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Dentures Flashcards

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1
Q

Describe Non-Soluble Denture Adhesives…

A
  • Pads and wafers
  • Sodium alginate, ethylene oxide polymer
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2
Q

What are some different materials for final impressions for dentures?

A
  • Plaster
  • ZOE
  • Polysulfide
  • Silicones
  • Polyether
  • Waxes
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3
Q

What are some Advantages of Immediate Complete Dentures?

A
  • Prevent embarrassment
  • Promote health
  • Provide optimal esthetics
  • Provide guide for occluding vertical dimension
  • Promote healing
  • Promote better ridge form
  • Prevent collapse of facial musculature
  • Hasten patient adaptation
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4
Q

To increase denture support, would you want distribution of applied forces over wide or short area?

What does this help with?

A
  • For support, you want distribution of applied forces over as wide an area as possible
  • Helps with ridge preservation, prosthesis stability, and retention
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5
Q

What is the purpose of a Post Palatal Seal?

A
  • Close tissue contact during speech and swallowing
  • Seal adaptation/increased retention
  • Compensate for polymerization shrinkage
  • “Sunken” border less conspicuous to tongue
  • Less gagging
  • Cross sectional strength
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6
Q

What are 3 Overdenture Types?

A
  • Immediate
  • Transitional
  • Remote
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7
Q

What is the prevalence of Combination Syndrome among denture patients?

A

24%

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8
Q

Describe the patient spectrum regading youth and elderly for neuromuscular control…

A
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9
Q

What 5 things contribute to good denture stability?

A
  1. Good retention
  2. Non-interfering occlusion
  3. Prper tooth arrangement
  4. Proper tooth form and contour of polished surface
  5. Good control and coordination of the patient’s musculature
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10
Q

Regarding the Neutrocentric Technique, what is the Condylar Inclination, Incisal Guidance, and Tooth Form set at?

A

0°

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11
Q

What are the 2 types of Lingualized Articulation?

A
  1. Balanced concept
  2. Nonbalanced concept
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12
Q

Which ridge experiences more loss of bone in denture patients, mandible or maxilla?

A

Mandible

4x greater loss of bone over first seven years

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13
Q

What are 2 components of Chemically Activated Resins?

A
  1. Liquid: Methylmethacrylate + chemical activator (tertiary amine)
  2. Powder: prepolymerized spheres of polymethylmethacrylate + benzoyl peroxide (initiator)
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14
Q

What do you do if the posterior palatal seal is too short?

A
  • Define border and PPS
  • Reline
  • Chemical cure addition
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15
Q

What are some advanced treatment options for edentulous patients?

A
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16
Q

What is a Soft Liner?

A

A liner, whether hard or soft, should be used as a simple tool to improve clinically acceptable prostheses

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17
Q

What are some advantages of Overdentures?

A
  • Stable record bases
  • Reversible
  • Convertible
  • Prevent Combination Syndrome
  • Decreased tissue trauma
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18
Q

How do you record the Neutrocentric Technique?

A
  • No facebow transfer
  • No protrusive or lateral records
  • Just OVD + CR
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19
Q

During a chairside remount for a balanced occlusal scheme, what do you adjust regarding Protrusive Movements?

A
  • Adjust M inclines of mandibular cusps and D inclines of max cusps
  • Centric: re-adjust as needed
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20
Q

What is the rationale for Nonanatomic Occlusion?

A
  • Nonanatomic teeth set with a compensating curve
  • Balance provided by anterior-posterior and lateral curves
  • Rationale is to eliminate lateral forces and preserve residual ridges
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21
Q

What are some important anatomical landmarks for a maxillary denture?

A
  • Hamular notch: between pterygoid hamulus and tuberosity
  • Tuberosity will resist movement in anterior direction
  • Posterior border of denture
  • Post palatal seal
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22
Q

Describe Light-Activated Denture Base Resins…

A
  • Urethane dimethacrylate matrix
  • Micro fine silica
  • High MW acrylic resin monomers
  • Filler: acrylic resin beads
  • Activator: visible light
  • Initiator: comphoroquinone
  • High-intensity visible light cure
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23
Q

What is a Remote Overdenture?

A
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24
Q

What is the position of the posterior teeth in the Neutrocentric Concept (Monoplane)?

