Denture related pathology

Question 1

List 4 causes of denture related pathology?

Answer 1

Trauma
Infection
Autoimmune
Neoplasia

Question 2

How does traumatic denture pathology normally manifest?

Answer 2

Ulcers

Question 3

What tends to cause denture granuloma (inflammatory hyperplasia)?

Answer 3

Chronic trauma

Question 4

What causes extreme alveolar atrophy?

Answer 4

Long standing heavy loading of alveolar ridge causing bone to be resorbed - chronic trauma

Question 5

How can dentures causes traumatic ulcers

Answer 5

Over-extension of flange
Sequestration of bony spicule (tori/exostoses) before treatment
Rough fitting surface
Foreign body beneath denture (food)

Question 6

Describe the manifestation of traumatic ulcers

a) size
b) sensation
c) site
d) describe look
e) histology

Answer 6

Varying in size
Painful
Correspond to trauma
Inflammatory margins 
Non-specific histology

Question 7

Management of traumatic ulcers?

Answer 7

Correction of cause
Review
If no resolution = referral

Question 8

What is denture granuloma?

Answer 8

Inflammatory hyperplasia

Excess folds of firm tissues form inside the mouth around edges of ill-fitting dentures

Question 9

Management of denture granuloma?

Answer 9

Relieve the effected area

Encourage patient to leave denture out

Question 10

What causes leaf fibroma?

Answer 10

Persistant long-standing irritation in mouth (chronic trauma)

Question 11

Describe leaf fibroma

Answer 11

Scar-like reaction - flat leaf-like structure that lifts away from palate - attached by a thin stalk

Question 12

What is extreme alveolar atrophy more commonly known as?

Answer 12

Flabby ridge

Question 13

Describe flabby ridge?

Answer 13

Resorbed alveolar bone with mobile soft tissues on top

Question 14

What fungal infection is common in denture wearers?

Answer 14

Candia Albicans

Question 15

List 4 types of candida infections

Answer 15

Acute pseudomembranous candidiasis
Acute atrophic candidiasis
Chronic hyperplastic candidosis
Chronic atrophic candidosis

Question 16

What causes acute psuodomembranous candidosis?

Answer 16

Immune system doesn’t function properly

Question 17

What causes acute atrophic candidosis?

Answer 17

Steroid cream or broad spectrum antibiotics (alters oral flora - opportunistic infections)

Question 18

How can chronic hyperplastic candidosis be diagnosed, what does it suggest?

Answer 18

White membrane cannot be wiped off

Pre-cursor to candidia

Question 19

What does chronic atrophic candidosis cause?

Answer 19

Denture induced stomatitis

Question 20

Symptoms of chronic atrophic candidiasis (denture induced stomatitis)

Answer 20

Mucosal bleeding, swelling, burning, halitosis, unpleasant taste, dryness

Question 21

Why do females have a higher prevalence of denture induced stomatitis?

Answer 21

They wear their dentures for longer periods of time

Question 22

How can denture induced stomatitis be classified?

Answer 22

Type I - pin point hyperaemia and localised inflammation
Type II - diffuse erythema of most of denture bearing area
Type III - granular inflammation or inflammatory papillary hyperplasia

Question 23

What are the extra-oral presentations of denture induced stomatitis?

Answer 23

Angular chelitis

Question 24

What can cause/pre-disposing factors denture induced stomatitis?

Answer 24

Candida albicans
Denture plaque
Denture trauma
Continuous denture wearer
Xerostomia
Poor host defences 
Malnutrition
Oral AB

Question 25

Management of denture induced stomatitis?

Answer 25

Denture hygeien advice
Leave dentures out over night
Tissue conditioners
Correction of denture faults
Diet advice
Miconazole if it doesn't work

Question 26

How should patients clean their dentures?

Answer 26

Brush and liquid hand soap
Lay towel on bottom of basin and fill with water so not dropped onto hard basin
Denture cleaning tablets at least 1x a week