Post insertion denture problems HTTP://.
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Transcript of Post insertion denture problems HTTP://.
HTTP://www.rxdentistry.net
Post insertion denture problemsPost insertion denture problems
• Complaints about Complaints about comfortcomfort of dentures of dentures causescauses
• Complaints about Complaints about functionfunction of dentures and of dentures and causescauses
• Complaints about the Complaints about the estheticsesthetics of the of the dentures and causesdentures and causes
• Complaints about the Complaints about the phoneticsphonetics with the with the dentures and causesdentures and causes
HTTP://www.rxdentistry.net
Complaints aboutComplaints about comfort comfort of of denture and causesdenture and causes
• Sore spotsSore spots
• Burning sensationBurning sensation
• Tongue and cheek bitingTongue and cheek biting
• Fiery redness of all tissues contacted by Fiery redness of all tissues contacted by denturedenture
• Redness of bearing tissuesRedness of bearing tissues
• Pain in temporomandibular jointPain in temporomandibular joint
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Sore spotsSore spots
• Sore spots in vestibuleSore spots in vestibule– Over-extended borderOver-extended border
• Sore spots posterior limit of upperSore spots posterior limit of upper– Posterior palatal seal too deepPosterior palatal seal too deep– Sharp posterior palatal sealSharp posterior palatal seal– Over-extensionOver-extension
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Sore spotsSore spots
• Single sore spots over ridgeSingle sore spots over ridge– Malocclusion in that areaMalocclusion in that area– Inaccurate denture baseInaccurate denture base– Bubbles of acrylic resinBubbles of acrylic resin
• Generalized soreness over the ridgeGeneralized soreness over the ridge– Vertical dimension too greatVertical dimension too great– Inaccurate denture baseInaccurate denture base
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Sore spotsSore spots
• Soreness under lingual flange of lowerSoreness under lingual flange of lower– Centric occlusion not in harmony with centric, Centric occlusion not in harmony with centric,
drives lower denture forwarddrives lower denture forward– Over-extended lingual flangeOver-extended lingual flange
• Soreness under labial flange of lowerSoreness under labial flange of lower– Too much overbiteToo much overbite– Patient’s habit, wants to masticate in protrusivePatient’s habit, wants to masticate in protrusive– Over-extended labial flangeOver-extended labial flange
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Burning sensation Burning sensation
• Anterior hard palate and anterior alveolar Anterior hard palate and anterior alveolar ridge areasridge areas– Pressure on anterior palatine foramenPressure on anterior palatine foramen
• Bicuspid area to molar tuberosityBicuspid area to molar tuberosity– Pressure on posterior palatine foramenPressure on posterior palatine foramen
• Lower anterior ridgeLower anterior ridge– Pressure on mental foramenPressure on mental foramen
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Tongue and cheek bitingTongue and cheek biting
• Posterior teeth edge to edgePosterior teeth edge to edge
• Over-closureOver-closure
• Posterior teeth too far lingual or buccalPosterior teeth too far lingual or buccal
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Fiery redness of all tissues Fiery redness of all tissues contacted by denture including contacted by denture including tongue and cheekstongue and cheeks
• Denture base allergyDenture base allergy
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Redness of bearing tissuesRedness of bearing tissues
• Ill-fitting dentureIll-fitting denture
• Avitaminosis Avitaminosis
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Pain in temporomandibular jointPain in temporomandibular joint
• Vertical dimension of occlusal too smallVertical dimension of occlusal too small
• Centric occlusion not in harmony with Centric occlusion not in harmony with centric relationcentric relation
• ArthritsArthrits
• Trauma Trauma
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Complaints about Complaints about functionfunction of of dentures and causesdentures and causes
• InstabilityInstability
• InterferenceInterference
• General feeling dentures are not right, but General feeling dentures are not right, but with absence of pain (patient has high pain with absence of pain (patient has high pain tolerance)tolerance)
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Instability Instability
• When not occludingWhen not occluding– Over-extension of border and posterior limitOver-extension of border and posterior limit– Under-extended borderUnder-extended border– Loss of posterior palatal sealLoss of posterior palatal seal
• Posterior palatal seal on hard palatePosterior palatal seal on hard palate
• Posterior limit not in hamular notchesPosterior limit not in hamular notches
• Insufficient posterior palatal sealInsufficient posterior palatal seal
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Instability Instability
• When not occludingWhen not occluding– Dehydration of tissues due to alcoholismDehydration of tissues due to alcoholism
– Flabby tissues displaced when making Flabby tissues displaced when making impressionimpression
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Instability Instability
• When incising foodWhen incising food– Loss of posterior palatal sealLoss of posterior palatal seal– Anterior teeth placed too far labiallyAnterior teeth placed too far labially– Poor denture foundation (flabby anterior Poor denture foundation (flabby anterior
tissues)tissues)– Improper incising habitsImproper incising habits
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Instability Instability
• When occluding in centricWhen occluding in centric– Mal-occlusionMal-occlusion
• Premature individual tooth contactsPremature individual tooth contacts
• High occlusion on one side of archHigh occlusion on one side of arch
• High occlusion in bicuspid areasHigh occlusion in bicuspid areas
– Upper denture riding on median hard palateUpper denture riding on median hard palate
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Instability Instability
