AAA
Dental Pulse
es
COMPLETE DENTURE
I. REFERENCE BOOKS TAKEN:
1. Boucher’s prosthodontic treatment for edentulous patients - 10th edition
2. Prosthodontic treatment for edentulous patients by Zarb-Bolender —
412th edition
3. Essentials of complete denture prosthodontics by Winkler— 2nd edition
4, Text book of prosthodontics by Nallaswamy ~ 1st edition
1, IMPRESSION PROCEDURES
In making a final impression for a complete denture, the
most important area of the impression is
a). Ridge area of maxila and buccal shelf of mandible
b) Lingual border area of mandible
¢) Junction of hard and soft palate of maxilla and disto
a) Use a tray with spacer
bb) Not maintain intimate contact with tissues
©) Use a close fitting tray
4) Following normal procedures
(alps -95)
Lingual area of mandible 6. In primary impression the stock tray should be _ mm
4) Mid palatal area of maxilla and ridge of the mandible larger than ridge.
(MAN -02) 2) 2mm b) &mm
2. The stability of a mandibular complete denture will be ) &mm 4) 8mm
‘enhanced when (AIPG 99)
a) The level of occlusal plane fs above the dorsum of the 7. Passive impression technique involves:
tongue a). Impression with silicone
b) The tongue rests on the occlusal surface b) Impression compound
¢) The lingual contour of the denture is concave ) Impression plaster) Alginate
4) The posterior teeth on the denture have a broad (AIPG -99)
buccolingual width 8. Primary stress bearing area in mandibular edentulous
(MAN -97, 94) ridge i
3. The primary stress bearing area of maxillary complete a) Buccal shelf ») Crest of the ridge
denture is )_ Retromolar pad ) Lingual flange
2) Alveolar ridge b) Buceal Range (AIPG -96, AP -02)
¢) Palate 4) Posterior palatal seal area 9. Vomiting during impression making procedures may be
(KAR -99, AP-01) prevented by:
4. The mean denture bearing area in the edentulous 4) Sedating the patient b) Injecting local anesthetic
mandible is approximately )_ Asking patient to come empty stomach
3) 12.25 em® (14cm!) b) 16.25 em? 4) Change the impression material
) 18.12 em® 4) 20.25 em? (AlPG -01)
(MAN -95) 10. Retromolar ps
5. While taking impression of flabby fibrous tissue on 4) Should not be covered by low denture
maxillary ridge for complete denture care is taken to: b) Should be covered by lower denture
7 © 2 8 3) A 4 A BDA 6) C © 8) A 8) B10) 8 ——————
)_ Has tendon of temporal muscle attached to it
4) Disappears on eruption of mandibular last molars
COMPLETE DENTURE
4) Use specially fitted tray
(AIPG -03, KAR -99)
{AIIMS -90) 22. The zinc-oxide eugenol impression paste is used to
11, Which material is carried in a custom tray? enhance quality of:
2) High fusing compound b) Reversible hydrocolloid a) Modeling compound impression
) Metalic oxide pasted) Inreversible hydrocolloid bb) Reversible hydro-colloid impression
(AIIMS -98) ©) Alginate impressions d) Wax impressions
12, The following property of saliva affect denture retention? (KAR -97)
2) Quality & Quantity of serous & mucus saliva 23, Muscle which has influence in the formation of buccal
») Quantity of mixed saliva frenum of maxilla
©) Quantity of only serous saliva a) Levator anguli orisb) Quadratus lab superioris
4) None of the above ©) Triangularis «) Infetioris
(ar -03) (AP -04, COMEDK- 07)
13, How should the lingual extension of the mandibular 24. Atmospheric pressure as a factor of retention is effective only
‘impression be tested a) If saliva is present
