DTHY 361: MIDTERM

suction graspsthumb to nose penyou should place the suction _____ to the toothclose -bevel parallel to B/F/Luses of rubber damn-maintains dry environment -safer for patient -saves time -psychological benefitsinstruments used in rubber dam application1. 6x6 square 2. paper napkin 3. hole punch 4. frame 5. forceps 6. retainer (clamp)setup of rubber damn-stamp rubber damn -punch necessary holes -apply appropriate frame -apply forceps and secure3 parts of restorative hand instrumenthandle shank working endcutting instrumentsevacuator hatchet gingival margin trimmer chisel hoeevacuator-spoon-shaped working end -"scoop out" decayhatchet-smooth walls of cavity prep -remove unsupported enamelgingival margin trimmerplace bevel along gingival margin of cavity prepchisel-beveled cutting edge -smooth cavity prephoe-blade perpendicular to handle -smooth cavity prephandpieces and burs-used to remove decay/old restorations -used to prep tooth for restoration -used to finish/polish restorationstypes of handpiecesstraight (lab) contra-angled friction grip latch griptypes of bursround inverted cone fissured/crosscut end-cutting trimming and finishing3 parts of a burshank neck head (working end)points and stoneswhite brown/green gray pinkmandrelslong shortwhat is endodontics?treats pathology of pulp and periapical tissues -typically involved root canal therapy (RCT)what codes are used in endodontics?3000advanced education of endodontics-grad of accredited dental school (DMD or DDS) -application for endo residency -length of program variesAmerican Association of Endodontics-dedicated to advancing the art and science of endo -promotes highest standards of patient careAmerican Board of Endodontics-only certifying board for specialty of endodontics -3 part exam: written, oral, submission of completed casesbecoming a diplomat of American Board of Endodontics-reach highest level of edu in endo -apply new research and lit in clinical practice -confidence in clinical decision-making and treatment planning -enhance techniques for pt care -advanced edu or military career -contribute to reputation & vitality of endodontics specialtydiagnostic tests to determine treatmentpercussion mobility temperature sensitivity probing electric testing radiographs can the tooth be restored?percussiontake the end of an instrument and tap on the incisal/occlusal edge of the toothtemperature sensitivity*endo ice* if the pain lingers or the pt does not feel anything, this indicates endocan the tooth be restored?RCT Extraction Implantprepping access cavity-adequate local anesthesia -rubber damn *manditory* -high speed handpiece (access to pulp chamber) -endo explorer (locate all canals)endo files-remove contents of canals -enlarge & shape canal for final filing -hand or hand piece driven -moved in circular and up/down movements -standardized sizing of files -x-ray to determine length of canal -master apical file -x-ray taken taken of master filemaster apical filelargest file to shape apexelectronic apex locatorelectronic device used in endo to determine position of apical constriction and thus determine length of root canal spaceirrigants-kill bacteria in canals -dissolve pulp tissue -flush debris from canals -lubricate canals during instrumentationcommon irrigants-sodium hypochlorite (bleach) -chlorhexidine gluconate -sterile salinepaper points-dry canal before fitting -standardized sizinggutta percha-flexible at room & body temp -softens when heated about 150 degrees F -66% zinc oxide, 20% gutta percha, 11% barium sulfate, 3% waxes/resinsmaster cone-same size & length as master file -coated w/ sealer to ease placement -x-ray taken to confirm proper lengthlateral condensation-laterally to master cone -place accessory cone into opening created by spreader -continued placing accessory cones -x-ray taken to ensure adequate fillendodontic sealer-dental cement -coats canal space & fills voids -easier insertion of cone -ZOE products w/ extra additives (Roth cement) -calcium hydroxide product availableradiographs taken during RCToriginal working length master file master cone accessory cones (TreeShot) final fillrestoration & recall-temporary restoration placed -restore tooth in timely manner -permanent restoration critical -subsequent x-rays at recall appointmentanterior teeth require a _______ whereas posterior teeth will require a _______simple filling core and crowncomplications of