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Flashcards in Prosthodontics Deck (400)
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1
Q

The incisive papilla provides a guide for the
anteroposterior placement of maxillary anterior
denture teeth. The labial surfaces of natural
teeth are generally 8 to 10 mm anterior to this
structure.
A. Both statements are true.
B. The first statement is true, and the second
statement is false.
C. The first statement is false, and the second
statement is true.
D. Both statements are false.

A

A. The incisive papilla provides a guide for the antero-
posterior position of the maxillary anterior teeth. The

labial surfaces of the central incisors are usually 8 to
10 mm in front of the papilla. This distance varies
depending of the amount of resorption of the

residual ridge, the size of the teeth, and the labio-
lingual thickness of the alveolar process.

2
Q

Which of the following statements is true con-
cerning vertical dimension of rest (VDR)?

A. VDR = physiologic rest position.
B. VDR = position of the mandible when opening
and closing muscles are at rest.
C. VDR is a postural relationship of the mandible to
maxilla.
D. VDR = the amount of jaw separation controlled
by jaw muscles when they are in a relaxed state.
E. All of the above.

A

E. All of the above statements are correct. Vertical
dimension of rest (VDR) is a physiologic rest
position; it is the position of the mandible when
the muscles are in their minimum state of
tonicity, which occurs when a patient is relaxed
with the trunk upright and the head
unsupported. In this position, the interocclusal
distance is usually 2 to 4 mm when observed at
the first premolar area.

3
Q

The following are characteristics of a post-
palatal seal of complete dentures, except which

one?
A. Compensates for shrinkage of the acrylic resin
caused by its processing.
B. May reduce the gag reflex.
C. Improves the stability of the maxillary denture.
D. It is most shallow in the midpalatal suture area.

A

C. Stability is resistance to movement toward the
residual ridge. The function of the posterior
palatal seal is to improve retention, not stability.
Stability is determined by the size, height, or
shape of the ridge.

4
Q

Which of the following is the most likely cause
of an occlusal rest fracture?
A. Inadequate rest-seat preparation
B. Improper rest location
C. Structural metal defects
D. Occluding against the antagonist tooth

A

A. In McCracken’s Removable Partial Prosthodontics,
ed 11 (St Louis, Mosby, 2005), McCracken states,
“Failure of an occlusal rest rarely results from a
structural defect in the metal and rarely if ever is
caused by distortion. Therefore the blame for such
failure must often be assumed by the dentist for not
having provided sufficient space for the rest during
mouth preparations.”

5
Q

The primary purpose of a maxillary denture
occlusal index is to _____.
A. Maintain the patient’s vertical dimension
B. Maintain both the correct centric and vertical
relation records
C. Maintain the patient’s centric relation
D. Preserve the facebow record

A
  1. D. In order to preserve the mounting relationship
    in the articulator of the maxillary cast (facebow
    record) after processing a denture, an
    occlusal index of the maxillary denture is made

after occlusal adjustments, and before de-
casting the denture. This procedure has nothing

to do with the mandible’s relationship to the
maxilla.

6
Q

An edentulous patient with a diminished verti-
cal dimension of occlusion is predisposed to

suffer from which of the following conditions?
A. Epulis fissuratum
B. Pemphigus vulgaris
C. Papillary hyperplasia
D. Angular chelosis
A

D. Angular chelosis is described as inflamed and
cracked corners of the mouth that can become
infected with bacteria and fungal organisms. It is

commonly seen in denture patients with dimin-
ished vertical dimension of occlusion. It is best

treated with antifungal creams and correcting the
vertical dimension of occlusion.

7
Q

When performing a diagnostic occlusal adjust-
ment on diagnostic casts, the mandibular cast

should be mounted to the maxillary cast in an
articulator using which of the following?
A. A centric relation interocclusal record
B. A hinge articulator
C. A maximum intercuspation wax record
D. A facebow transfer

A

A. When performing an occlusal adjustment, the
goal is to make CR and MI to coincide. None of
the other choices allows one to reliably mount

the casts in CR or allows one to accurately per-
form this procedure.

8
Q

When border molding a mandibular complete
denture, the extension of the lingual right and
left flanges are best molded by having the
patient _____.
A. Purse the lips
B. Wet the lips with the tongue
C. Open wide
D. Swallow
E. Count from 50 to 55

A

B. The main purpose is to capture the influence of the
mylohyoid muscle. The extent of this flange is
determined by the elevation of the floor of the
mouth when the patient wets the lips with the tip
of tongue. Pursing the lips will form the extension
of the buccal vestibule. The buccal vestibule is
influenced by the buccinator muscle, which
extends from the modiolus anteriorly to the
pterygomandibular raphe posteriorly and has its
lower fibers attached to the buccal shelf and the
external oblique ridge.

9
Q
The main function of the direct retainer of a
removable partial denture is \_\_\_\_\_.
A. Stabilization
B. Retention
C. Support
D. Add strength to the major connector
A

B. The direct retainer’s function is to retain the RPD

by means of the abutments. Stabilization is pro-
vided by the minor connector. Support is provi-
ded by the rest. The indirect retainers improve

the efficiency of the direct retainers. Direct
retainers do not add strength to the major
connector.

10
Q

Lack of reciprocation of a removable partial
denture (RPD) clasp is likely to cause _____.
A. Tissue recession due to displacement of the
RPD
B. Insufficient resistance to displacement
C. Fracture of the retentive clasp
D. Abutment tooth displacement during removal
and insertion

A

D. Tooth mobility is prevented or diminished during

function by the reciprocating clasp. The recipro-
cating clasp should contact the tooth on or above

the height of contour of the tooth, allowing for
insertion and removal with passive force.
Displacement of the RPD toward the tissue,
causing tissue recession, is a function of the lack
of occlusal rests.

11
Q

Centric relation is the maxillomandibular rela-
tionship in which the condyles are in their

most _____.
A. Posterior position with the disc interposed at its
thickest avascular location
B. Posterior position with the disc interposed at its
thinnest locale
C. Superior position with the disc in its most
anterior position
D. Superior-anterior position with the disc
interposed at its thinnest location

A

D. This meets the definition of centric relation and

the normal anatomic relationships of the tem-
poromandibular discs to the condyles. Centric

relation is a clinically repeatable mandibular

position primarily defined by the temporo-
mandibular joints, not the teeth.

12
Q

The denture base of a mandibular distal exten-
sion RPD should cover _____.

A. The retromolar pads
B. All undercut areas and engage them for
retention
C. The hamular notch
D. The pterygomandibular raphe
A

A. The retromolar pad should always be covered for
support of the mandibular denture base. The

retromolar pads and the buccal shelf are consi-
dered primary areas of support for a mandibular

distal extension removal partial denture or com-
plete denture.

13
Q

A good landmark for the anteroposterior posi-
tioning of the anterior maxillary teeth in a com-
plete denture is the _____.

A. Residual ridge
B. Incisive papilla
C. Incisal foramen
D. Mandibular wax rim+

A

B. Anatomic guidelines to be used as guides in
arranging the anterior teeth are the incisive
papilla, the midsagittal suture, and the ala of the
nose (canine lines).
The incisive papilla is a good guide for the

anteroposterior positioning of the maxillary ante-
rior teeth. The labial surfaces of the central inci-
sors are usually 8 to 10 mm in front of the papillae.

This distance varies depending on the size of the
teeth and the labiolingual thickness of the alveolar
process, so it is not an absolute relationship.

14
Q

Which is one of the purposes or characteristics
of the postpalatal seal?
A. Provide a seal against air being forced under the
denture.
B. Usually should extend posterior to the fovea
palatinae.
C. Improves the stability of the maxillary denture.
D. It is carved deeper in the midpalatal suture area.

A

A. The vibrating line is located by finding the ptery-
gomaxillary (hamular) notches, and continues to

the median line of the anterior part of the soft
palate slightly anterior to the foveae palatinae.
A V-shaped groove 1 to 1.5 mm deep and 1.5 mm
broad at its base is carved into the cast at the
vibrating line. The narrow and sharp bead will sink
easily into the soft tissue to provide a seal against air
being forced under the denture. Stability is
resistance to movement toward the residual ridge.
The post-dam improves retention, not stability. It is
carved shallow in the midpalatal suture area.
Stability is determined by the size, height, or shape
of the ridge.

15
Q
The \_\_\_\_\_ is used as a guide to verify the
occlusal plane.
A. Ala-tragus line
B. Interpupillary line
C. Camper’s line or plane
D. All of the above
A

D. The ala-tragus line posteriorly and the interpu-
pillary line anteriorly are used as a guide to align

the occlusal plane for complete dentures.
The Camper’s line is also known as the ala-tragus
line.

16
Q

Balanced occlusion is less important during
chewing than during nonchewing events. This
difference occurs because the time teeth are in
contact during nonchewing events is much

greater than the time teeth are in contact dur-
ing chewing.

A. Both statements are true.
B. The first statement is true, and the second
statement is false.
C. The second statement is true, and the first
statement is false.
D. Both statements are false.

A

A. Teeth come together every time a patient swal-
lows. This can dislodge dentures due to breaking

the denture seal.

17
Q
Which of the following conditions can be
caused in an edentulous patient by an ill-fitting
denture flange?
A. Papillary hyperplasia
B. Epulis fissuratum
C. Candidiasis
D. Fibrous tuberosity
A

B. Epulis fissuratum is a reactive growth to an
overextended or ill-fitting denture flange. It is best
removed surgically. Papillary hyperplasia is found
in the palatal vault. It is caused by local irritation,
poor-fitting dentures, poor oral hygiene, or leaving
dentures in 24 hours a day. Candidiasis is
associated with papillary hyperplasia. Fibrous tuberosity is commonly seen with large tubero-
sities.

18
Q

Inadequate rest-seat preparation for a remov-
able partial prosthesis can cause _____.

A. Tooth mobility
B. Ligament widening
C. Occlusal rest fracture
D. Occlusal rest distortion

A

C. In McCracken’s Removable Partial Pros-
thodontics, ed 11 (St Louis, Mosby, 2005),

McCracken states, “Failure of an occlusal rest
rarely results from a structural defect in the metal
and rarely if ever is caused by accidental
distortion. Therefore the blame for such failure
must often be assumed by the dentist for not
having provided sufficient space for the rest
during mouth preparations.”

