This document discusses the process of denture insertion and adjustment. The key steps include: 1) examining the finished denture for any areas causing discomfort, interference, or aesthetic issues; 2) modifying the occlusion as needed; 3) instructing the patient on denture use and care; and 4) assessing denture retention, stability, and occlusion. The dentist checks for pressure areas, sharp edges, and proper extension and makes any necessary adjustments to ensure a well-fitting, functional denture.
this presentation has all the techniques in impression making in the fabrication of an RPD.
The presentation is available on request. Mail me at apurvathampi@gmail.com
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
A single complete denture is a complete denture that occludes against some or all of the natural teeth, a fixed restoration, or a previously constructed removable partial denture or a complete denture.
Opposing natural teeth that are sufficient in number and do not necessitate a fixed or removable partial denture.
Opposing a partially edentulous arch in which the missing teeth have been or will be replaced by a fixed partial denture.
Opposing arch with an existing complete denture.
Neutral Zone
In dentistry, the neutral zone refers to that space in the oral cavity where the forces exerted by the musculature.of.the tongue are equal and balanced with the.forces exerted by the buccinators.muscle of the cheek.laterally and the orbicularis.oris muscle anteriorly
phonetics play an important role in planning and preparing complete denture for the complete edentulous patients.design of the prosthetic denture affects speech in a number of ways.
Post insertion complaints in cd patients/ orthodontic continuing educationIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
this presentation has all the techniques in impression making in the fabrication of an RPD.
The presentation is available on request. Mail me at apurvathampi@gmail.com
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
A single complete denture is a complete denture that occludes against some or all of the natural teeth, a fixed restoration, or a previously constructed removable partial denture or a complete denture.
Opposing natural teeth that are sufficient in number and do not necessitate a fixed or removable partial denture.
Opposing a partially edentulous arch in which the missing teeth have been or will be replaced by a fixed partial denture.
Opposing arch with an existing complete denture.
Neutral Zone
In dentistry, the neutral zone refers to that space in the oral cavity where the forces exerted by the musculature.of.the tongue are equal and balanced with the.forces exerted by the buccinators.muscle of the cheek.laterally and the orbicularis.oris muscle anteriorly
phonetics play an important role in planning and preparing complete denture for the complete edentulous patients.design of the prosthetic denture affects speech in a number of ways.
Post insertion complaints in cd patients/ orthodontic continuing educationIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
FPD failures/dental CROWN & BRIDGE courses by Indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
A presentation on the instructions to be given to complete denture patients at the insertion appointment. Dealing with patients can be hard at times but with a proper approach, a strong rapport can be formed with the patient.
Failures in fixed partial dentures /certified fixed orthodontic courses by In...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
HIPERPLASIA FIBROSA INFLAMATORIA TRATADA CON VESTIBULOPLASTIA MODIFICADA: REP...Edwin José Calderón Flores
La hiperplasia fibrosa inflamatoria es una condición reactiva que se origina, con mayor frecuencia, por el uso de prótesis totales o parciales mal adaptadas, produciendo un traumatismo crónico de baja intensidad. Las lesiones pequeñas pueden ser manejadas de forma conservadora mientras que las lesiones extensas y de larga evolución necesitarán de escisión quirúrgica. La técnica quirúrgica empleada debe restaurar el contorno normal del tejido y la adaptación protética.
7-Try-in of the wax trial complete dentureAmalKaddah1
CLINICAL STEPS FOR COMPLETE DENTURE CONSTRUCTION
1- Diagnosis and Treatment Planning for Removable Prosthodontics
2- Preliminary Maxillary and mandibular impression procedures
3- Final Maxillary and mandibular impression procedures
4- Jaw Relation Registration
a.Introduction and the stomatognathic system
What 'occlusion' is and why it is important
b.Definitions.
c.Check denture foundation and Establishment of facial contour.
d.Establishment of the occlusal plane.
e.Importance of mounting the maxillary cast using Maxillary face-bow record and transfer.
f. Determination of vertical dimension of centric occluding relation.
g.Determination of centric and eccentric relations at the accepted vertical dimension.
5- Selection of Artificial Teeth
6- Prosthetic Problems and possible solutions in Setting –up of teeth for skeletal Class II and Class III arch relationship of completely edentulous patients.
7- Try-in of the wax trial complete denture.
8- Complete denture insertion (Delivery)
9- Managements of Post Insertion Problems and Complaints.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
complete denture instructions to patients/ orthodontic practiceIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
9- Denture placement and occlusion correction.AmalKaddah1
COMPLETE DENTURE CONSTRUCTION
1- Diagnosis and Treatment Planning for Removable Prosthodontics.
2- Preliminary Maxillary and mandibular impression procedures.
