Questions 1-10 Question #1 In reference to the partially edentulous arch and accompanying framework shown---what is the Kennedy classification? Class I, Modification 0 Class II, Modification 1 Class III, Modification 0 Class IV, Modification 0 Does this RPD have an axis of rotation? If so, where is it located? What class(s) of RPDs do not have an axis of rotation? Answer to Question #1 The correct answer is According to the Kennedy Classification, the partially edentulous arch shown is a Class I, Modification 0. There are bilateral posterior extension areas with no other modification (edentulous) space(s) present. All class I RPDs have an axis of rotation. To be very specific, the axis of rotation will pass through the rigid metal closest to the edentulous space that lies above the survey line (height of contour). If the design is correct and the laboratory and clinical procedures are carried out properly, the axis of rotation should pass through the most distal rests on each side. The axis of rotation for this case is indicated by the black line. Class I and Class II RPDs always have an axis of rotation. Class III RPDs never have an axis of rotation. Class IV RPDs seldom have an axis of rotation---some people consider that Class IV RPDs have an axis of rotation if all the incisors and both canines are missing, creating an "anterior extension" area. Question #2 The accompanying figure depicts the lingual surface on the lower anterior teeth of a patient who is currently wearing a bilateral distal extension removable partial denture that was fabricated 5 years ago. What do you think is the most likely cause for the tissue damage that has occurred on tooth #22? The lower anterior teeth should have been plated and were not. The patient's oral hygiene is poor and tissue breakdown followed pocket formation on the distal of tooth #22. A rest preparation and rest should have been placed on tooth #22. A cast circumferential clasp was used on tooth #22----it should have been wrought wire. Answer to Question #2 The best answer is INCORRECT. Although plating may help to prevent this situation from occurring, definitive rest seats under the plating would still be required. INCORRECT. Poor oral hygiene can contribute to tissue breakdown. However, this type of damage is caused by trauma from the downward movement of the RPD during function. CORRECT. A rest preparation and rest are essential to proper functioning of the RPD. The damage shown in the illustration is primarily caused by movement of the RPD toward the tissues during function. Such damage would not have occurred if a good rest seat and rest were present. INCORRECT. The type of clasp arm has nothing to do with tissue trauma of this type. Question #3 Your patient has teeth 20-29 remaining. You plan to use mesial rests and I-bars on both terminal abutments. Because there are lingual tori present, you will need to use linguoplating in the premolar areas. The illustration is a lingual view of teeth 27-29. The dotted line on #29 represents the height of contour (survey line). What should be the relationship of the superior border of the plating and the survey line? The plating should extend above the survey line. The plating should end at or below the survey line. The plating must end exactly at the survey line. The plating must end below the survey line. Answer to Question #3 The correct answer is The plating must end exactly at the survey line (height of contour). If the plating ends below the survey line, there will be a space between the superior edge of the plating and the tooth creating a food trap. In addition, the edge of the plating will stand away from the tooth and may be irritating to the tongue. If the plating ends above the survey line, it will pre-empt the mesial rest. The axis of rotation will pass through the plating instead of the rest. The I-bar will contact the tooth in front of this "new" axis of rotation and will engage the tooth when the extension base moves toward the residual ridge. Also, since the plating will act like a rest on an inclined plane, there will be the tendency to push the tooth toward the facial during function. The fact that the plating must end exactly on the survey line makes framework fabrication much more difficult for the laboratory technician. Therefore, whenever possible, avoid plating terminal abutments on distal extension RPDs. Question #4 In the maxillary class III RPD shown either a palatal strap or an anterior-posterior palatal strap major connector may be used. If an anterior-posterior strap design is to be considered, the opening between the anterior and posterior palatal straps should be at least _______ mm. 5 10 15 20 Answer to Question #4 The best answer is Although the exact space required is somewhat arbitrary, we generally feel that the opening should be at least 15 mm. If the opening is less than 15 mm, the benefit gained from uncovering the tissues may be offset by the increased "sensitivity" of the tongue to the multiple major connector borders. Question #5 True or False Because there are no movable tissues on the palate, the borders of maxillary major connectors may be located farther from the gingival margins than those of mandibular major connectors. True False Answer to Question #5 The correct answer is True Major connectors on the maxillary arch should be at least 6 mm from the gingival margin. On the mandibular arch, the proximity of movable tissues will not permit this amount of distance. In general, mandibular major connectors should be at least 3 mm from the gingival margin. Question #6 On the mandibular class III framework shown, circumferential clasps have been used on the canine, premolar, and molars. Which one of the following statements regarding the clasping is TRUE? The retentive arms on the canine and premolar should be wrought wire while those on the molars should be cast. The lingual arms on the molars are frequently the retentive arms because there are often no usable facial undercuts. If the undercut on the second premolar is on the distofacial, the circumferential retentive arm would most likely be changed to I-bars. In order to ensure adequate retention, the tips of both the buccal and lingual arms on the molars should be placed in undercuts. Answer to Question #6 The correct answer is Incorrect. All of the clasps should be cast. Since there is no functional movement of a class III RPD, there is no need for the stress-breaking effects of wrought wire clasps. Correct. Lower molars, particularly second or third molars, frequently have no facial undercuts. In addition, the normal drift of the teeth is to the lingual, accentuating lingual undercuts and minimizing facial undercuts. Incorrect. Modified T-bars would be the retainers of choice if the undercuts were on the distofacial. I-bars could be used but the tiny space between the I-bars and the denture base would create food traps and would make the plastic very difficult to finish properly. In addition, the Ibars would tend to be very short and inflexible. Incorrect. Only one arm of each clasp assembly should extend into an undercut (be retentive). The other arm must be rigid to provide bracing or reciprocation and thus cannot extend into an undercut and provide retention. Question #7 True or False On the RPD framework shown, the rests on teeth numbers 20 and 28 are indirect retainers and function when the patient bites down on the distal extension area. True False Answer to Question #7 The correct answer