Preparing the mouth for partial dentures

Question 1

define denture induced stomatitis

Answer 1

diffuse inflammation of denture bearing mucosa, often of multiple aetiology

Question 2

4 causes of denture induced stomatitis

Answer 2

candida albicans
poor denture hygiene
mechanical trauma
systemic conditions

Question 3

4 systemic conditions contributing to denture stomatitis

Answer 3

diabetes
iron deficiency anaemia
vit B12 anaemia
broad spectrum antibiotics

Question 4

6 modifications of existing dentures

Answer 4

• addition of clasps, teeth, flanges
• repair of fractures
• occlusal adjustment
• temp relining
• tx of denture induced stomatitis
• construction of interim prosthesis

Question 5

treatment of denture induced stomatitis

a. initial 4
b. if persists 3
c. final resort

Answer 5

a. -mechanical cleaning (soft brush)
- chemical cleaning (chlorhexidine)
- remove dentures at night
- temporary reline with tissue conditioner eg viscogel if trauma is a factor

b. -miconazole gel 24mg/ml QDS to fitting surface of denture before insertion
- nystatin pastilles 100 000 units QDS. suck for 5 mins then swallow (without denture present)
- fluconazole 50mg once daily for 7 days

c. refer to oral medicine department

Question 6

what should be done first: master impression or tx of denture induced stomatitis

Answer 6

tx of denture induced stomatitis

Question 7

how to clean acrylic dentures 3

Answer 7

• after every meal: rinse, remove debris with soft brush, soap, cold water
• soak in alkaline hypochlorite (miltons) for 20 mins max in the evening
• rinse dentures thoroughly with cold water and soak in cold water overnight

Question 8

how to clean metal dentures 3

Answer 8

-after every meal: rinse, remove debris with soft brush, soap, cold water
-soak in alkaline peroxide solution (sterident) for 15 mins OR alkaline hypochlorite (miltons) for 10 mins max in the evening
-rinse dentures thoroughly with cold water and soak in cold water overnight
STERI METAL

Question 9

what type of cleaner should NOT be used with metal dentures

Answer 9

acid cleaners

Question 10

8 possible pre prosthetic surgery

Answer 10

• removal of retained roots
• removal of unerupted teeth
• removal of bony exostosis (palatal/mandibular tori)
• removal of cysts
• removal of hyperplastic tissue
• frenectomy
• surgical crown lengthening
• gingivectomy

Question 11

explain the relationship between periodontal disease and prosthesis

Answer 11

prosthesis –> worse periodontal disease around denture AND opposing arch

• more plaque
• more pathogenic bacteria –> worse quality plaque

Question 12

outcome of prosthesis related periodontal disease

Answer 12

root caries

Question 13

what part of a denture are strongly associated with root caries

Answer 13

gingivally approaching clasps (worse in pts with cariogenic diet and poor plaque control)

Question 14

4 reasons for ortho treatment for prosthesis

Answer 14

• closing spaces
• redistributing spaces
• uprighting teeth
• intruding/ extruding teeth