Tx Planning For Complete Dentures Flashcards
What information needed to make complete dentures?
Patient complaints
Denture history
Dental history
Medical history
Social history
What areas are often subject to patient complaint?
Appearance
Eating
Pain/discomfort
Looseness
Retching
Speech
Dislike wearing a denture
What information should be gathered under denture history?
Age of dentures
Matched set?
Most recent worn set?
When was their first dentures?
How many sets of dentures have they had?
Material of the denture
Were they a success or failure
What should be asked under dental history?
When were their teeth lost?
Why were their teeth lost?
Any retained roots, pain or swelling?
How is their anxiety, mobility and dental attendance
Has anything else been tried for current problem?
What are particularly important conditions that affect making complete dentures
Neuromuscular problems
Stroke
Dementia
Dry mouth
Medications - antidepressants, polypharmacy
Sjogren’s
Radiotherapy
Anti-resorption drugs - MRONJ
What information is needed from a social history?
Mobility
Barriers to treatment
Alcohol/smoking
Capacity to consent
Is support needed
What information is important to gather in an extra-oral examination?
Signs of TMJ dysfunction - click or tenderness
Facial pathology
Facial contours
Overall appearance of dentures
What information is important to gather in an intra-oral examination?
Mucosal health
If overdenture then abutments (retained roots)
Periodontal health
Periapical status
Caries
Support in edentulous areas
Mouth opening
What facial tissue problems to complete denture wearers often face?
Angular cheilitis
Denture stomatitis
Denture hyperplasia
Where is support found in the upper jaw?
Primary support area - hard palate
Secondary support area - ridge crest
Where is support found in the lower jaw?
Primary support areas - buccal shelf and pear-shaped pad
Secondary support areas - ridge crest and genial tubercles
What are the areas of examination when dentures are in the mouth?
Occlusal planes - anterior and posterior
Vertical height: RVD - OVD = Freeway Space
Occlusion recorded correctly
Lip support
Overextension or underextension
Retention
Stability
Adaptation
Describe the Intercuspal Position (ICP)
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
Describe the Retruded Contact Position (RCP)
Guided occlusal relationship occurring at the most retruded position of the condyles in the joint cavities
Which occlusion is used to make complete dentures and why?
RCP
ICP is not used as there are no natural teeth
What is retention?
The resistance to displacement of a denture away from the ridge
What is stability?
The ability of a denture to resist displacement by functional stresses
What is adaptation?
The degree of fit between a prosthesis and supporting structures
What are the areas of examination when dentures are out of the mouth?
Base extension - overextension or underextension
Tooth position
Excessive wear of denture
Alterations since insertion - repairs, additions
Denture hygiene
What happens in the pre-treatment phase?
Aim to make the tissues healthy prior to constructing replacement prostheses
Use of tissue conditioners: coe-comfort
Referral for investigation or further opinion if concerns about mucosa
What are the steps of formulating a treatment plan?
Pre-treatment phase if necessary
Referral for opinion if necessary
Reassessment and modify plan if necessary - history and exam
Construction of dentures
Review after treatment
What can alter treatment options in complete dentures?
Who - degree of difficulty
What - replica or conventional or combination
When - delay eg personal commitments or medical treatment
Where - patient mobility eg - care home
How - NHS or private