19
Q

Which of the following is the main disadvan-
tage of resin-modified glass ionomer compared

to conventional glass ionomer?
A. Reduced fluoride release
B. Increased expansion
C. Reduced adhesion
D. Cost
A

B. Resin-modified glass ionomers combine some of
the advantages of glass-ionomer cements, such
as fluoride release and adhesion, but provide

higher strength and low solubility. These materi-
als are less susceptible to early moisture expo-
sure than are glass-ionomer cements but, due to

the addition of resin, they exhibit increased ther-
mal expansion.

20
Q

You are planning to replace a maxillary cen-
tral incisor with a fixed prosthetic device

(FPD). The edentulous space is slightly wider
than the contralateral tooth. In order to
achieve acceptable esthetics, you should
ensure that _____.
A. The line angles of the pontic are placed in the
same relationship as the contralateral tooth
B. The pontic should be made smoother than the
contralateral tooth
C. The pontic should have a higher value than the
contralateral tooth
D. The line angles should be shaped to converge
incisally on the pontic

A

A. The width of an anterior tooth is usually identified
by the mesiofacial and distofacial position of the
line angles, the shape of the surface contour, and
light reflection between these line angles. The
contralateral tooth features should closely be

duplicated in the pontic, and the space discrep-
ancy can be compensated by modifying the

shape of the proximal areas.

21
Q

Polycarboxylate cement achieves a chemical
bond to tooth structure. The mechanism for
this bond is _____.
A. Ionic bond to phosphate.
B. Covalent bond to the collagen.
C. Chelation to calcium.
D. These cements do not form a chemical bond.

A

C. The carboxylate groups in the polymer molecule

chelates to calcium.

22
Q

Which of the following properties of a gold
alloy exceeds a base metal alloy in numerical
value?
A. Hardness
B. Specific gravity
C. Casting shrinkage
D. Fusion temperature

A

B. Gold alloys are heavier for a given volume. Gold
alloys are softer. Base metals are cast at higher
temperatures, leading to greater shrinkage.

23
Q
Which of the following impression materials
has the highest tear strength?
A. Polyether
B. Polysulfide
C. Addition silicone
D. Condensation silicone
A

B. Polysulfide has the highest tear strength of all

elastomeric impression materials.

24
Q
Chroma is that aspect of color that indicates
\_\_\_\_\_.
A. The degree of translucency
B. The degree of saturation of the hue
C. Combined effect of hue and value
D. How dark or light is a shade
A

B. Chroma is the saturation or intensity of the color
or shade. Value is the relative lightness or darkness
of a color. Opalescence is the light effect of a
translucent material.

25
Q
In order for an alloy to be considered noble
metal, it should \_\_\_\_\_.
A. Contain at least 25% Ag
B. Contain at least 25% Pt or Pd
C. Contain 40% Au
D. Contain at least 80% gold
A

B. Noble metals are gold (Au), platinum (Pt), and
palladium (Pd) [silver (Ag) is not considered
noble; it is reactive, but improves castability].
Noble alloys (old term was semiprecious metal)

have a noble metal content ≥25%. (To be classi-
fied as noble, Pd-Cu, Pd-Ag, Pd-Co alloys have no

stipulation for gold.)
High noble alloys have a high content of gold
(more than 60%).

26
Q
The purpose of fabricating a provisional
restoration with correct contours and marginal
integrity is \_\_\_\_\_.
A. For protection
B. To supervise the patient’s dental hygiene and
give them feedback during this stage
C. To preserve periodontal health
D. All of the above
A

D. All these reasons are correct. The provisional is
placed to protect the tooth and preserve healthy
tissues if proper contours and marginal integrity
are present. This is an excellent time to evaluate
and give feedback to the patient on how well they
are brushing and flossing.

27
Q

A compomer cement _____.
1. Is indicated for cementation of metal-ceramic
crowns.
2. Is indicated for cementation of all-ceramic
restorations.
3. Is indicated for some all-ceramic crowns, inlays,
and veneers with some contraindications.
4. Has low solubility and sustained release of
fluoride.
A. All are correct.
B. 1, 2, and 3 are correct.
C. 1, 3, and 4 are correct.
D. 2, 3, and 4 are correct.

A

C. Compomer cements (also known as resin-modified
glass ionomer cements) have low solubility, low
adhesion, and low microleakage. They are not
recommended to be used with all-ceramic
restorations because they have been associated
with fracture, which is probably due to their
water absorption and expansion.

28
Q
Heating the metal structure in a furnace prior
to opaque application in a metal-ceramic
crown is necessary to \_\_\_\_\_.
1. Harden the metal.
2. Oxidize trace elements in the metal.
3. Eliminate oxidation.
A. 1 only
B. 1 and 2
C. 1 and 3
D. 2 only
E. 3 only
A

D. An important factor that affects the metal–ceramic
bond is the surface treatment of the alloy before

firing porcelain. Air-abrasion of the cast alloy is typi-
cally performed before the oxidation step to help

remove surface contaminants that remain from
devesting, and to help clean the casting and provide
microscopic surface irregularities for mechanical
retention of the ceramic. The oxidation step for the
alloy can be performed in air or by using the
reduced atmospheric pressure (approximately 0.1
atm) available in dental porcelain furnaces.

29
Q

Which of the following are probably not clini-
cally significant in terms of influencing the

retention of a cemented restoration?
1. Tooth preparation
2. Surface textur
3. Casting alloy
4. Tooth taper
5. Luting agent
A. 1, 3, and 4
B. 1, 2, 3
C. 1, 2, 3, 5
D. 3 and 5
A

D. The casting and luting agent have been shown to
have a minimal effect in the retention of a crown.
The geometry of the preparation, parallelism
between the walls (taper), and surface texture of
the preparation have an effect on the retention of
a crown.

30
Q

Which articulator is capable of duplicating the
border mandibular movements of a patient?
A. Nonadjustable
B. Arcon-type
C. Nonarcon-type
D. Fully adjustable

A

B. The arcon-type is capable of duplicating a wide
range of mandibular movements, but is generally
set to follow the patient’s border movements.

The terminal hinge axis is located and a panto-
graph is used to record the mandibular move-
ments. These mandibular movement tracings or

recordings are used to set the articulator.

31
Q

Tooth #30 is endodontically treated after a con-
servative access cavity was made through a

typical MO amalgam restoration. The restora-
tion of choice is a _____.

A. Chamber-retained amalgam foundation
B. Custom cast post and core
C. Wire post and core
D. Parallel-sided prefabricated post with cast core

A

A. If there is an existing pulp chamber and
remaining sound tooth structure, there is no
need to place a post. Placement of a post tends
to require taking additional tooth structure,
which weakens a tooth.

32
Q

Potential problems in connecting implants to
natural teeth include all of the following except
_____.
A. Stress is concentrated at the superior portion of
the implant
B. Breakdown of osseointegration
C. Cement failure on the natural abutment
D. Screw or abutment loosening
E. Fracture in the connector area of the prosthesis

A

E. A tooth moves within the limits of its periodontal
ligament during function. The relative immobility
of the osseointegrated implant compared to the
functional mobility of a natural tooth can create
stresses at the neck of the implant up to two
times the implied load on the prosthesis.
Potential problems when connecting an implant
with a tooth include (1) breakdown of the

osseointegration; (2) cement failure on the natu-
ral abutment; (3) screw or abutment loosening;

and (4) failure of the implant prosthetic compo-
nent. Fracture in the connector area is rarely

seen in this situation.

33
Q

Which is true of a minor connector of an RPD?
A. Should be thin to not interfere with the tongue
B. Should be located on a convex embrasure surface
C. Should conform to the interdental embrasure
D. All of the above
E. A and C only

A

C. The minor connector must have sufficient bulk to
be rigid so that it transfers functional stresses
effectively to the abutment or supporting teeth and

tissues. It should be located in the interden-
tal embrasure where it doesn’t disturb the

tongue, and should be thickest in the lingual sur-
face, tapering toward the contact area but not

located on a convex surface.

34
Q

The design of a restored occlusal surface is
dependent upon the _____.
1. Contour of the articular eminence.
2. Position of the tooth in the arch.
3. Amount of lateral shift in the rotating condyle.
4. Amount of vertical overlap of anterior teeth.
A. 1 and 3
B. 2, 3, and 4
C. 2 and 4 only
D. 3 and 4 only
E. All of the above

A

E. The posterior and anterior factors, position in the
mouth, and side shift have influence on the
occlusal anatomy of a restoration.

35
Q

Which is a main function of a guide plane sur-
face contacted by a minor connector of an RPD?

A. Provides a positive path of placement and
removal for an RPD
B. Can provide additional retention
C. Aids in preventing cervical movement
D. All of the above
E. Only A and B
A

E. The contact of the framework with parallel tooth
surfaces acting as guide planes provides a positive

path of placement and removal for a remov-able partial denture. In addition, guide planes can

provide retention by limiting the movement of the
framework. The rest on a removable partial
denture prevents vertical or cervical movement.

36
Q

From the following list of components of an
RPD, which must be rigid?
A. Major connector, minor connector, and retentive
clasp
B. Wrought wire clasp, rests, and minor connector
C. Minor connector, rest, and major connector

A

C. The clasps are meant to be flexible in order to
engage in undercut. The rest of the components
of an RPD should be rigid.

37
Q
Which type of clasps are generally used on a
tooth-supported removable denture?
A. Circumferential cast clasp
B. Combination clasp
C. Wrought wire clasp
A

A. Circumferential cast clasps are more rigid than
combination clasps or wrought wire clasps. Since
there is good stability of the prosthesis when the
tooth is supported, there is no need for the added
flexibility in a normal situation.

38
Q
Which of the following disinfectants can be
used with alginate impressions?
A. Alcohol
B. Iodophor
C. Glutaraldehyde
D. All of the above
E. B and C only
A

E. The impression should be rinsed and disinfected
with glutaraldehyde or iodophor and should be
poured within 15 minutes from the time the
impression was removed from the mouth.

39
Q

A dentist replaces an amalgam on tooth #5 and
notices a small pulpal exposure. He elects to
use a direct pulp cap procedure. Which of the
following best predicts success?
A. Size of the lesion
B. Isolation of the lesion
C. Use of calcium hydroxide
D. Age of the patient

A

B. Isolation is the most important factor since it pre-
vents bacterial contamination, increasing the

success of the pulp cap procedure.

40
Q

In a tooth-supported RPD with a circumferen-
tial cast clasp assembly, there is _____.

