UDMSD Prosthodontic UDMSD Prosthodontic Competency ExaminationCompetency ExaminationFor Complete and Partial For Complete and Partial

Denture Insertion or Denture Insertion or DeliveryDelivery

Michael L. Linebaugh DDS MSMichael L. Linebaugh DDS MS

Competency will begin at 10:00 am Competency will begin at 10:00 am and 1:00 pm no exceptions!and 1:00 pm no exceptions!

Student must have opposing Student must have opposing prosthesis either a CD/RPD, prosthesis either a CD/RPD, CD/CD etc.CD/CD etc.

Start Check!Start Check!

Patient Presentation:Patient Presentation: Health History and Dental History Health History and Dental History

1. Brief explanation of diagnosis1. Brief explanation of diagnosis and treatment planand treatment plan2. Presentation of the original2. Presentation of the original diagnostic casts mounteddiagnostic casts mounted3. Examination of radiographs3. Examination of radiographs4. Student will identify patient’s 4. Student will identify patient’s medications and how theymedications and how they effect treatmenteffect treatment

Pre-insertion Pre-insertion

• Unpackaged/checked/ examined Unpackaged/checked/ examined

• All instrumentation present/suppliesAll instrumentation present/supplies

• Examined intaglio surface prosthesis Examined intaglio surface prosthesis

• Preparation of remount castsPreparation of remount casts

Pre-insertion Phase Pre-insertion Phase Instructor will be presentInstructor will be present

Student will unpack prosthesis and Student will unpack prosthesis and examine intaglio surface with finger examine intaglio surface with finger and evaluate.and evaluate. With Instructor With Instructor PresentPresent

2. Instrumentation Needed for Insertion2. Instrumentation Needed for Insertion

SS hand piece and proper bursSS hand piece and proper bursIndicators /disclosing wax & applicatorsIndicators /disclosing wax & applicatorsPIP paste (disclosing paste)PIP paste (disclosing paste)Occlusal indicator paperOcclusal indicator paperTorch/lighterTorch/lighterAlu wax, or occlusal registration material Alu wax, or occlusal registration material Sticky waxSticky waxWax spatulaWax spatulaArticulatorArticulatorBard parker knife and buffalo knifeBard parker knife and buffalo knifeMounting stoneMounting stoneMounting jig Mounting jig

Preparation of remount cast to be completed in clinicPreparation of remount cast to be completed in clinic

Instrumentation Instrumentation

Student will prepare maxillary Student will prepare maxillary and mandibular and mandibular remount castsremount casts..

Casts returned from the Casts returned from the laboratory cannot be used.laboratory cannot be used.

Remount CastsRemount Casts

Prepare prosthesis to pour remount castsPrepare prosthesis to pour remount casts

Remount castsRemount casts

Note: Blockout & VaselineNote: Blockout & Vaseline

Remount CastsRemount Casts

Note: Blockout & VaselineNote: Blockout & Vaseline

Insertion PhaseInsertion Phase

• Student will place PIP paste (disclosing Student will place PIP paste (disclosing wax on the intaglio surface and evaluate wax on the intaglio surface and evaluate the results for the instructor.the results for the instructor.

• Student will adjust the intaglio surface Student will adjust the intaglio surface and have the instructor evaluate.and have the instructor evaluate.

• Student will evaluate peripheral borders, Student will evaluate peripheral borders, extensions, frenums and posterior palatal extensions, frenums and posterior palatal seal.seal.

Insertion Phase: Insertion Phase: Instructor will evaluate Instructor will evaluate

1. 1. Student will place PIP paste Student will place PIP paste (disclosing wax) on the intaglio surface (disclosing wax) on the intaglio surface and evaluate for instructor.and evaluate for instructor.

Evaluation of the fit of the prosthesis: Evaluation of the fit of the prosthesis: maxillary archmaxillary arch

Evaluation of the fit of the prosthesis: Evaluation of the fit of the prosthesis: mandibular archmandibular arch

2. Student will adjust the intaglio 2. Student will adjust the intaglio surface and have instructor evaluate.surface and have instructor evaluate.

3. Student will evaluate peripheral 3. Student will evaluate peripheral borders, extensions, frenums and borders, extensions, frenums and posterior palatal seal.posterior palatal seal.

Occlusal Evaluation and Adjustment Occlusal Evaluation and Adjustment • Student will know how to use remount jig or substitute a Student will know how to use remount jig or substitute a

facebow transfer to mount maxillary cast.facebow transfer to mount maxillary cast.• Student will choose occlusal registration material and Student will choose occlusal registration material and

complete occlusal registration in centric relation. complete occlusal registration in centric relation. • Student will complete clinical remount and demonstrate Student will complete clinical remount and demonstrate

accuracy to clinical condition,accuracy to clinical condition,Instructor will evaluateInstructor will evaluate

• Student will explain the adjustment procedureStudent will explain the adjustment procedure• Student will complete adjustment for CR and lateral and Student will complete adjustment for CR and lateral and

medialtrusion. medialtrusion. Instructor will evaluateInstructor will evaluate

• Student will evaluate new occlusal relationship intraorally.Student will evaluate new occlusal relationship intraorally.

1. Student will know how to use 1. Student will know how to use remount jig or substitute a facebow remount jig or substitute a facebow transfer to mount maxillary cast.transfer to mount maxillary cast.

2. Student will choose occlusal 2. Student will choose occlusal registration material and complete registration material and complete occlusal registration in CRocclusal registration in CR

3. Student will complete clinical 3. Student will complete clinical remount and demonstrate accuracy to remount and demonstrate accuracy to clinical condition clinical condition Instructor will evaluateInstructor will evaluate

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Clinical RemountClinical Remount

Clinical RemountClinical Remount

Clinical RemountClinical Remount

Need to demonstrate other Need to demonstrate other materials and how they can be materials and how they can be used.used.

Clinical RemountClinical Remount

Instructor Will Examine Centric Instructor Will Examine Centric Relation IntraorallyRelation Intraorally

Clinical Clinical RemountRemount

4. Student will explain the adjustment 4. Student will explain the adjustment procedure.procedure.

• Centric relation Centric relation

• Lateraltrusion (working contact)Lateraltrusion (working contact)

• Medialtrusion (balancing contact)Medialtrusion (balancing contact)

• Concept of balanced occlusionConcept of balanced occlusion

5. Student will complete adjustment 5. Student will complete adjustment for CR and lateral and medialtrusion.for CR and lateral and medialtrusion.

Centric Relation AdjustmentCentric Relation Adjustment

Centric Relation AdjustmentCentric Relation AdjustmentBeforeBefore

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Centric Relation AdjustmentCentric Relation AdjustmentAfterAfter

6. Student will evaluate new 6. Student will evaluate new occlusal relationship occlusal relationship intraorally.intraorally.

Esthetic ResultEsthetic Result

Student will allow patient to comment Student will allow patient to comment on result and then discuss results with on result and then discuss results with instructor.instructor.

Patient InstructionsPatient Instructions

• Follow up instructions for patient Follow up instructions for patient adaptationadaptation

• 24- 48hr adjustment and 24- 48hr adjustment and evaluation appointmentevaluation appointment

• Appropriate aids/literature givenAppropriate aids/literature given

Need picture of aidsNeed picture of aids