RCTuntreated canals broken files perforations (file comes out of the apex of the root) -MTA used to repair -mineral trioxide aggregateapicoectomy and retrofills*RCT 95% successful* failure -retreat w/ RCT -apicoectomy w/ retrofil -extraction w/ implant apicoectomy -remove 1-3mm of root apex retrofill -filling placed at apex of rootadvanced education of pediatric dentistry-specialized masters degree -2-3 years beyond dental school -grad from accredited dental school (DDS or DMD)education properties for the pediatrics-advanced diagnostic and surgical procedures -child psychology and development -clinical management of children -oral pathology -child-related pharmacology -patients w/ special needs -conscious sedation & general anesthesiarole of the dental hygienist in pediatrics-child prophy -fluoride -sealants -radiographs (pano/occlusal) -nitrous oxide monitoring -hospital dentistry -special needsoffice atmosphere for the dental hygienist in pediatrics-fast paced (hygiene assistants) -ortho treatment -referral based practice -more aggressive txpulpotomy-removal of coronal portion of pulp -*deciduous teeth*: permanent procedure (stainless steel crown) -*permanent teeth*: temporary procedure (followed by RCT)space maintainerappliance that prevents the drifting of teeth when adjacent tooth is prematurely lost -helps to decrease need for ortho -removed once permanent tooth begins to eruptsilver diamine fluorideused for caries arrest; black in colornonaqueous elastomeric impression materialspolysulfides condensation silicones polyethers addition siliconesnon aqueous elastomeric impression material characteristics-rubber base materials, elastomers -set via polymerization reactions -more stable than hydrocolloidspolysulfide*1st non aqueous material used* -rubber or rubber base -paste-paste system -more accurate than alginate -unpleasant smell/taste; can stain -best results for custom trays -inexpensive -used for crowns, bridges, denturesthe white paste is the _____ and the brown paste is the ______white paste = base brown paste = acceleratorpolysulfide mixing techniquedispense equal lengths on paper pad and mix to homogeneous mixturecondensation silicones-*hydrophobic*: have little or no affinity of water -set via condensation reaction (produce alcohol by-product) -difficult to pour -not commonly usedpolyethers-developed for sole use by dental industry in 1960s -shorter working and setting times -sets very stiff -unpleasant taste (only available in one viscosity)addition silicones*most popular* -crown & bridge impressions -clean, easy to work with -most accurate & stable -most expensive -different viscosities (body: light, med, heavy, mono phase, putty -dispensed through auto mix-gun (spiral shaped baffle tip)surfactants-increase wetting, decrease chance of bubbles -reduce contact angle of mixed gypsum -aid in pouring modelhydrogen absorbers-production of hydrogen gas in problem -creates bubbles on poured model -proper disinfection decreases chance of gas -gas will dissipate during transporttemporary crowns-impression taken prior to prep -impression used to make temporarybite registration materials-record relationship of mx and md arches -material placed directly onto occlusal surfaces -pt bites into material and allows it to set up -used by dental laboratory to help create archesoptical impressions-impression taken w/ intraoral camera -may be sent digialty to lab -may be used by CAD/CAM machine in officedouble-mix putty wash technique*mix technique for addition silicone impression material* -uses 2 different viscosities to capture impression -thicker material *putty* used to line tray -thinner material *wash* placed around tissues/teeth of interestwhy do you use addition silicone impression materials?-used as a *final impression* material for crowns/bridges -increased stability of impression material -> delayed pour -very popular material used todaytray preparation of addition silicone impressions-select proper plastic stock tray -paint tray w/ tray adhesive -allow tray adhesive to air dry for 10 minutes (becomes tacky to touch)what does painting the tray with adhesive do?