A. More than 180 degrees of encirclement in the
greatest circumference of the tooth
B. A distal rest on the tooth anterior to the
edentulous area
C. A mesial rest on the tooth posterior to the
edentulous area
D. Only B and C
E. All of the above

A

E. On a tooth-supported RPD with a circumferential
cast clasp assembly, there should be more than
180 degrees of encirclement by the clasp in the
greatest circumference of the tooth (that passes
from diverging axial surfaces to converging axial
surfaces). Mesial and distal rests anterior and
posterior to the edentulous areas, respectively, are
generally used.

41
Q

What is a nonrigid connector?
A. An appliance composed of a key and keyway
that is used to connect one piece of a prosthesis
to another
B. An appliance that is used to connect two
crowns rigidly fixed
C. A bar appliance that is used to maintain a space
for a tooth that has not erupted
D. None of the above

A

A. Nonrigid connectors are used when it is not pos-
sible to prepare two abutments for a fixed partial

denture (FPD) with a common path of place-
ment or to segment a large or complex FPD into

shorter components. Nonrigid connectors can be
prefabricated plastic patterns (female or keyway
portion, and male or key portion) that are

embedded in the waxed crown and pon-
tic patterns or custom-milled in the cast crown.

The second part is then custom-fitted to the
milled retainer and cast.

42
Q

The distance between the major connector on a
maxillary RPD framework and the gingival mar-
gins should be at least _____.

A. 3 mm
B. 2 mm
C. 6 mm
D. 15 mm

A

C. The recommended space or distance between
the border of the framework and the marginal
gingiva should be at least 6 mm.

43
Q

The component that is responsible for connect-
ing the major connector with the rest and clamp

assembly is:
A. The bar
B. The minor connector
C. The proximal plate
D. The guide plane
A

B. The minor connectors are the components that
serve as the part of the removable partial denture
that connect the major connector and other
components such as the clasp assembly, indirect
retainers, occlusal rests, or cingulum rests.

44
Q

The three dimensions of the Munsell Color
Order System, the basis for shade guides such
as Vita LuminTM, are _____.
A. Absorption, scattering and translucency
B. Color, translucency, and gloss
C. Size, shape, and interactions with light
D. Hue, value, chroma

A

D. The Munsell Color System, which is the basis of
shade guides such as Vita Lumin®, is divided into
three dimensions: hue is the shade or color of an
object; chroma is the saturation or intensity of the
color or shade; and value is the relative lightness
or darkness of a color.

45
Q

The purpose of applying a layer of opaque
porcelain in a metal-ceramic restoration is to
_____.
A. Create a bond between the metal and porcelain
B. Mask the metal oxide layer as well as provide a
porcelain–metal bond
C. Create the main color for the restoration
D. A and B are correct
E. All of the above

A

D. The opaque porcelain is used for masking the

oxide layer of the metal and provides the porce-
lain–metal bond. The minimum thickness of the

opaque is about 0.1 mm.

46
Q
The impression material that is mainly
composed of sodium or potassium salts of
alginic acid is \_\_\_\_\_.
A. Polyether
B. Irreversible hydrocolloid
C. Polyvinyl siloxane
D. Polysulfide
A

B. Irreversible hydrocolloid (IH) or alginate is the
material of choice to produce diagnostic casts. Its
composition is mainly sodium or potassium salts
of alginic acid. They react chemically with
calcium sulfate to produce insoluble calcium
alginate.

47
Q

A complete denture patient presents with angular
cheilitis. A review of recent medical examination
revealed that vitamin deficiency is not a factor.
A possible predisposing factor is _____.
A. Excessive vertical dimension of occlusion
B. A closed or insufficient vertical dimension of
occlusion
C. Improper balance of the occlusion
D. Poor contour of the denture base

A

B. A closed or insufficient vertical dimension of

occlusion is thought to be one predisposing con-
dition for angular cheilitis, which usually is asso-
ciated with Candida albicans. Improperly

balanced occlusion or poor contour of the den-
ture base are not predisposing conditions for

angular cheilitis.

48
Q

Each of the following is a feature of papillary
hyperplasia except one. Which one is not true?
A. It is a proliferative bone disease
B. It can be caused by wearing the dentures at night
C. It can be caused by poor oral hygiene
D. It can be caused by an ill-fitting denture

A

A. Paget’s disease of bone is a bone disease char-
acterized by bone resorption followed by

attempts at bone repair involving proliferation
leading to bone deformities. Its etiology is
unknown and it occasionally involves the maxilla

and mandible. Papillary hyperplasia is character-
ized by multiple papillary projections of the

epithelium caused by local irritation, poor-fitting
denture, poor oral hygiene, and leaving dentures
in all day and night.

49
Q

For optimum esthetics when setting maxillary
denture teeth, the incisal edges of the maxillary
incisors should follow the _____.
A. Lower lips during smiling
B. Upper lips during smiling
C. Lower lips when relaxed
D. Upper lips when relaxed

A

A. Maxillary teeth should contact the wet dry lip line
when fricative sounds f, v, and ph are made.
These sounds help to determine the position of
the incisal edges of the maxillary anterior teeth.

50
Q
Excessive monomer added to acrylic resin will
result in \_\_\_\_\_.
A. Increased expansion
B. Increased heat generation
C. Increased shrinkage
D. Increased strength
A

C. Using more monomer than needed will cause
increased shrinkage. The more monomer used,
the less expansion, less heat, and reduced
strength will be produced.

51
Q
Which is the purpose of adjusting the occlusion
in dentures?
A. To obtain balanced occlusion.
B. To stabilize dentures.
C. To obtain even occlusal contacts.
D. All of the above.
A

D. Occlusal adjustment of dentures should be done
with the premise of obtaining even occlusal
contacts with balanced occlusion in order to
stabilize the dentures during function.

52
Q

Which may be a consequence of occlusal trauma
on implants?
A. Widening of the periodontal ligament.
B. Soft-tissue sore area around the tooth.
C. Bone loss.
D. All of the above.

A

C. Bone loss is usually seen on the most coronal
aspect of the implant in the form of a wedge.
There is no periodontal ligament on implants, so
there is no feeling of soreness.

53
Q

Which of the following is true of an occlusal rest
for a removable partial denture?
1. One-third facial lingual width of the tooth
2. 1.5 mm deep for base metal
3. 2.0 mm labiolingual width of the tooth
4. Floor inclines apically toward the center of the
tooth
A. All of the above
B. 1, 3, and 4
C. 1, 2, and 4
D. 3 and 4

A

C. Rests are critical for the health of the soft tissues
underlying the denture resin basis and the minor
and major connectors. It should prevent tilting
action and should direct forces through the long
axis of the abutment tooth. In order to function as
specified, an occlusal rest should have a rounded
(semicircular) outline form, be one-third the
facial lingual width of the tooth, one-half the
width between cusps, and at least 1.5 mm deep
for base metal. The rest floor inclines apically
toward the center of the tooth and the angle
formed with the vertical minor connector should
be less than 90 degrees.

54
Q

A patient is unhappy with the esthetics of an
anterior metal-ceramic crown, complaining that
it looks too opaque in the incisal third. The
reason for this is most likely _____.
A. Using the incorrect opaque porcelain shade.
B. Inadequate vacuum during porcelain firing.
C. Not masking the metal well enough with the
opaque.
D. The tooth was prepared in a single facial plane.

A

D. D is the best answer because generally it is the
dentist’s fault and not the technician’s. Incorrect
opaque may influence the resultant shade.
Inadequate vacuum will affect the esthetics. If the
opaque does not mask well, the metal result is a
grey appearance or lower value in the restoration.

55
Q

An endodontically treated tooth was restored
with a cast post-and-core and a metal-ceramic
crown. Three months later, the patient complains
of pain, especially on biting. Radiographic
findings and tooth mobility tests are normal. The
most probable cause of pain is _____.
A. A loose crown
B. Psychosomatic
C. A vertical root fracture
D. A premature eccentric contact

A

C. Usually, vertical fractures will refer pain when bit-
ing. In this case, the patient had recent endodon-
tic treatment and there is no periapical lesion to

indicate that is due to inadequate root canal ther-
apy. There is no sign that the crown is loose, no

premature contact, and no mobility.

56
Q

For an occlusal appliance used for muscle
relaxation to be effective, the condyles must be
located in their most stable position from a
musculoskeletal perspective. This is _____.
A. Centric occlusion
B. At the vertical dimension of rest
C. Centric relation
D. Maximum intercuspal position

A

C. The condyles should be in centric relation, which
is defined as “the maxillomandibular relationship
in which the condyles articulate with the thinnest
avascular portion of their respective disks with the
condyle–disk complex in the anterior-superior

position against the shapes of the articular emi-
nences.” (Glossary of Prosthodontic Terms,

J Prosthetic Dent 94(1):21-22, 2005.)

57
Q

A diagnostic wax-up is indicated when _____.
A. Re-establishing anterior guidance
B. A provisional fixed prosthesis is to be fabricated
C. Uncertainty exists regarding esthetics
D. All of the above

A

D. It is recommended that any time there is a ques-
tion regarding the treatment outcome involving a

prosthetic device, or the need to produce tem-
plates for provisional restorations that reproduce

a desired form of teeth, a diagnostic wax-up
should be generated.

58
Q

Which of the following is the single most
important predictor of clinical success of a cast
post and core?
A. Amount of remaining coronal tooth structure.
B. Post length.
C. Post diameter.
D. Positive horizontal stop.

A

A. The length, canal enlargement, and a finish line
for the post are unimportant if there is no sound
remaining coronal tooth structure to get a ferrule
of the final restoration.

59
Q
Which of the following are factors associated
with bone loss?
A. Initial implant instability.
B. Excessive occlusal force.
C. Inadequate hygiene.
D. Inadequate prosthesis fit.
E. All of the above.
A

E. Bone resorption around dental implants can be
caused by inadequate oral hygiene, premature

loading, and repeated overloading. If an implant-
supported framework does not fit passively, the

implant is placed under constant force. If signifi-
cant compressive forces are placed on the inter-
facial bone, these can lead to implant failure.

60
Q

Which of the following statements is(are) true
concerning the evaluation of the occlusion on a
cast restoration?
A. The restoration is in proper occlusion if it holds
shim stock.
B. The restoration is in proper occlusion if the
adjacent teeth hold shim stock.
C. The restoration is in proper occlusion when
articulating paper marks multiple points of
contact on the restoration.
D. A, B, and C.
E. None of the above.

