PROSTHODONTICS 525P CLINICAL PREPARATORY COURSE IN REMOVABLE PARTIAL DENTURES & MANAGEMENT OF THE IMMEDIATE DENTURE PATIENT Spring Quarter 2008 Course Director: Assistant Course Director: Faculty: Dr. Andy Marashi Dr. Brian Toolson Dr. John Evans Dr. Thomas Helbert Dr. Richard D. Lowe Dr. Polly Ma Dr. Dennis Nordlund Dr. Don Pierce Dr. Nelson Vitous Dr. Hai Zhang TABLE OF CONTENTS Page REMOVABLE PARTIAL DENTURES Overview... S-2 Objectives... S-3 Reading Assignments... S-5 Project List... S-6 Policies... S-7 MANAGEMENT OF THE IMMEDIATE DENTURE PATIENT Goals of Part I, Section 1... S-9 Objectives of Course Manual... S-9 Facts About Conventional Immediate Dentures... S-10 Facts About Interim Immediate Dentures... S-12 Facts About Overdentures... S-14 S-1
PROSTHODONTICS 525P CLINICAL PREPARATORY COURSE IN REMOVABLE PARTIAL DENTURES & MANAGEMENT OF THE IMMEDIATE DENTURE PATIENT APRIL 1, 2008 Class meets every Tuesday during Spring Quarter. Lectures begin at 8:30 AM in D-209. Then we move to the D-1 laboratory from 10:30 AM until 12:00 noon, and from 1:30 to 4:30 PM. There will be additional lectures in the afternoon, which are optional for attendance. This preparatory course includes practice in all steps you may be called upon to do in the clinic. The syllabus describes procedures, not only in terms of managing the Dentoform, but also lists variations you may find necessary in clinical treatment. Therefore, it is expected that you will refer to the syllabus as needed during your third and fourth years. A Dentoform is used rather than a patient because of: (1) Some steps are irreversible on natural teeth; (2) The amount of preparation varies with each patient; (3) Not all important steps are required on all patients, such as crowns, secondary impressions, or temporary partial dentures, etc. You are required to purchase a new syllabus in this course. There are several reasons for this: no textbook is required; the syllabus has to be printed in advance, so I have to assume everybody needs one; nonpurchase by some students would increase the cost to all other students. However, an effort will be made to use materials already on hand from other courses, to share materials, and to reuse various projects in order to minimize your costs. Prosthodontics 525P is a 4 credit hour course. Your grade will be determined from 7 daily quizzes, your timely submission of acceptable lab projects, evaluation of laboratory projects by faculty, a midterm, and a final examination. A total of 200 points is possible in this course. 7 daily quizzes, 5 points each Total = 35 points 8 projects*, 1 point for each step Total = 75 points Midterm examination (April 24, 2007) Total = 35 points Final examination (Date TBA) Total = 55 points Grand Total = 200 points *One point will be lost for each week beyond its due date that a project is not turned in. Grades are based on the percentage of points obtained. 96% and above = 4.0 84% = 2.8 72% = 1.6 95 = 3.9 83 = 2.7 71 = 1.5 94 = 3.8 82 = 2.6 70 = 1.4 93 = 3.7 81 = 2.5 69 = 1.3 92 = 3.6 80 = 2.4 68 = 1.2 91 = 3.5 79 = 2.3 67 = 1.1 90 = 3.4 78 = 2.2 66 = 1.0 89 = 3.3 77 = 2.1 65 = 0.9 88 = 3.2 76 = 2.0 64 = 0.8 87 = 3.1 75 = 1.9 63 = 0.7 86 = 3.0 74 = 1.8 62 and below = 0.0 85 = 2.9 73 = 1.7 S-2
OBJECTIVES OF PROSTHODONTICS 525P General The overall objective of Prosthodontics 525P is to prepare a dental student to construct a removable partial denture which will satisfy the biomechanical requirements of a partially edentulous clinical patient. It will also introduce the student to available procedures to construct immediate dentures and subsequent reline procedures. This objective will be pursued through the use of a syllabus, lectures illustrated with PowerPoint presentations, and laboratory projects. Whether or not the objective has been met will be determined with written and practical examinations. Specific Given a partially dentate arch simulating natural teeth, the student should be able to prepare guiding planes and rest seats. Given a cast with teeth that have been recontoured, the student should be able to design an example cast to guide a dental technician. Given wax patterns of crowns, the student should be able to modify the waxed crowns to receive a removable partial denture. Given casts representing a CD/RPD patient with multiple crown preparations, the student should be able to establish an acceptable plane of occlusion for the crowns. Given a model of a mouth requiring a distal extension partial denture, the student should be able to make a secondary impression and alter the original master cast. Given a partial denture framework and master cast, the student should be able to fabricate an occlusion rim. Given occlusion rims and mounted models and specific dimensions representing a CD/RPD patient, the student should be able to trim the rims to represent the vertical dimension of occlusion and to record centric relation. Given lectures on the selection of artificial teeth, the student should be able to select the appropriate tooth form and material and describe the desired occlusal scheme for patients with various combinations of partially and completely edentulous jaws. Given mounted casts of a CD/RPD on a semi-adjustable articulator, the student should be able to set artificial cusped teeth in balanced occlusion. Given a waxed-up partial denture, the student should be able to make a remount cast. Given a model with some teeth to be extracted, the student should be able to trim the cast, set teeth and wax up a temporary removable partial denture suitable for processing. Given partial or complete acrylic resin dentures with broken parts, the student should be able to use an autopolymerizing acrylic resin to repair the appliance. S-3
