Pathology Related to Dentures Flashcards
What pathologies are associated with Dentures?
Ulcers- mostly traumatic
Denture stomatitis
Angular cheilitis
Denture irritation hyperplasia
Flabby ridges
MRONJ/Osteoradionecrosis- relieve space (no load on these areas)/prevent through well fitting dentures
Allergic reactions
What sites do ulcers caused by dentures usually occur at?
Undercut regions
Lingual frenum
Mylohyoid ridge
-> tends not to be primary load bearing areas
What aspects of dentures can make them cause ulcers?
If denture is overextended/becomes ill fitting
If there are sharp bits
Occlusal trauma
If particular area pressing on localised area too hard
** common in new dentures
How are dentures adjusted to prevent the causing ulcers?
Identify area of denture responsible for ulceration
-> Pressure indicating paste/articulating paper
Ease with acrylic bur
-> Occlusal adjustment
-> trim/polish base
-> Combination
Review within a few weeks to check healing
When should ulcers be referred urgently?
If ulcers do not heal despite adjustments
If lesion is very suspicious- large, rolled edges, doesn’t look related to trauma
If unexplained ulceration/induration/swelling of oral mucosa that has persisted for 3 weeks
Refer to MAXFACS
How does denture stomatitis present?
Oedema and erythema in the denture bearing area
How is denture stomatitis managed?
Take denture out at night
Clean denture with a soft brush
Steep denture- Milton (3 x 30 mins per week- not chrome)
Chlorhexidine mouthwash
Use of nystatin or fluconazole
Consider making new denture
Consider deficiency/disease that may be underlying- diabetes or haematinic deficiency
What are the denture related causes of angular cheilitis?
Over-closure- loss of OVD/excessive FWS
-> often related to old worn ill fitting dentures (consider replacing)
-> Associated with denture stomatitis
What pathogens are associated with Angular Cheilitis
Candida albicans
Staphylococcus Aureus
Beta-haemolytic strep
What are the potential underlying factors that contribute to Angular cheilitis in denture wearers?
Diabetes
Haematinic deficiency
Xerostomia- polypharmacy
How is angular cheilitis managed?
Using miconazole (interacts with Coumarins)
How does denture irritation hyperplasia occur?
Chronic trauma from old/ill-fitting dentures results in hyper plastic respond of tissues
How is Denture hyperplasia managed?
Major ease of denture or remove denture for a week
Use of tissue conditioner- COE comfort
Review and repeat
Consider replacement denture
What is the cause of flabby ridges?
Trauma of denture hitting usually anterior ridge often when lower anteriors only present and no lower denture
-> bone resorption and fibrous replacement resorption (ridge becomes easily displaceable)
What can be done to manage flabby ridge?
Make new denture covering whole denture bearing area with good peripheral seal
-> as ridge is displaceable- may need special impression technique
Ensure opposing arch has denture to give posterior support