A

D. When checking the occlusion of a cast restora-
tion, mylar paper or shim stock is a very accu-
rate method for testing occlusal contacts. The

procedure is to check with the mylar paper

before placing the restoration in the teeth adja-
cent to the tooth to be restored and the oppos-
ing side. Place the restoration and check

whether the same occlusal contacts are main-
tained on the tested teeth. When all teeth,

including the one being restored, hold the mylar
paper upon occluding and even, articulating
markings are present, then occlusion contacts
are correct.

61
Q

In a Kennedy Class I arch in which all molars
and the first premolar are missing and the rest
of the teeth have good periodontal support, the
preferred choice of treatment is _____.
A. A removable partial denture replacing all missing
teeth
B. A fixed dental prosthesis replacing the missing
premolar and a removable partial denture
replacing the molars
C. Implant supported crowns replacing the first
premolars and a removable partial denture
replacing the molars
D. A and B are preferred choice of treatment over C.
E. B and C are preferred choice of treatment over A.

A

E. A fixed dental prosthesis replacing the first
bicuspids improves the prognosis of the second
bicuspids when placing a removable dental
prosthesis. Implants would also improve the
prognosis by not leaving the second bicuspid
standing alone and acting as a cantilever when
in function with the removable prosthesis.

62
Q

Which of the following is(are) uses for the
surveyor?
A. To aid in the placement of an intracoronal
retainer.
B. To block out a master cast.
C. To measure a specific depth of an undercut.
D. All of the above.
E. Only A and B are correct.

A

D. The surveyor is used for surveying a diagnostic
cast and to measure a specific depth of undercut.
It also helps to determine the most desirable path
of placement for a removable partial denture. It

identifies bony areas that may need to be surgi-
cally removed because they interfere during

insertion of the RDP. It is also used to survey
crowns, place intracoronal retainers, machine or
mill cast restorations, and survey and block out a
master cast before constructing an RDP.

63
Q

A dentist is preparing all maxillary anterior
teeth for metal-ceramic crowns. Which of the
following procedures is necessary in order to
preserve and restore anterior guidance?
A. Protrusive record.
B. Template for provisional restorations.
C. Custom incisal guide table.
D. Interocclusal record in centric relation.

A

C. Anterior guidance must be preserved by means of

construction of a custom incisal guide table, espe-
cially when restorative procedures change the

surfaces of anterior teeth that guide the mandible
in excursive (lateral, protrusive) movements.
64
Q
A radiolucency near the apex of tooth #28 is
seen radiographically. The tooth is
asymptomatic and does not have caries or
periodontal problems. Which is most likely the
cause of the radiolucency?
A. Submandibular fossa.
B. Periapical granuloma.
C. Complex compound odontoma.
D. Mental foramen.
A

D. The tooth does not exhibit any pathology to indi-
cate that the radiolucency is derived from the tooth.

The mental foramen can appear on the apex,
depending on the direction of the x-ray beam.

65
Q

The minor connector for a mandibular distal
extension base should extend posteriorly about
_____.
A. Two-thirds the length of the edentulous ridge
B. Half the length of the edentulous ridge
C. One-third the length of the edentulous ridge
D. As long as possible

A

A. The minor connector for the mandibular distal
extension base should extend posteriorly about
two thirds the length of the edentulous ridge; this
adds strength to the denture base.

66
Q

Which are characteristics of a major connector
that contribute to health and well-being?
A. It is rigid and provides unification of the arch
stability.
B. It does not substantially alter the natural contour
of the lingual surface of the mandibular alveolar
ridge or the palatal vault.
C. It contributes to the support of the prosthesis.
D. All of the above.
E. Only A and B.

A

D. Rigidity is provided by cross-arch stability through
the principle of broad distribution of stress. The
major connector should not alter dramatically the
contours of the supporting structures, and it
should contribute to the support of the prosthesis.

67
Q

When does a fixed dental prosthesis (FDP),
which was cast in one piece, need to be
sectioned?
A. When a cantilever pontic is used.
B. When the fit cannot be achieved or verified with a
one-piece cast.
C. When single crowns are adjacent to the FDP.
D. Always, in order to achieve a good fit.

A

B. Common reasons for a FDP not to fit in one piece
are lack of parallelism between the abutments
and distortion of the wax pattern during removal

from the dies. In any of these cases, the frame-
work may not fit in the prepared abutment teeth

and must be sectioned between one of the con-
nectors between the pontic and retainer to fit the

two pieces individually, and a solder record must
be made to solder the pieces.

68
Q

When soldering a fixed partial denture, what is
the effect of flux when heated on the area to be
soldered?
A. To remove oxides from the metal surface.
B. To displace metal ions from the area.
C. To change the composition of the alloy.
D. To reduce the surface tension of the metal.

A

A. The soldering flux used with gold alloys is usually
borax glass (Na2B4O7), because of its affinity for
copper oxides. Flux is applied to a metal surface
to remove or prevent oxide formation. With an
oxide-free surface, the solder wets the surface
freely and spreads over the metal surface.

69
Q

The component of an RDP that is spoon-shaped
and slightly inclined apically from the marginal
ridge of a tooth is the _____.
A. Indirect retainer
B. Minor connector
C. Rest
D. Lingual bar

A

C. The rest should be spoon-shaped and is slightly
inclined apically from the marginal ridge of the
abutment tooth. It should restore the occlusal
morphology of the tooth and not interfere with
the normal existing occlusion.

70
Q

Metamerism invariably involves _____.
A. A color difference between two objects under
one or more illuminant(s)
B. One object having a lower chroma than another
C. One object having a lower lightness than another
D. A significant color change of one object as it
moves from one illuminant to another

A
  1. A. Metamerism is the phenomenon where a color

match under a lighting condition appears differ-
ent under a different lighting condition.

71
Q

Ante’s law

Effect on length of FPD

A

Root surface of abutment > root surface of Pontic

Longer FPDs less stable

72
Q

QUESTION: Where do you attach a non-rigid retainer from a FPD?

A

Distal of mesial abutment & mesial of the distal abutment
- Keyway = lock & key for non-rigid retainers, is located on the mesial of the distal abutment to prevent stress on the distal tooth (most likely to fail)

73
Q

Most immediate sign after high occlusion on a bridge?

A

Myofacial pain

74
Q

fixed partial denture keeps breaking, why?

A

POOR FRAMEWORK

75
Q

Most common reason for PFM bridge breakage? Firing schedule, high contact, inadequate design

A

inadequate design

76
Q

FPD seats during framework try-in but when come back for final cementation, the FPD holds up/doesn’t seat. Why?

A

Interproximal (porcelain over contoured)
- Check proximal contacts first when cast that fits on die cannot be seated on the teeth in the mouth.

77
Q

All ceramic FPD should cover how much of abutment?

A

360 degrees

78
Q

What is the basis for classification of different FPD pontics:

A

Relation of the pontic to the supporting tissue

79
Q

Modified ridge lap pontic has what kind of contact?

A

Minimal contact w/ residual ridge

80
Q

modified pontic how should it touch the gum?

A

Barely touch it

81
Q

MOST esthetic pontic: Saddle, steins, sanitary, conical ridge lap, Modified ridge lap

A

Modified ridge lap

82
Q

Pontic of 3-unit FPD should rest

A

gently on the soft tissue & should not blanch tissues.

83
Q

Anterior teeth, which pontic is best?

A

Ovate or modified ridge

84
Q

Pontic length on a bridge, what’s most important?

A

AP dimension, MD dimension

85
Q

Strength of abutment connection to pontic which is more important?

A

occlusogingival width

86
Q

Most important dimension that ensures the metal connector between abutment and pontic is sufficient (in 3-unit fpd bridge)?

A

occlusal-gingival

87
Q

QUESTION: A pontic in the bridge shows the metal, why?
Under-reduction
Framework was not done well

A

Framework was not done well (since is a pontic this is probably the answer)

88
Q

QUESTION: Edentulous space is wider than adjacent anterior tooth, how to match them? Make pontic line angles farther apart and deeper interproximal embrasures
Make pontic line angles closer and deeper interproximal embrasures
Make pontic line angles farther and shallower interproximal embrasure
Make pontic line angles closer and shallow interproximal embrasures

A

Make pontic line angles closer and deeper interproximal embrasures

89
Q

QUESTION: How do you decrease the width of an artificial tooth?
Deepen the facial line angle proximally and increase the interproximal embrasure
Deepen the facial line angle proximally and decrease interproximal embrasure
Take the facial line angle labially and increase the interproximal embrasure
Take the facial line angle labially and decrease the interproximal embrasure.

A

Take the facial line angle labially and increase the interproximal embrasure

90
Q

How do you make a crown narrower?

A

Move line angles more facially (closer together)

91
Q

Ante’s law: 3 abutments, one being lateral, with 2 pontics, prognosis is good, poor, excellent?

A

Poor

92
Q

Which of the following is not ideal abutment-pontic connection?
Lateral Incisor-Central Incisor
Central Incisor- Lateral Incisor,
Canine-Lateral Incisor

A

worst cantilever

lateral abutment with central pontic

93
Q

QUESTION: Which cantilever bridge would be most destructive of the abutment tooth:

A

lateral incisor as abutment with central incisor as
pontic (larger root surface of pontic than abutment, Ante’s Law)

94
Q

strength of soldered connector of FPD in enhanced by? 1. Using higher carat solder
2. Increasing height
3. Increasing width
4. Increasing gap

A

Increasing height

95
Q

When soldering, what is the most important factor?

A

Height

96
Q

What system is best for soldering adjusted FPD framework?

A

Oxygen something, use a torch

97
Q

Keyhole for post /core is to

A

prevent rotation

98
Q

Cast post and core - you put extra slit - what is that for?

A

Prevent rotation (keyhole)

99
Q

What is the advantage of a fiber post over a cast post

A

Fiber post has the same modulus of elasticity as dentin

100
Q

How does a dowel post & core help prevent vertical fracture? Ferrule, Ventilating groove, bevel, vertical stop

A

Ferrule

101
Q

What is the point of putting a dowel post on an RCT tooth?

A

Retain core, metal set into root canal to provide support to crown

102
Q

How should prep an RCT for cast post?

A

Need at least 4 mm of GP to preserve apical seal

103
Q

Hue, value, chroma

What’s most important in color matching

A

Hue - color - least important
Value - brightness - most important
Chroma - saturation

104
Q

Metamerism

A

Color appears different under different light

105
Q

QUESTION: Most important when selecting shade? Value, translucency, chroma, hue, color

A

Value

106
Q

Least important in selecting shade? fluorescence, value, chroma, hue

A

hue - due to lack of variation in mouth

107
Q

When you have color index of 100, which of the following is effected?

