1- Picture of an upper denture with Adam’s cribs on the 6’s what kind of denture

is it?

a. Spoon denture

b. Every’s denture

c. Tooth supported denture(correct)

A Spoon Denture : is a small denture usually to replace just one or two front
teeth. The palate part of the denture on suction to hold it in place as it does not
make contact with the inner surfaces of the back or side teeth. This means that
it tends to be unstable and requires skill on the part of the patient to use their
tongue to stabilise it while eating. This lack of stability is the main disadvantage
and the subsequent movement can lead to gum recession and further loosening.
The advantages are that it is cheap and easy to make and as the gum margins of
the other teeth are not contacted by the denture base, there is less likelihood
of decay or gum disease occurring.

Every Denture: is a mucosa borne denture with a specific design to ensure

gingival health.Restricted to the use in upper arch.

2- management of missing incisors in adults and children

-5-bridge parts and cr/co denture. kennedy class.

6-type of bridges and indications

7- Partial denture design 5 sub questions – abutment (mesial rest, distal rest),
increase/decrease occlusal plate, increase/decrease support on mucosa area
(saddle), stress-breaking design

8- Questions on Kennedy’s classification of dentures

9- A picture of a man whose central incisor has just been extracted and who is
going to get an implant in the next 6 months what is the best way to preserve
the space

a. Chromium cobalt denture

b. Acrylic denture-

c. Orthodontic wire

10- The same picture and the question was what traumatic injury could have
occurred

a. Avulsion

b. Concussion(correct)

c. Luxation

d. Subluxation (The question is not clear)

11-Mandibular teeth should be placed in the centre of the crest of ridge such
that the central fossa of mandibular teeth should lie at the centre of the crest.

12-The bucal cusp of mand 2nd premolar should engage the embrasure b/w max
1st and 2nd premolar and mesiobuccal cusp of mand 1st molar should engage the
embrasure

13-between maxillary 1st molar and max 2nd premolar.The lingual cusps of the
max 1st molar should occlude in central fossa of mand 1st molar and same is for
max and mand 2nd.

14- Factor affecting retention of teeth.

15- Lots of questions about the components of the Removable partial denture

saddle,clasps,rests and connectors

17- How to measure the vertical dimension : Vertical dimension = rest - free way
space

can be mearsured by facial musculature,willies guage,spring dividers.This is to

ensure there is an adequate interocclusal clearance. Vertical dimension Pg 312
pink book

18- Recording the occlusion in an edentulous patient, full denture Pg312 pink
book

19- What is the length of a clasp..

A retentive clasp should be at least 15 mm in length if it is constructed in cast

cobalt-chromium alloy

 A retentive clasp should be at least 7 mm in length if it is constructed in

wrought wire.

20- When is a crown indicated?

21- A picture showing a partial denture design and we were asked to identify
the indirect retention, support, rest and clasps. Have to see the picture to know
what the exact situation is. Direct and indirect retainers given nicely in
Churchill pg 316, 317

22- Several questions with different clinical scenarios and we were asked to
choose the most appropriate for the patient-a conventional fixed fixed bridge,a
minimal preparation fixed fixed bridge, a conventional cantilever bridge,a
minimal preparation cantilever bridge,a denture or an implant.

For example a 21 yr old male with a missing upper central incisor,good abutment
teeth with well developed alveolar ridge;implants
23- Prosthodontics- crowns ,partial dentures- Kenedy classification

24- Which structure gives guidance to the placement of maxillary incisors on

dentures? -- incisive papilla

25- Picture of lady with large hands and complaining of unfitted dentures :
acromegaly

26- Picture of RPD

27- Problems caused by palatine torus. Anterior posterior palatal strap

28- Die fail to fit preparation and cast – die damage + distorted pg 244 pink
book

29- Inlay fail to fit to prepare – undercuts

30- Various clinical scenarios, different age groups – treatment options –

crowns, bridges, RPD, acrylic denture, implant

31- Kennedy classification and pics of diff cast repeated

32- Picture of two casts with wax blocks having teeth in occlusion they asked
what can u identify from the picture options were. bite registration,there is
class 2

or 3,protrusive record etc. Have to see the picture to answer this one

33- Trial wax

34-what is the freeway space : what is The difference rest position and
intercuspal position ? Freeway space is the space between the occlusal surfaces
of teeth when the mandible is at rest and is usually 2-4 mm

35-Pt with dentures that doesn’t fit,why? diagnose the cause Pg 314 pink
book common problems

36- what is Chroma-intensity of colour

37-setting of teeth in relation to ridge and papilla:

-Natural teeth lie 10mm from papilla ; with resorption this comes to lie on
ridge so the anterior teeth should be placed labial and buccal to the ridge to
give adequate lip support and naso-labial angle of 90 degrees.

