Professional Documents
Culture Documents
Options?
• Elastic • Hydrocolloids
• Non-elastic
– (Reversible/ Agar)
• Compound
– Irreversible / Alginate
Non-elastic Synthetic elastomers Hydrocolloids
• ZnO eugenol
(5 day Hydrogum)
Silicones
– Polyethers
ZnO/eugenol
Condensation – Silicones
Waxes Addition
• condensation
• addition
1
Clinical stages Impressions Impressions
Adhesive
Freeend saddle
2
Final Impression Primary Impression
Free end saddle impression
alginate silicone
technique
• Tray modification
• Blocking out
undercuts
Buccal shelf
Retromolar pad
• Adhesive Retromylohyoid
Ridge
Retromolar pad
Buccal shelf
Retromylohyoid
Silicone impression in a special tray
Summary
Handling impressions
Dealing with the FES
• Support
– Rest Metal try in
– Wide saddle coverage / palatal plate
– Disinfection – Clinical muco-displacive impression
– Transport • Stability
– Casting – Retromylohyoid extension
• Retention
– Indirect
• Abutment damage
– Mesial rest
– Flexible clasp
3
Metal Framework Metal Framework
• Fit -
Does it fit the cast?
Does it seat correctly in the mouth? CJR stage
Adjust now
• Occlusion -
Is it interfering with the occlusion?
Adjust now
• If two frameworks –
adjust each separately then
both together
Jaw relationships
The purpose of the CJR stage is to collect the
following information for the technician Tooth contact is stable?
- Hand articulate Tooth position
4
Occlusal plane
Inter-pupillary line • Ala-tragus line
Posterior occlusal
Anterior occlusal plane
plane
5
Tooth selection Tooth selection
Tooth selection
Mould and shade Mould and shade
Posselt’s space
How?
envelope 1. Simple
hinge
2. Average
value
Border movements Base stability
Horizontal and vertical control
Recording RCP
Locate
3. Semi
adjustable
4. Fully
adjustable
6
Try in Fit
N.B.
• Base • Fit
• Occlusion Process partial dentures on duplicate • Occlusion
• Tooth position models • Appearance
• Appearance
Cleanser
Adhesive
7
Adhesives Cleansers Review
• History
• Examination
• Treatment plan
Relines Hard
– Lab acrylic
– Chairside acrylic copolymer
Repairs
local Takuso Rebase
Additions
Soft
- Chairside Viscogel
etc.
8
Problem Solving Problem Solving Problem Solving
• Patient factors • Patient factors • Patient factors
9
Special materials
Problem Solving Problem Solving
/ Special techniques
• Assessment Systematic approch can be applied to -
• Diagnosis
Options • Looseness
Nothing • Fracture
Adjust /correct • Appearance
Replace
• Allergy
Standard technique
Special technique • Impaction
• Other
• Stability • Surgery
• Psychological • Maintenance
• Cost
Benefit v Harm
Magnets
Informed consent
1. Perfect - BSD
2. Imperfect anonymous
3. Imperfect and personal
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Factors that control aesthetics CAD CAM CAD CAM
Scanning
• OVD
• Major tooth position CAD
• Minor tooth position
• Tooth selection Printing
• Tooth modification
Template for
• Gingival modification Conventional
casting
Additive Subtractive
• Flexible • Adjustable?
• Added to
• Aesthetic a CoCr tooth borne or • Reline?
tooth and mucosa borne
framework • Repair?
11
Swinglock dentures Two part dentures
• Sectional dentures Locked by -
• Two part
• Cobalt chrome
• Valplast
12
Goodall W et al. Brit Dent J. 2017; 222:79 - 84
Impaction
Swallowed Inhaled
• Goodall W et al. Brit Dent J. 2017; 222:79 - 84
• Symptoms
– Early
– Medium
– Late
• Risk factors
• Diagnosis /Treatment
• Prevention
Diagnosis?
Allergy to what?
Potential Adverse
Reactions
• Infection
Allergic/ MMA
• Irritation
Hypersensitivity reactions Non- Allergic reactions
(Immunological)
Pigments
Type I Anaphylactic,
antibody-mediated
Type II Cytolytic or
cytotoxic reactions
Type III
Immune complex reaction
Type IV Delayed-type Chemical Irritation Psychological Impact • True allergy Metals
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Retching Retching Retching
Denture design –
Thin
Mr L
Reduced extension
Palateless
14
Prominent retch reflex Prominent retch reflex Prominent retch reflex
• Mechanical
Combined physical • Maxillary impression warm
Denture design
and psychological Palateless alginate or compound
treatment IROD • Training plate 2/3 post dams
• Progressive increase in
• Psychological wearing
Anti anxiety • Add teeth
(Errorless learning)
• New denture ? copy
Systematic desensitisation
technique
Laboratory
and finally........
15