Prosthetic Dentistry 4th Year Questions of the Exam (1)

8/12/2019 Prosthetic Dentistry 4th Year Questions of the Exam (1)

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1. Central occlusion definition .CO signs. Characteristic of two fundamental elements of COelements.

Central occlusion: maximal interdentally contacts between upper & lower jaws. This contact occurs whenmandible goes from the central position to forward on 0.5-.5 mm. the condyle is situated on base of articulareminence ! glenoid fossa" . #t happens when there is bilateral contraction of muscles that ele$ate the mandible4 signs of Central Occlusion:%or all teeth

" ental:

'$ery tooth has ( antagonists) .except lower central incisor & third upper molars.

The midline of face coincides with inter incisor line.

*nterior buccal cusp of first molar of maxilla is situated between anterior buccal cusp & middle buccal

cusp of mandible first molar.

+pper dental arch is wide !large" than lower dental arch. That)s mean that maxilla o$erlapping mandible

(" ,uscular : ,uscles that ele$ate mandible mae symmetrical bilateral contraction." T,/ : the condyle of mandible is situated on the base of slop of articular eminence !glenoid fossa"." eglutition : in Central 1cclusion $ery con$enient to swallow.For frontal group:

,edial face line is situated in the same plane with inter incisor line between upper incisor.

+pper frontal teeth co$er lower teeth till 2.

For lateral group:

3uccal cusp of upper lateral teeth is located outside from the same cusp of lower lateral teeth. first upper molar contact with first lower molar co$ering it on (2 & and second lower molar co$ering it o

2 but medial $estibular cusp of first molar is situated in fissure mesio $estibular & central $estibular olower first molar.

2. Bite definition .physiologic and pathologic types of the bite.3ite 4occlusion definition: is closure of dental rows or group of teeth during different mandible mo$ements.1cclusion can be physiologic and pathologic6ateral7 anterior7 posterior .and central occlusionPhysiologic:. 1rthognat !presence of all signs of C1".(. 8ead to head occlusion: +pper frontal incisors !their cutting edges" ha$e a contact with cutting edges of low

frontal incisor.. 3iprognat: frontal teeth of upper & lower jaw together with their al$eolar process ha$e $estibular inclination. 1pistognat occlusion: frontal teeth of upper and lower jaws together with their al$eolar process ha$e oral

inclination.Pathologic:8as disturbance in function. 9rognaty: is characteried by forward position of upper teeth .presence of cleft !space" between upper andlower teeth.;ey of occlusion: $estibular medial cusp of first upper molar is localied on $estibular medial cusp of first molarand (ndpremolar of lower jaw.(. 9rogeny: is characteried by forward position of lower teeth .lower frontal teeth o$erlap the upper teeth.;ey of occlusion: cusp of stmolar is situated between st& (ndmolar of lower jaw or mae contact with cusp o

(ndlower molar.. eep occlusion: is characteried by deep !big" o$erlap of upper frontal teeth. Can be trauma of gingi$al bycutting edges of the teeth.;ey of occlusion is normal. Crossed occlusion!cross bite": is characteried by $estibular cusp of lateral lower teeth o$erlap the cusp oflateral upper teeth. Can be unilateral & bilateral.


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3. Mandibular est !osition "M!# definition. $unctional test of M! determination .practicalmeaning.

MRP: one of the articular positions of mandible due to minimal contraction of masticatory muscle & totalrelaxation of mimic muscle.This position is appeared when the mandible doesn)t participate in chewing7 speech. ue to this position there inter-occlusion space between jaws about (- mm. this space can $ary from = mm due to pathological abrasio#n ,


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open mouth widely 7external shoulder of compass applied on chin and nasal top

after that close the mouth not change position of compass shoulders

#f internal to will situated on nasal top and external shoulders one on chin and second on pupil.

This position corresponds with relati$e rest position E,


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Contact:

cusp to cusp type

cusp to slop of the cusp

flat contact !due to pathologic abrasion"

absence of occlusal contact.