A

Over the residual ridge as far lingually as possible

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25
What are some disadvanges to the anatomic scheme?
* Precise records required * Greater lateral forces on inclines * Technically demanding, results short lived * More difficult in class II, III, and crossbite situations
26
What are some advantages to the anatomic scheme?
* Esthetics * Bolus penetration * Decreased vertical stresses * Increased denture stability in parafunctional movements
27
What are some Disadvantages of Immediate Complete Dentures?
* Increased complexity * Limited evaluation of trial denture * Increased patient discomfort * Increased maintenance * Increased patient visits * Increased treatment cost
28
What is the rationale for the Anatomic Scheme?
* Better chewing efficiency * Better stability of articulation
29
What are some clinical uses for tissue conditioners?
* Tissue conditioning before final impression (change every 3 days) * Diagnostic relining * Impression material * Immediate complete denture treatment * Post surgical and during implant therapy
30
What factors are involved in denture retention?
* Adhesion * Cohesion * Interfacial viscous tension * Capillary attraction * Oral and facial musculature * Atmospheric pressure and peripheral seal * Mechanical locking * Gravity * Occlusion
31
What is the Form of teeth in the Neutrocentric Concept (Monoplane)?
Flat teeth with no deflecting inclines
32
What are 3 techniques for denture base resins?
* Compression flask * Injection-molding * Pour techniques
33
During a chairside remount for a balanced occlusal scheme, what do you adjust regarding Working Cusps?
* Adjust using BULL Rule (buccal UPPER, and lingual LOWER)
34
What are 4 things you can use to determine vertical dimension?
* Physiologic rest * Phonetics and esthetics * PAtient-reported perception of comfort * Closest speaking space
35
What are some surgical treatments you can provide to enahance denture support?
* Placement of osseointegrated implants * Hyperplastic tissue, epulis fissuratum, and papillomatosis * Frenular attachments and pendulous tuberosity * Bony prominences, tori * Discrepancies in jaw size * Pressure on mental foramen
36
What angles are set for teeth in Nonanatomic Occlusion?
* Teeth with cuspal inclination of 0-19° * Anatoline: 10° * Monoline: 0°
37
How much monomer is left in a processed denture?
* Chemically acticated resin: 3-5% residual monomer * Heat acticated resins 0.2-0.5% residual monomer
38
During the first year of dentures, how many mm of bone heigh is lost during the first year after extractions for immediate dentures?
4 mm
39
Describe the Occlusal Spectrum of denture teeth arrangements?
40
What are some advantages of Lingualized Articulation?
* Esthetics * Better bolus penetration * Less vertical force * Simple technique * Parafunctional stability with balanced arrangement * Reduced lateral forces * Easier to adjust * Can be used in Class II, III, and crossbite situations
41
What is a pendulous tuberosity?
Enlarged maxillary tuberosity, may need surgical excision
42
What are some Disadvantages of the Neutrocentric Concept?
* Less esthetic * May not be compatible with tongue, oral function * Poor bolus penetration * Class II patients may function forward of CR * Encourages lateral chewing component
43
What degrees are teeth setup regarding the Anatomic Scheme?
30° - 45°
44
What are some contraindications for denture adhesives?
* Ill-fitting dentures * Fractured prosthesis * Obvious pathology or tissue hyperplasia
45
What are 2 categories of Denture Adhesives?
1. Soluble 2. Non-soluble
46
What are some Disadvantages of Overdentures?
* Add tx time and $ * More exacting * Caries and periodontal disease * Maintenance * May affect esthetics * Increase denture fracture
47
What is Epulis Fissuratum?
Epulis fissuratum (also termed inflammatory fibrous hyperplasia, denture-induced fibrous inflammatory hyperplasia, denture injury tumor, denture epulis, denture induced granuloma, and granuloma fissuratum is a benign hyperplasia of fibrous connective tissue which develops as a reactive lesion to chronic mechanical irritation produced by the flange of a poorly fitting denture.
48
What are the 2 components of Heat-Activated Denture Resins?
1. Powder (Prepolymerized PMMA spheres/Benzoyl peroxide (initiator) 2. Liquid * Unpolymerized methyl methylacrylate * Glycol dimethacrylate (corsslinking agent) * Hydroqinone (inhibitor)
49
What is some important anatomy for a mandibular denture?
* Retromolar pad (Mucous glands, temporalis tendon, buccinator, pterygomandibular raphe, superior constrictor) * Occlusal plane references * "Pear-shapped pad": scar after 3rd removal * Rare resorption
50
What are the 3 methods of making a post palatal seal?
1. Empirical alteration 2. Functional/direct: Korecta wax 3. Semi-functional: T burnisher/reduce cast according to palpated amount of tissue depressibility
51
What is the rationale for Semi-Anatomic Occlusal Scheme?
