Ch 30 Care Of Dental Prosthesis Flashcards
Missing Teeth:
Patient with no teeth
1 or more teeth but less than of natural teeth
Fully edentulous
Partially edentulous
Edentulous Mouth:
Residual ridge
Which loss is greater mand or max
Remains after tooth removal. Undergoes resorption
Mand loss greater
Mucous membranes
Composition:
Mucosa
Submucosa
Which mucosa does the denture support depend on
Tension. Test shows what
Masticatory lining and specialized mucosa
CT, vessels, nerves, adipose tissue and glands(attached to bone)
Submucosa
Attached tissue over bony ridge and loose lining mucosa of vestibule
Consequences of not replacing missing teeth (4)
Migration of adjacent teeth
Migration of opposing teeth (super erupt)
Loss of occlusal vertical dimension (over closure)
Loss of vertical dimension may cause pooling of saliva which causes fungal growth and results in angular cheilitis
Fixed partial dentures aka
Composed of
Bridges
Retainer on abutment, Pontic, retainer
Types of Fixed Partial Dentures
Natural tooth supported
- cantilever : Pontic supported by 1 or more teeth at one end only
-resin retained: wing like extensions bonded with cement to etched enamel (min or no prep) aka Maryland bridge
Implant supported
Removable partial denture
Replaces what
Base and teeth made of
Replaces 1 or more but not all teeth
Base=plastic acrylic resin
Teeth = porcelain, plastic resin or metal
Types of complete dentures:
- Tissue supported
- Implant
- Overdenture
- Interim denture
5.immediate denture
6.denture for primary teeth
- Mucosa covered alveolar ridge on max or mandible
- Supported by one or more implants. Denture itself is not implantable
- Rests on one or more remaining natural teeth
- Aka provisional. Esthetics, stabilizing, function for limited time to be replaced
- Placed immediately after removal of teeth. Remade, etc after 6 mos
- Congenitally missing or extracted due to rampant Carie’s or trauma
Components of denture
- Base-rests mucosa
- Impression surface- inner surface not polished, lies directly on residual ridges and adjacent tissues. Lined temporary or perm soft silicone liner
- Polished surface -outer
- Occlusal surface- makes contact with opposing denture or natural teeth
- Teeth - plastic acrylic resin porcelain or polymethyl methacrylate or metal
Root supported Overdenture
Advantages
Teeth selected for this process
When pt clinical crowns are not restorable and root is Carie’s free and periodontally healthy
Less bone absorption
Better stability, retention
Improved chewing and Efficiency
Retain some senses bc pdl is present
Pt pschy acceptance
Canines
Implant supported denture
How many implants are necessary for maxilla Overdenture
Mandibular placed where
Advantages
More widely used than root supported
4 or more
Generally in position of canine
No risk for Carie’s
Less bone loss than complete
Improve stability than complete
Better chewing and quality of life
Obturator
- Made with what
- Purpose
- Clinical application
- Professional continuing care
Prosthesis designed to close congenital or acquired opening such as cleft of hard palate
- Resin base and retainer clasps for stability
- Loss of palate - cocaine, trauma, cancer of maxilla, Cleft palate
- Stay in place to prevent choking or aspiration of water/materials
Removed with rads
If pt is severe may sleep with it and so tissue may spontaneously bleed. Advise pts to use short periods during day for tissue rest if so - Minimum 3 visits a year. Will change over time
Denture marking for identification
Marker that can withstand cleaning methods and radiopaque if swallowed
Inclusion Methods for marking
More permanent, expensive and trained personal
ID Band-shallow indention
ID Strip- surface of impression when fabricated
Electromagnetic chip- cost
Laser etch - copper laser. Those with metal frameworks
Radio- tags not widely used $
Bar codes - printed on silk and incorporated into clear acrylic resin
Surface markers
Top coat is
How long do they last
Light ___ also
Also engraving tool or bud
Info to include
2 coats of fingernail acrylic applied after written
Last for 6 months
Light curved
Include: name and initials for temp
If name alone not enough include social
Possibly blood type, conditions, DOB, etc
Professional Care
All typical care plus checking Margins cfor possible Carie’s/irregularities,etc
Continuing care at minimum of 6 months
Pt self care
Debris removal
Biofilm removal from abutment teeth
oral irrigator, biofilm removal with TB
Sulcular brushing, fluoride containing, nonabrasive tp, interdental care
Care of fixed prosthesis:
Areas requiring emphasis
Toothbrushing
Floss
Beneath Pontic and connectors
Charters and single tuft brush can be recd
Floss threaders, tufted floss
Pro care for removal prosthesis
Care at appt
When natural teeth are present the mouth has higher
Check condition
Evaluate fit and function
Biofilm control major factor for long term abutment teeth
Microbe diff partial vs compete dentures. Natural teeth=higher levels of actinomyes, haemophilus, corynebacterium, veillonella but Fewer lactobacillis and streptococcus
Pt self care for removables
Which brushes are recd
Water temp
Never soak longer than ___ in _____ _____ solution
-Removed at night or for 6-8 hr period daily
If not may result in inflammation from exposure to microorganisms
-Clean at least 2x daily
-store in solution
-reg dental exams
Denture and clasp brush
Use only warm water
10minutes in sodium hypochlorite
Denture deposits
Denture calc occurs within _ days and completely calcified by _ weeks
3 days, 2 weeks
Pt self care procedures
Chewing make take 6-8 wks
Ideally rinse after meals
Denture Induced OMLs
Factors
Ill fitting
Improper storage
Inadequate hygiene
Continuous wear
Not thoroughly rinsing chemo toxins
Allergy
OTC products for relining
Xerostomia
Denture stomatitis
Associated with
More common in
General inflammation and erythema of mucosa covered by denture
C albicans
Maxilla
Tissue hyperplasia
Inflammatory hyperplasia
Flabby ridge
Epulis fissuratum-growth over alveolar ridge
palate-pebble shaped red edematous projections
Mobile soft tissue. Manage with surgery