! groups of occlusal contact:st group: occlusal contact created by $estibular cusps of lower premolars and molars and occlusal fossa of uppe

lateral teeth.(nd group: occlusal contact created by incisor cutting edge of lower frontal teeth and palatal surface of upper fronta

teeth.rd group: occlusal contact created by palatal cusp of upper premolar and molar and occlusal fosses of lower laterateeth.

0. Clinical eamination conseuence. Component parts of subecti4e eamination.*u#%ecti(e e+amination:" Complains.(" 8istory of patient." 8istory of diseases.O#%ecti(e e+amination:*" 'xtra oral 3" intra oral.

,+tra oral e+amination:Inspection:. ymmetry of the face.(. color of the sin 7 $isible mucosa. 'xpression of face.. floors examination7 all of them should be eHual one to another:

st floor: till supra-orbital line.

(nd floor: till nasal wings.

rd floor: till the lower edge of mandible !chin"

5. Dasolabial line.=. *ngle of mouth?. 9athological formation.

Palpation:. T,/: a" at rest and during mo$ement of mouth b" 1pen and close mouth !le$el of amplitude"by application of index and middle finger in area of condyle.

(. ,uscle palpation :

,imic muscle.

,asticatory muscle !to palpate e$ery muscle separate in relaxed and forced position.

a" extra oral>close the mouth $ery tightlyb" #ntra oral and extra oral by index finger.

. Painful paints (allae:. upra-orbital.(. canine fossa.

. ,ental foramen.*s if the patent has pain.5. 6ymph node palpation: occipital7 auricular7 sub-mandibular7 sub-mental. %ront & bac of C, muscle.$uscultation:T,/: osculate the joint region >pathological sound7 crac. ,ild-se$er crepitating.

Intraoral e+amination:#nspection:

color of lips transition from outside to inside7 correlation of lips and oris $estibule mucosa.

degree of mouth opening !if has Trismus"

#f during opening the mo$ement of mandible free7 with2without de$iation.

,ucosa of oris $estibule: color7 moist7 with2without pathological formation.

type of occlusion !orthognat7 head to head".


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inspection of dental arch and e$ery teeth separate

ental arch shape!u 7$7 w"- ymmetry

Teethfrom upper right side..left side ..left lower..right lower..

#f present caries7 change in color.

#f present 3 79."=- #nspection of dental arch and e$ery tooth separate :

Dental arch:shape !+7 G7 B"7 symmetry

Teeth : from upper right side7 left side7 left lower7 left upper.

#f present caries 7 changes in color


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#f present 3 7 97"

signs of C1 : dental frontal and lateral

8ow the upper teeth o$erlap lower !if present midline7 ey of occlusion" .

Inspection of al(eolar process:- *trophy ! degree of atrophy "- 9rotuberance7 tuberosity de$elopment.- 8ard palate ! if present torus "- 'xostoses

- #f it id total edentia ! type by chroder & ;eller "- 'xamination of post dam area 7 trans$ersal rugae & incisi$e papilla- 9lace !border" of muscle attachment.

Inspection of mucosa :- Color7 atrophy7 pliability7 resilience.- #f painful during mastication- Classification by lejuyax & supple.- Condition of frenulum

Trans$ersal ,-B & agittal spee cur$e .igns of central occlusion: .dental (. ,uscle . T,/ .deglution.ongue inspection:

- imension7 hyper 2 hypo-throphic7 edema.

- 9athological formation.- Bhite deposition near the tongue root .*ali(ary gland stenon or worthon duct if hypertrophied7 obstruction.Dental formula #y IDF--I -(- !%our parts of dental arch"

. +pper right side(. +pper left side. 6ower left side. 6ower right side

P$/P$IO):

1f lower al$eolar process

1f e$ery tooth separate

%luctuation 7 sali$ary gland under the tongue

'xostoses Tubresity de$elopment >

1f muscles7 dental tooth mobility.

P,RC0IO): of the teeth.

