Edentulous State Flashcards

1
Q

What are the three kinds of prosthodontics?

A
  1. Fixed Pros
  2. Removable Pros
  3. Maxillofacial Pros
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2
Q

What percent of procedures in GPD invove removable pros?

A

35%

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3
Q

What population does edentualism most affect?

A

most vulnerable populations – the aging and the economically disadvantaged

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4
Q

____ can be disabling and handicapping

A

Tooth Loss

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5
Q

What are some of the science categories that complete dentture pros requires

A
  1. Basic sciences
  2. Biomaterials
  3. Occlusion
  4. Esthetics
  5. Phonetics
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6
Q

A removable dental prosthesis that replaces the entire dentition and associated structures of the maxillae or mandible

A

Complte Denture

Replaces, teeth soft tissue and hard

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6
Q

What 3 main things does becoming edentulous depend on?

A
  1. Level of caries & periodontal disease
  2. Attiude, behavior, & dental attendance
  3. Socioeconomic status, drugs, etc.
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7
Q

Is the destruction of part of the facial skeleton accompanying distortion of soft tissue shape and varying degrees of functional inadequacy

A

Tooth loss

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8
Q

Represents a loss of the integrity of the masticatory system, which is frequently accompanied by adverse functional and esthetic sequelae.

A

The edentulous State

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9
Q

Teeth are involved in the ____ of food

A

Trituration; chewing

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10
Q

Explain the relationship of teeth and periodontum

A

Teeth are attached to the socket via periodontum (AB, PDL, Gingiva), which is attached to the alveolar bone

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11
Q

provides a resilient suspensory apparatus resistant to functional forces and allows teeth to adapt in response to stress.

A

Periodontun

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12
Q

What are the soft and hard connective tissues of the periodontum?

A

Soft= PDL & Lamina propia of the gingiva
Hard= Cementum and AB

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13
Q

What are the 2 principle functions of the periodontum?

A
  1. Support
  2. Postional adjustment of tooth
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14
Q

Natural dentition has the dependent function of ____ preception

A

Sensory Preception

Edentulous teeth no logner have proprioception

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15
Q

In natural dentition during mastication what 2 things occur?

A
  1. Biting forces are transmited through dentiton
  2. Forces increase steadily depending on what youre eating, reach peak then zero.
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16
Q

In natural dentition teeth are in occlsuion in what 3 situations?

A
  1. Deglutition (swallowing)
  2. Ocasional when mastication
  3. During clenching and grinding (parafunction)
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17
Q

What is tooth contact like in edentulous Pt?

A

All forces in prosthetic oclussion are not as controlled. Consequently time dependent repsonse of tissues supporting dentues is diffrent!

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18
Q

What is the basic challange in compelete dentures?

A

To understand the differences between the ways natural teeth and their artificial replacements are supported.

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19
Q

Explain 5 Biochemical support mechanims of periodontum

A
  • 45cm^2 functional support in each arch
  • Viscoelastic propertiees
  • Sensory mechanims
  • Bone remodeling
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20
Q

Explain 4 Biochemical support mechanims of Edentulous arch

A
  • Tissues are unsuited to play support
  • Maxillary mucosa support 22.96cm^2
  • Mandibular mucosa support 12.25cm^2
  • Denture bearing ridge becomes smaller as residual ridge resorbs
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21
Q

In an edentulous arch ____ has little tolerance or adaptability to denture wearing

A

Mucousa

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22
Q

What can worsen adaptibility of the mucousa in an edentulous arch for denture wearing?

A
  • Systemic disease:anemia, hypertension, diabetes, xerostomia

Any disturbance initiates inflammation

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23
Q

Compare natural teeth biting froce vs CD biting force

A

Natural teeth (200N) biting power VS Complete Denture (60-80N) max

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24
Q

What 3 things does the residual ridge consist of?

A
  1. Denture bearing mucousa
  2. Submucosa & periodsteum
  3. Underlying bone
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25
Q

What happnes after tooth extraction when the alveoli (root location) is filled with new bone?

A

Formation of the residual alveolar processes, forming the residual ridge

Foundation for dentures, lol, ill suited.

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26
Q

The alveolar ridge is subject to ongoing gradual ____

A

Resorption

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27
Q

resorbtipn ocurs most rapid where?

A

In the anterior mandible, doesa not occur evenly over ridge, rate varies depending on pt.

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28
Q

Bone resporbiton on the maxilla occurs?

A

Superio posterior direcrion

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29
Q

Bone resporbiton on the mandible occurs?

A

Inferior anterior direction

30
Q

Overtime, due to bone loss you loose?

A

Verticle dimension of occlsuion; sunken face.

31
Q

CDs should be designed in an attempt to decrease the ____ by its recurrent functional movements (increasing RETENTION).

A

Decrease residual ridge reduction to increase retention

More resorbtion= bigger bulkier denture

32
Q

What are the 2 factors in CDs that doctor controls?

A
  1. Optimal extension of denture base
  2. Maximally intimate contact of the denture base to its basal seat
33
Q

Teeth arrangement determined by the functional balance of the orofacial and lingual musculature

Occurpied by teeth & alveolar process until no teeth/

A

Neutral Zone

Filled with dentures,.

34
Q

What 2 things retain and stabalize CDs?

