TRY IN APPOINTMENT & POST INSERTION INSTRUCTIONS

Int. Academy of Prosthodontics www.prosth.net

THE TRY – IN APPOINMENT :

DEFINITION :

A trial denture defined as preliminary arrangement of denture teeth that has been prepared for placement into the patient’s mouth to evaluate aesthetics and maxillo – mandibular relationship.

Section 1 :

Perfection and verification of jaw relation records.

Section 2 :

Eccentric jaw relation records ; articulator and cast adjustments ; establishment of posterior palatal seal.

Section 3 :

Creating facial and functional harmony with anterior teeth.

Section 4 :

Phonetics.

Section 1 :Perfection and verification of jaw relation records.

Verifying vertical dimension

Verifying the centric relation

Intraoral observation of intercuspation

Extra oral articulator method

Verifying vertical dimension

Pre extraction records.

The amount of inter occlusal distance.

Phonetics and aesthetics.

The amount of inter occlusal distance between the teeth when the mandible is in its rest position.

Study of facial dimension and facial expressions.

Lip length in relation to the teeth.

The inter arch distance and parallelism of the ridges.

The condition and amount of shrinkage of the ridges.

Verifying the centric relation

Intraoral observation of intercuspation

Extra oral articulator method

Section 2 : Eccentric jaw relation records

Methods of registering the condyle path

Extra oral

Gysi & McCollum techniques

Intra oral

Plaster & carborundum grid – in

Chew – in by opposing wax

Chew – in modified by a central bearing point

Needles’s styluses cutting a compound rim

Needles’s technique modified by Messer man tracer

Protrusive registration in softened compound

Protrusive registration in plaster

Protrusive registration in softened wax

establishment of posterior palatal seal.

Soft tissue along the junction of hard and soft palates on which pressure within the physiological limits of the tissues can be applied by a denture to aid in retention of the denture.

T burnisher is used for marking the hamular notch on each side and PPS is marked.

PPS extends from ……….

Anteriorly … anterior vibrating line

Posteriorly… posterior vibrating line

Laterally … pterygomaxillary notch

Techniques :

Conventional technique

Boucher’s technique

Fluid wax technique

Stick compound technique

Extended palatal technique

Section 3 :Creating facial and functional harmony with anterior teeth.

Maintaining facial support and neuromuscular balance

When the muscles are correctly supported by a complete dentures impulses coming to them from the CNS cause a shortening of the fibers that allows the face to move in a normal manner.

Three factors affect the face in repositioning the orbicularis oris with complete denture.

The thickness of the labial flanges.

The anterioposterio position of the anterior teeth.

The amount of the separation between the mandible and the maxilla.

When properly shaped dental arches and favorable vertical dimension

Normal function of the facial muscle

Normal facial expressions and proper tone of the skin

Basic guides to developing facial & functional harmony :

The preliminary selection of the artificial teeth.

The horizontal orientation of the anterior teeth.

The vertical orientation of the anterior teeth.

The inclination of the anterior teeth.

Harmony in the general composition of the anterior teeth.

Refinement of the individual tooth positions.

The concept of harmony with sex, personality, and age of the patient.

The correlation of the aesthetics and incisal guidance.

The preliminary selection of the artificial teeth.

Size , form , color of the teeth.

Rotation , overlapping and spacing between the teeth.

The horizontal orientation of the anterior teeth.

If the anterior teeth are in proper position vermilion border is visible ,corner of the mouth assume normal contour & skin is toned & nasolabial groove is prevented from drooping.

A common error is to attempt to establish a standard vertical & horizontal overlap without regard to the ridge relation this should not be done because anterior posterior position must correspond to the position of the ridges.

The vertical orientation of the anterior teeth.

Test :

length of the upper lip can be estimated by placing the index finger on the incisive papilla with relaxed upper lip extending down over the finger.

the finger length covered by the upper lip indicates the length of the upper lip.

The inclination of the anterior teeth.

The inclination of the anterior teeth should be parallels to the profile line of the face.

Harmony in the general composition of the anterior teeth.

Central incisors in square arch assume a position on a line with a canine.

In tapering arch rotating and overlapping of the teeth is common.

In ovoid arches canine position forwardly with seldom rotation.

Refinement of the individual tooth positions.

Maxillary central incisors – parallel to the profile line

Maxillary lateral incisors – cervically inwards

Maxillary canine – cervically outward

Mandibular central incisors – cervically inward

Mandibular lateral incisors – cervically outward then mandibular central incisors

Mandibular canine – cervically outward

The concept of harmony with sex, personality, and age of the patient.

Femininity is characterized by curved surface, roundness and softness.

Masculinity is characterized by boldness , vigor and square ness.

Personality divided into delicate , medium, and vigorous.

It affects the selection of molds , colors , position of the teeth and forms.

Section 4 : Phonetics

Bilabial sounds …. B, P, M are the sounds where the two lips contacts.

Labiodental sounds …. F, V are the sounds shows the relationship of the incisal edges of the maxillary incisors to the lower lip.

Linguodental sounds …. eg Th are the made with the tip of the tongue extending slightly between the upper and lower anterior teeth.

Linguoalveolar sounds …. T , D, S, Z, V, L are the sounds which makes the contact of the tip of the tongue with the most anterior part of the palate.

POST INSTRUCTIONAL INSTRUCTIONS :

INDIVIDUALITY OF THE PATIENT

Don’t compare their progress with new denture to the other person’s experiences.

Adaptability to new denture is modified by age.

APPEARANCE WITH NEW DENTURE

Feel strange , bulky,.

Fullness of the lips and cheeks

Advice to change glasses and hair styles.

MASTICATION WITH NEW DENTURES

6 – 8 weeks

Excess flow of saliva

Soft food

Both sides

Eat from posterior teeth

SPEAKING WITH NEW DENTURES

2 – 3 weeks

Read aloud and repeat words that are difficult to pronounce

ORAL HYGIENE

Instructed to rinse the dentures after meal

Cleanser

Never use tooth paste because most contains abrasive materials

Denture should be brushed over a basin partially filled with water

Brush ridge and tonguePRESERVING THE RESIDUAL RIDGES

Denture must be left out from the mouth in the night

Not to use abrasive and home liners for ill – fitting denture

Put the denture in the water

Thank you