3- Final Maxillary and mandibular impression procedures.
4- Jaw Relation Registration.
a. Introduction and the stomatognathic system
What 'occlusion' is and why it is important.
b. Definitions.
c. Check denture foundation and Establishment of facial contour.
d. Establishment of the occlusal plane.
e. Importance of mounting the maxillary cast using Maxillary face-bow record and transfer.
f. Determination of vertical dimension of centric occluding relation.
g. Determination of centric and eccentric relations at the accepted vertical dimension.
5- Selection of Artificial Teeth
6- Prosthetic Problems and possible solutions in Setting –up of teeth for skeletal Class II and Class III arch relationship of completely edentulous patients.
7- Try-in of the wax trial complete denture.
8- Complete denture insertion (Delivery).
9- Occlusal corrections.
10- Managements of Post Insertion Problems and Complaints.
11- Single denture and Kelly's Syndrome.
12- Denture Processing and Laboratory Errors.
9- Denture Placement and occlusion correction.pptxAmalKaddah1
COMPLETE DENTURE CONSTRUCTION
1- Diagnosis and Treatment Planning for Removable Prosthodontics
2- Preliminary Maxillary and mandibular impression procedures
3- Final Maxillary and mandibular impression procedures
4- Jaw Relation Registration
a. Introduction and the stomatognathic system
What 'occlusion' is and why it is important
b. Definitions.
c. Check denture foundation and Establishment of facial contour.
d. Establishment of the occlusal plane.
e. Importance of mounting the maxillary cast using Maxillary face-bow record and transfer.
f. Determination of vertical dimension of centric occluding relation.
g. Determination of centric and eccentric relations at the accepted vertical dimension.
5- Selection of Artificial Teeth
6- Prosthetic Problems and possible solutions in Setting –up of teeth for skeletal Class II and Class III arch relationship of completely edentulous patients.
7- Try-in of the wax trial complete denture.
8- Complete denture insertion (Delivery)
9- Occlusal corrections.
10- Managements of Post Insertion Problems and Complaints.
11- Single denture and Kelly's Syndrome
12- Denture Processing and Laboratory Errors.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
1. Denture insertion
The finished denture must fulfill :
1. Physical needs required to perform adequate
function without trauma to supporting
structures
2. Physiologic needs to allow proper support by
muscles for good esthetics.
3. Psychologic needs to provide proper function
& esthetics .
2. Objectives :
1. To identify and correct :
-- Any area of denture base causing pain or discomfort.
-- Any area of denture interfering with retention & stability of dentures.
-- Any part of denture that is esthetically unpleasing
2. To modify occlusal surfaces to harmonize occlusion (refine occlusion )
3. To instruct the pt. how to use & care his denture .
4. To instruct the pt. in proper care of denture supporting tissues .
5. To advise the pt. on limitations of dentures to be expected
3. Spatula try-in
The well adapted rims
surfaces are paralels, lay
onto each other, and bases
are attached to the maxilla
and mandibule
5. Transversal Christensen phenomenon
Means that when the patient bites with well-adapted occlusal
rims laterally, rims are in occlusion only on the workingside. On the balancing side an open, wedge-shaped gap
occurs at the molars, between the upper and lower rims.
7. Insertion procedures :
1. Extraoral examination of the finished denture:
A. Examination of impression surface
B. Evaluation of denture borders.
C. evaluation of polished surface.
2. Intraoral examination of the finished denture :
A. Location & relief of pressure areas in denture base
B. Identification & reduction of overextended borders
C. Evaluation of retention & stability
D. Evaluation of esthetics & facial contours
E. Refinement of occlusion
F. Patient’s instructions
8.
9. ARTCULATOR
PIP
Rubber bowl , mouth wash
Hand mirror
Completed dentures & study casts
Straight handpiece & burs
Occlusal indicating wax
Articulating paper
Mouth mirror & napkin
16. Avoid sharp edges when trimming labial frenum notch .
Frenum must be able to “ roll over” the denture
17. If stretched cheek is released , buccal frenum will lie tightly
against functional border of the denture. As mouth is opened ,
buccal frena are stretched back & down. So, frena contribute to
a well adapted border
18. To check retention of upper denture , pull down with 2 fingers .
As denture moves down, then holds well, air is trapped under
denture base upon insertion.
To check retention of lower denture , push gently against lower
anteriors with closed pliers as tongue filling floor of the mouth
19. Retentive denture is removed by breaking border seal with index fingers or
by pulling out the cheeks
Demonstrating masticatory stability when a closing force is exerted in the
area of posterior teeth
21. Pt. must not hold lower
denture using a squeezing
action during cleaning
Recommended method to
hold a lower denture during
cleaning
22. Pt. must not use hot water ( above 70 C ) to clean
dentures. Elevated temperature crazes the denture
surface resulting in a bleached appearance.
