Denture Placement Techniques Quiz

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Questions and Answers

What is the primary action the patient is performing to simulate tissue compression?

Sucking on the denture

Removing the denture

Biting forcefully (correct)

Gently tapping the denture

For how long does the patient perform the biting action?

30 seconds

One minute (correct)

Two minutes

Five minutes

What is the significance of the biting action in relation to denture wear?

It enhances the fit of the denture

It relaxes the jaw muscles

It increases the patient’s swallowing capability

It provides feedback on denture comfort (correct)

What might be indicated if a patient frequently bites forcefully after wearing a denture?

The denture is fitting incorrectly Signup and view all the answers

What does the act of compressing tissue simulate when wearing a denture?

Natural chewing pressure Signup and view all the answers

What is the primary consideration when seating a denture?

Ensuring uniform contact with minimal streaks Signup and view all the answers

What should be checked after seating the denture?

Peripheral overextensions Signup and view all the answers

What is the purpose of border molding during denture placement?

To ensure flanges adequately fill the vestibule Signup and view all the answers

What is the purpose of positioning the dentures and trimmed CR compound record together before reinsertion?

To verify the accuracy of the record intraorally. Signup and view all the answers

When manipulating the denture, how should the flanges behave?

They should remain stable and not be dislodged Signup and view all the answers

The mounting of the mandibular cast is based on which of the following?

The interocclusal relation that was recorded. Signup and view all the answers

Which of the following is NOT a sign of a properly seated denture?

Presence of streaks Signup and view all the answers

Which step is performed after positioning the dentures and the CR compound?

Rechecking the accuracy of the record intraorally. Signup and view all the answers

What does the abbreviation 'CR' in CR compound stand for?

Centric Record. Signup and view all the answers

Why is it important to verify the accuracy of the record intraorally before advancing?

To ensure the accuracy of the mandibular cast mounting. Signup and view all the answers

What should be added to Dazzle Paste to prepare it for use?

Water and liquid soap Signup and view all the answers

What is a recommended tool for applying Dazzle Paste in the lab?

Dampened felt cloth wheel Signup and view all the answers

Which of the following is a step in post insertion care for new dentures?

Mastication and speaking with the new dentures Signup and view all the answers

What is crucial for maintaining oral hygiene with dentures?

Following oral and denture hygiene instructions Signup and view all the answers

What is NOT a recommended practice for denture care?

Soaking dentures in vinegar overnight Signup and view all the answers

What is a consequence of excessive Occlusal Vertical Dimension (OVD)?

Generalized muscle soreness Signup and view all the answers

What is a symptom associated with insufficient Occlusal Vertical Dimension (OVD)?

Lack of muscle force to bite Signup and view all the answers

When might someone experience continual muscle soreness related to OVD?

When OVD is excessive Signup and view all the answers

What overall effect does an excessive Occlusal Vertical Dimension have on a person’s physical condition?

Chronic fatigue and discomfort Signup and view all the answers

What is the likely outcome if OVD is insufficient?

Lower effectiveness in biting Signup and view all the answers

What thickness of articulating paper is recommended for selective grinding?

80 microns Signup and view all the answers

What is the purpose of starting with a thicker articulating paper during selective grinding?

To help visualize initial contact points better Signup and view all the answers

Which of the following statements is true regarding the use of articulating paper in selective grinding?

Articulating paper thickness can vary during the grinding process. Signup and view all the answers

Why might a dentist choose to finish with a thinner articulating paper?

It provides a more precise occlusal contact point assessment. Signup and view all the answers

What might be a disadvantage of using a thicker articulating paper for selective grinding?

It may obscure subtle contacts. Signup and view all the answers

Study Notes

Prosthodontics - Sheet #14

Denture Insertion Procedure:
- Final denture is delivered in a sealed plastic bag with tap water after lab procedures.
- Denture evaluation should occur: outside the patient's mouth, inside the patient's mouth, for occlusion, and instruction to the patient.
- Prior to insertion, the patient should remove their old denture for 12-24 hours.
- Common error sources in complete dentures include: dentist errors, laboratory errors, material deficiencies, and biological factors.

Prior to Appointment

Extraoral Examination:
- Inspect for sharp areas on the denture using gauze.
- Smooth out any sharp edges or angles using appropriate techniques.
- Blend angular changes on the denture's periphery.
- Inspect the posterior border. Ensure a gradual tapering of the posterior border to the soft palate (2-3 mm thick).

Order of Adjustments

Check and Adjust:
- Evaluate base fit using pressure-indicating paste (PIP).
- Check peripheries with PIP (one side at a time).
- Check occlusion using articulating paper.
- Clinically remount if necessary.
- Account for esthetics and phonetics, patient concerns.