2) By functional movements of the facial muscles ) If adequate peripheral seal is present
) By vigorous extreme movements of the tongue )_ If principle of mucostatcs is applied
{)_ By functional movements of the tongue 4) IF good neuromuscular co-ordination is present
4) By lateral and protrusive movement of the mandible (COMEDK -04, AP -03)
(KAR-01) 25. The purpose of boxing an impression is
14, The relationship of the denture base that resists 4) Boxing preserves the border width after border molding
dislodgement of denture in horizontal direction is: b) To serve as a base forcast poured
a) Stability b) Pressure ©) Both A&B 4d) None of the above
) Support 4) Retention (KAR -97)
(KAR -02, AIPG -92) 26. If 2 complete denture patient has genial tubercle at the
15, Denture bearing area of the ridge is level of the crest of mandibular ridge, the denture bi
2) Non Keratinised ——b) ‘Keratinised a) Cancover them ——_b)_ Should not cover them
) Parakeratinised d) None of the above ©). Should cover them but relief is nat necessary
(a -98) 4) Should cover them and relief is must
16, The thickness of the spacer used in special tray 4s, (AlPG -0¢, 2012)
2) 2.5mm b) 2.0mm 27. The masseteric notch in distobuccal corners of the
) 1.5 mm 4) 1.0mm ‘mandibular denture is due to
(ar 24) a) Action of buccinator on masseter
17, The main purpose of covering the retromolar pad area is b) Action of masseter on buccinator
a) Stability b) Retention )Palatoglossus on buccinator
) Support 4) Contraction 4d) Superior constrictor on masseter
(KAR -99) (KAR 97, ATPG 2X)
18, Selective pressure impression technique indicated in 28. The lingual extension of a lower denture is limited by all
4) Fim healthy mucosal covering over the ridge of the following (except)
) Flabby ridges: ) Modiolus b) Mylohyoid muscle
). Knife edge with movable mucosa ©) Origin of genioglossus d) Sublingual salivary glands
4) When sharp bony spicules are present in the ridge (ATIMS 93, MAN 94)
(GCET-14, KAR -98) 29. The lingual flange area in molar region in mandibular
19, Emergency retentive force is: complete denture is determined by
4) Atmospheric pressure b) Surface tension a) Mylohyoid b).Hyoglossus
©) Cohesion 4) Adhesion ©) Geniaglossus ) Geniohyoid
(APs -2k) (KAR 98, 02)
20. An important factor that aids in stability of complete 30. Custom tray is better than stock tray for impression of,
denture is crown due to following reasons except:
) Harmonious occlusion a) Custom tray is easy to adapt
5) Proper extension of denture bases b) Stock tray may not record full lange
)_ Polishing of denture bases ©) Custom tray is cheaper d) Stock tray can distort easily
4) None of the above (AlLMs -92)
(AP -98) 31, Oral tissues are best recorded in functional state by
21, To make an impression of hyperplastic tissue one should @) Mucocompressive b)-Mucostatic
a) Use wax for impression ) Selective minimum pressure technique
5) Use elastomeric impressions to displace the tissues 4) All ofthe above
<)_ Ensure intimate contact of impression material tothe tissue (GCET-14, AIPG - 94)
mye 1) A a) © 1) A 15) 8 1) 6 GB 18) A IO) A 20) A MC mA BA
24) 8 25) C26) D 27) B28) A 29) A_30) C31) C
(SSss°) = Dental Pulse
_
32. Denture stability refers to resistance of a denture: 42. Im the treatment plan of a conventional immediate
) To move ina vertical direction away from basal seat complete dentures, the anterior teeth are extracted?