A

Value - Color value is 0 = black while 100 = white

108
Q

dentist adjusts the shade of a restoration using a complementary color. This procedure will result in
A. increased value.
B. decreased value.
C. intensified color.
D. increased translucency.

A

decreased value.

109
Q

Crown #9 and #10. One of the crowns looks very light (white). What did the dentist pick wrong? Hue
Chroma
Value

A

Value

110
Q

What does staining do for ceramics?

A

Decreases value. Alters chroma

111
Q

What can’t occur with the addition of stain? Increase value, decrease value, increase chroma, increase hue, decrease chroma

A

Increase value

112
Q

What can’t you change? hue, increase value, decrease value, change chroma

A

Increase value

113
Q

When you add a different color to a resin, you increase what?

A

Chroma

114
Q

How to change hue?

A

Add orange to it (some sources says it changes chroma)

115
Q

How do you lower value in a restoration?

A

STAIN w/ Complement color or orange - when you add a complement color, the colors mix & turn grey, thus changing value

116
Q

What complementary color to darken porcelain & decrease value? gray, orange, ochre, violet.

A

orange

117
Q

If you add a complementary color yellow, what happens to the hue?

A

decrease red content of yellow red shade
- Side note: adding yellow stain = Inc chroma of basic yellow shade
- Pink purple makes yellow –> yellow red

118
Q

Which represents position on the spectral wavelength?

A

Hue

119
Q

Which color characteristic is dependent on spectral wavelength?

A

Hue

120
Q

QUESTION: What is best way to determine value:
Open eye as wide as you can
Half close eyes (squint) to increase sensitivity to better select value.
Arrange the shade guide in increasing value (from light to dark)

A

Arrange the shade guide in increasing value (from light to dark)

121
Q
A

More rods than cones so eyes are more sensitive to value

122
Q

-
QUESTION: How to prevent metamerism –

A

look at shade under multiple light sources
Porcelain, look at it with different light sources (metamerism)

123
Q

The phenomenon whereby various light sources produce different perceptions of color is called A. fluorescence.
B. incandescence.
C. opalescence.
D. translucency.
E. metamerism

A

metamerism

124
Q

Upper molar crown has a wear facet in porcelain on the MB inclination of MB cusp. Most likely associated with?

A

Interference in protrusion & working interference

125
Q

30 gold crown has wear located on the MB cusp of the MB incline, cause –

A

protrusive and working side movement

126
Q

Contact on lingual portion of buccal cusp of mandibular molar, what kind of interference? Non-working, working, protrusive

A

Non-working

127
Q

Contact on buccal portion of lingual cusp of maxillary molar, what kind of interference? Non-working lateral, working, protrusive

A

Non-working lateral

128
Q

Wear facets on lingual incline of maxillary lingual cusp & facial incline of mandibular facial cusp on left side? pt has: left nonworking interference, protrusive interference, right nonworking interference, left working interference

A

left working interference

129
Q

Working side interferences are seen on what surfaces?

A

palatal inclines of buccal cusp of upper and buccal incline of lingual cusp of lower; (the nonworking cusps on the final side are interfering)
- In MIP or CO, the buccal incline of palatal cusp of upper and lingual incline of buccal cusp of lower.
- Balanced side interferences are buccal incline of palatal cusp of upper and lingual incline of buccal cusp of lower (it’s the working cusps
interfering)

130
Q

Wear on buccal of maxillary premolars due to, due to mandibular movement working or nonworking?

A

Working

131
Q

When will the BULL rule be utilized with selective grinding?

A

Working side

132
Q

QUESTION: The mesiobuccal incline on the mesiobuccal cusp of mand molar (with stainless steel crown) has wear. This is because of movement
in which direction(s):

A

working and protrusive movement

133
Q

Max molar on mesial slope of mesial lingual cusp, where do you have wear on lower teeth? Mesial or distal incline of either mesial facial or mid facial cusp?

A

Distal incline of midfacial cusp

134
Q

The mesial angle of the ML of max 2nd molar occludes with what on the man 2nd molar
a. Mesial MB cusp
b. Distal MB cusp
c. Mesial DB cusp
d. Distal DB cusp

A

Distal MB cusp

135
Q

Mesial angle of the L of maxillary second molar occludes with what on the mand 2nd molar.?

A

Distal of MB CUSP

136
Q

Pt bites down after cementing down and deviates to the right #30:

A

Lingual incline of the buccal cusp

137
Q

Crown on number 30, pt tries to close, contact interference deviates to left, lingual incline of buccal cusp needs to be altered buccal incline of the lingual cusp

A

buccal incline of the lingual cusp

138
Q

In restoring a canine protected occlusion, with anterior overbite of about 2mm. The buccal cusps of posterior teeth should be flat,
BECAUSE they will guide the protrusion.

a. both are true
b. only the second statement is true
c. both are false
d. only the first statement is true

A

d. only the first statement is true

139
Q

What kind of occlusion if in right lateral movement all posterior teeth are not in occlusion:

A

canine guidance

140
Q

Which of the following would result in inaccurate terminal hinge record? acutely apprehensive patient, severe skeletal cl III, tooth
contact, muscle pain, etc

A

tooth

contact,

141
Q

You have a patient who wants an all porcelain on number 8 – the incisal edge keeps breaking off and u have to come in to repair,
why does it keep breaking off?

A

Because the anterior guidance and the protrusive movements/clearance space was not properly
calculated/maintained

142
Q

What is Bennett angle?
a. it is the angle that is formed by the non-working condyle and the sagittal plane during lateral
movement
b. it is the angle that is formed by the condyle and the horizontal plane during protrusive
movements.
c. It is a difference in condylar inclination between protrusive and lateral movements
d. It is the difference between in the condylar and incisal inclinations.

A

a. it is the angle that is formed by the non-working condyle and the sagittal plane during lateral
movement

Bennett angle: formed between sagittal plane and average path of advancing condyle as viewed in the horizontal plane during lateral mandibular movements. Avg range: 7.5 - 12.8

143
Q

Bennett shift mainly on:

A

lateral movement or working side

144
Q

Most common form of internal TMJ derangement

A

anterior misalignment or displacement of the articular disk above the condyle.

145
Q

disk displacement with reduction

A

disk returns

clicking and pain with chewing

146
Q

disk displacement without reduction

A

remains displaced
no clicking, max opening < 30mm
capsulitis

147
Q

TMD without clicking

A

no clicking no reduction

148
Q

upper compartment of TMJ

A

tranlsation

149
Q

lower compartment of TMJ

A

rotation

150
Q

Where to the condyles go in CR?

A

Superio-anterio-Medial

151
Q

Which anatomical components are responsible for rotation of the mandible?

A

Disc and condyle

152
Q

If you both condyle break, what you get?

A

Posterior open bite

153
Q

Dislocation of condyle-

A

mandible deviates opposite

154
Q

Clicking in TMJ:

A

internal derangement with reduction

155
Q

Patient always had internal derangement with clicking. All of a sudden, no noise and open max 30 mm. What happened?
Myofascial pain, Lockjaw, Internal derangement w/o reduction

A

Internal derangement w/o reduction

156
Q

Which way is the articular most displaced?

A

Anterior-medially

157
Q

Which artery supplies the TMJ? D

A

eep auricular, maxillary, superficial temporal…MADS

- MADS: Middle meningeal from maxillary, ascending pharyngeal, deep auricular, superficial temporal

158
Q

Best imaging for TMD (soft tissue, disc & condyle of TMJ):

A

MRI

159
Q

Best diagnostic eval for TMJ disc? MRI, CT, PA radiograph

A

MRI

160
Q

Rotation involves what structures? Condyle, glenoid fossa, disc, TMJ

A

Condyle

161
Q

Which anatomical components are responsible for rotation of the mandible?

A

Condyle & articulating disk

162
Q

When TMJ is in rotational movement, rotation is in the

A

lower compartment

163
Q

What causes TMJ ankyloses? Trauma, Rheumatoid arthritis

A

Trauma

164
Q

Patient can’t speak English well, she doesn’t work, she has TMJ problems, she is on meds. Which one will not affect her oral
hygiene prognosis?

A

TMJ problems
- Rationale here is; she may not be able to afford hygiene procedure, she might not understand doctor’s recommendations, and her meds
can contribute to hygiene issues. TMJ problem was not serious enough, as in she can open her mouth to clean her teeth.

165
Q

Man comes in after years of TMD with reduction and is now only able to open 25mm w/ with muscle pain. What’s his disorder?

A

Myofacial pain syndrome
- myofacial pain syndrome (can cause clicking, limited opening, pain), internal derangement without reduction has no noises or clicking but
limited opening to < 30mm

166
Q

High school football player wears a mouthguard. He has crepitation of left TMJ & trigger zone tenderness to palpation of left
temporalis area, stiffness upon wakening: Myofacial pain syndrome, TMJ dislodgement

A

Myofacial pain syndrome

167
Q

Symptoms of pain & tenderness upon palpation of the TMJ are usually associated with which of the following?

a. impacted mandibular third molars
b. flaccid paralysis of the painful side of the face
c. flaccid paralysis of the non-painful side of the face
d. excitability of the second division of the fifth nerve
e. deviation of the jaw to the painful side upon opening the mouth

A

e. deviation of the jaw to the painful side upon opening the mouth

168
Q

TMJ pain are mostly related to: 1- VII, 2-V3, 3-V2, 4-V111

A

2-V3

169
Q

What branch off facial nerve gets damaged the most during TMJ surgery?

A

Temporal

170
Q

TMJ ligaments purpose is to – limit the movement of mandible, helps open mandible, helps closes mandible

A

limit the movement of mandible

171
Q

Which muscle mainly responsible for positioning and translating condyles?

A

Lateral pterygoids

172
Q

Muscles elevating the jaw:

A

masseter, temporal, medial pterygoid and SUPERIOR belly of lateral pterygoid

173
Q

Trismus includes what muscle?

A

Medial pterygoid

174
Q

How do you treat bruxism?

A

Mouthguard

- Stress causes immune weakness which leads to disease and bruxism.

175
Q

Main function of the occlusal guard:
• Distribute occlusal forces more evenly
• To relax the musculature
• Bruxism

A

Distribute occlusal forces more evenly

176
Q

What happens when you take an impression & lip immediately swells?

