dentures.txt

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emm64
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188638
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dentures.txt
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2012-12-10 23:12:58
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Dentures Practice final
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Dentures F2012 practice final
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  1. What is the Posterior palatal seal
    • Purpose: to enhance retention & maintain the peripheral seal of the maxillary denture base by compensating for:
    • 1. polymerization shrinkage
    • 2. minor denture base functional movements
  2. What histologic structures lie beneath the mucosa of this area in the patient (1 point)
    Glandular tissue
  3. 11. List the five factors comprising Hanau’s Quint (5 pts total — 1 Pt each)
    • 1. Condylar Guidance
    • 2. Incisal Guidance
    • 3. Occlusal Plane Inclination
    • 4. Compensating Curve
    • 5. Cuspal Inclination
  4. 12. Of the five factors in Hanau’s Quint, which two factors are under the greatest control of the dentist? (2 pts total — 1 pt each)
    • 1. Cuspal inclination
    • 2. Compensating Curve
  5. 13. List two factors in Hanau’s Quint that cannot be easily altered by the dentist and why they cannot be easily altered by the dentist (6 pts total — 1 Pt for each factor and 2pts for each reason.)
    • 1. Patients presents you with Condylar Inclination
    • 2. Occlusal Plane cannot be altered substantially since functional requirements dictate position
    • Within the confines of esthetics and phonetics, minimize Incisal Guidance in Complete Dentures to minimize inclined tipping forces
  6. 14. List three of the five primary impression objectives according to your textbook (page 227) (3 pts total — 1 Pt each)
    • 1. Preservation
    • 2. Support
    • 3. Stability
    • 4. Esthetics
    • 5. Retention
  7. 15. Define the following terms stability, retention, support(6 pts total — 2 pts each)
    • Stability: Resistance to laterally oriented dislodgment forces
    • Retention: Resistance to dislodgment forces in a vertical direction away from the bearing surface
    • Achieved by proper contouring of polished surface to enhance neuromuscular control
    • Achieved by establishing intimate adaptation of tissue surface of denture to bearing tissues to maximized
    • adhesion and cohesion effects
    • Achieved by establishing a peripheral seal to maximize the effect of atmospheric pressure, or ―suction‖ to
    • help oppose dislodgment forces away from bearing surfaces
    • Support: Factors of the bearing surface which resist forces in a vertical direction towards the bearing surface
  8. Occlusal plane:
    imaginary surface which touches the incisal edges of incisors and the cusp tips of the occluding surfaces of the posterior teeth
  9. Vertical Dimension of Occlusion:
    vertical separation of jaws when teeth are in occlusion (alternative: length of face when teeth are in contact & the mandible or the teeth are in centric relation)
  10. Balanced Occlusion:
    generally refers to the stable simultaneous contact of opposing upper and lower teeth in centric relation position and a smooth bilateral gliding contact to any eccentric position within the normal range of mandibular function
  11. Vertical Dimension of Rest (VDR)
    vertical separation of jaws when the opening & closing muscles of the mandible are at rest in tonic contraction (alternative: length of face when the mandible is in rest position).
  12. Interocclusal distance of Freeway space
    distance between the occluding surfaces of the max & mandibular teeth when the mandible is in its physiological rest position
  13. Centric Jaw Relation (CR)
    relation of the mandible to the maxillae when the condyles are in their most anterior/superior position in the glenoid fossa from which unstrained lateral movements can be made. CR learnable, repeatable, recordable.
  14. 17. According to your handout and lecture, what are three reasons centric relation position is utilized to start construction of a stable denture occlusion? (3 pts total — 1 Pt each)
    • 1. CR is learnable
    • 2. CR is repeatable
    • 3. CR is recordable
    • 4. CR is an unstrained position
  15. 18. Once the proper incisal pin position is determined and set, why must incisal pin to incisal guide table contact be maintained throughout denture fabrication procedures? (2 pts total)
    To maintain the VDO
  16. 19. Name 5 anatomic landmarks useful in developing occlusal plane position and inclination (5 pts total — 1 Pt each)
    • 1. Retromolar pads
    • 2. Modiolus
    • 3. Tongue position as it related to occlusal plane ―e‖ and ―ah‖
    • 4. Neutral zone as it relates to position of cheeks and tongue in buccolingual direction
    • 5. Camper’s line, Fox plane, Ala/tragus line
    • 6. Commissure of lips
    • 7. Interpupillary line
  17. 20. What are the consequences of the following errors in posterior tooth and occlusal plane placement? (8 pts total — 2 pts each)
    • a. Too high: poor bolus control, inability to clear vestibule, & tipping of denture bases
    • b. Too low: inadequate tongue and cheek support, tongue biting
    • c. Too lingual: retraction of tongue, impede speech & tongue functions
    • d. Too buccal: tipping of denture bases
  18. 21. Name three categories of complete denture artificial tooth forms and an example (manufacturer’s name) of
    • each. (6 pts total — 1 Pt each)
    • a. Category: Anatomic—Pilkington Turner 30 Degree
    • b. Category: Semianatomic (functional)—Anatoline 10 Degree Posteriorsc. Category: Non-Anatomic (rational)—Monoline Zero Degree Posteriors
  19. 22. List three indications for the use of anatomic denture teeth. (3 pts total — 1 Pt each)
    • 1. well coordinated patient
    • 2. good residual ridges
    • 3. opposing natural dentition
    • 4. previously successful anatomic dentures