-aids in retention of impression material -use adhesive and impression material from same manufacturerpreparing the auto mix gun of addition silicones-load selected cartridge -remove sealing cap & SAVE -dispense pea-size amount of material onto tray check for clogs -install new baffle (mixing) tip -discard baffle tip after use and replace capprepping wash (syringe) material-might utilize impression syringe -remove retraction cord -place wash material inter proximally and cover prepared tooth -allow to set 5-7mins -remove tray w/ quick snap motion -rinse and disinfect impression -transport to lab for pouringprepping putty (tray) material-used w/ *low-viscosity* material -tray lined first w/ putty -dispense equal volumes of base & catalyst using correct scoops -use only non-latex gloves to mix -use *fingertips* to kneed to homogenous color (30 sec) -roll mix into cylinder (3-4in long) and place into tray3 reasons for placing temporary crowns-patient comfort and esthetics -pulpal protection -interim or provisionalrequirements for a temporary crown-reproduce anatomy (occlusal, proximal contacts and overall contour) -inner surface promotes retention -material able to withstand occlusal surfacesavailable forms of temporary restorationspreformed shell fabricated from negative moldmaterials used to construct temporary crownsacrylic resins bis-acryl materials preformed crown materials (polycarbonate and metal shell)polycarbonate crowns-variety of widths -one shade available -incisor, cuspids, and bicuspidsmetal shell crowns-typically tin (aluminum in past) -easier to adapt than stainless steel -molars and premolarsacrylic resin temporary crown-constructed intra-orally -uses mold of unprepared tooth (wax, elastic impression material, thermoplastic polymer) -resin system placed in mold -mold seated over prepared tooth -when set, remove temporary and trimgeneral health indicatorsdiabetes HIV nutritional deficiences leukemiaclinical assessmentobservation palpation (digital/bidigital, manual/bimanual, bilateral, circular compression) auscultation olfactionregions of the head and neckanatomic structures of the external earsinus cavitieslymph nodes-clusters of bean-shaped bodies along lymphatic vessels -filter toxic products from lymph to prevent entry into bloodhealthy lymph nodessmall, soft, and mobile in surrounding tissue -cannot be visualized or palpatedchanges in lymph nodeslymphadenopathy firm/hard attached/fixed tendernesmuscles of masticationtemporomandibular joint (TMJ)joint formed between upper skull and lower jaw parts -condyle -disc -fossa -ligamentthyroid glandoral regionpalatesalivary glandsparotid (stensen's duct) sublingual submandibular glandstonguebase anterior dorsum ventral lateral papillae (circumvallate, fungiform, filiform, foliate)mucosaalveolar vestibular buccal/labiallocation-nearest anatomic landmark -lesions anatomic relationship to structure (anterior/posterior, medial/lateral, inferior/superior, ipsilateral/contralateral) -unilateral/bilateraldistributionsingle or multiple separate or coalesced localized or generalizedsize and shape-measure w/ probe (length, width, height) -boarders (well-defined or irregular)color-unusual color change -common color changes (red and white OR blue, purple, yellow, black, and gray) -hemorrhagic (spontaneously or with tough)atrophythinning of tissue layers w/ shiny and translucent appearance -ex: lichen Plansbullaelevated cavity containing free fluid larger than 1 cm in diametermaculeflat circumscribed alteration of tissue that may vary in size, shape, or color ex: freckle, amalgam tattoonodule5mm-1cm solid elevation of tissue which is usually deep seated and involves submucosapapulecircumscribed superficial pinhead to 5mm elevation of tissue ex: tiny moleplaquea 5mm or more slightly raised lesion with a broad, flat toppustulepus-containing elevation of tissueulcera deep defect that extends below the epithelium ex: aphthous ulcervesicleelevated 1cm or less alteration of tissue containing fluid (serum, mucin, blood) ex: blisterwhealirregularly shaped, slightly elevated area; small, localized area of edema on the surface of the skin; typical of allergic reactions (hives)cratercentral depressioncrustdry or scab like textureindurationhardness or firmness of soft tissuepapillaryResembling small, nipple-shaped projections or elevations found in clusterspseudomembranea false membrane formed as a response to a necrotizing agent (a covering)smoothdeep lesion that pushes up and stretches a surface tissueverrucouswart-like appearancesessileflat, broad basepedunculatednarrow pedicle of attachmentdepth and mobilitycheck w/ palpation (deep or superficial) mobile fixatedconsistencydegree of firmness