Endodontics Lecture by Dr. Alborz Endo

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Questions and Answers

What is a critical step to confirm when seating a partial denture?

  • Aligning the denture with the midline before adjustment
  • Ensuring proper color matching with adjacent teeth
  • Checking for gaps in the intaglio and rocking during biting (correct)
  • Confirming the weight of the denture is balanced

Which material is commonly associated with flexible base partials?

  • Polycarbonate
  • Metal alloy
  • Thermoplastic nylon (correct)
  • Acrylic resin

What is an advantage of using flexible partial dentures?

  • They are typically less expensive than traditional dentures
  • They are less likely to irritate oral tissues due to their soft nature (correct)
  • They are easier to adjust and modify than rigid dentures
  • They offer more rigidity than conventional acrylic dentures

What is an important consideration for the care of partial dentures?

<p>They should be removed after eating and cleaned to prevent debris accumulation (B)</p> Signup and view all the answers

What is typically necessary after an adjustment of a partial denture?

<p>A recall appointment to check on irritating spots (C)</p> Signup and view all the answers

What is a primary treatment goal for fabricating interim partial dentures?

<p>Reducing overall treatment time and cost (D)</p> Signup and view all the answers

Which aspect of interim partial dentures is typically compromised due to their design?

<p>Stability and support (A)</p> Signup and view all the answers

When should occlusal adjustments be particularly focused on during the use of interim partial dentures?

<p>When the partial is tooth-borne (B)</p> Signup and view all the answers

Why are wrought wire clasps preferred for interim partial dentures?

<p>They can pass over contour heights more easily (B)</p> Signup and view all the answers

What is a common application for interim partial dentures?

<p>Providing aesthetics during healing after extraction (D)</p> Signup and view all the answers

What is a significant disadvantage of using resin-based interim partials?

<p>Poor durability and function (D)</p> Signup and view all the answers

How can interim partial dentures affect adjacent teeth if worn for extended periods?

<p>They may jeopardize the integrity of adjacent teeth (A)</p> Signup and view all the answers

What is a key consideration when designing interim partial dentures?

<p>A minimal amount of intraoral preparation (D)</p> Signup and view all the answers

Which of the following is NOT a primary reason for the fabrication of interim partial dentures?

<p>To establish permanent occlusal relationships (B)</p> Signup and view all the answers

What method is recommended for taking impressions for interim partial dentures?

<p>Using alginate and stock plastic trays (B)</p> Signup and view all the answers

What should patients be informed about the primary function of interim partial dentures?

<p>They serve more for aesthetics than function (D)</p> Signup and view all the answers

Which of the following describes a limitation of flexible base materials used for partial dentures?

<p>They may wear out or lose retention over time (D)</p> Signup and view all the answers

What is one of the most common reasons patients request interim partial dentures?

<p>To maintain aesthetic appearance (A)</p> Signup and view all the answers

What is a potential downside of flexible base partials?

<p>Chromatic instability (B)</p> Signup and view all the answers

What is the main purpose of relines and rebases?

<p>To extend the functional life of a denture (A)</p> Signup and view all the answers

What procedure involves resurfacing only the tissue side of a denture?

<p>Reline (A)</p> Signup and view all the answers

Which factor might contribute to the looseness of a denture over time?

<p>Fit imbalances or changes in tissue (A)</p> Signup and view all the answers

What distinguishes a rebase from a reline?

<p>Rebase involves replacing the entire denture base material. (B)</p> Signup and view all the answers

Which condition is an indicator that a denture may require a reline or rebase?

<p>Excessive movement and rocking during function (A)</p> Signup and view all the answers

Which of the following statements about ridge resorption is accurate?

<p>Ridge resorption patterns vary significantly by patient. (D)</p> Signup and view all the answers

What observation might indicate overextended flanges on a denture?

<p>Evident inflammation and soreness (C)</p> Signup and view all the answers

In what way can occlusal adjustments benefit a patient with dentures?

<p>They can alleviate discomfort and improve function. (A)</p> Signup and view all the answers

What is one main reason a dentist might decide against reline or rebase procedures?

<p>Insufficient clinical evidence of changing tissue. (B)</p> Signup and view all the answers

Which factor contributes to potential complications during function for denture wearers?

<p>Changes in ridge anatomy and fitting (A)</p> Signup and view all the answers

What might be a visible sign of loss of occlusal vertical dimension in denture patients?

<p>Angular cheilitis (D)</p> Signup and view all the answers

What type of partial denture design is noted for its ability to provide a lighter, more flexible fit?

<p>Flexible base partials (B)</p> Signup and view all the answers

What is a key diagnostic factor in assessing denture stability over time?

<p>Length of time since denture delivery (C)</p> Signup and view all the answers

Flashcards

Partial denture adjustment

Adjusting a partial denture to ensure proper fit, seating, and occlusion.

Partial denture delivery

Process of delivering a partial denture to the patient, including checking for fit and adjusting as needed.

Occlusal adjustments

Adjustments to the partial denture's biting surfaces for proper occlusion with the natural teeth.

Flexible base partial

A type of partial denture made with a flexible base material.

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Partial denture recall

A follow-up appointment to check for adjustments and address patient concerns after receiving a partial denture.

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Denture Reline

Resurfacing the tissue side of a denture with new base material to adapt to changes in the denture-supporting area.

