The document provides instructions for denture insertion and adjustment. Key steps include: 1. Checking the retention, jaw relations, and accuracy of the completed dentures and making any necessary adjustments. 2. Ensuring dentures are properly finished with smooth surfaces and accurate casts before remounting on the articulator. 3. Using pressure indicating paste to evaluate tissue contact and relieve any pressure spots by adjusting the denture base. 4. Verifying centric relation and removing any deflecting occlusal contacts by grinding with casts mounted on the articulator.

1. 1

2. 2

3. 3

4. 4

5. • DENTURE INSERTION
The process of directing a prosthesis to a
desired location. GPT-9
5

6. • To check the retention and the accuracy of the jaw
relations of the completed dentures, and to adjust
where necessary.
• To instruct the patients in the correct use of their
dentures.
• To advise the patients on the proper care of their
dentures and of the denture-supporting tissues.
• To advise them on the limitations to be expected
of artificial dentures.
6

7. • That the polished surfaces are smooth and devoid
of scratches.
• No imperfections on the tissue surface remain.
• The borders are round with no sharp angles in the
border areas.
• The accurate maxillary remount cast is properly
attached to the articulator.
• That an accurate mandibular cast is prepared for
the patient remount.
7

8. Fitting surfaces:
• Use gauze or cotton roll to inspect the
entire tissue surface for spicules or sharp
edges (gauze will snag on the spicules) ,
smooth any sharp areas if present.
• Inspect the posterior border - it should
be 2-3 mm thick, gradually tapering to
the soft palate , not thick or ending in a
sharp ledge.
• If necessary use a large acrylic bur to
blend any sharp changes in the flange
periphery with the art portion of the
denture.
8

9. • Denture border : Ensure that there are no
sharp or angular margins.
• Polished surfaces : Examine the polished
surfaces of the dentures to ensure that they have
been adequately finished and that there is no
plaster contained in the gingival crevices.
9

10. • After processing, dentures
should be returned to their
previous articulator positions
on their casts before
separation.
• Accomplished by using split
cast mounting plates or
devices, or by notching casts
to create a key in the
mounting plaster.
10

11. 11

12. • Before delivery, the
dentures must be soaked
in water for 72 hrs for
proper dimentional
hydration recovery.
12

13. • ask patient if it is comfortable, identify areas of
discomfort for potential adjustment
• if there is any resistance to seating, proceed
immediately to next step
13

14. • Evaluation of the tissue side of the denture base
for undercut areas and accuracy of tissue contact.
• Check the adaptation of the denture base using Pressure
indicating paste (PIP).
• Remove a small amount of paste and place it on a
mixing pad, dry the denture, place a thin coat of
pressure indicating paste on the tissue surface with a
stiff bristled brush.
14

15. Leave streaks in the paste, but use enough material so
that the denture appears more the colour of the
indicating material rather than the denture (i.e. more
white than pink)
15

16. • Seat the denture firmly over the first molars
(not the palate), remove carefully and
inspect the paste:
1. Burnthrough - no paste left, indicates
excessive pressure that should be relieved
2. Streaks remaining - no tissue contact; other areas
need to be relieved to produce contact
16

17. 3. Paste remaining with no streaks
- proper amount of contact
- relieve pressure spots using acrylic burs
- take care with undercuts
- they will cause burnthrough as the denture is seated
past the height of contour of the soft tissue. These
areas may not require adjustment.
17

18. Lower denture displays a
pressure point on
mylohyoid ridge. This
pressure spot is removed
with bur.
This recording and
trimming is repeated until
denture base surface do not
show through the paste.
The paste layer is even. 18

19. Even paste record. No
more adjustments are
needed.
PIP must be wiped off
with cotton using firm,
uni-directional strokes,
not in back and forth
mation.
19

20. • Processing errors induced by movement of
teeth during processing are easily detected
and these deflecting occlusal contacts are
removed by grinding with casts on the
articulator.
• The original occlusal vertical dimension is
recaptured and the centric occlusion-
relation position of cusps to opposing
tooth surfaces may be secured.
• Face-bow index is made before separating
the dentures from the casts so that the
maxillary denture may be reseated in its
original relationship on the articulator. 20

