Ministry of Health Protection of Ukraine
Kharkov National Medical University Orthopedic Dentistry Department
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“APPROVED” The Head of Orthopedic Dentistry Department Kharkov National Medical University Professor MD, DDS, PhD _________Victor P.Golik " 30 " August 2012.
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Methodological instruction
to the practical class VII TERM
TOPIC № 89
(for teacher)
Module 3
«COMPLETE removable PROSTHODONTICS»
MAKE ON THE BASE OF CREDIT-MODULE SYSTEM ACADEMIC PROCESS ORGANIZATION FOR DENTAL FACULTY STUDENTS OF ΙΙΙ-IV LEVELS ACCREDITATION HIGHER EDUCATIONAL
Contents module 2
Laboratory procedures complete dentures. Impact of basis laminem dentures on tissues oral cavity.
Methodological instruction is composed
by assistant NATALIYA N. BreSLAVETS
Kharkov 2012
Topic № 89: |
CHECKING CONSTRUCTION COMPLETE DENTURES. |
Technological card PRACTICAL CLASSES
Stages of practical classes |
Time |
Equipment |
Place |
The organization employment and training workplaces |
10 |
Visual slides, posters, phantoms table. |
Classroom |
Analysis of educational homework questions |
35 |
Tables: "Groups of teeth, anatomy jaws" "Teeth, dentitions”. "Tests for topics control. |
Classroom |
Demonstration of practical skills for independent work of students |
20 |
Phantoms jaw, phantom skull, plaster models, design prostheses. Thematic patients. |
Clinical cabinet |
Independent work of students with the advice of the teacher |
65 |
Phantoms jaw, phantom skull, plaster models, design prostheses. Thematic patients. |
Clinical cabinet |
Summing up the results classes and give homework |
5 |
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Classroom |
CURRENT TOPICS. Design verification of complete dentures is an important step in prosthetics edentulous jaws. With its holding to have some mistakes that could be admitted to the previous stages and eliminate them. Thus the proper conduct of this phase significantly reduces the amount of overtime complete dentures, and greatly reduces the number of errors that can occur in the determination or fixing centric.
GENERAL PURPOSE OF CLASSES. Know the stages of design verification of complete dentures, as the articulator, and in the mouth. The skills diagnosis of possible errors in the determination and the centric. To be able to eliminate the errors that are detected during design verification of complete dentures.
FOR THE FULFILL THE OVERALL OBJECTIVE STUDENT SHOULD BE ABLE
Specific objectives |
Purpose of the initial level of knowledge |
1. Know the method for determining the height of the lower part of the face. |
1. To be able to determine the state of physiological rest of the mandible. |
2. Know articulation and occlusal Bite. |
2. Be able to identify the central jaw relationships. |
3. Know the structure of the facial skeleton |
3. Able to determine the style and color of the set of teeth according to the type and age of the patient's face. |
4. Know the control procedures wax bases with artificial teeth on the models and in the mouth. |
4. To be able to clinically determine a correct setting of the teeth in the mouth. |
Theoretical questions ON WHICH BASIS PERFORMANCE OF TARGET KINDS OF ACTIVITY IS POSSIBLE
- Sequence, the amount of manipulation techniques and clinical testing of wax reproductions of complete dentures
- The criteria for correctness of the central Bite
- Phonetic test, used for testing wax reproductions of full dentures.
- Possible medical errors in the determination of individual elements of the central occlusion.
- Errors in the formation of the bite block, their consequences, prevention.
- Subject to errors in the transfer of the central landmarks Bite in bitelock, articulator, the design of artificial dentition, causes, prevention.
PRACTICAL SKILLS:
- Inspection and testing of models of the teeth in productions bitelock, requirements
- Check character interdigitation in central occlusion and articulation
- Check stabilize wax composition of complete dentures
- Verification of the effectiveness of aesthetic prosthesis
- How to resolve the errors identified and clinical correction wax composition of complete dentures.
Literature recommended
Main Sources:
Prosthetic treatment of the edentulous patient. Fourth edition. R.Basker, J.Davenport. Blackwell. 2002 – 316 p.
Complete Denture. Manual. Robert W. Loney, DMD, MS. 2009.- 99 p.
Duncan, J. P., Taylor, T. D.: Simplified complete dentures. Dent Clin North. 2004;48:625.
Felton, D. A., Cooper, L. F., Scurria, M. S.: Predictable impression procedures for complete dentures, In Engelmeier, R.L., ed. Complete Dentures. Dent Clin North Am. Philadelphia: W.B. Saunders, 1996;40:39-51.
Petropoulo.s, V. C., Rashedi, B.: Compute denture education in U.S. dental schools. J Prosthodont. 2005:14:191-7.
Organizational structure of the practical classes (Implementation of practical class plan):
At the beginning of the class a teacher calls the register and designates a student on duty, names the topic and purpose of the class, finds out unclear questions, which appeared during independent work of students.