A

Orofacial and tongue muscles

34
Q
  • help appreciate flavor of foods
  • Indirectly involved in the excitation of salivary and gastric secretions
  • Important to the complete digestion of foods
A

Mastication

CD are poor substitiution for good mastication

35
Q

Occurs because of dislodging forces of the surrounding musculature, exposing the tissues to constant frictional contact

A

Denture Movement
* CDs go under displacing, lifting, sliding, tilting, and rotational movements

36
Q

What are 3 parafunctional considerastions of CDs

A
  1. Havits involving repeated or sustained occlusal contacts to CDs together
  2. Harmful to other components of masticator system
  3. clenching causing sorness
37
Q
  • Horizontal & Vertical
  • Prolonged & excessibe
  • Diurnal & Nocturnal
A

Parafunction

38
Q
  • Verticle
  • Intermittent & light
  • Diurnal
A

Mastication

39
Q

Initial discomfort associated with new dentures:

thrust against denture to secure it

A

Sore tongue

40
Q

Initial discomfort associated with new dentures:

until patient is confident and muscles adapt for retention

A

Constant Clenching

41
Q

Initial discomfort associated with new dentures:

Occurs when when Mandibular CD is not stable

A

Sore/tired lower lip

42
Q

Initial discomfort associated with new dentures:

decreased blood flow (small vessels)

A

Sore mucosa

43
Q

Initial discomfort associated with new dentures:

Cheek and tongue biting

A

Cheek and tongue biting

44
Q

Morphological Changes with Edentulism are what 3 features?

A
  1. Occur slowly
  2. Depend on balance of osteoclas and osteoblast activity
  3. TMJ involves in articular changes
45
Q
  • Occur as a result of occlusal tooth surface loss
  • Mainly due to attrition and abrasion of occlusal surfaces
  • It is very obvious on patients wearing worn out dentures
A

Face Height Changes

45
Q

Causes a decrease in total face height

A

Residual Ridge Resorbtion

46
Q

Ridge resorption then results in

A

Mandibular prognathism

portrusion of lower jaw

47
Q

Mandibular anterior ridge resorbs ____ faster than Maxillary anterior ridge

A

4x faster on Mandibular

Much less vascularity

48
Q

Denture teeth are postioned at certian heights to do what 3 things?

A
  1. Restore function
  2. esthetics
  3. phonetics (speech)
49
Q

What is a good guide for checking postioning of teeth and VDO?

A

Phonetics! Speech.

50
Q

How far apart ridges will be and how the two jaws relate to one another

A

Verticle Dimension of occlsuion

51
Q

α

Questionnaires & Patient Interview (“The Conversation”)

A

medical and dental history

52
Q

Detection, assessment, and treatment of oral lesions and disease e.g., oral cancer screening

A

Intra and extra oal exam

53
Q

Clinical factors influencing stability,
retention, and support of complete dentures
-Denture assessment
-Prognosis

A

Prosthodontic assessment

54
Q

What do you do at the 1st visit?

A
  • Eval soft tissue & exsisitng dentues
  • Alginate preliminary impression of maxilla and mandibular arches
55
Q

What do you do at the 2nd visit?

A

Fabricate custom trays (using 1st impressions)
* Adapt trays to the mouth
* Border mold trays using
compound.
* Make final impressions using
rubber base or VPS impression material

56
Q

What do you do at the 3rd visit?

A
  • Establish maxillary plane
  • Establish vertical dimension
  • Centric relation record
  • Facebow recording
  • Tooth selection
  • Mount casts on the articulator
57
Q

What do you do at the 4th visit?

A
  • Eval esthetics & phonics
  • Evaluate midline and VDO
  • Patient Approval
  • Photos
58
Q

What do you do at the 5th visit?

A
  • Seat and use pressure indicator to check
  • Remount on articulator
  • Adjust occlusion
  • Patient education
  • 24 hr eval & adjusment
  • 1 week evall
59
Q

LOOK maxillary

A

LOOK maxillary

60
Q

$

Look mandible

A

Look mandible

61
Q

3 foundation of prosthetics

A
  1. Retention
  2. Support
  3. Stability
62
Q

Resistance to vertical displacement of the denture away from the denture bearing surface during function.

A

**Rentention **
Resistance to vertical displacement of the denture away from the denture bearing surface during function.

63
Q

Resistance to vertical forces of occlusion. Factors of the bearing surface that resist or absorb occlusal loads during function.

A

Support
Resistance to vertical forces of occlusion. Factors of the bearing surface that resist or absorb occlusal loads during function.

64
Q

Resistance to lateral displacement of the denture during function.

A

stability
Resistance to lateral displacement of the denture during function.

65
Q

These are all what?

  • Quality of oral mucosa
  • Alveolar ridge contour
  • Muscle attachments
  • Saliva
  • Neuromuscular control
A

FACTORS THAT IMPACT RETENTION, SUPPORT & STABILITY of denture

66
Q

How muh larger do you want your tray to be than the residual ridge?

A

5mm larger

67
Q

The mandibular tray should extend to the what?

A

Ascending ramus

68
Q

A negative registration of the areas of the mouth over which the dental prosthesis (the complete denture) will rest

A

Impression

69
Q

An impression made for the purpose of making a preliminary cast which is used for diagnosis and/or fabrication custom, individualized, impression tray

A

Preliminary Impression

70
Q

The preliminary impression should be as accurate as possible and ____ of peripheral borders is preferred

A

overextension