The document discusses the try-in process for complete denture patients. It defines try-in and trial dentures as preliminary fittings used to evaluate aesthetics, fit, and jaw relationships. The try-in involves extraoral and intraoral examinations to check the denture bases, teeth arrangement, occlusion, retention, stability, and other factors. Adjustments are made to optimize aesthetics, function, and patient comfort before the final dentures are fabricated.
The patient who requires a single denture opposing a natural or restored dentition challenges the clinician even more than the completely edentulous patient does. This is due to the biomechanical differences in the supporting tissues of the opposing arches. So a proper evaluation, correction of the existing factors and proper sequence of denture construction is necessary to give a more stable prosthesis.
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
The patient who requires a single denture opposing a natural or restored dentition challenges the clinician even more than the completely edentulous patient does. This is due to the biomechanical differences in the supporting tissues of the opposing arches. So a proper evaluation, correction of the existing factors and proper sequence of denture construction is necessary to give a more stable prosthesis.
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
ARRANGEMENT OF POSTERIOR TEETH ACCORDING TO DIFFERENT THEORIES OF OCCLUSION/ ...Indian dental academy
Description :
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
Sequelae of wearing complete dentures/ orthodontics training coursesIndian 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.
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.
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.
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 I, 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.
13- Relining, rebasing and repair of removable dentures
sources of information mainly from these 2 books, 1- Fenn, Liddelow, and Gimsons' Clinical Dental Prosthetics
2- Yasemin K. Özkan, Complete denture:ProsthodonticsTreatment and Problem Solving,2017.
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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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!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Definition
Try-in Verification / Aesthetic try-in :
“A preliminary insertion of a removable denture wax- up
or a partial denture casting or a finished restoration to
determine the fit, aesthetics, maxillomandibular relation.”
– GPT
Trial denture :
“A preliminary arrangement of denture teeth that has
been prepared for placement into the patients mouth to
evaluate aesthetics & maxillomandibular relationships”
- GPT
Importance:
It is the last opportunity to evaluate many of the
previous steps already accomplished.
2
3. Objectives
1) To check and verify the established maxillomandibular
relationship:
Verify that centric occlusion and centric relation
coincide.
Test for the acceptance of the established vertical
dimension of occlusion.
2) To determine if the positions of the teeth and the
contours of the denture bases are compatible with the
surrounding oral environment.
1) To verify tooth selection and arrangement for proper
esthetics and phonetics.
3
4. Various aspects of try in:
Extraoral examination of the trial dentures.
Intraoral examination of the trial dentures.
4
6. The master cast
As the finished denture is processed on the master cast.
So the master cast should be:
In good shape.
Free from air bubbles or scratches.
Free from wax debris which lead to improper adaptation
of the trial denture bases leading to false relationships.
If there are any undercuts present in the cast, these
undercuts should be relieved to avoid scratching of the
cast by the trial denture bases.
7. The trial denture bases
Check the following:
The trial denture bases must be
stable.
The borders of the trial denture
base should be smooth, round, and
have no sharp edges.
Also the border should be shaped
to conform to the depth and width
of the sulci.
7
8. On the articulators
The mounted cast is checked for:
a) Maintaining of the vertical
dimension of occlusion
Top of the incisal pin is flush
with the upper member of the
articulator.
The incisal pin is in contact
with the incisal table.
8
9. b) The mounting rings are firmly screwed in their position
c) Moving of the articulator smoothly from centric to
eccentric positions without cuspal interlocking.
d) The trial denture bases lie properly on their casts and
the teeth meet evenly in centric relation.
9
10. The teeth
It is the dentist responsibility to select the proper
shade, and mould of the teeth and to determine that
the teeth are set correctly.
Elimination of the excess wax is done to avoid the
camouflages of the teeth relationships to overlook the
occlusion.
10
12. To reduce the risk of cross- contamination, the
trial denture should be sprayed with suitable
antiseptic solution and washed in running water,
before inserted in patient mouth.
1) Checking the trial dentures separately:
Trying- in the upper denture.
Trying- in the lower denture.
2) Checking the upper and lower dentures
together.
