dental materials 3.doc.doc.doc

Module: Prosthodontics

Faculty Teaching Guide for Dental Materials

Module - Prosthodontics

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Review of Previous Module

Review topics from the previous module to confirm understanding prior to presenting new material.

Module Overview

Prosthodontics is the specialty concerned with replacement of teeth and missing or deformed oral structures. The

accuracy of crowns, inlays, bridges, or dentures, and therefore the dental health of the patient, depends on the

physical properties of the materials involved. The success of these prosthesis also rests with dental personnel

who manipulate the materials and equipment during the process of creating the prosthesis. Dental laboratory

technicians are partners with dental office personnel in the endeavor for maximum service for the patient. Strict

attention to detail, and knowledge of materials used, are essential for dental assistants in order to aid in this

process of fabricating oral structures.

The Big Picture

ResourcesThis module utilizes the following learner resources:

Textbooks: Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J. Phinney and Judy Halstead.

Delmar Learning, 2004. ISBN 1-4018-3480-9.

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Faculty Teaching Guide forDental Materials

Module:Prosthodontics

Section 2:Removable

Prosthodontics

Section 1:Fixed

Prosthodontics

Part A: Removable Partial Dentures

Part B: Removable Complete Dentures

Part A: Types of Fixed Prosthetics

Part B: Fixed Prostheses Procedures


Materials and Procedures for Today’s Dental Assistant, by Ellen Dietz, Delmar Learning, 2004. ISBN 1-4018-

3733-6.

Workbook: Workbook to Accompany Dental Assisting, A Comprehensive Approach, 2nd edition, by Donna J.

Phinney and Judy Halstead, prepared by Karen L. Waide, Delmar Learning, 2004. ISBN 1-4018-3483-3.

Instructor’s Manual: Instructor’s Manual to Accompany Delmar’s Dental Assisting, A Comprehensive Approach,

2nd edition, by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN 1-4018-3482-5.

Electronic CD-ROM: Delmar’s Dental Assisting Interactive Skills and Procedures CD-ROM, ISBN 1-4018-3485-

X.

Faculty CD-ROM: The faculty CD-ROM includes this Faculty Guide the PowerPoint Presentation for Dental

Materials.

Additional ResourcesSafety Standards and Infection Control for Dental Assistants, by Ellen Dietz. Delmar Learning, 2002. ISBN 0-

7668-2659-7.

Electronic Classroom Manager to Accompany Delamr’s Dental Assisting, A Comprehensive Approach, 2nd edition,

by Donna J. Phinney and Judy Halstead. Delmar Learning, 2004. ISBN: 1-4018-3484-1.

Section 1: Fixed Prosthodontics

Section OverviewA fixed prosthesis is cemented permanently in place in the patient’s mouth, and if cared for properly by the

patient, is designed to last a lifetime. It is a restoration that replaces missing tooth structure, improves mastication,

prevents drifting of teeth, and promotes better oral health. The dental assistant’s meticulous responsibilities at

each phase of the procedure contribute to the success of the final product. There are many steps involved and

each one is vital to the ideal end result.

Outline of Section 1Part A: Types of Fixed Prosthetics

Part B: Fixed Prostheses Procedures

Learning Objectives and CompetenciesThese learning activities directly address the Learning Objectives and competencies as stated.

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Knowledge

1. Define the Key Terms.

Comprehension

2. Describe various types of fixed prostheses and their functions.

3. Describe dental material used in fixed prostheses.

4. Explain the role of the dental assistant in fixed prosthodontic treatment.

Application

5. Demonstrate the knowledge and ability to assist during a crown preparation appointment.

6. Demonstrate the knowledge and ability to assist during a crown cementation appointment.

Learning ActivitiesThese learning activities directly address the Learning Objectives and Competencies as stated.

[Insert Homework Assignment icon] Key Term Glossary (Part A, All Objectives)

[Insert In-Class Activity icon] Porcelain Veneer Set Up (Part A, Objectives 2-5)

[Insert Homework Assignment icon] Textbook Assignment (Part A, All Objectives)

[Insert In-Class Activity icon] Crown Preparation (Part B, Objectives 2-5)

[Insert In-Class Activity icon] Crown Cementation (Part B, Objectives 2-4, and 6)

[Insert Homework Assignment icon] Interactive Skills and Procedures CD-ROM (Part B, Objective 5-6)

[Insert Homework Assignment icon] Workbook Assignment (Part B, All Objectives)

[Insert Homework Assignment icon] End of Chapter Activities (Part B, All Objectives)

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Be sure to explain each learning objective and demonstrate how obtaining this learning will increase their success in the workplace. Spend time on learning objectives before diving into the content.

Teaching Tip


Part A: Types of Fixed Prosthetics OverviewThis part examines the various permanent fixed prostheses and materials used to restore missing tooth

structure. Each requires a certain amount of tooth reduction by the dentist, and is an investment for the

patient in their oral health. They are designed to provide maximum chewing efficiency and a lifetime of

service. These restorations are prepared outside of the patient’s mouth, in a dental lab, and therefore are

called indirect prosthetics. Dental assistants need to understand the various types of fixed prostheses and

how they are fabricated, in order to support the dentist, as well as to be able to educate the patient

regarding choices to improve the patient’s dentition.

Initial Questions and Activities1. Is there anyone here who has a permanent crown or bridge? If not, what do you

think a patient might experience if they were to have a permanent crown or

bridge?

