problem
- Identify trigger zones
- Anxiety reduction
- Pateince and empathy
What methods of relaxation can be used?
Passive - dim lighting/music/avoid sight of dental instruments
Active - controlled rhythmic or relaxed abdominal breathing
Hypnosis
What are some distraction methods for dental pros management?
Talking
Get px to raise leg
Get Px to press temple
Put salt on tongue
Ask Px to close eyes
Rinse mouth w/ v cold water just before tx
Acupressure and acupuncture
What are some desensiisation methods used for dental pros management?
- Repeated brushing/stroking ant. palate or tongue w/ finger
- Homework of brushing/stroking for patient pre Tx
Swallowing w/ mouth open
What are some denture design methods used for dental pros management?
- Is a denture really needed
- Horseshoe palate
- Use of multiple postdams to provide pressure
If a Px dentures are loose what do you need to look for/at in the initial assessment?
- Severely resorbed ridges
Flabby ridges
Tori
Prominent mentalis muscle/Mylohyoid ridges/genial tubercles/high muscle attachments
Pain on ridge palpitation
What must you remind Px’s when designing a denture in terms of their expectations?
Compromise is req and Px will need to adjust their expectations
Be realistic and inform patient before Tx
Do not give Px false hope
