Post Denture insertion complaints

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Clinical Removable Prosthodontics
Forth Year

Published in: Health & Medicine, Business

Post Denture insertion complaints

  1. 1. POST INSERTION PROBLEMS
  2. 2.  aap ne jo waday kiye woh nibhana aap,meri zindagi ko jannat banan aap
  3. 3.  All the pateints receving remmovable partial or complete dentures shoul be seen within 24 hours after the insertion of the prosthesis.  If potential problems are detected & coreected in their early stages,the patient may never be subjected to the pain and discomfort that might other wise occur.  If there are any problems the patient should be reassured that most problems can be solved rapidly & simply.
  4. 4. COMPLAINTS 1. 2. 3. Pain or discomfort arising from the hard & soft tissues of the edentulous ridge Soreness of one or more teeth. Miscellaneousa) instabilty of the prosthesis b) Tongue and cheek biting c) Speech difficulties d) Eating difficulties
  5. 5. Soft tisue irritation  Laceration or ulceration -generally produced by an FIG.1 overextended denture base fig 1. • • • Complaintsoreness/irritation may or may not be accompanied with discomfort. Diagnosis- areas displaying increased redness or tranlucency(just before ulceration starts) Fig 2 FIG.2
  6. 6.  Degree of overextension can be determined by visual examination  With the prosthesis in position,the buccal tisssues should be manipulated in downward,outward,upward and anterosuperior directions.  If the denture border is overextended,movement of border tissues will be impeded  If interfernce with movement and a change in soft tissue cover are evident,the denture flange must be reduced.
  7. 7. Overextension of the denture base on the lingual aspect of the mandibular edentulous ridge may be identified and confirmed by manipulation of the patients tongue  A forward or lateral thurust of the tongue usally will disclose the location of overextension.  Another method is disclosing wax but use with caution.it is usally used to verify or to isolate an area that is under suspicion follwing visual observation.  The use of pip is not genrally indicated. 
  8. 8.  Dependable method for identifying an over extesion is through the use of an indelible pencil. FIG 3&4 FIG 3 FIG 4
  9. 9. •Border extension is corrected with a lab bur or an arbor band FIG 5. FIG 5 •Warm saline mouth washes 4hly. •No local anestheticsif pt is seen within 24 hrs.
  10. 10. Erythema(redness)  Genrally caused by Fig 6 -roughness of the denture base -by a slight rubbing movement of the denture base against the soft tissues FIG 6
  11. 11. Roughness can be corrected by pressure indicating paste FIG 7 & 8 FIG.7 FIG 8
  12. 12.  An excellent method of identifying irregularities on the intaglio surface is to pass a fingertip or gauze pad over the tissue surface of the resin FIG 9 FIG 9
  13. 13. •Redness may also be caused by occlusal discrepencies or prmaturities. •This lack of occlusal disharmony is the greatest factor in prosthesis related discomfort.
  14. 14. Irritation to the teeth  After soft tissue irritation has been eliminated,teeth that are in contact with prosthesis should be evaluated.  With the prosthesis out of mouth,mesial,distal,buccal,and lingual pressure should be applied to the remainig natural teeth.pressure can best be applieed using the index fingers of each hand  If the prosthesis has exerted undesirable forces on one or more teeth,a painful response will result.
  15. 15.  If the pt is seen within 24 hrs of delivery he may not be aware of discomfort untill finger pressure is applied.  If a longer time may be painful. has elapsed,the tooth aor teeth  Leave the prosthesis ot till discomfort is over.  Later adjusrtment should be carried.
  16. 16.  Use disclosing wax. fig10 Fig 10 Disclosing wax is displaced from an area that is causing pressure
  17. 17.    If soreness or pain is not caused by pressure from RPD the next obiviuos cause can be occlusal trama. One of the most common causes of discomfort for a RPD patient is occlussal interference between a natural tooth in one arch and the metal of the prosthesis in opposing arch. Articulating paper is commonly used to locate the portion of the partial denture causing the interference.11. 11
  18. 18. •IT IS DIFFICULT TO IDENTIFY ARTICULATING PAPER MARKS ON HIGHLY POLISHED METAL SURFACES 12
  19. 19. IF ARICULATING PAPER MARKS ARE DIFFICULT TO IDENTIFY,THE SURFACES OF THE METAL MAY BE ROUGHENED USING A FINE STONE OR AIR BORNE PARTICLE ABRASION SYSTEM 13
  20. 20. ARTICULATING PAPER MARKS ARE READILY IDENTIFIED ON A ROUGHENED SURFACE 14
  21. 21. ADJUSTMENTS ARE MADE USING A MULTIFLUTED BUR IN A HIGH-SPEED HANDPIECE 15
  22. 22. •A METAL THICKNESS GAUGE IS USED TO EVALUATE THE THICKNESS OF REMMOVABLE PARTIAL DENTURE COMPONENTS. 16 RESTS AND CLASPS MUST BE AT LEAST I MM THICK
  23. 23. MISCELLANEOUS COMPLAINTS GAGGING  CAUSES -POOR ADAPTATION  FAILURE TO MODIFY STOCK TRAY -FAULTY IMPRESSION TECHNIQUE
  24. 24. •AN INDELIBLE PENCIL IS USED TO MARK THE POSTERIOR BORDER OF A METAL MAJOR CONNECTOR 17
  25. 25. •PROSTHESIS SEATED IN THE ORAL CAVITY 18 18
  26. 26. THE POSITION OF THE REMOVABLE PARTIAL DENTURE,S POSTERIOR BORDER IS TRANSFERRED TO THE PALATAL TISSUES,AND THE PLACEMENT OF PIOSTERIOR BORDER IS EVALUATED 19 19
  27. 27. • AN OVEREXTENDED MAJOR CONECTOR MAY BE SHORTENED USING A HEATLESS STONE IN A LOW -SPEED HANDPIECE OR DENTAL LABORATORY ENGINE 20
  28. 28. • THE BEAD LINE THAT PREVENTS FOOD FROM COLLECTING BETWEEN THE MAJOR CONNECTOR AND THE PALATAL TISSUES HAS BEEN LOST AS A RESULT OF ADJUSTMENT.THIS MAY NECESSITATE REMAKING THE RPD 21
  29. 29. PROBLEMS WITH PHONETICS • WHEN PLACED TOO FAR PALATALLY THE ARTIFICIAL PREMOLARS MAY INTERFERE WITH SPEECH 22
  30. 30. •CORRECTING PROSTHETIC TOOTH PLACEMENT WILL CORRECT PHONETIC DIFFICULTIES 23
  31. 31. CHEEK OR TONGUE BITING • CHEEK BITE RESULTS IN LINEAR ULCERATION OF THE BUCCAL MUCOSA 24
  32. 32. • CHEEK BITING MAY BE MINIMISED BY ROUNDING THE MANDIBULAR BUCCAL CUSPS 25
  33. 33. • TONGUE TENDS TO FLATTEN AND BROADEN WHEN IT IS NOT CONFINED BY POSTERIOR TEETH OR APPROPRIATE PROSTHESES 26
  34. 34. o DIFFICULTY IN CHEWING •THE SURFACES OF ACRYLIC RESIN TEETH MAY BECOME FLATTENED AND INEFFICIENT BECAUSE OF POOR POLISHING TECHNIQUE OR PROLONGED WEAR 27
  35. 35. ADITIONAL GROOVES AND SLUICEWAYS IMPROVE MASTICATORY EFFICIENCY 28
  36. 36. LOOSE DENTURES Fatigue or mishandling of clasps  Adjust or remake  Long term may need reline 
  37. 37. THANK YOU

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