There will be various answers depending on learners’ experiences. Ask

what they remember about having impressions done and wearing a

temporary restoration while the permanent prosthesis was being made.

Remind learners that relating to the patient’s experience will help them be

more caring dental assistants.

Key Concepts References and Activities SlidesIntroduction to Module Slides 1-2

Introduction to Section 1 Slides 3-4

Key Terms [Insert Home Ass icon] Key Term Glossary Slide 5

Types of Fixed Prosthetics Chapter ___, pgs. ____ (Phinney & Halstead)

[Insert Group Activity icon] Porcelain Veneer

Set Up

[Insert Home Ass icon] Textbook Assignment

Slides 6-15

[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Act [ ] Evaluation

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has strong feelings about his/her educational experiences. Remember to provide him/ with the best experience possible. You might have to overcome previous bad experiences.

The Adult Learner….


[Insert In-Class Act icon] In-Class Activities Porcelain Veneer Set Up (Part A, Objectives 2-5). Goal: To have learners set up for and understand Porcelain

Veneer procedures. Instructor should ensure enough materials and supplies are available for learners and

place them into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter

____(Phinney & Halstead). Learner workbooks contain check off sheets that can be utilized. Depending on

supplies available, grading may include verbal explanation of certain steps, by the learners to the evaluator.

Instructor should allow enough time for learners to practice steps before evaluating. The instructor should be

the operator during testing and grading of this procedure.

[Insert In-Class Dis Ques icon] In-Class Discussion1. Describe a good impression of a patient’s arch?

A good impression is an accurate negative reproduction of a persons teeth

and surrounding tissues.

2. What would happen if not enough material is used for the impression?

The impression may not acquire enough of all oral structures necessary,

if there isn’t enough material mixed, loaded into the tray, and then

placed properly in the patient’s mouth.

3. What could happen if too much material is used for an impression?

This could cause the patient to gag.

[Insert Home Ass icon] Homework AssignmentsKey Term Glossary. Learners will define key terms listed in the PowerPoint presentation. They are to enter this

glossary on disk, in a dedicated notebook or in a designated part of a notebook. They are expected to augment

information from text or lecture with other resources including any available in the school or public libraries or on

the Internet and will be graded at the end of the module on completeness and presentation.

Textbook Assignment. Learners are to read Chapter ____ (Phinney & Halstead).

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Pay attention to each learner individually. How do they do in group activities? How effective or independent are they in lab activities? Can you make any suggestions to assist in learning? Instead of looking at your entire class as a whole, assess each learner as an independent member of the group.

Teaching Tip


Presentation Tools

Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.Slide 1 [Insert DM 3-1]

DM – Stands for Dental

Materials. The 1st number “3”

indicates the Module called

Prosthodontics. The 2nd

number indicates the slide

number.

Power Point Presentation for Dental Materials


Prior to introducing this module. Ask learners if any

questions remain from the previous module. If questions

remain review the material as needed.

Introduce this Module.

Slide 2 [Insert DM 3-2] Module: Prosthodontics

Introduce the sections and each part.

Slide 3 [Insert DM 3-3] Section 1: Fixed Prosthodontics

Discuss each objective in detail. Learners need to know

what they will be learning and why. Try to relate it back to

their careers as dental assistants.

Slide 4 [Insert DM 3-4] Section 1: Fixed Prosthodontics (cont.)

Continue to discuss each objective in detail.

Slide 5 [Insert DM 3-5] Key Terms (cont.)

Continue to review each key term and discuss.

Homework Assignment: Stop here and go over the Key

Term Glossary assignment.

Slide 6 [Insert DM 3-6] Part A: Types of Fixed Prosthodontics

Review the definition of prosthodontics and introduce the

functions of these types of restorations.

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Inform learners that these are the ideal replacements for

lost tooth structure.

Slide 7 [Insert DM 3-7] Contraindications for a Fixed Prosthesis

Explain the reasons why the dentist and patient may

decide against a fixed prosthesis.

Review the vital role DAs have in educating their patients

towards making an informed decision regarding their

dental health.

Explain that if a mouth shows habitual lack of care, and

the patient does not respond to counsel for improvement,

the effort, time, and expense may be wasted; or if the

patient is unable to follow strict oral hygiene, due to a

physical handicap, a fixed prosthesis is contraindicated.

Slide 8 [Insert DM 3-8] Cosmetic Dentistry

Explain how advances in technology and materials are

continually expanding in this field of dentistry.

Discuss how rewarding it is to give patients an improved

smile which often results in a boost of confidence and

self esteem.

Review each procedure on the slide, explaining the

meaning of each.

Point out that esthetics may also be spelled aesthetics.

Slide 9 [Insert DM 3-9] Types of Fixed Prostheses

Explain how full cast crowns, partial crowns, inlays, and

onlays are made in the dental lab from elastomeric

impressions taken of the patient in the dental chair.

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Explain that the dental lab technician will construct a

restoration that is an exact replica of the tooth, and made

with precision to fit on or into the shape of the tooth

preparation.

Point out that a full cast crown covers the entire coronal

portion of a tooth and a partial crown covers the coronal

surface but leaves the natural facial surface intact.

Describe the difference between an inlay and an onlay.

Explain that the tooth being replaced is called a pontic,

and the tooth used to support or stabilize a bridge is

called an abutment.

Describe a Maryland bridge as a resin-retained fixed

bridge that replaces only one tooth.