is FALSE Although the rests on teeth numbers 21 and 28 are indirect retainers, they function when the extension base attempts to move away from the tissues (residual ridge)---not toward the residual ridge as would occur when the patient bites down. These rests are called indirect retainers because they increase the effectiveness of the direct retainers (clasps) when there is an attempt to dislodge the prosthesis. Question #8 True or False Guide surface preparations should be completed before rest seat preparations. True False Answer to Question #8 The correct answer is TRUE The tooth structure removed during guide surface preparation will adversely affect the shape and contour of the rest seat preparation. Thus, the guide surfaces should be created BEFORE rest seats are prepared. Question #9 True or False In the class II mandibular RPD shown to the right, the clasp on tooth #27 should be wrought wire BECAUSE the cingulum rest acts like a distal rest and the tip of the retentive arm is in front of the axis of rotation. True False Answer to Question #9 The correct answer is TRUE Both the statement and the reason are true. The rigid metal located above the survey line (height of contour) and closest to the edentulous space is that portion of the rest where it joins the guide plate/minor connector. The tip of the clasp lies in front of the axis of rotation and the clasp will be activated when the extension base moves toward the residual ridge. Thus, the clasp must be flexible to provide stress relief for the abutment. Question #10 True or False When tripoding a cast, the vertical arm of the surveyor must be locked in position. True False Answer to Question #10 The correct answer is TRUE The purpose of tripoding is to allow re-orientation of the cast in the same position at a later date. Tripoding is based on the geometric principle that three points determine a plane. If the vertical arm of the surveyor moves during the tripoding process, the plane indicated by the marks would not be the same as that currently being used. Question #11 Referring to the maxillary class II RPD design shown to the right, which of the following statements is TRUE? A short thick I-bar clasp could be used on tooth #6. A wrought wire circumferential clasp could be used on tooth #6. It is sometimes not necessary to use any clasp on tooth #6. 2 and 3 are both true Answer to Question #11 The best answer is Incorrect. Cast clasps should not be used anterior to the axis of rotation. Incorrect. #2 is a true statement but not the BEST answer. The most commonly used solution would be to use a WW clasp. The WW clasp would provide stress-relief through its increased flexibility: an important attribute in this case since the abutment tooth is in front of the axis of rotation. Incorrect. #3 is a true statement but not the BEST answer. If the patient is an experienced RPD wearer and retention is of minor importance, one might consider leaving the retentive arm off tooth #6. This would be more likely if esthetics were a major consideration. A good option might be to include the WW clasp initially and check the need for the clasp after delivery. This would be done by merely bending the clasp slightly away from the tooth and having the patient wear the prosthesis for a few days. If the patient managed the RPD without retention from the clasp, it could be cut off. Correct. #4 is the BEST answer. Both 2 and 3 are true statements. Question #12 The following statement refers to the drawing of the class I RPD to the right: The clasp arm on tooth #20 should be wrought wire BECAUSE functional forces cause tissueward movement of the denture base, the denture rotates around the rest (which is on the distal), and the clasp arm engages the tooth, tending to tilt it distally. The statement and the reason are true AND related. The statement and the reason are true but are NOT related. The statement is true but the reason is false. Neither the statement nor the reason is true. Answer to Question #12 The answer is The statements are both true and are related. The tip of the clasp arm would lie in front of the axis of rotation and the clasp would engage the tooth during functional movement of the extension base. Thus, the clasp needs to be flexible to provide stress relief to the abutment. Question #13 In the maxillary class I RPD shown at the right, the posterior border of the palatal plate major connector should be located as far forward as is possible while maintaining enough width for strength approximately 20 mm behind the anterior border approximately 10 mm anterior to the fovea palatini at the posterior palatal seal area Answer to Question #13 The answer is Incorrect. The palatal plate major connector is selected because it provides maximum support and denture style retention. Moving the posterior border forward negates both of these attributes. Incorrect. There is no such relationship between the anterior and posterior borders of a maxillary palatal plate major connector. Incorrect. One of the primary reasons a full palate is used is to create "denture style retention." Termination of the major connector 10 mm anterior to the fovea palatini would place the bead on the hard palate and a "seal" would be very difficult to achieve. Correct. The border should be placed in the posterior palatal seal area and should be beaded. One of the primary reasons a full palate is used is to create "denture style retention." To do so, a "seal" must be created at the posterior border by slightly depressing the soft tissues. Question #14 True or False All components of a maxillary major connector should cross the palate at right angles to the midline and curves in the major connector should be located to one side of the midline. True False Answer to Question #14 The answer is TRUE Crossing the midline at right angles seems to create a situation which is less noticeable to the tongue. Question #15 In the case shown to the right, which is the most effective indirect retainer? The rest on tooth #19. The rest on tooth #21. The rest on tooth #27. The rest on tooth #28. Answer to Question #15 The correct answer is The rests on #19 and #28 are not indirect retainers. Rests on #21 and #27 are indirect retainers. The rest on #21 is further from a line connecting the tips of the retentive arms on theeth numbers 19 and 28 and is thus more effective than the rest on tooth #27. In reality, the rest on #27 could be omitted without appreciable loss of indirect retention. Question #16 What is the most significant problem with the rest shown on the mandibular canine to the right? The rest should be wider inciso-gingivally. The rest should be located more toward the incisal edge. The rest should be thicker buccolingually. The rest should be located in a prepared rest seat. Answer to Question #16 The correct answer is Rests must be placed in prepared rest seats. This is particularly important on anterior teeth where, without prepared rest seats, rests lie on inclined planes. Downward pressure on the rest will tend to push the abutment buccally. Note: the rest could be a little wider incisogingivally and it could also be a little thicker. However, these problems pale in comparison to the fact that there is no rest preparation. Question #17 True or False In the RPD shown to the right, the guide surface - guide plate contacts on the distal surfaces of teeth numbers 20 and 29 determine a definite path of displacement/dislodgement. True False Answer to Question #17 The answer