-Normally 8-10 mm infront of the centre of incisive papilla.Incisal edges of

upper central incisors,canines,both cusps of 1st and 2nd premolars and
mesiopalatal cusp of the 1st max molar should touch occlusal plane.

40– what you can check outside patients mouth in articulator - read page 114
master dentistry

On articulator before trial on the patient,we can check complete teeth set
up.The occlusion is then assessed,checking balance in excursive movements.

41– Willis bite gauge and surveyor pictures shown and you need to say their
names

42- When making Dentures, what you cannot change? – condylar horizontal
plane because this the physiological position for the mandible so it can’t be
changed.

43– Fixed- movable bridge – read page 101 master dentistry

44– Second impression for resorbed ridge in denture ,which is the best material
to use? – ZOE with low space tray- 0.5 mm space is required
For elastomers the space required between the tray and ridge is 0.5-1.5

For alginate is 3mm ( Info about elastomers and alginates is unrelated to the
question)

45- Butt joint margin in buccal surface for porcelain bonded crown, what for?
Strength

46- Picture anterior crown, which characteristic cause gingival inflammation?

Subgingival margin?? Material? Subgingival margin.

47– Pontic design shown and need to be identified ?– modified ridge lap

48– Name of instrument for survey models, options given - Surveyor

49- Picture of surveyor

http://products.dentalproductsreport.com/community/DisplayAd.asp?id=4824

50- Surveyor cannot determine where occlusal rests have to be placed--- yes
thats right because it tells you where the undercuts are for clasps placement.

51- The best restoration for a missing maxillary central incisor in an otherwise
healthy, caries-free mouth is an implant

52- When will you use a butt joint in a crown preparation? When an increased
thickness of material is required which in turn is required for increased
strength

53- Which is the first step to be taken after taking an impression?

Disinfection-washing with water and immersing in 10000 ppm Sodium
hypochloride for 5 mins

54- Lower premolar is set on the alveolar ridge – yes

Upper anteriors are set labially to the ridge

Upper posteriors are set slightly buccal to the residual ridge, parallel to ala
tragus
Lower Anteriors : when little resoption teeth placed marginally in front of the
ridge crest , cases with excessive resoption teeth placed over buccal sulcus.

Lower Posterior : teeth directly on the ridge

55- Upper incisors are set 8-10 mm anterior to the incisive papilla.- yes

56- Where do you take support while restoring a tooth? On the tooth of the
same arch

57- Picture of a 3-unit fixed fixed bridge

58- Picture of a pontic in a 3 unit fixed bridge. saddle

59- A 16-year old boy requires a crown with minimal caries.

60- Restoration for peg lateral? Composit build up or porcelain veneer to

increase the mesio distal width.

61- Most difficult to achieve? Inter-condylar guidance, Dont have a clue

about theses.

62- Adjusting the over-jet & over-bite will alter inter-codylar angle

63- Picture of Willis gauge

https://my.supplychain.nhs.uk/catalogue/product/ilj3712/bite-gauge-willis-bite-
gauge

64- What can be adjusted on a cast before the patient comes? Anatomical
tooth position.balance and excursive movements on an articulator before trial
65- When do you use in prosthesis only 1 rim? To do OVD, rest vertical
dimension, etc

66- Prosthesis – neutral zone technique

http://www.dentistry.bham.ac.uk/cal/impress/nz.htm

67- Articulators

68- Bridge

69- Trauma by denture in buccal sulcus---- teeth should be set in neutral zone
and over extensive should be trimmed

70- Group function, canine-guided occlusion :

Group function : multiple tooth contacts on working side during lateral

excursions but no contact on non working side.

-Canine guided occ: During lateral excursions there is disculsion of all teeth on
the working side except for canine and no contact on non working side.

