Prosto lec 4

Introduction
In this lecture we are going to talk about the main principles of
making and fabricating CD and they include: stability, support
and retention. All of these we work to attain them to have the
best fabricated denture we can make.
Support
Def: It is the resistance of vertical forces of mastication,
occlusal forces and other forces applied in a direction towards
denture bearing area
** bearing area differs for mandible than maxilla where the avg
of bearing area in maxilla denture is 24 sq.cm but in mandible
denture it is 14 sq.cm
To increase the support there is things must be done and they are
1 to achieve the maximum coverage which will distribute the
forces all the way over the bearing areas and reduce the amount
of the forces and stress on the non bearing areas (snowshoe
effect) but maintain the function and location of the supporting
tissue
2 do a special physiological type of border molding to the
patient
3 make a good space inside the tray for the final impression
material
4 do a special relief by wax not complete one but the partial one
for both upper and lower as u did in the lab while making the
special tray
5 use the best impression material that you find it suitable to
work with depend on the situation
6 insert the tray in a proper way inside the patient mouth to
reach the best benefit in recording things
7 final impression material and the tray material must be stable
and dont undergo any changes to help in making the best of the
best
8 the final impression should be highly detailed coz the shape of
it will be the same as the denture that will be fabricated
9 always in the final steps be accurate while fitting the trays and
taking impression coz it is the final perfect steps that will
denture will depend on it
tention Re
Def: quality inherent in the denture that resists the vertical
forces of dislodgement
** The forces that may affect retention of the CD are:
1force of gravity (especially maxillary)
2 the adhesiveness of food (sticky food that will remove CD
from place)
3 forces of the opining of the jaw (include muscle work and lips
and other things)

The factors that affect the retention and make it more are 6
categories and they are:
1 anatomical factors
2 physical factors
3 physiological factor
4 mechanical factors
5 surgical factor
6 psychological factor
** Anatomical factors: things related to the anatomy of the
upper and lower jaw either themselves or if there was anything
to be done to them and they include:
1 the maximum coverage of the basal seat area by extending the
flanges of the denture to cover all the details but without
disturbing the functional areas
2 quality of the denture bearing area means that you must look
at the ridge if it was more pronounced, parallel and obvious it
will be better than flat one
3 oral and facial musculature it can supply supplementary
retentive force by the properly polished surface that will apply
the best ability to form retention
4 occlusal plane must be at the correct level
5 the arch form of the teeth must be in the neutral zone between
the tongue and the cheek so no one of them can displace the
denture from its place coz if u put it in one of these areas it will
be dislocated by the movement of them
6 patients can control the denture by their muscle using the
nerves so the younger patient will always have more controlling
the old patient
** Physiological factors: it is mainly about the saliva and talking
about the best type of saliva to retent any denture
$$ saliva is either thick high mucin saliva that is more viscous
than the watery saliva or watery serous saliva that can be
interposed in a thinner film than the first one
$$ excessive salivation is bad for retention also reduced
salivation is bad too
$$ well hydrated mucosa is better in retention than dry one
** Physical factors: it includes these things:
1 adhesion: it is the attraction between the different types of
molecules it depend on the saliva where it come between the
denture and the tissue and it is increased when the distance
between the denture and the tissue is decreased also increasing
of saliva fluidity will increase it
2 cohesion: it is the attraction between the same type of
molecules and mainly it is in the layer of saliva that separate the
denture from the oral mucosa
3 interfacial surface tension: it is a thin layer of fluid that is
present between two parallel surfaces of rigid materials and we
must mention that denture has higher surface tension than oral
mucosa but once coated by salivary pellicle tension is reduced
4 capillarity: it is the state due to surface tension where there
will be elevation or depression of the fluid surface which in
contact with the solid so it's important come where saliva work
as capillary and retention is formed between the surface of both
mucosa and denture
5 atmospheric pressure: the source of it is the weight of the
atmosphere 14.7 lb.sq inch
++ It will give us a power called suction that will result in
resistance of the denture to be dislodged and removed from its
place
++ It is also affected by 3 things: perfect peripheral seal, perfect
border molding and selective pressure teqnique
6 gravity: not an important factor but it affect as a retentive
force for lower denture and as a displacement force for the
upper denture ((only when the patient is setting straight up))
** Mechanical factors: includes (insertion pathways, undercuts,
denture adhesives and parallel walls)
1 undercuts: the resilience of the mucosa and sub mucosa
overlying the basal bone allow for the existence of modest
undercuts that can enhance retention
++ Undercuts that work as a retention factor are:
((Less severe undercuts of the lateral tuberosities+ maxillary
premolars areas +destolingual areas + lingual mandibular
midbody areas))
2 insertion pathways: provides resistance to vertical
displacement
3 parallel walls: prominent alveolar ridge with parallel buccal
and lingual walls; it works as a retention factor by increasing the
surface area and maximing the interfacial and atmospheric
forces
4 denture adhesives: non toxic material indifferent forms that is
used by putting it on the tissue surface of the denture to enhance
the retention of it
** Psychological factors: include both the patient tolerance; how
much he can be corporative with you and patient education his
knowledge and ability to work with u
** surgical factors: tuberoplasty + zygomaticoplasty +
vestibuloplasty these are the main three features affecting the
denture that we can do them and reach them by surgeries
depending on the patient situation
Stability
We mean by this concept is the ability of the denture to be:
1 firm
2 stable an constant
3 resistance to displacement
4 able to hold position when forces are applied
++ It is affected by several factors and they are:
1 vertical height of the residual ridge: be aware that vertical
ridge must be like a mountain and the more that it look like it
the better effect coz if it got resorped then we will lose the
stability that it gives
2 tissue covering the ridge: if the tissue is firmly attach and
resilience then it is better than the flabby tissue in facing
masticatory forces
3 impression quality: in here 3 things we concern about it which
are (accurate detail recording + impression material stability to
avoid 3d change + pouring time must be immediately
4 occlusal plane: it must be oriented in a way that maintain a
good interocclusal space to increase stability
5 teeth arrangement it must be in an accurate occlusal way to
reach the best stability also dont forget the neutral zone
placement
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by this slides and book are all included you will find similarity
and almost copy paste of the slides coz they have more things
than the book