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Evidence Guide: HLTDEP008 - Construct and insert an implant retained overdenture

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

HLTDEP008 - Construct and insert an implant retained overdenture

What evidence can you provide to prove your understanding of each of the following citeria?

Elements define the essential outcomes

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Plan treatment

  1. Ensure a structured professional relationship with a dentist is established
  2. Obtain accurate, complete and legal records of the patient’s personal, medical and dental history
  3. Provide details of the procedure to the patient or carer and obtain and document consent following ethical and legal requirements
  4. Make accessible in the clean zone of the surgery the patient’s required laboratory work and necessary charts and records
  5. Ensure emergency procedures are in place and ready for use according to relevant guidelines
Ensure a structured professional relationship with a dentist is established

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain accurate, complete and legal records of the patient’s personal, medical and dental history

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide details of the procedure to the patient or carer and obtain and document consent following ethical and legal requirements

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Make accessible in the clean zone of the surgery the patient’s required laboratory work and necessary charts and records

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure emergency procedures are in place and ready for use according to relevant guidelines

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Take a primary impression

  1. Select correctly the equipment, instruments and materials for the primary impression
  2. Apply standard precautions to take primary impressions of the maxilla and/or mandible using an impression material in stock edentulous trays
  3. Pour impression material in dental stone and trim for custom tray fabrication
Select correctly the equipment, instruments and materials for the primary impression

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Apply standard precautions to take primary impressions of the maxilla and/or mandible using an impression material in stock edentulous trays

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Pour impression material in dental stone and trim for custom tray fabrication

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare to take a final impression

  1. Fabricate a custom tray with sufficient spacing over impression copings
  2. Attach static (non-screw) retained impression copings to the abutments
  3. Attach impression copings to the abutments
  4. Try-in the custom tray in the mouth and check for comfort and path of insertion with sufficient space between tray and impression coping
Fabricate a custom tray with sufficient spacing over impression copings

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Attach static (non-screw) retained impression copings to the abutments

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Attach impression copings to the abutments

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Try-in the custom tray in the mouth and check for comfort and path of insertion with sufficient space between tray and impression coping

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Take the final impression

  1. Paint the custom tray with an appropriate adhesive for the impression material to be used
  2. Mix the selected impression material according to the manufacturer’s instructions and load material into custom tray
  3. Seat the impression tray over the impression copings
Paint the custom tray with an appropriate adhesive for the impression material to be used

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Mix the selected impression material according to the manufacturer’s instructions and load material into custom tray

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Seat the impression tray over the impression copings

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Pour master and/or working models and fabricate occlusal rims

  1. Seat replica analogues into impression copings
  2. Pour master and/or working models
  3. Fabricate customised occlusal rims
Seat replica analogues into impression copings

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Pour master and/or working models

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Fabricate customised occlusal rims

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Record jaw relationships and occlusion

  1. Position the patient comfortably for the procedure
  2. Instruct the patient on participation during the procedure
  3. Ensure stability and comfort of registration rims
  4. Observe centric and eccentric mandibular movements
  5. Determine and record functional measurements and dimensions
  6. Consider referral if jaw relationship cannot be determined
  7. Check recordings by observation and repetition
  8. Maintain integrity of the recording during extra-oral transfer
  9. Ensure the patient’s wellbeing before they leave dental workplace
Position the patient comfortably for the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Instruct the patient on participation during the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure stability and comfort of registration rims

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Observe centric and eccentric mandibular movements

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Determine and record functional measurements and dimensions

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Consider referral if jaw relationship cannot be determined

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Check recordings by observation and repetition

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Maintain integrity of the recording during extra-oral transfer

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure the patient’s wellbeing before they leave dental workplace

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Select appropriate artificial teeth

  1. Ensure adequacy of natural and artificial light for selection of colour and shade
  2. Consult patient regarding aesthetic and functional requirements
  3. Consider properties and composition of artificial teeth in relation to wear and aesthetics
  4. Examine manufacturer’s mould and shade guides
  5. Select artificial teeth that are appropriate in shade, size and shape
Ensure adequacy of natural and artificial light for selection of colour and shade

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Consult patient regarding aesthetic and functional requirements

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Consider properties and composition of artificial teeth in relation to wear and aesthetics

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Examine manufacturer’s mould and shade guides

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Select artificial teeth that are appropriate in shade, size and shape

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Fit and evaluate try-in prosthesis

  1. Position the patient comfortably for the procedure
  2. Instruct the patient on participation during the procedure
  3. Examine the try-in prosthesis for retention and stability
  4. Examine the occlusal relationships of the try-in prosthesis for accuracy of centric relation
  5. Assess the aesthetic appearance of teeth and gums
  6. Assess that speech has not been affected
  7. Assess patient comfort
  8. Complete documentation as required
Position the patient comfortably for the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Instruct the patient on participation during the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Examine the try-in prosthesis for retention and stability

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Examine the occlusal relationships of the try-in prosthesis for accuracy of centric relation

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess the aesthetic appearance of teeth and gums

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess that speech has not been affected

