Post-insertion Appointment Flashcards
All patients with new dentures should be appointed and seen ___ hours after insertion of the dentures
24-48 hours
The most crucial time in the patient’s perception of success or failure of dentures is the ___________ period
adjustment period
________________ may be the single most significant factor in the successful manipulation of complete dentures under function
Neuromuscular control
What are important prognostic indicators during the post-insertion appointment?
tongue function
denture wearing experience
What are the common problems of the mandibular dentures?
- discomfort
- poor retention and stability
- lack of support
What are the common problems of the maxillary dentures?
- poor retention and stability
- esthetics and phonetics
What are the 4 major areas to check during the post-insertion appointment?
- esthetics
- phonetics
- tissue irritations
- loss of retention and stability
What is the time to remedy esthetic problems?
trial placement appointment
What do you need to check with phonetics during the post-insertion appointment?
- check the thickness of the maxillary palatal portion
- reevaluate the position of max anterior teeth
- open vertical dimension of occlusion
- might just take time to adjust
What can cause tissue irritation?
- overextension
- trauma from faulty occlusion
- pressure from the denture base
- tissue abrasion from prosthesis movement
What are the possible causes of loss of retention and stability?
- occlusion
- base contours
- teeth not in neutral zone
- posterior palatal seal
- overextension or underextension
- salivary flow and character
What is a good way to have a patient point to an area of soreness?
use a cotton tipped applicator to touch the area
Soreness in depth of vestibule is usually caused by…
overextended border of flange
Soreness of the crest of the ridge is usually due to…
- occlusion error
or - pressure spot (tray show through)
What causes soreness to the frenum?
frenal notch is too shallow or too sharp
What causes soreness to the tissue overlying the coronoid process?
too much thickness at distobuccal corner of maxillary denture
What causes numbness or burning sensation to the anterior palate?
pressure on incisive papilla
What can cause soreness when swallowing?
- irrtation at mylohyoid ridge
- retrmylohyoid flange extension
What causes numbness or burning sensatio in the lower premolar areas?
pressure over mental nerve due to an atrophied alevolar ridge
What is a possible problem with buccal mucosa at the occlusal plane level?
- biting cheek
- trapping mucosa between base
What should you do to fix cheek biting during post-insertion appointment?
increase the horizontal overlap by grinding down the mandibular posterior buccal cusps
What is the problem with teeth contacting during speaking?
- OVD is too far open
- IOD (freeway space is too small)
- ridges are sore due to constant pressure
Dentures fit fine at first insertion, but loosen after wearing them for _______ hours
3-4 hours
- caused by occlusal errors
If the maxillary CD dislodges when yawing or opening wide what is wrong?
DB corner of denture is too thick
If smiling causes maxillary CD to dislodge what is wrong?
denture flange is too thick posterior to the buccal frenum
If the maxillary CD dislodges when eating what is wrong?
- posterior palatal seal too deep
- occlusion needs correction
What is wrong if there is whistling with s sounds?
anterior palatal contours are incorrect
What is wrong with dentures the dislodge easier than expected?
- Overextension of borders-”toaster denture”
- Form of external flanges
- Teeth locations violating “Neutral Zone”
What is the problem if the dentures feel to large and it is difficult to eat/speak?
- tongue space is too small
- tooth position violates the “neutral zone”
What is the neutral zone?
That area where the forces applied by the tongue is equal or neutralized by the force applied by the cheeks & lips
What can be wrong if the patient is gagging with the dentures?
- loose dentures
- poor occlusion
- incorrect extension or contour
- incorrect teeth positions
- an excessive OVD
- psychogenic factors
What does tissue trauma manifest as?
- Hyperemia
- Inflammation
- Ulceration
- Pain
Do you need to smooth and polish the areas of the denture that you adjust?
YES!
Polish cameo surface & borders (lathe on SLOW SPEED) – rag wheel
with pumice and then high shine
