Intro and Edentulous Problem Flashcards

1
Q

What are the comorbidities with complete edentulism?

A
  • Malnutrition
  • Obesity
  • Increased COPD events
  • Increased pneumonia related hospitalizations
  • Increased risk of head/neck cancer
  • Decline in cognitive function
  • Predictor of cardiovascular disease mortality
  • Reduced, but nonreplaced dentition associated with increased risk of mortality
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2
Q

How many people in the USA are edentulous in at least 1 arch?

A

36 million

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3
Q

How many complete dentures are done each year in USA?

A

5.5 million

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4
Q

If you smoke, you are __x more likely to be edentulous

A

3 times

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5
Q

What percent of the gross salary of average general practice in the US is from partial or complete edentulism?

A

27%

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6
Q

What is the main problem with dentures?

A

In the edentulous state, there are few natural adapative mechanisms left. The dentures rest on tissues that will change progresively and irreversibly.

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7
Q

Almost all the principles of complete denture fabrication have been formulated to…

A

decrease movement
minimize the forces transmitted

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8
Q

More movement of the denture causes…

A

more soreness and more resorption

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9
Q

What are some basic causes of denture movement?

A

resiliency of tissue
instability of the dentures

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10
Q

What tissue do artificial teeth rest on in dentures?

A

mucous membranes

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11
Q

What are the supports in the natural dentition?

A

dentin
cementum
PDL
alveolar bone

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12
Q

What are the cm^2 area of PDL in each arch?

A

45 cm^2

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13
Q

What are the mean denture-bearing areas in the maxilla in cm^2?

A

23 cm^2 (1/2 of original)

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14
Q

What are the mean denture-bearing areas in the mandible in cm^2?

A

12 cm^2 (1/4 of original)

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15
Q

What is Wolff’s Law?

A

living bone responds to functional stress by depositing bone in areas of stress

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16
Q

What type of patients have very little adaptation to functional stress on alveolar bone?

A

edentulous patients

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17
Q

Wearing of dentures is almost always accompanied by an undesirable loss of _________

A

bone

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18
Q

In complete denture wearers, the mean reduction in anterior mandibular ridge is _____ times that of the maxillary ridge

A

4 times

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19
Q

How many hours a day should a patient remove the dentures?

A

at least 8 hrs/day

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20
Q

What are the proper impression techniques for a denture patient?

A
  • record tissues at rest
  • extend denture base to use max support area
  • placement of pressure on those tissues besta ble to tolerate stress
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21
Q

What are some ways to reduce pressure on residual ridges?

A
  • no contact of anterior teeth
  • clinical remount and equailibration at delievery to reduce occlusal issues
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22
Q

The maxillary ridge is partly covered by a layer of _____________ after teeth extraction

A

cortical bone

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23
Q

The mandibular ridge crest remains _________ after teeth are extracted

A

spongy and trabeculated
- not resistant to resorption

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24
Q

What type of bone is more resistant to resorption?

A

cortical bone

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25
Q

What is the buccal shelf?

A

primary denture support area on the mandibular arch (compact bone)

26
Q

What is the snowshoe principle?

A

decrease the pressure per unit area by extending the denture base to cover the maximum area with physiologic tolerance

27
Q

More saliva contact =

A

more contact adhesion (retention)

28
Q

Proper peripheral extension =

A

good border seal (retention)

29
Q

What is retention?

A

resistance to dislodgement/resistance to movement away from the foundation

30
Q

What challenges does xerostomia present to denture patients?

A

discomfort, ulcerations, retentnio loss, chewing problems

31
Q

Quantity and quality of ______ affects denture retention

A

saliva

32
Q

What medical conditions are associated with xerostomia?

A
  • autoimmune and inflammatory conditions
  • graft-versus-host disease
  • immunoglobulin G4- related sclerosing disease
  • degenerative disease
  • granulomatous disease
  • infections
  • salivary gland aplasia
33
Q

What medicines are associated with xerostomia?

A
  • anticholinergic drugs
  • antihistamines
  • antihypertensive agents
  • opioids
  • psychotropic agents
  • skeletal muscle relaxants
34
Q

What is adhesion?

A

attraction of unlike molecules for each other

35
Q

The amount of retention attributable to adhesion is directly proportional to…

A

the wettability of the denture base material, to the area covered by the denture base, and to the viscosity of the saliva

36
Q

What is stability?

A

resistance to movement in the horizonal plane/resistance to rotation/resistance to lateral movement

37
Q

What factors affect stability of the dentures?

A
  • shape of alveolar ridges
  • size of alveolar ridges/vestibular depth
  • flange length and shape
  • intimate fit of prosthesis
38
Q

What percent of denture wearers had at least one problem with a denture (Redford 1996)?

A

60%

39
Q

What are complete dentures often regarded as substitute treatment for?

A

expensive restorative therapy, periodontal therapy, or unesthetic dentition

40
Q

What is the new trend of denturism?

A

lab technicians feel that they should be allowed to bypass the dentist and deal directly with the public

41
Q

What are the steps of complete denures?

A
  • diagnosis
  • treatment planning
  • denture fabrication
42
Q

Dentures do not cure edentulism. They are not a substitute for natural teeth. They are a substitute for ______

A

no teeth

43
Q

The patient’s _____________ _____ ____________ _______ ________ _____ play a substantial role in overall complete denture success

A

personality and relationship with the dentist

44
Q

What are very important determinants of denture satisfaction?

A

psychological
social
interpersonal factors

45
Q

What are the three categories of prosthodontics?

A

fixed (crown and bridge)
removable (RDP)
maxillofacial

46
Q

What are the three big things to consider with compete dentures?

A

support
stability
retention

47
Q

What are the important factors of retention?

A

adhesion
cohesion
interfacial surface tension
intimate tissue contact
border seal
atmospheric pressure
neuromuscular control

48
Q

What is the resistance to displacement of the denture base away from the ridge?

A

retention

49
Q

What is the resistance to horizontal or rotational movements?

A

stability

50
Q

What is the resistance to vertical movement of the denture base towards the ridge?

A

support

51
Q

What does adhesion mean?

A

attraction between unlike molecuels

52
Q

What does cohesion mean?

A

force between molecules of same material

53
Q

What is the thin fluid film between 2 closely contacting objects?

A

interfacial surface tension

54
Q

What prevents ingress of air?

A

border seal

55
Q

What is a learned phenomenon (external contour of denture bases promote this)?

A

neuromuscular control

56
Q

What helps minimize residual ridge resorption?

A
  1. remove dentures at least 8 hrs/day
  2. proper impression techniques
  3. no contact of anterior teeth in centric relation
    - ensure occlusal harmony
57
Q

What are the 9 denture problems?

A
  1. dentures move in the mouth
  2. dentures creat pressure on supporting mucosa and bone
  3. pressure causes bone resorption
  4. bone resorption results in decreasing horizontal stability and decreasing retention
  5. retention of dentures requires saliva of good quality and quantity
  6. technical quality of dentures is not very high
  7. “Denturism”
  8. Not a substitute for natural teeth
  9. Life of dentures is 7-10 years
58
Q

What are the steps in complete denture fabrication?

A
59
Q

What are the four patient classifications?

A
  • philosophical
  • exacting/critical
  • hysterical
  • indifferent
60
Q

What is important on an intraoral exam of a denture patient?

A

mucosa
basal seat
arch form
interarch space

61
Q

What is border molding?

A

allows the intraoral soft tissues to form the length, width, and shape of custom tray borders prior to making the secondary impression