Prosthodontics lab1-part1 Dony by : Ahmad khasati Date: 29/10/2011 Removable prosthodontic(1)- Complete denture

Definitions:
Prothesis (:) Replacement of lost body part Prosthetics: science and art that deal with prosthesis Dental prosthesis is called prosthodontics : ) )replacement of loss oral tissues related to oral cavity . Prosthodontist :person who specializes in prosthodontics. Complete Denture (CD) : dental prosthesis that replaces all missing teeth and associated structures . Edentulous: patient with no teeth (.) Partial edentulous: patient with some teeth missing. Dentate: still have teeth. Complete Denture : deals with edentulous patient ONLY -----------after extract all teeth ( ) there is Bone + soft tissue. (See figure )

palate
tonge space ridge Residual Alveolar Ridge Ridge (RAR)

Complications or Problems in Edentulous patient : 1-Defect in speech ( e.g. patient cant say "S" correctly)-(function). 2-Chewing difficulty - (function). 3- appearance. ---------------------------Steps of making complete denture : - Its complex process need long time
-

You need lab and technician.

- There is Clinical steps and laboratory (technical) steps.

Clinical Steps Primary Impression 1-Impression material:

a- Alginate b-Impression compound (thermoplastic material )

Lab Steps -convert negative replica to

positive replica (Pouring) - Pouring primary impression by using (gypsum type II) -Diagnostic cast (Not Accurate ) because : 1- Tray not accurate 2- impression material not accurate

2-stock tray ()
Notes: 1st clinical visit :

3- stock tray cant reach History, examination, treatment functional depth and width planning, primary impression for vestibule upper and lower jaws, Pt dismiss You need secondary cast & custom Tray(Special Tray) Custom tray can capable to reach sulcus After 1 week (tray should be shorter than sulcus about 2mm-3mm) -Border modeling using Green Stick to reach functional depth and width of sulcus . -Secondary impression (final impression) -more accurate due to custom tray& accurate impression material :

-Beading and Boxing (secondary Impression) -pouring by using gypsum type III Dental stone (stronger than typeII) Notes: edentulous lost vertical relationships btw jaws & post,lateral relationships -Record block :device that
technician fabricates to record the vertical and horizontal relationships of the patient

a- zinc oxide eugenol (most common)

-Record Block contains pas plate and wax rim *

Done by: Ahmad Mohammad khasati

Prosthodontics lab1-part2 Dony by : Amr Alsadi Date: 29/10/2011

To do a complete denture there are 5 clinical steps and 4 laboratory steps and sometimes we have to recall the patient as of some problems may occur.

The first step in doing a complete denture is : primary impression which is a clinical step , to do It we need an impression material .

The possible impressions are : alginate , impression compound , elastomeric impression material ( addition silicon , condensation silicon , polyether, polysulfide ) .

The most used impression is: alginate and impression compound.

Impression compound consist of : wax , resins , fillers , certain colors ( to give it a specific color ) ,and they have a good smell .

We classify impressions as : rigid , elastic ..

Ex of Rigid: eugenol , impression compound ,

Eugeniol : pink or white color , and its the material which gives the smell of clinics .

Note: rigid compound have tow way to set: chemically ( zinc ,eugenol, ) , thermoplasticly ( as impression compound ) .

Ex of elastic: aqueous (hydrocolloids) , non aqueous (addition silicon , condensation silicon , polyether, polysolfied) . ..Ex of Hydrocolloids: alginate and agar agar (usually used in the lab, not that much in the clinic) We divide hydrocolloids to : thermoplastic ( agar agar) , reversible hydrocolloid , chemically irreversible type ..

The irreversible type is the most used type of hydrocolloids, an example of it is : alginate .

We produce agar agar from seaweeds, while alginate is synthetic and it replaced agar agar.

Note: hydrocolloids mean: hydro from water , colloids : a mix of several material .. And its an 80% water compound

Difference between elastic and plastic : elastic after it sets it will rebound after we remove the force on it while plastic will remain as his new shape when we put a force on it , so we can shape it as we want ..

Chemically ( zinc ,eugenol, ) Rigid thermoplasticly ( as impression compound )

Thermo plastic Aqueous reversible hydrocollod hydrocolloids

Elastic irreversible type non aqueous (addition silicon , condensation silicon , polyether, polysolfied)

Thermoplastic ( agar agar ) Irreversible type ( alginate )

Impression compound:

Its a rigid material at room temperature and at mouth temperature, thermoplastic, set with a hot water or a flame

We soften it with hot water or flame, and then when we put it on the patients mouth, it will cool down and solidify, then we take it out. The advantages : its dimensionally staple after we take it out from the patient mouth , cheap , if there are any deficiencies we dont have to mix a new impression , as we can reuse it by reheating it ( reusable ) , as of this we use it for educational issues .. One of the main disadvantages of it: its not suitable for patient with deep bony or ridge under cusps (as it become rigid when it cools down).

Alginate:

Its an elastic material, chemically set, and its water based material, irreversible.

It used with patients who have deep bony under cusps (as it still elastic when it cools down) , and we can use it either with Edentulous or a patients with teeth ..

Its not reusable; we have to make a new one, if there are any deficiencies. Trisodium phosphate is used for slowing down the reaction speed Advantages: it works will in a wet environment (saliva).

Disadvantages : its ability to dehydrate ( as its a water based material ) , dimensionally unstable , affected by the humidity of the environment , and it has a high ability to distort ( low resistance ) ..

We have tow identifications special for alginate:

Syneresis: the loss of water Imbibition : the gain of water

Putty:
Its an elastic material , Non aqueous , with a good component , but its expensive ..

( we will talk more about it later )

Materials must be soften at a low degree (60 c maximum), not to burn the patient mouth, if it was more than 60 we have to modify the temperature by reducing it ..

The material that we use determines the tray that will be produced.

We have stock trays and custom trays

Stock trays can be made out of metal or plastic , some of them without holes , and some of them have holes , we need the holes for retention of the materials on the tray , otherwise some materials dont need these holes , like impression compound , while elastomeric impression materials need these holes to stay on the tray .. (metal trays without holes are the most used )

Stock trays should be 3 to 6 mm larger than the patient mouth as the materials we used are thick, while the custom tray should be closely fit the mouth. We have upper trays and lower trays: the upper has a palate, the lower has an open area for the tongue.

 Trays have different sizes, to fit different patients mouths.

The lower tray requires less material than the upper.

Then the doctor started to give us a practical information , which we will have it as a skills

, 06 , 06 ,

Done by : amr sadi