Insert Maxillary Denture First

Adaptation Check:
- Evaluate the denture's comfort and resistance to seating. Identifying potential adjustment areas.
- Use pressure-indicating paste (PIP) to check for proper adaptation of the denture base.

Clinical Remount (if necessary)

Indications: Not always required. Usually with gross errors and non-cooperative patients, but otherwise done chair-side.
Procedure: Dentures are remounted on an articulator to allow adjustments, avoid complications associated with removal/replacement in the patient's mouth.

Remounting Maxillary Dentures

Procedure: Carefully place a remount jig, seat the remount index on the jig, seat the maxillary denture in the index, and mount the cast into the denture using plaster.

Record Centric Relation

Procedure: Record the relationship between upper and lower dentures using a small amount of bite registration material. Ensure precise and repeatable recording, with no penetration of material. Soften modelling compound in a water bath (110°F).
Placement into water bath Mandibular denture placed in water bath for 10 seconds, then place the lower denture intraorally, and guide the patient into centric relation just short of tooth contact. Once complete, remove the CR record.

Maintaining Accuracy and Appearance

Trimming: Trim excess material, carefully and precisely, only removing cusp tip indentations
Visually Checking: Visually verify the accuracy of the seating of the dentures.

Mounting Mandibular Cast

Procedure: Mount the mandibular cast based on the interocclusal relation recorded. Interdigitate the dentures and stabilize them with sticky wax.

Selective Grinding

Procedure: Use articulating paper, progressively thinner, to ensure smooth, simultaneous, bilateral centric contacts, on posterior and anterior teeth.

Balanced Occlusion

Ensure balanced contacts are present during all movement.
Intensity: Ensure that contacts are not heavier than the working contacts.
Grazing: The contacts of anterior teeth are light grazing (minimal).
Vertical Dimension: Verify vertical dimension (2-4 mm interocclusal distance).

Phonetics

Checking Sounds: Check 'F' and 'S' sounds for proper phonetics.

Polish Adjusted Areas

Use Brasseler Acrylic Polishing compound and Dazzle Paste to ensure the denture is clean, smooth and non-discolored.

Provide Care Instructions (Post Insertion Instructions)

Instructions: Include instructions on mastication and speaking, as well as oral and denture hygiene.

Summary - Denture Base

Retentive: The base should be retentive, non-displaceable under moderate vertical pressure.
Extension: Flange extension should be appropriate (medium extension, no areas of significant impingement).
No spicules/sharpness: No spicules, smooth and well-polished.
Thickness: Proper flange thickness (generally not > 4-5 mm, rolled, not sharp).
Frenula: Proper relief for frenula.
Landmarks: Base should terminate at anatomical landmarks.
Patient Comfort: Ensure that the patient is comfortable.

Summary - Occlusion

Contacting Posterior Teeth: Posterior teeth contacting bilaterally/simultaneously, no shifting.
Contact in Eccentric Positions: Acceptable degree of balance evident in centric, eccentric positions.
Interocclusal Space: Acceptable interocclusal space.
Anterior Tooth Contact: Anterior teeth should not be in contact in centric occlusion.
Grazing Contact in Protrusion: Grazing contact in protrusion.
Esthetics & Phonetics: Acceptable phonetics and esthetics.

Post-Insertion Problems

Denture Base: Common issues include impingements, spicules, sharp edges, soreness, and inflammation.
Occlusion: Problems include pain, difficulty in determining the cause, avoidance of certain movements, discomfort when biting.
Retention: Problems with retention include short flanges, altered lip-seal, difficulties in maintaining tissue contact or inadequate tissue contact.
Vertical Dimension: Vertical dimension problems may result in excessive pressure, fatigue, and muscle soreness, or insufficiency (difficulty in biting).
Occlusal Vertical Dimension: Excessive or insufficient occlusal vertical dimension leading to pain and difficulty biting.
Allergies and Infections: These can manifest as generalized inflammation.
Tooth Position: Instability or improper tooth position can lead to complications during chewing.

Most Common Areas Requiring Adjustments

Maxillary: Hamular notches, labial frenum, mid-line fulcrums, zygomatic impingement.
Mandibular: Lingual frenum, retromylohyoid overextension (sore throat, changes in posture), buccal shelf overextension, phonetic problems.

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Description

Test your knowledge on the essential techniques and considerations for denture placement. This quiz covers the actions, significance, and steps involved in seating and adjusting dentures for optimal patient comfort and function. Perfect for dental students and professionals alike.