OM 526
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115 terms
Terms | Definitions |
|---|---|
 immediate | denture is completed b/f the extractions of the teeth |
| CID | post teeth are removed; residual ridge needed to be heal; custom impression tray post teeth are extracted |
| healing time for CID | 10-12 weeks |
| Indications of conventional ID | post teeth removed ant teeth that have sufficient bone support to maintain VD duplication of ant tooth position pt is unable to remain edentulous during healing |
| adv of conv ICD | 1) pt never be w/o teeth 2) comfortable transition 3) one denture has to be made 4) reduces amt of time 5) low dental care 6) border extension and contours are precise 7) less adjustment required at insertion and post insertion 8) Stability and comfort 9) less post insertion adjustment 10) less chairside relines |
| disadv of CID | 1) must be fitted w/ reline material several times after insertion 2) additional chirside time 3) extra fee 4) need lab reline to refit the denture 5) no esthetic try in |
| final impression for cID | alginate custom tray |
| interim ID | alginate in a stock tray triad light cure record base |
| CR | aluwax |
| denture is constructed w/ many of ant & post teeth present | interim |
| replaced w/ final 9-12 months later after tooth removal | interim |
| interim ID indications | Full mouth extractions ant tooth mobility ant teeth replaced w/ RPD medical complications when pt want rapid result |
| adv of interim | rapid procedure duplicate position & size of existing teeth can change esthetics can construct one arch at a time can serve as a spare |
| disadv of interim | difficult to establish the correct border extension and contour tissue contact is rapidly changed need temp relines increase chair time, fee denture position is rapidly changed |
| immediate overdenture | one or more retained natural teeth providing support for the denture |
| indication of immediate OD | abutment teeth is not strong enough to support RPD abutment teeth has a reasonable life expectancy pt should expect min of 2 yrs service pt scared of being edentulous when indicating rapid ridge loss and denture instability good OH |
| adv of immediate overdenture | better support protect ridge preserve alveolar bone reduces frequency of relines improve stability of prosthesis psychologically helps pt bc some teeth remain |
| disadv of Immediate OD | high cost delay a completion limitation on artificial tooth position denture breakage required home care cannot be used where undercuts exist |
| temp immediate RPD | resin partial denture short-term replacement for ant or post inserted when the NAT removed |
| conv. Immediate denture | permanent denture duplicates ant teeth fewer post insertion appt |
| major limitation of conv. immediate denture | indirect reline required difficult to make changes in tooth-position no-try in of ant teeth require 2 surgery appt |
| conv immediate OVD | permanent denture duplicates ant teeth least post insertion appt maintain occlusal VD maintain support and stability preserve alveolar bone provides tactile sensation yu98 |
| limitation of conv. immediate ovd | require indirect reline difficult to make changes in tooth position no-try in usu require 2 surgery appt need pt interest in care of abutments |
| interim immediate | provides spare denture later easy to make large changes in tooth position in final denture can duplicate tooth position if desired full arch extraction are possible rapid results can do one arch at a time if desired can limit surgery to 1 appt if desired |
| limitation of interim immediate | require final CD only temporary require post-insertion appt (mostly) |
| Interim immediate OVD | provides spare denture later changes can be made in tooth position but limited to position of retained overdenture teeth full arch extraction possible except for remained teeth rapid results can do one arch at a time if desired can limit surgery to 1 appt if desired maintain occlusal VD maintain support and stability preserve alveolar bone provides tactile sensation |
| limitation of interim immediate OVD | require final CD only temporary need pt interest in care of abutments require more post-insertion appt than conv. Immediate, but fewer than for an interim immediate (conv immediate < interim immediate OVD < interim immediate |
| short term | IID |
| relined after healing | CID |
| can be used as a spare denture | IID |
| need to use tissue conditioning | IID |
| high cost | IID |
| need 2nd denture | IID |
| rapid procedure | IID |
| how long to complete CID | 3 month 3-4 weeks for post healing 2 month to fab and place CID |
| Multiple ant & post teeth remaining | IID |
