Examination, Diagnosis & Treatment Planning of the Edentulous Patient Flashcards

1
Q

How to make a tx plan?

A

careful consideration of pt complaint

pt expectations must be determined

tx plan tailored to pt complaint, needs and abilities

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2
Q

presenting complaints

usual complaints from pt needing complete denture?

A

looseness of denture

pain/sores

unable to chew food

food packing under the denture

speech disturbance

damaged denture

unhappy with appearance

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3
Q

What are common causes for damaged denture?

A

burning out of the wax during the conversion of the denture to the acrylic base

or

processing of the fusing to the prosthetic teeth to the wax to acrylic base wax is not removed properly

= bond between acrylic teeth and denture base is affected

= denture might come off from denture base

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4
Q

Common cause of midline fracture?

A

shave back labial frenum extensively

midline fracture on palate

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5
Q

Why can a denture fracture if a pt has been wearing the denture for a long time?

A

resorption of the alveolar ridge

now a space has formed between the denture and new shape of alveolar ridge

make the denture flex

= midline fracture

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6
Q

Questions to ask pt about PC regarding first denture?

A

howlong since the teeth were lost

what was/were the reasons for tooth loss

if a long time ago, why was replacement not sought before

what is/are the reasons for change of mind to seek replacement now

was there any reason to not have dentures previously

ever used partial denture

do you know about complete dentures? family/friends?

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7
Q

Questions to ask pt about PC regarding current complete denture?

A

what is/are the problems with current denture

current problem longstanding or of recent origin

how long has current denture been in use for

has there been problems previously with the current denture

has repairs/adjustments been done to the current denture

has the current denture ever been comfortable

how many pairs of dentures have you has up till now

how long since the teeth were lost

what was/were the reasons for tooth loss

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8
Q

Cause of dry mouth?

A

diabetes

antihypertensive

salivary gland disease

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9
Q

diabetes and complete denture?

A

really need good dentition

need varied diet to help regulate glucose

bad dentition - eat softer foods. usually high in sugar

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10
Q

SH importance for complete denture?

A

logistics to attend for tx
- elderly, bus

motivation for treatment
- e.g. wedding

motivation for maintenance

habits
- nail biter

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11
Q

EO exam - what to focus on?

A

asymmetry

smile line

lower facial height and posturing

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12
Q

IO assessment full denture?

A

localised trauma
- ulceration in areas of high load

generalised damage due to incorrect vertical height of denture or occlusion

tissue overgrowth from trauma
- denture granuloma

chronic irritation
- denture induced stomatitis

angular cheilitis
- normally seen in deep folds in corers of mouth
- reduced OVD

irregular bine loss

thin atrophic tissues

surgical repair in denture base

restricted oral opening
- can appropriate imps be taken

bone replaced by fibrous tissue
- flabby ridge

denture hyperplasia

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13
Q

What is it called with tissue overgrowth from trauma?

A

denture granuloma

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14
Q

What causes denture granuloma?

A

The flange of a denture impinging on the vestibular mucosa may stimulate a reactive irregular hyperplasia

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15
Q

stomatitis?

A

inflammation of the mouth and lips. It refers to any inflammatory process affecting the mucous membranes of the mouth and lips, with or without oral ulceration.

usually caused by candida = oral thrush

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16
Q

Angular cheilitis

A

a common skin condition affecting the corners of your mouth. It leads to painful, cracked sores.

17
Q

In F/F pt, why can they experience angular cheilitis?

A

recued OVD

CORNERS OF MOUTH DROOP DOWN - salva cannot be retained in the mouth

18
Q

What has occurred here?

A

flabby ridge

19
Q

Why has a flabby ridge occurred?

A

full upper denture

lower partial

  • large occlusal load on upper

Flabby ridges occur when hyperplastic soft tissue replaces the alveolar bone, resulting in mobile, hypermobile, and frequently edematous tissue.

20
Q

What is a flabby ridge?

A

Flabby ridges occur when hyperplastic soft tissue replaces the alveolar bone, resulting in mobile, hypermobile, and frequently edematous tissue.

21
Q

What can cause denture hyperplasia?

A

overextension of the denture

22
Q

What is shown?

A

tori/extostoses

23
Q

What would you check in the oral environment for denture?

A

fissured tongue

dry mouth - enough moisture to keep denture in mouth

excessive resorption mandibular ridge

genial tubercles and mylohyoid ridge

24
Q

genial tubercle?

A
25
Q

genial tubercle in dentate vs edentulous pt?

A

dentate - lower down

edentulous - higher up due to resorbed ridge

26
Q

effect of genial tubercle and/or mylohyoid ridge being higher up in edentulous pt?

A

hinderance to denture - think about design

compromise extension on denture

27
Q

what is shown here?

A

mylohyoid ridge

28
Q

What is shown here?

A

mucosa overlying thin bony prominence

29
Q

Affect of thin bony prominence and denture?

A

can cause pain when biting/ when pressure is applied

not resistant to trauma

30
Q

overdenture?

A

use of implants to support a mandibular complete denture

could also use retained roots and crowns

31
Q

copy denture?

A

copy current denture

pt is happy with current denture and only needs minor adjustments e.g. teeth or extensions

32
Q

transitional denture?

A

get pt use to a denture before moving to complete denture

33
Q

immediate denture?

A

replacement of all extracted teeth with a completed denture immediately after extraction