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Review diagnosis and treatment plan for RPD with instructor. Decisions regarding teeth to be retained, surgical procedures to be employed, and restorations to be placed must be made with the ultimate design of the RPD in mind Identify and confirm suitability of abutments you will use to support the RPD 2. Make two maxillary and mandibular alginate impressions and pour in dental stone CAST 1: 1. Mark the first set of cast as Cast 1 and articulate them (by hand if possible, with record bases if needed) 2. Design a RPD by surveying the cast by placing it on a survey table. Tilt the cast anteriorly or posteriorly to achieve a line of draw for the proposed guide plane and undercut location for the proposed clasp design 3. Measure and show the location of the undercut (terminal portion of the clasp engaging in a 0.01 inch undercut gauge –this is the undercut rod with one line as shown). Place a red dot on the cast where there is adequate undercut.
4. Tripod casts. Tripod loci must be visible in order to establish remount orientation. Survey must be done with only one (tilt) for all teeth 5. Diagnostic casts should have survey lines on abutment teeth and potential tissue undercuts 6. Draw the design on preliminary design form 7. The faculty and GPD must approve the design and submits it for further review and approval of the design. The study cast and preliminary design is submitted to the CDL where the design will be reviewed by the quality assurance team and signed. It will be returned to the module with the routine lab work. 8. Design is approved or altered and returned to the GPD. 9. Cast 1 is set aside and saved and the preliminary partial design form is placed in the patient record. Note: No tooth alteration can be performed without this signed form in the chart.
The master impression is reviewed by the faculty and approved by the GPD with their signature on the prescription to be poured (NOTE: For Kennedy Class I and II cases. except when opposed by a complete denture. 5. 5. Faculty approves alteration of the dentition.CAST 2: Mark the second set of cast as Cast 2 and using the already approved design draw the design on this cast. the tray may have to be sectioned. 4. 2 . If you have thin and easily breakable teeth on casts. This is practice before making these changes on your patients. guide planes and contour modifications. Survey and tripod master cast just like on cast 1. 2. CDL will not separate the cast from the impression. PATIENT: 1. SURVEY AND DESIGN ON MASTER CAST: 1. 4. Student picks up cast from CDL 24 hours later. Make cast alteration representing tooth modifications such as rests. Articulation is required when OPPOSING framework fabrication is requested. Bring impression to the laboratory directly for pouring master casts. the location of undercut must be marked with a red pencil dot at the terminal portion of retentive clasp. The patient’s teeth are altered using Cast 2 as a guide to duplicate the design 2. One layer of wax should be placed over the edentulous ridge). major and minor connectors. tissue stops and denture base areas. Casts should be presented attached to the mounting plates. 3. 3. See figures below. When fabricating custom trays. RPD work authorization form must be signed by the faculty and co-signed by the GPD. Note: ONLY SURVEYING and TRIPODING MARKS SHOULD BE ON MASTER CASTS so that cast is not abraded in any way. DRAW THE RPD DESIGN ON THE RPD WORK AUTHORIZATION FORM: Outline rest seats. 2 layers of wax should be placed over the teeth. 6. Again. final impressions must be made using custom trays. (Note student pours all other casts and counter models). type of clasps. Master casts should have three index notches cut into the bases for remounting purposes. An impression is taken according to the standard technique using medium body polyvinylsiloxane materials. In order to separate the cast from the impression place it in hot water to soften the wax spacer and compound if used for border molding.
9. Check shade/mold availability chart located in clinics. centric or maximum intercuspation records. number Shade Mould 7. 11. 12.M.D. place form in box located outside of Central Dental Laboratory labeled ‘TOOTH ORDER BOX”. 6. 4. Assure that the occlusion is not altered or vertical increased with RPD components such as rests. Confirm vertical dimension. Each morning.D. 2. Write a prescription signed by the faculty and co-signed by the GPD.M. rearticulation may not be necessary). Send articulated casts. number Patient I. to 3:30 P. At any time of day. Include shade for acrylic resin. frameworks to laboratory for tooth arrangement.6. Write prescription and send to CDL to process RPD.M. INCLUDE TEETH. 5. CDL personnel will process these orders. Fabricate occlusion rims or send to lab if this is extensive. to 11:30 A. and 2:30 P. Articulate casts and select teeth with proper shade and mold. Students can pick-up their teeth orders between: 10:30 A. (If casts are already articulated. 3 . Check tooth arrangement to accept or send back for alterations. After the framework is adjusted and properly seated. Forms must be completed listing all requested maxillary and mandibular anterior and posterior molds and shades. Faculty must approve and sign tooth selection form 8. 3. esthetics and make changes if necessary. Obtain artificial tooth selection form from the supply desk.M. Prescription form must be signed by the faculty and co-signed by the GPD. Laboratory will return complete tooth arrangement and wax up. Try-in patient’s mouth. 10. The form should include: Student I. FRAMEWORK TRY IN AND ADJUSTMENTS AND CONFIRMATION OF OCCLUSION AND JAW RELATIONS RECORDS: 1. Submit to lab.
Flanges are required in molar area with free end saddle. Rest seats are not necessary on anterior teeth. Used only when there is significant loss of alveolar bone. Laboratory will return RPD processed and finished GENERAL CONSIDERATIONS Lingual plate should only be fabricated if necessary. Embrasure clasps are to be avoided Double palatal bars should be used selectively RPI should only be used if indicated Indirect retainers should only be placed when essential Rugae area are not to be covered when there are no missing anterior teeth U-shaped palatal design is to be used if anterior teeth are missing Flanges anterior of the molar area are to be avoided. 4 . Teeth are to be butted when possible using teeth equal in size to patient's own teeth.13.