• When occluding in centricWhen occluding in centric– Flabby tissues over ridgeFlabby tissues over ridge– Teeth set too far buccallyTeeth set too far buccally– Centric occlusion not in harmony with centric Centric occlusion not in harmony with centric
relationrelation
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Interference Interference
• Swallowing Swallowing – UpperUpper
• Over-extension in the posteriorOver-extension in the posterior
• Too thick in posteriorToo thick in posterior
– Lower Lower • Over-extension in the lingualOver-extension in the lingual
• Too thick lingual posterior flangesToo thick lingual posterior flanges
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Interference Interference
• Swallowing Swallowing – Over-closure of the vertical relation of Over-closure of the vertical relation of
occlusionocclusion– Posterior teeth too far lingual-crowds tonguePosterior teeth too far lingual-crowds tongue– Too great a vertical relation of occlusionToo great a vertical relation of occlusion
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Interference Interference
• Gagging Gagging – Immediate gagging on insertionImmediate gagging on insertion
• Over-extension (upper)Over-extension (upper)
• Too thick posterior border (upper)Too thick posterior border (upper)
• Disto-lingual flange too thick (lower)Disto-lingual flange too thick (lower)
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Interference Interference
• Gagging Gagging – Delayed gagging (2weeks to 2 months after Delayed gagging (2weeks to 2 months after
insertion)insertion)• Incomplete border seal allowing saliva under dentureIncomplete border seal allowing saliva under denture
• Mal-occlusion causing denture to loosen, allowing Mal-occlusion causing denture to loosen, allowing saliva under denturesaliva under denture
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Interference Interference
• Clicking Clicking – Vertical dimension of occlusion is too greatVertical dimension of occlusion is too great
– Unstable lower (borders over-extended)Unstable lower (borders over-extended)
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Interference Interference
• Deafness Deafness – Vertical dimension of occlusion is too smallVertical dimension of occlusion is too small
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Interference Interference
• Muscles of mastication become fatiguedMuscles of mastication become fatigued– Vertical dimension of occlusion is too smallVertical dimension of occlusion is too small
– Vertical dimension of occlusion is too greatVertical dimension of occlusion is too great
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General feeling dentures are not General feeling dentures are not right, but with absence of painright, but with absence of pain
• Patient has high pain tolerance.Patient has high pain tolerance.– Mal-occlusionMal-occlusion– Centric occlusion is not in harmony with centric Centric occlusion is not in harmony with centric
relationrelation– Incorrect vertical relation of occlusionIncorrect vertical relation of occlusion
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Complaints about the Complaints about the estheticsesthetics of of the dentures and causesthe dentures and causes
• Fullness under noseFullness under nose
• Depressed philtrum and/or nasolabial sulcusDepressed philtrum and/or nasolabial sulcus
• Upper lip sunken inUpper lip sunken in
• Shows too much of the teethShows too much of the teeth
• Artificial lookArtificial look
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Esthetic Esthetic
• Fullness under noseFullness under nose– Labial flange of upper too long or too thickLabial flange of upper too long or too thick
• Depressed philtrum and/or nasolabial sulcusDepressed philtrum and/or nasolabial sulcus– Labial flange too short, too thinLabial flange too short, too thin
• Upper lip sunken inUpper lip sunken in– Upper anterior teeth too far lingualUpper anterior teeth too far lingual
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Esthetics Esthetics
• Shows too much of the teethShows too much of the teeth– Vertical dimension too greatVertical dimension too great– Incisal plane too lowIncisal plane too low– Cuspids and laterals too prominent Cuspids and laterals too prominent
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Esthetics Esthetics
• Artificial lookArtificial look– Technique set-up, the teeth are in too regular Technique set-up, the teeth are in too regular
alignment (individualize by rotating and alignment (individualize by rotating and shortening some teeth)shortening some teeth)
– All teeth same shadeAll teeth same shade– Lack of grinding incisal edges and anglesLack of grinding incisal edges and angles– Lack of individualizing gingival contours and Lack of individualizing gingival contours and
color of denture basecolor of denture base
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Complaints about the Complaints about the phoneticsphonetics with the dentures and causeswith the dentures and causes
• Whistle on “S” soundsWhistle on “S” sounds
• Lips on “S” soundsLips on “S” sounds
• ““Th” and “T” sounds indistinctTh” and “T” sounds indistinct
• ““T” sounds like “Th”T” sounds like “Th”
• ““F” and “V” sounds indistinctF” and “V” sounds indistinct
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Phonetics Phonetics
• Whistles on “S” soundsWhistles on “S” sounds– Too narrow an air space on the anterior part of Too narrow an air space on the anterior part of
the palatethe palate
• Lisp on “S” soundsLisp on “S” sounds– Too broad and air space on the anterior part of Too broad and air space on the anterior part of
the palatethe palate
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Phonetics Phonetics
• ““Th” and “T” sounds indistinctTh” and “T” sounds indistinct– Inadequate inter-occlusal distantInadequate inter-occlusal distant
• ““T” sounds like “Th”T” sounds like “Th”– Upper anterior teeth too far lingualUpper anterior teeth too far lingual
• ““F” and “V” sounds indistinctF” and “V” sounds indistinct– Improper position of upper anterior teeth either Improper position of upper anterior teeth either
vertically or horizontallyvertically or horizontally