Ensure learners understand that each tooth of a crown or

a bridge is called a unit, and that is how insurance

companies code the procedure, how the office will charge

the patient, and how the lab will charge the doctor – per

unit.

Explain that veneers improve the appearance of the

patient by using a conservative preparation on the facial

surface of the tooth and placing a thin layer of tooth-

colored material.

Address the difference between direct and indirect

veneers, as well as porcelain veneers.

Describe the reasons for these types of restorations.

Slide 10 [Insert DM 3-10] Materials Used for Fixed Prostheses

Discuss how pure gold would be too soft and that a

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precious metal alloy is a stronger material.

Explain that porcelain may be attached to the metal alloy,

which adds strength to the ceramic material, or used

alone where the forces of mastication shouldn’t fracture

the restoration.

Point out that recent composite resin techniques are

becoming popular due to continuous improvement in

technology and materials.

Slide 11 [Insert DM 3-11] Retention of Restorations

Explain that core buildups and retention pins are used to

help retain the filling material on badly broken down

teeth, when not much tooth structure is left to restore.

Describe how pins are screwed into the dentin so the

amalgam, composite, or the silver alloy/glass ionomer

material has something to adhere to.

Point out that a post, placed inside of the root canal is

necessary to strengthen a tooth following endodontic

treatment.

Refer to the figure in Chapter ___ (Phinney & Halstead)

which illustrates a post and core with a pin.

Explain that dental implants are surgically inserted into

the bone, and following the healing process, provide

support for prostheses.

Point out that implants prevent resorption of the patient’s

alveolar ridge, and must be routinely cleaned to remove

plaque.

Discuss the use of devices used to clean under and

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around implants as well as fixed bridges, such as bridge

threaders, proxi-floss, dental tape, and interproximal

brushes.

Explain that dental hygienists will scale implants with

plastic coated instruments so the precious metal won’t

become scratched.

Refer to the figure in Chapter _____ (Phinney &

Halstead) which illustrates the screw-retained implant

prosthesis and the cement-retained implant prosthesis.

Slide 12 [Insert DM 3-12] The Dental Laboratory

Explain that the dental lab technician uses the impression

and bite registration taken on the patient, and follows the

dentist’s written instructions on the lab prescription in

order to fabricate a prosthetic restoration.

Describe how the lab tech pours the elastomeric

impression with die stone, and constructs an exact

replica of the normal tooth in wax on the die.

Explain that this wax pattern is then invested and cast

into a metal alloy duplicating normal tooth form, just as

jewelers cast metal for jewelry. Point out that this is

called a precision cast restoration because each step

requires absolute accuracy.

Ensure learners understand that the lab can only work

with what is sent to them and that errors such as

distorted or inaccurate impressions will affect the final

prosthesis, and may not fit the patient’s tooth preparation.

Slide 13 [Insert DM 3-13] Dental Assistant Responsibilities

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Explain that the DA has many responsibilities during fixed

prosthetic procedures, and that these duties vary

depending on the dentist as well as state regulations.

Point out that DAs, highly skilled in restorative

procedures, are always in demand.

In-Class Activity: Stop here for the Porcelain Veneer

Set Up activity.

Homework Assignment: Stop here to assign and

discuss the homework.

Part B: Fixed Prosthesis Procedures

Overview

Chairside procedures preparing for fixed prosthetics must be detailed and

accurate in order for the lab to create a quality product. The dental assistant’s

role is to set up for the procedure, assist the dentist, explain the process and oral

hygiene instructions to the patient, and to coordinate scheduling with the dental

lab. These tasks may be expanded depending on the dental office. Knowledge

of the many materials and equipment used are mandatory during each step.

Initial Questions and Activities1. How can the dental assistant help a patient feel more comfortable during a long crown preparation procedure?

The dental assistant should ensure all materials and supplies needed for the procedure are prepared

and ready, help the dentist work quickly and efficiently, and continue to ask the patient how they are

doing throughout the procedure, when appropriate. Ask the patient if they need a break.

Key Concepts References and Activities SlidesFixed Prosthesis Procedures Chapter ___, pgs. ___ (Phinney & Halstead) Slides 14-22

Assessment Questions [Insert Group Activity icon] Crown Preparation

[Insert Group Activity icon] Crown

Slide 23

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Pay close attention to learners who don’t participate in initial discussions. Try to determine the reasons for their lack of participation and address it.

Teaching Tip


Key Concepts References and Activities SlidesCementation

[Insert Homework Ass icon] Interactive Skills

Procedures CD-ROM

[Insert Home Ass icon] Workbook

Assignment

[Insert Home Ass icon] End of Chapter

Activities

[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Activity [ ] Evaluation

[Insert In-Class Act icon] In-Class Activities Crown Preparation (Part B, Objectives 2-5). Goal: For learners to have the opportunity to practice chairside

assisting skills during a crown preparation procedure. Place learners into teams. Learners should be graded on

the procedure steps as outlined on pg. ____, Chapter ____(Phinney & Halstead). Learner workbooks contain

check off sheets that can be utilized. The instructor should allow enough time for learners to practice all steps

before evaluating and should perform as the operator during testing and grading of this procedure. The more

actual materials and supplies used, and hands-on practice learners are allowed, the better quality training they

will acquire. If possible this should be practiced on a live patient as much as possible, at least for the

elastomeric impression and bite registration.