8) To move in a vertical dimension towards basal seat a) At the first appointment
©) To movements on its tissue foundation especially to b) Before making the immediate denture
lateral forces )_ Before extracting the posterior teth
44) Against any kind of movement more the 24 um in any 4) After making the immediate denture
direction
{ALPG) 43. The retromolar pads asa landmark is
33, Functional impression technique can be applied 8) Relatively unstable b) Relatively stable
) Uniformly firm ridge consistency c) Variable 4) None of the above
) All variety of residual ridges (BHU-2012)
©) KMFE edge ridged) Displacable alveolar ridge 44. The purpose of relieving mid-palatine area in complete
{COMEDK-06) dentures is to prevent
34, Masseter muscle is a powerful muscle because of a) Pressure on palate b) Midlne fractures in dentures
4) Bipennate arrangement of fibres. €) Incontect centric relation
5) Multipennate arrangement of fibres @) Resorption of bone
©) Tthas multiple tendionous septa (aP- 2013)
4) Tts attachment to bone is unique 45. The mandibular labial frenum is a fibrous band that can
(COMEDK-05, COMEOK-15) be influenced by
35. Retruded tongue position in an edentulous patient results in 2) Incisivus ') Orbiculars ors
2) Good peripheral seal b) Over extended impression ) Caninus and incisivus 4) Incisivus and orbicularis ors
«)_Under extended impression (COMEDK- 2013)
4) Increased stability of lower denture 46. Setting time of plaster is influenced by
{COMEDK-06) 2) Water: powder ration b) Speed of mixing
36. Impression material of choice in patients with submucos c) Adding of aypsum — d) Allof the above
fibrosis is: (NET. 2013)
) Zinc oxide eugenol _b) Adltionalstcon 47, While taking final impression tray should be seated first:
) Condensation silicon 4) Plaster of pars, a) Anteriorly »b) Posteriorty
(A1P6-06) ) Anteriorly or posteriorly depending upon operators
37. Esthetics starts with: choice
) Taking impression b) Occlusal rims 4) Anteriorly and posteriorty simultaneously
«Teeth setting 4) Selection of teeth (ATINS-2012)
(BHU-07) 48. While making impression of flabby fibrous tissues on
38. Which one of the following is not essential for primary maxillary ridge for complete denture prosthesis, care is
impres taken to
3) Retention by Stabitty a) use mucostatic impression technique
) Phonetics 4) Aesthetics b) use selective pressure technique of impression making
(Bhu-o7) ) use a close fitting tray
39. Disinfection duration of atignate impressions when 4) follow normal procedure
immersion method is used should not exceed (COMED-14)
a) 10min b) 20 min 49, Which of the following are stress bearing areas?
3) Simin 4) 30 min 8), Buccal shelf are, incisive papilla and palatine agae
(cOMED-2010) ) Slopes of residual ridge, palatine rugae and midpalatine
40. A ten-year-old complete denture wearer wants raph
replacement of his denture. The most suitable impression ) incisive papilla, slope of the residual ridge and crest of
technique in this case is the residual ridge
4) Selective pressure technique 4) slope of residual ridge, buccal shelf area and hard palate
5) Minimal pressure technique (COMED-14)
«)_ Dual impression technique 50, The non-pressure or the mucostatic techniques of
4) Pressure technique impression making was introduced by
(UPS¢-2008) a) Page ) Boucher
41, Emergency retentive force for the maxillary complete ©) Carole Jones 4) Hall
denture is (ccer-14)
4) Deep palate ) Soft palate 51. Which of the following is incorrect regarding the
) Posterior palatal seal d) Base ofthe tongue elastomeric impression taken in a custom tray?
(COMED-2010) a) Custom tray uses less material
b) Custom tray is the best method of choice of impression
‘aking
RC 3) A Ba) B35) 8 5) B37) A SPE) A MYA ADC WD GB MA
45) 046) D_ 47) A 48) A 49) D 50) A 51) D |
52.
53.
54.
55.
56.
)_ Impression isnot distorted in custom tray
4) Teompressed lightly then it fs easier to remove
(P61 aUNE-13)
‘Torquing movement in maxillary denture is avoided by?
a) Adhesion b) Cohesion
) Surface tension) Border seal.
(Pot aune-13)
Most common reason to repeat impression fs?
2) Improper positioning of tray
8) Too less or excess material
©) Void that are ineparable
Improper mixing
(esr 0EC-13)
Dull appearance of mouth temperature wax indicates
2) nsuffcient material b) Overextesion
) Contact of the material with issues
d) Partial contact of tissues
(KERALA-2015)
[iginate at 20 degrees, the gel is formed in
2) 36 mins ) 6-8 mins
6) 15-16 mis @) remin
(ATINS may-14)
Which muscle has an indirect effect on the extent of
{impression in labial vestibule (maxilla)
+2) Orbicularis oris b) Buccinator
) Master 4) Levatorangul ors
(APPG-15)
COMPLETE DENTURE
==
32) D3) A (SADE) 55) A [SA Warn
Dental Pulse
'C [Boucher's 10th ed 182,211 / Winkler 2nd ed 89, 90]
‘B [Boucher’s 10th ed 176 / Winkler 2nd ed 50]
‘The dentures should be shaped and polished such that the
‘tongue and cheek tends to seat rather than unseat the
dentures, Ifthe posterior teeth are too wide buccolingualy
the tongue and cheeks will unseat the dentures.