13. Maxillary trial denture
Denture base extension:
The labial and buccal extension:
marked overextension of the flanges, will stretch the
sulcus tissues and when denture is inserted, leads to
elastic recoil resulting in dislodgment of the denture,
immediate denture displacement after its seating.
Examination of the extension:
Insertion of the upper trial denture in its place with
light pressure on the occlusal surface, move the cheek
in functional movement. With the release of the
pressure, the denture will fall down.
Need adjustment till little or no movement occurs.
14. Also under extension of the upper trial denture leads to
poor physical retention.
Correction will usually entail making a new final
impression.
Provision of the frena {labial and buccal} should be done
to ensure that they have adequate clearance.
14
15. Posterior extension
The posterior border of the upper trial denture base
should extended from the one hamular notch to the
other along the vibrating line of the soft palate, and
correctly placed on the master cast.
If the p.p.s is not done before, it should be done at
this stage.
Arbitary scraping of the cast and redapting the
record base
15
16. Establishment of Posterior
Palatal seal
Advantages to placing the seal in Trial dentures :
1)Trial base will be more retentive, this can produce more
accurate maxillomandibular records
2) Patients will be able to experience retentive qualities of
the trial base, giving them psychologic security about
retention
3)Denture wearer will be able to realize the posterior
extent of denture.
16
17. Retention
It is noted that the retention of the trial denture is
less than that of completed denture, due to:
Absence of a posterior palatal seal.
Poor adaptation of the trial denture base to the
tissues.
The trial denture should stay in position when the
mouth is opened.
Looseness of the upper trial denture makes it
impossible to carry out an accurate assessment of the
occlusion {may use denture fixative} especially, in
patients with unfavorable anatomical factors.
18. How to test the retention of
upper denture?
Seat the upper trial denture with a firm
upward and backward pressure.
Allow the tissues to settle around the
denture
Grip the labial and lingual surfaces of the
upper denture teeth between the thumb
and forefinger
Apply a firm downward vertical pull to
dislodge the denture away from the
tissues
If the retention is good, dislodgment of
the trial denture may be difficult
18
19. Stability
It is tested by applying pressure in a tissueward direction
with the ball of the index finger in the premolar and molar
regions on each side alternately.
This pressure must be directed at right angles to the
occlusal surface where displacement does occur.
Causes of instability
Warpage of the denture base.
Posterior teeth set buccal to the underlying alveolar
ridge
Hard unrelieved area in the midline
e.g. torus palatinus.
19
20. Orientation of the occlusal
plane
Properly oriented occlusal plane is
important to:
Patient esthetics.
Patient comfort
Chewing function
Balance of occlusion
20
21. Orientation of the anterior end of the occlusal plane is
determined by esthetics.
The amount of the upper anterior teeth that will be seen
during speech and facial expression depends on length
and movement of the upper lip.
If the upper lip is relatively long, the natural teeth may
not be visible when the lip is relaxed or even during
speech.
The movement of the lips during function varies
considerably among patient thus , the amount of the
upper teeth that will be visible varies for each patient.
21
22. Lower denture trial
Denture base extension:
The lower trial denture extension should be tested
with the patient mouth is opened no more than half
opened position to allow the surrounding
musculature is in an acceptable state of relaxation.
Labial and buccal extensions are checked as for
the upper trial denture.
23. How to evaluate lower denture retention?
Usually the lower denture retention is poor when
compared to the upper denture due to:
1. Small denture bearing area
2. The difficulty in obtaining an efficient border seal.
Testing of the lower trial denture retention:
a) Ask the patient to open his mouth slightly and let his
tongue touch the cingula of the lower anterior teeth,
support the chin of the patient with the left hand and
pull the teeth straight upwards to check the retention of
the anterior labial and lingual flanges.
b) Tilt the lower trial denture outward from the canine
region to test the retention of the opposite retro molar
pad.
24. Lower occlusal plane
In most patients, the incisal edges
of the natural lower canines and
the cusp tips of the lower first
premolars are located at the level
of the lower lip at the corner of
the mouth when the mouth is
slightly open.
