Tooth selection and framework try in

Question 1

what is the order of try in with patients?

Answer 1

• framework try in from master cast
• framework with wax record blocks try in
• framework with tooth trial try in

Question 2

what are you looking for when assessing the try in with the patient?

Answer 2

• fit
• retention
• occlusion

Question 3

what is the procedure before the patient arrives?

Answer 3

• check framework is returned from lab on master cast
• check patient’s details
• check design has been followed
• look for any damage or wear to cast
• if mounted to an articulator, check pin is on table
• feel surfaces on denture with gloved finger to check for sharp areas
• put in Perform to disinfect

Question 4

what is the procedure with the patient?

Answer 4

• inspect patient’s mouth - healthy tissues, changes, path of insertion
• seat comfortably in patient’s mouth - don’t force in
• check adaption of clasps to teeth - clasp may be deactivated
• check the adaptation to the tissues - framework should not touch mucosa, free end saddles may rock

Question 5

what can you do if the framework is not sitting?

Answer 5

• look into the patient’s mouth for changes to abutment teeth
• carefully seat and identify problem areas
• use an articulating spray
• spray onto the fit surface of the framework and re-seat
• spray will have rubbed off in areas of rubbing
• small areas can be adjusted with a straight handpiece and bur
• if there are big problems, the master impression may be distorted - discuss with technician, may need a new impression and remake

Question 6

what is the procedure of checking retention?

Answer 6

• check all clasps engage
• don’t adjust too much (work hardening) as more likely to fracture
• won’t be very retentive but should have some grip

Question 7

what is the procedure of checking occlusion? how do you fix the occlusion if it has changed?

Answer 7

• check occlusion with no denture/old denture and with new denture fully seated
• identify area of early occlusion with articulating paper or articulating spray
• make small adjustments chairside or removals/remake in lab

Question 8

why may occlusion have changed?

Answer 8

• position of rest seats planned incorrectly at design stage
• rest seat not prepared deep enough
• CoCr made too thick in a section

Question 9

what do you need to determine during tooth selection?

Answer 9

• tooth shade
• tooth size
• tooth shape

Question 10

what are the different shade guides for shade selection?

Answer 10

• VITA shade guide - A1-D4
• Senator shade guide

Question 11

what is the best way to select shade?

Answer 11

• under natural light
• hold teeth from shade guide next to natural teeth
• canine is more yellow as has more dentine
• get a second opinion - patient

Question 12

how would you select tooth size and shape?

Answer 12

• natural teeth help with mould and shade selection
• tooth size does not correspond with face shape
• measurements are good starting points
• use existing teeth and previous denture as a guide

Question 13

what are the shapes avilable for upper anterior teeth?

Answer 13

• square
• ovoid
• tapering