128 Consecuti4eness of dental arch clinical eamination 9 physiological ; pathologicaltypes"cancelled#138 clinical eamination of edentulous area of al4eolar process and mucosa of oral ca4ity 9 threetypes of mucosa according to mobility propreties 9 anatomical formation 11

1%8 Clinical eamination of static ; dynamic occlusion9 occlusal contact recording1 .

Dynamic occlusion: ! anteriorforward 7 posteriorbacward 7 lateralleft 7 right "- $nterior occlusion: is determined due to propulsion of lower jaw & characteried by contact head to head

in this position can be determined free point contact bonwill ! in frontal & ( in lateral parts " or absence o


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contacts between lateral teeth 7 condyle are situated on slope of articular 'minence 7 muscles are not inmaximal contact .

- Posterior occlusion : due to pressure on mental region ! for determination of ,9 " by 'antoro(ichmethod7 in this position teeth ha$e contact only in lateral parts 7 condyle are situated on the top of articufossa ! the most deep part of fossa"

- /ateral occlusion: can be left & right due to lateral occlusion between dental arches distinguish woring s& balance side.

On or2ing sideteeth ha$e contact with the same cusps !upper buccal with lower buccal"

On #alance sidewith different cusps contact !upper palatal with lower buccal"7 due to excessi$edisplacement of lower jaw on the woring side ca not be contacts.

$symmetry of the face3 condyle has different position in articular fossa: on woring sidenear theshape of articular eminence with a little rotation mo$ement7 on balance side condyle is situated on top ofarticular eminence.

1) A Clinical ; !ara clinical eamination of maillofacial region musclesalue3 morphology of remained teeth cron:*nalysis of crown morphology !$alue" molars on diagnostic model 7 we need it to now for retenti$e elements!clasps".


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i$. C/$** 4hypertrophied and mo$able mucosa with non regular thicness.

Practical importance:the thicness and elasticity of mucosa of prosthetic field determines the le$el of holding anrefrain,aintenance of prosthesis in oral ca$ity and determines the degree of its pliability to remo$able denture.

3-. maillary mucosal classification by G:H,=& and degree of its pliability by EHG7=,EO 9stage

Classification #y /I0),D: of palate; 4 =ones:

i. ?O), 1

agittal sutura

the mucosa is thin firmly adjacent to bone and $ery sensible to forces !0.5-mii. ?O), al$eolar ridgewith adjacent narrow7 strip7 which is widening by way to molars7 with low le$el pliability !0.5-mm".

iii. ?O), !trans$ersal palatal fold sat the anterior 2 of hard palatemedium degree of pliability becauselayers of subcutaneous fatty tissue !-(mm"

i$. ?O), 4posterior 2 of hard palateglandular one with great degree of pliability called one ofshredder! -mm".

'0/$@,)'O classification:depend on different ones of buffer $aries from !0.5-(.5mm".

3/.30 maillary prosthetic area bone classification at partial edentation by G=7OF,=I. !oint outthe most unfa4orable "negati4e# class. Maillary tubercles classification 9types of hard palate and

its practical importance.$l(eolar process:

i. -igh and ill mar2ed al(eolar process ith (esti#ular and lingual slope7 parallel between them withoexostoses

ii. Medium degree of al(eolar processatrophy $estibular and lingual slope are slightly obliHue as a result oloss of bone base

iii. $l(eolar process ith little prosthetic (alueand great degree of atrophy because of wearing noncorresponding prosthesis.

i$. $l(eolar process ith negati(e prosthetic (alueand $ery great degree of atrophy !partial2total" as a resof wearing non corresponding prosthesis.

Ma+illary protu#erance:

i. Fa(ora#le7 retenti$e protuberances with parallel slopes.

ii. Protu#erances ith medium degreeof relief prominence7fa$orable for prosthesis fixation.

iii. Protu#erance ith degree of relief prominence!without anyrelief"7 that does not gi$e any possibility to pro$ide prosthesisstability is negati$e.

i$. Protu#erances that re9uire surgical modelingfor remo$ingmared retention places or create interferences with oppositeal$eolar process.

