1. Patient C., came to a dental clinic for the purpose of replacement. Objective: edentulous lower jaw. Uniformly severe atrophy of the alveolar process. Alveolar arch barely rises above the floor of the mouth. Attaching the bridles and the location of folds high. Mucous membrane is mobile. Determine the atrophy type of edentulous jaw by Keller.
A type II
B type I.*
C type III
D type ²U
2. Patient B. 72 years old produced complete dentures. Objective: Orthognathic jaw relationships, pronounced atrophy of the upper jaw. How to put the artificial teeth in the upper denture?
A 12 teeth
B 8 teeth
C 10 teeth
D 14 teeth*
E 16 teeth
3. The main informative methods of examination patients with edentulous jaws:
D) analysis of photographs
* E) all of the above
4. With a help of speech samples and motor function can be determined
A) jaw relationships with edentulous jaws
B) the amount of vertical overlap of the teeth
C) the optimum height lower face
D) the amount of functional rest period
* E) all of the above
5. When X-ray examination of the patients with edentulous jaws should pay attention
A) the presence of cysts
B) to assess the supporting properties of prosthetic area
C) the presence of residual roots, sequesters
D) the ability to forecast the stability of bone atrophic process
* E) all of the above
6. In the design of complete dentures should be considered
A) the condition of the tissue prosthetic area
B) differential pressure distribution on the basis of the underlying tissues
C) carefully the valve area
G) prosthetic area
* E) all of the above
7. Support properties of prosthetic area can be related
A) the degree of atrophy of the jaw bone
B) with an area of prosthetic area
C) the state of the submucosa
D) the effects of masticatory and facial muscles on the prosthesis
* E) with all of the above
Special-purpose Training Tests for study the topic level testing
1. Positive for use root of the tooth is saved
a) the use of the root of the tooth as a support for the denture (attachment, magnets, etc.)
b) transfer of chewing pressure after surviving root
c) increase in chewing efficiency prosthesis
d) slow atrophy of the alveolar process
* e) all of the above
2. For patients with edentulous jaws we use the following method of surgical training
a) removal of bands, moving bridles
c) deepening vestibule of mouth
d) subperiostal implantation
* e) all of the above on the testimony
3. The main task in preparing patients for prosthesis
* a) the normalization of the relations of jaw and interalveolar height
b) prevention of arthropathy
c) increasing the efficiency of mastication
g) aesthetic demands
d) reducing the function of speech
4. The most appropriate tactics if the average severity of the torus is
* b) differential impression
c) isolation torus
g) shortening of the prosthesis
e) modelling of the denture with bypass torus
5. In order to prevent injury incisive papilla be taken
a) the basis of modelling with bypass papilla
* b) surgical excision of his
a) print a differential pressure
d) isolation of his model
e) sawing denture in the papilla
6. During the formation of the distal edge of the full upper denture should be considered
a) The contours of the distal edge of the palate
b) structural elements of the glandular tissue mucosa zone
c) form the slope of the soft palate
d) the direction of the slope of the soft palate and pharynx
* e) all of the above
7. The most favorable type of atrophy of the lower jaw to make the prosthesis is
a) expressed uniform atrophy of the alveolar process
* b) a small uniform atrophy of the alveolar process
c) atrophy of the alveolar bone in the lateral parts with relative preservation of the anterior
d) atrophy in the anterior
d) non-uniform atrophy
8. Carefully the boundaries of prosthetic area must
a) the presence of a narrow, acute alveolar
b) with a sharp narrowing of the spaces
c) location of the holes chin above the crest of the alveolar process
d) if the mobile mucosal side portions jaw
* d) for all of the above
9. The greatest impact on retention prosthesis has
a) the circular muscle of the mouth
c) the muscles that drive the angle of the mouth
d) the muscles that lift the corner of the mouth and upper lip
* e) all of the above
10. Mitigate the negative impact of the muscles (masseter and facial) to stabilize the prosthesis can
a) connective tissue layer transition folds
b) adipose tissue in the transitional folds
g) interstitial fluid
*e) all of the above
Ministry of Health Protection of Ukraine
Kharkov National Medical University Orthopedic Dentistry Department
The Head of Orthopedic Dentistry Department
Kharkov National Medical University
Professor MD, DDS, PhD ___________Victor P.Golik
" 30 " August 2012.
to the practical class VII TERM
TOPIC ¹ 80
«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 1
Examination oral cavity of the patients with edentulous jaws. Taking functional impressions. Biomechanical movements of the lower jaw.