    • 5. lingualized occlusion
  20. 23. List five indications for the use of monoplane denture teeth. (5 pts total — 1 pt each)
    • 1. patients with poor residual ridges
    • 2. poor coordination—neuromuscular control critical prognosticating factor
    • 3. potential bruxers
    • 4. previous denture with monoplane teeth
    • 5. severely worn occlusion of previous dentures
    • 6. Class II or III or crossbite
    • 7. immediate dentures—easier adaptation (accommodation for post surgical swelling, resorption, etc), except
    • when opposing natural dentition
  21. 24. What is the purpose of placing balancing ramps? (2 pts total)
    • To make balanced occlusion possible with rational zero degree teeth. Balancing ramps are compensatory for the
    • Christiansen Phenomenon—the separation of the posterior teeth as the condyles translate down and forward
    • along the articular eminence
  22. 25. What determines the size of the occluding surface of the balancing ramps (how large must we make the balancing
    • ramps)? (2 pts total)
    • Must be large enough to provide adequate balancing contacts throughout the functional range of tooth contact
    • (usually anterior edge to edge contact in protrusive and lateral excursive movements - approximately 3-5 mm in
    • all directions)
  23. 26. List four disadvantages of porcelain denture teeth. (4 pts total — 1 Pt each)
    • Porcelain teeth (disadvantages)
    • 1. chip and fracture - brittle
    • 2. relies on mechanical retention for attachment
    • 3. difficulty in restoring surface polish after grinding
    • 4. may weaken denture since they do not bond to denture base chemically
    • 5. harder sound "click" in function
    • 6. can accumulate stain at gingival margin
    • 7. abrade opposing natural teeth and resin or metal restorations
  24. Porcelain teeth (advantages)
    • 1. resists abrasion
    • 2. maintains cutting edge
    • 3. less wear - maintains VDO
    • 4. polishing is facilitated
    • 5. inert in mouth - no dimensional changes
    • 6. natural appearance
    • 7. force and temperature distortion resistance
  25. Plastic teeth (advantages)
    • 1. useful with reduced space between residual ridges
    • 2. chemically bonds to denture base - increased fracture resistance
    • 3. useful opposing natural teeth and metal restorations
    • 4. shock absorber effect?
    • 5. ease of adjustment
    • 6. ease of restoration of surface polish
    • 7. break and chip resistant
    • 8. contact sound reduction
    • 9. insoluble in mouth fluids
  26. 27. What is the primary difference between the neutrocentric concept of occlusion and the monoplane occlusion which we developed in our laboratory exercise? (2 pts total)
    • Neutrocentric occlusion: non-balanced occlusion in excursionMonoplane occlusion: in occlusion, there are at least three stable contacts widely distributed around the arch—2
    • balancing ramps & simultaneous anterior contact in excursion
  27. 28. List two ways in which we attempt to decrease lateral destabilizing destructive resorptive forces in the UCLA monoplane occlusion setup. (4 pts total —2 pts each)
    • 1. Minimize vertical overlap within the dictates of esthetics and phonetics
    • 2. Keep occlusal plane horizontal to horizontal portion of residual ridge
  28. 29. According to your lecture material, what are perhaps the two most significant factor in a patient’s ability to successfully adapt to their complete dentures, particularly their mandibular complete denture? (4 pts total — 2 pts each)
    • 1. neuromuscular control may be the single most significant factor in the successful manipulation of complete
    • dentures under function
    • 2. tongue function and denture wearing experience
  29. 30. After careful examination and a complete radiographic survey you determine that your 60 year old female patient will require complete dentures. The residual ridges are large and well formed but there is very little inter-ridge space. The patient is not a bruxer and is a skeletal class III. The patient is well coordinated. The posterior teeth of choice would be:
    • (circle answer) (2 pts)
    • a. porcelain, rational
    • b. plastic, anatomic
    • c. porcelain, anatomic
    • d. plastic, rational
    • e. porcelain, functional
  30. plastic: useful for reduced space between residual ridges
    non-anatomic (rational): indicated for class II or III occlusion
  31. 31. A poorly coordinated skeletal class I patient presents to your office. He gives you a picture of himself taken prior to extraction of his teeth which reveals a 4mm vertical overlap of his anteriors. He wishes to look the same if possible. You would:
    • 1. use monoplane occlusion with balancing ramps to compensate for the overbite
    • 2. set anteriors according to phonetic and esthetics
    • 3. minimize horizontal overlap of the denture teeth
    • 4. decrease the vertical overlap as much as possible taking into account function and esthetics
    • 5. set the denture teeth exactly where the natural teeth were since this is what the patient wants and this is what
    • was natural anyway
    • (circle answer) (2 pts)
    • a. 1, 2, 4
    • b. 1, 2, 5
    • c. 2, 3, 4
    • d. 1, 5
    • e. 2, 4
    • A
  32. 32. Your fully balanced anatomic denture set up is missing the buccal centric contacts on the right side but have excellent lingual centric contacts. The Curve of Wilson on both the maxillary and mandibular teeth is reversed. To fix this setup, you should: (Circle the INCORRECT answer) (3 pts)
    • a. align all marginal ridges on the maxillary teeth
    • b. raise the buccal cusps of the mandibular teeth into contact
    • c. lower the buccal cusps of the maxillary teeth into contact
    • d. increase the Curve of Wilson of both maxillary and mandibular teeth
    • e. check to see that the mandibular teeth reside over the mandibular ridge
  33. C

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