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Denture Rebase

Replacing the entire denture base material with a new material in an existing denture.

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Denture Maintenance

Procedures to extend the lifespan of a denture by updating the prosthesis to reflect tissue and material changes.

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Denture Stability Check

Clinically examining denture movement and stability on each dental arch by light pressure application.

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Maxillary Ridge Resorption

Maxillary ridge resorption leads to an upward and backward movement of the denture, potentially causing anterior vestibule pain.

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Mandibular Ridge Resorption

Mandibular ridge resorption leads to a downward and forward movement of the denture.

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Occlusal Vertical Dimension (OVD) Loss

Loss of OVD, indicated by angular chelitis, heavy occlusal wear, and potential Class III relationship.

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Immediate Denture

Denture placed immediately after tooth removal; rapid tissue changes expected.

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Conventional Denture

Denture placed after a period of healing; less rapid tissue changes anticipated.

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Tissue Hyperplasia

Excessive growth of soft tissue, often seen in areas with ill-fitting dentures that have been worn for a long time.

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Tissue Adaptation

Checking denture fit evaluation by assessing pressure and border movement

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Treatment Rationale

Understanding the rationale and approach to choose the right treatment (reline, rebase, etc), based on patient's situation.

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Chromatic Instability

The tendency for a material to change color, specifically in flexible partial denture designs.

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Clasp Resiliency

The ability of a clasp to maintain its shape and strength when subjected to force.

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Denture Fit Imbalance

Problems with denture fit, causing looseness, soreness, or difficulty chewing.

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Interim Partial Denture

A temporary removable denture used to replace missing teeth while a permanent solution is being planned or fabricated.

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Why Immediate Interim Partial?

It is delivered at the time of tooth extraction, allowing the patient to have teeth immediately even though the tissue is still healing.

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Why Not Reline Interim Partials?

They are usually made of resin and wrought wire clasps, which are not designed for long-term use. Relining would improve fit but not enhance durability.

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Interim Partial Goals

To achieve treatment outcomes quickly and cheaply, while maintaining space, improving occlusion, conditioning tissues, and acclimating the patient to a removable prosthesis.

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Interim Partial vs. Complete Denture

Interim partials are rarely relined and converted to definitive prostheses because they lack the durability and longevity compared to complete dentures.

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Interim Partial: Aesthetics

A common reason for patients to request interim partials, as they are designed to look better than a gap in their smile.

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Interim Partial: Space Maintenance

Helps prevent teeth from shifting or erupting while waiting for a permanent solution, especially important before implant placement.

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Interim Partial: Occlusion

While it can re-establish occlusal relationship, it is primarily achieved with fixed prostheses as interim partials offer limited stability for occlusal adjustments.

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Interim Partial: Tissue Conditioning

Wearing an interim partial allows the residual ridge to adapt to the load of a denture, preparing it for a future distal extension RPD.

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Interim Partial: Patient Conditioning

Helps the patient get used to the feeling, function, and care of removable prostheses before a permanent solution.

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Interim Partial: Pros

Cost-effective, easy to design and fabricate, minimal preparation needed, quick turnaround, and acceptable aesthetics are some advantages.

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Interim Partial: Cons

Poor function due to flexible clasps, low durability, and the clasps are not aesthetically pleasing are some disadvantages.

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Interim Partial: Bottom Line

These are primarily for aesthetics while a more permanent solution is being planned. They are temporary solutions and should not be considered permanent restorations.

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Interim Partial Impressions

Alginate and stock plastic trays are typically sufficient.

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Interim Partial Design

Can be done on a design cast or lab script. Wrought wire clasps are commonly used for retention, and the base design maximizes tissue coverage.

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Study Notes

Dr. Alborz Endo Lecture

  • Steps in endodontic procedure:
    • Patient assessment (PA and bwx)
    • CBCT if indicated
    • Rubber dam isolation
    • Caries control/gingivectomy (as needed)
    • Determine restorability and build-up
    • Canal preparation
    • Shaping, cleaning, and obturation
    • Post-operative instructions (RX: 600mg ibuprofen q6h prn pain. ABX only if swollen, typically first 72 hours)

Pulpal Diagnosis

  • Normal pulp
  • Reversible pulpitis (sharp cold response resolving immediately)
  • Irreversible pulpitis (two types):
    • Symptomatic (sharp cold response with dull/throbbing ache lingering beyond 3-5 seconds)
    • Asymptomatic (normal cold response after pulpal exposure)
  • Necrotic pulp (no response to cold)
  • Previously treated pulpits (pulpotomy or pulpectomy)

Periradicular Diagnosis

  • Normal periradicular tissue
  • Symptomatic periradicular periodontitis (tenderness to percussion)
  • Asymptomatic periradicular periodontitis (normal to percussion)
  • Acute periradicular abscess (clinical swelling, with or without drainage)
  • Chronic periradicular abscess (clinical swelling, with or without drainage)

TTX-Resistant

  • Tetrodotoxin resistant Na channels (a form of Na channels resistant to local anesthetic)
  • Up-regulation during inflammation

Hygienic Rubber Dam

  • Used as a barrier during endo procedures

  • Latex and non-latex options available

  • Dental dam clamps (color-coded)

  • Wedjets (latex and non-latex)

  • Why bwx?

    • Extent of caries
    • Height of pulp chamber

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