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1.What is the most commonly used technique and materials for immediate denture impression?
- Rubber-base Material: 2 mm
- Border mold and finish with rubber base material
Custom tray reqs
- 2-3mm short of vestibules to allow proper border molding
- Cover the retromolar pads & tuberosities
- Provide extra clearance for any frenum
2. What is the alternative impression technique then? When do you need to use the alternative technique?
- Alginate & Stock Tray
- 3-4mm space
- Only when considerable tooth misalignment,
- gross bony undercuts or/and great teeth mobility are present
- 2-stage extraction
3. Describe the differences in making custom trays for rubber-base and alginate materials?
- wax spacer around teeth according to your selected impression material:
- Rubber-base Material: 2 mm
- Alginate: minimum 3-4 mm
4. What are precautions in making and handling master impression using the alginate material, instead of rubber-base material.
- necessity of border molding: areas of the tray that are too short require border molding
- Requires more vigorous border movements of tissues during alginate setting to avoid an overextended impression
- Must be poured immediately
- Two-stage pour technique for a master cast to establish proper vestibular reflection and land
disadvantages of alginate impression technique
- compromised retention
- potential periphery sores caused by the likelihood of overextended impression
Best material option is determined during the _____ appointment and can be reaffirmed with removable consults.
5. What are the requirements for record base for jaw relation?
- Large edentulous area(s)
- Distorted or instable occlusion
- 3rd APPT
6. When the existing occlusion deemed unacceptable and new VDO deemed necessary to establish, how do you determine the new VDO? List criterions or principles.
- Remaining teeth position, mobility and facial appearance (2 stage necessary?)
- status of existing RPDs
- free way space
- Determine the VDO
- Confirm the VDO with the closest speaking space during sibilant sounds
Extend the record base and make contact with the _______ surfaces of the teeth to obtain retention and stability
proximal and lingual
Free way space
(VDR-VDO: Interocclusal Space) is 2-4 mm
Closest Speaking Space
- s, ch, and z are sounds
- interocclusal space minimum without teeth coming
- into contact
7. Based on what jaw position the new horizontal position can be determined ?
- Centric Occlusion: existing occlusion. Usually this coincide with habitual closing position or muscle position (tapping position).
- If the Pt. presents unreliable, or physiologically unacceptable jaw position, follow the principle of complete dentures (CR position).
Jaw relation steps
- 1. Face bow record
- 2. Evaluate and determine VDO
- 3. Take horizontal record
- 4. Take protrusive record
- 5. Mark and transfer the posterior palatal seal.
9. What are surgical options to address anatomical conditions potentially interfere with the design of immediate dentures and impair their retention and stability?
- Removal of boney undercuts
- Removal of maxillary and mandibular tori
- Tuberosity reduction
8.What anatomical conditions potentially interfere with the design of immediate dentures and impair their retention and stability.
- Bilateral boney undercuts
- Enlarged tuberosities or supererrupted alveolar bone may create a problem in inter-arch space for denture teeth set-up.
- Significantly developed exostoses and tori interfere with the extension and adaption of dentures
10. How do you identify these problems and plan the surgery. How do you ensure the execution of the planned surgery.
- Obtain an approval also from a surgeon during surgical consultation.
- approved surgical plan is simulated on the master cast by reducing the areas during setting up teeth. This simulation will be conveyed precisely to the surgeon via a surgical stent.