Pathology Related to Dentures Flashcards
What feature of a denture is most likely to lead to oral mucosal lesions?
ill-fitting dentures
In what ways can dentures cause pathology?
- mechanical denture injury
- usually accompanied by acute/chronic reaction
- acute or chronic reactions
- microbial denture plaque
- poor denture hygiene
- usually accompanied by mechanical injury
- microbial denture plaque
- allergy
- constituents of denture base
- most commonly acrylic
- rare
- constituents of denture base
What pathological changes can be seen and associated with dentures?
- ulcers
- denture stomatitis
- angular chelitis
- denture irritation hyperplasia
- flabby ridges
- MRONJ/osteoradionecrosis
- allergic reactions
How can dentures lead to ulcers?
- mostly related to denture trauma
- ill fitting denture
- overextension
- sharp areas on denture
- occlusal trauma
- occlusal error in denture
- one area receiving all occlusal forces
Where are the most common locations to find ulcers associated with dentures?
- lingual frenum
- mylohyoid ridge
- undercut areas
- rarely a primary load bearing area
How should ulcers caused by dentures be addressed?
- identify the source of trauma
- pressure indicating paste
- articulating paper
- ease
- occlusal adjustment
- acrylic trimming
- polishing of base
- review
- be vigilant about suspicious ulcers
At what point should an ulcer cause concern and what action should be taken?
- non-healing ulcer despite adjustments
- obviously suspicious lesion
- location not conducive with trauma
- lateral tongue
- floor of mouth
- location not conducive with trauma
- unexplained ulceration
- persisting over 3 weeks
- urgent referral to max-fac
- must check local procedures
How can dentures cause denture induced stomatitis and what is its appearance?
- closely related to denture bearing area
- denture hygiene issue most commonly
- Candida albicans
- oedema and erythema
- shape of denture base
- usually painless
How can denture stomatitis be managed?
- denture hygiene advice
- take denture out at night
- clean denture with soft brush
- steep denture in appropriate solution
- chlorhexidine mouthwash
- antifungals
- fluconazole on denture
- new denture
- infiltration of fungi into acrylic base
- master impression once oedema reduced
- Coe Comfort as barrier
What conditions can be associated with denture induced stomatitis?
- deficiencies
- folate
- vitamin B12
- ferritin
- diabetes
- angular cheilitis
How can dentures cause angular cheilitis?
- worn dentures lead to over closing
- loss of vertical dimension
- excessive freeway space
- fungal overgrowth
- Candida Albicans
- Staph. Aureus
- Beta-haemolytic streps
How can angular cheilitis be managed?
- construction of new dentures
- increased OVD
- reduced freeway space
- reduced over-closing
- antifungals
- miconazole
- be aware of interaction with coumarins
- miconazole
What conditions can be associated with angular cheilitis?
- diabetes
- deficiencies
- folate
- vitamin B12
- ferritin
- xerostomia
- often polypharmacy
- denture induced stomatitis
How can dentures cause denture irritation hyperplasia
- usually old, ill-fitting dentures
- chronic trauma
- hyper plastic response
How can denture irritation hyperplasia be managed?
- major ease of denture
- remove large amounts of acrylic
- denture will not fit
- placement of tissue conditioner
- Coe Comfort
- review and repeat tissue conditioner
- must allow tissues to shrink back
- new denture
- referral to oral surgery
- only for severe cases
- removal of excess tissue
