Dentistry Two-Stage Extractions

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Questions and Answers

What is a critical reason for conducting staging with mounted casts?

To facilitate the positioning of the occlusal plane. (correct)

To maintain the aesthetics during the procedure.

To allow for extraction of more teeth at once.

To ensure accurate impressions are taken.

Which teeth are included in Stage 2 of the preliminary treatment plan?

#5 and #28

#22 and #27 only

#2, 5, 15, 18

#6, 11, 12, 21-28 (correct)

What is emphasized as critical in preliminary impressions for IU/IPL?

Capturing the patient's bite accurately.

Ensuring a smooth surface on the tray.

Incorporating the retromolar pads. (correct)

Using a digital scanning method.

When designing a custom tray, what needs to be captured apart from teeth?

Soft tissue landmarks including retromolar pads. Signup and view all the answers

Which feature is crucial in the design of a provisional or transitional restoration?

The location and type of wire rests. Signup and view all the answers

What is essential to consider when pre-fitting the definitive prosthesis for an immediate or interim procedure?

It should be checked for intaglio and borders only. Signup and view all the answers

Which item should not be utilized for adjusting occlusal contact on a pre-fitted partial denture?

Pressure Indicating Paste Signup and view all the answers

What could hinder a partial denture's seating after processing?

Inconsistent acrylic in undercuts Signup and view all the answers

Which is a factor to avoid when planning for tooth extraction staging?

Inserting mandibular cast partial denture immediately Signup and view all the answers

When designing a custom tray, what must be ensured about the acrylic material?

It must encourage accurate impressions. Signup and view all the answers

What should be the primary consideration for provisional design in denture fabrication?

The ability to adjust occlusal contacts readily. Signup and view all the answers

Why is it important to grind judiciously during denture adjustments?

To prevent over-adjusting and compromising fit. Signup and view all the answers

Which aspect should be monitored for the partial denture to fit properly post-processing?

Any acrylic in areas inconsistent with path of insertion. Signup and view all the answers

What is the minimum healing time required before fabricating a delayed interim denture?

6 weeks Signup and view all the answers

In which scenario is staging extractions deemed necessary?

When the patient cannot undergo two-stage surgery due to medical complications Signup and view all the answers

How long should typical healing be allowed before a definitive reline, rebase, or remake?

6-8 months Signup and view all the answers

What is the first step in the two-stage extraction process?

Extracting posteriors while leaving one posterior stop Signup and view all the answers

Which option correctly outlines the necessary adjustment time for tissue conditioners and soft liners?

24hr, 48hr, 72hr, weekly, monthly Signup and view all the answers

What is a critical aspect of the treatment workflow after posterior extractions?

To set up and finalize the immediate denture after initial healing Signup and view all the answers

What should be done with the remaining dentition in Stage 2 of the extraction process?

Extract remaining dentition when dentures are insertion-ready Signup and view all the answers

Which document(s) must be completed prior to initiating treatment planning for immediates and interims?

Yellow Card and Consent Signup and view all the answers

What is a common condition before fabricating a prosthesis after extractions?

Allow time for adjustments and tissue conditions changes Signup and view all the answers

When determining the preliminary treatment plan, what stages are typically addressed?

Stages 1 and 2 of extractions with specific teeth identified Signup and view all the answers

Study Notes

Stages of Extractions

Staging extractions are necessary in most cases
Two-stage extractions are the treatment of choice
- Stage 1: Extract posteriors - leaving one posterior stop
  - Save a posterior stop to have a reproducible occlusal reference
  - Posterior stop also helps maintain vertical dimension of occlusion (VDO)
- Stage 2: When the denture is ready, the remaining dentition is extracted followed by denture insertion
Full mouth extractions are recommended for medically compromised patients who cannot undergo two-stage surgery
- In this case, the patient will have full mouth extractions without denture insertion and will be placed on a delayed interim/immediate denture

Treatment Workflow

The treatment of choice is a two-stage extraction
Save one posterior stop to act as a reference for bite registration
Perform tooth setup and try-in based on the model
Remove anterior teeth before setup and try-in
Finalize immediate denture setup and wax up

Preliminary Treatment Plans

Case #1
- Stage 1: Extractions of #5, 17, 28-32
- Stage 2: Extractions of # 6-11, 13, 20, 21, 23-26
Case #2
- Stage 1: Extractions of #2, 5, 15, 18-20, 28, 29-31
- Stage 2: Extractions of #6, 11, 12, 21-28

Delayed Interims

Average healing time before definitive reline, rebase or remake: 6-8 months
Minimum healing time before a "delayed immediate/interim" denture: 6 weeks

Pre-Fit Instructions

Pre-fitting the definitive prosthesis before the first stage extractions can save time
Pre-fit intaglio surfaces and borders first to save time
Occlusion can be addressed after insertion

Fitting the Prosthesis

If the prosthesis does not fully seat after processing, potential errors include acrylic covering clasp arms, acrylic covering guide planes, acrylic covering undercuts, or inconsistent acrylic in other locations.

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Description

This quiz covers the two-stage extraction process in dentistry, highlighting the importance of staging extractions for optimal outcomes. You'll learn about the workflows involved, including the setup for immediate dentures and considerations for medically compromised patients. Test your knowledge of best practices in dental extractions and denture insertion.