Quiz fatma

• Prosthodontics

  Branch of dentistry concerned with the restoration and maintenance of oral function, comfort, appearance, and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and craniofacial tissues with artificial substitutes
• Post insertion problems in complete denture

  Problems that arise after the insertion of a complete denture
• Treating a completely edentulous patient and being able to restore some degree of function, esthetics, and the individuals self- esteem can be a very satisfying experience for a dentist
• It is unlikely that any dentist can solve all the problems that patients may present
• Post insertion care

  Critical phase in the treatment of the edentulous patient where scheduled and systemic follow up care can uncover minor problems and complaints which can become major problems if not treated promptly
• Problems that may arise subsequent to the insertion of complete dentures

  • Transient problems
  • Serious problems that result in the patient being unable to tolerate the dentures
  • Problems requiring a quick solution
  • Difficulty in adapting to required changes in their day time habit pattern
• General categories of complete denture problems

  • Complaints about comfort of the denture
  • Complaints about function of the denture
  • Complaints about esthetics
  • Complaints about phonetics
• Two thirds of the denture wearers surveyed in a study reported that they were "very satisfied" with their maxillary denture as compared with 51% for mandibular dentures
• Of the individuals who wore their dentures "all day", 5% were "very dissatisfied" with at least one of their dentures
• There is often not total agreement between the patient and the dentist as to the adequacy of their dentures
• Most frequent complaints with complete dentures

  • Aesthetics
  • Retention and stability
  • Comfort while eating
  • Accumulation of food under the appliance
• Factors that may influence patients' satisfaction with their dentures

  • Quality of bone tissue
  • Oral mucosa of denture bearing area
  • Adaptability of the neuromuscular mechanism
  • Individual feeling of security by denture wearing
  • Influence of the surrounding muscles on denture flanges
  • Viscosity of saliva
  • Patient's age
  • Position of occlusal plane
  • Occlusion
  • Hygiene
  • Type of food
• Immediate complaints

  Complaints that arise immediately after denture insertion
• Delayed complaints

  Complaints that arise some time after denture insertion
• Complaints about comfort of the denture

  • Sore spots
  • Burning sensation
  • Redness
  • Pain in TMJ
  • Tongue & cheek biting
  • Swallowing & sore throat
  • Nausea & gagging
  • Deafness
  • Fatigue of the muscles of mastication
• Complaints about function of the denture

  • Instability or poor fit
  • Interference when swallowing
  • Clicking
• Complaints about esthetics

  • Fullness under the nose
  • Depressed philtrum or naso-labial sulcus
  • Upper lip sunken in
  • Too much of teeth exposed
  • Artificial look
• Complaints about phonetics

  • Whistle on "S" sounds
  • Lisp on "S" sounds
  • Indistinct "TH" & "T" sounds
  • "T sound like "TH"
  • " F" & "V" sounds indistinct
• Causes of sore spots on the mandible

  • Overextension
  • Unpolished or sharp edge
  • Herpetic or apthous ulcer
  • Bone spicules
  • Spinous ridge crest
  • Pressure spots at time of impression
  • Occlusal prematurities
  • Overextension in anterior area
  • Maximum intercuspation not in harmony with centric relation
• Causes of sore spots on the maxilla

  • Overextension
  • Unpolished or sharp edge
  • Herpetic or apthous ulcer
  • Maxillary frenum
  • Sharp edge at the post dam area
  • Prominent midsuture or torus palatinus
  • Improper occlusion
  • Maximum intercuspation not in harmony with centric relation
  • Excessive vertical dimension of occlusion
• Causes of burning sensation

  • Pressure on anterior palatine foramen
  • Pressure on posterior palatine foramen
  • Pressure on mental foramen
  • Improperly processed denture base
• Causes of redness

  • Denture base allergy
  • Ill-fitting denture
  • Avitaminosis
• Causes of tongue and cheek biting

  • Thin or under extended periphery
  • Insufficient interarch clearance
  • Inadequate amount of horizontal overlap in molar region
• Causes of pain in TMJ

  • Insufficient vertical dimension of occlusion
  • Maximum intercuspation not in harmony with centric relation
  • Arthritis
  • Trauma
• Causes of gagging

  • Maxillary denture overextended or too thick in posterior border
  • Lack of retention
  • Mandibular denture too thick in distolingual flange
  • Incomplete border seal allowing saliva under denture
  • Improper occlusion causing denture to loosen
• Causes of deafness

  • Decrease vertical dimension of occlusion
• Causes of fatigue of the muscles of mastication

  • Excessive vertical dimension of occlusion
  • Insufficient vertical dimension of occlusion
• Causes of instability of mandibular denture

  • Error in occlusion (maximum intercuspation not in harmony with centric relation)
• Correct faulty occlusion by remount
• Reline denture

  1. Delay (2 weeks - 2 months after insertion)

  2. Increase border seal with self-curing acrylic resin (possibly at the posterior palatal border)

  3. Correct occlusion (clinical remount)
• Mandibular denture too thick in distolingual flange

  Reduce thickness or distolingual flange
• Incomplete border seal allowing saliva under denture

  Increase border seal with self-curing acrylic resin (possibly at the posterior palatal border)
• Improper occlusion causing denture to loosen and allowing saliva under denture

  Correct occlusion (clinical remount)
• Deafness

  Decrease vertical dimension of occlusion (rare)
• Fatigue of the muscles of mastication

  Excessive vertical dimension of occlusion
• Insufficient vertical dimension of occlusion

  Increase vertical dimension of occlusion
• Instability

  1. Correct faulty occlusion by remount and regrind procedure

  2. Reset teeth at a lower plane

  3. Rebase denture providing proper extension

  4. Use denture adhesives to help develop skill in handling denture (for a short time only)
• Looseness of maxillary denture

  • Correct with self-curing acrylic resin; first check with compound for diagnostic purpose
  • Correct Occlusion
  • Adjust denture accordingly
• Dehydration of tissue due to alcoholism

  Remove cause
• Displacement of flabby tissues when making impression

  Correct surgically; modify impression technique to change primary denture stress-bearing area to the buccal shelf