-ard palate:i. Deep ith hori=ontal ide surfacehard palate7 which

pro$ides maximal adhesion7 without palatal torus7 with mediumpalatal joint non-sensiti$e for pressure7 with chroder ones of

a little depressi$eness. this ind of hard palate is the mostfa$orable for future prosthetic stabiliation.

ii. Medium mar2ed hard palate7 but wide enough7 di$ided by medium joint with relief sensible to pressure anreHuiring isolation during remo$able prosthesis manufacturing.

iii. 7ently sloping hard palatewith little prosthetic $alue characteriing by the absence of horiontal surfaceand the presence of ( obliHue slopes that cannot pro$ide stability of remo$al prosthesis.

i$. *loping hard palate ith prolonged *chroder =onedi$ided by $ery sharp medium joint7 which sometimhas a form of well mared palate torus. This type does not allow remo$able prosthesis adhesion.

%5. Mandible prosthesis area bone classification by G=7OF=HI. :ndicate the unfa4orable forms omandible protuberance type.$l(eolar process:


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i. *l$eolar process with good prosthetic (alue7slightly atrophied7 with well mared $estibular and lingualslopes7 painless without exostoses and the mandibular torus7 with smooth inner obliHue lines. This type themost fa$orable for prosthetic treatment with remo$able denture.

ii. *l$eolar process with medium prosthetic (alue7 but still able to stabilie and use the remo$able denture.

iii. *l$eolar process with little prosthetic (alue7 with mared resorption becausethe wearing not adeHuateprosthesis.

i$. *l$eolar process with negati(e prosthetic (alue7 with conca$e relief in frontal and agittal plane. 'xternaand inner obliHue lines are near the al$eolar ridge. ,ental foramen is situated on the prosthetic filed 7 thebone is $ery painfull at pressing on it.

Mandi#le protu#erance:

i. ,andible protuberance are fa(ora#le for sta#ili=ation and fixing of remo$able denture 7not mo$able7co$ered by healthy fibro-mucosa.

ii. ,andible protuberance are less fa(ora#le for sta#ili=ationand fixing for remo$able denture7 but still able be used prosthetic 7 less con$ex and more mo$able7 more depressible.

iii. ,andible protuberances are (ery slightly fa(ora#le for sta#ili=ationand fixing of


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- Cylindrical cap- *rtificial crown

O. older system.Classification of clasps:

. 3y material:- ,etal- *cryl- ,ixed

(. 3y topography:- ental

- *l$eolar- ento-al$eolar.

. 3y form :-


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istal:not in e$ery cases we can co$er completely the mandibular protuberance. !epend on pliability of mucosthere"

Gestibular:upper on 0.5mm from neutral mucosa pass all frenulum.

6ingual:frontaltill 0.5mm upper from neutral mucosa.

9osterior inner obliHue line7#n the main teeth !frontal & lateral" Xalways co$er till supra-eHuatorial area.

%-8 :ndications for !& with metal frame wor and elastic lining maing .materialsery important for the #iomechanics of P$RD is:

Clasp lines.

number of retainer teeth

9osition of clasps of these retainer teeth.

Fi+ation of the prosthesis can #e:. 9ointed.(. liner !agittal7 trans$ersal7 diagonal". %latted.

The correct choice of retainer teeth is important for the spreading of masticatory pressure.For clasp fi+ation should #e:

table.

high clinical crown

Bith good prominent eHuator.

Bithout morph functional disorders in per apical region.

9ointed fixationless fa$orable.6inear fixationmore fa$orable.

