4. Conditions That Affect Denture Design & Wearing

Question 0

Oral Diseases

Diabetes Type 1

1) What does it do to the surrounding tissues?
2) Effects on denture wearing?

Answer 0

1) Epithelium is thinner and less KAM

2) Reduced support and tolerance of denture

Question 1

Occlusion

Over-Closure

Answer 1

Over-closure can cause limited space for prosthesis.

However, Palla S (1997) argues that occlusion, though biomechanically important, plays a minor role in determining success of failure of denture treatment. Psychosocial factors, such as aesthetics, are more likely to be more important than prosthodontic factors for positive outcomes.

Question 2

Oral Diseases

Oral Lichen Planus

1) What does it do to the surrounding tissues?
2) Effects on denture wearing?

Answer 2

1) Erosive lesions and subsequent scarring

2) These lesions and scarring can occur in the buccal shelf area and
when it does, denture extension is limited which leads to reduced
support and tolerance to their denture.

Question 3

Oral Diseases

Pemphigold Lesions

1) What does it do to the surrounding tissues?
2) Effects on denture wearing?

Answer 3

1) Chronic ulceration with subsequent scarring of oral mucosa

2) Limited denture extensions causing reduced support, stability,
retention and tolerance.

Question 4

Oral Diseases

Chronic Candidiasis

1) What does it do to the surrounding tissues?
2) Effects on denture wearing?
3) Treatment

Answer 4

1) Fungal infection usually due to low salivary flow leading to increased
fungal organisms. Leads to burning and irritation of the denture
bearing mucosa. Also, fungus is kertolytic, causing tissue to thin
around lesion.

2) Tolerance is reduced

3) Treat with antifungal therapy by applying:
- Nystatin powder (100kunits/g) to undersurface of denture 3x/day
for 3-4wks
- Nystatin cream for lesions associated with corners of mouth
- Nystatin rinse generally ineffective
- Nystatin oral lozenges for infestations that extend beyond denture
bearing surfaces

Question 5

Oral Diseases

Inflammatory Fibrous Hyperplasia

1) What does it do to the surrounding tissues?
2) Effects on denture wearing?

Answer 5

1) Begins as traumatic ulcer secondary to an ill-fitted denture.
2) Reduced tolerance

Question 6

Oral Diseases

Inflammatory Papillary Hyperplasia

1) What does it do to the surrounding tissues?
2) Effects on denture wearing?
3) Treatment

Answer 6

1) Caused by ill-fitting maxillary dentures and is sometimes further
complicated by chronic candidiasis.

2) ???

3) Treat with
> Antifungal medications topically
> In extreme cases, surgical excision

Question 7

Saliva

Xerostomia

Answer 7

Xerostomia is a presenting sign of many systemic conditions and is often a serious issue with patients for complete denture. It is the subjective symptom of dry mouth.

Caused by MUSATRIADS

Treatment
- Prilocaine and cevimeline (cholinergic agonists) to stimulate
parasympathetic n.s to increase serous saliva production.
> This is contraindicated for pt with drug-induced xerostomia or
those with uncontrolled asthma, glaucoma, chronic respiratory
and renal diseases.

Question 8

Saliva

Significance of saliva to denture wearing population

Answer 8

Minor salivary glands contribute to the success of denture retention and comfort. Presence of a layer of mucous saliva is essential for retention and comfort as it has:

• High viscosity
• Provides good surface retention
• Assist in maintaining a good peripheral seal

In Niedermeier W et al 2000, research shows
- Reduced palatal mucous salivary flow were associated with dry
mouth and burning mouth syndrome.
- Reduced parotid serous salivary flow were not associated with these
- Thus highlighting importance of mucous saliva in comfort

Note: Denture itself can mechanically cause compression of salivary ducts and parenchyma which can result in hyposalivation.

Question 9

Salivary gland hypo function page

Answer 9

Don’t understand

Question 10

Denture Induced Stomatitis & Mucotitis

Answer 10

Due to ill fitting of dentures.