Course Title: Construct and insert an implant retained overdenture

National Element Code & Title:

HLTDP608C Construct and insert an implant retained overdenture

Performance Criteria:

1.1 Make accessible in the clean zone of the surgery the client's required laboratory work and necessary charts and records
1.2 Obtain accurate, complete and legal records of the client's personal, medical and dental history
1.3 Interpret prescription where required
1.4 Provide full details of the procedure to the client and/or carer
1.5 Obtain and document consent following ethical and legal requirements
1.6 Implement standard precaution during all procedures
1.7 Ensure emergency procedures are in place and ready for use according to relevant guidelines

Performance Criteria:

2.1 Select correctly the equipment, instruments and materials for the primary impression
2.2 Take primary impressions of the maxilla and/or mandible using an alginate material in stock edentulous trays
2.3 Relieve the denture in the area of the abutments
2.4 Reline the denture with a tissue conditioning material
2.5 Pour alginate impression in dental stone and trim for custom tray fabrication

Performance Criteria:

3.1 Fabricate an open window custom tray to provide an accurate impression of tissue details and the relationship of the abutments to one another and to surrounding oral tissues
3.2 Ensure abutment screw tightness
3.3 Attach impression copings to the abutments with the proper length guide pins
3.4 Try-in the custom tray in the mouth and check for comfort and path of insertion
3.5 Mould the borders of the custom tray
3.6 Seal the window with baseplate wax and soften in a heated water bath
3.7 Insert custom tray over the guide pins and impression copings

Performance Criteria:

4.1 Paint the custom tray with an appropriate adhesive for the impression material to be used
4.2 Mix the selected impression material according to the manufacturer's specifications
4.3 Load the impression material into the tray and syringe and inject around the impression copings
4.4 Seat the impression tray using the guide pins and holes in the wax window as a guide for placement
4.5 Complete moulding of the borders
4.6 Clear excess impression material from guide pins before complete setting
4.7 Loosen the guide pins and remove the impression

Performance Criteria:

5.1 Screw replicas onto the impression copings with guide pins
5.2 Bead and box the final impression and cast in diestone
5.3 Unscrew each guide pin completely before separating the impression from the cast
5.4 Fabricate attachment and bar extensions according to the prescription
5.5 Evaluate casting for accuracy of fit on the abutments
5.6 Fabricate a customized record base incorporating attachments
5.7 Add occlusal rims to the trimmed and polished base

Performance Criteria:

6.1 Position the attachment bar in the mouth
6.2 Place pressure indicator paste on the fitting surface of the base and ensure the base is fully seated in the mouth
6.3 Check the base for attachment retention and potential pressure areas
6.4 Record maxillomandibular relationships
6.5 Establish lip support and phonetics at the correct vertical dimension
6.6 Select tooth shade and denture tooth mould

Performance Criteria:

7.1 Evaluate trial denture for tooth arrangement, aesthetics, phonetics and vertical dimension of the occlusion
7.2 Adjust the trial denture for denture soreness
7.3 Record another centric relation and process as normal
7.4 Ensure complete seating of the overdenture into the attachment bar

Performance Criteria:

8.1 Snap denture onto the attachment bar
8.2 Use pressure indicator paste to adjust any potential sore areas
8.3 Check centric relation and remount denture for final adjusment
8.4 Provide hygiene and home care instructions

"Pocket Atlas of Oral Diseases" by G.Laskaris (Thieme books) "Prosthetic Treatment of the Edentulous Patient" 5th Ed. by R M Basker and J C Davenport (Blackwell Munksgaard books)