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lec 7 Flashcards

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1
Q

MATERIAL FOR POURING:

A
  • Type 3 stone/ dental stone
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2
Q
  • Can be used for most final impression except alginate impression (wax does not adhere to alginate material).
A

METHOD 1: BOXING USING BOXING WAX

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3
Q
  • Suitable for alginate impressions.
A

METHOD 2: PUMICE-PLASTER METHOD

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4
Q

MASTER CAST
Dimensions: (3)

A
  • 3 mm wide – land area
  • 2-3 mm – sulcus depth
  • 1.5 cm – base
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5
Q

à An interim denture base used to SUPPORT the record rim material for recording maxillomandibular records.

A

RECORD BASE (TRANSFER BASE, TRIAL DENTURE BASE, TEMPORARY DENTURE BASE)

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6
Q
  • Serve as a base to fabricate and support the wax occlusion rims and trial denture.
  • Determine accuracy of impression by checking the retention, stability and border extension of record base.
  • Check for gag reflex.
  • Observe adequate salivary flow.
A

RECORD BASE (TRANSFER BASE, TRIAL DENTURE BASE, TEMPORARY DENTURE BASE)

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7
Q

REQUIREMENTS OF RECORD BASE (6)

A
  1. Well adapted to the final cast.
  2. Stable and retentive in the mouth.
  3. Rigid and dimensionally stable.
  4. Smooth and not irritate the oral tissue.
  5. 1mm thick on the crest and facial slope of the ridge, and 2mm thick in the palatal and lingual flange for rigidity.
  6. Borders should be smooth and rounded.
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8
Q

MATERIALS USED
A. TEMPORARY BASES

A
  1. Shellac
  2. Auto polymerizing acrylic resin
  3. Vacuum formed vinyl or polystyrene
  4. Baseplate wax
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9
Q

MATERIALS USED
B. PERMANENT BASES

A
  1. Heat-cured acrylic resin
  2. Gold alloy
  3. Chrome cobalt alloy
  4. Chrome nickel alloy
  5. Swaged metal base
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9
Q
  • Thermoplastic material
A

SHELLAC

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10
Q

SHELLAC * Precautions

A

overheating can cause the material to stick to the cast resulting in breakage during removal. It also causes bubbling, smoking and blackening.

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11
Q
  • Inexpensive and easily available .
  • Easy to use and adapt.
A

SHELLAC

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12
Q
  • Brittle.
  • Tends to warp or distort when heated repeatedly.
  • Difficulty in recording jaw relations if distorted and unstable.
A

SHELLAC

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13
Q

*self-cured acrylic resin is cured in a pressure pot (20-30mins) for improved strength and properties.

A

AUTO POLYMERIZING RESIN

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14
Q

AUTO POLYMERIZING RESIN (3)

A

A. Non-flasking or Adapting method
B. Sprinkled on technique (Alternate applications)
C. Flasking method

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15
Q
  • Using a sheet of thermoplastic resin and a thermal vacuum machine surface.
A

VACUUM FORMES BASES

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16
Q
  • Inexpensive
  • Easy to form
  • Esthetic
  • Easy to set teeth when interridge space is less.
A

BASEPLATE WAX

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17
Q
  • Lacks rigidity and dimensional stability.
A

BASEPLATE WAX

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18
Q
  • A wax pattern of the denture base is made on a duplicate cast and processed with heat cured resin
A

HEAT CURED RESIN

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19
Q
  • Rigid, accurate, and dimensionally stable
  • Retention and stability can be tested before delivery of denture
A

HEAT CURED RESIN

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20
Q
  • Duplicate cast is required
  • Time consuming and more expensive
A

HEAT CURED RESIN

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21
Q
  • Occluding surfaces fabricated on interim or final denture bases for the purpose of making maxillomandibular relationship records and arranging teeth.
A

OCCLUSION RIM (RECORD RIMS, BITE RIMS, OCCLUSAL RIMS)

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22
Q

USES:OCCLUSION RIM (RECORD RIMS, BITE RIMS, OCCLUSAL RIMS)

A
  • Determination of lip support and facial esthetics
  • Determination of arch form
  • Determination of plane of occlusion
  • Aids in establishing teeth size and position
  • To establish the contour of the polished surface
  • For the (tentative) establishment, recording and transfer of jaw relation
  • To see the patient’s response to a denture-like form
  • Arrangement of artificial teeth
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23
Q

