1 - Reasons for rendering a patient edentulous

Question 1

What is a complete denture?

Answer 1

• removable dental prosthesis that replaces an entire dental arch (maxilla and/or mandible)
• full denture

Question 2

CU

Answer 2

complete upper

Question 3

CL

Answer 3

complete lower

Question 4

F/F

Answer 4

complete upper and lower

Question 5

-/F

Answer 5

natural upper dentition, complete lower

Question 6

What are some problems associated with having a complete denture and natural teeth?

Answer 6

• occlusion is not controlled like in F/F
• uneven bite
• stability is difficult to achieve

Question 7

What are the different types of complete denture?

Answer 7

• PMMA (acrylic), most common, usually last 5 years
• CoCr and acrylic, rare, used in those with severe bruxism
• nylon (base) and porcelain (teeth), used in those with allergies to acrylic, deteriorate quickly (18 months)

Question 8

Edentulous

Answer 8

• when a person loses all their teeth
• debilitating, irreversible condition and considered final marker of disease burden of oral health, caused by failure to control the disease

Question 9

What factors are relevant in edentulism?

Answer 9

• age
• socioeconomic
• MH
• OH

Question 10

What are some of the effects of edentulism?

Answer 10

• self esteem
• general health (lack of nutrition due to limitations of mastication)
• quality of life
• speech (s/f/v sounds difficult)
• loss of masticatory function
• appearance
• ridge resorption
• soft tissue changes
• reduction in face height (assess this in EO exam)

Question 11

What is the classification of ridge resorption called?

Answer 11

Cawood and Howell

Question 12

Describe the atrophy stages of ridge resorption in the mandible.

Answer 12

1. before extraction (tooth present)
2. post extraction
3. high, well-rounded ridge
4. knife-edge ridge
5. low, well-rounded ridge
6. depressed bone levels (nerves/blood vessels may be exposed)

Question 13

How do the maxilla and mandible differ in ridge resorption?

Answer 13

• mandible more susceptible to severe resorption
• maxilla tends to have better ridges for denture retention

Question 14

Why are complete dentures a compromise restoration?

Answer 14

• inefficient at mastication
• requires good neuro-muscular control (stroke/parkinsons)
• stability of lower dentures compromised by tongue movements

Question 15

What are some common reasons for patients to become edentulous?

Answer 15

• rampant caries
• periodontal disease
• debilitating tooth wear
• failing dentition
• occlusal collapse
• appearance

Question 16

Describe a failing dentition.

Answer 16

• overambitious treatment can lead to the failure of natural teeth (ie over-extended bridges)
• cycles of replacement lead to more natural tooth tissue lost each time

Question 17

What are some less common reasons for patients to become edentulous?

Answer 17

• head and neck chemo-radiotherapy
• head and neck cancer resection
• transplant patients
• cardiac surgery
• patient’s request

Question 18

How does chemo-radiotherapy cause patients to become edentulous?

Answer 18

• radiation can cause osteo-radionecrosis (ORN)
• blood vessels in supporting bone are affected
• if teeth are extracted post-op (ie gross caries), large portions of bone can come with the tooth, poor healing
• teeth can then be extracted before cancer treatment as a preventative measure

Question 19

How does being a transplant patient cause edentulism?

Answer 19

• transplant patients are often placed on immuno-suppressants post-op
• any infection in the mouth could have a greater impact
• teeth can be extracted as a preventative measure

Question 20

How does have cardiac surgery result in patients being rendered edentulous?

Answer 20

• heart valve surgeries carry the risk of infective endocarditis
• poor dentition can carry significant infection risks

Question 21

What are the different methods of complete denture construction?

Answer 21

• conventional dentures
• replica dentures
• digital dentures