%08inummerate functional forces that influence on !& .eplain the biomechanics of such ind denture when 4ertical force influences near the natural teeth on mailla on second class of partiaedentation by Eennedy0% 6M7 and muscles changes at complete edentationDM@ changes:" *s rule ha$e morph-functional7 atrophic character.(" after losing the teeth ha$e more expressed amplitude ! a specially when both al$eolar processes try to

mae a contact "

3) temporal fossabecomes more flat 7 condyle are displaced forward and distally" lateral mo$ements of lower jaw and mo$ements of lower jaw forward pro$oe essential pressure in T,

and mae articular dis thinner ! in some cases punched "5" in the condition of relati$e physiological rest of lower jaw condyle occupied distal portion=" displacement of condyle distally in the large amplitude results in extension of articular capsule that ofte

lead to luxation and sub luxation of lower jaw?" the patient has a pain 7 headache 7hyper sali$ation 7 sensation of burning of mucosa and in the tongue

! syndrome of good friend "Changes in muscles:

" ,imic muscles changes -N decrease tonus(" ,astication muscles changes-N the tonus of the muscles that ele$ate mandible is reduced gradually .wbe present muscle tiredness7 spasm7 hype 2 hyper-tonicity of muscle7 hypertrophy7 pain in muscles.

>0)# supporting "bearing# and functional area on upper aw. eisering space9 palatal torus9classification by landaD" *upport =ones of upper %a: gi$es the possibility to eep


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" 9alatal torus of rounded form located distally(" 9alatal torus of elongated form" 9alatal torus of ellipsoid form 7big in $olume and $ery prominent and located in frontal and middle part o

hard palate" Darrow palatal torus but $ery elongated and situated in frontal part of hard palate5" 9alatal torus that starting from frontal part and finished in distal part !whole length of hard palate "

>0+# supporting "bearing # and functional areas on lower aw at complete edentation D*upport =ones stress #earing =ones ; :

*l$eolar process

,andible protuberance that in some cases can be co$ered partially 2totally with complete denture

Functional =ones: paired ones:

- one of mandible protuberance- 6ateral lingual one- 6ateral $estibular one

( unpaired ones:- Central lingual one- Central $estibular and lingual one

>0-# muscles situated net to the prosthetic field on upper and lower aws at complete edentation

practical importance ." Masseter muscles: it taes origin from ygomatic arch and inserts on the lateral surface of the mandible infront of the angle %unction ele$ation the mandible.

; Medial pterygoid muscle:

1rigin: ( heads:

" eeplateral surface of pterygoid process

(" uperficialtuberosity and pyramidal process of maxilla

#nsertionmedial surface of mandible near the angle

%unction ele$ation and side-to-side mo$ements of mandible!; Mylohyoid muscle:

Origin:mylohyoid line in the mandible.Insertion: anterior surface of the hyoid bone

Function: to decrease !depress" the mandible4; $nterior #elly of digastrieus muscle :

Origin:digastrics fossa of mandibleInsertion: body of hyoid boneFunction: open mouth by decrease depress the mandible

Importance:

ue to contraction of the muscles the mandible without problem achie$e maxilla !ele$ated"

#f will be disorders in the muscles cause to T,/ changes !arthritis 7 pain.."

>0/# characteristics of functional Kones types of 4estibular slope of al4eolar aws processes atcomplete edentation. &escribe their importance.Functional =ones:!secondary7 section7 seal " @ co$ers mucosa that come in contact with complete denture edges

" %unctional ones of upper jaw :- Gestibular one !pocet $estibular labial space and $estibular lateral space"- istal one !post dam area"

*urfaces of (esti#ular functional =one of ma+illa :! forms of slope of al(eolar process:

. teep(. lightly sloping. 1$erhanging

3y


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Functional =ones of loer %a:! paired =ones:

- one of mandible protuberance- 6ateral lingual one- 6ateral $estibular one !fish pocet"

unpaired =ones :- Central lingual one- Central $estibular and labial one

Gestibular lateral onefunction: different denture insertion 7has form of depression !more or less"

Gestibular central onecan be exostoses7 buccal frenulum in region

6ingual lateral one anatomical: . torus mandibular 7 (. 1bliHue line !mylohyoid m. insertion "

6ingual central one. 6ingual frenulum (.geniohyoid m.digastrieus m. insertion.

