Denture complaints (Post insertion complaints in complete denture patients)

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Information about Denture complaints (Post insertion complaints in complete denture patients)

Published on August 15, 2017

Author: jjjj4444

Source: slideshare.net

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4. Restore the patient`s functional, esthetic & mental discomforts as requests . 8/15/2017 4smile

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6. Purpose of recall appointments is to eliminate problems faced by patient in wearing of denture. Dentist must LISTEN, EXAMINE, TREAT the condition. Complaint to be categorized in patients own8/15/2017 6smile

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12.  LOOSENESS  DISCOMFORT  POOR APPEARANCE  MISCELLANEOUS 8/15/2017 12smile

13. Symptoms :  Fall on speaking, laughing  Food entrapment  Pain Why do denture become loose? 1. Decreased retentive forces 2. Increased displacing forces 3. Support problem 8/15/2017 13smile

14. 1. Why Decreased retentive forces?  Lack of seal  Air beneath impression surface  Xerostomia  Poor neuromuscular control What causes lack of seal?  Under extended borders in depth & width Mx : addition of tracing compound to required extension & processing it with acrylic 8/15/2017 14smile

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16. • Incorrect PPS Mx : border molding done in PPS & processed with new material 8/15/2017 16smile

17. Extend of posterior border should not extend beyond the PPS ; as posterior over extension can lead to looseness of denture while eating , laughing , coughing etc… 8/15/2017 17smile

18. Addition of tracing compound to under extended borders 8/15/2017 18smile

19.  In elasticity of cheek (agening,scleroderma,fibrosis) Mx : slight reduction of depth & width of borders & border molding done as increments.  RRR Mx : relining What are the causes for air entrapment beneath impression surface? 8/15/2017 19smile

20.  Poor fit during technical works - Deficient impression - Damaged cast - Warped denture - Over adjustment of impression surface Mx : areas to be identified using Pressure Indicating Paste (PIP) & relined 8/15/2017 20smile

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22.  Over trimming for insertion Mx : rotational path of insertion, soft liner used 8/15/2017 22smile

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24.  Excessive relief Mx : relining Trapped air expands as denture move away from supporting tissue until it reaches borders & seal is broken.  Change of fluid content of supporting tissue due to: - Lack of recovery of tissue from pressure of old denture - Use of diuretics Mx : ensure old denture in not worn 72hrs prior to impression making, reline/rebase by minimum pressure technique 8/15/2017 24smile

25. What are the causes for xerostomia?  Diabetes  Drugs (atropine, phenothiazine,CPZ)  Menopause  Irradiation  Vitamin deficiency (A, B12, B2, folic acid)  Sialolithiasis Xerostomia causes reduced ability to form seal along borders & impression surface of denture Mx : artificial salivary substitutes, soups, intermittent sipping of water, pilocarpine hydrochloride, sucking sour candy 8/15/2017 25smile

26. How can poor neuromuscular control interfere with denture wearing?  Incorrect denture shape Mx : denture should occupy in neutral zone & polished surface should be contoured 8/15/2017 26smile

27.  Tongue unable to control denture Mx : proper tongue positioning need to be trained - Practice mouth opening / closing with tongue in forward position resting against inside of denture flange & lower front teeth even while receiving any food. - If maxillary denture become loose, advice the patient to close the mouth & swallow 8/15/2017 27smile

28.  Change in shape relative to old denture Mx : duplication of old denture with provided VD & occlusion  Upper/lower motor neuron disorder Mx : denture adhesive 8/15/2017 28smile

29. 2. Why increased displacing forces?  Over extended borders(posterior & distal corner of maxillary denture) Mx : use PIP & correct the borders  Poor fit Mx : reline/rebase  Denture not in optimal space Mx : reshaping the borders 8/15/2017 29smile

30.  Occlusal problems - Anterior & posterior prematrities Mx : selective grinding - MIP not coinciding with CR ( unable to control mandible movements, poor ridge, skeletal class II , non anatomic teeth ) Mx : remounting - Incorrect plane of occlusion ( last tooth too far, tuberosity) Mx : last tooth removed 8/15/2017 30smile

31. 3. What causes support problems? (associated with contour of ridge)  Lack of ridge support {RRR} Mx : optimal border extension in depth & width, denture adhesives 8/15/2017 31smile

32.  Fibrous displaceable ridge – denture sink in on mastication  Mx : reline / rebase, optimal Occlusal balance 8/15/2017 32smile