Methodological instruction is composed
by assistant NATALIYA N. BreSLAVETS
Topic ¹ 80:
TAKING ANATOMICAL IMPRESSIONS FROM EDENTULOUS UPPER AND LOWER JAWS FOR MANUFACTURING INDIVIDUAL TRAYS
Technological card PRACTICAL CLASSES
Stages of practical classes
The organization employment and training workplaces
Visual slides, posters, phantoms table.
Analysis of educational homework questions
Tables: "Groups of teeth, anatomy jaws" "Teeth, dentitions”. "Tests for topics control.
Demonstration of practical skills for independent work of students
CURRENT TOPICS. To obtain anatomical prints using special metal or plastic trays for the upper and lower jaws. Tray made of body and handle. In the body of the upper substrate to distinguish bed imprint of the teeth or alveolar process, a bed for the imprint of the palatal vault and the outer side. Lower tray different from the top in that instead of the bed for imprint of the palatal vault, it has a clipping of the language, limited internal board. The boards are used to hold the tray impression material, and the handle helps to correct fixing tray in the mouth. Trays come in various shapes and sizes. If the print used elastic mass, the tray should be perforated.
GENERAL PURPOSE OF CLASSES. Upon receipt of the anatomical impression, first of all, pick the appropriate substrate. The correct choice of substrate is important to get a good impression. Depending on the size and shape of a tray made in the following sizes and designations. To obtain prints from the upper jaw: U-1, U-2, U-3, U-4, U-5, followed by numbers trays toothless jaw U-6, U-7, U-8, U-9, U-10. For reprints from the lower jaw: L-1, L-2, L-3, L-4 and L-5 combined, that is, in the front section with a high sides for 6 front teeth, and in the lateral parts - smaller recess; trays, numbered L-6, L-7, 8, 9 - for edentulous jaw. On the lower jaw must see to it that does not impede the nomination tray tongue forward. For individual patients, the standard substrate adapted by extending the sides of the wax, cutting out holes for the remaining teeth. This avoids the difficulties in obtaining a print. However, standard trays are not always suitable for the purpose. In some cases (when the terminal defects of dentition, complete loss of teeth) is necessary to make an individual tray. A doctor can, roll out the dough to a uniform thickness of the fast-plastic tray to simulate individual working model, the shape and size of the impression tray by the shape of the jaw, the width and length of the dentition, the topography of the defect, the height of the remaining bits of teeth, the severity of the toothless alveolar and other conditions. If we consider all the possible combinations of these conditions, it appears that to get impressions for partial loss of teeth require a large number of different substrates. In fact, there are only a few types of standard trays, do not always meet the requirements. Therefore it is often necessary to simulate the edge of a tray, altering them. Well-matched tray facilitates removal of slip, and the more complex conditions of its production, must be chosen more carefully tray. When choosing it should be borne in mind: the side of a tray to defend teeth at least 3-5 mm. The same distance should be between the hard palate and palatal bulge tray. Do not choose a tray with short or long, rests in the transitional fold edges. The best will be the tray, the edges of which when applied to the tooth rows while checking reach the transitional fold. When removing the impression between the bottom teeth will fall trays and impression material layer thickness of 2-3 mm, side tray reaches the transitional fold, and the resulting gap is filled impression material. This will form the edge of the print both passive and active movements of the soft tissues. With emergence of the edge of the tray this possibility is excluded, as it would interfere with the movement of the edge of language, bridles and other folds of mucous membrane. Must be considered when choosing and some anatomical features of the mouth. Thus, in the lower jaw to look out on the lingual side tray, which should make an outside to be able to push deep into the soft tissue of the bottom of the mouth. This should be emphasized. Experience shows that often enough reliefs for this reason lingual edge of the print.