>00# types of al4eolar process at complete edentation according to (chroder and ollerclassification and the degree of mucosa pliability by supple. Giund*chroder classification of al(eolar process atrophy on the upper %a ! types ;

. #s characteried with well expressed al$eolar process eHual at all his extension with well prominent maxillatuberosity and enough high palatal $ault. !deepness" transitory folds places of muscles attachments aresituated relati$e high . This type of atrophy is more fa$orable for prosthetic treatment 7because of anatomicretention formation are expressed not interfere in the prosthetic fixation .

(. #s characteried by medium degree of al$eolar process7 preser$ed maxillary tuberosity and well prominent

palatal $ault . Transitory folds are situated near the top of al$eolar process .in this case conditions forprosthetic treatment usually are well7 but at abrupt contraction of muscles surrounding prosthetic field canlead displacement of the denture .

. #s characteried by abrupt atrophy of al$eolar process7 disappear of al$eolar process and flat hard palate .transiti$e fold 7labial frenum and place of muscles insertion are situated near to the top of al$eolar process the le$el of hard palate. This type of atrophy not fa$orable for prosthetic treatment because of absence ofanatomical retention formation and $ery often we ha$e displacement of complete denture .

'oller classification of al(eolar process atrophy loer %a;. Bell expressed al$eolar process eHual to at whole his extension with small degree of atrophy .this type is

characteried for simultaneous teeth extraction and fa$orable for prosthetic treatment . 3ecause anatomicaformation are expressed well and not interfere denture fixation during mo$ements of lower jaw .

(. +niform ad$anced atrophy of al$eolar process in some cases with in$ol$ement the body of mandible !4Xal$eolar process " with accentuated atrophy of the bone mass 7created $ery different conditions for prosthetreatment . $ery close placed insertion of the muscle 7near the top of al$eolar ridge 7lead to displacement ofC during the function

. Bell expressed atrophy of al$eolar process in lateral area and small atrophy in frontal area . this type ofatrophy is relati$e fa$orable for prosthetic treatment because of atrophy of al$eolar process in lateral area interfere micro mo$ements of C in trans$ersal plane . retention one only represented in frontal area andinterfere displacement of C in agittal area !plane"

. Bell expressed atrophy of al$eolar process in frontal area and small atrophy of al$eolar process in lateralarea .stability of denture is possible in trans$ersal plane and bad in agittal plane that creates possibility fosliding the denture forward.

egree of mucosa atrophy by supple :. 8ealthy mucosa with moderate thicness and elasticity resilience that can support shocs during masticati

function and decrease displacement of C(. *trophied thin mucosa with decrease resilience that cannot support pressure during mastication function a

create not fa$orable condition during mastication .pain during mastication.. Thic mucosa with increase degree of resilience that lead to displacement of C during function. 8ypertrophied mobile mucosa lie a ocs-comb this type of mucosa need surgical treatment

6inud classification of hard palate mucosa:

. agittal


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*u#%ecti(e:. Complains(. *namnesis morbi !history of disease". *namnesis $ita

O#%ecti(e:,+tra oral:

. symmetry of the face(. color of the sin7 $isible mucosa !lips7 conjuncti$a". expression of the face4. three floors:

till supra-orbital line till nasal wings

till chin !mental"

#n edentulous patient of ### floors

5. nasal-labial line=. angle of mouth?. M@ :

mo$ements of condyle

open and close mouth

crepitating

O. muscles palpation !masseter7 temporal": extra oral & intraoral

K. some pathological formations0. palpation of painful points:

- upra-orbital foramen !infra-orbital"- Canine fossa- ,ental foramen

*s the patient if he2she has a pain in these regions. Palpation of lymph nodes:

- occipital- auricular- sub-mandibular- sub-mental- front2bac of C, muscle

intraoral. Coloration of lips & oris $estibule !mucosa"

- egree of mouth opening. ,+amination of the al(eolar process

- palpate the al$eolar process- degree of al$eolar process atrophy- the $estibular slope forms

!. e+amination of oral mucosa classification #y /e%uyeu+;

