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Prostho > 3. Fully edentulous patient > Flashcards

3. Fully edentulous patient Flashcards

1
Q

Define fully edentulous patient (2)

A
  • Individual (usually an adult) without erupted teeth nor tooth buds in its jaws.
  • lost all of his/her teeth or never has had any
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2
Q

Define edentulism

A

state of being edentulous; without natural teeth

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3
Q

What was the prevalence of edentulism in 1975 in the US

A

11% of population

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4
Q

What was the prevalence of edentulism in 2000 in the US

A

10% of the population

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5
Q

Avg age for edentulism?

A

70-80

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6
Q

What decreases the prevelence of edentulism? (2)

A

prevention and conservative dentistry

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7
Q

What increases the prevalence of edentulism?

A

increased life expectancy

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8
Q

Etiology of edentulism? (4)

A
  • Periodontal disease ( most common cause)
  • Caries
  • Traumatisms
  • Anodontia
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9
Q

What is anodontia? (2)

A
  • congenital absence of teeth

- Usually due to hereditary syndromes, like ectodermal dysplasia

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10
Q

What is the most common Etiology of edentulism?

A

• Periodontal disease

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11
Q

What changes when a patient is edentulous? (5)

A 
Personality
• Facial changes
• Intraoral changes
• Extraoral changes
• Functional changes
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12
Q

What personality changes occur with edentulism?

A

-shyness

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13
Q

First appointment with an edentulous patient should not be…

A

very through

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14
Q

What facial profile changes occur with edentulism? (5)

A
  • Decreased VD
  • Loss of bone support for perioral muscles.
  • Lip alterations
  • Pseudoprognathism
  • Deepened facial furrows
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15
Q

What lip alterations occur with edentulism? (3)

A
  • Lip collapse.
  • Loss of lip expressivity.
  • Widening of the mouth
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16
Q

What deppened facial furrows occur with edentulism? (2)

A
  • Nasolabial furrow.
  • Corners of the mouth:
    Due to loss of VD » angular cheilitis.
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17
Q

Edentulism: What intraoral changes occur with oral mucosa ? (3)

A

• Two kinds: masticatory mucosa (attached gingiva)
and lining mucosa (alveolar mucosa).
• Muco-gingival junction.
• Atrophic mucosa

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18
Q

Edentulism: What happens with atrophic mucosa ? (4)

A
  • Slimming of mucosa.
  • Retraction.
  • Loss of elasticity.
  • Fragility.
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19
Q

Edentulism: Bone reabsorption factors? (4)

A

• Anatomical factors: previous quantity and density of bone.
• Metabolic factors: bone metabolism (PTH, TSH,
calcitonin)
• Prosthetic factors: bad fit of the prosthesis.
• Surgical factors: careless tooth extraction
• Functional factors

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20
Q

Edentulism: what are the functional bone reabsoprtion factors? (3)

A
  • Pressure (Bose’s law & Jore’s law)

- Vascularization

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21
Q

What is Bose’s law? (5)

A
  • functional bone reabsorption factor
    -Intensity of pressure
    § Strong pressure: high resorption
    § No pressure: high resorption
    § Mild pressure: least resorption
22
Q

What is Jores’ law? (5)

A
  • functional bone reabsorption factor
  • Frequency
    Constant pressure: resorption
    § Discontinuous pressure with short resting
    times: resorption.
    § Discontinuous pressure with long resting
    times: least resorption.
23
Q

Vascularization and bone reabsorption? (2)

A
  • functional bone reabsorption factor
  • Too much or too little can
    promote bone resorption
24
Q

Edentuluism: What intraoral changes can occur? (5)

A
  • Oral mucosa
  • Bone reapsorotion
  • morphology of alveolar ridge
  • tongue
  • saliva
25
Q

edentulism:

What type of resorption occurs for the upper alveolar ridge?