| only ant teeth present | CID |
| not support an existing RPD | CID |
| only ant teeth extracted when placement | CID |
| both post & ant teeth extracted when placement | IID |
| 2 extraction visits are needed | CID |
| 1 surgical appt | IID |
| can change esthetics | IID |
| cannot convert existing prosthesis (RPD) | CID |
| Immediate denture | CD or RPD for placement immediately after the removal of natural teeth allow pt to continue social activitis w/ being in an edentulous state |
| disadvantage of ID | the arrangement of artificial teeth cannot be obsrved at a try in appointment final esthetic outcome cannot always be predictable inability to review tooth arrangment and estethic before processing and inserting |
| position of ant teeth | duplicate the pt's natural tooth not always compatible w/ esthetics |
| article 3 | allow pt to evaluate the artificial tooth arrangement & resultant b/f the completion of denture give the dentist a chance to satisfy the pt longer chair time mx ant teeth were added to processed denture w/ autopolymerized acrylic resin chance of discolorization can use as spare lab work increased |
| limitation of this procedure | pts w/ severe undercuts needing extensive alveooplasty |
| article 3 | allows the esthetic try in of mx ant artificial tooth arrangment b/f extraction and completion immediate mx denture provide a pts the opportunity to observe the arrangment of artificial ant teeth b/f final processing and insertion of denture |
| 1st step in tx for partially edentulous pt | 1) review medical hx 2) examine the mouth 3) complete green removable prosthodontic exam form 4) obtain alginate impression for dx cast 5) consider a nutritional assessment if caries or bone loss is evident |
| immediate | denture is completed b/f the extraction of teeth teeth are removed and then the denture is inserted, immediately thereafter rapid resorption of alveolar ridge in extraction area need reline procedure to insure maximal denture base stability & retention planned follow-up care over the 1st 12 months is required |
| can be impinged by mx nerve | nasopalatine nerve incisive foramen |
| rarely impinged by denture | ant palatine nerve |
| region of 2M | greater palatine foramen |
| region of 1M | zygomatic process of mx |
| guid to positioning artificial cuspid | cuspid eminence |
| temporalis muscle | coronoid process |
| articulates w/ glenoid or articular fossa at the base of temporal bone | condyle |
| md 1 & 2PM region | mental foramen |
| forms the FOM | mylohyoid muscle |
| arch has a tendency to become smaller due to resorption | mx |
| arch has a tendency to become larger | md |
| the resorption rate is 4xs faster in | edentulous md |
| effect on the disto-buccal border of md impression | masseter |
| no direct effect on the denture area | lat pterygoid |
| limiting factor of length of ling flange of md denture | mylohyoid muscle |
| genioglossus & geniohyoid | origins are on the genial tubercles |
| attached to alveolar process either mx and md | buccinator |
| muscle that // w/ occl plane | buccinator |
| drops the soft palate | tensor veli palatini |
| ant to vibrating line/ located on the soft palate/ 2 small depressions in the midline in the post valut | fovea palatinin |
| determine the post extension of mx denture | vibrating line |
| ant from the vibrating line, displaceable. | Pst palatal seal area |
| limit buccal extension of denture | Ext oblique ridge |
| anteriorly the mylohyoid ridge fades out FOM is formed by this area | sublingual gland area |
| inadequate inter-arch space | low tuberosities excess eruption overclosure |
| inter-arch space | 5-6mm |
| Index areas | indicate how well the bone holds up to additional stress |
| positive bone factor | favorable response to increased stress better long-term px since abutment will be subjected to additional loads |
| negative bone factor | loss of bone due to added stress no RPD has been worn px is poor due to increase in stress from RPD |
| longitudinal study of RPD pts by carlsson, Hedegard, Koivumaa | RPD abutment teeth had a high incidence of caries, gingivitis, deepened gingival pockets and mobility CI pts had the most dz pre-denture standard of OH is not sufficient when RPD is worn |
| Bergman, HUGOSOn, Oslsson | instruction in oral and denture hygine no significant deterioration mobility of abutment teeth decreased 2 of the 5 carious lesions found w/ carefully planned prosthetic tx and adequate checks, no dmage to remaining teeth and periodontla tissue |
| Schwalm, smith, erikson | increase in plaque score w/n a year after RPD more plaque on teeth contacted by RPD RPD is not plaque trap when OH considered necessity of recalling pts periodically to reemphasize OH procedures and provide routine dental care |