is FALSE. The guide surface - guide plate contacts DO NOT determine a definite path of insertion in this case. If the minor connectors to the rests on the mesial occlusal surfaces of the premolars are in intimate contact with the abutments, they may help to ensure a definite path of insertion/dislodgement. However, it is safest to place the tips of the I-bar retentive arms just in front of the greatest mesiodistal curvature of the facial surface of the abutments. If the tips are placed at or behind the greatest mesiodistal curvature, it would be possible for the RPD to move slightly upward and backward allowing the retentive arms to escape the undercuts without flexing. Under these circumstances, the RPD would not exhibit retention. Question #18 True or False The all plastic maxillary RPD should be avoided in all partial dentures except where the prosthesis is considered transitional and loss of the remaining teeth is imminent. True False Answer to Question #18 The answer is TRUE All plastic RPDs lack rigidity and tend to encourage plaque collection. Also, most lack adequate rests. They should only be used on a temporary basis or when the dentition is "terminal." Question #19 True or False Tooth-supported RPDs require physiologic relief of the guide plates. True False Answer to Question #19 The answer is FALSE Because tooth-supported RPDs do not exhibit movement toward the tissues during function, physiologic relief is not necessary. Extension RPDs, on the other hand, do exhibit functional movement and do require physiologic relief. This is accomplished as follows: first coat the guide plates with chloroform and rouge or another disclosing medium, seat the framework in the mouth, and push toward the tissues over the extension areas; then relieve the guide plate with a fine textured stone. Repeat as necessary. It is very important that the guide plates do not bind against the abutments during functional movement --- otherwise they will pre-empt the planned mesial rests. Question #20 The superior border of a mandibular lingual bar major connector must be at least _____ mm below the gingival margins. 1-2 2-3 3-4 4-5 Answer to Question #20 The correct answer is 3-4 mm is a minimum. Numerous studies have shown that placing the superior border of the major connector less than 3 mm away from the gingival margin leads to increased plaque collection and subsequent increased marginal inflammation. Question #21 For maxillary major connectors, except where plating is used, the border of the major connector should be at least ______ mm away from the gingival margin. 1 3 5 6 Question #22 For the anterior-posterior palatal strap maxillary major connector, the anterior, posterior, and lateral straps should be about ______ mm wide. 4-6 6-8 8-10 at least 10 Question #23 The basic philosophy of dental treatment for a partially edentulous patient is to preserve what remains and restore what is missing replace the missing teeth improve the path of insertion reshape rotated teeth Question #24 It is best not to use a balanced occlusion when mandibular RPDs oppose maxillary complete dentures. True False Question #25 The function of the guide plate is to help establish a definitive path of insertion/dislodgement. stabilize the RPD by controlling its horizontal position. provide contact with the adjacent tooth. all of the above Question #26 What is the design error in the maxillary RPD framework shown to the right? The anterior teeth should have been plated. An anterior-posterior palatal strap major connector should have been used. There should be a cast circumferential clasp on tooth #6. The posterior border of the major connector should cross the palate at right angles to the midline. Question #27 What would be the best denture base connector when there is limited interocclusal space (<3 mm). Open latticework Meshwork All metal base All plastic base Question #28 The first consideration in developing occlusion is the evaluation and establishment of the correct position of the occlusal plane. This may be compromised by super-erupted and malposed teeth. True False Question #29 Your patient's partially edentulous arch is depicted in the illustration to the right. The missing teeth (with the exception of the third molars) were extracted three weeks ago. What would be the best denture base/replacement teeth combination in this instance? Open latticework Metal bases with beads for attachment of processed tooth colored acrylic resin. An all metal base Tube teeth Question #30 A wrought wire clasp is NOT used in which of the following situations? On a terminal abutment of an extension RPD. As an embrasure clasp. On a tooth with an indirect retainer on it. Both 1 and 2 above. Questions 31-40 Question #31 True or False In designing a RPD framework for the partially edentulous arch to the right---if at all possible, circumferential clasps should be used on the numbers 28 and 30. They would be preferred to infrabulge retainers. True False Question 32 True or False Determining areas for physiologic relief is accomplished by marking the framework intraorally. This process includes adjusting the casting to allow for functional movement on Class I and II RPDs to relieve stress on the terminal abutment teeth. True False Question 33 Reciprocation between bracing and retentive components requires I-bars be used bracing components contact after retentive components correct timing of contact during seating and removal of the RPD both 2 and 3 Question 34 Infrabulge clasps originate above the height of contour below the height of contour above the 0.01" undercut above the occlusal surface of most premolars Question 35 True or False A modified palatal plate is used in maxillary class II cases and may or may not include lingual plating True False Question 36 All of the following clasps are infrabulge clasps except? I-bar Modified T-bar Roach clasp Akers clasp Question 37 A clasp assembly should have a retentive arm with adequate length and taper for flexibility have a retentive arm that terminates in an undercut have elements that considered together, provide 180 degree encirclement all of the above Question 38 The partial denture that will be completed on the framework shown to the right can do all of the following except transfer stresses to the abutment teeth transfer stresses across the arch minimize supereruption of opposing teeth act as an orthodontic retainer for the lower incisor teeth. Question 39 True or False Maxillary class II RPDs do not have an axis of rotation because no functional movement will occur over the hard midline suture of the palate. True False Question 40 In a Class III modification 1 RPD, the rests are usually placed on the canines away from the modification space in the area of the opposing occlusal contact adjacent to the modification space. Questions 41-50 Question #41 A mandibular lingual bar major connector such as the one shown in the RPD to the right requires a minimum of _____mm of vertical height between the gingival margin and the floor of the mouth. 4 5 7 8 Question 42 The presence of mandibular lingual tori would indicate the need for a metal base lingual plating tube teeth extra indirect retainers Question 43 The illustration to the right shows a framework for a mandibular class II RPD. The indirect retainer on tooth 21 functions when the patient chews on something hard the patient chews on something soft the patient chews on something sticky the patient bites the bullet Question 44 True or False An anterior-posterior palatal strap maxillary major connector has greater strength and rigidity than a horseshoe design. True False Question 45 Your patient has the mandibular arch form shown to the right. A rest on which tooth would be the most effective indirect retainer? 