Crown Cementation (Part B, Objectives 4-5). Goal: For learners to practice assisting during a crown

cementation procedure. Instructor should ensure enough materials are available for learners. Place learners

into teams. Learners should be graded on the procedure steps as outlined on pg. ____, Chapter ____(Phinney

& Halstead). Learner workbooks contain check off sheets that can be utilized. The instructor should allow

enough time for learners to practice all steps before evaluating and should perform as the operator during

testing and grading of this procedure. The more actual materials and supplies used, and hands-on practice

learners are allowed, the better quality training they will acquire.

[Insert In-Class Dis Ques icon] In-Class Discussion1. What were some problems found when manipulating elastomeric impression materials and bite registration?

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Discuss problems learners had with these materials. Explain proper techniques regarding mixing or

using an extruding gun, loading the tray, and placing it in a patient’s mouth.

[Insert Home Ass icon] Homework AssignmentsInteractive Skills and Procedures CD-ROM. Learners should use the CD-ROM to practice the Crown

Preparation and Cementation Prosthodontic procedures.

Workbook Assignment. Learners are to complete the workbook Chapter ___questions. Learners should be

prepared to review these in class.

End of Chapter Activities. Have learners complete the Review Questions and Critical Thinking Questions at the

end of Chapter ____ (Phinney & Halstead).

Ideas for learners struggling with this material … Group Participation. Ask learners if they are a good participator in group activities? Encourage them to

ask themselves if they add to the group or inhibit its effectiveness? Suggest they conduct a short

assessment on their group participation, both in class discussion and in small groups. Tell them they

should make a plan of action if they see areas where they can improve.

Ideas for learners who are ahead and want to learn more … Web Research. Have learners go to http://www.ada.org to research more information on cosmetic dentistry.

Have them prepare a short paper on their findings to present to the class.

Presentation Tools

Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.Slide 14 [Insert DM 3-14] Part B: Fixed Prosthesis Procedures

Review Part A.

Review the homework and make sure any remaining

questions are answered.

Introduce Part B.

Inform learners that the crown preparation procedure is

fairly complicated as it has many steps to remember and

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http://www.ada.org/


that they will have the opportunity to practice this procedure

following this part. Point out that diligence by the DA during

each step contributes to the quality of the final prosthetic

restoration.

Explain that the DA will need to retract the patient’s cheek

or tongue while the dentist prepares the tooth with the

handpiece.

Slide 15 [Insert DM 3-15] Selecting a Tooth Shade

Explain how important a proper shade is in order to match

existing dentition as closely as possible.

Point out that just as during the composite restoration

procedure, the shade should be taken before the tooth is

prepared, the shade guide moistened, and compared to the

natural teeth under natural light.

Ensure learners understand that the shade chosen must be

recorded in the patient’s chart as well as on the lab

prescription form.

Slide 16 [Insert DM 3-16] Margin Preparations.

Describe that where the cast restoration meets the tooth is

called the margin, and that the dentist will design the

margin carefully, with meticulous attention to detail.

Slide 17 [Insert DM 3-17] Tissue Retraction

Explain how necessary tissue retraction is in order to obtain

an accurate impression of the gingival margin. Point out

that the retraction cord is placed around the tooth and into

the gingival sulcus.

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Explain that the cord may be impregnated with a chemical,

or dipped in a hemostatic solution which will control

bleeding and cause the gingiva to temporarily shrink in

order for the impression material to flow around the margin

of the preparation.

Slide 18 [Insert DM 3-18] Elastomeric Impressions

Ensure learners understand how important the impression

is, and that if there is an air bubble, or other distortion

detected in the impression, the dentist will want to retake it.

Explain that latex glove powder can interfere with the

setting of elastomeric materials, the impression can shift in

the patient’s mouth while it is setting, or the tray may not fit

properly.

Describe the various ways to obtain impressions.

Address how the lab tech will need an accurate occlusal

relationship from a bite registration in order to fabricate a

restoration that fits properly.

Slide 19 [Insert DM 3-19] Provisional Restorations

Explain that the temporary crown or bridge will provide

temporary coverage for the tooth or teeth while the dental

lab makes the permanent prosthesis.

Ensure learners understand that the provisional restoration

protects the tooth, while providing esthetics and comfort for

the patient.

Point out how important the provisional is for stabilizing the

contacts between the teeth as well as the occlusion.

Explain how the prosthesis may not fit if the temporary

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restoration is not made correctly, or if the patient loses it.

Discuss how it must fit snugly at the gingival margin to

prevent plaque and debris away from the tooth.

Address the various types of provisional restorations.

Slide 20 [Insert IDA 3-20] The Laboratory Prescription

Explain that the lab prescription gives detailed instructions

to the lab technician regarding the prosthesis, including the

date the permanent crown or bridge is expected to be in

the dental office.

Slide 21 [Insert IDA 3-21] Crown Cementation

Explain that the temporary crown is removed from the

patient’s tooth, then the permanent restoration is tried on to

ensure it fits properly and that the occlusion is accurate. It

is then adjusted if necessary and permanently cemented

into place in the patient’s mouth.

Describe how the DA mixes the cement when the dentist is

ready, and places it in a thin layer within the dried

permanent prosthesis.

Point out that after the cement sets, the excess is removed

with instruments and dental floss.

Slide 22 [Insert IDA 3-22] Fixed Prostheses Maintenance

Ensure learners understand that the DA will be educating

the patient on how to care for the new investment in their

oral health.