density of tissuefluctuance-fluid filed lesion -does the liquid move around when you push on one side -liquid will not leave unless rupturedemptiabilitywhen you push on the lesion, the fluid comes outsymptomsubjective condition reported by patientsignobjective condition directly observeddocumentationhow long has it been present? any changes in shape/size? any pain, tingling, burning, or paraesthesia? any lab results?what is oral surgery?field of dentistry that treats fractures of the maxilla, mandible, and other facial structuresoral surgery utilizesfixation devices (plates, screws, and/or heavy gauge wires) for immobilizationprogram requirements for oral surgery-graduation from accredited dental school -4-6 year program (101 programs in US) -various residency/fellowship programs -board certification is *optional*skin cancersmost common types are *basal cell and squamous cell* -85% located on head/neck (direct exposure to sunlight) -good prognosis: diagnosed early, slow growth, usually does not metastasizemelanomaless common, possibly fatal; rapid growth risk factors -sun exposure -family historyoral and oropharyngeal cancer75% head/neck originate in oral cavity ->54,000 Americans will be diagnosed this year ->15,000 deaths per year -twice as common in men -equal among races -average age of diagnosis: 62 years old -20x higher risk of developing 2nd occurancehuman papilloma virus (HPV) oral cancers*type 16* -fastest growing oral cancer segment -white males under 55 yo -non-smoking, non-drinking -better prognosis than non-hpv oral canceroral squamous cell carcinoma (OSCC)94% of all oral cancers -carcinoma in situ (early stage; only present in outer layers -invasive squamous cell carcinoma (grown into deeper layers of oral cavity)risk factors of OSCCtobacco use alcohol use HPV infection excessive sun exposuremost common sites of OSCC in the USlateral boarder of the tongue floor of the mouth oropharyngeal (posterior soft palate, uvula, fauces) lower lipchronicitycontinues presence because of failure to healerythroplakiaused to identify red patch that is smooth, granular, and velvety and cannot be diagnosed as any other lesion without biopsyerythroleukoplakia (mixed)having a combination of both red and white color changesfissuringsurface texture may exhibit ridges and irregularities reflecting abnormal cell growthfixationimmobility occurring resulting from abnormally dividing cells invading to deeper areas into muscle and boneleukoplakiaused to identify white, plaque-like lesion that cannot be wiped off and cannot be diagnosed as any other lesion without biopsylymphadenopathyinvolvement of regional lymph nodes (and tonsils) resulting in firm, enlarged, fixed, and painless nodes in cancer casesulceration or erosionloss of skin surface layer(s) resulting from destruction of epithelial integrity from cell maturation discrepancy, loss of intercellular attachments, disruption of basement membranescreening recommendations for self-examination-no mandated oral screening regimen -asymptomatic -> late stage diagnosis -takes less than 5min -adults over 40 = annually -adults under 40 = every 3 yearsmaterials needed for examgauze gloves lighting loupes (optional)clinicans should visually examinelips buccal mucosa hard/soft palate tongue oropharynx nasopharynx larynxTNM staging systemT = size of tumor N = lymph node spread M = metastasisstage I-lesion not more than 2cm -without spread to lymph nodes or metastasisstage II-lesion between 2-4cm -without spread to lymph nodes or metastasisstage III-lesion larger than 4cm -without spread to lymph nodes or metastasis OR -any size lesion and has spread to single, ipsilateral lymph node (w/o metastasis)stage IVconsult textbook pages 237-8brush biopsy-1999 by OralScan lab -non-invasive screening for presence of oral cells -sensitivity ranges from 71.4% to 100% -specificity ranges from 32% to 100% -low percentage of false negatives -positive result -> conventional excisions biopsybiopsysurgical removal of a section of tissue -diagnosis -estimate prognosis -monitor cause of diseasepunch biopsytubular surgical instrument inserted to deeper tissueexcisional biopsyentire lesion removed -boarders analyzedincisional biopsyonly representative tissue samples are obtained -wedge biopsyhand-held fluorescence devices-quickly screen patients for abnormal tissues -discovery tools not diagnostic tools -vizLite Plus w/ T-Blue -Velscope -orascoptic