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess patient comfort

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Complete documentation as required

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Process, evaluate and insert the completed overdenture

  1. Position the patient comfortably for the procedure
  2. Instruct the patient on participation during the procedure
  3. Examine the prosthesis for retention and stability
  4. Check the fitting surfaces of the appliance and ensure there are no sharp ridges or acrylic pearls
  5. Place denture in the mouth and assess that no over-extensions occur along the periphery of the dentures
  6. Seat denture onto overdenture abutments
  7. Confirm the occlusal relationships are acceptable
  8. Assess aesthetics of removable dental prosthesis
  9. Assess phonetics of removable dental prosthesis
  10. Assess patient comfort of removable dental prosthesis.
  11. Provide instructions on the insertion and removal, hygiene and ongoing maintenance of the prosthesis and abutments
  12. Ensure the dentist in the structured professional relationship is informed of completed final prosthesis
Position the patient comfortably for the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Instruct the patient on participation during the procedure

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Examine the prosthesis for retention and stability

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Check the fitting surfaces of the appliance and ensure there are no sharp ridges or acrylic pearls

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Place denture in the mouth and assess that no over-extensions occur along the periphery of the dentures

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Seat denture onto overdenture abutments

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Confirm the occlusal relationships are acceptable

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess aesthetics of removable dental prosthesis

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess phonetics of removable dental prosthesis

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess patient comfort of removable dental prosthesis.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide instructions on the insertion and removal, hygiene and ongoing maintenance of the prosthesis and abutments

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Ensure the dentist in the structured professional relationship is informed of completed final prosthesis

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Plan treatment

1.1 Ensure a structured professional relationship with a dentist is established

1.2 Obtain accurate, complete and legal records of the patient’s personal, medical and dental history

1.3 Provide details of the procedure to the patient or carer and obtain and document consent following ethical and legal requirements

1.4 Make accessible in the clean zone of the surgery the patient’s required laboratory work and necessary charts and records

1.5 Ensure emergency procedures are in place and ready for use according to relevant guidelines

2. Take a primary impression

2.1 Select correctly the equipment, instruments and materials for the primary impression

2.2 Apply standard precautions to take primary impressions of the maxilla and/or mandible using an impression material in stock edentulous trays

2.3 Pour impression material in dental stone and trim for custom tray fabrication

3. Prepare to take a final impression

3.1 Fabricate a custom tray with sufficient spacing over impression copings

3.2 Attach static (non-screw) retained impression copings to the abutments

3.3 Attach impression copings to the abutments

3.4 Try-in the custom tray in the mouth and check for comfort and path of insertion with sufficient space between tray and impression coping

4. Take the final impression

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 instructions and load material into custom tray

4.3 Seat the impression tray over the impression copings

5. Pour master and/or working models and fabricate occlusal rims

5.1 Seat replica analogues into impression copings

5.2 Pour master and/or working models

5.3 Fabricate customised occlusal rims

6. Record jaw relationships and occlusion

6.1 Position the patient comfortably for the procedure

6.2 Instruct the patient on participation during the procedure

6.3 Ensure stability and comfort of registration rims

6.4 Observe centric and eccentric mandibular movements

6.5 Determine and record functional measurements and dimensions

6.6 Consider referral if jaw relationship cannot be determined

6.7 Check recordings by observation and repetition

6.8 Maintain integrity of the recording during extra-oral transfer

6.9 Ensure the patient’s wellbeing before they leave dental workplace

7. Select appropriate artificial teeth

7.1 Ensure adequacy of natural and artificial light for selection of colour and shade

7.2 Consult patient regarding aesthetic and functional requirements

7.3 Consider properties and composition of artificial teeth in relation to wear and aesthetics

7.4 Examine manufacturer’s mould and shade guides

7.5 Select artificial teeth that are appropriate in shade, size and shape

8. Fit and evaluate try-in prosthesis

8.1 Position the patient comfortably for the procedure

8.2 Instruct the patient on participation during the procedure

8.3 Examine the try-in prosthesis for retention and stability

8.4 Examine the occlusal relationships of the try-in prosthesis for accuracy of centric relation

8.5 Assess the aesthetic appearance of teeth and gums

8.6 Assess that speech has not been affected

8.7 Assess patient comfort

8.8 Complete documentation as required

9. Process, evaluate and insert the completed overdenture

9.1 Position the patient comfortably for the procedure

9.2 Instruct the patient on participation during the procedure

9.3 Examine the prosthesis for retention and stability

9.4 Check the fitting surfaces of the appliance and ensure there are no sharp ridges or acrylic pearls

9.5 Place denture in the mouth and assess that no over-extensions occur along the periphery of the dentures

9.6 Seat denture onto overdenture abutments

9.7 Confirm the occlusal relationships are acceptable

9.8 Assess aesthetics of removable dental prosthesis

9.9 Assess phonetics of removable dental prosthesis

9.10 Assess patient comfort of removable dental prosthesis.

9.11 Provide instructions on the insertion and removal, hygiene and ongoing maintenance of the prosthesis and abutments

9.12 Ensure the dentist in the structured professional relationship is informed of completed final prosthesis

Required Skills and Knowledge

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Plan treatment

1.1 Ensure a structured professional relationship with a dentist is established

1.2 Obtain accurate, complete and legal records of the patient’s personal, medical and dental history

1.3 Provide details of the procedure to the patient or carer and obtain and document consent following ethical and legal requirements

