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1、UnitThirtyFour
COMPLETEDENTURE
Whensomeonelosesallhisteeth(becomesedentulous),healsolosessomeoftheabilitytoperformcertainaclivities-eating,speaking,facialexpression-andhisappearanceisimpaired.Hisappearanceisimpairednotonlybythelossoftheteeththemselvesbutalsobecauseofthelossofsupportforthefacialtis
2、sueslyingoverthem.Whentheteetharelost,someofthesupportingthemboneresorbs.Theartificialsubstitutes-completesdentures-mustnotonlyreplacethelostteethandlostsupportingboneandsofttissue,butalsorestoretheimpairedfunctionsandappearance.
ClinicalstageI.
Historyandexamination
Clinicalstage2.
Primaryimpre
3、ssions.
Objectives:Toobtainanimpressionofthewholeofthedenture-supportingareaofeachjaw;torecordthefullextentofthesulcus;toobtainanimpressioninwhichcertainlandmarksontheedentulousjawsarcrecorded.
Byachievingtheseobjectivesamodelcanbeobtaineduponwhichacorrectlydesignedtraymaybeconstructedinordertomak
4、ethesecondaryimpression.Furthermore,onlyimpressioncompoundhasthecorrectpropertiesofconsistencyandabilitytobemanipulatewhicharenecessaryinaprimaryimpressionmaterial.
LaboratoryproceduresI
Thepreparationforthevisitatwhichthesecondaryimpressionswillbemadeinvolvestheconstructionofcastsfromtheprimaryim
5、pressionsandtheconstructionofspecialtraysonthesecasts.
Clinicalstage2(continued)
Secondaryimpressions
Objective:toobtainanimpressionfromwhicharetentivedenturebasecanbeconstructed.
Thedenturebaseshouldsatisfythefollowingrequirements:
1. Itmustbeextendeduntilitsborderliesondisplaceabletissuewhere
6、asealcanbedeveloped.
2. Thetissueadjacenttothebordershouldbedeformedenoughtoachieveasealbutnotsomuchthattheytendtodisplacethedentureorsufferinjury.Musclesrelatedtothebordermustnotbepreventedfromfreeactivity.
3. Itshouldhavetheclosestpossiblecontactwiththesurfaceorthemucousmembranelyingbeneathit.
7、4. Extensiontoprovideretentionensuresthemaximumcoverageofthejaw,andthisinturnensuresthatthemininiuniforceperunitareaistransmittedtothesupportingtissuesbythedentureduringfunction.
TheadventofVinyl-polysiloxaneoffersanalternativematerialforupperandlowerimpressions.Itisofsuitableconsistencyandgivesane
8、xcellentsurfacelothecastanddentures.Polyethermaterialsarealsoused.
Laboratoryprocedures2
Atthisstagethepermanentbasesaremadeandwaxocclusionrimsareaddedtotheminpreparationforthenextclinicalstepofrecordingthejawrelation.
Clinicalstage3
i)Chcckingretentionofthebasespriorto
establishingjawrelations
9、hips
2) Establishingjawrelationshipswithpermanentbases.
Objectives
1. Toaccuratelyrecordcentricjawrelationship.
2. Totakeafacebowrecordtoenablethebaseplateandocclusionrimstobepositionedinthearticulatorsothattheirrelationshiptotherotationalaxesofthearticulatoristhesameastherelationshiptheywillbea
10、rtotherotationalaxesofthemandiblewhentheyarcinthemouth.
Procedure
Assessthelipsupport
Measuretherestverticaldimension
Establishtheocclusalverticaldimension
Recordthecentricjawrelationship
Methods,whichmaybeusedtoassistthepatientinclosingtoaretruded,position.
3) Protrusiverecord
Whenapalientp
11、rotrudesthelowerjaw(hecondylesbothmoveforwardanddownward,guidedbytheformofthearticularfossae.Thedownwardmovementsofthecondylesresultinasimilardownwardof(helowermolarregion.Theprotrusiverecordmeasures(heamountoflhedrop.Withitthearticulatorisadjustedsothatitwillproduceasimilaramountofdropwhenasimilara
12、mountofprotrusionisused.Theteethonthedenturecanthenbearrangedsothatcontactbetweentheposteriorteethismaintainedinprotrusion(protrusivebalance).
4) Thefacebowrecord
5) Selectionofteeth.
Tochooseartificialteethwhoseformandcolourwillharmonizewiththepatient'sfcaturccs.
Laboratoryprocedures3
1) Addin
13、gthepost-damtotheupperdenturebase.
2) Mounting(hebaseplatesandocclusionrims.
3) Selectingposteriorteeth.
4) Settingtheteeth.
Clinicalstage4
Thetrialdentures
Tocheckthat(hearrangementofthe(ee(hissuchthatspeechandmasticationwillberestoredandtoensurethatapleasingappearanceisobtained.
Laboratoryp
14、rocedure4
Atthisstagetheprotrusiverecordisusedtosetthecondylartrackanglesandthentheocclusionisadjustedtoprovidebalanceineccentricpositions.Followingthiswaxsurfacesarecontoured,thedenturesareinvestedinaflask,andlhewaxisremovedandreplacedbyacrylicresin.
1) Settingthecondylartrackangles
2) Developin
15、gthelateralandprotrusiveocclusions.
3) Contouringandfinishingthewaxsurfaces.
4) Processingdentures.
Clinicalstage5
Insertingthecompleteddentures.
Objective.
1) Tochecktheretentionandtheaccuracyofthejawrelationsofthecompleteddentures,andtoadjustwherenecessary.
2) Toinstructthepatientsin(hecor
16、rectuseoftheirdentures.
3) Toadvisethepatientsonthepropercareoftheirdenturesandofthedenture-supportingtissues.
4) Toadvisethemonthelimitationstobeexpectedofartificialdentures.
Laboratoryprocedures5
Alteracheckcentricjawrelationshiprecordhasbeentaken,(helowerdenturemustberemountedinthearticulator
17、,andadjustmentofthecentricandeccentricocclusionsmade.
1) Remounting
2) Reformingcentriclateralandprotrusiveocclusions.
Clinicalstage6
Adjustmentofdentures
1) Useofdisclosingwax(ontheborder)andpressurereliefcream(onthefittingsurface).
2) SubsequentvisitsVOCABUL/XRY
1. artificialsubstitutedentu
18、re-supportingarea
2. sulcuslandmark
3. edentulousjawmodel
4. trayprimaryimpression
5. secondaryimpressioncompound
6. bordersealfreeactivity
7. trialdenturebalanceineccentivepositions
8. investedflaskprocessingdenture
9. remountedpost-dam
10. reformingdisclosingwax
11. pressurereliefcreamfi
19、ttingsurface
12. retentionpermanentbase
13. waxocclusionrimestablishingjawrelationship
人工替代物義齒承托區(qū)（間隙）溝標(biāo)志無牙頜模型托盤初印模二次印模印模膏邊緣封閉自由活動試牙非正中平衡裝盒義齒熱處理重新上合架后堤糾正指示蠟壓力顯示糊組織面固位恒基托蠟咬合堤建立咬合關(guān)系正中合關(guān)系
14. centricjawrelationship facebowrecord
15. articulatorrotationalaxes
16. restverticaldimensionocclusalverticaldimension
17. articularfossaeprotrusivebalance
面弓記錄
合架
旋轉(zhuǎn)軸
休息位垂直距離咬合位垂直距離關(guān)節(jié)窩
前伸合平衡
人工牙
18. artificialteeth
專業(yè)英語 Unit 34教案.docx
