Module 4 Flashcards
What are the purposes for wearing dentures?
- replace missing teeth adn adjacent structures
- provide function
What adjacent structures do dentures restore?
facial contour, lip support, tmj position
What are the types of removable dentures?
- tissue supported denture
- implant denture
- overdenture
- interm partial prosthesis
- immediate denture
- denture for primary teeth
What is a tissue supported denture
replaces entire dentition, rests on the mucosal covered ridge
What is an implant denture
supported in whole or part by one or more implants
what is a overdenture
rests on one or more remaining teeth, tooth roots, and or implants
what is an interm denture prosthesis
designed to enhance esthetics, stabilization, and fuction for a limited period after which it will be replaced by a definative prosthesis
WHat is an immediate denture
fabricated for placement immediately following the removal of a natural tooth or teeth
What is a denture for primary teeth
- replace teeth that may be congenitally missing or have been ext from rampant caries
- provide esthetics and function
- as permanent teeth erupt parts of denture are cut away
- caries prevention is initated to pretect permenant
WHat happens with residual ridged after teeth have been removed
they are in a continual process of remodeling
What undergoes resorption in an edentulous mouth
the alveolar bone
How long do the major bony changes occur after teeth are removed
mostly in the first year but continues throughout life
Mandibular bone loss is ________ times greater than maxillary bone loss
four
What may need to be removed before a denture can be constructed?
Tori, and exostosis
What does masticatory muscosa cover in an edentulous pt.?
edentulous ridges and hard palate (lamina propria and stratified squamous epithelium-keratinized)
WHat does the lining mucosa cover in an edentulous pt?
floor of the mouth and vestibules and cheeks
what is the submucosa?
unerneath the mucous membrane which is attached to bone, composed of CT with vessels nerves and glands
what does the submucosa support?
its supports or cushions the denture, depends on the makup of the submucosa, varies throughout mouth
Can you see the MGJ in an edenulous patient?
a line of demarcation similar to the MGJ is present
Are the frenal attachments still observed in edentulous patients/?
yes
How do you prepare a patient for new dentures?
- start well in advance of delivery day
- may be emotional
- give patient idea of what to expect
- denture satisfaction after delivery is due to contidioning before
What is postinsertion care for an immediate denture?
- leave denture in for 24 to 48 hours after extraction
- pt returns to have denture removed, rinse and give instructions
What is postinsertion care for new dentures over healed ridges?
- regular appts. 1st appt w/in 24 to 28 hrs
- limit instructions to basic care
- reptition over several appts
- written instruction
- denture cleaning methods
What can alveolar ridge remodeling lead to ?
- loss of denture support, facial height, lip support
- increased chin prominence
- TMJ manfestations
- occlusal disharmony
How does the patient compensate for bone changes?
- the way they wear and manage dentures
- drug store remedies
- denture adhesives shouldnt be used to compensate
How do the tissues react to dentures?
- varies
- one mouth may have thinning of mucosa and sub, particularly the epithelium
- another mouth may have normal keratinization
What are factors that influence the mucosa
- systemic
- againg-thiner mucosa
- denture and tissue hygiene
- wearing denture constantly
- xerostomia
- fit and occlusion of denture
What is the effect of xerostomia in denture wear
diminished salivary flow can influence tissue lubrication
Why is lubrication important
saliva is needed for protection against frictional irritaion by the denture
why is saliva important in denture retention
helps create suction of the denture
How does the tactile sense change in a denture wearing patient?
- sensitivity diminished to small objects in mouth
- proprioception is lost due to abscence of PDL
How does taste change in denture wearing patients
food has a different taste, taste buds of palate are covered, biofilm on dentures can alter taste
What do we do with a denture patient?
do and intra and extra exam to look for mucosal leisons because they are asymptomatic
What are the principal causes of leisons under dentures?