Explain how each oral hygiene aid on this slide will be used

by the patient to keep the new prosthesis clean.

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Discuss how to use a floss-threader to remove plaque from

under bridges.

Slide 23 [Insert IDA 3-23] Assessment Questions

Short Activity: Stop here and have learners answer the

questions on the slide. Review material as needed to

enhance understanding.

Short Activity: Stop here to discuss the case study in

Chapter ____ (Phinney & Halstead).

In-Class Activity: Stop here for the Crown Preparation

and Crown Cementation activities.

Homework Assignment: Stop here to assign and discuss

the homework.

Section 2: Removable Prosthodontics

Section OverviewRemovable prosthodontics is the art and science of dentistry that provides the replacement of lost dental tissues

and their components. This replacement for missing teeth is divided into two categories: removable partial

dentures and removable complete dentures. Intraoral factors such as muscular function, the shape of the alveolar

ridge, and the mucosa covering the residual ridge will be considered by the dentist when deciding whether a

partial denture, or a complete denture would be best for the patient. Extra oral factors to be considered are the

patient’s age, mental and physical health, as well as the attitude toward improved oral hygiene and retention of

natural teeth. In many instances a removable prosthesis must be used for a portion, or all of the replacement

dentition.

Outline of Section 2Part A: Removable Partial Dentures

Part B: Removable Complete Dentures

Learning Objectives and CompetenciesThese learning activities directly address the Learning Objectives and

Competencies as stated.

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Walk around during lab activities and give feedback to each individual learner. Encourage them to help each other and to write down exactly where they get stuck in a procedure or exactly what they do not understand. Participate fully in lab activities and monitor each learner closely.

Teaching Tip


Knowledge

7. Define the Key Terms.

8. List the components of a partial denture.

Comprehension

9. Explain the reasons for removable prostheses.

10. Describe the consultation appointment for a removable prosthesis.

11. Explain the difference between a removable partial and a complete denture.

12. List and discuss the appointment steps for a partial denture and a complete denture.

13. Explain denture reline, repair, and adjustment procedures.

Application

14. Demonstrate partial denture final impressions and delivery.

15. Demonstrate setting up and assisting during a jaw relationship and a denture relining procedure.

Learning ActivitiesThese learning activities directly address the Learning Objectives and Competencies as stated.

[Insert Homework Assignment icon] Key Term Glossary (Part A, Objectives 7-9)

[Insert In-Class Activity icon] Partial Denture Final Impressions (Part A, Objective 14)

[Insert In-Class Activity icon] Delivery of a Partial Denture (Part A, Objective 14)

[Insert Homework Assignment icon] Textbook Assignment (Part A, All Objectives)

[Insert In-Class Activity icon] Field Trip (Part B, All Objectives)

[Insert In-Class Activity icon] Jaw Relationship Appointment (Part B, Objective 15)

[Insert In-Class Activity icon] Denture Reline (Part B, Objective 15)

[Insert Homework Assignment icon] Workbook Assignment (Part B, All Objectives)

[Insert Homework Assignment icon] End of Chapter Activities (Part B, All Objectives)

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Part A: Removable Partial Dentures

Overview

A removable partial denture restores a large span of lost dentition. A fixed bridge is the ideal replacement for

missing teeth, but may not be feasible due to existing conditions in the patient’s mouth. Each patient’s individual

oral conditions must be evaluated, such as the extent of caries, the quality and quantity of remaining supporting

tissue, and tooth contours. Esthetics, mastication, phonetics, and comfort should be restored, while at the same

time preserving teeth, the alveolar process, gingival tissue, tooth position, occlusion, and oral as well as overall

systemic health. The DA will prepare diagnostic casts, radiographs, and visual aids for the denture consultation

appointment. Assisting the dentist during each phase of the process to ensure a quality partial will be part of DAs

responsibility as will patient education regarding how to care for the new appliance.

Initial Question and Activities

1. Why do you think a partial denture would be needed rather than a fixed

prosthesis?

A fixed prosthesis is the ideal restoration, but if there are too many

teeth missing already, especially on both sides of an arch, a partial

denture will restore function to both sides of the mouth.

Key Concepts References and Activities SlidesIntroduction to Section 2 Slides 24-25

Key Terms [Insert Homeword Ass icon] Key Term

Glossary

Slide 26

Removable Partial Dentures Chapter ____, pgs. ____ (Phinney & Halstead)

[Insert Group Activity icon] Partial Denture

Final Impressions

[Insert Group Activity icon] Delivery of a

Partial Denture

[Insert Home Ass icon] Textbook Assignment

Slides 27-32

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For good learner retention, keep an eye on both the struggling learners and the best in the class. Address each learner in appropriate ways to ensure that they are getting the most from the class and are not in danger of leaving because they are bored or struggling. Address any problems immediately.

Teaching Tip



[Insert In-Class Act icon] In-Class Activities Partial Denture Final Impressions (Part A, Objective 14). Goal: For learners to practice setting up and

assisting during Final Impressions for a Partial Denture. Instructor should ensure there are enough materials

and supplies for the class and separate learners into teams. Instructor should be the operator for this

procedure. If possible this should be practiced on a live patient as much as possible, at least for the

elastomeric impression and bite registration. Some of the steps may be simulated and procedures verbalized

so the instructor knows the learner being evaluated understands the procedure. Learners should be graded

on the procedure steps as outlined on pg. ____, Chapter ____(Phinney & Halstead). Learner workbooks

contain check off sheets that can be utilized.