20 21 22 27 Question 46 Your patient exhibits the mandibular class II modification 1 arch shown to the right. Tooth #30 is tilted mesiolinguallly and has very little tissue undercut on the lingual. What is the best clasp for this situation? Cast circumferential clasp utilizing a distolingual undercut Cast I-bar utilizing a mesiolingual undercut Cast ring clasp utilizing a mesiolingual undercut Wrought wire circumferential clasp utilizing a distolingual undercut. Question 47 Rigid metal retention is associated with a dual path of insertion a class IV RPD the need for excellent esthetics all of the above Question 48 True or False The palatal strap maxillary major connector is primarily used in short span maxillary class III modification 1 RPDs. True False Question 49 Your patient has the class I arch shown to the right. The axis of rotation is most frequently determined by: the placement (location) of the primary rests the type of clasp arms selected the placement of the minor connectors the placement of the indirect retainers Question 50 In maxillary RPDs, the bead line is approximately _______mm thick (deep). 4 3 2 1 Questions 51-60 Question #51 The C + 1 rule Does not apply to class IV RPDs Does not apply to class III RPDs Gives a general rule for the number of clasps Both 1 and 3 Question #52 Which of the following maxillary major connectors possesses the least strength and rigidity? Anterior-posterior palatal strap Horse-shoe Palatal plate Modified palatal plate Question #53 True or False A cingulum rest is normallly placed between the middle and incisal thirds of the maxillary incisors in order to avoid occlusal interferences. True False Question #54 Your patient exhibits the mandibular class II modification 1 arch shown to the right. Tooth #30 is tilted mesiolingually, but has a very severe tissue undercut on the lingual. What is the best clasp for this situation? Cast circumferential clasp utilizing a distolingual undercut. Cast I-bar utilizing a mesiolingual undercut. Cast ring clasp utilizing a mesiolingual undercut. Wrought wire circumferential clasp utilizing a distolingual undercut. Question #55 True or False All methods of measuring the vertical dimension of occlusion agree on one major principle: In physiologic functions (speaking and swallowing) the teeth should make contact. True False Question #56 True or False Malposed or super-erupted teeth may cause a discrepancy between centric relation and centric occlusion. Therefore, it is recommended that the opposing teeth not touch during the making of a centric relation record for mounting of diagnostic casts. True False Question #57 True or False The purpose of the centric relation record is to record the exact position of the maxilla to the mandible in a protrusive relation. True False Question #58 True or False If abutment teeth require crowns, the RPD design is prepared after the crowns are cemented. True False Question #59 True or False Alginate impression materials have excellent dimensional stability over time and seldom lead to over extended vestibular extensions. True False Question #60 True or False Master casts for patients with lone-standing abutments should be poured in "Silky Rock" stone. True False Questions 61-70 Question #61 True or False The altered cast impression technique is often used on Class I and Class III RPDs. True False Question #62 Your patient exhibits the partially edentulous mandibular arch shown to the right. The maxillary arch is to be restored with a complete denture. Teeth 20 and 29 will receive crowns. There are no contraindications to any type of clasping. Which of the following clasp assemblies would you use on 20 and 29. Mesial rests and I-bars Mesial rests and modified T-bars Distal rests and WW circumferential clasps Distal rests and cast circumferential clasps. Question #63 Your patient exhibits the partially edentulous mandibular arch shown to the right. The maxillary arch is to be restored with a complete denture. Teeth 20 and 29 will receive crowns. There are very high labial frenal attachments on both sides. Which of the following clasp assemblies would you use on 20 and 29? Mesial rests and I-bars Mesial rests and modified T-bars Distal rests and WW circumferential clasps Distal rests and cast circumferential clasps. Question #64 Your patient exhibits the partially edentulous mandibular arch shown to the right. The maxillary arch is to be restored with a complete denture. The undercuts on 20 and 29 are on the distal portion of the facial surface. There are no contraindications to either infrabulge or suprabulge retainers. Which of the following clasp assemblies would you use on 20 and 29? Mesial rests and I-bars Mesial rests and modified T-bars Distal rests and WW circumferential clasps Distal rests and cast circumferential clasps Question #65 True or False Reciprocation of clasps is related to the timing of contact between the bracing and retentive clasp arms in order to prevent undue forces on the abutment teeth during seating and removal of the RPD. True False Question #66 Your patient has the partially edentulous arch shown to the right. The undercuts on 21 and 28 are on the mesiofacial surfaces. The most commonly used clasp assemblies on the premolars would be: Distal rests and I-bars Distal rests and modified T-bars Distal rests and cast circumferential clasps Distal rests and WW circumferential clasps Question #67 Your patient has the partially edentulous arch shown to the right. The undercuts on 21 and 28 are on the distofacial surfaces. There are no contraindications to any types of clasps. Under these circumstances, the most commonly used clasp assemblies on the premolars would be: Distal rests and I-bars Distal rests and modified T-bars Distal rests and cast circumferential clasps Distal rests and WW circumferential clasps Question #68 Your patient has the partially edentulous arch shown to the right. The undercuts on 21 and 28 are on the mesiofacial surfaces and there are no contraindications to suprabulge or infrabulge retainers. The long range prognosis for the molars is poor but your patient does not want them extracted at this time. Several alterations in the usual design could be made to facilitate later conversion of the prosthesis to a class I RPD. One of them involves the clasp assemblies on the premolars. Your recommendation? Distal rests and I-bars Distal rests and modified T-bars Distal rests and cast circumferential clasps Distal rests and WW circumferential clasps Question #69 True or False Your patient has the partially edentulous arch form shown to the right. The molars have drifted mesially and lingually. With these factors in mind, rigid metal retention could be considered for use on the molars. True False Question #70 Which one of the following classes of RPDs NEVER has an axis of rotation? Class I Class II Class III Class IV Questions 71-80 Question #71 What is the major problem with the RPD framework shown to the right? Teeth numbers 21 and 28 should be plated. The plating on the lingual surfaces of the anterior teeth should cover the cinguli. Distal rests would be better than mesial rests on teeth numbers 21 and 28. Cast circumferential clasps are preferred with the