1. 30. Insertion and Followup John Beumer III, DDS, MS and Robert Duell DDS Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry UCLA School of Dentistry This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.

22. Clinical Remount – Lingualized Occlusion Using the remount casts the dentures are remounted on the articulator. Make sure to lock the condyles in centric while remounting the dentures.

38. Ask the patient where their worst sore is. 24 hour check

40. Note the posterior palatal seal area: The bead is too deep and too sharp. Note the ulcer at the midline. 24 hour check

42. 24 hour check This area represents a bony spicule just beneath the mucosa. Unless the denture is properly adjusted in this area, the irritation will progress to ulceration.

43. 24 hour check Inspect the frenum areas. This is the anterior maxillary frenum. It is the most common frenum to become irritated from denture overextension.

45. Beware of the inferior alveolar nerve 24 hour check In patients with severe resorption of the alveolar ridge, a portion of the inferior alveolar nerve may be exposed. Pressure in these areas may cause significant pain.

46. Evaluate the Occlusion If you observe change repeat the clinical remount procedure Open contact

53. Result: a. Improved retention. Note denture snaps onto retention bar. b. Improved stability (from the implants and the retention bar). c. Improved support (anteriorly). d. Better control of the bolus (tongue no longer must position denture and control bolus simultaneously and can concentrate on control of the bolus). Possible Solutions 1. Dentures retained with osseointegrated implants