Identification Of Complete Denture Problems
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This document discusses factors that can cause discomfort with dentures, including adverse anatomy, clinical issues, technical problems, and patient adaptation factors. It lists specific issues like impression surface problems, occlusal surface problems, looseness arising from reduced retention or increased displacing forces, and problems with adaptation. Potential causes and treatments are provided for each factor. The document also references several sources on the topic of complete denture prosthodontics.
Identification Of Complete Denture Problems
- 1. JOURNAL CLUB DEVI 2nd MDS Amrita School of Dentistry
- 4. • Adverse intra oral anatomic factors • Clinical factors • Technical factors • Patient adaptional factors 4
- 5. List of factors resulting in discomfort related to the impression surface of dentures 5 1
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- 11. Factors resulting in discomfort-relating to occlusal and polished surfaces 11 1
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- 15. • 5. Cheek and or lip biting • For cheeks-likely that functional width of sulcus was not restored ; for lips-poor lip support/inadequate anterior horizontal overlap • for cheek biting – restore functional width of sulcus and/or reset; for lips-grind incisors to provide a more appropriate incisal guidance angle 15
- 16. 6. Tongue biting • Lack of lingual overjet-teeth generally placed lingual to lower ridge • Remove lower lingual cusps, or reset teeth 16
- 17. Related polished surfaces 17 Symptoms : Causes : Treatment :
- 18. Factors resulting in discomfort-factors with possible systemic associations 1. Burning sensation 2. Beefy red tongue 3. Frictional lesions 4. Tongue thrusting 5. Herpetiform ulcers 6. Painful click to TMJ 7. Allergy to dental material 8. Painless erythema of mucosa 18
- 20. Factors resulting in looseness of dentures- arising from decreased retention factors 20 A. Lack of Peripheral Seal
- 21. • B • Inelasticity of cheek tissue • Aging • Softened tracing compound 21
- 22. c. Air beneath the impression surface • Causes: o deficient impression, o damaged cast, o warped denture, o over adjustment of impression surface, o RRR, o under cut, o excessive relief , o change in fluid content of supporting tissue. 22 Treatment : Reline Remake Stabilise fluid content of tissue & use minimal pressure impression method.
- 23. d. Xerostomia • Medication • Radiation H & N region • Salivary gland disease Design denture to maximise retention Artificial saliva 23
- 24. Neuromuscular control • Essential • Correct design faults 24
- 25. Factors resulting in looseness of dentures : arising from increased displacing force 25
- 26. Factors resulting in looseness of dentures : arising from increased displacing force -occlusal and anatomical factors • 1. occlusal errors : Causes : • uneven tooth contact – tilting of dentures, prevents seating • lack of freedom in ICP- denture will shift 26
- 27. • 2.ulceration labial to lower ridge Excessive vertical overlap of anterior teeth Last mandibular molars placed too far posteriorly 27
- 28. • 3. fibrous displaceable ridge Masticatory forces tend to cause denture to sink into and tilt towards supporting tissues Reline 28
- 29. • 4.bony prominences covered with thin mucosa o Denture rocks over prominences 29
- 30. • 5. Non-resilient soft tissue Does not adapt to impression surface of denture reducing support and retention factors Reline , use low viscosity imp. material 30
- 31. • 6. pain avoidance mechanisms : Use of excessive amounts of fixative , or self-applied reline material Eliminate the cause of pain. 31
- 32. List of denture problems associated with problems of adaptation 32 Noise on eating or speakingNoise on eating or speaking Eating difficultiesEating difficulties Blunt teeth Blunt teeth Jaws close too farJaws close too far Not wide enoughNot wide enough Speech problemsSpeech problems GaggingGagging AppearanceAppearance Too much visibility of teeth Too much visibility of teeth Creases at corners of mouth Creases at corners of mouth Colour of denture base material ‘unnatural’ Colour of denture base material ‘unnatural’
- 33. 1. Noise on eating /speaking • Increased OVD • Occlusal interferences • Poor perception of patient to denture wearing • Loose denture 33
- 34. 2.Eating difficulties • Unstable denture 34
- 35. 3.Blunt teeth • Broad posterior occlusal surface • Non anatomical type teeth 35
- 36. 4. Jaw close too far • Lack of OVD • May increase up to 1.5mm by relining / remake 36
- 37. 5. Cannot open mouth wide enough for food • Excessive VDO • Can remove up to 1.5mm from occlusal plane /remake 37
- 38. 6. Speech problems • Unfamiliarity • Retention & Stability ??? 38
- 39. 7. gagging • Loose dentures • Thick distal border of upper denture • Lingual placement of upper posteriors • Low occlusal plane 39
- 40. 8. Appearance • Patient failed to comment at trial stage • Replacement ? • Teeth – too light /dark !! _ too small / big !! _ arrangement-too even / irregular or lacking diastema “ Accurate assessment of patient’s requirements “ 40
- 41. 9.Too much visibility of teeth • Level of occlusal plane – unacceptable • Placed on upper anterior ridge • No proper lip support 41
- 42. 10. Creases at corners of mouth • Labial fullness and anterior tooth position • OVD 42
- 43. 11. ’ Unnatural’ colour of denture base material 43
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- 45. References • J.F.McCord, A.A. Grant. BDJ vol 189 no 3 august 12 2000 • Complete denture prosthodontics –sharry • Essentials of complete denture prosthodontics – sheldon winkler 2nd edition • Complete denture : swenson • Syllabus of complete denture: Heartwell • Bouchers prosthodontic treatment for edentulous patients 45
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