72- Bur to prepare “rest” in prosthesis –

- for occlusal rest--no 4 tungsten carbide bur

for cingulum rest -large diamond cylinder bur

(reference-nallaswamy textbook chapter 18)

74- Prostho rpd two designs identify support and indirect retension

75- Implants ,fpd indications

76- Partial denture..What does P stand in RPI system :distal guiding Plate

RPI system: mesial Rest, distal guiding Plate and the mid buccal I bar

77- Many pics were given and we had to mark the rest , bars clasps
78- What is an Akers clasp : a classic clasp with

An Akers' clasp is the classic direct retainer for removable partial dentures.
Named after its inventor, Polk E. Akers, this suprabulge clasp consists

of a rest, a guide plate, a retentive arm and a reciprocal arm. Akers' clasps, as
a rule, face away from an edentulous area. Should they face the

edentulous area, they are termed reverse Akers' clasps

SIMPLE CIRCLET DESIGN (Aker’s clasp)

Widely used

Tooth support RPD

Engage undercut remote from edentulous area

Half round cross sectional

Disadvantages

- Increase circumference clinical crown

- Increase tooth coverage

REVERSE AKER DESIGN

Undercut located adjacent to edentulous area

Infrabulge clasp is contraindicated

Kennedy class I ,II

Disadvantage

- Reduced strength

- Lack of rest adjacent to edentulous area

- Poor esthetic

MULTIPLE CIRCLET DESIGN

2 simple circlet clasp joined at the terminal aspect of their reciprocal

elements

Principle abutment is periodontal compromised

Disadvantage

79-a 70yr old woman with missing

central incisor as a result of periodontal problems. Give partial denture or

resin bonded bridges. Resin bonded bridge

80- some questions about treatment plan with different cases,like:

a 15 years old boy has lost his central tooth in skiing,what is the best opt for
him? resin based fixed bridge

Ext, implant,resin bonded crown, partial denture

81- Picture - Patient complains about her lower canines (last teeth), she has a
nice partial denture, canines pocketing less then 2mm and

and immediate dentures, RCT if Canines treatable and overdenture

implant-based overdenture, extraction and wait for healing to make a new

denture, extraction

83- Kennedy classification figures – 5 sub questions (look up for classes and
modification 1)

84- 2 different clinical cases of need to be extracted upper central incisor and
the best way to replace it – options: acrylic dentures, chrome-cobalt partial
denture, implant, adhesive bridge, fixed-fixed bridge

a- for a 45years courier with other lost upper molars and PMs – acrylic
denture
 b- other quite well-financial situated guy, for immediate replacement –
socket implants.

85- Picture of 2 cast models – first management – occlusal diagnostic mounting

86-Complete Denture Phonetics

In a full denture case If the patient is having trouble saying F or V, then the
incisors have been placed too far palataly. Or if the patients S sounds more Th,
then it could be due to palatal positioning of incisors or thicker palate. Pg 322
pink book.

COMPLETE DENTURE PHONETICS

Mechanism of speech
 The voice is produced in the larynx: the muscles of the thorax and abdomen
control the flow of the air with nasal cavity act as resonant chamber
 The air from the larynx divided into 2 streams by the velum:
a) Upper stream: the air expelled entirely through the nose to produce the nasal
sounds: N-M-Ng.
b) Lower stream: the air expelled through the oral cavity and altered by the
palate, tongue and position of the teeth and lips to produce all other sounds.