21. • Place petroleum jelly on the tissue surface of denture .
• Blockout all undercuts in maxillary and mandibular
dentures with moistened pumice or wax.
• Set the denture into the index fabricated on your remount
jig( or into a new facebow record, if an index has not been
fabricated) attached to the articulator.
21

22. • Vibrate fast set plaster into
the denture, and attach to the
maxillary mounting ring .
• Plaster should capture the
peripheral roll of the denture
flange but it should not
overlap onto the external
surface of the denture.
• When plaster is set, separate
the denture from the
remount cast. Alternatively
casts can be made separately
from the articulator and
subsequently attached with
mounting plaster.
22

23. • The maxillary denture and cast are attached to
the articulator using the face-bow index.
• Both dentures are then inserted and a centric
relation record is taken from the patient.
• The mandibular denture and cast are mounted on
the articulator by means of this record.
• Centric relation is verified, and the deflecting
occlusal contacts are removed.
23

24. To determine if
(1) The border extensions and contour are
compatible with the available spaces in the
vestibules,
(2)the borders are properly relieved to accommodate
the frenum attachments and the reflection of the
tissues in the hamular notch area,
(3)the dentures are stable during speech and
swallowing. 24

25. • Apply disclosing wax to the borders of the maxillary
denture in the same manner as the impression
compound was applied during the border refining
procedures.
• Instruct the patient to open the jaws as in yawning, push
the lower jaw forward, and move the lower jaw from
right to left.
25

26. • Disclosing wax is more displaceable than softened
impression compound; therefore slight overextensions
that might be developed with compound can be
determined.
• Relieve any existing overextensions by grinding; polish
the relieved area.
• Apply disclosing wax to the remaining borders of the
maxillary denture and to the mandibular denture
borders.
26

27. Checking labial notch- as the
denture is seated, labial
frenum is too narrow.
Avoid sharp edges when
trimming labial frenum notch.
Frenum must be able to “roll over”
the denture.
27

28. If stretched cheek is released, buccal frenum will lie tightly against functional
border of the denture. As mouth is opened, buccal frena are stretched back
and down. So, frena contribute to a well adapted border.
28

29. • Insert both dentures, place a cotton roll between the
posterior teeth on both sides and have the patient bite
forcefully for one minute.
• This will simulate compression of the tissue after the
patient has worn the denture for a period of time. Then
place the patient in centric relation and visually check the
occlusion.
29

30. • Occlusal disharmony in the completed
dentures may result from
(1) Undetected errors in registering jaw
relations,
(2) Errors in mounting casts on the articulator,
(3) Differences in tissue adaptation between the
processed denture bases and the record bases
that were used in recording maxillo-
mandibular relations,
(4) Changes in the supporting structures since
the impressions were made. This is
particularly true if the patient is using other
dentures. 30

31. INTRAORAL METHODS-
1. Articulating paper
2. Central-bearing devices
3. Occlusal wax
4. Abrasive paste
EXTRAORAL METHODS-
1. Laboratory Remounting
2. Clinical Remounting 31

32. • Articulating paper give an
accurate indication of
premature contacts either on
articulator or in patient’s mouth.
• Articulating paper should be
placed on both arches, as
placing articulating paper on
one side of the arch may induce
the patient to close to or away
from that side.
32

33. • Articulating paper of a different colour must be used to
distinguish contacts marked in eccentric position (BLUE
MARKS) from those in centric position (RED MARKS).
33

34. • Markings and grinding procedure is repeated for both
lateral movements until markings indicate uniform
contacts on working and balancing sides.
34

35. • Evaluate the areas of tooth contact in the centric
and eccentric positions prior to selection of the
point or area to be reduced or altered.
• With the condylar elements against the centric
relation stops, close the articulator until the
posterior teeth are in contact.
• The anterior teeth should not be in contact.
• Examine the lingual cusps of the maxillary
posterior teeth and the buccal cusps of the
mandibular posterior teeth.
• Premature contact appears when the remainder of
the teeth fail to make maximum intercuspation.
35

36. • Record the area or areas of premature contact.
• The contacts may be in varying amounts and
may involve more than one cusp or tooth.
• These varying situations make necessary critical
evaluation prior to grinding procedures in the
centric position: however, further evaluation in
the eccentric positions is necessary before one
starts any grinding.
36