1.4 Make accessible in the clean zone of the surgery the patient’s required laboratory work and necessary charts and records

1.5 Ensure emergency procedures are in place and ready for use according to relevant guidelines

2. Take a primary impression

2.1 Select correctly the equipment, instruments and materials for the primary impression

2.2 Apply standard precautions to take primary impressions of the maxilla and/or mandible using an impression material in stock edentulous trays

2.3 Pour impression material in dental stone and trim for custom tray fabrication

3. Prepare to take a final impression

3.1 Fabricate a custom tray with sufficient spacing over impression copings

3.2 Attach static (non-screw) retained impression copings to the abutments

3.3 Attach impression copings to the abutments

3.4 Try-in the custom tray in the mouth and check for comfort and path of insertion with sufficient space between tray and impression coping

4. Take the final impression

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 instructions and load material into custom tray

4.3 Seat the impression tray over the impression copings

5. Pour master and/or working models and fabricate occlusal rims

5.1 Seat replica analogues into impression copings

5.2 Pour master and/or working models

5.3 Fabricate customised occlusal rims

6. Record jaw relationships and occlusion

6.1 Position the patient comfortably for the procedure

6.2 Instruct the patient on participation during the procedure

6.3 Ensure stability and comfort of registration rims

6.4 Observe centric and eccentric mandibular movements

6.5 Determine and record functional measurements and dimensions

6.6 Consider referral if jaw relationship cannot be determined

6.7 Check recordings by observation and repetition

6.8 Maintain integrity of the recording during extra-oral transfer

6.9 Ensure the patient’s wellbeing before they leave dental workplace

7. Select appropriate artificial teeth

7.1 Ensure adequacy of natural and artificial light for selection of colour and shade

7.2 Consult patient regarding aesthetic and functional requirements

7.3 Consider properties and composition of artificial teeth in relation to wear and aesthetics

7.4 Examine manufacturer’s mould and shade guides

7.5 Select artificial teeth that are appropriate in shade, size and shape

8. Fit and evaluate try-in prosthesis

8.1 Position the patient comfortably for the procedure

8.2 Instruct the patient on participation during the procedure

8.3 Examine the try-in prosthesis for retention and stability

8.4 Examine the occlusal relationships of the try-in prosthesis for accuracy of centric relation

8.5 Assess the aesthetic appearance of teeth and gums

8.6 Assess that speech has not been affected

8.7 Assess patient comfort

8.8 Complete documentation as required

9. Process, evaluate and insert the completed overdenture

9.1 Position the patient comfortably for the procedure

9.2 Instruct the patient on participation during the procedure

9.3 Examine the prosthesis for retention and stability

9.4 Check the fitting surfaces of the appliance and ensure there are no sharp ridges or acrylic pearls

9.5 Place denture in the mouth and assess that no over-extensions occur along the periphery of the dentures

9.6 Seat denture onto overdenture abutments

9.7 Confirm the occlusal relationships are acceptable

9.8 Assess aesthetics of removable dental prosthesis

9.9 Assess phonetics of removable dental prosthesis

9.10 Assess patient comfort of removable dental prosthesis.

9.11 Provide instructions on the insertion and removal, hygiene and ongoing maintenance of the prosthesis and abutments

9.12 Ensure the dentist in the structured professional relationship is informed of completed final prosthesis

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

• performed the activities outlined in the performance criteria of this unit during a period of at least 240 hours of work in a clinical dental workplace environment

• prepared 2 patients for insertion of an implant retained overdenture

• followed procedures to ensure patient safety during try-in and insertion

• constructed 2 functional and aesthetic implant retained overdentures.

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the work role. This includes knowledge of:

Australian/New Zealand Standards, workplace health and safety (WHS) policies, Dental Board of Australia guidelines on infection control, Commonwealth and State/Territory legislation and organisation policies relating to dental prosthetics work

dental practice or organisation policy and procedures, including registration standards and guidelines

advantages of an implant retained overdenture to the patient including:

better aesthetics especially when resorption has decreased the size of the alveolar process in the maxilla

fewer implants, abutments and prosthetic components

less component stress and breakage

lower treatment costs compared to fixed prosthetics

simplified construction technique

the specific skills and techniques that are required when processing implant overdentures for a successful outcome

disadvantages of implant retained overdentures including the wear of attachments with repeated removal and seating of the overdentures

properties of dental materials used for construction

implant attachment options for overdentures

importance for patients to follow pre and post-procedural instructions, including:

removal of the overdenture

use of a standard soft toothbrush to brush abutments

use of dental floss to clean under the bar and around each abutment cylinder

use of an interdental brush to clean the under surface of the denture and the overdenture framework

instructions on the insertion and removal, hygiene and ongoing maintenance of the prosthesis and abutments.