Delivery of a Partial Denture (Part A, Objective 14). Goal: For learners to practice setting up and assisting

during Delivery of a Partial Denture. Instructor should ensure there are enough materials and supplies for the

class and separate learners into teams. Instructor should be the operator for this procedure. Some of the

steps may be simulated and procedures verbalized so the instructor knows the learner being evaluated

understands the procedure. Learners should be graded on the procedure steps as outlined on pg. ____,

Chapter ____(Phinney & Halstead). Learner workbooks contain check off sheets that can be utilized.

[Insert In-Class Dis Ques icon] In-Class Discussion1. What type of gypsum material is used by the lab technician for fabricating

crowns and bridges?

Die stone is used because it is stronger than plaster or lab stone. Die

stone is also used for partial denture modes because it is stronger and

shouldn’t be fractured by insertion and removal of the clasps.

[Insert Home Ass icon] Homework AssignmentsKey Term Glossary. Learners will define key terms listed in the PowerPoint presentation. They are to enter this

glossary on disk, in a dedicated notebook or in a designated part of a notebook. They are expected to augment

information from text or lecture with other resources including any available in the school or public libraries or on

the Internet and will be graded at the end of the module on completeness and presentation.

Textbook Assignment. Learners are to read Chapter ____ (Phinney & Halstead).

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Participate fully in lab activities. Watch learners carefully to see that they are understanding the information and keeping on track. Lab sections should be as informative as lecture sections

Teaching Tip


Ideas for learners struggling with this material … Use Homework Wisely. Encourage learners to focus on their homework as a learning aid rather than one

more task to do to pass the course. Remind them their goal is to learn the information so they will be

successful in their new career and that studying more than necessary will enable them to excel and be proud

of their accomplishments.

Ideas for learners who are ahead and want to learn more … Web Research. Have learners go to http://www.nadl.org and find out if there is an accredited dental laboratory

education program in the area. Have them prepare a short report to share with the class regarding their

findings.

Presentation ToolsNote: If you change Objectives or Assignments, don’t forget to change the

slides accordingly.

Slide

24

[Insert DM 3-24] Section 2: Removable Prosthodontics

Discuss each objective in detail. Learners need to know

what they will be learning and why. Relate it back to their

careers as dental assistants.

Slide

25

[Insert DM 3-25] Section 2: Removable Prosthodontics (cont.)

Continue to discuss each objective in detail.

Slide

26

[Insert DM 3-26] Key Terms

Review each key term and discuss the importance of

knowing the definition of each.

Homework Assignment: Stop here to remind learners

about the importance of completing the Key Term

Glossary assignment.

Slide

27

[Insert DM 3-27] Part A: Removable Partial Dentures

Explain the purpose of a partial denture and what may

22

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take placed during a consultation appointment.

Point out that the most important step in achieving a

quality partial denture is adequate preparation of the

mouth by the dentist before construction of the

prosthesis.

Explain that these preparations enable a mouth to accept

and support a partial denture for the maximum period of

time, and with minimal adverse reaction on the remaining

natural teeth and supporting tissues.

Inform learners that photographs of the patient may be

taken in order to provide before and after treatment

documents, and visual aids used to explain how the

prosthesis is inserted, removed, and maintained.

Explain how the DA will take alginate impressions of the

partially edentulous mouth and pour plaster study models

on which the dentist will draw the design for the partial

and decide locations for the partial framework

components.

Slide

28

[Insert DM 3-28] Advantages of a Removable Partial

Discuss advantages of a removable partial denture.

Slide

29

[Insert DM 3-29] Contraindications for a Partial

Discuss how important a sound foundation is in order for

a partial denture to be successful, and the reasons why it

may not be the best choice for the patient.

Slide

30

[Insert DM 3-30] Components of a Partial Denture

Explain each component of a partial denture to the

learners.

Point out that the framework is the skeleton that provides

- 23 -

23


the basic support for all other components.

Explain that the rests are metal projections, on or near

the clasps, and are designed to lie in a prepared recess

on the occlusal, lingual, or incisal surface of the tooth

crown.

Describe how the connectors may be a lingual or palatal

bar, and that the retainer is the clasp that provides

stability and enables the partial to be removed and

inserted easily by the patient.

Explain that the denture base or saddle is gingival-

colored acrylic that lies over the alveolar ridge and holds

the artificial teeth which teeth may be constructed of

either porcelain or acrylic.

Note to Instructor: Having a visual aid when describing

parts of a partial would be helpful.

Slide

31

[Insert DM 3-31] Metal Frameworks

Point out that the framework of a partial denture is

constructed in wax by a dental lab technician, according

to the dentist’s precise design, and then cast from

precious metals.

Explain that the framework may be tried in the patient’s

mouth before teeth are added to ensure proper

positioning of the clasps and the path of insertion.

Slide

32

[Insert DM 3-32] Appointments for a Partial Denture

Discuss the various types of appointments necessary for

a partial denture.

Explain that rest preparations are made by the dentist, on

the abutment teeth, with a high speed handpiece, and

24


that these recessed areas are prepared to receive the

extension of the rests on the clasps of the framework.

Point out that the patient doesn’t usually need anesthetic

as this is minor re-contouring of teeth to be used for

retention and support of the prosthesis, and to provide

enough depth for proper occlusion.