FABRICATION OF OCCLUSION RIMS (5)

A
  1. Soften a sheet of pink wax with Bunsen burner.
  2. Roll into soft cylindrical shape.
  3. Bend to form an arch and adapt to the record base.
  4. Seal the wax to the base with hot spatula.
  5. Finish the contour with a broad bladed spatula following proper dimensions.
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24
SHAPE OF OCCLUSION RIMS Arch forms:
A. Square (U shaped) B. Tapering (V shaped) C. Ovoid
25
DIMENSIONS AND POSITION OF OCCLUSION RIMS Position: Width:
Position: within Neutral zone Ø Posterior: over the crest Ø Anterior: slightly labial to the crest Width: Ø Anterior: 3-5 mm Ø Premolar: 5-7 mm Ø Molar: 8-10 mm
26
ESTABLISHING LABIAL FORM OF OCCLUSION RIM Aim:
establish the anteroposterior position of the anterior teeth and the esthetics of the lips and face
27
Facial esthetics as guide: (4)
* Fullness of the upper lip * Philtrum * Nasolabial fold * Commissures of the mouth
28
 Shape and dimensions of the occlusion rims constructed in the laboratory are_________________. During _____________, the occlusion rims are tried in the patient’s mouth and reshaped. This appointment is the most vexing of all appointments _____________.
only tentative. clinical phase ESTABLISHING MAXILLO-MANDIBULAR RELATION
29
FULLNESS OF THE LIPS (2)
Inadequate Support: Excessive Fullness:
30
Inadequate Support: (4)
* Upper lip looks flabby and unsupported * Deepening of nasolabial creases/folds * Loss of definition of the philtrum * Drooping or lowering of the commissures of the mouth
31
Excessive Fullness: (6)
* “Stretched look” * Philtrum appears shallow * Nasolabial fold appears smooth * Corners of the mouth appears stretched outward * Nasolabial fold looks filled out or almost invisible when the occlusion rims are too far forward * Philtrum looks filled out or flattened when the occlusion rim is too far forward or labial borders are too thick.
32
 Guide to the shape of the occlusion rims and the vertical height.
COMMISSURES OF THE MOUTH
33
space between the buccal surface of the posterior teeth and the inner surface of the cheeks.
Buccal corridor
34
when posterior area of occlusion rim is positioned too far lingually. Dark space mat appear excessive and unaesthetic.
Ø Excessive Buccal corridor
35
when the posterior teeth are positioned too buccally resulting in the obliteration of the buccal corridor.
Ø Inadequate Buccal corridor
36
ESTABLISHING LEVEL AND INCLINATION OF THE OCCLUSAL PLANE Aim:
establishes the superoinferior position of the teeth especially that of the anterior teeth. The level and slant of the plane of occlusion is also determined.
37
the plane at which the upper and lower teeth meet during occlusion.
Occlusal plane
38
ESTABLISHING OCCLUSAL PLANE USING THE MAXILLARY OCCLUSAL RIM ANTERIOR HEIGHT  Incisal visibility – ___________________  Interpupillary line – _________________
1-2mm visible when lips are at rest. parallel
39
ESTABLISHING OCCLUSAL PLANE USING THE MAXILLARY OCCLUSAL RIM POSTERIOR HEIGHT  _______________– parallel (using fox plane guide).  Once the occlusal height of the maxillary occlusion rim is established, the lower occlusion rim height is adjusted to provide for an ________________________________.
Ala-tragus line (Camper’s line) interocclusal rest space of 2 to 4 mm.
40
ESTABLISHING OCCLUSAL PLANE USING THE MANDIBULAR OCCLUSAL RIM à Anterior height – _______________ à Posterior height – _______________
0.5mm visible when jaws are at rest. 2/3 of the retromolar pad
41
 Any spatial relationship of maxillae to the mandible.
MAXILLOMANDIBULAR RELATIONS
42
MAXILLOMANDIBULAR RELATIONS Classification:
1. Orientation relations 2. Vertical relations (vertical dimension) 3. Horizontal relations
43
* Are those that orient the mandible to the cranium in such a way that, when the mandible is kept in its most posterior position, the mandible can rotate in the sagittal plane around an imaginary line passing through or near the condyles.
ORIENTATION JAW RELATION
44
* Determine the amount of separation between two jaws and has to be established correctly for the proper comfort, health and function of the mouth.
