Reasons for rendering a patient edentulous Flashcards
What is a complete denture?
- removable dental prosthesis that replaces an entire dental arch (maxilla and/or mandible)
- full denture
CU
complete upper
CL
complete lower
F/F
complete upper and lower
-/F
natural upper dentition, complete lower
What are some problems associated with having a complete denture and natural teeth?
- occlusion is not controlled like in F/F
- uneven bite
- stability is difficult to achieve
What are the different types of complete denture?
- PMMA (acrylic), most common, usually last 5 years
- CoCr and acrylic, rare, used in those with severe bruxism
- nylon (base) and porcelain (teeth), used in those with allergies to acrylic, deteriorate quickly (18 months)
Edentulous
- when a person loses all their teeth
- debilitating, irreversible condition and considered final marker of disease burden of oral health, caused by failure to control the disease
What factors are relevant in edentulism?
- age
- socioeconomic
- MH
- OH
What are some of the effects of edentulism?
- self esteem
- general health (lack of nutrition due to limitations of mastication)
- quality of life
- speech (s/f/v sounds difficult)
- loss of masticatory function
- appearance
- ridge resorption
- soft tissue changes
- reduction in face height (assess this in EO exam)
What is the classification of ridge resorption called?
Cawood and Howell
Describe the atrophy stages of ridge resorption in the mandible.
- before extraction (tooth present)
- post extraction
- high, well-rounded ridge
- knife-edge ridge
- low, well-rounded ridge
- depressed bone levels (nerves/blood vessels may be exposed)
How do the maxilla and mandible differ in ridge resorption?
- mandible more susceptible to severe resorption
- maxilla tends to have better ridges for denture retention
Why are complete dentures a compromise restoration?
- inefficient at mastication
- requires good neuro-muscular control (stroke/parkinsons)
- stability of lower dentures compromised by tongue movements
What are some common reasons for patients to become edentulous?
- rampant caries
- periodontal disease
- debilitating tooth wear
- failing dentition
- occlusal collapse
- appearance
Describe a failing dentition.
- overambitious treatment can lead to the failure of natural teeth (ie over-extended bridges)
- cycles of replacement lead to more natural tooth tissue lost each time
What are some less common reasons for patients to become edentulous?
- head and neck chemo-radiotherapy
- head and neck cancer resection
- transplant patients
- cardiac surgery
- patient’s request
How does chemo-radiotherapy cause patients to become edentulous?
- radiation can cause osteo-radionecrosis (ORN)
- blood vessels in supporting bone are affected
- if teeth are extracted post-op (ie gross caries), large portions of bone can come with the tooth, poor healing
- teeth can then be extracted before cancer treatment as a preventative measure
How does being a transplant patient cause edentulism?
- transplant patients are often placed on immuno-suppressants post-op
- any infection in the mouth could have a greater impact
- teeth can be extracted as a preventative measure
How does have cardiac surgery result in patients being rendered edentulous?
- heart valve surgeries carry the risk of infective endocarditis
- poor dentition can carry significant infection risks
What are the different methods of complete denture construction?
- conventional dentures
- replica dentures
- digital dentures