Ensure learners understand that an accurate final

elastomeric impression will be taken following the rest

preparations and sent to the lab.

Explain that it is the DA’s job to teach the patient proper

home care of the removable prosthesis during the

delivery appointment.

Point out that the DA will need to describe to the patient

how plaque accumulates and how the acid present in

plaque decalcifies enamel, making such areas soft and

readily abraded during removal and insertion of the

partial denture.

Discuss how the DA should instruct the patient to remove

the partial after eating, to remove debris from the clasps,

rests, and saddle, to vigorously brush the abutment teeth

to remove plaque, and when the partial is not worn, to

keep it moist in order to avoid warping.

In-Class Activity: Stop here for the Partial Denture Final

Impressions activity and the Delivery of a Partial Denture

activity.

Homework Assignment: Stop here to assign and

discuss the homework.

- 25 -

25


Part B: Removable Complete Denture

OverviewRemovable complete dentures, as with partial dentures require many exta oral procedures to be performed by the

dental assistant. These include coordinating appointments for the patient and communicating with the dental lab.

The dental assistant will also teach the patient how to care for their prosthesis and assist the dentist during

chairside, lab, and other associated procedures. It is often traumatic to lose teeth and learn how to use facial

muscles to control a prosthesis during chewing and speaking. The patient may need reassurance that they are

making the correct decision regarding their health.

Initial Questions and Activities1. Why would extracting teeth and replacing them with a denture always be the last option considered?

Anytime a tooth is removed, bone loss occurs. Keeping teeth, as well

as the bone surrounding them, is the healthiest result for us all.

2. How do you think a denture stays in place in the mouth during mastication?

The denture will fit the alveolar ridge and sit on top of it. The mucosa will

become tough over time, but the patient will struggle when first losing

their teeth, both physically and mentally. The dental assistant can reassure the patient during this

period of adjustment.

Key Concepts References and Activities SlidesRemovable Complete Dentures Chapter ___, pgs. ____ (Phinney & Halstead)

[Insert Group Activity] Field Trip

Slides 33-43

Assessment Questions [Insert Group Activity icon] Jaw Relationship

Appointment

[Insert Group Activity icon] Denture Reline

Slide 44

Summary of Module [Insert Home Ass icon] Workbook Assignment

[Insert Home Ass icon] End of Chapter

Activities

Slide 45

26

Remind learners that homework activities are not busy work and that they will get out of them as much learning as they put into them. Encourage learners to excel in their homework.

Teaching Tip



[Insert In-Class Act icon] In-Class Activities Field Trip (Part B, All Objectives). Goal: For learners to see a working dental laboratory. Instructor should call

a dental laboratory and set up a time for the dental assisting learners to tour as a group. During the tour,

learners should write down what they see. They then should prepare a report to present and discuss in class.

Jaw Relationship Appointment (Part B, Objective 15). Goal: For learners to practice setting up and

assisting during a Jaw Relationship Appointment. Instructor should ensure there are enough materials and

supplies for the class and separate learners into teams. Instructor should be the operator for this procedure.

Some of the steps may be simulated and procedures verbalized. Learners should be graded on the procedure

steps as outlined on pg. ____, Chapter ____(Phinney & Halstead). Learner workbooks contain check off

sheets that can be utilized.

Denture Reline (Part B, Objective 15). Goal: For learners to practice setting up and assisting during a

Denture Reline. Instructor should ensure there are enough materials and supplies for the class and separate

learners into teams. Instructor should be the operator for this procedure. Some of the steps may be simulated

and procedures verbalized. Learners should be graded on the procedure steps as outlined on pg. ____,

Chapter ____(Phinney & Halstead). Learner workbooks contain check off sheets that can be utilized.

[Insert In-Class Dis Ques icon] In-Class Discussion1. What is rest preparation for a partial denture?

The dentist prepares the teeth so there are recessed areas on the

occlusal, lingual, or incisal edge, in order for enough depth for proper

occlusion after the partial is seated in place.

2. Why would the dental assistant construct a custom tray for impressions rather than to use a stock tray?

A custom tray will fit just one patient’s dentition for a more accurate impression.

[Insert Home Ass icon] Homework AssignmentsWorkbook Assignment. Learners are to complete the workbook Chapter ___ questions. Learners should be

prepared to review these in class.

- 27 -

27

Remind learners that there are opportunities to meet with you individually to help clear up those fuzzy learning points.

Teaching Tip


End of Chapter Activities. Have learners complete the Review Questions and Critical Thinking Questions at

the end of Chapter ____ (Phinney & Halstead).

Ideas for learners struggling with this material …

Review Learning Objectives. Suggest that learners continue to refer back to the learning objectives and

check them off when they are confident that they have achieved the objective. Tell them that they should

review these often to ensure that they have retained the information in their long term memory and to realize

how much they have retained.

Ideas for learners who are ahead and want to learn more… Web Research: Have learners go to http://www.ada.org, oral health care topics, and under “dentures” find

questions patients frequently ask about removable dentures. Have them write a short report of their findings

to present to the class.

Presentation ToolsNote: If you change Objectives or Assignments, don’t forget to change the

slides accordingly.

Slide

33

[Insert DM 3-33] Part B: Removable Complete Denture

Review Part A and make sure that any remaining questions

are answered.

Review the homework and address questions as needed.

In-Class Activity: Prior to beginning Part B, complete the

Field Trip activity.