* Technique same as anatomic * Rationale is to overcome the problems with anatomic occlusion
52
What is Papillomatosis?
Papillomatosis is skin surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae. These papillary projections of the epidermis form an undulating surface under microscopic examination.
53
What is another term for Combination Syndrome?
Anterior Hyperfunction Syndrome
54
When does Combination Syndrome occur?
When an edentulous maxilla is opposed by natural mandibular anterior teeth
55
What is a Contraindication for Immediate Complete Dentures?
* Patients with certain systemic or mental conditions may necessitate minimal episodes of surgical correction
56
Where is the Hamular Notch located?
Between pterygoid hamulus and tuberosity
57
What does relining with a soft liner accomplish?
Offers short-term resolution to a patient's problems
58
What is the rationale for Overdentures?
* Maintenance of alveolar bone * Proprioception * Increased masticatory efficiency * Increased stability and support * Psychological
59
What are some indications for Overdenture Attachments?
* More stability and retention needed * Xerostomia * Poor ridge form * Congenital deformity * Gain improved patient acceptance and function * Doubtful RDP abutment
60
If you are looking for a durable soft liner that will help prevent growth of candida, what would you choose?
* Silicone Liner * More durable * Silane _heat polymerized_ silicone rubber
61
During a chairside remount for a balanced occlusal scheme, what do you adjust regarding CO?
* Correct vertical processing error and restore to CO * Adjust fossa and inclines first
62
What is the sequence for occlusal adjustment during a chairside remount regarding a balanced occlusal scheme?
1. Centric Occlusion 2. Working 3. Balancing 4. Protrusive
63
Describe neural control/feedback for Dentate Vs. Edentulism..
* Dentate: Neural Control * Edentulism: Loss of PDL neural feedback
64
What is teeth/cuspal inclination in Semi-Anatomic Occlusal Scheme?
20 - 30°
65
When treatment planning Immediate Complete Dentures, how many phases are there?
* One phase * Two phase
66
What do you do if the posterior palatal seal is too long?
* Define border and judiciously remove * Re-establish PPS with wax * Chemical cure addition
67
What are some different attachments/bars for Overdenture Abutments?
* Stud * Bar * Magnets
68
Describe the Tripodal Method of recording CR in a denture patient...
* Stable relationship, minimum contact, maximum visibility * More accurate control of mandibular reocrd base * Minimum pressure * Easily verified in mouth
69
What are some denture enlargement procedures?
* Vestibuloplasty * Ridge Augmentation
70
What are some different Overdenture Abutment restoration options?
* Amalgam restoration * Dome (gold coping) * Attachments/bars
71
What is the Proportion of teeth in the Neutrocentric Concept (Monoplane)?
Reduced the tooth 40% to reduce vertical stress on the ridge
72
What is the difference between short term and long term liners?
* Short term liners: \< 30 days (tissue conditioners) * Long term liners: \> 30 days
73
What are some criteria to consider when choosing Overdenture abutments?
* Sound perio/endo * Bilateral, symmetrical * Canines * Single rooted vs. multirooted * No opposing/adjacent teeth
74
Compare support structures for Dentate Vs. Edentulism...
* Dentate: Tension and Alveolar Bone * Edentulism: Residual ridges exhibit continued resorption
75
What do soft liners enhance in regards to force distribution?
* Allows uniform distribution of stress at the mucosa/lining interface * Energy absorbed by liner material
76
What are some risks in using denture adhesives?
* Mask underlying condition (tumor, etc.) * Ill-fitting denture will be more ill-fitting
77
What are 2 general categories of Soft Liners?
1. Acrylic 2. Silicone
78
What is Modiolus?
* Point in the corner of the mouth where multiple muscles meet * Muscles of facial expression * Zygomaticus Major * Zygomaticus Minor * Levator Angulii Superioris * Incisivus Labii Superioris * Buccinator * Depressor Anguli Oris * Depressor Labii Inferioris * Incisivus Labii Inferioris * Mentalis * Obicularis Oris * Risorius
79
Describe Soluble denture adhesives...
* Paste, powders, creams * Hydrated (swelling) polyvinylether metyl cellulose or carboxymethylcellulose
80
What can you do to prevent Combination Syndrome?
1. Overdenture 2. Routine Maintenance (Check Posterior Occlusion/Reline)
81
When can a Posterior Palatal Seal be made?
* At impression phase * Before packing * After fabrication
82
What are Chemically Activated Resins also known as?
Self-curing, cold-curing, autopolymerizing resins
83
What are some non-surgical procedures that can enhance denture support?
* Rest: 48-72 hours (Tissue conditioners + 24 hours) * Occlusal and vertical dimension correction in existing dentures * Nutrition * Good oral hygiene: Candida * Massage
84
What is Hanau's Quint/Theilmann's Formula?
