denture-complaint.pdf

7/27/2019 Denture-Complaint.pdf

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Complaints

Diagnosis Causes Treatment

Patient

DissatisfactionDenture error

Denture settling

Denture

limitations

Types of

atients

Philosophical ExactingIndifferentHysterical

De ntu re C ompl ai nt

Problems

Retention Support Muscle BalanceOcclusal

Balance


2/10

Complaints1- Over extension Movement interfere with muscle movement ( Stability)

2- Under extension Break the Seal ( Retention)

3- Trimming Thick or thin border (ttt) Boxing.

Problems of New Denture

[ I ] Tissue irritation


3/10

In the form of :

Hyperemia Cut in vestibule Ulceration

Causes:

Over-extension Pressure by denture Movement of denture Improper occlusion

ttt:

Remove the cause Tissue rest

Types:

Generalized Localized

Acute Chronic

1) Generalized Tissue irritation


4/10

2) Localized Tissue Irritation

TuberosityRetro

Mylohyoi

d

Median

Palatine

Raphe

Ant. lingual

& Lat.

buccal slop

VestibuleCrest

- Over

extension

- Over

extension

labially lift

the denture

posteriorly.

____

Over extension

(displacing

wax)

- Un polished

(Visual&

digital)

*D.D.

Aphsus ulcer

__

Border

- Bilateral

undercut

(Relief)

- Pressure

area

- Dimensional

changes

(Relief

Rebase)

- pressure- relief

(Denture

rocking)

- support

of 1ry stress

bearing

area

(Relining or

Rebasing)

- Pressure

__

-Ridge

(x ray &

visual *Ex)

-Spicules&

remaining

roots

(Visual Ex)

- Denture

pressure

*(P.I.P.)

Basal

Seat

__

- Occlusal

interference

on oppositesideDenture

move in

opposite

direction.

- Anterior

contact in

C.R. *ttt(Reset)

- Deflective

occlusal contact

7 7

- *C.O. *C.R.

Loose denture

anteriorly

- Tooth off

ridge

- Deflective

occlusal

contact

Occlusion

D.D. Differential Diagnosis.

Ex. Examination.

P.I.P. Pressure Indicating Paste.

C.O. Centric Occlusion.

C.R. Centric Relation.

ttt Treatment.

C.C. Chief Complaint.


5/10

[ II ] Poor Denture Fit

Cause: Lack of retention& Support.

Lower denture more than Upper. Why?

Support Saliva Tongue

Chief complaint (C.C.):

Loose denture Too bulky Rocking denture

Related symptoms:

Normal Abnormal

- Open wide (Yawing) Coronoid process. - Speaking.

- Cough& sneezing the pressure. - Eating.

- New denture Saliva. - Pain.


6/10

[ III ] Pain

[ IV ] Esthetic problem

Color :


7/10

a) Teeth too dark or too yellow.

b) Acrylic resin.

Size:

a) Too larger.b) Too smaller.

Arrangement:

a) Too even or Irregular.

b) Visibility of anterior teeth (Too for forward) or (Too for backward).

c) Cheeks& lips Falling-in Unsupported lip& cheek Plumping (Building-out

the upper denture to compensate for the loss of muscular tone).

Nose& Chin approximation (closed bite):

- Due to Vertical dimension.

General dissatisfaction:

- Who? Female / middle age.- Need Kindness& Patience.

[ V ] Spee ch d if ficul tie s

Anterior teeth:a- Vertical overlap "S" sound.

b- Improper Labio-lingual positioning "S" sound (Whistling or lisping).

Encroachment on tongue space:

a- Posterior teeth placed too far lingually.

b- Too great Bucco-lingual width of posterior teeth.

c- Excessive thickness of the lingual flange.d- Poor palatal contour (Rugae area) "S" sound P.I.P.

Poor denture retention.

Excessive salivation. Vertical dimension P, B, F, V.

N.B. When pronouncing letter "S" the lateral margins of the tongue Contact the lingualsurface of posterior teeth, and the tip of the tongue contact with the palate in rugae area

forming a slit like channel.

a. Whistling: If anterior teeth placed too forward, the channel will be to large& the

air will escape with a whistling sound Resetting the teeth backward or

thickening the denture base behind these teeth.

b. Lisping: If anterior teeth placed too backward, the channel will be obliterated&

the patient may lisp Resetting the anterior teeth forward or reducing the

denture base in the Rugae area.


8/10

[ VI ] Nausea Cause: Contact of the denture with the soft palate or the tongue.

Posterior Periphery of upper denture Loose denture

Over-extension Under-extension Thickness

[ VII ] Inef fic ient e ating Borders Improper.

Basal seat Unstable denture.

Occlusion

Teeth Vertical dimensions

Blunt Flat cusps V.D.O. V.D.O.

Elevate the muscle& don't work. Patient can't open to get food.

[ VIII ] Cheek, Lip& Tongue Biting

a) Cheek& Lip biting:

Overlap Lower buccal cusp or Reset.

Laxity of muscle (loose of muscle tone).

Vertical dimension sagging of cheek.


9/10

b) Tongue biting:

Teeth set lingual Rounding the lower lingual cusps or Reset.

[ IX ] Alter taste

[ X ] Clattering teeth

Unfamiliarity with Vertical dimension Cuspal interference Unstable dentureNew denture.

- Teeth contact sooner.

Problems of Old Denture


10/10

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