37. • Secure the right condylar element in the centric
position and place the lingual cusps of the maxillary
posterior teeth in balancing relation with the buccal
cusps of the mandibular posterior teeth.
• This procedure also places the buccal and lingual
cusps of the maxillary and mandibular posterior
teeth and the cuspids in their working position on
the opposite side.
• The teeth are placed in these positions and not
shifted from the centric to the eccentric position
with the teeth in contact.
37

38. • When the teeth on the balancing side are not in
the correct relation, the error appears on either
the balancing or working side.
• If the balancing contact is excessive, the working
side teeth will not be in contact.
• If the working side contact is excessive, the
excess prevents contact on the balancing side.
• If the teeth on the working side are too long, there will
be no contact on the balancing side.
• If a single tooth is high on the working side, there will
be contact neither on the balancing side nor on the
working side.
38

39. • Record the premature contacts.
• Repeat the procedure with the left side as the
working side and record the premature contacts.
• Use articulating tape to mark the areas of
premature contact for selective grinding.
• When using tape, exercise care to prevent the tape
from wrinkling or doubling, as this will result in an
error in marking.
• Place the tape on the occlusal surfaces and the
incisal edges of all the mandibular teeth.
• When the teeth are brought together, this position
assures that the same force is exerted on all the
teeth.
39

40. • Return the incisal guide pin to the table and
use the following grinding procedures to
ensure balanced occlusion in the centric and
eccentric position.
• If the cusp is high in centric and eccentric
position, reduce the cusp.
40

41. • If the cusp is high in centric and not in the
eccentric position, deepen the fossae or the
marginal ridges. 41

42. • When one wishes to refine the teeth to retain
contact when the articulator is being moved to
and from centric and eccentric position—
balanced gliding occlusion—use the following
SELECTIVE GRINDING procedures:
42

43. • Error- any pair of opposing teeth can be too long and
hold other teeth out of contact.
• Correction- fossae of teeth deepened by grinding, cusp
are not shortened.
43

44. • Error- upper and lower teeth can be too nearly end to
end.
• Correction- grinding of lingual inclines of upper
palatal cusp and buccal inclines of lower buccal
cusp.
44

45. • Error- upper teeth can be too far buccally in
relation to the lower teeth.
• Correction- lingual cusp of upper tooth made
narrow by broadening of central fossa, and
buccal cusp of the lower tooth is moved
buccally by broadening of the central fossa.
45

46. • ON THE WORKING SIDE reduce
(a)the lingual inclines of buccal cusps of the
maxillary teeth and
(b)the buccal inclines of lingual cusps of
the mandibular teeth.
i.e.(B.U.L.L . RULE)
46

47. • central-bearing pin works on a spring.
• As the patient closes his mouth, the pin in the
mandibular mounting contacts a metal plate in
the vault of the maxillary denture.
47

48. • Thus, by holding the maxillary denture up and
the mandibular denture down, the pin creates
a tension before the teeth contact.
• If a premature contact is made by one tooth, the
dentures do not shift because the spring holds the
other teeth apart.
• The interceptive occlusal contacts are located
with articulating ribbon.
48

49. • Adhesive green wax is placed on the occlusal
surfaces of the mandibular denture.
• Points of penetration that occur upon closing
with the jaws in centric relation may be marked
with a lead pencil and relieved where indicated.
49

50. • The use of abrasive paste in the mouth has
many disadvantages.
• The shifting of the base as a result of premature
contact may result in altering the occlusion so
that centric occlusion does not correspond to
centric relation.
• Cusps that maintain the occlusal vertical
dimension may be destroyed.
• Abrasive paste is not adviced to used.
50

51. • Clinical remounting is a procedure where by
occlusal adjustment is carried-out on the
articulator after remounting the dentures with new
records obtained from the patient.
• These records are
1.Facebow record.
2.Remount record index to mount the
maxillary denture on the articulator
3.Centric relation record to mount the
mandibular denture 51

52. • DEFINITION-
Any change in the occlusion intended to alter
the occlusal surfaces of the teeth or restorations to
change their form.-GPT-9
52

53. • Correction in centric position
• Correction in eccentric
position
1.working side
2.non working side
3.Correction in protrusive
position 53

54. • Functional cusps should not be altered(palatal cusps of
maxillary denture and buccal cusps of mandibular
denture).
• If the functional cusps are indicated for modification, the
opposing fossae should be modified or the opposing cusp
incline is ground.
• Functional cusp height should never altered:
1. To maintain the vertical dimension
2. To maintain the functional efficiency
54