Introduce Part B.

Explain that complete dentures are for patients without

teeth, or who will be having teeth extracted, and will

become edentulous.

Slide

34

[Insert DM 3-34] Indications for a Complete Denture

Discuss the reasons a patient may need a complete

28

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denture.

Ensure learners understand that this treatment is a last

resort and that if there is any possibility of preserving some

teeth, and therefore bone, it should be considered and

communicated to the patient.

Slide

35

[Insert DM 3-35] Components of a Complete Denture

Point out that there are fewer components in a complete

denture than there are for a partial denture.

Explain that the denture base must sit on the mucosa,

which must support it, and that the patient’s facial muscles

must help hold it in place, during mastication as well as

when speaking.

Describe the flange as the part of the acrylic base that

extends to the areas of retention on the natural landmarks

of the alveolar ridge.

Explain that the flange extends to the retromolar area, the

oblique ridge, and the mylohyoid ridge on the mandible.

Point out that on the maxillary arch, the flange conforms to

the curvature of the residual ridge, and fits into the

vestibule.

Slide

36

[Insert DM 3-36] Appointments for a Complete Denture

Discuss the appointments necessary for construction of a

complete denture and the procedures that will take place at

each.

Explain that photographs of the patient, before they lost

teeth, may be used in order to evaluate the mold, or shape,

of the original dentition, or to provide before and after

- 29 -

29


treatment documents.

Point out that the posterior teeth may be removed, and that

the mouth allowed to heal before the final impression

appointment, or all the teeth may be extracted at one time,

and the immediate denture delivered then.

Explain that the immediate denture will act as a bandage

over the surgical area and that the patient will need to

return to the office in a few days so that the dentist can

make any adjustments to the denture. Any sutures placed

during the extraction appointment would also be removed

at this time.

Slide

37

[Insert DM 3-37] Final Impressions

Discuss how important the final impression is to a quality

final prosthesis.

Explain that the impression compound will be added onto

the custom tray and used to acquire an accurate

impression of the periphery.

Ensure learners understand that the periphery is the

outermost part of the patient’s mucosa, where the denture

must fit, including fitting properly onto the frenum muscle

attachments in the vestibule of the mouth.

Slide

38

[Insert DM 3-38] Construction of Complete Dentures

Explain that the baseplate is a preformed shape made of

shellac, or acrylic resin that temporarily represents the

base of the denture, and that the wax bite rims are built to

represent vertical dimension.

30


Discuss vertical dimension as the space provided by the

normal teeth.

Slide

39

[Insert DM 3-39] Jaw Relationship Set-Up

Inform learners that the base plate-bite rim assembly is

tried into the patient’s mouth and vertical and centric

relationships recorded by the dentist.

Explain that the patient will be asked to move their jaw

forward, backward and from side-to-side.

Discuss how the tooth shade is taken and recorded, as well

as the mold, or shape of the teeth.

Slide

40

[Insert DM 3-40] Try-in Appointment

Explain that if the patient is edentulous, the teeth may be

set in wax and tried in the patient’s mouth to evaluate how

they look, and how well they will function, before they are

finished in the dental lab.

Slide

41

[Insert DM 3-41] Delivery Appointment

Discuss the procedures completed during the delivery of

the complete denture.

Ensure learners know that the DA will explain to the patient

how to care for removable prostheses.

Refer to the home care instructions illustration found in

Chapter ___ (Phinney & Halstead).

Slide

42

[Insert DM 3-42] Denture Relines, Adjustments, and Repairs

Explain the importance of denture relines, and the

difference between a tissue conditioner, temporary reline,

and a permanent reline.

- 31 -

31


Ensure they understand that the bone will shrink, or resorb,

following tooth extractions, and that the prosthesis will no

longer fit.

Point out that the patient may come to the office for several

soft relines, before the tissue has resorbed to a point when

the dental lab will permanently reline the denture.

Explain that as the bone and other tissues change, the

patient may develop sore areas that must be adjusted. The

dentist, or dental assistant, will use an acrylic bur to relieve

the sore areas, and the patient instructed to return if more

sores occur.

Discuss how some repairs to dentures can be done in the

office whereas other repairs may require the denture to be

sent to the lab.

Ensure learners understand that removable prostheses

must be kept moist to avoid distortion.

Slide

43

[Insert DM 3-43] Implants and Overdentures

Discuss with learners how important it is to keep the

alveolar bone from resorbing. Explain that teeth can be

treated with endodontics and restorative procedures, or

implants may placed in the alveolar ridge, and therefore

used to stabilize a prosthesis.

Explain to learners that the patient will need to clean the

retained teeth at home, and schedule regular recall visits to

the dental office.

Slide

44

[Insert DM 3-44] Assessment Questions

Short Activity: Ask the group to answer these questions to

32


assess their comprehension of the material recently

presented. Review any material that does not seem clear.

Short Activity: Stop here to discuss the case study in

Chapter ____(Phinney & Halstead).

In-Class Activity: Stop here to complete the Jaw

Relationship Appointment activity and the Denture Reline

activity.

Slide

45

[Insert DM 3-45] Summary of Module

Review with learners all they learned during this module,

from fixed to removable prosthodontics, and the diverse

intra oral and extra oral procedures performed in the dental

office, as well as and those completed in conjunction with

the dental laboratory.

Homework: Stop here to assign and discuss the

homework assignment.

- 33 -

33

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