RPD Insertion

Question 1

what is the objective of the insertion appointment

Answer 1

• to fit the denture base to the edentulous ridge
• to correct the occlusal discrepancies
• to adjust retentive clasps if necessary
• ton instruct the patient in home care

Question 2

the denture base will usually exhibit heavy contact with the:

Answer 2

lateral walls, both buccal and lingual or palatal of the ridge

Question 3

the denture base will exhibit light or no contact with:

Answer 3

the ridge crest

Question 4

what are the most frequently observed undercutareas

Answer 4

• undercuts buccal to the edentulous ridge in the mandibular premolar
• maxillary tuberosity area
• mylohyoid ridge

Question 5

denture base flange length contributes to:

Answer 5

• resistance to horizontal or lateral displacement of the denture
• a major share of vertical support for the partial denture

Question 6

where are tooth-borne RPD evaluated and adjusted for occlusion

Answer 6

intra orally

Question 7

how do you correct occlusal discrepancies in tooth tissue borne RPD

Answer 7

clinical remount

Question 8

how should natural teeth contact

Answer 8

teeth which contact without the prosthesis in place continue to do so with the prosthesis in place

Question 9

what are the steps in the clinical remounting procedure

Answer 9

• facebow
  -pick- up impression
  -block out undercuts
  -remount cast and intra occlusal record
• articulation

Question 10

what does selective grinding do

Answer 10

• by altering the incline of a cusp, intereferences can be eliminate without changing cusp height
• the cusp tips should not be relieved arbitrarily

Question 11

how should you adjust the retentive clasp

Answer 11

• at time of insertion use slightly less than maximum retention
• clasps should be adjusted in small increments

Question 12

what tool should be used to adjust the half round, cast circumferential retentive clasp

Answer 12

• No. 139 plier

Question 13

what is the home care instructions

Answer 13

• brush the RPD using soap and a denture brush
• prosthesis should be removed for 8 hours each day and soaked upon removal

Question 14

what does soaking denture do

Answer 14

prevents distortion of the acrylic resin

Question 15

why should the patient not soak in RPD in bleach

Answer 15

it will cause the metal to corrode and make the framework more brittle

Question 16

how should the patient remove the RPD from the mouth

Answer 16

grasp acrylic resin denture bases on each side of the arch and carefully withdraw the removable partial denture from the mouth

Question 17

when are adjustments done

Answer 17

• 24 hours after delivery and 1 week after insertion
• prosthesis should be inserted 4-5 hours before the appointment so that problem areas can be visualized
• use PIP to aid in locating overextension or pressure area

Question 18

what are common complaints

Answer 18

• problems with phonetics
• cheek or tongue biting
• difficulty in chewing
• loose denture
• gagging

Question 19

what causes problems with phonetics

Answer 19

• improper placement of the prosthetic anterior teeth or changes in the contour of the anterior palate

Question 20

what happens if there is improper placement of maxillary and mandibular premolars if positioned too far lingually

Answer 20

the action of the tongue may be limited and speech may be affected

Question 21

how are phonetics affected if positioned too far buccally

Answer 21

whistling or slurring of speech

Question 22

how can you correct an RPD positioned too far buccaly

Answer 22

soft utility wax adapted to the lingual surfaces of the premolar teeth to decrease the escape of air and the whistling or slurring effect

Question 23

what is cheek biting caused by

Answer 23

insufficient horizontal overlap between maxillary and mandibular teeth

Question 24

how can horizontal overlap be increased to stop cheek biting

Answer 24

• if artificial teeth are correctly positioned- round the buccal cusps of mandibular posterior teeth to move cusps slightly lingual
• if artifical teeeth are incorrectly positioned reset teeth

Question 25

what is tongue biting caused by

Answer 25

the artifical teeth being positioned too far lingually and there is a decrease in the tongue space

Question 26

how do you fix tongue biting

Answer 26

- gentle rounding or rolling the lingual cusps and recontouring of the lingual surfaces of the mandibular teeth - if tongue biting continues after the teeth have been reshaped the artificial teeth need to be reset

Question 27

when would the patient have difficulty chewing

Answer 27

if the patient has been missing teeth for several years they have lost neuromuscular skills required to incise and grind food - chewing pattern will be reestablished

Question 28

during early period of adjustment to RPD patient should avoid:

Answer 28

extremely tough, stringy, or sticky food

Question 29

how can difficulty chewing be affected by occlusal surfaces of teeth

Answer 29

- if the occlusal anatomy is not adequate the tooth will be inefficient in chewing

Question 30

how can occlusal surfaces be modified to help with chewing difficulties

Answer 30

- additional sluiceways and grooves should be added to the occlusal surface to increase the cutting efficiency

Question 31

what is gagging caused by and how is it fixed

Answer 31

- poor adaptation of a maxillary RPD to the tissues of the hard palate due to faulty impression - if maxillary RPD is overextended posteriorly- trim the posterior border of the major connector - overextension both in length and bulk of the denture base flanges at the distal extension areas - increase/decrease in occlusal vertical dimension

Question 32

what is soft tissue laceration or ulceration of the soft tissues caused by

Answer 32

an overextended denture base

Question 33

what should cause suspiscion of over extension

Answer 33

increased redness or translucency

Question 34

when does translucent appearance of soft tissue appear

Answer 34

just before actual ulceration occurs

Question 35

what is erythema and what is it caused by

Answer 35

- redness of soft tissues - roughness of the denture base or a slightly rubbing movement of the denture base against soft tissues - occlusal discrepancies or prematurities

Question 36

how can you identify irregularities on the intaglio surface

Answer 36

to pass a fingertip or gauze pad over the intaglio surface of the resin

Question 37

how do you confirm the roughness of the RPD causing soft tissue irritation

Answer 37

PIP

Question 38

when soft tissue irritation has been eliminated, evaluate:

Answer 38

all teeth that are in contact with the prosthesis

Question 39

how should natural teeth be evaluated

Answer 39

with prosthesis out of the mouth, mesial, distal, buccal and lingual pressure should be applied

Question 40

what is irritation to teeth caused by

Answer 40

pressure from the partial denture such as pressure from the metal or resin of the prosthesis on the abutment teeth upon which the prosthesis is seated

Question 41

how can irritation to teeth be evaluated

Answer 41

producing an area of show through in the disclosing wax

Question 42

if there is no show through in disclosing wax and teeth are irritated what should you suspect

Answer 42

occlusal trauma caused by interference between a natural tooth in one arch and the metal of the prosthesis in the opposite arch

Question 43

if the RPD exhibits instability what should you do

Answer 43

adjust one or more of the retentive clasps and if this does not work remake the RPD

Question 44

what do you need to be careful of when adjusting posterior extension of RPD major connector in maxillary

Answer 44

dont remove the beads - if you do food will trap there