Trial Placement

Question 1

What is another name for the trial placement?

Answer 1

wax try-in

Question 2

Why are esthetics important for a trial placement?

Answer 2

it needs to be neat since it is going into the mouth and the patient is going to see it

Question 3

What is a wax trial placement?

Answer 3

denture stage becomes a critical phase of complete denture care in evaluating this relationship

Question 4

The dentist should approach the appointment with the attitude that…

Answer 4

errors may exist in all areas

Question 5

What is a trial denture?

Answer 5

a preliminary arragement of denture teeth that has been prepared for placement into the patient’s mouth to evaluate esthetics and maxillomandibular relationships

Question 6

Shapes and sizes of teeth selected are based on…

Answer 6

anatomic averages

Question 7

Why should you not overlook problems?

Answer 7

• difficult/impossible to change after processing
• may require removal, restting and re-prossessing
• can be costly and time consuming

Question 8

What are the parts of a checklist for the steps of clinical evaluation for trial placement?

Answer 8

• CO = CR
• occlusal vertical dimension
• midline
• horizontal and vertical overlap
• lip support
• occlusal plane
• buccal corridor
• esthetics
• phonetics
• maxillary posterior limit
• protrusive record and articulator settings

Question 9

What should you use inside the trial bases when trying them on?

Answer 9

denture adhesive powder

Question 10

What should you check during the trial denture clinical evaluation?

Answer 10

Question 11

How can you assess occlusal vertical dimesion?

Answer 11

• numerous methods suggested
• all methods are unscientific
• should access using a combo of methods for more accuracy

Question 12

What should you check when considering the OVD?

Answer 12

2-4 mm space between teeth when mandible is in PRP

Question 13

How do you do a OVD assessment? (stretch-relax method)

Answer 13

• dot on nose and chin; open wide (hold for 20 seconds)
• slowly close until lips first touch and measure that distance
• hold for 15 seconds and then close until teeth touch; measure again
• difference in measurements is “interocclusal distance” (about 2-4 mm)

Question 14

How do you do a OVD assessment? (swallow-relax method)

Answer 14

• patient is asked to swallow and then relax
• teeth contact while swallowing and the separate when relaxing

Question 15

What should the closest speaking space be?

Answer 15

• rapid speech of sibilant sounds (S, Ch, “sixty six, san francisco, kansas city, chiefs”)
• should be no contact of max and mand teeth when speaking

Question 16

What should you verify about the casts during the trial placement?

Answer 16

make sure the casts are mounted correctly in CR on the articulator

Question 17

How do you check if your casts are mounted correctly in CR?

Answer 17

• check with articulating paper
• stablize the mandibular denture
• new CR record
• make new interocclusal record in mouth and check on articulator
• use a small amount of recording material
• remount if needed…

Question 18

How do you know if you have an accurate mounting?

Answer 18

• teeth interdigitate perfectly
• condylar ball should contact fossae wall

Question 19

How do you determine the level of occlusal plane anterior?

Answer 19

• anterior determined by esthetics/phonetics
• resting upper lip: 1-2 mm incisor teeth visible
• smiling: displays most of teeth length but minimal amount of base

Question 20

Maxillary incisors should have positive contact with lower lip when ________ sounds are made.

Answer 20

fricative sounds (F, V, “very funny”)

Question 21

How do you determine the level of occlusal plane posterior?

Answer 21

• molars should be 2/3 up the retromolar pad
• plane should be 2-3 mm below dorsal surface of resting tongue
• planes should parallel the two residual ridges and bisect the space between the ridges

Question 22

Maxillary posterior teeth generally parallel to what plane?

Answer 22

ala-tragus plane (Camper’s plane)

Question 23

Maxillary posterior teeth should do what on the occlusal plane?

Answer 23

should not appear to descend posteriorly

Question 24

What are sibilant sound?

Answer 24

S, Ch
(occulsal vertical dimensions)

Question 25

What are fricative sounds?

Answer 25

F, V (incisors hit wet/dry line of lip)

Question 26

If teeth touch when speaking S sounds, occlusal vertical dimension is...

Answer 26

too far open

Question 27

If the patient whistles on sibilant sounds then what is wrong with the contour of anterior palate?

Answer 27

too narrow

Question 28

If the patient lisps on sibilant sounds then what is wrong with the anterior palate?

Answer 28

too broad

Question 29

What can cause lisping?

Answer 29

- non-uniform overjet of the anterior teeth - diastemas between teeth - palatal contours - diamond-shaped openings between incisors

Question 30

What should the incisal plane be in relation to interpupillary line?

Answer 30

parallel to it

Question 31

Where shoudl the posterior tooth positions be?

Answer 31

mediolaterally centered over denture-bearing area

Question 32

What should you check during the trial placement?

Answer 32

Question 33

What is one of the most important parts of the trial placement?

Answer 33

- patient approval (friends and family as well) - leave the patient alone for a few mintues to look in a mirror

Question 34

What should the denture base be: convex or concave?

Answer 34

should NOT be convex

Question 35

What will happen if the denture base is too thick? Too thin?

Answer 35

Too thick - impair comfort Too thin - weakened

Question 36

What should the laboratory prescription be?

Answer 36

- processing, finishing, and polishing - laboratory remount of the dentures - adjustment of occlusion to compensate for processing changes