The posterior end of the occlusal
plane should be at the level of the
anterior two thirds of the retro
molar pad.
24
25. Tongue space
Natural teeth occupy a position in the mouth where the
inward pressure of the lips and the cheeks is neutralized
by an equal and opposite outward pressure of the tongue,
and it is in this zone of neutral pressure that the artificial
teeth must be set (neutral zone).
25
26. To check for the neutral zone in the patient’s mouth, let the
patient open his mouth half-way and touch the lower
anterior teeth with the tip of his tongue, while his tongue is
relaxed. Feel the amount of pressure exerted by the tongue
and cheek on the lower teeth, using a plastic filling
instrument. Pressure should be roughly equal on the lingual
and buccal sides of the teeth.
26
27. Lack of tongue space
(cramped tongue)
If the tongue is more mobile than the cheeks will cause
greater instability of the lower denture.
Cramped tongue may be due to:
1. Posterior teeth set lingually to the neutral zone.
2. Posterior teeth tilted lingually
3. Posterior teeth too broad bucco-lingual.
Testing of the tongue space:
Ask the patient to raise the tongue. If the tongue is
cramped, the denture will begin to rise immediately. As
the tongue moves it tries to expand laterally and
whenever the tongue moves the denture will move.
27
28. Checking the upper and lower
dentures together
It is usually advisable to insert the lower
trial denture first and then the upper
because there is less chance of having the
upper denture drop down.
The patient should be seated in an upright
position.
The patient head is not supported by the
headrest (the headrest may effect the
physiologic rest position of the mandible
so, it effect the amount of interocclusal
distance).
28
30. Verifying the Vertical dimension
Checking of labial frenum
Evaluation of Vertical dimension at rest & at occlusion
pre extraction records
amount of inter occlusal distance to which pt. was
accustomed
phonetics & esthetics
facial dimension & facial expressions
lip length in relation to teeth
inter arch distance & parallelism of the ridges
30
31. Verifying Centric Relation
Intra Oral Observation of Intercuspation
Pt. is guided into CR by a thumb placed on the anteroinferior
portion of the chin & index finger bilaterally on the buccal
flanges of the lower denture.
Any Error in CR will be apparent when teeth slide over each
other.
31
32. If Error is due to mounting :
anterior teeth if not placed to support lip, are corrected.
vertical overlap of anterior teeth are carefully noted .
posterior teeth are removed from lower occlusal rim
Impression plaster is mixed & placed on the rim.
32
33. Pt. is instructed to close the mouth slowly until the
anterior teeth have same vertical overlap as they had
before the posterior teeth were removed.
After the plaster is set, rims are removed & this
corrected new record is mounted on a articulator.
33
34. Extra oral articulator method
Process :
- Impression material (eg. Aluwax) is placed over mandibular
posterior teeth
- wax sealed – denture placed in mouth – just wax portion is
immersed in water bath of 130o
F for 30 secs – denture
placed back in pts mouth - mandible guided into CR so that
upper teeth makes contact with the wax – denture
removed & chilled in ice water & returned back to patients
mouth for re-checking
34
35. – CR is confirmed – Trial dentures are then locked in
articulator – opposing teeth should fit in the indentation in
every way (anteriorly, posteriorly, laterally & vertically ) if
the original CR was correct.
- If it does not fit, mandibular cast should be separated &
remounted with last occlusal record.
35
36. Eccentric relation records
It is essential that the movements of articulator should
simulate movements of the patient within the range of
normal functional contacts of teeth.
For this, condylar elements of articulator must be adjusted
so that they approximate condylar guiding factors within
TMJ.
36
39. Creating facial & functional harmony
with Anterior teeth
Appearance of entire lower half of face depends on
dentures.
