Why render a patient edentulous?

Question 1

Give some dental reasons for rendering a patient edentulous

Answer 1

• Difficult to articulate existing small dentition of natural teeth and an opposing complete denture
• rampant caries
• advanced periodontal disease
• severe tooth wear
• failing dentitions from overambitious treatment
• appearance of complete dentures > occlusal collapse

Question 2

What are the effects of edentulous on a patient?

Answer 2

Loss of mastication function
- can lead to loss of quality of life and general health issues due to reduced feeding

Poor aesthetics and self esteem

Issues with speech

Question 3

What clinical signs of effects of edentulism can be seen

Answer 3

Ridge resorption

Loss of facial height

Reduction in lip support

Pronounced folds at angles of mouth or around lips

Question 4

How can tooth extraction affect bone resorption?

Answer 4

Bone resorption occurs rapidly after the first extraction of a tooth, particularly first 6 months.

This is why retain teeth for ALAP.

Question 5

What non-dental reasons may we render a patient edentulous?

Answer 5

Head and neck chemo-radiotherapy causing osteo-radiation

Cancer resection or reconstruction in the maxilla / mandible

Pre-chemo or leukaemia treatment, dentition may pose a risk of infection

At patients request - consent to remove teeth

Question 6

When would a conventional denture be used? What are the benefits?

Answer 6

If there is no previous denture or the previous one was poor/unsuccessful

Can make major changes due to new design, and correct faults more easily

Question 7

What is and when would a replica denture be used? Advantages?

Answer 7

A replica of a previous denture, keeps the existing design and can add small adaptations to it.

Jaw registration is simple