intro Flashcards
how common is edentallious patients betwen 65-74 years old
26%
how bad is it to be edentallious according to World health organization
Physically impaired and handicapped due to the ability to properly function
consequence of tooth loss on the face
small chin
does the alveolarbone stop remodeling
No, even with no teeth
fixing residual ridge resorption
Chronic, progessive and irversable
why do Complete dentures for residual ridges
mitigate the pressure exerted on residual ridge to further prevent resorption
Goals of complete dentures
Stability Retention Esthetics Comfort Function Support
resist lateral displacement and rotation during function
Stability
resist vertical displacement
Retention
resist vertical placement
Support
what to test for when trying in dentures
CR
VDO
what may contraindicate dental treatment
follow-up significant response
systemic conditions that may impact therapy
need a physician consultation
debilitating disease present
difficulty with edentulous patients
Multi-morbid patietns with complex polypharm is comm
side effect of anti-hypertensive meds
Dryness and postural hypotension
side effect of corticosteroid and anti-parkinsons agents
dryness and confusion
behavoral change
what therapy compromises the overal prognosis of complete denture therapy
therapies that lead to xerostomia
should roots be extracted
Fractured roots lying close to the surface of the mucosa
is retained or roots in the bone may be left is asymptomatic
what to check for in an extraoral examination
General appearance
Facial symmetry
eyes and skin: color, complexion, texture
lips and smile line: length, thickness, symmetry, mobility
Palpation of head and neck
Muscle tonus
TMJ examination: crepitus, clicking, popping, discomfort, deviations
Neuromuscular coordination
face shape for retrognathic
Convex
face shape for normal people
flat
face shape for prognathic
concave
what to check in an intraoral examination
Mucosa Cheeks Tongue Floor of the mouth Maxillary tuberosities Hard palate Soft palate Arch form and relationship Residual ridge form Quantity and quality of saliva Presence of undercuts
what to check for general tissue health
Mucosa thickness, density, color, and displaceability
what type of mucosa needs conditioning
Pathogenic
why might someone need anti-fungal
no teeth causes folds in mouth
what is checked in the intraoral examination of the tongue
size (normal vs large)
Position (normal vs retracted/retruded-35%)
what happens to the denture if the floor of the mouth is near the level of the ridge crest
retention and stability is severely compromises
what does hyperactive Floor Of Mouth do to a denture
Reduces retenetion and stability
what happens to the floor of the mouth if great ridge resorption
Floor of mouth in sublingual and mylohyoid regions spills over the ridge
what shape of residual ridge is best
U shape is most favorable for retention and stability
favorability of V shaped residual ridge forms
Unfavorable
favorability of Flat/shallow/knife edge residual ridge forms
Unfavorable
what happens to the dneture with flat/shallow/knife edges residual ridge forms
Resorbed ridges
Poor resistance to lateral forces
what happens to denture if maxillary tuberosity is hypermobile
Allows the denture to move
problem with maxilary tuberosity that is enlarged with fibrous tissue
the maxillary occlusal plane may be placed too low
what must be done with enlarge and fibrous maxillary tuberosities
surgical reduction may be necessary to create adequate interocclusal space for denture bases and teeth
why would you do ridge alveoloplasty
Accomodation of Complete denture
Reduction in pressure ulcers
Class I soft palate
Large and normal in form with a relatively immovable band of resilient tissue 5-12mm distal to aline drawn across the distal edge of the tuberosities
Class II soft palate
MEdium size and normal in form
relatively immovable band of tissue 3-5mm distal to a line drawn across the distal edge of the tuberosities
Class III soft palate
the curtain of tissue turns down abrutly 3-5 mm anterior to a line drawn across the distal edges of the tuberosities
what are hamular notches
Maximum posterior extent of the maxillary dneture
what forms the distal limit of the buccal vestibule
Hamular notches
what happens if you over extend the denture from the hamular notch
Inflammation and pain
what happens if you under extend a denture in relation to the hamular notch
Non-retentive denture
problem with mandibular dentures ridge
Less surface area for retention
tongue and floor of mouth to mandibular denture
interfere with retention
where is the keratinized attached mucosa of the mandibular ridge
onfined to the alveolar ridge
what happens if youover extend a mandibular denture
displaced
resorption rate of mandible vs maxilla
mandible is 4x faster
what makes up the buccal shelves
Dense cortical bone
do the buccal shelves resorb
No, due to muscle attachment
problem with frenum in the mandibl
can affect denture extensions
what is the retromolar pad
Triangular pad of tissue at the distal end of the residual ridge
what is found under the retromolar pad
dense cortical bone due to muscle attachment reistant to resorbition
why does the retromolar pad matter to dentures
must be covered for suppor and lack of long term cortical bone resptions
Creates peripheral seal
what does the retromylohyoid space determines
The posterior extension of the mandibular denture lingual flange
- determines stability and retention
what does Prognosis based on
bearing surface anatomy ability to reproduce CR Tongue Position Floor of mouth posture Neuromuscular control Dental history Psychological classification
what should preliminary impression do
Accurate rep of anatomical lands that permites fabrication of properly extended custom tray
what to do if someone has really problemmatic extraoral features
talk to a specialists
facial form may help with what
Class I, II, and III in addition to the shape of teeth
how far can mucosa displace
2mm
can you do dnetures on someone with a problem
No
ideal ridge shape
Class I
CLass II ridge
High palatal vaul, compromising retention
Class III ridge
ovoid, xombo of I and II
what is the appointments order for Dentures
- examination, diagnoses and preliminary impressions
- custom tray fabrication - definitive edentulous impressions
- master casts poured - Maxillomandibular relationship
- teeth are placed in - esthic try-in for CR, VDO verification
- Delivery
setting time for alginate
3-4 min