A

Angioedema (allergy reaction)

177
Q
Which of the following systems is thought to malfunction in the hereditary form of angioneurotic edema?
A. C-1 esterase
B. C-1q inhibitor
C. CH50 consumption
D. Serine phosphatase
E. Complement synthetase
A

A. C-1 esterase

178
Q

What’s used in angioedema

A

C1 inhibitors, to inhibit the complement system

179
Q

Syneresis,

A

which is the exudation of the liquid component of a gel leads to alginate shrinkage.

180
Q

Most inaccurate impressions?

A

Irreversible hydrocolloid

181
Q

If you decrease water temp (colder), you have

A

more working time for an irreversible hydrocolloid

182
Q

Alginate impression in 100% humidity, why will shrinkage occur? Imbibemnt, syneresis, historgysm

A
  • syneresis = extraction or expulsion of a liquid from a gel àshrinkage
183
Q

Which is not recommended for final FPD cast impression?

  • irreversible hydrocolloid
  • reversible hydrocolloid
  • PVS
  • Polyether
A

• irreversible hydrocolloid

184
Q

Which material cannot be used to get cast impression?

o Reversible hydrocolloid
o Irreversible hydrocolloid
o Polysulfide
o PVS

A

o Irreversible hydrocolloid

185
Q

syneresis and imbibition happen to

A

hydrocolloids

186
Q

Tolerates moisture the most – hydrocolloid, polyether, addition silicone, polysulfide

A

hydrocolloid

187
Q

Imbibition and syneresis affect which one the most

a. reversible hydrocolloid
b. impression compound
c. polysulfide
d. silicone

A

a. reversible hydrocolloid
- Imbibition is a special type of diffusion when water is absorbed by solids-colloids causing an enormous increase in volume

188
Q

how to decrease expansion of gypsum

A

older investment, more water than powder

189
Q

Gypsum: If you increase water to powder ratio, you have

A

decrease expansion.

190
Q

Gypsum: If you have decrease spatula/mixing, you

A

decrease expansion.

191
Q

If you have increase spatula/mixing, you

A

increase expansion

192
Q

Increased trituration time will increase compressive strength/decrease setting expansion

A

decrease setting expansion

193
Q

What decreases setting time of Gypsum:

A

Decrease water: powder ratio

194
Q

What happens if you increase water in gypsum stone?

A

Less expansion and strength (b/c particles are farther apart)

195
Q

Decrease setting time -

A

increase spatulation time, increase water temperature, use of slurry water, decreases water: powder ratio

196
Q

What happens when you increase water/powder ratio of an investment: increase thermal expansion, decrease thermal expansion,
increase setting expansion

A

decrease thermal expansion,

197
Q

Most stable impression material or provides best dimensional quality:

A

additional silicones (aka PVS)

198
Q

When pouring gypsum material into an impression, which material will cause the least amount of bubbles? Polysulfide, polyether,
silicone, irreversible hydrocolloid

A

silicone

199
Q

Most stability:
hydrocolloid reversible
hydrocolloid irreversible
polysulfide

A

polysulfide

*PVS and polyether were not option

200
Q

Polyvinyl siloxanes (PVS) + latex

A

gets affected by latex, sulfur in latex gloves retards the setting of PVS.

201
Q

Polyether, disadvantage compared to other elastomeric? sticks to teeth/hard to remove from teeth, longer working time, less
accuracy

A

ticks to teeth/hard to remove from teeth,

202
Q

Which one most likely to get stuck in mouth?

A

Polyether

203
Q

Impressions, what’s wrong with polyether?

A

It’s hard & engages undercuts.

204
Q

When compared to other materials, which of the following is the main disadvantage of using polyether elastomeric impression
materials:

A

is much stiffer

205
Q

Most rigid impression material:

A

Polyether

206
Q

Which is hardest one to remove from the oral cavity (STIFFEST)?

A

Polyether

207
Q

What material would you not use for a single crown: a) polyether b) polysulfide c) PVS etc

A

polysulfide

208
Q

Which of the following is the best for tear strength – polysulfide / polyether

A

polysulfide

209
Q

Polysulfide gives out?

A

water

210
Q

Catalyst of POLYSULFIDE impression material-

A

lead dioxide

211
Q

Condensation silicone release – as by product

A

ethyl alcohol

212
Q

Addition silicones (PVS) releases?

A

H2 (as secondary reaction)

213
Q

The most stable elastic impression in moisture environment?

a. polyether
b. additional silicone
c. condensation silicone
d. polysulfide

A

b. additional silicone

214
Q

Which impression material is least distorted by water?

A

Additional silicone (Condensation silicone better ans if available)

215
Q

Property of interocclusal recording material?

A

Low resistance to jaw closure

216
Q

Why elastomer is not a good interocclusal record?

A

Rebound when mounting

217
Q

RPD rest

A

prevents displacement of RPD towards tissue; transfers forces of mastication to the supporting teeth

218
Q

RPD major connector

A

connect components of two sides of the arch together

219
Q

RPD minor connector

A

connects all components of RPS to major connector, stress distribution

220
Q

Denture base connector

A

where fake teeth sit

221
Q

RPD clasp

A

direct retainer, prevents RPD from moving away from hard and soft tissues

222
Q

which parts of RPD provide support

A

support is for rigidity and vertical forces

denture base, major connector, rests

223
Q

which parts of RPD provide stability

A

stability is against rocking, horizontal forces

provided by minor connector (lingual plates, guide planes, etc

224
Q

which parts of RPD provide retention

A

indirect and direct retainers

NEVER major connectors

225
Q

Retentive clasp:

A

engages undercut below height of contour, gingival 1/3 of the crown (suprabulge)
- engage in undercut to prevent movement

226
Q

Reciprocal clasp:

A

passively touches above the height of contour, middle 1/3 of the crown
- Functions:

o Provide stability & reciprocation against retentive arm
o Denture is stabilized against horizontal movements
o Acts as indirect retainer (prevent minor rocking)

227
Q

Indirect retainers:

A

consists of one or more rests, their minor connectors, and proximal plates adjacent to edentulous areas.

o Located on the opposite side of fulcrum line, assist direct retainer to prevent denture displacement
o Should be placed far from distal extension base

228
Q

Primary stress bearing area/retention:

A
  • Mandibular – buccal shelf (slow resorption, access determined by buccinator attachment)
  • Maxillary: ridges in RPD, hard palate
229
Q
QUESTION: Purpose of Major Connector
Stability and Rigidity
Stability and Retention
Retention and Rigidity
Rigidity and Esthetics
A

Stability and Rigidity

230
Q

Requirement of a major connector?

A

Rigidity

231
Q

Purpose of the reciprocating arm of clasp:

A

Stabilization

232
Q

Reciprocating arm

A

counteracts the effects of direct retainer, stabilizes the tooth, indirect retainer

233
Q

Function of clasp arm?

A

both stability (reciprocal arm) and retention

234
Q

Reciprocal clasp is placed

A

on or above the height of contour.

235
Q

Reciprocal anchorage in ortho – bodily movement, tipping, rotation, equal and opposite force

A

equal and opposite force

236
Q

Where does the retentive clasp engage on abutment:

A

passively on the suprabulge
- Retentive clasp– gingival third of the crown w/I the undercut (suprabulge), Reciprocal Clasp– middle third of the crown

237
Q

Retentive clasp is base metal alloy.

A

false

238
Q

What is function of rest?

A

Support (To resist the horizontal tissue force)

239
Q

The purpose of the rest seat is:

A

prevent displacement

240
Q

What’s the purpose of an indirect retainer?

A

to prevent distal extension from lifting up

241
Q

Function of minor connector?

A

Stability

242
Q

QUESTION: Main purpose of buccal flange of Mx denture?

A

Stability

243
Q

Primary stress bearing area in mandible:

A

buccal shelf

244
Q

What is main area of support for distal extension RPD?
Ridge
buccal shelf
external oblique ridge

A

buccal shelf

245
Q

Primary support for max denture –

A

max: ridge, 2nd-palate

246
Q

Primary support for mand:

A

buccal shelf, 2nd- ridges

247
Q

Best indicator for success of denture is –

A

Ridge

248
Q

Definition of a combination clasp:

A

cast reciprocal arm and a wrought wire retentive clasp

249
Q

What connects major connector with occlusal rest seats?

A

Minor connector

250
Q

What is reason for the altered cast technique when doing a distal extension RPD?

A

support

Altered cast method of impressions mostly for distal extension (Kennedy Class I & II arch form), requires selective tissue placement to
obtain desired support from tissues, mostly in mandibular area

251
Q

What property of RPD framework will limit adjustments of clasps?

a. Yield strength
b. Ductility
c. Stiffness

A

a. Yield strength

252
Q
What mechanical property effects permanent composition for RPD clasps?
Stiffness
Yield strength
Ductility
Hardness
A

Yield strength

253
Q

When tx planning an RPD for a pt what’s the first thing you do? Mount casts, find undercuts, find abutments, extract
hopeless and perio teeth.

A

Mount casts

254
Q

Best way to eval available space for rests-

A

mounted casts

255
Q

Which of the following explains why a properly designed rest on the lingual surface of a canine is preferred to a properly designed
rest on the incisal surface?
A. The enamel is thicker on the lingual surface.
B. Less leverage is exerted against the tooth by the lingual rest.
C. The visibility of, as well as access to, the lingual surface is better.
D. The cingulum of the canine provides a natural surface for the recess.

A

Less leverage is exerted against the tooth by the lingual rest.

256
Q

After surveying and designing which is the first step you do?

A

reduction the axial for proximal plate

257
Q

QUESTION: How should distal extension RPD fit in comparison to other RPDs?

A

Passive clasp fit

258
Q

Pt presents with a restricted floor of the mouth, only 6 mandibular anterior teeth and diastema b/w several teeth, which of the
following major connector is appropriate for this pt:

A

lingual plate with interruptions in the palate at the diastemas

259
Q

First step in realigning a distal extension denture you must first-

A

try in the framework

260
Q

Chromium characteristics for

A

corrosion resistance

261
Q

What prevents corrosion on a noble metal? Chromium or nickel

A

Chromium

262
Q

RPD denture frame or PFM, what metal is responsible for allergic reaction? nickel, chromium, cobalt or copper

A

nickel

263
Q

most common metal allergy

A

nickel

264
Q

What happens when no indirect retainer on distal extension:

A

distal extension pop up off of tissue

265
Q

Insufficient indirect retention on RPD when what happens?

