EPA 4C: Edentulous Removable Denture

Edentulous Removable Denture	Meets Expectations of the Graduate	Progressing	Below Expectations	Critical Error

Impressions	All critical landmarks captured, learner could define landmarks (depth of vestibule, frena, posterior palatal seal area, palatal vault; lingual extension, buccal shelf, retromolar pad) Borders properly extended: for definitive impressions, the material should extend to the depth of the vestibule without displacing tissues Good quality of impression	Some landmarks are not perfectly smooth/well defined, but learner identified them and the consequences Slightly over or under extended, would require adjusting in restoration if not corrected Small voids, bubbles, tears	Some non-critical landmarks not captured and not identified by learner Grossly over or under extended, but learner identified and requested assistance to correct Larger voids, bubbles or tears that may or may not affect the final restoration quality, but learner identified and sled for assistance to correct	Learner could not identify landmarks, or missing critical landmarks (posterior palatal seal, retromolar pad) Grossly over or under extended would result in ill-fitting restoration Large voids, bubbles, tears that would affect certainly the quality of restoration
MMR/Try-In	Rims or try-in is adjusted to centric relation is appropriate for the patient Vertical dimension of occlusion (VDO) is appropriate for the patient (speech and esthetics are acceptable) Correct soft tissue support Appropriate esthetic evaluation Ideal phonetics: patient speaks all sounds clearly, and learner appropriately evaluated Occlusal plane is correct Occlusion and occlusal relationship appropriate for patient	Centric relation is close but may be slightly off. Close enough that Could be corrected at subsequent step VDO is close, but may be slightly off Close enough that could be corrected at subsequent step Soft tissue support; Midline slightly off or small cant within acceptable range Phonetics are acceptable. Learner may not have evaluated all, but understands concepts and how to improve Plane of occlusion slightly high or low (references: 1/2–2/3 retromolar pad) Some occlusal contacts missing, could be tolerated or adjusted easily	Centric relation is incorrect, but learner identified and requested assistance to correct VDO is incorrect, but learner identified and requested assistance to correct Soft tissues slightly over or under supported Patient cannot clearly pronounce all sounds (fricative or sibilant), but learner identified and asked for help Occlusal plane incorrect, but the learner identified and asked for help Occlusion/occlusal scheme not ideal, but learner identified and asked for help	Centric relation is grossly incorrect or not evaluated VDO is grossly open or closed, would result in poor restoration Learner did not evaluate or did not ask patient’s opinion; soft tissues grossly over/under supported; midline grossly incorrect; smile display unacceptable Patient cannot say fricative or sibilant sounds, or phonetics not evaluated Reverse curve of Spee not identified by learner; He of occlusion grossly incorrect and would affect final restoration Occlusal contacts not adequate: unilateral or heavy contacts, or gross interferences not identified
Insertion/Post-op	Prosthesis fully seated	Small interference or undercut remains, but able to seat	Learner could not seat fully, recognized and asked for help	Pressure Indicating Paste (PIP) not used; prosthesis not well adapted, loose or rocking
		Occlusion is appropriately equilibrated	Some contacts missing, but bilateral contacts exist	Occlusion is incorrect, but learner identified and asked for help	Patient not in CR/MICP as appropriate, occlusion not evaluated
		Patient feels comfortable with prosthesis, can insert and remove	Learner identified all issues, even if unable to address	Some slight rough areas or overextensions not completely smoothed	Unaddressed sore spots; patient not asked, or cannot insert/remove prosthesis
		Vertical dimension of occlusion (VDO) is appropriate for the patient (speech and esthetics are acceptable)	VDO slightly open or closed, could be adjusted or accommodated	VDO incorrect, but learner identified and asked for help	Vertical so open or closed that could cause complications; learner did not evaluate VDO
		Esthetics are acceptable	Esthetics not completely ideal, but within acceptable range to clinician and patient	Esthetics not ideal, but learner identified and asked for help	Unacceptable esthetics, or forgot to evaluate or ask patient
		Phonetics are acceptable	Phonetics are acceptable. Learner may not have evaluated all, but understands concepts and how to improve	Patient cannot clearly pronounce all sounds (fricative or sibilant), but learner identified and asked for help	Patient cannot say fricative or sibilant sounds

Fixed Partial Denture - Implant Dentoalveolar Surgery