‘X [Boucher's 10th ed 151]
‘The compact bone in combination with tightly attached
dense submucosa and keratinised mucosa makes the alveolar
Fidge area resistant to occlusal forces.
“X [Boucher 12th ed 232]
According to 12th edition the average available denture
base area for an edentulous mandible is 14 em® and for
maxilla is 26 em?
(According to 10th edition the mean denture bearing area of
edentulous maxila is 22.96 cm® and of mandible is 12.25 cmt.)
The mean denture bearing area of edentulous
mandible and maxilla respectively ts
(COMED-14)
b) 2éem® and tem?
6) 2émm? and 4mm?
a) Adem? and 24cm?
6) 14mm? and 24mm?
'X [Boucher's 10th ed 174, 224]
The flabby tissue will interfere with stability of denture
The best treatment is finger massage or surgical removal to
‘improve the denture foundation area.
'C [Bouchers 12th ed 221/Winkler 2nd ed 91]
If the tray is too large, it wil distort the tissues around the
borders of impression. If itis too small, the border tissues
will collapse inward onto the residual ridge and thus reduce
the support for the dentures.
°C [Boucher's 10th ed 224]
Passive impression or mucostatic or pressure less impression
technique records the tissues with minimal distortion and
cause least possible displacement of tissues. There will be
large amount of space between the tray and soft tissues and
‘it uses very fluid type of impression material.
Impression plaster is the common material used in this
techaique.
°K [Bouchers 12th ed 233]
Buceal shelf area is covered with cortical bone whieh is
usually at right angles to occlusal forces. For this reason,
it offers excellent resistance to occlusal forces and it takes
off the occlusal load imposed on the sharp nartow crest of
alveolar ridge.
1.
12,
2B.
eva
15,
16.
cee
18.
19.
‘B [Boucher’s 12th ed 239]
The retromolar pad must be covered by denture to perfect
the border seol in this region. This area contains glandular
tissue and fibres of temporalis tendon, buccinator, superior
pharyngeal constrictor and pterygomandibular raphae. All
these limiting structures prevent placement of extra pressure
fn retromolar pad during impression procedures.
'C [Boucher’s 10th ed 240]
silicone or metallic oxide paste or rubber base materials are
used in a custom tray during final impression.
Impression compound, reversible hydrocolloid (Agar-Agar),
and irreversible hydrocolloid (alginate) are used in a stock
tray For preliminary impression.
w
joucher's 12th ed 438)
“C [Bouchers 12th ed 246, 247]
[Boucher’s 10th ed 271)
8" [Boucher’s 12th ed 211]
B' [Boucher’s 12th ed 225]
Wax spacer is used to provide the space in the tray for the
final impression material and allows the tray to be properly
positioned in the mouth during border-moulding procedures.
Base plate wax covers the basal seat area except for labial
and buccal reflections and the posterior palatal seal area.
3B’ [Boucher’s 12th ed 230/Winkler 2nd ed 90]
Retromolar pad:
a) Gives peripheral seal of lower denture
b) Gives distal extension limit.
©) Gives height of occlusal plane.
4). Relieving area since it contains 3 muscles and Aids in
stability of denture
Though retromolar pad provides stability, support and
retention, the main objective of covering it is retention.
'N (Boucher's 10th ed 224)
For options ‘B,C, ‘U., mucastatic impression technique is
used.
‘NX [Boucher's 12th ed 441]
[Atmospheric pressure is called as emergency retentive force
or temporary restraining force. The weight of atmospheric
pressure is about 14.7 Ubfin®. It is effective only where
there is adequate peripheral seal. ne COMPLETE DENTURE Wo 199)
‘© Support: It is the resistance to the occlusal forces in
vertical direction. It is a bone borne phenomenon,
‘Stability: It is resistance to lateral shifting.
‘Preservation of remaining structures.
‘Atmospheric pressure as a factor of retention is,
effective only (KERALA-2015)
8) If saliva is present
b) If adequate peripheral seal is present
) If principle of mucostaties is applied
4) If good neuromuscular co-ordination is present
33.