VERTICAL RELATIONS (DIMENSION)
45
* Distance between 2 anatomic or marked points, one on a fixed (tip of the nose) and one on a movable member (chin).
VERTICAL RELATIONS (DIMENSION)
46
VERTICAL RELATIONS (DIMENSION) Types:
1. Vertical dimension of rest (VDR) 2. Vertical dimension of occlusion (VDO) 3. Inter occlusal dimension (IOD) / “freeway space”
47
postural position of the mandible when an individual is resting comfortably in an upright position and the associated muscles are in state of minimal contractual activity.
Physiologic rest position
48
Physiologic rest position à Factors affecting are:
1. Tonicity of jaw muscle 2. Position of the head
49
distance between two selected measured when the mandible is in the physiologic rest position.
Vertical dimension of rest (VDR)
50
distance between two points when occluding members in contact. ______________ * In dentate patients, it is established by ___________________________. * In edentulous patients, it is established with ________________.
Vertical dimension of occlusion (VDO) occlusal stops provided by teeth the help of occlusal rims
51
VDO = ______________ or VDO = _________________
VDR – IOD VDR – 2 to 4 mm
52
difference between the VDR and VDO.
Inter occlusal dimension (IOD) / Inter occlusal rest space / Freeway space / inter occlusal distance
53
Importance of Inter occlusal dimension (IOD):
adequate freeway space is necessary for the comfort of the patient, health of the tissues and proper functioning of the dentures.
54
patient is asked to swallow and relax, there should be 2-4mm of space between the rims in the pre molar region.
* Swallow and relax
55
two markings are made and measured after the patient swallowed and relaxed.
* Niswonger’s method (1934)
56
PHONETICS AS GUIDE:
* “m” sound * “ch”, “s”, “j” sounds - at right vertical height, there should be 1mm space between the upper and lower occlusion rims. * “thirty-three” – there should be enough space for the tip of the tongue to protrude between the anterior teeth. * “f” or “v” sounds – maxillary incisal edge should lightly contact the lower lip. If the patient contacts the lower lip well into the oral portion, maxillary incisal edge may be too short, if contacted with force, maxillary rim may be too long. * Silverman’s closest speaking space – establishes vertical relation when the jaws are in function. “s” or “ch” sounds.
57
ESTHETICS AS GUIDE:
* Willis method (facial proportion) – the distance between the outer canthus of the eye and the corner of the mouth should be equal to the distance between the lower border of the septum of the nose and the lower border of the chin.
58
EFFECTS OF DECREASED VERTICAL DIMENSION (7)
1. Decreased chewing efficiency 2. Cheek biting – flabby cheek tissues get trapped 3. Appearance – deep wrinkles, lips loose their fullness, face appears flabby. 4. Angular cheilitis – constant wetness on deep creases at the corner of the mouth due to saliva leads to infection and soreness 5. TMJ pain, clicking sounds, headaches 6. Consten’s syndrome(mandibular joint neuralgia) due to prolonged overclosure - A complex of symptoms that includes loss of hearing, tinnitis, dizziness, headache, and a burning sensation of the throat, tongue, and side of the nose. 7. Limited tongue space
59
What is Consten’s syndrome(mandibular joint neuralgia) ?
A complex of symptoms that includes loss of hearing, tinnitis, dizziness, headache, and a burning sensation of the throat, tongue, and side of the nose.
60
What causes Consten’s syndrome(mandibular joint neuralgia) ?
due to prolonged overclosure leading to decreased vetrical dimesion
61
EFFECTS OF INCREASED VERTICAL DIMENSION (8)
1. Discomfort and annoyance to the patient 2. Trauma to underlying mucosa 3. Rapid resorption of alveolar bone 4. Clicking of teeth 5. Rapid wear of acrylic teeth 6. Strained appearance (elongated face) 7. Difficulty closing lips 8. Difficulty swallowing
62
* If exposure is high,_____________ can be selected to reduce display of denture base.
longer teeth
63
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