A

Distal extensions lift away from mucosa

266
Q
With mandibular bilateral distal extension RPD, when you place pressure on one sides the opposite side lifts and vice versa, what is
the problem?
a. no indirect retention used
b. rests do not fit
c. acrylic resin base support
d. occlusion
A

a. no indirect retention used

267
Q

Pt complains “it feels loose” from a new bilateral distal extension RPD. Edentulous bilateral and rocking of denture- inadequate
seating of denture or inadequate indirect retainers.

A

inadequate indirect retainers.

268
Q

RPD rocks when you apply pressure on either side of fulcrum line, why?

A

inadequate indirect retainer

269
Q

Pt complains “it feels loose” from a new bilateral distal extension RPD. Why?
Thin flanges bases
Deflective Occlusal contacts
Indirect retainer

A

Indirect retainer

270
Q

Distal extention lower RPD, when you push on that area & the indirect retainer rest comes up, how do you tx?
Reline
Tell them to use denture adhesive
Tighten clasps

A

Reline

271
Q

The main reason of breaking of RPD clasp?

A

High Module of Elasticity (less likely to change shape – less deformation = VERY RIGID)

272
Q

Pt comes in w/ interim partial denture. If you fabricate it in cast partial, how is it gonna be different?
Aesthetics of teeth
Retention
Resistance to occlusal loading

A

Resistance to occlusal loading – cuz interim doesn’t have rest seats)

273
Q

QUESTION: In Max CD vs opposing Mand bilateral distal extension (Kennedy class 1), why is the anterior of the wax rim beveled?

A

length is good

esthetically but there is not enough interocclusal space @ that length.

274
Q

Beveling on upper occlusal rim due to?

A

length is adequate for esthetics but inadequate interarch space

275
Q

Patient has occlusal rims prepared and bevels the max, why?

  • VDO and length of max occ rim was adequate
  • vdo was incorrect bur length of occ rim was adequate
  • Always bevel max occ rim
  • Length of occlusal rim as adequate but VDO was wrong
A

-Length of occlusal rim as adequate but VDO was wrong

276
Q

In which classification is a direct retainer very important?

A

Kennedy class 2

277
Q

Describes a denture with bilateral edentulous space anterior to natural teeth:

A

Kennedy class 4

278
Q

Which type of Kennedy classification doesn’t have a modification?

A

Kennedy Class IV

279
Q

Reline for Kennedy class one:

A

Make sure rpd is seated

280
Q

Which one of the following is usually an issue for denture patients?

A

Lower denture

281
Q

QUESTION: Retention of denture is impacted by

A

saliva flow (THIN & watery saliva is better and aids in adhesion)

282
Q

Disadvantage of reduced saliva in dentures?

A

Reduced retention

283
Q

Saliva and denture, which one is correct? Relationship that leads to denture and tissue adhesion, no relationship

A

Relationship that leads to denture and tissue adhesion

284
Q

Physiologic rest position:

A

When mandible and all of supporting muscles are in their resting posture, Muscle guided position

285
Q

Primary stability for an edentulous CD on maxillary?

A

Palate and residual ridges

286
Q

Posterior extension of post palatal seal is:

A

2mm past vibrating line (fovea palatini)

287
Q

QUESTION: Which 3 things determine the posterior palatal seal?

A

throat form, tissue type and fovea location
- dentist look at before placing palatal seal – vibrating line, throat configuration, tension of tissue throat form, tissue type and fovea
location.

288
Q

Which of the following best explains why the dentist should provide a postpalatal seal in a complete maxillary denture? The seal will
compensate for:
A. errors in fabrication.
B. tissue displacement.
C. polymerization and cooling shrinkage.
D. deformation of the impression material.

A

C. polymerization and cooling shrinkage.

289
Q

Purpose of placing posterior palatal seal:

A

compensates for shrinkage

290
Q
Excessive depth of the posterior palatal seal usually results in
A. unseating of the denture.
B. a tingling sensation.
C. greater retention.
D. increased gagging.
A

A. unseating of the denture.

291
Q

If the palatal vault is too deep: vibrating line is

A

more pronounced and forward

- The higher the vault, the more abrupt & forward the vibrating line is.

292
Q

If the palate is very deep, what happens to the vibrating line?
More pronounced
Forward
Backward

A

Forward

- In the palate class III variation, there is a high vault in the hard palate. Soft palate has an acute drop and a wide range of movement. The
vibrating line is much more anterior and closer to the hard palate. This gives a narrow posterior palatal seal area.
293
Q

When do you remove palatine torus?

A

Prevents seating of denture & formation of posterior seal

294
Q

Patient is going to get dentures and he has palatine tori, why should it be removed? To increase peripheral seal, Because the
mucosa is too small and it will hurt him

A

To increase peripheral seal

295
Q
Palatal tori, when should it be removed?
• If undercut-so can’t be cleaned
• If posterior to vibrating line
• 3mm anterior to vibrating line 
• When denture is created around tori and functions properly
A

• 3mm anterior to vibrating line - interferes with posterior palatal seal

296
Q

Pt has bilateral maxillary tori that extends to the posterior palatal seal. You need to make an upper and lower complete. What
should you do?
a. Make a post palatal strap
b. Make CD around tori, remove tori and allow to heal, reline denture
c. Remove tori, then make CD

A

c. Remove tori, then make CD

297
Q

QUESTION: Reason for splint in palatal torus removal:

A

prevent infxn, flap necrosis, hematoma formation

298
Q

Mandibular tori in first premolar and canine. If you were to remove the tori, would you have the patient sign an informed consent
of lingual nerve injury?

A

Yes

299
Q

Hinge axis:

A

Face-bow

300
Q

What does the facebow do?

A

translates the relationship of the maxilla to the terminal hinge axis using a 3rd point of reference

301
Q

QUESTION: Primary purpose of plaster index of occlusal surface of max denture before removing the denture from the articulator and cast:

A

Preserve face-bow transfer

302
Q

Why take plaster index?

A

Teeth are then put back exactly in their original position aided by plaster key

303
Q

You delivered a set of complete dentures. Why do you take impression of max denture and mount it to articulator? (clinical
remount):

A

so you don’t have to take facebow registration again (preserve facebow)

304
Q

Lab & clinical remount, why are they done?

A

Establish and maintain VDO, correct errors in capturing VDO

- remounts are done if CO needs to be corrected or if VDO is incorrect

305
Q

Dentist mounted maxillary cast without using facebow, but now wants to increase vertical dimension 4mm: open articulator 4mm,
get new CR, take new facebow, lateral movements

A

get new CR(most anterior superior),

306
Q
QUESTION: If you want to increase patient’s VDO by 4mm, what do you do?
take new CR
take new facebow
adjust articulator
change condylar angulation
increase VDR
A

take new CR

307
Q

What to do if you increase VDO after mounting?

A

New CR and remount

308
Q

SIBILANT sounds

A

(hissing, “s/sh” sounds) allow maxillary incisors to nearly touch the mandibular incisors.
- Check VDO

309
Q

Fricative sounds

A

(“f/th” sounds) are made by allowing the maxillary incisors to nearly touch the slightly inverted lower lip.
- check labial incline of anterior teeth

310
Q

VDO =

A

VDR - Freeway Space

311
Q

At what point do you check the proper placement of teeth?

A

At the tooth try in appt

312
Q

When do you check for silabount sounds:

A

at the try-in appt.

313
Q

At what visit do you test phonetics in complete denture?

A

Tooth try-in

314
Q

When do you check phonetics for a CD/CD?

A

Wax try-in

315
Q

Making F sound –

A

teeth touches lip

316
Q

If doing a denture try-in, where would the teeth touch compared to vermilion border when saying “F” sound?

A

they would just

touch (wet/dry lip line)

317
Q

What can’t the patient say if upper anterior are too superior and forward for denture teeth?

A

F and V

318
Q

Too labially placed upper anterior teeth. What sounds are hard to say:

A

Fricative (F-V)

319
Q

What do you use to check if VDO and anterior teeth are set correctly for denture teeth?

A

S sound

320
Q

Asked about what sound will determine VDO?

A

S sound. This will bring teeth slightly together with 1-1.5 mm separation. This is the
“closest speaking space”

321
Q

S, z, and ch sounds the teeth must be: close together or far apart

A

close together

322
Q

When the denture wearer says “S” sounds & the posterior teeth are touching, why?

A

excessive vertical so decrease VDO

323
Q

Which position depends on patient’s posture (sitting up vs laying down)? vdr, centric relation, vdo

A

vdr

324
Q

Patient has short lower face and sagging lips. What should you do?

A

increase VDO

325
Q

Patient has clicking with dentures –

A

inadequate resting space, insufficient interocclusal distance

326
Q

If you hear teeth clicking in denture patient it is due to?

A

vertical dimension = too little VDR

327
Q

A patient who has a moderate bony undercut on the facial from canine-to-canine needs an immediate maxillary denture. There is
also a tuberosity that is severely undercut. This patient is best treated by
A. reducing surgically the tuberosity only.
B. reducing surgically the facial bony undercut only.
C. reducing surgically both tuberosity and facial bony undercut.
D. leaving the bony undercuts and relieving the denture base.

A

A. reducing surgically the tuberosity only.

328
Q
QUESTION: When you find VDO &amp; the max tuberosity touches retromolar pad, what should you do?
• Make metal extension on mand RPD
• Surgery on max tuberosity
• Surgery on retromolar pad
• Open VDO
A

• Surgery on max tuberosity

329
Q

QUESTION: An examination of a complete denture patient reveals that the retromolar pad contacts the maxillary tuberosity at the occlusal
vertical dimension. To remedy this situation, which of the following should be performed
a. reduced the maxillary tuberosity by surgery
b. covers the tuberosity with a metal base
c. increases the occlusal vertical dimension
d. reduces the retromolar pad by surgery
e. omit coverage of the retromolar pad by the mandibular denture.

A

reduced the maxillary tuberosity by surgery

330
Q

Patient feels fullness of upper lip after delivery of complete denture:

A

Overextended labial flange

331
Q

After a couple of months of delivery of upper and lower complete, patient complains of burning of lower lip? Candida or impinges
of mental nerve.

A

impinges

of mental nerve.

332
Q

You give patient a maxillary denture and they come back with generalized soreness under the denture. no sore spots or anything
visible clinically, what’s causing this? allergy, significant malocclusion

A

significant malocclusion (gross occlusal misalignment)

333
Q

Soreness all along the ridges?