20. ‘N' (Bouchers 12th ed 414) 36. 8
Balanced occlusion in which the teeth are placed in neutral
zone without any premature contacts helps in the stability 35, “8”
of denture
36. 8
21. 'C [Boucher's 10th ed 174, 224]
‘The impression of hyperplastic tissue fs recorded in passive 37, ‘A’ [Heartwell Sth ed 227]
state and mucostatic or pressure less technique ts used In an impression technique for complete dentures, the
(Refer Synopsis) procedures must strive fr five primary objectives, They ares
+ Support
22.‘ [Bouchers 10th ed 175) Pre
‘Advantages of 20E paste include: + Stability
2) Accurate borders are formed, since the material is more ‘Esthetics
plastic in nature, + Retention
) Does not absorb the mucous secretions produced in * Preservation of remaining residual idge
palate and thus accurately records the palatal part of
Impression. 38. ‘C [Heartwell 5th ed 227]
Refer No. 37
Does not require a separating medium.
39. ‘N [Philips 11° ed 246]
The current protocol for disinfecting hydrocolloid impression
is to use household bleach (1:10 dilution), fodophors or
synthetic phenols. The time of immersion should not exceed
20 min. when immersion method is used.
23. ‘'X [Boucher’s 12th ed 216]
There are 3 fren (1 labial and 2 buccal) in maxilla and 4
freni (1 labial + 2 buccal +1 lingual) in mandible
Buccal frenum of maxilla contains caninus or levator anguli
‘ris and buccal frenum af mandible contains triangularis or
depresgor angel ons 40. 'N [Check Explanation Below]
Selective pressure technique is the most widely respected
2s. and accepted theory by transferring load to acceptable areas.
[Boucher’s 12th ed 441]
Minimal pressure technique is a compromise between
‘mucostatic and mucocompressive technique, but the amount
of pressure to be applied cannot be assessed and ensured; so
is not used eventually.
25. ‘C [Bouchers 12th ed 229]
26. ‘D' [Boucher’s 12th ed 107, 234]
an.
Y [Bouchers 12th ed 239/Winkler 2nd ed 90}
t / 1 Pressure technique has its disadvantage by placing tissue
28.‘ [Boucher's 12th ed 239, 243] Under continuous pressure
Both ‘D’ and ‘C limits the lower denture in anterior region,
mylohyoid muscle limits the denture in molar region
and distal most part of denture on the lingual surface is
influenced by palatoglossus and superior constrictor muscle
°C [Check Explanation Below]
Retention due to atmospheric pressures directly proportional
to the area covered by denture base. Atmospheric press is
called emergercy retentive force or temporaray retraining
force. It is about 14.7 lb/sq.inch and is effective only when
there is adequate peripheral seal or post palatal sea.
29.
[Boucher's 12th ed 239]
30. '€ [Boucher’s 10th ed 175] 42. ‘0 [Nallswany 1 ed 258)
31. ‘C’ [Boucher’s 12th ed 478] ‘ Anterior teeth on the master cast are broken away and
‘immed upto the cervical margin and smoothened. The
32. ‘C [Nallaswamy 1* ed 64] ridge lap (cervical) portion of the artificial teeth are
Objectives of impression are: ‘rimmed and arranged on the master cast.
+ Retention: It is the resistance to displacement away + Artificial teeth are arranged over the area where the
from tissue surface, It's a mucosa botne phenomenon. teeth are to be extracted, The teeth arrangement should
be in harmony with the existing teeth as well as the
prosthetic teeth 44,
45.
46.
47.
43.
Dental Pulse
The denture is asked, dewaxed, packed, processed and
finished.
During the insertion appointment, the remaining anterior
teeth are extracted as atraumaticaly as possible,
preserving the soft tissues and bone. The finished denture
‘is seated in patient's mouth.
[arb & Bolender 12th ed 239]
‘X [Bouchers 11th ed 142/ Nallaswamy 1st ed 54]
Mid palatine raphe is the median suture area covered by
thin submucousa and the mucosa layer is practically in
‘contact with the underlying bone. For the reason the soft
tissue covering the median palatal sutures is non resilient
and may need to be relived to avoid trauma from the denture
base,
‘D’ [Nallaswamy Ast ed 55/ Winkler 2nd ed 90}
‘The mandibular labial frenum isa fibrous band that ean be
influenced by the incisivus and orbicularis oris muscles.
