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What is the selective pressure technique?
combo of extension for maximum coverage within tissue tolerance (light pressure or intimate contact with moveable loosely attached tissues in vestibules. Refined w/ minimum of pressure using light body.
Maxillary tray requirements
- 2-3 mm periphery
- rounded edges
- rest of tray 1-2mm
- 10mm long x 15 mm wide handle stright down from ridge
What area of maxillary is not recorded at rest?
posterior palatal seal area
How do you adjust tray to posterior palatal seal area?
- 1. mark middle of vibrating line
- 2. ID hamular nothch
- 3. extend 2-3 mm beyond line
tray compound melting temp?
Preferred impression material?
- free flowing, light body, polysulfide
- 8-10 minute polymerization time
- pour within 1 hour
Good impression factors
- 1. smooth well defined peripheries
- 2. max extension
- 3. even pressure
- 4. initmate tissue contact
How do you record highly mobile hypertrophic tissue with minimum displacement?
- window tray impression technique
- usually with pts w/ combination syndromedo not remove because ridge is usually knife edged-> tissues cushion and rarely impinge on interocclusal space
- window tray technique:
- 1. outline mobile tissue on cast
- 2. custom tray has window over mobile area
- 3. handle middle of palate
- 4. border mold/polysulfide as usual
Mobile tissue recorded with Zn Oxide material Krex
What material is used to record highly mobile tissue?
window tray technique using Zn Oxide (Krex) over mobile tissues
Lab tasks for 3rd clinical appointment
- 1. box impressions
- 2. pour master casts in stone
- 3. trim, index mark master cast
- 4. make record bases with occlusion rims
Master cast features
- 1. 4-6mm land
- 2. 2-3mm depth of peripheral roll
- 3. base 15-20mm thick
- 4. trim, mark
- 5. notch for future remount
What are the primary support areas of mandible? why?
- buccal shelf: parallel to occlusal plane and dense bone that is relatively resistant to resorption
- retromolar pad: constant, unchanging, doesn't resorb from denture use. Contains glandular tissue, lower margin of pterygomandibular raphe, fibers of buccinator, superior constrictor and temporalis tendon
what determines length of lingual flange of mandibular denture?
- mylohyoid: muscular floor of mouth
- extending onto retromylohyoid space improves dentrue stability and retention.
- Philosophical: rational, sensible, realistic expectations
- Exacting: methodical, precise, severe demands (reach understanding before starting)
- indifferent: apathetic, uninterested, uncooperative, doesn't follow instructions (poor prognosis)
- hysterical: emotionally unstable, excitable, apprehensive (may requre psychiatric help)
What is the chewing efficiency of dentures compared to complete dentition?
1/4 to 1/6th
maxillary resorption patterns
- buccal-labial toward lingual
- affects stability mostly
denture oral lesions
- epulis fissuratum: inflammatory fibrous hyperplasia-> surgery, shorten flange
- inflammatory papillary hyperplasia: usually complicated by candidiasis
Therapy of palatal papillary hyperplasia with candidiasis
- nystatin powder: undersurface of denture (3-4 weeks)
- nystatin cream: corners of mouth
- reline denture
- remake denture
- Surgical excision w/ electrosurgery
- *nystatin rinse ineffective, supposotories or lozenge if extend beyond dentures
- ** not premalignant
What is the tissue conditioning material?
- 1. shorten borders
- 2. remove resin from bearing surface
- 3. mix and apply smooth layer
- 4. immerse in water bath before reinsertion
- 5. verify VDO, midline
- 6. 10 minutes revaluate and trim excess
How are gross occlusal discrepancies adjusted?
tooth colored resin (acrylic) reestablish CR
What are the factors affecting prognosis?
- 1. bearing surface anatomy
- 2. tongue position
- 3. FOM posture
- 4. denture history
- 5. psychosocial classification
- leave out for 6-8 hours a day
- brush gums, tongue, palate 1x day
- unwaxed floss
- clean over towel or water to prevent fracture
- soak 2x week: 2 tsp calgon, 1 tsp bleach, 1 cup H2O
- soak when not using