23. Upper denture with a clear palate. It enables areas of high
pressure under the denture to be seen & preferred by some
pts. due to its lighter appearance
24. PIP is used to identify areas on fitting surfaces of dentures ,
which exert heavier pressures on the tissues
25. Thin layer of PIP is painted
on denture fitting surface
Denture is seated in mouth
& removed . Areas of high
pressure are identified
26. Dynamic relationships of teeth as the jaw is moved to right & left
and when protruded . This is checked with articulating paper of a
different color
27. Pattern of occlusal contacts produced by sliding the mandible to
the right ( working side ) & the left as the balancing side . Even
occlusal contacts , such as those , are produced by grinding cusps
.
28. Occlusal indicator wax may be used instead of articulating
paper to indicate the location & extent of occlusal
contacts , or near contacts .
29. Wax has a shiny , mildly adhesive coating on one side .
Pencil is used to mark the teeth where the opposing arch is
penetrating the wax
30. Areas of heavy tooth contact will cause penetration of wax , that allows
identification of near contacts . Teeth must be marked where wax is
penetrating
Areas of heavy occlusal contacts
32. At first , insert upper denture & observe the length of denture
border for proper extension . Frenum may be displaced while
making impression , so the frenal area must be checked
33. Labial frenum is displaced by notched border of the denture .
So, notch must be slightly deepened & widened vertically with
a large fissure bur. Also, bevel the inner margin of the notch
34. Border of lower denture is checked & adjusted . In mentalis
muscle & retromolar pad areas impression tends to be
overextended , so examination must be carefully performed
35. PIP is used as a thin layer painted on denture fitting surface
so that brush marks are visible
36. Denture is inserted & heavy pressure is applied with fingers.
Location of pressure spots in denture base that displace
soft tissue can be determined & eliminated .
37. An area where the paste is very thin or completely
displaced indicates pressure spots
38. Lower denture displays a pressure point on mylohyoid
ridge. This pressure spot is removed with a bur
39. This recording & trimming is repeated until denture base surface
do not show through the paste. The paste layer is even
40. PIP layer may be displaced due to brushing against the residual
ridge on insertion & removal of denture. It must be determined
as to whether areas with displaced paste are pressure areas or
due to accidental contact during insertion & removal
41. PIP must be wiped off with cotton using firm , uni-directional
stokes , not in a back & forth motion
42. Even paste record. No more adjustments are needed
Areas roughened during adjusting the basal surface must be smoothed with a
sandpaper cone & polished with silicone point
43. After adjusting the basal surface , occlusion refinement is done
at chair-side . Prior to occlusal adjustment , cotton rolls are
placed on both sides between upper & lower posterior teeth
44. Occlusal adjustment is always needed as inserting new dentures.
Occlusal contacts in CO must be checked using thin articulating paper
Heavy contacts in CO must be corrected by grinding the fossae &
cusp inclines
45. These procedures must be repeated until posterior teeth have
even occlusal contacts in CO
46. If interferences are found as the jaw is moved to right & left ,or
protruded , they must be eliminated ( like selective grinding on
articulator )
47. Occlusal registration paste
A separating medium is placed on upper teeth & relationship of
dentures recorded using occlusal registration paste .
48. An even layer of carborundum paste is placed on occlusal
surface of lower posterior teeth . Pt. is instructed to slowly move
the jaw to right & left and anteroposteriorly.
49. * Adjustment of the occlusion is necessary
1. to account for inherent errors caused
by processing changes
2. to eliminate errors apparent at the try-in
stage.
50. Causes of Occlusal Disharmony
1- Undetected errors in registering
jaw relations.
2- Errors in mounting the master casts
on the articulator.
3- Processing errors.
4. Dimensional changes of acrylic denture base
material
51. 5- Differences in tissue adaptation between the
processed denture bases & the record bases that
were used in recording maxillo- mandibular relations.
6- Changes in the supporting structures since the
impression is made ( as pt .using ill-fitting denture )
52. Correction of Occlusal Disharmony
* Selective Grinding
. To provide balanced contacts between the
teeth in the retruded jaw relationship,
. and in lateral & protrusive contact relations,
. and free sliding contact movements to
eccentric positions without cuspal
interferences.
. The occlusal vertical dimension must be
maintained.
53.
54.
55. Occlusal Discrepancies may be
corrected by either:1- Intra-oral Adjustment Techniques
a- Articulating paper
b- Occlusal indicator waxes
c- Central bearing devices
d- Abrasive paste.