—e
The key aspect of the nonsurgical management is the
choice of impression technique like
‘+ Use of muco compressive technique which compresses
the flabby tissue in order to obtain maximum support
from it (01)
‘= Use of mucostatie technique with the aim of achieving
‘maximum retention,
According to many authors mucostatic is more effective as it
does not displace the flabby tissue and the denture maintains
contact with the tissue in resting position also there by
providing optimal retention; whereas mucocompressive
technique distorts the fibrous tissue and the denture will fit
only when seated by occlusal pressure.
Flabby ridge is seen most commonly in the MHCET-15)
a) Anterior maxilla ») Posterior maxilla
) Anterior mandible __) Posterior mandible
Unite maxilary labial frenum, the mandibular labial fenum 49+‘! [Check Synopsis Point No 26]
fs active because ofits attachments trom the orbicularis .
Be 50. ¥ [Rangarajan ast ed 41]
Hany Lpage introduced mucostatic impression technique in
1938
Thick muscular labial fenum is because of?
{AIMS Nov-14) -
4) Septal muscle b) Orbiculars oris assist arsviE Ease
€) Buccinator 4) Nasopalatne muscle Selective pressure Boucher
‘D’ [Phillips 11th ed 264 - 265) a ——
‘The W/P ratio is an important factor in determining the eee ae ene
physical and chemical properties of gypsum products. If ect
W/P ratio increases, the setting time increases and setting 54+ ‘D' [Schillinberg 3rd ed 290]
‘expansion decreases. Within the physical limits, the longer Glinical_advantages_obtained_with the use_of custom
nd more rapidly the plaster is mined, shorter fs the setting WAYS-over stock trays are:
time, The setting ime can be ecelerated by edding gypsum 1s Contos size and conserves the volume of material
(< 20%), Potasium suignate oF NaCl (<25%) required for the “impression, This minimizes the
polymerization induced shrinkage, also reduces patient
“X (Zarb & Bolender 12th ed 229] {scomfort and reduces finally the cost.
The correct positioning of tray in the patients mouth fs 2, Custom tray provides dimensional accuracy and stability
essential to make 2 good final impression. The tray should by providing a uniform thickness of material throughout
be seated first anteriory with labial notch act as guide the tay.
for the placement of the tray in the patient's mouth fr 3, custom tay gt reduces the potential for distortion
making final impression. This is most easily achieved by of the impression in comparison to the flexible stock
‘observing the position of the labial frenum relative to the me pe
labial notch inthe tray when the frum i positioned with .
in the notch the index finger are shifted to the molar region 4. Use of tray adhesive is not required,
to apply pressure.
ply pr 52. ‘D’ [Boucher’s 12th ed 438)
1y [Winkler ond ed 62/ Rangarajan ast ed 77 Lateral toruing forces and horizontal forces are best resisted
Mesa ar Novo Rebbe ecua (Mentltny anterior BY adequate border seal (stability) in maxillary denture,
aoe whereas adhesion, cohesion and interfacial surface tension
‘region most.comman) ts by hes in achieving denture retention ie, the resistance to
* ‘Surgical (or) removal in a direction opposite that of insertion.
Non-surgical, if the tissue 4s localized and. doesnt
interfere with the stability ofthe denture 53. 1% [Mallaswamy 4st ed 90)
The most common reason to repeat an impression is improper
positioning of the impression tray. If the tray position is
‘improper, the flange of the impression which lies on the side
of deviation will be excessively thick and the flange of the
impression opposite to the deviation willbe thi, |
COMPLETE DENTURE
The other reasons are improper consistency, large voids,
movement of the tray during setting and too litle or too
much impression material
54, ‘DeC’ [Removable partial denture by Renner and Louis J.
Boucher 233 /Nallaswamy 1st ed 87]
‘The mouth temperature wax impression is removed after 4-6
minutes and examined Glossy areas means tissue contact has
‘occurred. Dull ateas show areas which were not in contact
with the tissues. The impression should show uniform tissue
contact. Areas which appears dull, are added with the wax
and the procedure is repeated.
With green stick compound, dull areas means contact,
whereas glossy areas show ateas without contact. The key
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