 Types of sound:
I. Vowels:
 Produced by vibration of the vocal cords and not affected by oral structures.
The tongue is positioned in the floor of the mouth and contact lingual surface of
anterior teeth.
 Types: Vowels are: a-e-i-o-u.
II. Consonants:
 Produced by constriction, obstruction and direction of the air stream when
the air pass through the mouth
 Types:
a) According to the manner of production:
1. Nasal sounds: N-M-Ng
 Produced through the nose. When the nasal cavity is blocked (adenoid
hypertrophy- deviated nasal septum), hypernasality occurs.
2. Plosives sounds: P-B-T-D-K
 Produced by complete stop of air stream, build up of pressure in the oral
cavity then sudden release and explosion of air
3. Sibilant (fricative) sounds: S-Ch-H-X-Z
 Produced by friction of the air stream when forced through narrow path way
b) According to the site of production:
1. Bilabial sounds: B-P-M
 Formed by lip only. The air from the lung builds up pressure behind the closed
lip, explosion produced when the lip suddenly opened
2. Labiodentals sounds: F-V
 Formed by lips and teeth. Produced by the contact between the upper incisors
and the lower lip
3. Lingudental sounds: Th
 Formed when the tip of the tongue is positioned between upper and lower
incisors
4. Lingualveolar sounds:
a. Tongue and the anterior portion of the hard palate: S, T-D
 S: the tongue form a slit like channel into which the air hisses and the air
escape from the median grove of the tongue when it is positioned behind
maxillary incisors. If this groove is flattened, lisping occurs (S is pronounced
Ch), and if the groove is deepened whistling occurs
 T-D: the sided of the tongue contact the teeth, the air stops and sudden
release (explode)
b. Tongue and the intermediate portion of the hard palate: Sh-Ch-J
 The tongue is pressed against large area of the hard palate and alveolar
process
c. Back of the tongue and soft palate: K,G
5. Nasal sounds: N-M-Ng

Effect of complete denture on speech (prosthetic factors affecting speech):

A. Denture base:
1- Denture base thickness:
Thin well adapted denture base (1mm thickness) not greatly affect the speech
 Increasing the thickness of the denture base leading to cramping of denture
space, decrease air volume and obstruction air channels
 Thickening the denture base in the anterior palatal → lisping (S pronounced
Ch), and T pronounced D
 Thickening the denture base in posterior palatal border → defect in vowels
(e,i) and consonants (k,g), so the border should be smooth tapered and merge
with the soft palate (not form a square edge)
 Thickening the denture base at lower lingual flange → cramping of tongue
space → lisping
 Decreasing the thickness of the denture base → whistling, D pronounced T

2- Extension of the denture base

 Proper extension of the denture flanges aid retention and stability of denture
which help in proper articulation of sounds as with poor retention, the tongue
try to reseat the denture against the palate during the speech.
 Avoid overextension of the flanges to decrease interference with muscle
movement during speech → indistinct speech especially if the lip affected

3- Polished surface
 Reproduction of incisive papilla and rugea area (by wax carving –tin foil) on the
polished surface of the anterior palate aid in correct production of anterior
palatal sounds.

B. Denture relations:
1- Occlusal plane
 Too high occlusal plane: tongue spread on the lower teeth→ lisping (S
pronounced Ch), and F pronounced V
 Too low occlusal plane: difficulty in correct positioning of the lower lip and
tongue contact occlusal surface during the speech → V pronounced F
2- Vertical dimension
 Increased vertical dimension: denture teeth make contact during speech→
clicking, defect in Ch-C-J sounds, whistling, Th pronounced T due to failure of
the tongue to be placed between anterior teeth
 Decreased vertical dimension: leading to lisping (S pronounced Ch)
 M sound: used as an aid to obtain correct vertical dimension. When the
patient say M, if the lips are straightened and unable to make contact, the
record blocks are occluded prematurely and the VD is high
 S sound: also used as an aid to obtain correct vertical dimension. When the
patient say S (sixty-six), the upper and lower teeth should be separated 2mm
from each other (closest speaking space method)
3- Teeth arrangements:
1- Width of the dental arch:
 Too narrow dental arches→ the tongue cramped and the size of air channel
decreased → faulty articulation of consonants (T-D-N-K-C), therefore, the
teeth should be placed in the position previously occupied by natural teeth
2- Antro-posterior position of the anterior teeth
 Upper anterior teeth
 Too far palatally:
- Upper incisors difficult to contact the upper lip → affect labiodentals sounds
(F-V)
- Tongue make contact with the teeth prematurely → affect lingupalatal
sounds→ lisping (S pronounced Ch), T pronounced D
 Too far labially: whistling and D pronounced T
 Lower anterior teeth:
 Too far lingually: Th pronounced T and the tongue rested in the floor of the
mouth behind lower anterior teeth in pronunciation of vowels
 Too far labially: affect pronunciation of vowels.
3- The relationship of upper and lower anterior teeth
 Abnormal protrusive or retrusive Jaw relations (class II, class III angle
classification) associated with increase or decrease the overjet leading to
difficulty in pronunciation of S sound (increase overjet→ whistling)

88.Altered cast technique http://www.dentistry.bham.ac.uk/cal/impress/altcast.htm