57. Intra-oral Adjustment
Techniques
a- Articulating paper
* It will not give an accurate indication of
premature contacts because the resiliency
of the supporting tissues allows the
denture
to shift producing markings which are
frequently false.
59. Articulating paper of a different color must be used to
distinguish contacts marked in eccentric positions from those
marked in centric position
60. When selective grinding in lateral occlusions is completed ,
incisal pin usually stays in contact with incisal table during
lateral excursions
61. Marking & grinding procedure is repeated for both lateral
movements until markings indicate uniform contacts on working
& balancing sides
62. After completing selective grinding , marks made by movements
in all directions must show uniform contacts. Red marks show
contacts made in centric position & blue marks show contacts
made during lateral and protrusive movements
63. b- Occlusal Indicator Wax
* Two strips of adhesive green occlusal
indicator wax 6 mm. wide are placed
on the occlusal surfaces of the mandibular
denture.
The dentures are placed in the patient’ s
mouth & the patient’s is guided into
retruded contact position.
64. Wax must be carefully adapted
to occlusal surfaces of teeth
Mandible is gently guided so
that teeth make contact with the
lower jaw maximally retruded
65. c- Central- bearing Devices
* When a centralbearing
device
assembled,
bearing
is
the
pin
is
adjusted to permit
an evaluation of the
occlusion
66. D- Abrasive Paste
* Should not be used to eliminate errors
in occlusion of cusp teeth.
* The shifting of the denture bases as a
result of premature contact may result in
altering the occlusion so that centric
occlusion does not correspond to centric
relation.
67. Extra-oral Adjustment
Techniques
* Extra-oral adjustment of occlusion is
carried out by a procedure known
as
remounting & selective grinding.
It includes:1- Laboratory Remounting
2- Clinical Remounting
68. Laboratory Remounting
* Objectives:
1- Restore or re-establish the vertical
dimension of occlusion.
2- Perfect working and balancing occlusion
3- Establish protrusive balanced occlusion.
70. Supporting or Centric Holding
Cusps
* The vertical
dimension of occlusion
is maintained by
occlusion of the palatal
cusps of the maxillary
teeth & the buccal
cusps of the mandibular
teeth.
71. Rules of adjustment
a- If the cusp is high in
centric & eccentric
positions. Reduce the
cusp.
b- If the cusp is high in
centric & not in eccentric
positions. Deepen the
opposing fossa or
marginal ridge.
72. * After all interceptive
contacts have been
eliminated in centric
& eccentric
positions:
a- Don’t reduce upper
palatal cusps or
lower buccal cusps
b- Don’t deepen the fossa
or marginal ridge of any
tooth
73. II- Occlusal Balance in Lateral
Excursions
* Rules of Adjustment
A- On the Working Side
Adjust the buccal cusps of the upper teeth & the
lingual cusps of the lower teeth ( B.U.L.L. rule ) to
eliminate deflective contacts.
74.
75. B- On the Balancing side
Reduce inner inclines of lower buccal cusps , don’t reduce the
cusp tip as it is a centric holding cusp
76. III- Selective Grinding for Protrusive
Balance
* In protrusive balance, the anterior teeth
should make incisal edge contact at the
same time that the tips of the buccal &
lingual cusps of the posterior teeth contact.
77. Rules of Adjustment
a- If anterior teeth have heavy contact
with no posterior contact:
* Reduce the labio-incisal surfaces of the lower
teeth & the palatal surfaces of the upper
teeth.
78. b. If posterior teeth have heavy contact with no
anterior teeth contact. Reduce distal inclines of
upper cusps & mesial inclines of lower cusps
79. Clinical Remounting
* It consists of remounting the finished
denture on an articulator by using
interocclusal records in the patient’s
mouth
* The occlusion is then adjusted on the
articulator to remove discrepancies &
interferences.
80. Step by Step Procedure
I- Preserve the orientation of the Maxillary
cast to the Articulator:* A plaster remount index is an occlusal
registration of the maxillary denture which
is recorded on a remount jig attached to
the lower member of the articulator.
81.
82. II- Preparation of the Remount
Casts
Casts should be constructed to facilitate
the positioning of the complete denture on
articulator & the process of occlusal
correction.
83.
84. III- Centric Interocclusal Record
* The centric
interocclusal record
is used to mount the
mandibular denture
on the articulator as
a part of the clinical
remount & selective
grinding procedure.
85. Advantages of Clinical Remounting
1- It reduces patient participation.
2- It permits the dentist to see better what
he is doing.
3- It provides a stable working foundation;
denture bases are not shifting .
86. 4- The absence of saliva makes possible
more accurate markings with the
articulating paper.
5- Corrections can be made away from
the patient .