After vertical dimension of occlusion & CR has been
verified. To obtain a harmonious effect with the patient
face, modifications are made in arrangement of teeth
Incorrect positioning of anterior teeth or supporting base
material alters normal appearance of vermilion border, the
philtrum & mentolabial sulcus
39
41. 1. Preliminary selection of
artificial teeth
Evaluated for size, form & color
6 anterior teeth should be of sufficient overall width to
extend approx. corner of mouth
Color should blend with the face
Any records used in initial selection
should be consulted & changes should
be made if it improves the appearance of patient
42. 2. Horizontal orientation of anterior teeth
Teeth set directly over ridges causes insufficient lip
support characterized by:
Drooping of corners of mouth,
Reduction in visible part of vermilion border,
Deepening of nasolabial sulcus,
Wrinkles over vermilion border
Excessive lip support causes stretched lips, tendency
of lips to dislodge dentures during function,
elimination of normal contours of lips, philtrum &
sulci.
42
43. Labial surface of many natural central incisors are about
8 – 10mm from center of incisive papilla
43
44. 3. Vertical orientation of anterior teeth
Index finger is placed on incisive
papilla with relaxed upper lip &
amount of finger covered gives
indication of length of upper lip.
Lower lip is better guide for
vertical orientation of anterior
teeth. Incisal edges of lower
canine & cusp tip of lower first
premolar are even with corner of
mouth when mouth is slightly open.
44
45. If lower teeth are above then,
1. plane of occlusion may be too high
2. vertical overlap of anterior teeth may be too much
high
3. vertical space between the jaws may be excessive
45
46. 4. Inclination of anterior teeth
Inclination of labial surface of residual ridges seen on
edentulous cast gives guide to inclination of anterior
teeth
Inclination of anterior teeth parallels the profile line
of face
46
47. 5. Harmony in general composition of
anterior teeth
A. Harmony of dental arch form & form
of residual ridge:
I. Square arch form
Central incisors are more nearly in line with
canine
4 incisors should have little rotation to give
broader effect to teeth
II. Tapering arch form
Central incisors are greater distance
forward from canine
rotating or lapping of teeth may be present
III. Ovoid arch form :
teeth seldom rotated
show greater amount of labial surface
47
48. B. Harmony of long axis of central incisors
& face
Imaginary perpendicular line from mid point of Inter
pupillary line should mark middle of dental arch to be in
harmony with face
Mid line also determined by observing position of incisive
fossa
Mid line of mandibular central incisor is aligned with that
of maxillary incisors
48
49. C. Harmony of the teeth with smiling line of the
lower lip
Line formed by upper anterior teeth should follow curved
line of lower lip during smiling
Vertical positioning of upper canines are responsible for
shape of smile line
49
50. Canines should be arranged in such a way that their
incisal edges should be slightly shorter than that of
lateral incisors, if not it will create reverse smile
line.
Reverse smile line is one of the frequent cause of
artificial appearing dentures.
50
51. D. Harmony of opposing lines of Labial & Buccal
surfaces
Asymmetrical symmetry is essential for natural
appearing teeth
eg. If maxillary right lateral incisor is set at 5 degrees
to perpendicular then opposing lateral should be of
same angle but in opposite direction
Labial & buccal lines should be in harmony with lines of
face.
51
52. E. Harmony of incisal wear & age
Incisal edges of denture teeth should be grinded to
simulate the wear surface that would have developed by
the time patient reached his current age.
This wear is placed on teeth where it would have occurred
during function & also where it assists in the mechanics of
balancing the occlusion
53. F. Harmony of spaces & individual tooth
position
Use of spaces between teeth can be effective in
emphasizing individual tooth position & natural
appearing arrangement
Spaces designed should be self cleansing
53
54. Conclusion
For the success of a complete denture the teeth should
be arranged in harmony with the intraoral and circumoral
structures and adjusted so that they occlude and
articulate evenly.
After the preliminary arrangement of the artificial
teeth on the occlusion rims, it is essential that the
accuracy of the jaw relation records made with the
occlusion rims be tested, perfected if incorrect, and
then verified to be correct.
During Try-in all the procedures carried out in
fabrication of denture are verified clinically.
54
55. References
Prosthodontic Treatment for Edentulous patients, 12th edition :
Zarb – Bolender
Essentials of complete denture prosthodontics, 2nd edition :
Sheldon Winkler
Text book of prosthodontics, Deepak Nallaswamy
http://www.slideshare.net/narendrabasutkar/try-in-complete-
dentures
www.gr.dentistbd.com
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