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Describe the sequential procedures during RPD delivery appointment
- achieve good fit, adaptation, and occlusion
- Tissue surface refinement (PIP)
- Periphery refinement (disclosing wax)
- Occlusion refinement (clinical remount and occlusal equilibration)
- -First obtain jaw record (face bow +CR record)
- alginate pick-up impression is made with RPD in place in the mouth and removed with the RPD embedded in the impression.
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•What is a pick-up impression for RPD
- alginate impression with RPD embedded to Generate a remount cast for RPD
- pick up the prosthesis and record the remaining teeth.
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•How to generate a remount cast for RPD
- stock tray shortened to stay away from the distal extension area.
- alginate impression to pick up the prosthesis and record the remaining teeth.
- air dry the RPD within the alginate pickup impression, apply clay/mud material with #7 wax spatula to
- block out the following areas: the retainers, proximal plate/and minor connector areas
- low-fusing metal is melted in a ladle until it just reaches pouring viscosity
- paper clips and create some retention loops.
- Plaster base is added to complete the fabrication of RPD remount cast
- Adjust for centric relation first and eccentric second.
- The occlusal adjustment goal is to achieve solid centric contacts on both natural teeth and denture teeth.
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•How to perform a clinical remount for RPD
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•Why is clinical remount necessary for RPD
- 1.Accuracy The occlusal discrepancies are compensated due to the compressibility of oral mucosa and difficult to interpret intraorally
- 2. Versatile assessment We can access the occlusion from both buccal & lingual aspects
- 3. Patient management The equilibration can be completed in the lab, not in front of patient
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•RPD maintenance and decision making of various options
- Fluoride gel: 1x/day all tooth contact surfaces with a cotton swab, or fluoride
- stent is useful for all residual teeth.
- tapered brush: clean clasps and guide planes. Soaking alone does not remove plaque.
- week-10 days: to get used to
- place w fingers, don't bite
- cut food w/knife
- denture cleaners AFTER scrubbing
- Relines
- expectations: not real teeth
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Loose RPD
implants if existing is adequate support stability retention and pt still subjuctively not happy
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RPD lab reline
- identical to altered cast impression procedure
- Remove about 1 mm of resin from the RPD base before the reline impression to allow for uniform thickness of impression material
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Why use low fusing metal? Why not use stone?
- Low fusing metal is liquefied over the heat and poured into only the occlusal surfaces of the teeth in the alginate impression
- 1. Superior wear resistance
- 2. fast setting quality
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