Given lectures on the delivery and follow-up of removable partial dentures, the student should be able to describe the procedures and sequence and necessary materials for the delivery and maintenance of an RPD in a clinical setting. Understand and describe when an immediate denture is appropriate. Describe the major characteristics of conventional immediate dentures, immediate overdentures, interim immediate dentures, and relines and rebases when each is indicated. Be able to communicate the various treatment options to the patient, and recommend the appropriate immediate denture procedure and the advantages and disadvantages of each procedure. Understand and describe the clinical and laboratory procedures for each type of immediate denture. Understand the surgical procedure involved in each type of immediate denture. S-4
READING ASSIGNMENTS FOR PROSTHODONTICS 525P All reading assignments are in the 2008 RPD Technique & Immediate Dentures Clinical Manual portions of this book. (Prior to:) Reading Assignment Quiz April 1 PART I (Immediate Dentures) No Quiz April 8 PART II Sections 1, 2, 3 Sections 1, 2, 3 April 15 Section 4 Section 4 April 22 Section 5 Section 5 April 29 Sections 6 and 7 Mid Term Exam PART I, Sections 1 and 2 PART II, Sections 1-5 May 6 Sections 8 and 9 Sections 6, 7, 8, and 9 May 13 Sections 10 and 11 Sections 10 and 11 May 20 Section 12 Section 12 May 27 Sections 13, 14, and 15 Sections 13, 14, and 15 June 3 Section 16 and 17 No Quiz Finals Week Section 6-17 Final Examination PART I, Sections 3, 4, 5, and 6 PART II, Sections 6-17 S-5
PROJECT LIST FOR PROSTHODONTICS 525P April 8 April 15 April 22 Begin an immediate temporary RPD. Complete the immediate temporary RPD. Make diagnostic casts of maxillary and mandibular Dentoforms, design RPD s, make path of insertion guides, and cut guide planes. Complete mouth preparations on ivorine teeth and make check casts. Replace # s 18, 27, and 28 with crown preparation teeth. Make one impression in the stock plastic tray of the crown-and-bridge model using polyvinylsiloxane. Pour with Prima-Rock. After separating, pour the impression in yellow stone; this second cast does not need die pins or separate dies. NOTE: This impression must be done today, even if the rest preparations are not yet complete, in order to keep on schedule. During Week: Pindex the crown-and-bridge cast (Prima-Rock) and trim the three dies. April 29 Make baseplate on non-die model. Mount the Dentoforms in the Frasako Head with silicone index. Record centric jaw relation with Rigid Regisil. Mount upper cast and lower FPD working cast. During Week: Wax three dies to normal contours. The wax patterns should be removable (but margins are not critical for this case). May 6 May 13 May 20 May 27 June 3 Exam Week Modify the wax patterns with guide planes, rests, and buccal shoulder. Make custom tray for upper. Make alginate impression in stock tray for lower master cast. Evaluate refractories, frameworks, add tray, and make altered cast impression. Alter master cast. Make occlusion rims for CD and RPD. Record jaw relations. Mount master casts on the Hanau articulator. Set cusped teeth for CD/RPD. Complete the set-up and waxing. Make RPD remount casts. Repair a complete denture. Complete any remaining projects. Final examination. NOTE: The pink check sheets in your clinic manual must be completed and signed by your lab instructor and handed in by 4:30 p.m. on the day the project is due in order to be credited. If, for any unexcused reason, you do not complete the daily project and turn in the pink sheet, your S-6
points for the project will be reduced 1 point for each subsequent lab period in which it is not turned in. The purpose of this policy is to emphasize the need to stay current with your work. There is ample time available to complete each project during the assigned lab period. Please arrive on time, work only on RPD projects until they are complete, clean your work area, follow directions, organize your work, be prepared, and have the proper equipment ready for each lab session. POLICY ON ATTENDANCE Attendance of the class is mandatory. If you are unable to attend a required classroom or laboratory session, you must notify the course director in advance if possible or document the reason and submit it to the course director before the next class session. It will be up to the course director to decide if the excuse is valid. For those with valid excuses, an opportunity will be given to take a make-up quiz. If the excuse is deemed invalid, a score of 0 will be given for the missed examination. Questions you may have about how a quiz or examination was evaluated must be resolved within 2 weeks of its return to you to be effective in any grade change. POLICY ON EXAMINATIONS No tests are open book. You must have a passing score (2.0) and have completed each laboratory project (pink sheets signed by course faculty) in order to pass the course. There will not be any make-up written examinations or projects in Summer Quarter. POLICY ON RADIOS, CD-TAPE PLAYERS IN LAB Please do not play radios, CD s, or tapes in the laboratory during lab sessions (10:30 AM-12:00 noon, 1:30-4:30 PM). It is too difficult for instructors to speak/hear over the noise competition. Use of earphones is discouraged so that you can benefit from hearing discussions between faculty and other students, as well as with yourself. S-7
MANAGEMENT OF THE IMMEDIATE DENTURE PATIENT Assistant Course Director -- Dr. Brian Toolson April 1, 2008 Overview of Available Procedures Section1 Conventional Immediate Dentures Section 2 8:30 9:15 am Immediate Overdentures Section 3 Interim Immediate Dentures and Selection the Appropriate Procedure Section 4 9:30 10:15 am Relines/Rebases of Immediate Dentures Sections 5 & 6 10:30 11:00 am Break 11:00 am 1:30 pm Conservative Exodontia 1:30 2:30 pm Lab Exercise 2:30-4:00 pm Chapters 1-2 included in midterm examination. Chapters 3-6 included in final examination. This is 10% of your grade for Pros 525. S-8