-ill fitting dentures
-inadequate OH
-continuous wearing of dentures
-
Why do ill fitting dentures cause leisons
- tissue changes occur over time
- pt may not been informed of having regular exam of dentures and mucosa
why does inadequate OH cause leisions
- dentures and mucosa need daily care
- denures can accumulate heavy biofilm or calculus that may irriate mucosa, cause infection and inflammation
Why does continuous wearing of dentures cause leisons
- mucosa needs rest
- allows tissue to recover in its natural environment
What are contributing factors of inflammatory leisons
- denture trauma from fit occlusion or habits
- OH
- chemotoxic effect from cleaners
- allergy to denture base
- pt self treatment
- continuous wear
What is another name for localized inflammation
sore spots
What is the appearance of localized inflammation
red, inflamed, ulcerated
waht are contributing factors to a sore spot
tongue bite, trauma, foreign object under denture
What is generalized inflammation caused by
candida albicans infection
What form of oral candidiasis is a reoccuring disease common to denture wearers
denture stomatitis
Whar are characteristics of Candida albicans
red, inflammed, burining, discomfort, bad taste,
are denture wearers aware of they have candida albicans
usually not
What is the etiology of candida albicans
-trauma, continual wear, decreased salivary flow, lack of denture cleanliness, attachement of biofilm to old dentures
What patients are more prone to oral candidiasais
-depressed immune system, head and neck radiation therapy, antibiotic use
What kind of tx is typical of oral candidiasis
antifungal, new denture, massaging tissue
What are ulcerative leisons relate to?
overextended denture border
What does an ulcer resemble?
a cancerous leison, should be biopsied if it lasts 2 weeks after adjustment
What is the appearance of papillary hyperplasia
located on palate, rarely outside confines of bony ridges, group of closely arranged pebble shaped red edematous projections
what are contributing factors of papillary hyperplasia
unknown
what is papillary hyperplasia associate with
poor denture hygiene, ill fitting dentures, possibly C albicans
What is another name for denture irritation hyperplasia?
epulis fissuratum
What is the appearance of epulis fissuratum
long standing, chronic inflammatory tissue that appears in single or multiple elongated folds r
what is epulis fissuratum related to
the border of an ill fitting denture
What is the appearance of angular chelitis?
fissuring at angles of the mouth with cracks, ulcerations, and erythema, moist with saliva or dry with a crust
What are contributing factors of angular chelitis
- lack of support of the commisure because of overclosure
- riboflavin deficiency or c.albicans infection
what is used in treatment of angular chelitis
antifungal
What is best for prevention of denture problems
denture hygiene care of oral mucosa rest for tissues diet and nutrition relief from xerostomia dental caries control
When should dentures be cleaned
after each meal, cleansing solutions should be cleaned daily
How should oral mucosa be cleaned
brush to clean and massage and preform digital massage
What kind of rest should be provided for tissues
-out while sleeping, may cause TMD
-daytime for as long as possilbe
-keep in solution while out of mouth
-
teaching of food selection cant be ______
overemphasized
What foods should be emphasized
-foods from basic food groups
What should be controlled and avoided
weight, avoid foods that are related to specific chronic condiditons
What may affect nutrition
learning to adapt to an inital denture
What should a patient with a new denture be instructed to consume
soft diet to relearn to chew
How can a patient get relief from xerostomia
saliva substitutes
WHat is so important for overdenture wearers?
meticulous care of natural retained teeth
What should over denture wearers with natural teeth use everyday?
fluoride
When can a patient expect to need a reline,rebase or remake of a new denture?
6 months to 1 year
What is the frequency of maintenance appointments with a denture wearing patient?
depends on patients needs and risk factors, seek care for discomfort
Why do we mark dentures?
- legally required
- ID patient in forensic dentistry
- immediate identification
- ID mislaid dentures in rest homes
What is the criteria for marking a denture relative to the denture?
no effects on denture,must not compromise denture, cosmetically acceptable
What makes a good marking procedure?
easy, simple, inexpensive, durable
What are the characteristics that should be used in a marking system
fire and humidity resistant, raqiopaque
How are new dentures marked?
enclosed insert in denture material, covered with acrylic
what materials are used to make the id label of a denture
onionskin, tissue paper, metal strip, microchips, copper vapor abel
how do you mark existing dentures?
make an indentation with a bur for the paper, cover with acrylic
how to use a idelible pen or ballpoint for marking denture
put identification on, cover with fingernail acrylic, lasts 6 months
How to use an engraving tool?
grooves created with engraver, darkened with a special pencil and then sealed
What information should be included on a denture in a nursing home
name and intials
what should be included on a denture marking in a community?
name, s security #, armed service #
what other useful information should be included on a denture?
blood type, vital drug, disease or condition
what markings are the most significant
information that will provide immediate identification