Then the teacher analyzes subject questions, tasks of students’ research work and methods of practicing skills in accordance with the methodologic instruction, by means of actively questioning all students of the group.
The teacher is guided by the extent of knowledge obtained by the students during their independently studying the material in the textbooks, lecture notes and methodologic instructions, as well as preparing students’ research work in the albums for independent work.
Besides, the teacher can choose to check the hometask in oral or written form, as well as in mixed and oral-and-written form. The teacher can use situational tasks and test questions in addition to routine subject questions.
Having controlled the students’ knowledge for the class, the teacher demonstrates to the students methods of preparation and obtaining of a print thermoplastic impression material.
After the demonstration the students start to independently train practical skills on each other under supervision of a senior laboratory assistant or the teacher.
At the end of the class the teacher gives marks for oral answer or written work, for independent students’ work, signs the protocol of the laboratory work, as well as names the next topic and questions for study.
Summary
Try-in of the trial denture
Preliminary insertion of complete denture wax up (trial denture) to determine the fit, esthetics, maxillomandibular relations etc.
Importance:
It is the last opportunity to evaluate many of the previous steps already accomplished.
It offers an excellent opportunity for patient education and facilitates the patient's acceptance of the finished prosthesis.
Objectives:
1- To check and verify the established maxillomandibular relationship:
A) Verify that centric occlusion and centric relation coincide.
B) Test for the acceptance of the established vertical dimension of occlusion.
2- To determine if the positions of the teeth and the contours of the denture bases are compatible with the surrounding oral environment.
A) To verify the occlusal plane level relative to the ala-tragus plane horizontally.
B) To assess the posterior arch width as it relates to the mandibular residual ridge, modiolus area, and buccal corridor.
3- To verify tooth selection and arrangement for proper esthetics and phonetics.
4- To make additional interocclusal maxillomandibular records if needed for further adjustment of the articulator e.g. protrusive interocclusal record.
The various aspects of the try-in procedure:
- Extraoral examination of the trial dentures.
- Intraoral examination of the trial dentures.
Extraoral examination of the trial dentures
1- On the articulators
The mounted case is checked for:
a) Maintaining of the vertical dimension of occlusion
- Top of the incisal pin is flush with the upper member of the articulator.
- The incisal pin is in contact with the incisal table.
b) The mounting rings are firmly screwed in their position
c) Moving of the articulator smoothly from centric to eccentric positions without cuspal interlocking.
d) When the articulator is locked in centric, no other movements are permitted other than simple hinge movement.
e) The trial denture bases lie properly on their casts and the teeth meet evenly in centric.
f) If the case is mounted on the adjustable articulator, the sagittal and lateral condylar guides should coincide with the readings obtained from eccentric jaw relation records. These reading are better registered on the upper cast.
2) The master cast:
As the finished denture is processed on the master cast. So the master cast should be:
A) Has good shape.
B) Free from air bubbles or scratches.
C) Free from wax debris which lead to improper adaptation of the trial denture bases leading to false relationships.
D) If there are any undercuts present in the cast, these undercuts should be reviled to avoid scratching the cast by the trial denture bases.
3) The trial denture bases
Check the following:
- The trial denture bases must be stable.
- The borders of the trial denture base should be smooth, round, and have no sharp edges.
- Also the border should be shaped to conform to the depth and width of the sulci.
4) The teeth
1. The dentist responsibility to select the proper shade, and mould of the teeth to determine that the teeth is stetted correctly.
2. Elimination of the excess wax to avoid the camouflages of the teeth relationships to overlook the occlusion.
3. The relation of both upper and lower teeth to the opposing ridges must be checked: if there is excessive anterior tooth contact on the articulator, should be corrected to avoid the excessive forces on the maxillary anterior ridge which causing bone destruction in that area that is already a target for bone loss.
4. denture occlusion:
The occlusion of the teeth on the articulator should meet the following in the class I jaw relationship:
- The upper anterior teeth overlap the lower anterior teeth by about 1 – 2 mm, in both horizontal and vertical planes.
- The mandibular incisors do not protrude beyond the labial vestibule, and should present a curve when viewed from the occlusal surface this curve depends on the shape of the underlying alveolus.
- The lower posterior teeth should be set vertically on the ridge (not lingual to not interfere with the tongue), also the central grooves of mandibular posterior teeth should be on the crest of the ridge (better stability).
- The posterior end of the occlusal plane should be located at the junction between the middle and the distal thirds of the retro molar pad; also the height of the occlusal plane coincides with the line joining the incisal tip of the mandibular canine to the retro molar pad.
- Uniformly balanced occlusal contacts between the maxillary and mandibular posterior teeth, and maximum intercuspation between upper and lower posterior teeth when checked from both buccal and lingual aspects.
After being satisfied with the case on the articulator: