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D1 Spring - Occlusion & Fixed Pros. > 4/1: The Post-Insertion Appointment > Flashcards

4/1: The Post-Insertion Appointment Flashcards

1
Q

When should all patients with new dentures be appointed and seen?

A

24-48 hours after insertion of the dentures

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2
Q

How long should patients wear dentures prior to post-insertion appt? Why?

A

Several hours to better evaluate mucosal irritations

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3
Q

Patients who are seen for denture adjustment appointment _______ hours post-insertion do better with the dentures

A

24-48 hours

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4
Q

When is the most crucial time in the patient’s perception of success or failure of dentures?

A

Post insertion adjustment period

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5
Q

What may be the single most significant factor in the successful manipulationof complete dentures under function?

A

Complete denture manipulation

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6
Q

What are important prognostic indicators?

A

Tongue function and denture wearing experience

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7
Q

What are common problems in the mandibular denture?

A

Discomfort
Poor retention and stability
Lack of support

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8
Q

What are common problems of the maxillary denture?

A

Poor retention and stability
Esthetics and phonetics

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9
Q

What are the 4 major areas of post-insertion?

A

Esthetics
Phonetics
Tissue irritations
Loss of retention and stability

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10
Q

What are vague complaints about the dentures?

A

Pt may be unhappy with esthetics

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11
Q

When is the time to remedy esthetic problems?

A

Trial placement appointment

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12
Q

Most patients adapt and learn to speak with new dentures quickly unless the teeth are improperly locaated in the ______, _______ or _________ plane

A

Vertical, horizontal, frontal

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13
Q

What are ways to check for problems with phonetics?

A
  • check the thickness of the max palatal portion
  • reevaluate the position of the max anterior teeth
  • if everything appears normal it may be a matter for the patient to adapt
  • open vertical dimension of occlusion
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14
Q

What is a common problem with phonetics in the max palatal portion?

A

Excessive thickness of the max palatal portion

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15
Q

What are causes of tissue irritation?

A
  • overextension
  • trauma from faulty occlusion
  • pressure from the denture base
  • tissue abrasion from prosthesis movement
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16
Q

What are many possible causes of a loss of retention and stability?

A

Occlusion, base contours, teeth not in “neutral zone”, posterior palatal seal, overextension or underextension, salivary flow and character

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17
Q

What should you check for in the post insertion appt?

A

Occlusal contacts
- remount to adjust occlusion if error is detected

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18
Q

Much of the selective grinding done in the mouth according to articulating paper marks made actually _____ the amount of error in the occlusion

A

Increase
- occlusal errors may be small, but the soreness they produce is very real and disturbing to the patient

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19
Q

What should you evaluate during the post-insertion appointment?

A
  • remove dentures and evaluate palate and residual ridges throughout
  • evaluate vestibular reflections for red areas
20
Q

What should you ask patients to point out in the post insertion appt?

A
  • point to areas of soreness
  • cotton tipped applicator (not their finger) - touch area
  • address the most urgent area first
21
Q

What is soreness in depth of vestibule caused by?

A

Overextended border of flange (due to an overextended final impression)

22
Q

What is this?

A

Sore on crest of ridge or ridge slope

23
Q

What is a sore on the crest of ridge or ridge slope due to?

A
  • occlusion error usually
  • pressure spot (tray show through) in secondary impression
24
Q

What is this?

A

Soreness at frenum

25
Q

What is the cause of a sore frenum?

A

Frenal notch too shallow or sharp

26
Q

What is the soreness of tissue overlying coronoid process due to?

A

Too much thickness at distobuccal corner of max denture
- PIP on cameo surface

27
Q

What is numbness or burning sensation in anterior palate due to?

A

Pressure on incisive papilla

28
Q

What is swallowing soreness due to?

A

Irritation at mylohyoid ridge

29
Q

What is numbness or burning in lower premolar areas?

A

Pressure over mental nerve due to an atrophied alveolar ridge

30
Q

What is buccal mucosa at occlusal plane level due to?

A
  • biting cheek - increase horizontal overlap
  • trapping mucosa between bases
31
Q

What does it mean if teeth contact during speaking?

A

OVD is too far open
- too little IOD (Freeway space)
- ridges are sore due to constant pressure

32
Q

What could be a sign of occlusal errors?

A

Dentures fit fine at first insertion, but loosen after wearing them for 3 or 4 hours

33
Q

What does it mean if maxillary CD dislodges when yawning or opening wide?

A

DB corner too thick

34
Q

What does it mean if smiling causes max CD to dislodge?

A

Denture flange too thick posterior to buccal frenum

35
Q

What are suspects for maxillary CD dislodging when eating?

A
  • posterior palatal seal too deep
  • occlusion needs correction
36
Q

What does it mean if there is a whistling with ‘s’ sounds?

A

Anterior palatal contour is incorrect
Uses PIP on the cameo surface to check phonetics/tongue contact on the denture

37
Q

What is the cause of a denture dislodging easier than expected?

A
  • Overextension of borders “toaster denture”
  • form of external flanges
  • teeth locations violating “neutral zone”
38
Q

What are causes of these complaints:
“denture feels too large”
“feels like a mouthful”
“difficult to speak or eat”

A

Tongue space is too small and dentures crowd the tongue
- problem could be tooth position, denture base contours or both
- think “neutral zone”

39
Q

What is the “neutral zone”?

A

Area where the forces applied by the tongue are equal or neutralized by the force applied by the cheeks and lips

40
Q

What can gagging result from?

A
  • loose dentures
  • poor occlusion
  • incorrect extension or contour of dentures
  • incorrect teeth positions (too far lingual or occlusal plane too low)
  • excessive OVD
  • psychogenic factors
41
Q

What does tissue trauma manifest as?

A
  • hyperemia
  • inflammation
  • ulceration
  • pain
42
Q

What is used as a presure indicating paste (PIP) to detect improper adaptation?

A

Zinc oxide paste

43
Q

What is PIP sprat used in?

A

Patients with xerostomia in order to prevent the PIP from sticking to the mucosa

44
Q

How do you use PIP for denture adjustment?

A
  1. Dry denture and brush thin layer of PIP on intaglio surface
  2. Spray with separator if mouth is dry and insert denture
  3. Dry the tissue and denture with gauze
  4. Touch irritated area with indelible marker - Thompson marker
  5. Insert denture to transfer mark to denture base
45
Q

What are instruments to use during a denture adjustment?

A
  • acrylic resin cutters
  • # 8 round bur
  • polishers
46
Q

How should you smooth the denture?

A

Rubber wheel/point

47
Q

How should you polish the denture?

A

Cameo surface and borders (lathe on SLOW SPEED) - rag wheel with pumice and then high shine

D1 Spring - Occlusion & Fixed Pros. (17 decks)

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