mesial rests on teeth numbers 20 and 29. Question #72 Which of the following could be reason(s) for choosing the double lingual bar major connector shown to the right? Large interproximal spaces have resulted from periodontal surgery. The patient exhibits a high floor of the mouth. There is overlapping of the anterior teeth. Both a and b above. Question #73 True or False When possible, plating on maxillary RPDs should be avoided due to the potential for interfering with speech and occlusion. True False Question #74 The survey line (height of contour) of a full contour wax-up for a crown for an RPD abutment tooth can be visualized using red wax zinc stearate powder border wax pressure indicating paste Question #75 Your patient has only teeth numbers 20 through 29 remaining. You have tried in the framework and are border molding the extension areas in preparation for an altered cast impression. The distobuccal area is shaped by the? Buccinator muscle Masseter muscle Internal pterygoid muscle Mylohyoid muscle Question #76 Your patient has teeth numbers 20 through 29 remaining. The survey line and undercut (shaded area) for tooth #29 are as shown on the right. There is no contraindication to the use of an infrabulge clasps but there is a very solid contact in the mesialocclsual fossa. What would be your choice for rest location and retentive arm? Distal rest and cast circumferential clasp Distal rest and cast I-bar Mesial rest and cast I-bar Distal rest and WW circumferential clasp Question #77 Your patient has teeth numbers 20 through 29 remaining. The survey line and undercut (shaded area) for tooth #29 are as shown on the right. There is no contraindication to the use of an infrabulge clasps and there are no occlusal problems affecting rest location. What would be the best choice for rest location and retentive arm? Mesial rest and I-bar Mesial rest and modified T-bar Mesial rest and WW circumferential clasp Distal rest and WW circumferential clasp Question #78 Your patient has teeth numbers 20 through 29 remaining. The survey line and undercut (shaded area) for tooth #29 are as shown on the right. There is no contraindication to the use of an infrabulge clasps. The opposing occlusion is provided by a complete denture. What would be your choice for rest location and retentive arm? Mesial rest and I-bar Mesial rest and modified T-bar Mesial rest and cast circumferential clasp Distal rest and WW circumferential clasp Question #79 Your patient has only teeth numbers 20 through 29 remaining. You have tried in the framework and are border molding the extension areas in preparation for an altered cast impression. The distolingual border molding is shaped by the? Masseter muscle Internal pterygoid muscle Superior constrictor muscle Mylohyoid muscle Question #80 True or False As a general rule, plating is indicated for the maxillary arch if there are less than three contiguous maxillary incisor teeth remaining. True False Questions 81-90 Question #81 All of the components listed below may be involved in the 180 degree encirclement rule EXCEPT I-bar Minor connector Guide plate Open latticework Question #82 What is the correct relationship of the foot of an I-bar to the survey line (height of contour) on a terminal abutment for an extension RPD? The foot should be entirely above the survey line. The foot should be partially above and partially below the survey line. The foot should be totally below the survey line. The relationship of the foot of the I-bar and the survey line is of no consequence. Question #83 True or False The primary indication for and Oddo clasp occurs when an anterior abutment has excessive labial inclination so that the retainer (clasp) would be very close to the incisal edge. True False Question #84 True or False The purpose of the altered cast impression procedure is to obtain the maximum support possible from the edentulous areas of class I and class II RPDs. True False Question #85 True or False When there are extensive edentulous areas present in both arches and no opposing teeth meet, we should establish the vertical dimension of occlusion prior to making a centric relation record. True False Question #86 True or False You are fabricating maxillary and mandibular RPDs for your patient. At the framework try-in appointment, both frameworks should initially be placed in the mouth to check for occlusal interferences. True False Question #87 True or False A protrusive record is made with the mandibular anterior teeth approximately 6 mm forward of centric relation (or with the mandibular and maxillary anterior teeth in an edge to edge relationship). This record is used to set the horizontal condylar guidance on the articulator. True False Question #88 True or False The space that opens between the posterior teeth during anterior movement of the mandible is called Christensen's Phenomenon. This posterior separation is increased if the incisal guidance is increased. True False Question #89 True or False Before trying in a framework, you should inspect the master cast for damage and inspect the framework for sharp fins. True False Question #90 True or False Your RPD framework fits the cast but does not fit in the mouth. One should assume that the impression for the cast was inaccurate and that a new impression will need to be made. True False Questions 91-100 Question #91 True or False The fewer teeth that remain, the more like a denture the RPD becomes and the more likely the need for a custom impression tray. True False Question #92 Reason(s) for selecting a mandibular lingual plate major connector is/are? The presence of lingual tori. Anticipated loss of one or more of the remaining teeth. A high lingual frenum. 1, 2, and 3 above Question #93 Your patient has teeth 20 through 29 remaining. Tooth #29 exhibits the tooth contours and undercut shown in the illustration to the right. Which of the clasp assemblies listed has the GREATEST DANGER of torquing the abutment during functional movements of the extension base? Mesial rest and cast I-bar Distal rest and WW circumferential clasp RPA clasp assembly with a cast clasp All have about the same potential danger Question #94 Which of the following clasps commonly utilize lingual undercuts? Ring clasp Extended arm clasp Half and half clasp Both 1 and 3 Question #95 Which of the abutments in the partially edentulous arch to the right has the greatest potential for utilization of a ring clasp? #18 #21 #28 None of the abutments have any potential for the use of a ring clasp. Question #96 True or False Metal denture bases are most commonly used over well-healed posterior ridges where vertical space is a problem. True False Question #97 True or False Referring to the partially edentulous arch shown to the right. The guide plates on teeth 21 and 28 should curve buccolingually and extend lingually just short of the distolingual line angles. True False Question #98 A cingulum rest should be placed between the occlusal and middle thirds of the incisor teeth. above the middle third of the incisor teeth. at the junction of the gingival and middle thirds of the incisor teeth. on the disto-incisal edges of the incisor teeth. Question #99 The external finish line is the external junction of framework metal and denture base plastic. the external junction of framework metal and supporting tissues. the external junction of the framework metal and the natural teeth. the external junction of the natural teeth and the denture base plastic. Question #100 True or False As a general rule, a removable partial denture needs C+1 clasps where C=Kennedy classification number. True False Questions 101-110 Question #101 A "bead" line" is used only on mandibular major connectors is a seal at the interface of framework metal and tissues should taper off as it approaches the marginal gingiva of the abutment teeth both 2 and 3 above Question 102 Your patient has the partially edentulous arch shown in the illustration on the left. Tooth #28 has the survey line and undercut shown in the illustration on the right. There are no contraindications to any type of clasp or to any rest location. What would be your first choice for the clasp assembly on tooth #28? distal rest and cast circumferential clasp distal rest and WW circumferential clasp distal rest and I-bar clasp distal rest and modified T-bar clasp Question 103 Your patient has the partially edentulous arch shown in the left illustration. Tooth #28 has the survey line and undercut shown in the illustration on the right. There are no contraindications to any type of clasp or to any rest location. What would be the most common choice for the clasp assembly on tooth #28? distal rest and cast circumferential clasp distal rest and WW circumferential clasp distal rest and I-bar clasp distal rest and modified T-bar clasp Question 104 The superior border of a mandibular lingual bar major connector should be at least 3 mm from the tooth/tissue junction at least 2 mm from the tooth/tissue junction located at the tooth/tissue junction at least 3 mm above the tooth/tissue junction Question 105 The internal finish line is the butt joint between the metal and plastic on the tissue side of the edentulous area the butt joint between the metal and plastic on the outer surface of the RPD a type of posterior palatal seal a special type of bead line Question 106 A class I modification 0 RPD normally has how many clasps? 1 2 3 4 Question 107 Select a maxillary major connector for the large Class III modification 1 RPD shown to the right. The residual ridges are good and the abutment teeth are strong. Palatal strap Modified palatal plate Horse-shoe Anterior-posterior palatal strap Question 108 True or False When an RPD is fully seated, the tips of the clasp arms should exert very light pressure against the abutment teeth. True False Question 109 Your patient's partially edentulous arch form is shown in the left illustration. The clasp assembly for tooth #20 is illustrated on the right. When is the retentive arm activated? When the patient bites down on the extension base. When there is an attempt to dislodge the RPD. When the extension base moves toward the tissues. It should never be activated. Question 110 True or False Guide plates for tooth-supported RPDs may extend above the height of contour while those on extension RPDs should not. True False Questions 111-120 Question 111 Select a maxillary major connector for the large Class III modification 1 RPD shown to the right. The residual ridges are of medium quality but the third molar abutment teeth are weak. A wide single palatal strap An anterior-posterior palatal strap A modified palatal plate A horse-shoe Question 112 Select a maxillary major connector for the Class III modification 1 RPD shown to the right. The residual ridges are of good quality and the first premolar and second molar abutment teeth are strong. Anterior-posterior palatal strap Horse-shoe Modified palatal plate Palatal strap Question 113 Select a maxillary major connector for the Class III modification 1 arch shown to the right. The residual ridges are of good quality and the first premolar and third molar abutment teeth are strong. The patient relates a long history of gagging problems and, in fact, had major problems with the impressions for the study casts. Anterior-posterior palatal strap Horse-shoe Modified palatal palte Palatal strap Question 114 Your patient has the partially edentulous arch shown in the left illustration. Tooth #28 has the survey line and undercut shown in the right drawing. An infrabulge clasp CAN NOT be used due to a very high frenal attachment immediately below the abutment. What would be your first choice for the clasp on tooth #28? A cast circumferential clasp A wrought wire circumferential clasp A cast circumferential embrasure clasp A wrought wire circumferential embrasure clasp Question 115 If a mandibular RPD abutment must be crowned, the FPD impression should include all the abutment teeth for the RPD a full arch impression the retromolar pads all of the above Question 116 A tissue undercut may preclude the selection of A suprabulge clasp An infrabulge clasp A half and half clasp A combination clasp Question 117 A combination clasp assembly generally has a cast bracing arm a distal rest a wrought wire retentive arm all of the above Question 118 Your patient's partially edentulous mandibular arch form is shown to the right. Which of the abutment teeth would be likely to have a combination clasp? Not likely on any of the abutments #20 very likely; #29 less likely #29 very likely; #20 less likely #31 very likely; not likely on either #20 or #29 Question 119 A modified T-bar on a terminal abutment for a Class I partially edentulous arch (such as the one shown) is used with a distal rest is placed into a distobuccal undercut should have the vertical approach arm distal to the greatest mesio-distal curvature of the facial surface both 1 and 2 Question 120 Which of the following should be considered in diagnosis for an RPD patient? interarch space tissue undercuts occlusal contacts all of the above Questions 121-130 Question #121 True or False For a removable partial denture abutment that must be crowned, more than the normal occlusal reduction will be required. True False Question 122 A lingual plate mandibular major connector may be selected because the mandibular incisors are tilted lingually there are mandibular tori present there is a high lingual frenum all of the above Question 123 A master cast for a RPD should be blocked out and duplicated before overlapped incisors are recontoured rest preparations are prepared the framework is waxed up all of the above Question 124 Rest placement on a terminal abutment of a Class I RPD depends on the opposing occlusion the tilt of the abutment tissue undercuts all of the above Question 125 What is the problem (if any) with the design of the I-bar on tooth #28? The I-bar should be placed in front of the greatest mesio-distal curvature, not behind it. The I-bar should be placed more distally, closer to the guide plate. The I-bar should extend above the survey line. There is no problem; the position of the I-bar is correct. Question 126 Your patient has the arch form shown to the right. You plan to use mesial rests and I-bars but will need to plate the premolars due to the tori. What should be the relationship of the superior border of the plating and the height of contour on the lingual surfaces of teeth numbers 20 and 29? The plating must end below the height of contour. The plating must end at the height of contour. The plating must end above the height of contour. None of the above is correct. Question 127 A general rule for clasping teeth which lie anterior to the axis of rotation (e.g. tooth #21 in the illustration to the right) in a Class II modification 1 RPD is: Always use cast clasps Never use suprabulge clasps Use wrought wire clasps Use 0.030 inch undercut for stability Question 128 A general rule for