lec 3 Flashcards
SOFT TISSUE REACTION TO DENTURE WEARING (2)
Injury and inflammation
Fibrous tissue growth (flabby hyperplastic tissue)
- If tolerance is low
. Injury and inflammation
- If tolerance is high and trauma tolerable
Fibrous tissue growth (flabby hyperplastic tissue)
CAUSES OF MUCOSAL IRRITATION (3)
- Mechanical irritation by denture
- Accumulation of microbial plaque on denture
- Toxic or allergic reaction to constituents of denture material
what does local irritation of mucosa increase?
mucosal permeability to allergens or microbial antigen
- Mild erythema or redness of the mucosa under the denture.
- Usually occurs in the maxilla
- Common in complete denture wearers
Denture Induced Stomatitis
o Middle to old age
o More common in females
o Has been found in up to 70% of denture wearers
Incidence of Denture Induced Stomatitis
o Wearing dentures at night
o Dry mouth
o Diabetes
o Increased carbohydrate diet
o HIV
Predisposing Factors of Denture Induced Stomatitis
Etiology of Denture Induced Stomatitis (4)
o Changes in the oral environment related to presence of dentures or removable orthodontic appliance
o Poor oral and denture hygiene
o Candida is the main cause (70%)
o Can also occur because of mechanical irritation and bacterial infections
localized simple inflammation or pinpoint hyperemia
Type I Denture Stomatitis
- a more diffuse erythema ( redness) involving a part or all the mucosa which covered by the denture.
Type II Denture Stomatitis
- inflammatory nodular/papillary hyperplasia commonly involving the central part of the hard palate and alveolar ridge.
Type III Denture Stomatitis
Management of Denture Stomatitis: (3)
- Correction of ill-fitting dentures
- Efficient plaque control (oral & denture hygiene)
- Anti-fungal therapy
- relining with soft tissue conditioner
- new denture when mucosa has healed
Correction of ill-fitting dentures
A soft high-molecular material which is applied to the impression surface of the denture base, to release the distortion and indentation of mucosa
Soft tissue conditioner/liner
- Remove and clean denture after meal
- Clean & massage mucosa with soft toothbrush
- Remove dentures at night
Efficient plaque control (oral & denture hygiene)
o Ketoconazole
o Amphotericin B
o Miconazole
o Clotrimazole
Local therapy
o Nystatin
o Fluconazole
Systemic therapy
Other terms of Angular Cheilitis
à Angular Cheilosis
à Perleche
à Stomatitis
- Often correlated with candida-associated denture stomatitis.
. Angular Cheilitis
o Overclosure of jaw
o Nutritional deficiencies
o Iron deficiency anemia
- Predisposing Factors of Angular Cheilitis
- 80% are associated with denture wearers.
angular cheilitis cases
- Long term denture wearers:
o Attrition of teeth
o Attrition of teeth due to prolonged usage, and resorption of the residual ridges, results to decreased vertical dimension.
- Long term denture wearers:
o Decreased vertical dimension
o Decreased vertical dimension results to deepening of the nasolabial groove, specially at the corners of the mouth, which leads to collection of saliva in this area resulting in skin being dry and fissured.
- Management of Angular Cheilitis: (5)
o Due to its varied etiology, unless the primary cause is corrected, the infection is not primarily cured.
o Antifungal, anti-inflammatory, or antimicrobial suspensions
o Corticosteroids
o Intralesional injections
o New dentures
- Due to replacement of bone by fibrous tissue.
Flabby Ridge
- Flabby Ridge is most common in _________
anterior part of maxilla when opposed by remaining anterior teeth in the mandible.
Flabby Ridge is caused by __________
excessive load of residual ridge and unstable occlusal condition.
- Management of flabby ridge (2)
Ø Remove surgically
- To improve stability & to minimize alveolar ridge resorption.
Ø In extreme atrophy, not totally removed because vestibule will be eliminated.
What does sequalae mean?
any complication or condition that results from a pre-existing illness, injury, or other trauma to the body
à Inflammatory fibrous hyperplasia,
à Denture-induced fibrous inflammatory hyperplasia,
à Denture injury tumor,
à Denture epulis,
à Denture induced granuloma, and
à Granuloma fissuratum
Denture Irritation Hyperplasia (Epulis Fissuratum)
- A benign hyperplasia of fibrous connective tissue which develops as a reactive lesion to chronic mechanical irritation produced by the flange of a poorly fitting denture.
Denture Irritation Hyperplasia (Epulis Fissuratum)
causes of Denture Irritation Hyperplasia (Epulis Fissuratum) (2)
o Chronic injury by unstable denture
o Thin, overextended denture flange
o Maybe single or quite numerous
o Composed of flaps of hyperplastic connective tissue
- Signs of Denture Irritation Hyperplasia (Epulis Fissuratum)