| instructions to pts | NO calgon-clorox soaking soln use fixodent denture cleaner fluoride application :stannous fluroide 0.4% brush and then brush on the gel for 1min fluroide rinse (fluorigard or ACT) if active caries exist |
| extension of lower impression | labial and the disto-lingual borders |
| what upper tray always requires | wax dam across the post palatal seal |
| a. reason for mounting casts | if enough space exists b/w the edentulous ridges to look for space where rest will be placed help present tx plan if surgery or crowns are required due to space problems if CO = CR to determine if RPD can restore face height |
| In case when mounting casts are not necessary | when one arch is edentulous; no concern abt CR = CO b/f denture bc there are no opposing natural teeth to misguide RPD replaces only a few teeth, no occl adjustment is needed |
| need 2 appointments for mounting free end RPD | impressions to make the casts and bases 2nd: recording jaw relation |
| labial frenum | fibrous band; no musc fiber; variable configuration; accomodated by groove extend from labial residual aveolar ridge to lip |
| labial frenge | potential space bounded by labial residual alveolar ridge terminates at th buccal frenum |
| incisive papilla | nasopalatine nerve, vessels and require relief in the finished denture base |
| ant residual alveolar ridge | tolerant (잘 견디는) area to resisting denture mvm and resulting irritation |
| rugae | 2nd stress bearing area |
| buccal frenum | levator anguli oris musc |
| median palatine raphe | may require selective relief w/n the denture base |
| buccal flange | mesial aspect thinner; thicker in the area of tuberosity from distal to buccal fenum to hamular notch |
| post residual alveolar ridge | supporting structure of mx ridge crest of mx residual alveolar ridge - primary stress bearing area --> most tolerant area to resisting denture mvm and resulitng irritation |
| max. tuberosity | bulbous extension of residual alveolar ridge 2M and 3M region, terminating in the hamular notch |
| post palatal seal | allows a selective pressure outline distal edge of mx denture base terminate ends at or b/f the vibrating line imaginary line across the post part of palate marks the dimension b/n the movable and immovable tissue of soft palate cam be identified when the movable tissues are activated |
| hamular notch | soft area of areolar tissue btwn the distal surface of the tuberosity and the hamuls houses the distolateral termination of the denture base |
| labial frenum | influenced by the incisivus and orbicularis oris muscles accommodated by a groove in the md denture |
| labial flange | lip support |
| sublingual crescent | ant portion of lingual flange maintain peripheral seal of lower denture position of the tongue is effective in mainitaining seal in this area denture base border should not interfere w/ the lingual frenum or the subligual carnuncles of Wharton's duct |
| lingual frenum | must be accommodated w/ sublingual crescent area primary stress bearing area in most impression tech is the crest of the alveolar ridge |
| baccal frenum | overlies depressor anguli oris Clearnance; to avoid dislodgement of md denture |
| post residual alveolar ridge | may be sharp, thin, cancellous, or contain large nutrient canals ext. oblique ridge or buccal shelf becomes the primary stress bearing area |
| buccal flnage | overlies a horizontal shelf of bone (buccal shelf) buccal shelf: ext oblique ridge buccinator muscle (not exhibit a dislodgement effect on denture base) attach to ex oblique ridge denture base rest on part of the buccinator attachment |
| lingual flange | terminates at the distal end of alveololingual sulcus mylohyoid muscle influence the mid & ant portion of inf border of lingual flange mvm of tongue and displaceability of FOM will deterine the length of flange |
| aveololingual sulcus | maintain peripheral contact |
| buccal shelf | horizontal shelf of bone ext. oblique ridge buccinator muscle attaches to the ext. oblique ridge |
| distolongual flange | influenced by the glossopalatine and sup constrictor msucle which constitue the retromylohyoid curtain |
| masseteric notch | accommodates the mesial border of the masseter msucle masseter inflences the denture base during opening & closing mvm of md overextentison will result both in soreness and in mvm of the denture base |
| retromolar pad | must be covered by denture base aids in the stability of the denture by adding another plane to resist mvm of base pterygomandibular raphe, sup. Pharyngeal constrictor, buccinator muscle, temporal tendon and glandular tissue |
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