B= Condylar Inclination X Incisal Guidance \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ OccPlane X Cuspal Inclination X CompCurve
85
What is some general diagnostic data that is good to gather for a denture patient?
1. Denal history (denture history) 2. Mental attitude * House Classification 1. Systemic status (neurologic) 2. Local factors * Factors affecting retention, stability and support
86
What is the Lingualized Occlusal Scheme?
* Articulates the maxillary lingual cusps with the mandibular occlusal surfaces in centric, working and nonworking mandibular positions
87
What is your goal when making a final impression for dentures regarding anatomy?
Capture optimum extension and refined borders
88
What are some Advantages of the Neutrocentric Concept?
* Simple technique, less precise records * Decreased lateral forces * Easier to adjust * Good stability (forces centralized) * Good for Class II, III, crossbites
89
What are the 3 objectives you want to achieve for denture patients?
1. Stability 2. Retention 3. Support
90
What are the characteristics of combination syndrome?
1. Maxillary anterior ridge resorption 2. Pendulous tuberosity 3. Maxillary papillary hyperplasia 4. Mandibular anterior extrusion 5. Mandibular posterior ridge resorption 6. Overclosure of OVD
91
How is a Triad Denture Base activated?
Light activated
92
Where is the Retromylohyoid Fossa?
93
During a chairside remount for a balanced occlusal scheme, what do you adjust regarding Balancing Contacts?
* Reduce the lingual incline of the mandibular buccal cusp only * Do not adjust cusp tip
94
What are some indications for denture adhesives?
* Trial bases * Immediate dentures * Reconstruction surgery * Psychological support * Compromised anatomy * Elderly patients * physically/mentally challenged patients * Xerostomia * New dentures: during adaptation to decrease anxiety * Osseointegrated implants: man implants make max feel loose * RDPs
95
Describe an Acrylic Soft Liner...
* **Adheres to denture better** * Polyethyl methacrylate powder and methacrylate ester and phthalated ester plasticizer
96
What are some local factors that can affect retention, stability, and support of dentures?
* Arch size (form) * Interarch space * Muscle tone, attachments * Saliva quality * Ridge relationships * Ridge size * Throat form * Palatal sensitivity * Tongue position * Soft tissue health
97
Compare the cm2 support for Dentate Vs. Edentulism...
* Dentate: 45 cm2 periodontal support/each arch * Edentulism: 23 cm2 max arch support, 12 cm2 man arch support
98
How are PMMA Denture Base Resins activated?
* Heat activated * Chemically activated * Microwave activated
99
What are some methods to record CR in a denture patient?
* Graphic recordings (Coble Balancer) * Functional recordings (FGP) * Direct recordings (tripodal method, regular CR record with "mush bite"
100
What are some desirable properties for Soft Liners?
* Resilience * Tear resistance * Biocompatibility * Lack of odor or taste * Adhesive bond strength * Ease of adjustability * Dimensional stability * Ease of cleaning
101
For the 2 Phase plan for Immediate Complete Dentures, how long do you wait inbetween phases?
6-8 Weeks
102
What is the prognosis for the 4 House Classifications?
* Philosphical - Excellent * Exacting - Good with education * Hysterical - Unfavorable * Indifferent - Unfavorable
103
How much volumetric and linear shrinkage do you get in a processed denture?
* Volumetric shrinkage: 7% * Linear shrinkage: 0.12% high-impact acrylic resin to 0.97% rapid heat cured
104
What may cause denture base acrylic resin porosity?
* Too much monomer * Not enough resin when packing flask * Insufficient packing pressure * Incorrect processing temperature/curing cycle (monomer boils)
105
Describe Microwave Polymerization...
* PMMA * Non-metallic flask * Conventional microwave oven * Good fit and physical properties
106
Regarding cloest speaking space, what is the most frequently used sibilant? How much clearance do you need for this sibilant?
* "S" * 1 - 1.5 mm
107
What are 2 different types of Denture Base Resins?
1. PMMA 2. Triad (Urethane Dimethacrylate)
108
What is the Pitch (inclination) that is placed in the Neutrocentric Concept (Monoplane)?
Occlusal plane is parallel to the underlying ridges, midway between
109
What % decrease in width of bone during first year of wearing dentures?
25%
110
What are 3 impression techniques for complete dentures?
1. Pressure-less 2. Functional 3. Selecive pressure
111
What are some factors to consider when considering occlusal schemes for complete dentures?
* Oral conditions * Ridge relationships * Neuromuscular coordination * Esthetics * What works best in your hands
112
What is denture stability?
* Resistance to horizontal movement * Decreases with the loss of vertical height of the ridges * Decreases with flabby, moveable tissue * Close adaption to the **undistorted** mucosa is important
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