rest placement on an abutment adjacent to an extension area is? Place the rest on the occlusal surface on the opposite side of the tooth from the extension area. Place the rest on the occlusal surface adjacent to the extension area. Place rests on both the mesial and distal occlusal surfaces. Do not place a rest on this tooth. Question 129 Low fusing metal is associated with which of the following procedures? The altered cast impression. Physiological adjustment of the framework. The RPD remount cast. Making records for RPDs. Question 130 Physiologic adjustment of the framework is usually done at delivery of the RPD. should be done at the framework try-in appointment. is usually done at the records appointment. may be omitted in the presence of strong abutments and good residual ridges. Questions 131-140 Question #131 True or False An exception to the C+1 rule for number of clasps is the Class II modification 0 case. True False Question 132 Physiologic adjustment is related to the axis of rotation adjustment of the framework to the teeth functional movement of the framework all of the above Question 133 True or False If physiologic adjustment of the framework is not done on a Class I modification 1 RPD, the clasps may not release in function. True False Question 134 True or False The bracing arm of a circumferential clasp assembly must always lie at or above the height of contour. True False Question 135 Your patient has the partially edentulous arch shown to the right. What would be the best clasps for tooth number 20 and 29 if they were tilted mesially? Mesial rests and cast I-bars Mesial rests and WW I-bars Distal rests and WW I-bars Distal rests and combination clasps Question 136 Your patient has the partially edentulous arch shown to the right. The premolars are tilted lingually and there are no facial undercuts. There are, however, undercuts on the lingual. What would be the best clasps for this situation? Lingual I-bars Roach clasps Akers clasps Half and Half clasps Question 137 The external finish line on a maxillary Class I RPD originates from the lingual of the guide plate of the terminal abutment and ends at the hamular notch. in the glenoid fossa. opposite the buccal pouch. opposite Stenson's duct. Question 138 The open latticework on a maxillary class I RPD covers the hamular notch. covers the tuberosity. does not cover the tuberosity. does not require substantial interach space. Question 139 The partial denture design should be finalized prior to any emergency treatment. any fixed prosthodontic treatment. preparation of rest seats. both 2 and 3 above. Question 140 Your patient has the partially edentulous arch shown to the right. The root of #29 has been saved as an overdenture abutment. True or False The presence of the overdenture abutment may change the axis of rotation but will not change the clasping considerations on tooth #28. True False Questions 141-150 Question #141 When placing the tripod marks on the diagnostic cast, the vertical arm of the surveyor should have the analyzing rod in place. should be moved up or down to touch the tissues at widely separated areas. Both 1 and 2 are true Neither 1 nor 2 are true Question 142 The internal and external finish lines are normally superimposed over each other. normally offset from each other to avoid weakness in the framework. normally designed and placed independently. none of the above statements are true. Question 143 In general, lingual plating should be supported by the inclined surfaces of the mandibular incisors. with minor connectors. with bracing arms. with rests. Question 144 A maxillary arch without three contiguous incisors (such as the one shown) usually requires plating of the remaining incisor should not be plated should have a horse-shoe major connector both 1 and 3 above. Question 145 The external finish line on the distal extension side of the mandibular Class II modification 1 RPD for the partially edentulous arch shown to the right runs from the lingual frenum to the retromolar pad. runs from the lingual of the guide plate to the floor of the mouth. runs from the mesial of the guide plate to the retromolar pad. cannot be determined without more information. Question 146 True or False Wrought wire retentive arms are usually selected for distal extension RPDs when the tips of the arms lie behind the axis of rotation. True False Question 147 Occlusal rest preparations should be spoon shaped at least 1/3 the buccolingual width of the occlusal surface at least one millimeter deep all of the above Question 148 Guide plates for anterior teeth should be kept to the labial for best esthetics. should be kept to the lingual for best esthetics. be thinned on the labial aspect. both 2 and 3 above. Question 149 An anterior-posterior palatal strap major connector is less rigid than a horse-shoe major connnector because it (the A-P strap) has less width. The first statement is true but the reason is false. The first statement is false and the reason is also a false statement. The first statement is true and the reason is true. The first statement is false but the reason is a true statement. Question 150 Your patient has the partially edentulous arch form shown. All of the abutments have good bone support. On which one of the abutments would you likely utilize a WW clasp? #22 #29 #32 None of the above. Questions 151-160 Question #151 Which of the following clasp assemblies utilize a primary rest and an auxiliary rest? RPA clasp Ring clasp Infrabulge clasp Extended arm clasp Question 152 True or False In a circumferential clasp assembly, only one of the arms may extend into an undercut. True False Question 153 Which of the following steps is done LAST? Rest preparation Framework try-in Centric relation records Altered cast impression Question 154 Incisal rests are generally more positive vertical stops than cingulum rests. may interfere with the opposing occlusion. should not be used on maxillary incisors. all of the above. Question 155 True or False Cast retentive arms are usually selected when the RPD is tooth supported or when the retentive tips release during functional movements of extension RPDs. True False Question 156 Cleaning a removable partial denture in sodium hypochlorite may result in increased caries activity increased periodontal problems corrosion of the metal of the framework 1 and 2 above Question 157 Which of the following clasp assemblies utilizes a lingual undercut and can be used on premolars for either extension or tooth-supported RPDs? half and half clasp lingual I-bar lingual modified T-bar ring clasp Question 158 If a metal base is to be used an altered cast impression should be made after framework try-in a stock tray should be used for the final impression a custom tray should be used for the final impression interocclusal records must be made after tooth selection Question 159 True or False When surveying to determine the height of contour of the abutments, the mark on the tooth must be made by the side of the lead marker. True False Question 160 Clasps help stabilize the RPD by controlling occlusal movement. help stabilize the RPD by controlling gingival movement. may also function as indirect retainers. prevent excessive biting forces on the abutments. Questions 161-170 Question #161 Your patient exhibits the partially edentulous arch shown to the right. Tooth #29 is tilted mesially. The undercut is on the mesiofacial surface. What would be the best clasp assembly for this