1. UDMSD Prosthodontic Competency Examination For Complete and Partial Denture Insertion or Delivery Michael L. Linebaugh DDS MS

2. Competency will begin at 10:00 am and 1:00 pm no exceptions! Student must have opposing prosthesis either a CD/RPD, CD/CD etc.

3. 3 Start Check!

4. Patient Presentation: Health History and Dental History 1. Brief explanation of diagnosis and treatment plan and treatment plan 2. Presentation of the original diagnostic casts mounted 3. Examination of radiographs 4. Student will identify patient’s diagnostic casts mounted 3. Examination of radiographs 4. Student will identify patient’s medications and how they medications and how they effect treatment effect treatment

5. Pre-insertion Unpackaged/checked/ examinedUnpackaged/checked/ examined All instrumentation present/suppliesAll instrumentation present/supplies Examined intaglio surface prosthesisExamined intaglio surface prosthesis Preparation of remount castsPreparation of remount casts

6. Pre-insertion Phase Instructor will be present

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

8. 2. Instrumentation Needed for Insertion SS hand piece and proper burs Indicators /disclosing wax & applicators PIP paste (disclosing paste) Occlusal indicator paper Torch/lighter Alu wax, or occlusal registration material Sticky wax Wax spatula Articulator Bard parker knife and buffalo knife Mounting stone Mounting jig Preparation of remount cast to be completed in clinic Preparation of remount cast to be completed in clinic

9. Instrumentation

10. Student will prepare maxillary and mandibular remount casts. Casts returned from the laboratory cannot be used.

11. Remount Casts Prepare prosthesis to pour remount casts

12. Remount casts Note: Blockout & Vaseline

13. Remount Casts Note: Blockout & Vaseline

14. Insertion Phase Student will place PIP paste (disclosing wax on the intaglio surface and evaluate the results for the instructor.Student will place PIP paste (disclosing wax on the intaglio surface and evaluate the results for the instructor. Student will adjust the intaglio surface and have the instructor evaluate.Student will adjust the intaglio surface and have the instructor evaluate. Student will evaluate peripheral borders, extensions, frenums and posterior palatal seal.Student will evaluate peripheral borders, extensions, frenums and posterior palatal seal.

15. Insertion Phase: Instructor will evaluate

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

17. Evaluation of the fit of the prosthesis: maxillary arch

18. Evaluation of the fit of the prosthesis: mandibular arch

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

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

21. Occlusal Evaluation and Adjustment Student will know how to use remount jig or substitute a facebow transfer to mount maxillary cast.Student will know how to use remount jig or substitute a facebow transfer to mount maxillary cast. Student will choose occlusal registration material and complete occlusal registration in centric relation.Student will choose occlusal registration material and complete occlusal registration in centric relation. Student will complete clinical remount and demonstrate accuracy to clinical condition, Instructor will evaluateStudent will complete clinical remount and demonstrate accuracy to clinical condition, Instructor will evaluate Student will explain the adjustment procedureStudent will explain the adjustment procedure Student will complete adjustment for CR and lateral and medialtrusion. Instructor will evaluateStudent will complete adjustment for CR and lateral and medialtrusion. Instructor will evaluate Student will evaluate new occlusal relationship intraorally.Student will evaluate new occlusal relationship intraorally.

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

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

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

25. 1 2 3

26. Clinical Remount

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

30. Clinical Remount

31. Instructor Will Examine Centric Relation Intraorally

32. Clinical Remount

33. 4. Student will explain the adjustment procedure. Centric relationCentric relation Lateraltrusion (working contact)Lateraltrusion (working contact) Medialtrusion (balancing contact)Medialtrusion (balancing contact) Concept of balanced occlusionConcept of balanced occlusion

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

35. Centric Relation Adjustment

36. Centric Relation Adjustment Before

37. ...... Centric Relation Adjustment After

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

39. Esthetic Result

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

41. Patient Instructions Follow up instructions for patient adaptationFollow up instructions for patient adaptation 24- 48hr adjustment and evaluation appointment24- 48hr adjustment and evaluation appointment Appropriate aids/literature givenAppropriate aids/literature given Need picture of aids