- color of the mucosa !pale7 if painful"- degree of pliability !upple7 6iund"

. examination of palatal torus !forms" by 6andaDiagnosis:

Consists of ! parts:. ,ain !primary" disorder of stoma. system(. complication of primary disorder. secondary disorder !disease"

,+:complete secondary edentation7 ## class by chroder on the upper jaw & ###class by ;oller on lower jaw aftercaries & its complications with mastication insufficiency by *gapo$.Para"clinical e+amination:

. P-


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. diagnostic models !to study on model is more exact"

151. Methods of fiation of complete "full# denture. &escriptions. "Cancelled#152. $iation and stability of complete denture. $unctional denture suction and adhesion.Fi+ation of CDis fixation of denture on prosthetic field on condition of relati$e physiological rest of the lower jaw%or such fixation the presence of adhesion of the base of denture to orthopedic field is enough.

*ta#ility of CDis the Huality of denture withstand !resist" the forces of the displacement in horiontal direction. relationship of denture base to the underlying bone.Changes of soft tissue & bone under the denture lead to lac of stability.

To promote fixation and stability of C anatomical formations are $ery important !palatal..." also additional factors that promote fi+ation and sta#ility of CD:

- atmospheric pressure- adhesion- cohesion- mechanical locs- muscle control- patient tolerance

*dhesionis the sticing one surface on another !denture to the prosthetic field".

The surfaces should be wet. *dhesion we need only for the fixation !& not stability" without applying pressure o

the C.

uctiongoes after adhesion !fixation"creation of $acuum for better retention. Be need it for stability of the

denture !resist to the forces in different planes without displacement of the C".

153. :ndi4idual tray. Maing methods. Hsed materials and techniue for indi4idual tray maing inclinic and in laboratory.Indi(idual tray is a special tray for impression materials for the taing functional !final" impression.Two methods for manufacturing indi$idual tray:

. irect !in clinic7 in oral ca$ity"-by 3rahman-by Gasileno

(. indirect !in laboratory"Direct method3 techni9ue of manufacturing #y asilen2o:. better than 3rahman !easier"

(. The edges of tray to mae shorter till the le$el of passi$emobile mucosa !neutral bone" & adapt theseedges by impression material due to taing functional impression.

. for distal border longer than 9ost-am area on 0.5cm

. 9erforation by way of middle- fibrous one on upper jaw for elimination of excessi$e impression material.

Other method #i"layer impression:direct;

ststep thermo-plastic material !..." on standard tray

(ndstep second layer by hard material !


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15%. Checing test of indi4idual tray border "periphery# by *erbst on upper and lower aws.:mpression taing with indi4idual tray.Functional tests #y -er#s for the ma+illa:

,aximal opening of the mouth:#f the tray is displaced7 the $estibular edge of the tray must be remo$ed from the pterygoid-mandible raphae &up to the place7 where the stmolar is situated !distal $estibular area".

ucing of lips:. *t tray displacement7 must be remo$ed $estibular edge at the area of buccal folds.

isplacement of lips in the tube !whiing":

(. *t tray displacement frontal area is remo$ed.

Functional tests #y -er#st for the mandi#le:wallowing mo$ement & maximal opening of the mouth:

- #f the tray is displaced during swallowing- the distal edges of tray7 from tubercular periforme to sublingual liis remo$ed. *fter remo$ing of this area7 we as the patient to open the mouth gradually till maximal openiif the tray is displaced from its distal edge7 it must shortened !remo$ed" from tubercular periforme till the plof (ndmolar !$estibular".

- ,o$ing up the patient)s top of tongue to the upper & lower lips7 if the tray is displacedZ the lingual edge of ton the region of mylohyoid muscle is remo$ed.

- The tip of the tongue touches the internal surface of the chee !right & left". #f the tray is displaced

opposite side of the tray is remo$ed.