situation? Distal rest and cast circumferential clasp. Distal rest and WW circumferential clasp. Mesial rest and I-bar. Distal rest and I-bar. Question 162 During biting, a maxillary Class I RPD will rotate around a line determined by the rigid metal above the survey line and closest to the extension areas. This line is called Camper's line Frankfurt line Dual path line Axis of rotation Question 163 The WORST clasp assembly for a terminal abutment on a mandibular class I RPD (such as #29 in the partially edentulous arch to the right) is Mesial rest and I-bar Distal rest and cast circumferential clasp Mesial and distal rest and a 1/2 and 1/2 clasp Mesial rest and modified T-bar Question 164 The guide surface preparation should be curved mesio-distally bucco-lingually occluso-gingivally none of the above Question 165 Fill in the blank What are the indications for a linguoplate as a major connector for a mandibular RPD? Click on button 1 for the answer Question 166 Fill in the blank. Name four types of suprabulge clasps. Click on button 1 to see the answer. Question 167 Fill in the blank. Your patient has teeth numbers 20 through 29 remaining. The illustration to the right shows the design for a modified T-bar retainer on tooth #29. The vertical line on the tooth represents the greatest mesiodistal curvature of the facial surface. Do you see any problems with the design? Click button 1 to see the answer. Question 168 Fill in the blank In the illustration shown to the right, what would be your first choice for a retainer (clasp) on tooth #6? Click on button 1 to see the answer. Question 169 Fill in the blank Your patient has the partially edentulous arch shown to the right. The molars have drifted mesially and lingually so that the only usable undercuts are on the mesiolingual. What clasps would you use on the molars if (1) there were no large tissue undercuts and (2) there were large tissue undercuts? Click on button 1 to see the answer. Question 170 Fill in the blank Which classes of mandibular RPDs require an altered cast impression? Click on button 1 to see the answer. Questions 171-180 Question #171 Fill in the blank Important factors in determining the path of insertion/dislodgement are: Click on button 1 for the answer. Question 172 Fill in the blank Incisal rests should generally not be used on maxillary incisors. Why? Click on button 1 for the answer Question 173 Fill in the blank For tooth-supported RPDs, where are the primary rests normally placed? Click on button 1 for the answer. Question 174 Fill in the blank For extension RPDs, where are the primary rests usually placed? Click on button 1 for the answer. Question 175 Fill in the blank What is/are the indications for the use of a maxillary palatal plate major connector which is composed partly of metal and partly of plastic? See example to the right. Click on button 1 for the answer. Question 176 Fill in the blank What are the indications for the use of a maxillary horseshoe major connector? Click on button 1 for the answer. Question 177 Fill in the blank The total retention for a RPD is obtained from Click on button 1 for the answer Question 178 Fill in the blank What are the components of a clasp assembly? Click on button 1 for the answer Question 179 Fill in the blank An ideal clasp assembly should possess the following qualities: Click on button 1 for the answer Question 180 SUPPORT for a RPD framework is provided by? Click on button 1 for the answer Questions 181-190 Question #181 Fill in the blank Explain the difference between bracing and reciprocation. Click on button 1 for the answer Question 182 Fill in the blank Factors important in the selection of a particular clasp design include? Click on button 1 for the answer. Question 183 Fill in the blank What are indirect retainers and how do they function? Click on button 1 for the answer. Question 184 Fill in the blank ______________________________ are mechanical retainers that originate from a point at or above the height of contour---usually from a rest, minor connector, or guide plate---and angle downward across the clinical crown where the tip is located in the prescribed undercut. Click on button 1 for the answer Question 185 For a circumferential clasp, the undercut must be located on the same side of the abutment as the point of origin. on the opposite side of the point of origin. Question 186 Fill in the blank What is a combination clasp? Click on button 1 for the answer. Question 187 Fill in the blank When is a combination clasp most commonly used? Click on button 1 for the answer. Question 188 Fill in the blank What is the "RPA" clasp concept and what is the problem with the design? Click on button 1 for the answer. Question 189 Fill in the blank What is the name of the clasp assembly shown to the right? Click on button 1 for the answer. Question 190 Fill in the blank What is the most significant error in the design shown to the right. (Hint: the error is not particularly easy to see but it involves the major connector.) Click on button 1 for the answer. Questions 191-200 Question #191 Fill in the blank The illustration shown to the right was taken from an advertisement that appeared in one of the dental journals. It suggests that a bar bridge/splint in combination with a precision or semi-precision removable partial denture is appropriate treatment for "Geriatric Reconstruction." What do you think about this type of treatment? Click on button 1 for the answer. Question #192 Fill in the blank The illustration to the right shows the tissue surface of a maxillary removable partial denture. The arrows point to the junction of the framework metal and the plastic denture base. What is this structure called? Click on button 1 for the answer. Question #193 Fill in the blank The illustration to the right shows a tooth-supported segment of a mandibular removable partial denture framework. The red arrow is pointing to the raised edge of metal where the framework and plastic denture base will meet. What is this structure called? Click on button 1 for the answer. Question #194 Fill in the blank The illustration to the right shows a maxillary class I RPD framework with an anterior-posterior palatal strap major connector. What is the minimum acceptable distance between the anterior and posterior straps (red arrow)? Click on button 1 for the answer. Question #195 Fill in the blank What Kennedy classification is the RPD shown in the picture to the right? What is the name of this type of major connector? Click on button 1 for the answer. Question #196 Fill in the blank What is the Kennedy classification of the maxillary RPD shown to the right? Click on button 1 for the answer. Question #197 Fill in the blank What is the Kennedy classification of the maxillary RPD shown to the right? Click on button 1 for the answer. Question #198 Fill in the blank The red arrows point to a "ridge" of metal on the framework where the framework and the denture base plastic will meet. What is this "ridge" called? Click on button 1 for the answer. Question #199 Fill in the blank The illustration to the right shows a tooth-borne segment of a mandibular RPD. There is an I-bar retainer on the molar abutment. What is unusual about this retainer? Click on button 1 for the answer. Question #200 Fill in the blank The illustrations above show a very large maxillary RPD and a close-up of one of the retentive arms. What type of retentive arms have been used on this prosthesis? Click on button 1 for the answer.