DK -inentafi 3000 ultraVizLite Plus w/ T-Blue-30 second rinse w/ acetic acid solution -want-like instrument emits chemiluminescent light -clinican must wear special eyewear -abnormal tissue = white and marked for biopsy using phenothiazine dye (T-Blue) -easy to use, one dose packagingVELscope-visually enhanced lesion scope -pt does not have to rinse w/ dye or stain -hand-held device emits a blue light -normal tissue = fluorescent green -abnormal tissue = appears dark -intraoral camera attached for pt educationOrascoptic DK3 functions -visualizes oral lesions -shows fractured teeth -detects carious lesions -LED light transilluminates teeth showing lesions/fractures -Pt rinses w/ acetic acid to agitate the cells -LED light changes to fluorescent source to show suspicious lesions which appear white -system entirely autoclavableIdentifi 3000 Ultra-uses serious of 3 different wavelengths of light -white LED: illuminates oral cavity for visualization -violet LED: excites normal tissue causing to appear fluorescent aboral tissue remains dull -green amber light: differentiates between normal and abnormal tissue vasculature -special eye where requiredindirect restorationsconstructed outside the mouthfixed restorationscannot be removed from oral cavity -cemented in placeclassified two waysamount of tooth structure restored material of fabricationamount of tooth structure restoredinlays onlays crowns veneers dental bridge complex restorationsinlays-intracoronal restorations -replace s/m amounts of tooth struture -do not restore cusp tips -retained by luting cementonlays-overlays -replace more tooth structure than inlays -may restore one or more cusps or entire occlusal -placed when likelihood of cusp fracture is high -protects cusps from occlusal surfaces -retained by luting cementcrowns-restore teeth that have lost significant amount of structure -intracoronal retention is available -materials: full cast metal, all porcelain, or PFMveneers-placed on facial surface of anterior teeth -used to treat esthetic concern onlydirect veneer*no tooth structure removed* -bonded composite added to facial surface -reversible procedureindirect veneer-facial surface prepared -impression -temporary restoration -2nd appt. for cementationdental bridge-replaces missing tooth/teeth -retainer crown at each end on abutment tooth -pontic replaces missing toothmaterial of fabricationmetals ceramics ceramometal compositemetals-variety of metals used -uses casting procedure (melt metal, force liquid metal into mold) -very tough and work well in high-stress situations -poor estheticsceramics-used when esthetics are important -stimulate natural colors and translucency -porcelain most commonly used -lack toughness and fracture resistanceceramometal*PFM* -metal-ceramic combination developed in 1950s -same process to bake porcelain on metal as was used to make sink/bathtubs -tough metal supports weak but esthetic ceramic material -considered "workhorse" in dentistrycomposite-particle-reinforced composite materials -cured at elevated temperature and/or pressure in lab -limited success due to strength issues -new product: composites reinforced w/ glass fibersprocedures for constructing indirect restorationsdiagnosis treatment planning restoration design preparation impression temporary restoration lab procedures restoration cementation treatment plan completiondiagnosiscause of missing tooth structure -caries, trauma, esthetic concerns, multiple restorations, periodontal disease, fracture, congenital deficiencestreatment planningfactors to assess -perio status must be stable -endo status: pulp vitality and PA radiograph -CRA and testing -build-up requiredrestoration design-esthetics (shade/translucency) -attrition of teeth/material -biocompatability of material -margin location: can affect esthetics, retention, periodontal response, and recurrent cariespreparation-prepared *after* restorative materials have been determined -margins vary w/ materialimpressions-captured after prep is complete -captures prep, adjacent teeth, and opposing teeth -full arch impressions are more accuratetemporary restoration-appearance and texture of prepared tooth not ideal -exposed dentin sensitive to heat, cold, air -temp restoration cemented after prep is completelab procedures-laboratory prescription -legal part of client record -impressions disinfected and sent to labrestoration cemention-additional appt -temp removed & cement cleaned -restoration "try-in" -if try-in is acceptable -- restoration cementedrestoration "try-in"-seated on prepped tooth -proximal contacts checked w/ floss -margins examined w/ explorers -occlusion evaluated using articulating paper -esthetic approval by dentist and clientCAD/CAM-computer-aided design/computer-aided manufacture -optical impression capture in-office -restoration created from solid piece of ceramic material either in office or lab -porcelain & stains added for esthetic -used in production of crowns, bridges, veneers, and dentureslost-wax technique-used for over a century -wax pattern: creating shape of final restoration in wax -wax is easy to mold/shape using heat sourcedental waxesinlay casting wax -burns away completely -leaves no residue sticky wax -sticks well after melting baseplate wax -used in fabrication of denture craft wax < dental wax < other dental materialsinvesting procedure-sprue attached to wax pattern to form opening (innate) -wax pattern attached to sprue base -casting ring placed over sprued wax pattern -wax pattern embedded in mold material (investment) -investment heated -> wax melts and flows out -wax burnout created mold space for metalgypsym-bonded investment material*most commonly used* -silica material added to improve resistance to heat -increases thermal expansion of mold -mold must expand to compensate for thermal shrinkage of metal as it cools to room temp -no expansion -> restoration will not fit properlyburnout-temperature-controlled oven melts wax pattern (burnout) -500-600 degrees C -wax melts and is volatilized -> clean mold space -casting ring left in oven for additional 30-60mins -complete burnout of wax pattern -mold has reached desired temperaturecasting-melt-casting alloy: temp depends on alloy -alloy placed in ceramic crucible -heat alloy to melting point -force melted alloy into mold place -centrifugal casting machine rapidly spins mold, crucible, and molten alloy in circle -molten alloy flows into mold space via innate left but spruedivesting, finishing, and polishing-after cooling, casting is divested by carving way investment material -casting is cleaned -excess metal is removed -casting is finished and polishedalloysmetals that are combination of several elementsalloys for all-metal cast restorations-pure gold too soft to use -high noble dental alloy is approx (75% gold, 10% silver, 5% copper, 2% palladium, 1% zinc)ADA specifications for all-metal cast restorations-no composition requirements -performance criteria: strength, elongation, tarnish resistance, biocompatibility -types I, II, III, IValloys for ceramometal restorations (PFM)requirements -same mechanical and biocompatibility as metal alloys -elongation not important -firing temperature of porcelain very high -- cannot be higher than melting temperature of metal alloypartial denture frameworks-historically frameworks were from cast gold -today less expensive alloys are used: nickel-chromium and cobalt-chromiumbonding porcelain to metal-metal substructure (coping) waxed and cast -metal is cleaned -oxide surface of metal using porcelain oven -porcelain powders applied (stacked) in layers *opaque porcelain *dentine porcelain *enamel porcelainsintering porecelain-sintering chances porcelain powder to solid (compacted together, less porous (denser) = greater strength) -final shape produced by grinding -stains and glazes applied and fired to finalize shadefracture-cast metal restorations are least likely to fracture -all ceramic restorations have highest risk of fracture -ceramometal restorations used in all areas of mouth -fracture of porcelain is the most common mechanical issueesthetics-dependent on location of restoration -all ceramic restorations are most naturalwearceramic materials are harder than natural teethmargins-cast restorations have more accurate margins -open margins increase the risk of recurrent cariesuses of acrylic resins in dentistry-developed in 1930s, first used in dentistry in 1940s -quickly replaced former denture materials -used as direct restorative material -- unsuccessful -current uses in dentistry: temporary crowns, custom trays, base plates for dentures, ortho retainers, non-dental use: bone cement in joint replacementsacrylic reins are _____-hard, brittle, glassy polymer -clear and colorless, but easily colored -thermoplastic materialacrylic resins are supplied as powder and liquidliquid -monomer, methyl methacrylate powder -polymethyl methacrylate resin w/ added colorants and benzoyl peroxidea complete denture replacesan entire missing arch including alveolar bone -colored material stimulates natural tissue -retained through suction requiring precise adaptation and peripheral sealtwo major components of a complete denture*white denture teeth* -purchased from manufacturer -available in variety of shapes, sizes, and shades -acrylic resin teeth (most commonly used today) -chemically bonded to the denture base during processing -porcelain or composite *pink denture base* -precisely created in dental lab -constructed on master cast -pink part of denture that rests on alveolar ridgeporcelain teeth-harder and more stain resistant -rarely used due to trauma, bone loss, and wear -mechanically retained by pinsdenture construction-requires multiple appts and lab procedures -preliminary impression -preliminary cast -custom tray -final impression -master castrecording of mx/md relationship-clients bite -improper relationship -construct baseplate and wax rims -wax rims used for -clients bite recorded -casts mounted on articulator -denture teeth set in wax -denture setup -wax try-inimproper relationship results in-overworked muscles of mastication -poor phonetics -unsatisfactory estheticsconstruct baseplate and wax rims-acrylic resin & wax -rest precisely on clients ridgewax rims used to determine-midline -plane of occlusion -size of denture teethclients bite recordedused to position upper and lower castscast mounted on articulatorplaster used to mount to articulatordenture setup-simulates proper bite -vertical dimension -overall estheticswax try-in-allows client to see arrangement of teeth -allows dentist to check function, occlusion, and phoneticsprocessing the denture-embed master cast and setup in denture flask -flask-filled w/ gypsum material -create split mold -acrylic resin placed in mold space -closed mold heated in water bath to activate resin -denture removed from mold, finished, polished, disinfected, and deliveredcreating split mold-teeth embedded in gypsum -wax and baseplate removed -master cast embedded in gypsumpartial dentures are*removable* supported by natural teeth and alveolar ridgepartial dentures have better results than _____mandibular complete denture -lack suction or retention and will "float" -floating causes sore spots and makes speech difficultframeworkcast metal -*clasps*: encircle abutment teeth (bendable - may need tightened overtime) -*connectors*: connect clasps and frameworks -*mesh framework*: creates mechanical retention resin -Valplast -More flexible -No metaldenture basemesh framework embedded in resinteethchosen based on size, shape, and colorprocessingsame as complete denture -acrylic resin must flow through and around meshrelining a denture-dentures loose fit over time -alveolar ridge atrophies and resorbs -adding a small amount of new material to inside tissue area of denture replaces additional loss in alveolar ridge -can be completed chairside or labuse of adhesive/liners for poorly fitting denture-makes cleaning difficult -foul smell -long-term use may cause tissue inflammation -may change bite or occlusion -> traumalaboratory reline-use existing denture to capture impression -denture and impression sent to lab -cast created, separated, impression removed from denture -new acrylic material added to fill space -superior to chairside relinechairside reline-material to make impression functions as added material -sets in clients mouth, then removed -excess trimmed, polished -returned to client during same appointment -new material more porous, not as smoothimmediate dentures-denture placed at same appt as extractions -initial appt: captures impressions -delivery appt: extractions & dentures -relined after complete healingrepairing acrylic prostheses-fractures commonly occur -repaired by added additional acrylic material as glue -clean surface: may grind away thin layer -apply monomer: dissolved set material -apply new material: allow to set -finish and polish: acrylic burs, pumice, etc.client care and maintenance-regularly clean w/ denture brush/cleaner -remove when sleeping and store in waterdental hygienist role in maintenance of acrylic prosthesis-remove plaque/calculus at recall appointment -store in water during appointment

DTHY 361: MIDTERM

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