- The tip of the tongue is put on upper lip & to the tip of nose. #f the tray is displacedwe remo$e from lingu

area !place for frenulum".- *cti$e mo$ements of muscles7 sucing the lips & maing lips in tube. #f the tray is displaced we remo$e

distally.Impression ta2ing ith indi(idual tray:#t is functional impression which is taen by indi$idual tray with siliconic material.%unctional impression which is taen during mo$ements.

15). 6ypes of functional impression depending on border tray height and compression degree onthe mucosa of the prosthetic field. :ndications.I. $ccording to the height of impression edges:

. %unctional impression with edges in the area of passi$e mucosa !natural one" proper functional

impressionfor denture with good relief of bone tissue.

(. %unctional suction impression edges of impression cross the neutral one on -(mm.II. $ccording to the methods of impression edges:

. 'dges of functional impression are made by passi$e mo$ements of mucosa.(. 'dges of functional impression are made by acti$e mo$ements of mucosa !realiation of functional tests".. 'dges of functional impression are made by acti$e mastication mo$ements & other functions of stoma. yste. ,ixed formations of edges of functional impression.

III. $ccording to compression degree on the mucosa:. Compressi$e impression- is taen by pressure techniHue7 manually by the doctor7 under chewing pressure &

closing- pressure on mucosa.(. e-compressi$e impression- non pressure !muco-static". electi$e impression- more distal7 less proximal !depends on type of mucosa".

Indications:

%or Compressi$e:. #n case of pliable mucosa !compress buffer one" $essels compression 1f prosthetic field & maing them

empty !without blood"(. with non-perforated tray. 6ow liHuid material !$iscous": gypsum7 silicon.. the pressure should be continuously !non-stop" & the pressure is stopped only after the hardening of the

material5. better fixation with this ind of impression

For De"compressi(e:- in case of low pliability of mucosa- presence of palatal torus- with high liHuid materials:


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entaflex

Pantopren

n% paste

- with perforated trayFor *electi(e:

- for #G class by upple- with perforated tray !in region of non-pliable mucosa

15+. !eculiarities of 4estibular cur4e and height of upper occlusal rims modeling. &etermination o

prosthetic plane.Modeling of (esti#ular surface of the upper occlusal rim:. ,ust be determination of the Huality of upper wax occlusal rim. *fter this7 its disinfection & introducing into

oral ca$ity.(. etermination the possible balancing of wax borders with occlusal rims.. afterwards7 woring with $estibular surface: closing of the mouth & if we see some protrusion of frontal

surface lip & lateral surface we remo$e from occlusal rim7 if the lip is falling down we add wax to the

occlusal rim.Determination of the height of upper occlusal rim:#t is determined simultaneously with the determination of the le$el & direction of prosthetic plane.

- The edges of the upper occlusal rim in frontal area should be in -.5mm lower than the edge of upper lip o

to be at the same le$el !but in the lower occlusal rim lower in -.5mm than the lower lip".

Determination of the le(el & direction of prosthetic plane:%ox: to use special de$ice with internal & external plane occlusal plane

- 6ine that connected external auditory canal !tragus" & spino-nasalis is [[ to occlusal plane !line which goesincisal edge & top of distal palatal cusp of (ndupper molar".

- in lateral area occlusal plane should be [[ to trago-nasal line !tragusspino-nasalis"

- in frontal area occlusal plane should be [[ to inter-pupil line

15-. &efinitionD Central 7aws elationships9 *eight of the Bite9 $ree (peech (pace9 :nter8occlusal !hysiological (pace. (tages of Central 7aws elationships at complete edentationdetermination.Central @as Relationships is a situation of mandible in regards to maxilla when the condyle occupied not forc

!rest" position to the base of the slope of articular eminence7 not depending on the presence or absence of the teeThis C/< is eHuilibrated by all components of stomatognat system in planes !$ertical7 trans$ersal & agittal" &create inter-jaws relationship that pro$ide optimal sie of the lower third of the face called physiological sie. %romthis C/ position of mandible7 begin & finish all the mo$ements of the lower jaw.

-eight of the


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5. determination & fixation !register" of C/

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Prosthetic Dentistry 4th Year Questions of the Exam (1)

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