Pros Flashcards
Limiting structures maxillary arch
Buccal sulcus
Buccal frenum
Labial sulcus
Labial frenum
Vibrating line
Hamular notch
Relief areas of maxillary arch
Palatine raphe
Crest of alveolar ridge
Palatine fovea
Support areas maxillary arch
Rugae
Tuberosity
Hard palate
Limiting structures mandibular arch
Labial frenum
Labial sulcus
Buccal frenum
Buccal sulcus
Retromolar pads
Lingual frenum
Alveololingual sulcus
Supporting structures mandibular arch
Buccal shelf
Residual alveolar ridge
Relief areas mandibular arch
Mylohyoid ridge
Genial tubercle
Objectives of complete dentures
Provide adequate masticatory function
Restore natural appearance
Restore normal speech
Comfort and preservation of supporting structure
Component parts of complete denture
Denture base, flange and border
Teeth
Denture surfaces
Polished surfaces
Fitting surface
Occlusal surface
Complete denture retention
The resistance to displacement of the denture base away from the ridge
Factors affecting physical retention of complete dentures
Adhesion
Cohesion
Atmospheric pressure
Gravity
Adhesion denture retention
Forces of attraction existing between dissimilar bodies in close contact - attraction between saliva and denture base
Cohesion denture retention
The forces of attraction existing between similar bodies in close contact - surface tension of saliva
Atmospheric pressure denture retention
The physical factor of hydrostatic pressure due to the weight of the atmosphere on the earth’s surface
Gravity denture retention
Working against the upper denture and for the lower denture
4 types of denture retention
Physical
Anatomical
Physiological
Mechanical
Anatomical factors affecting denture retention
Shape of edentulous area
Undercuts
Anatomy of border tissues
Physiological retention of dentures
Neuromuscular control - polished surfaces of the denture must be shaped to enable the musculature to fit naturally against the denture to reinforce the peripheral seal. The external form of the denture should allow the cheek and tongue to rest on the buccal and lingual flanges to hold in place
Viscosity and volume of saliva
Mechanical factors affecting denture retention
Balanced occlusion
Contour of polished surface
Position of the occlusal plane
Position of the teeth in respect to the ridge
Denture stability
Quality of a denture to be firm, steady and constant in position when forces are applied to it (especially to resistance against horizontal or rotary movements)
Stages of conventional complete dentures
Assessment
Primary impressions with stock trays
Master impressions with special trays
Occlusal rims and bases
Jaw registration and tooth selection
Wax tooth trial
Denture delivery
Effects of edentulism
Loss of masticatory function
Appearance
Self esteem
General health effects
QoL
Speech
Ridge resorption
Soft tissue changes to lip and chin
Reduction in facial height
Post extraction absorption
Happens rapidly particularly in first 6 months
May be dependent on pre-extraction status of teeth
Occurs throughout life
Why consider edentulism for a patient?
Caries and its sequelae - rampant
Advanced perio - hopeless teeth
Severe and debilitating tooth wear
Failing dentitions
Occlusal collapse
Appearance
Head and neck cancer radiotherapy
Pre chemo
Pre transplant - infection risk
Pre cardiac surgery such as prosthetic valve
When are conventional dentures made?
No previous denture / previous one unsuccessful
What information is required for complete denture construction?
Pt complaints
Denture history
Dental history
Medical history
Social history
Common patient complaints of dentures
Appearance
Eating
Pain/discomfort
Looseness
Retching
Speech
Denture history
Age of dentures
Matching set
Most recent set worn
Favourite set
First set of dentures
How many sets
Material
Success or failure
Dental history for dentures
When were teeth lost
Why were teeth lost
Retained roots/pain/swelling
Anxiety, mobility, attendance
Has anything else been tried for the current problem
Relevant medical conditions for dentures
Neuromuscular problems
Tremor e.g. parkinsons
Stroke
Dementia
Dry mouth
Medication
Sjogren’s syndrome
Radiotherapy
Social history
Alcohol/smoking
Barriers to treatment
Capacity
Support needed
Mobility
Extra oral exam
TMJ
Facial pathology
Facial contours
Appearance of dentures
Intra oral exam
Mucosal health
If overdenture abutments (retained roots)
Periodontal health
Periapical status
Caries
Common soft tissue conditions in denture wearers
Angular chelitis
Denture stomatitis
Denture hyperplasia
Support
Resistance of vertical movement towards the ridge
Freeway space
RVD - OVD
Intercuspal position
The complete intercuspation of the opposing teeth independent of condylar position, sometimes referred to as the best fit of the teeth regardless of the condylar position
Retruded Contact Position
Guided occlusal relationship occurring at the most retruded position of the condyles in the joint cavities
Adaptation
The degree of fit between a prosthesis and supporting structures
Jaw reg steps
Adjust upper block for retention
Adjust upper block for tooth position
Adjust upper block for occlusal planes
Lower tooth position and horizontal jaw relationship
Measure vertical dimension and establish face height
Record registration
Select shade, mould, setting
Possible causes of poor denture hygiene
Poor manual dexterity
Inability to self care
Xerostomia
Poor diet
Lack of knowledge
Poor neuromuscular control
Effects of poor denture hygiene
Caries
Periodontal disease
Denture stomatitis
Halitosis
Pain