33.  Bony prominence covered by thin mucosa (midline suture, tori , posterior nasal spine) Mx : relieve denture 8/15/2017 33smile

34. Symptoms :  Pain  Altered sensation  Difficulty in swallowing & chewing Why denture casues discomfort? 1. Defect in impression surface 2. Defect in polished surface 3. Defect in Occlusal surface 8/15/2017 34smile

35. 1. Defects in impression surface  Sharp acrylic nodule  Undercut areas & attachments not relieved  Over extension  Deep post dam- sore throat, difficulty in swallowing  Lower knife edged ridge Mx : PIP & trimming, use of permanent soft liners 2. Defects in polished surface  thick distobuccal flange of upper denture Mx : PIP & trimming 8/15/2017 35smile

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37. 3. Defects in occlusal surface  Premature contacts – pain on eating  CR not coinciding with MIP – pain & ulceration lingual to lower anterior ridge  Insufficient incisal over jet – pain /ulceration on labial aspect of lower ridge Mx : selective grinding, trimming, heal ulcer(avoid denture wearing 1 day) 8/15/2017 37smile

38.  Excessive VD Mx : VD >2mm – remake denture  Insufficient over jet – cheek/lip biting Mx : posteriorly buccal cusps rounded, anteriorily lower incisors corrected  Teeth placed lingual to lower ridge – tongue biting Mx : remove lower lingual cusps 8/15/2017 38smile

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41. OCCLUSAL PREMATURITIES WITH DECREASED OVERJET & OVERBITE 8/15/2017 41smile

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44. Symptoms :  Insufficient tooth visiblity  Too much tooth visibility  Creases at corner of mouth 8/15/2017 44smile

45. Excessive tooth visibility 8/15/2017 45smile

46. Causes for insufficient / excessive tooth visibility 1. Improper orientation of Occlusal plane 2. Improper VD 3. Improper labiolingual & labiopalatal positioning of anterior teeth Mx : remaking denture Patient consent need to be taken for aesthetics during try-in Creases at corner of mouth 1. Decreased labial fullness 2. Decreased VD Mx : remake denture 8/15/2017 46smile

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49. 1. Speech problems 2. Difficulty in eating 3. Clattering of teeth while eating & speaking 4. Altered taste 5. Nausea & gagging 6. Fibrous hyperplasia 7. Microbial infections 8. Soft tissue irritation 8/15/2017 49smile

50.  SPEECH PROBLEMS 1. Problem with sibilants “S” - Tooth contact on saying “S” due to increased VD & excessive overbite 2. Problem with bilabial sounds “P” & “B” - Incorrect VD & incisor position 3. Problem with labiodentals “F” & “V” - Incorrect VD & upper anterior placed too far back 8/15/2017 50smile

51.  EATING DIFFICULTY 1. Instability 2. Posterior teeth trimmed more 3. Incorrect VD  CLATTERING OF TEETH WHILE SPEAKING & EATING 1. Increased VD 2. Increased incisor overlapping 3. Loose denture 4. Cuspal interference 5. Use of porcelain teeth 8/15/2017 51smile

52.  ALTERED TASTE 1. Acrylic reduces thermal conductivity 2. Alternative with metal base  NAUSEA & GAGGING 1. Loose denture 2. Poor occlusion 3. Thick distal terminal of upper denture & overextended posterior border of upper denture 4. Palatal placement of upper posterior 5. Psychogenic (fear of aspiration of denture & saliva pooling) 6. Prefer atropine & sedatives at initial period of denture use 8/15/2017 52smile

53.  Whistling- high vault palate  Ear ache – decreased VD & Occlusal prematurities  Food & saliva under denture  Drooling of saliva – decreased VD  Inability to eat meat  Allergy 8/15/2017 53smile

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63. Denture insertion appointment is very important in delivering a functional & aesthetic denture to the patient. More important is the need for the patient to understand the limitations of the denture service & to comprehend the use &care of dentures. Dentist need to spend time in educating & recalling the patient for complete denture as it will lead to success of denture! Success of complete denture treatment depends on relieving complaints which are posed at different time intervals.. 8/15/2017 63smile

64.  Textbook of Prosthodontics – V Rangarajan  Textbook of Prosthodontics – Nallaswamy  Prosthodontic Treatment for Edentulous Patients – Zarb Bolender  A primer on complete denture Prosthodontics – K.Chandrashekharan Nair  World Wide Web 8/15/2017 64smile

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