A

Centripetal - more from the vestibule

26
Q

edentulism: What happens to the upper alveolar ridge? (2)

A
  • Alveolar ridge loses height and rounds off. Usually height is no more than 1-1’5 cm.
  • Reduction of the radius of the curve of the ridge
27
Q

Edentulism: What are the possible shapes of the upper alveolar ridge? (3)

A
  • U shape
  • V shape
  • C shape
28
Q

Describe the U shape of the upper alveolar ridge (2)

A

The best. More retention and

stability

29
Q

Describe the V shape of the upper alveolar ridge (3)

A
  • Typical of the long-term edentulous patient.
  • The edge is an area of trauma.
  • Less retention and stability.
30
Q

Describe the C shape of the upper alveolar ridge (3)

A
  • Drop shape
  • Convex sides.
  • Trauma while placing and removing the denture if the
    denture base is overextended.
31
Q

Edentulism: What happens to the lower alveolar ridge? (3)

A
  • Increase of the radius of the curve of the ridge.
  • Up to 4 times higher resorption than in the upper ridge
  • High resorption highlights chin, coronoid process, gonion
32
Q

What type of resorption occurs with the lower alveolar ridge?

A

Centrifugal - more resorption of the lingual bone

33
Q

Edentulism: What is the height of the lower alveolar ridge? (2)

A
  1. 3-0.5 cm.

- Can even be 0 cm or even negative

34
Q

Edentulism: What is the shape of the lower alveolar ridge? (2)

A
  • “V” shape in the anterior ridge

- “U” shape in the posterior with flat occlusal portion.

35
Q

Edentulism: What intraoral changes does the tongue go through? (3)

A
  • General atrophy of epithelium and filiform papillae
  • Macroglossia » Tongue invades teeth space.
  • Decreased taste sensitivity. Taste buds.
36
Q

Edentulism: What intraooral changes occur with saliva? (2)

A 
• Decrease in the amount of saliva.
• Affects minor salivary glands, which produce
mucous saliva (therefore worse retention for dentures)
37
Q

Edentulism: What extraoral changes occur? (3)

A
  1. TMJ.
  2. Masticatory muscles.
  3. Nerve sensitivity changes.
38
Q

Edentulism: What extraoral changes occur with the TMJ? (2)

A
  • Dysfunction.

* Osteoarthrosis.

39
Q

Edentulism: What extraoral changes occur with the masticatory muscles?

A

Atrophy due to hypofunction

40
Q

Edentulism: What extraoral changes occur with nerve sensitivity? (3)

A
  • Decrease in proprioception.
  • Decrease in coordination and neuromotorcapability.
  • Decrease in adaptation capability to carry a denture.
41
Q

Edentulism: What extraoral changes occur with proprioception nerve sensitivity ? (3)

A
  • Epicritic touch (pressure, vibration, location of stimuli).
  • Loss of peridontal propioceptors.
  • Loss of taste sensitivity.
42
Q

Edentulism: What functional changes occur? (3)

A
  • Masticatory function
  • Deglutition function
  • Phonation function
43
Q

Edentulism: What functional phonation changes occur? (2)

A
  • difficulties with interdental and labiodental sounds

* Prosthetic dysglossia.

44
Q

What is prosthetic dysglossia? (2)

A
  • Prosthetic teeth are located differently than natural teeth
  • Tongue changes its movement pattern (direction, speed and pressure)
45
Q

Edentulism: What functional deglutition changes occur? (2)

A
  • Use perioral muscle and tongue to help swallowing

- Choking: Lack of mandibular stablility frequently implies diffculty in hypopharynx elevation

46
Q

What occurs during normal deglutition? (2)

A
  • tooth contact occurs

- stabilizes mandible

47
Q

Edentulism: How does a denture help deglutition changes? (4)

A

-recovers physiologic swallowing pattern for correct hyoid bone movement:

  • tooth contact
  • tongue pressure against front palate
  • mandible stabilization
48
Q

Edentulism: What functional masticatory changes occur? (4)

A
  • Decrease in food chewing/ grinding
  • Oral mucosa adapts to friction from food.
  • Neurosensory changes
  • Decrease in muscle strength - 5x less
49
Q

Edentulism: What functional masticatory NEUROSENSORY changes occur ? (4)

A
  • Less capability to detect food b/w occlusal surfaces.
  • Produces an increase in muscular tonus » ↓VD.
  • No slowing down of teeth before tooth contact.
  • Adaptation period before
    patient can learn new neuromuscular patterns.
50
Q

Edentulism: What functional masticatory changes occur when the patient has a denture? (2)

A

similar to that of the dentate patient, but they get modified
when there is a denture

Prostho (17 decks)

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