1st lab of prosthodontics Salam bataineh 3esam al- 3alam

(10-14)/2/2013

" prosto lab 1 " ~~ Partial denture ~~

This semester we have 12 week absence without excuse allowed for 2 section . on the lab please always wear ur lab coat, name tags & bring all ur instrument. *

fabrication of complete denture :

Just to remind you on complete denture steps we need clinical & lab procedures :

1- history examination. 2- take a primary impression by using impression compound, alginate & butty silicon by stock tray on appropriate size for patient. 3-study cast made by plaster "gypsum type 2". 4-individual tray , or called (custom or especial tray). 5-secondry or final impression made by : { ZOE , plaster , elastomeric impression material like condensation silicon polyether [ a specific material on dentistry that made to be work on wet environment but its expensive ] & polysulfide , impression plaster " gypsum type 1 " its accurate but rigid material we can solve this problem by adding water to matrial after it set to take it out from the tray or teeth if it stick on the undercut for example } . 6-border molding by { green stick or impression compound } they are two material different on color but mainly they differ by fusing temperature mean at temp. where the material

become soft so we can mix green stick with impression compound . Note** these materials are rigid or elastic, some of them set by heat(thermoplastic) others by chemical reaction. But especial material needed for some cases like patient with undercuts so I must use a material go & set under them also be flexible that I can remove like alginate or butty silicon which set chemically but I am a student & I make a lot of mistakes so I need a material that can be reused like thermoplastic material "impression compound" & so on 7-secondry or master cast poured by using dental stone "gypsum type 3 " 8-base plate + occlusal rim ( wax rim ) = record block 9-teeth selection & mounting the upper & lower cast in the articulator according to jaw relationship then teeth sitting 10-try in stage to make sure of esthetic, function, phonetics, occlusion 11- fabrication ( dewaxing, packing, deflasking, finishing & polishing ) / insertion / recall visit **these steps need about five to seven clinical visits

Partial denture :
Patients with 1 or 2 missing teeth or with one remaining tooth for example all need something like dentures but bcz of teeth present on mouth it called partial denture as you know we have temporary(interim) or permanent(definitive) & they become in different designs according to the missing teeth on the jaws .

-we have to follow same sequence of complete denture but you can avoid doing some steps like on patient with one central incisor missing on upper jaw no need for secondary impression bcz it will be same to primary impression bcz on central incisor I am not worry about sulcus & no need for border molding !! also no need for all jaw records exactly like in complete denture or tray in stage for example so here I can make a partial denture on one or two visit ~~ but on class I mod 1 in a patient with two canine for example all steps needed. ** so steps for partial denture depend on remaining teeth structure
Some differences b/t partial & complete denture :

*1* here in partial denture we have some extra steps just on doing the metal frame we will learn about them later. *2* undercuts [ every patient with teeth have undercuts ] -Note: so elastomers used on primary & secondary impression but on the case we mention before who have just two canines impression compound can be used under tissue & elastomers under canines on same tray !! *3* in the lab before possessing we have to make clasp [stainless steal orthodontic wire with 0.7 0.8 diameter]

*4* impression is poured within minutes on stone instead of plaster bcz its stronger or we can use 50% plster + 50% stone

- plaster used on primary cast : [gypsum type 1] : 100g plaster need 60ml water [gypsum type 2] : 100g plaster need 50ml water -secondary cast : [gypsum type 3 ] : 100g plaster need 30ml water [gypsum type 4 ] : 100g plaster need 20ml water " called dental stone " The harder the gypsum product the less water used & vise versa

how to make an impression ?? 1. we have several types of trays for upper jaw which include the palate & lower jaw which have tongue space also there are perforated used to make the handling of impression material easier& nonperforated tray also different sizes {we must leave about 5-7mm b/t teeth & tray always} 2.we use utility wax if tray is under extended & usually to make sharp angels on tray more soft by cover tray border with it.

3.fill tray with the material used alginate for example mixed usually 3 scope enough for upper jaw & 2 scope enough for lower jaw . 4. put alginate on occlusal surface of teeth before entering tray on mouth. 5.tray inserted on patient mouth on lower jaw with slight pressure then make slight movement for lip & check to make functional movement of muscles & frenums then rase the tongue then move mandible rt & lf to record sublingual tissue. ** to accelerate sitting time we use hot water & to decrease sitting time we use cold water never change powder/water ratio. 6.remove the tray from the mouth on one movement. 7. for upper teeth we follow same steps but upper lip & cheeks can be moved by dental mirror also its very important to make sure that tray is extended beyond the vibrating lines. 8.impression poured in stone as we Saied before & when it set we make a base. 9.the cast is ready now to fabricate a removable partial denture.

Material used :
Last semester we talked about how complete dentures get their retentive nature via many things one of them is peripheral seal, the case with partial dentures are different; we cant have a peripheral seal in them and the reason behind this is that in complete dentures the borders (flanges) go all the way from suclus to suclus and to the post-dam area so air cant escape. In partial dentures the need of having wires or clips are to create a seal to the denture, the company provides us with wires in these forms. We need to use specialized tools to bend these wires, they are called Orthodontic Pliers . Orthodontists have many designs for these pliers if not hundreds , each design to accommodate each function . What characterizes the pliers are the geometric shape of the peaks, we have conical shape , pyramidal and triangular and many other shapes . Sometimes we have three peaks, sometimes we have peaks of the same shape ( e.g. two peaks , two triangular . ) sometimes we have them different from each other ( one conical and one triangular ) and so on , so there are lots of shapes to accommodate the need to make the design you want .

However the most common types of pliers we use in dentistry are actually two: Loop forming Pliers and Adams Universal

Pliers (named after the dentist who made it; Philip Adam).
During this semester we are going to work with the first one; the loop forming wires but in the next year we will be working with Adams pliers during orthodontic training. Before we start using the loop forming pliers we have to know how they work, looking at their peaks you can notice that one of the peaks is sharp and one is conical. If I bend the wire toward the sharp edge Ill get a sharp bend depending on how much force you applied. Also if you bend toward the conical edge Ill get a curve (loop) depending on how much force you applied. Adams pliers (two pyramidal peaks shape) produces a right angle bend which is much easier to do with this tool than with the loop forming pliers. Depending on where you put the wire: down at the junction or toward the tip, how acute the curve is or how wide the curve is the wire will be affected. If I put it at the tip Ill have a

bigger curve than if I put it at the junction down.

In orthodontics they make a 360 loop (spiral) curve, but in Prosthodontics we dont do that do you know why? In orthodontics they make these spirals to make springs in order to make teeth a little mobile when applying the orthodontic treatment. In Prosthodontics we dont want teeth to move we want them to be firm. So each one has its own objective.

When you cut the wires without paying attention to a proper way the wire might bounces off and hit your eye or cause permanent injury, you have to either cover the both ends or point the wire under the table ( or your lab coat ) so no one will get hurt . The wires themselves they have a diameter of 0.70.8, they are made out of stainless-steel

Done by: salam AL-bateineh