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Flashcards REMOVEABLE PROSTHODONTICS
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Removeable Prosthodontics
by vladtepesdrac, Dec. 2012 Subjects: removeable
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REMOVEABLE PROSTHODONTICS
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What kind of clasps should be used in MOST tooth

borne cases?
CAST SUPRABULGE
What kind of an undercut is needed for CAST

clasps?
0.01
What kind of an undercut is needed for WROUGHT

WIRE?
0.02
When are CAST SUPRABULGE clasps

contraindicated?
- Esthetic concerns
- abutments are mobile
- posterior abutment is mobile or questionable
prognosis
What are the components of the RPI clasp?
- REST (always MESIAL)

- Proximal plate
- I-bar
How far from the gingival margin should the inferior

border of the I-bar be?
4mm
When there is insufficient vestibule depth or severe

tissue undercuts, what can be used instead of an
RPI?
-RPA (aker's)
What Kennedy
Classification is this?
Class I
What Kennedy Class is

this?
Class II

this?
Class III

this?
Class IV
What Direct Retainer

choice should be used
for a case like this?
CLASP OF CHOICE: Akers > Double Akers

If abutment is severely tilted:
- cast circumferential with lingual retention
- ring clasp with support strat
- rotational path RPD
What Direct Retainer

choice should be used
for a case like this?
CLASP OF CHOICE: RPI

If can't use RPI, use RPA
If can't use mesial rest, use Combination clasp
(distal rest, buccal ww retention, lingual bracing)
What is the MINIMUM number of direct retainers

for CLASS I and II?
What is the MAXIMUM number of Direct

Retainers?
What are some ways of planning more retention

and eliminating direct retainer for aesthetics?
2 posterior abutments
- soft tissue coverage

- longer guiding planes
FULCRUM LINES
What is the best way to prevent rotation about the

fulcrum line?
What are some examples of INDIRECT

RETAINERS?
Know dis
INDIRECT RETAINERS
- Auxiliary cingulum rests

- Auxiliary occlusal rest
- Continuous bar retainers and lingual plates
Which ACRYLIC RESIN FINISH LINE should be

placed FURTHEST from abutment teeth?
Internal finish line
Why should INTERNAL and EXTERNAL denture

base finish lines be offset?
Improves strenght at the

metal / denture base
junction
The external metal finish line should be located

how far from the replacement denture teeth?
2mm lingual to the

lingual surface of
denture teeth
What kind of joint should the acrylic resin base

make with the major and minor connectors?
Butt joint (or slightly undercut)

- NOT feather edge
What is the advantage of ACRYLIC RESIN BASE?
- ability to reline base as supporting tissue changes

- esthetically superior to metal
- ease of repair
What are the DISADV of acrylic base?
- dimensional stability less than metal

- lower strength
- porous
- low thermal conductivity
Why is THERMAL CONDUCTIVITY important?
What are some advantages of METAL base?
What is the minimum size of CINGULUM

REST/SEAT?
What are some considerations and possible

treatments when a patient presents with this
statement:
--------------------------I can't stop whistling.

statement:
----------------------My ear is aching.

statement:
--------------------------I can't swallow anything.
Thought to maintain tissue health by ensuring

patients do not swallow substances that are too
hot. Some patients feel improved thermal
perception lessens the feeling of the denture as a
foreign object
- thermal conductivity
- accuracy and permanence of form
- hygeine
- weight and bulk
1mm
- too much air escaping at midline

- treatment: adding papilla, moving centrals
palatally, thinning behind laterals and canines
- TMJ pain actually from increased vertical

- Premature occlusion
- Upper posterior seal too long or too thick

- increased vertical
- xerostomia
- overextended lower lingual flange (especially in
retromylohyoid zone)

statement:
--------------------------Food sticks under my dentures
- some is normal
- adaptation problems
- short borders
- unilateral tooth contact
- poor posterior seal
- unilateral premature occlusion

statement:
---------------------------
- Probably due to resorption or rebound of resilient

tissues
- TREATMENT: adjust with PIP to decrease film
Saliva gets under my top plate.

statement:
--------------------------I can't taste my food anymore.

statement:
--------------------------Everything tastes funny (or odd).

statement:
--------------------------My plates come out when I sneeze.

statement:
--------------------------When I drink my dentures fall out.

statement:
--------------------------Water drools out of the corners of my mouth.
thickness
- TREATMENT: flavour their food better

- atrophy of taste buds with age is normal
- lack of heat transfer to palate (consider metal
base)
- worry
- menopause
- nervous patient
- poor OH
- porous chairside liners
- metallic taste
- salty drainage of cyst
- hemorrhage
- teeth too far buccally