A

Hyperocclusion

334
Q

Pt has general soreness along ridges from complete denture, what should you do? reline, adjust occlusion

A

adjust occlusion

335
Q

Pt has worn denture for 19 years, now he has a sore on buccal with swelling, what do you do? Refer out, biopsy, cytology, relieve
denture in area and re-evaluate in 2 weeks

A

relieve

denture in area and re-evaluate in 2 weeks

336
Q
A 6x3 mm asymptomatic white lesion seen under old man wearing a denture for 19 years, what is first thing done at initial
treatment?
Adjust and check in one week
Incision
Excision
Cytologic
A

Adjust and check in one week

  • Relieve any trauma, watch for 2 weeks, then biopsy, when your biopsy, you can do incisional
337
Q

What is the main reason for removing complete dentures at night?

A

providing rest to tissues

338
Q

Patient has mobile upper anterior maxillary tissue that is inflamed. Before making new denture, what do you do?
A) gingivectomy
B) apply conditioner to existing denture
C) make new denture that will immobile the existing tissue
D) something else

A

B) apply conditioner to existing denture

339
Q

No posterior teeth & incisal wear on the anterior why?

A

Absence of posterior teeth

340
Q

Reason for cheek biting with dentures? inadequate horizontal overjet, lack of vertical overlap, Increased VDO

A

inadequate horizontal overjet

  • not enough horizontal overlap of posterior teeth, insufficient VDO
341
Q

QUESTION: Pt wearing a complete dentures & is cheek biting:

A

posterior teeth set up with no horizontal overlap.

342
Q

You fit new completed denture and the patient complains of cheek bite, what will you do?

a. grinding buccal of lower teeth
b. grinding buccal of upper teeth
c. grinding lingual of lower teeth
d. grindinging lingual of upper teeth

A

a. grinding buccal of lower teeth

343
Q

Which denture base is not light cured?

a. Pressure formed
b. Injectable molding
c. Some other type of molding
d. Pour or fluid resin technique

A

Pour or fluid resin technique

344
Q

QUESTION: A denture tooth falls off the denture after processing, why?

A

there was some wax

that was not removed

345
Q

How far do we extend a maxillary complete denture?

A

To the Hamular notch

346
Q

Which of the following explains why mandibular molars should NOT be placed over the ascending area of the mandible?
A. The denture base ends where the ramus ascends.
B. The molars would interfere with the retromolar pad.
C. The teeth in this area would encroach on the tongue space.
D. The teeth in this area would interfere with the action of the masseter muscle.
E. The occlusal forces over the inclined ramus would dislodge the mandibular denture.

A

E. The occlusal forces over the inclined ramus would dislodge the mandibular denture.

347
Q

During try-in of mandibular denture, you want to check for

A

full movement of the tongue & do all working movements

348
Q

QUESTION: If teeth on the wax try- in don’t occlude like they did on the articulator what do you do?

A

Remount, redo teeth and retry

349
Q

What is the main benefit of immediate complete denture?

A

Esthetics

350
Q

When making a denture base, the hamulus is too close to the retromolar pad?

A

Surgery

351
Q

In an edentulous patient, the coronoid process can
A. limit the distal extension of the mandibular denture.
B. affect the position and arrangement of the posterior teeth.
C. limit the thickness of the denture flange in the maxillary buccal space.
D. determine the location of the posterior palatal seal of the maxillary denture.

A

A. limit the distal extension of the mandibular denture.

  • that’s the area where the mandibular turns from horizontal to vertical
352
Q

Coronoid process displace upper denture if:

A

too bulky at max distobuccal

353
Q

Coronoid –

A

when open mouth can dislodge denture (mand denture = masseter)

354
Q

Open mouth while maxillary border molding -

A

Coronoid process will block buccal extension

355
Q

Best way to prevent speech problems in complete dentures

A

keep teeth in same position

356
Q

freeway space

A

2-4 mm

357
Q

If denture teeth were set to a 20-degree condylar setting when the teeth need to be at 45 degrees, what will need to be changed?
• Incisal guidance increased
• Posterior cusps decreased
• Increase compensating curve

A

• Increase compensating curve

  • Or DECREASE INCISAL GUIDANCE (to compensate for increase in condylar guidance). Steep condylar path requires steep compensating
    curve, and decreased incisal guidance)
358
Q

A patient presents for try-in evaluation of balanced occlusion of complete maxillary and mandibular dentures. A dentist notes that
protrusive excursion results in separation of posterior teeth. This dentist can best correct this problem by
A. changing the condylar inclination.
B. increasing the incisal guidance.
C. increasing the compensating curve.
D. using a flat plane cusp for the posterior teeth.

A

C. increasing the compensating curve.

359
Q

compensating curve is determined by

A

inclination of posterior teeth and their vertical relationship to the occlusal plane.

steep condylar path requires a steep compensating curve for occlusal balance

360
Q

Protrusion denture causes dislodging.

A

Increase compensating

curve!!

361
Q

Setting condylar inclination on articular using protrusive, what
do with the pin?

A

Remove the pin (lift up)

362
Q

incisal guide pin position while checking protrusive, why?

A

determine condyle guidance

363
Q

Reason for Incisive guide table?

A

Anterior guidance

- When making a guide table…. Lift the pin up about 2 mm

364
Q

What is the best way to preserve the anterior guidance?

A

Translating the horizontal & vertical relationship onto the incisal table

365
Q

How to determine the angle of the incisal table?

A

By the horizontal plane (occlusal plane) of occlusion and a line in the sagittal plane
between incisal edges between maxillary and mandibular central incisors.

366
Q

Which plane is most important on anterior guidance:

A

Horizontal/occlusal

367
Q

Pt with class III will have the mandibular incisal angle? Increased, decreased

A

decreased

368
Q

CASE: Lower natural anterior teeth, upper PFM anterior teeth. Lowers had incisal wear facts, what do you think this is due to?

  • Same patient: a picture of lower teeth and upper teeth at edge to edge position: what is he doing?
  • Same patient: when he does this, what is happening to the TMJ?
A

Heavy incisal guidance (this was the most logical answer, as PFM vs natural teeth, natural teeth wear off)

Incisal guidance

Translation

o anterior guidance…TMJ TRANSLATES

369
Q

Retruded tongue habit with full denture means what?

A

Difficulty swallowing

370
Q

Border molding of lingual mandibular portion done by what movement?

A

Wetting of lips with tongue

371
Q

Mandibular denture border sitting on what muscle due to its orientation of its
fiber?

A

Masseter

372
Q

Posterior buccal extention of a mandibular complete denture is limited by:

A

Masseter muscle

373
Q

What muscle can you impinge on with denture? Masseter, medial pterygoid, or
lateral pterygoid

A

Masseter

374
Q

The denture base completely covers what muscle

a. Medial pterygoid
b. Lateral pterygoid
c. Masseter
d. Buccinator

A

Buccinator (Fibers of buccinator and buccal shelf)

375
Q

What muscle covers dentures flanges & doesn’t affect stability?

A

Buccinator

- the buccinators does not affect stability!!

376
Q

Denture will not be displaced by which muscle due to direction of fibers? Masseter, buccinators, lateral pterygoid, medial pterygoid

A

buccinators

377
Q

Which muscle will not interfere with the denture base?
• Buccinator
• Lateral pterygoid
• Masseter

A

Buccinator

378
Q

Lower denture impression lingual area muscle –

A

mylohyoid

379
Q

Which muscle helps border hold in the posterior lingual flange?

A

Mylohyoid
- Other muscles that help are: palatoglossus, superior pharyngeal constrictor, genioglossus (lingual border of mandibular impression)

380
Q

Man. Lingual flanges are affected by
• geniglossal
• mylohyoid

A

mylohyoid

381
Q

Mand CD interfere with what muscle in lingual side? .

A

Mylohyoid

382
Q

What determines lingual border of Mandibular impression?

A

BOTH Superior Pharyngeal Constrictor/mylohyoid muscle and buccal
is masseter.

383
Q

What muscles help in retention of lower complete denture:

A

palatoglossus, superior pharyngeal constrictor, mylohyoid and
genioglossus.

384
Q

Denture outline in border molding affected on the lingual of mandible by what?

A

Superior constrictor, palatoglossis, genioglossis,

mylohyoid

385
Q

You would relieve a mandibular denture in the area of the buccal frenum to allow which muscle to function properly?

A

Orbicularis

oris

386
Q

jaw elevators

A

temporalis
medial pterygoid
masseter

387
Q

jaw depressors

A

mylohyoid
geniohyoid
lateral pterygoid
anterior digastric

388
Q

How do you protect roots under an overdenture –

A

RCT with cast copings

389
Q

What is not important for an overdenture?

A

clinical crown size

390
Q

Which teeth roots are retained under an overdenture?

A

PICK roots from dense bone areas such as Mandibular Canine

  • Pref = canine –> premolars –> incisors –> molars
  • Bilateral, symmetrical, with healthy attached gingiva, adequate perio support (>1/2 root in bone), limited/no mobility
391
Q

What is the best way to treat a tooth supported lower denture?

A

Use metal copings to cover teeth

392
Q

A patient has acromegaly and needs dentures. Which denture will not fit? Maxillary or Mandibular

A

Mandibular

393
Q

If acromegaly is not controlled, lower jaw

A

protrudes

394
Q

Which of the following is the endocrine involvement that is related to jaw deformity:

A

Acromegaly

395
Q

Which of the following is the endocrine involvement that is related to the jaw deformity?

a. acromegaly
b. cherubism
c. Albrights
d. pagets

A

acromegaly

396
Q

First sign of increased occlusion? TMJ, myofascial, attrition, abfraction

A

TMJ

397
Q

combination syndrome

A
  • In pt with completely edentulous maxilla & partially edentulous mandible with preserved anterior
    teeth, they have severe anterior maxillary resorption combined with hypertrophic and atrophic changes in different quadrants of maxilla and
    mandible.

aka KELLY sundrome

398
Q

Which is not a symptom of combination (Kelly) syndrome? I

A

Increased VDO

399
Q

case of combination syndrome

A

Class I mandibular RPD vs max CD,
bone loss in anterior max, overgrowth in max tuberosity, papillary hyperplasia of hard palate,
supraeruption of man teeth, bone loss under distal extension

400
Q

A flabby, maxillary anterior ridge under a complete denture is frequently associated with
A. V shaped ridges.
B. Class II patients.
C. osteoporosis.
D. retained natural mandibular anteriors.

A

D. retained natural mandibular anteriors.

combination syndrome