FOR THE FULFILL THE OVERALL OBJECTIVE STUDENT SHOULD BE ABLE
Purpose of the initial level of knowledge
1. Know the definition of the terms "impression", "anatomical" impression "," functional impression. "
1. Know the basic steps of obtaining anatomical impressions.
2. Know the principles classifications of impressions. Classification by E.I.Gavrilov, A.I.Betelman. Modern classification impressions domestic and foreign authors.
2. Know the requirements for the
3. To be able to make a table of standard sizes of the upper and lower trays.
3. Know the methods of selection impression tray (standard and custom): depending on the impression material, depending on the clinical situation and the anatomical structure of the jaws.
4. To be able to select or prepare a standard impression tray for impression with prosthetic area
4. Know the methods of selection impression tray (standard or customized). Depending on the impression material.
5. Understand obtaining the correct impression quality depends prosthesis.
5. Know the standard sizes of the upper and lower trays.
Theoretical questions ON WHICH BASIS PERFORMANCE OF TARGET KINDS OF ACTIVITY IS POSSIBLE
1. What imprint.
2. Classification of prints.
3. Classification of impression materials.
4. "Prosthetic field" - the definition and clinical significance.
5. "Prosthetic area" - definition and clinical significance.
6. Choosing impression trays and material for edentulous jaw.
7. Assessment of quality of print.
8. Disinfection print.
9. Technology removal anatomical prints different masses.
SRWS (studying and research work of the student)
Write and sketch:
- Classification of the atrophy edentulous upper jaw by Shreder.
- Classification of the atrophy edentulous lower jaw by Keller.
- Classifications of conditional of the mucous membrane edentulous jaws by Lund and Supple.
1. Prosthetic treatment of the edentulous patient. Fourth edition. R.Basker, J.Davenport. Blackwell. 2002 – 316 p.
2. Complete Denture. Manual. Robert W. Loney, DMD, MS. 2009.- 99 p.
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.
Impression - Negative reproduction of the entire denture bearing area, stabilizing area and border seal area.
Anatomical impression – the tissue replica in rest
Functional impression - the tissue replica in functional state (chewing, swallowing, mimic motions, tongue motions)
Classification of impressions
- preliminary (primary)
- master (working)
· passive (with doctor‘s movements)
· active (with patient‘s movements)
· differential (selective)
§ It is an impression made in a stock tray for the purpose of making a study or primary cast on which special tray is constructed.
§ Taken either by the dentist or an expanded-function dental assistant.
§ Used to make a reproduction of the teeth and surrounding tissues.
§ Used to make (1) diagnostic models, (2) custom trays, (3) provisional coverage, (4) orthodontic appliances, and (5) pre-treatment and post‑treatment records.
§ It is an impression made in special tray and is used for the purpose of making the master cast on which the denture is constructed.
§ Final impressions
§ Taken by the dentist.
§ Used to make the most accurate reproduction of the teeth and surrounding tissues.
§ Used to make indirect restorations, partial or full dentures, and implants.
Requirements of impression trays
§ 1- Strong and rigid.
§ 2- Can be cleaned and sterilized.
§ 3- Allow for equal thickness of impression material.
§ 4- Cover the whole impression areas.
§ 5-Hold the impression material in correct position to prevent distortion.
§ Stock trays are ready-made
§ Supplied in various shapes and sizes
§ Used for making primary impression.
§ Made from
§ nickel Silver
§ stainless steel
Characteristics of Impression Trays
§ Quadrant tray
• Covers one half of the arch.
§ Section tray
• Covers the anterior portion of the arch.
§ Full arch tray
• Covers the entire arch.
§ Perforated tray
• Holes in the tray create a mechanical lock to hold the material in place.
§ Smooth tray
• Interior of the tray is painted or sprayed with an adhesive to hold the impression material.
Trays For completely edentulous patients
§ Round floors
§ Short flanges.
§ The handles should be staggered (inclined).
Tray Selection Criteria
§ Feel comfortable to the patient.
§ Extends slightly beyond the facial surfaces of the teeth.
§ Extends approximately 2 to 3 mm beyond the third molar, retromolar, or tuberosity area of the arch.
§ Is sufficiently deep to allow 2 to 3 mm of material between the tray and incisal or occlusal edges of the teeth.