- over-extended hamular notch
- poor posterior extension or seal
- teach patient to cover mouth with hanky (polite /
less embarrassing)
- normal to loosen at first

- poor peripheral seal
- poor occlusion
- pregnancy has been indicated

- TREATMENT: if vertical is correct then add resin
on lower in modiolus area
- increase or decrease vertical
- afraid to swallow or spit
- poor neuromuscular control
- excessive salivation

statement:
--------------------------My plates are sharp and cut me.
- xerostomia
- sharp borders or bubbles
- elderly and debilitated (try soft liners)
- chipped teeth
- resorption causing epulis fissuratum

statement:
- Hardy's need sharpening

- closed vertical due to resorption
--------------------------My teeth are getting dull.
- lacks neuromuscular skill

- teeth worn

statement:
--------------------------I bite my cheeks and tongue with these damn
things.
- poor occlusion
- decreased vertical
- edge to edge horizontal set
- insufficient buccal corridor

statement:
--------------------------My wife (husband) and friends say I have bad
breath.
- poor hygeine
- not soaking at night
- systemic or oral disease

statement:
--------------------------My mouth is always dry.

statement:
--------------------------My teeth are noisy.
- cholera
- nephritis
- high fever diseases
- psychotic
- drugs
- age health
- severe home stresses
- xerostomia treated with sialogogue
- radiation
- Vit A deficiency
- diabetes
- loose prosthesis
- poor neuromuscular skill
- porcelain teeth used
- over extended flanges pushing dentures away
from seal

statement:
--------------------------These things gag me. I'm throwing up.
- long posterior seal

- poor seal or retention
- mental health problems
- insufficient pressure at post dam

statement:
--------------------------My lower lip tingles
- pressure on mental foramina

- TREATMENT: relieve base
- soft liner
- surgery

statement:
--------------------------My mouth burns all over.
- TREATMENT: large doses of vitamins or liver

extract
- soft liners
- poor hygeine
- true monomer allergy
- nerve pressure
- avitaminosis
- menopause
- endrocrine imbalance

statement:
--------------------------I can't chew on either side.
- normal habit
- poor retention
- poor occlusion
- 20 - 25 percent only, but patients expect more

statement:
--------------------------My teeth are staining and getting uglier.
- poor hygeine
- old forms of plastic teeth

statement:
--------------------------My friends say I look horrible.
- Class II
- poor selection / arrangement of teth

statement:
--------------------------While I smile, my uppers fall down.
- overextended labial flange

- reline needed

statement:
--------------------------My tongue won't move
- crowded
- fear of tripping denture
- undercut lingual flange

statement:
--------------------------These teeth don't meet together.
- decreased vertical
- poor occlusion

statement:
--------------------------I can't wear the bottoms (lowers).
- typical
- short lingual flange
- short of retromolar pad
- resorption
- poor occlusion

statement:
--------------------------I have to use powder to make them stick.
- resorption
- habit from previous experience
- incorrect extensions

statement:
--------------------------My nose and chin are coming together, corners of
mouth are folding down

statement:
--------------------------I can't see my front teeth anymore.

statement:
--------------------------Why didn't you make me a set as good as Mrs.
Jones?
- closed vertical originally

- resorption
- resorption
- fracture of teeth or wear of teeth
- Class II
- poor tooth selection
- poor patient education

statement:
--------------------------You didn't get rid of my wrinkles.
- Class II or III

statement:
--------------------------I'm not going to be able to wear these.
Class II

statement:
--------------------------I can't talk with these.
- poorly positioned teeth

statement:
--------------------------My jaws are tired.
- increased VDO
- poor masticating alignment
What are the most common preparation

procedures in the mouth for RPD Phase I?
What are some requirements for a master cast?
What are some common metal framework

problems?
What are some solutions/ considerations for:

RPD frame fits cast but not oral cavity?
- performing extractions
- modification of the existing occlusal scheme
- definitive periodontal therapy
- endodontics
- operative dentistry
- fixed prostho
- casts must be accurate

- neatly trimmed
- dense
- free of voids / blebs
- should be extended to include all of the area
available for denture retention and support
- maxillary casts should indicate a definite posterior
border for the appliance and display hamular
notches and entire tuberosity
- mandibular casts should include all of the
retromolar pads and retromylohyoid fossa
- base of maxillary casts should be 1/2 inch thick
- lingual area of mandibular casts should also be
1/2 inch thick
- Frame fits cast but not oral cavity

- frame pops up before a complete insertion is
completed
- teeter-totter of framework
- bent major connector
- broken cast-type clasp
- distorted master impression. remake case

- abutment teeth have drifted. place self-cure resin
blocks into mesh area for temporary occlusion and
have the patient wear the frame for several days.
hope for orthodontic-like positional movement
- too much retention. reduce height of contour on

Frame pops up before a complete insertion is
accomplished?

Teeter-totter of framework.

Bent major connector.

Broken cast -type clasp
What are some of the components of

PREVENTION that we should be considering
during case planning?
What distance from the FREE GINGIVAL MARGIN

should a LINGUAL BAR be?
teeth
- inflexible retentive clasps. thin and taper the clasp
toward the tip
- rigid parts of the framework ie major connector,
bracing clasp, or guide plate are in harsh
premature contact with teeth. Reduce frame
thickness and/or height of contour of teeth. Also,
check the cast for signs of abrasion and adjust the
framework accordingle
- locate the fulcrum point with rouge-chloroform

and reduce frame and/or tooth
- distal extensions only. expect slight posteriordownward rock on a distal extension frame.
Essentially, you are usually observing mucosal
compression under the soft tissue stop. If your
impression was accurate then resin saddle will not
allow this rocking after processing. If posterior
downward rock persists at delivery then consider a
reline. If the downward rock at framework-try in is
gross, make an altered cast impression
- section major connector at the bend

- replace each part into oral cavity properly and
make a full arch over impression
- pore stone cast and send to lab for a weld repair
- distorted master impression: remake case.
- place clasp part and framework correctly into the

mouth. Dura-lay parts together. Take a full arch
impression pulling the framework with it. Pour cast
and send it to the lab for weld
- consider the above except have the lab place a
retentive wrought clasp into the adjacent resin
base or weld the wrought clasp to the framework.
- proper design of the entire oral prosthesis

- massage of the remiaining mucosa
- proper diet
- recall for periodic checkups and treatment
- occlusal adjustments
- excellent oral hygeine for the prosthesis and the
oral cavity
- removing removeable appliances at least 6 hours
every day
- proper education of the patient
3.0 - 4.0 mm
should a LINGUAL BAR be?
What is the WIDTH of a lINGUAL BAR?
Where should the inferior border of a LINGUAL

PLATE be?
4mm
- as close to the floor of the mouth as possible

without interfering with normal movement
In an AP strap, how far from the free gingival

margin should the ANTERIOR strap be?
6.0 mm
- should not be placed
any further anterior than
the anterior rests
- anterior and posterior
straps should be
perpendicular to the
mid-palatine suture
What should be the WIDTH of the ANTERIOR

STRAP of an AP strap?
8-10 mm to prevent flex
What should be the WIDTH of the POSTERIOR

STRAP of an AP strap?
8-10mm
In an AP strap, what should be the width of the

LATERAL straps?
7-9mm
How big should the palatal opening of an AP

STRAP be?
What are SINGLE PALATAL STRAPS usually

designed for? What class of denture?
15mm or more in the A-P dimension
Kennedy Class III with or without modification

spaces
What is the minimum width of the SINGLE

PALATAL STRAP?
- 8 mm
- determined by
edentulous space
- posterior to rugae
- perpendicular to midpalatine suture
What is the most POSTERIOR extension of

Kennedy Class I or II lower RPD's?
Retromolar pad
beginning
- most distal strut will be
placed at the base of
the retromolar pad
How wide should the STRUTS be in lower RPD

base?
1.5 to 2.0mm wide
What should the buccal and lingual position of

MANDIBULAR STRUTS of denture base be?
3-4mm lingual / buccal

to crest of the ridge
How far BUCCAL should the denture base struts of

a maxillary RPD be?
What should be the width of minor connectors?
4-5mm buccal to crest of the ridge
1.5 - 2.0 mm
What should be the distance BETWEEN minor

connectors?
How wide should proximal plates be in Kennedy

Class I or II?
Where should the approach arm for I-bar arise

from?
How much tooth contact is needed on an I-Bar?
How much of an
undercut is needed for a
WROUGHT WIRE
CLASP?
IDENTIFY A and B:
Which part of a RETENTIVE ARM engages the

undercut?
What are some indications for an RPD?
at least 5.0 mm
4.0 mm buccal-lingually
1st horizontal strut
From terminus (tip at

the height of contour) to
0.01 mid-buccal
undercut is
approximately 2.0mm
0.02"
A: retentive arm
B: reciprocal arm
terminal 1/3 engages 0.01 undecut
- lengthy edentulous span

- no posterior abutment for fixed prosthesis
- excessive alveolar bone loss
- poor prognosis for complete denture due to
residual ridge morphology
- reduced periodontal support of remaining teeth
- cross-arch stabilization of teeth
- need for immediate replacement of extracted

teeth
- cost / patient desire considerations
1) tissue / tooth borne

2) tissue borne
3) tooth borne
What are the three types of RPDs?
- rigidity
- non-interference with soft tissues
- food impaction
- unobtrusive
What are the requirements of a MAJOR

CONNECTOR?
What is a brief treatment sequence for RPD

fabrication?
1) Preliminary impression, diagnostic casts

(mounted), design of RPD
2) tooth preparations, border molding RPD tray,
final RPD impression
3) border molding CD tray, final CD impression
4) adjust the rpd framework
5) altered cast impression
6) maxillomandibular relations
7) setting of CD and RPD teeth, wax try in
8) delivery, adjustment, continuing care
- Please wax + cast a mand. partial denture

framework:
I MAJOR CONNECTOR
- lingual plate with mesial rest on #21 and #29
II RESTS
- mesial #21
- mesial #28
- mesial #29
EXAMPLE OF WORK AUTHORIZATION:
III GUIDE PLANES

- 2-3 mm metal guide planes on distal of #21 and
#29
IV CLASP RETENTION
- #21 I bar engaging 0.015' mesial-buccal undercut
Polish and return for try in.
Thanks,
L.D.
NOTE: Case has been disinfected with NaOCl
Please set the teeth for a wax-try in:
I ANTERIOR
- midline marked
- set teeth to bite rims -> 3mm overjet + no overbite
(vertical overlap)
- plastic
EXAMPLE OF WORK AUTHORIZATION:
II POSTERIOR
- 33 M rational flat plane teeth
- set to 0' linear occlusion
- plastic
Thanks
L.D.
NOTE: Case has been disinfected with NaOCl
What are some questions that must be asked in

regards to RPD FRAMEWORK CONSTRUCTION
PRIOR to submitting cases to the laboratory
Page
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100
- Has the case been properly disinfected and

indicated on the prescription?
- Are casts free of imperfections?
- Is the case properly designed?
- are the instructions clear and complete for each
abutment as to clasps, rests, etc?
- is the type of major connector specified?
- is the case tripoded?
- is the jaw relation stable, accurate, and
reproducible?
- are the preparations for the rests , embrasures
sufficient as to allow fabrication of strong clasp
assembilies?
- is there sufficient interocclusal or interridge space
to allow for metal, acrylic, and artificial teeth?
- does your occlusal plane need modification by
extraction, occlusal adjustment, or overlay?
- do you have sufficient undercut for the clasp you
are using, or do you need to modify the abutment?
- is your master cast poured with die stone?
- are there any special instructions to include on
the prescription?
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Search over 166 million flashcards

Flashcards REMOVEABLE PROSTHODONTICS

CARD RANGE TO STUDY

How to study your flashcards.

Click or Press Spacebar to Begin

417 Cards in this Set

What kind of clasps should be used in MOST tooth

What kind of an undercut is needed for CAST

What kind of an undercut is needed for WROUGHT

When are CAST SUPRABULGE clasps

What are the components of the RPI clasp?

- REST (always MESIAL)

How far from the gingival margin should the inferior

When there is insufficient vestibule depth or severe

What Kennedy Class is

What Kennedy Class is

What Kennedy Class is

What Direct Retainer

CLASP OF CHOICE: Akers > Double Akers

What Direct Retainer

CLASP OF CHOICE: RPI

What is the MINIMUM number of direct retainers

What is the MAXIMUM number of Direct

What are some ways of planning more retention

- soft tissue coverage

What is the best way to prevent rotation about the

What are some examples of INDIRECT

- Auxiliary cingulum rests

Which ACRYLIC RESIN FINISH LINE should be

Internal finish line

Why should INTERNAL and EXTERNAL denture

Improves strenght at the

The external metal finish line should be located

2mm lingual to the

What kind of joint should the acrylic resin base

Butt joint (or slightly undercut)

What is the advantage of ACRYLIC RESIN BASE?

- ability to reline base as supporting tissue changes

What are the DISADV of acrylic base?

- dimensional stability less than metal

Why is THERMAL CONDUCTIVITY important?

What are some advantages of METAL base?

What is the minimum size of CINGULUM

What are some considerations and possible

What are some considerations and possible

What are some considerations and possible

Thought to maintain tissue health by ensuring

- too much air escaping at midline

- TMJ pain actually from increased vertical

- Upper posterior seal too long or too thick

What are some considerations and possible

What are some considerations and possible

- Probably due to resorption or rebound of resilient

Saliva gets under my top plate.

What are some considerations and possible

What are some considerations and possible

What are some considerations and possible

What are some considerations and possible

What are some considerations and possible

- TREATMENT: flavour their food better

- teeth too far buccally

- normal to loosen at first

- pregnancy has been indicated