Post insertion complaints in complete dentures

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complete dentures, complaints, post insertion , common and uncommon complaints, management

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Post insertion complaints in complete dentures

  1. 1. Vinay Pavan Kumar.K 2nd year P G student Dept of Prosthodontics AECS Maaruti College of Dental Sciences
  2. 2. Post insertion complaints Classification of post insertion denture problems Management Common Complaints Uncommon Complaints Complains on aesthetics of the denture Complains on phonetics Complains on comfort of the denture
  3. 3. “ Most of the complaints associated with complete dentures are actual and not psychological, contrary to the belief of most clinicians.” Verma.M ,Post Insertion Complaints in Complete Dentures - a never Ending Saga; Journal of Academy of Dental Education, Vol 1, No 1 (2014), Pg: 1-8 “There was no statistically significant relationship between patient age, gender, systemic health and denture complaints; but statistically significant relationship exist between types of denture, denture faults and complaints.” Ogunrinde.T.J, The Influence Of Demographic Factors And Medical Conditions On Patients Complaints With Complete Dentures. Ann Ibd. Pg. Med 2012. Vol.10, No.2 16-21
  4. 4. Classification of post insertion denture problems  Complaints abut comfort of the denture: - Sore spots - Burning sensation - Redness - Pain in TMJ - Tongue & cheek biting - Swallowing & sore throat - Nausea & gagging - Deafness - Fatigue of the muscles of mastication.
  5. 5.  Complaints about function of the denture: - Instability or poor fit - Interference a) When swallowing b) Clicking • Complaints about esthetics: - Fullness under the nose - Depressed philtrum or naso-labial sulcus - Upper lip sunken in - Too much of teeth exposed - Artificial look
  6. 6.  Complaints about phonetics: - Whistle on “S” sounds - Lisp on “S” sounds - Indistinct “TH” & “T” sounds - “T sound like “TH” - “ F” & “V” sounds indistinct www.medkaau.com
  7. 7. According to Sharry  Frequent Complaints : - Excessive bulk - Speech difficulties - Masticatory shortcomings - Insufficient retention - Mucosal irritation - Unattractive Apperence Sharry.J.J Complete denture Prosthdontics, 3rd edition, chapter 17, pg 358
  8. 8.  Uncommon Complaints: - Whistling - Rough & sharp surfaces - Ear ache - Dull teeth - Difficult swallowing - Halitosis - Loss of taste sensation - Dry mouth - Saliva under the dentures - Noisy teeth - Peculiar taste - cheek, lip & tongue biting - Food under the denture - nausea & gagging - Dislodgement on sneezing - tingling of the lower lip - Dislodgement on drinking - burning of mouth - Drooling at the corner of the mouth - Inability to chew with equal vigor on both side.
  9. 9. According to Grant.A.A  POST INSERTION PROBLEMS CAN BE BROADLY GROUPED INTO:  Looseness of dentures i. Decreased retentive forces ii. Increased displacing forces.  Discomfort associated with dentures i. Related to impression surface of denture ii. Related to occlusal surface iii. Related to polished surface iv. Related to possible systemic association
  10. 10.  Support problems  Problems associated with retention and stability  Other difficulties i. Noise on eating and speaking. ii. Speech problems. iii. Eating difficulties. a. Altered taste sensation. b.Gagging (nausea). A.A.Grant, J.R.Heath, J.F.McCord- complete prosthodontics problems, diagnosis & management (1994)
  11. 11. Denture Complaints in relation to time of delivery  Immediate complaints.  Delayed complaints.  Problems without complaints.
  12. 12. Presentation of patient with complaints  Informed patient of possible problems.  Un-informed patient:  Sense of pain.  Sense of loss (waste of time and money).  Sense of deceit.
  13. 13. Pain  Over extension of borders  Poor fitting or rough surface dentures  Error during impression making  Incorrect centric relation or cuspal interferences.  Excessive vertical dimension  Uneven occusal balance and anterior contact at CR  Inadequate relief to the prominent genial tubercle & myloid ridge
  14. 14. Loose denture  PPS is not successfully made.  Lingually placed posterior teeth  Labially placed mandibular anterior teeth  Dryness of mouth  Occusal discrepancies  Inaccurate impression making  Rocking, tilting dentures (poor retention)  Nodules of acrylic- faulty impression /poor processing techniques
  15. 15. Faulty esthetics:  Unrealistic expectations  Over supported or under supported dentures  Altered vertical dimension Defective speech:  increased vertical dimension  deficiency of palatal contour  Poor PPS region  Thick lingual flanges or restricted tongue movements
  16. 16. Inefficacy  Discrepancies in vertical dimension and CR  Worn off teeth  Zero degree posteriors  Lack of occlusal balance  Occusal plane se at higher level Nausea & Gagging  Over extended posterior limit of maxillary denture  Thick posterior borders or loose denture  Uncommon belief
  17. 17. Fibrous hyperplasia  Continous wearing of ill fitting denture  Usually painless Microbial Infection  Poor oral & denture hygiene maintainance  Diabetes and oral habits
  18. 18. Costen’s syndrome: • Prolonged over closure • Deafness, tinnitus, • Tenderness over the TMJ • Dryness of mouth • Neuralgic symptoms – burning sensation of tongue, throat and headache.
  19. 19. Uncommon complaints  Whistling : high vault palate  Ear ache : TMJ problem  Food & saliva under denture : may be deficient of borders  Loss of taste  Cheek biting : lack of horizontal overlap, decreased VD or buccal placement of teeth  Drooling saliva : inadequate VD  Allergy : pigment or residual monomer of denture resin
  20. 20. CONCLUSION
  21. 21. References • Nair KC, A primer on complete denture fabrication, 1st edition, 2013, Ahuja publication, India Pp 158 -166  Winkler S, Essentials of complete denture Prosthodontics 2nd edition, 2012, AITBS Publishers, pp 318 – 330  Sharry JJ, Complete Denture Prosthodontics, 3rd edition, USA, Mcgraw-Hill Book Company, 1974, pp 289-294.  Heartwell C M , Syllabus of complete dentures, 4th edition, 1984, Varghese Publishing House, 407 – 420
  22. 22.  GrantA.A, Heath.J.R, McCordJ.F, complete prosthodontics problems , diagnosis& management (1994)  McCord J. F. and Grant A. A. , Identification of complete denture problems: a summary, British Dental Journal 2000; 189: Pp:128–134  Jethlia.H, Post Insertion Problems And Their Management In Complete Denture journal of Evolution of Medical and Dental Sciences.Vol 2(3) Jan, 2013 pp 194-99  Verma.M ,Post Insertion Complaints in Complete Dentures - a never Ending Saga; Journal of Academy of Dental Education, Vol 1, No 1 (2014), Pp: 1-8

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