55. • Adjust the horizontal and lateral condylar
inclinations of the articulator to the settings dictated
by the protrusive interocclusal maxillomandibular
relation record.
55

56. • Release the horizontal condylar elements to
allow freedom of the articulator movements
in the eccentric positions.
56

57. • Raise the incisal guide pin from the guide table
and secure it above the height of the table.
57

58. • ON THE BALANCING SIDE reduce
(a)the buccal inclines of upper lingual cusp
(b)the lingual inclines of lower buccal cusp
(LUBL)
58

59. • Error-anterior teeth have heavy contact
with no posterior teeth contact.
• Correction-labioincisal surface of mandibular
anterior teeth and palatal surface of maxillary
anterior teeth are reduced.
59

60. • To achieve BALANCE IN PROTRUSIVE
EXCURSION reduce the mesial inclines of the
maxillary cusps and the distal inclines of the
mandibular cusps (MUDL RULE).
Mesial Distal
60

61. • After completing the selective grinding
procedures to establish and maintain the desired
occlusion-
(a)refine the occlusal anatomy, using the
mounted inverted cone points and
(b)polish all the ground surfaces with wet
powdered pumice on a wet rag wheel.
61

62. • Seat the upper denture with
a firm upward and backward
pressure.
• Allow the tissues of the lips
and cheeks to settle around
the dentures.
• Grip the buccal surfaces of
the upper denture between
the thumb and forefinger in
the premolar region.
• Apply a firm downward
force and assess resistance
to it.
62

63. • Reseat the denture if necessary.
• Place the forefinger of the right hand on the
palate behind the upper incisor teeth and apply a
forward leverage designed to displace the
posterior border of the denture.
• Assess the resistance to this force.
63

64. • testing the retention of the lower denture by
applying an upward and backward force with a
probe inserted between the lower incisors.
• The tongue should be at rest behind the lower
incisor teeth.
• If the tongue is retracted the anterior lingual seal
will be broken.
64

65. • Apply unilateral force to posterior occlusal surface
of denture.
65

66. • Alternately apply unilateral force to posterior
occlusal surfaces.
66

67. • Denture is removed by
breaking border seal
with index fingers
pulling out the cheeks.
• If the denture is very
retentive, patient is
asked to blow with his
lips closed to break the
posterior seal and
remove the denture.
67

68. 1. Individuality of patients
2. Nature of complete dentures
3. Adjustment period
4. Appearance with new dentures
5. Eating
6. Excess saliva
7. Tongue position
8. Speaking with new dentures
9. Maintaining tissue health
10.Dentures wearing at night
11. Sneezing and coughing 68

69. • Patients must be reminded that their physical,
mental and oral conditions are individual in
nature.
• Thus, they cannot compare their progress with
new dentures to other persons, experiences
chewing and speech patterns with new dentures
that are considered successful for some persons
may be interpreted as totally unsuccessful by
others.
69

70. • It should be explained to patients that teeth have
acute proprioceptive system that detect minute
variations in movements, size, location and nature
unlike denture patients who have lost their tooth
guidance mechanism.
• These comparisons should not be made to
discourage the patient but to give an insight into
physical and mechanical disadvantages present
with complete dentures.
• The dentist must stress that these problems are
not insurmountable but can be overcome with
patience, determination and skill.
70

71. • Following the insertion of new dentures there is a
variable period (generally 2-6 weeks) during
which patients must adjust and accommodate.
• New dentures often feel bulky and awkward at first.
Soft tissues of the mouth, now covered, may have
been open or left uncovered by a previous denture.
• This temporary problems usually resolved during
the adjustment period.
71

72. 72

73. • Patients must be advised
that chewing is not random
but an intentional and
selective activity.
• Initially patient should limit
themselves to soft foods
and avoid tough fibrous
foods that will overtax the
capacity of their residual
ridges.
73

74. • After wearing the denture, patients should not
chew for the first two days (48 hours),but
should wear it for the maximum period of
time, in order to get used to it. During this
period, patients should read aloud or talk
wearing the denture.
• After 48 hours, they can have soft food like
softened bread, idlis etc.
• For the first two to three months, avoid sticky
food as it may cause displacement of the
denture while chewing.
74

75. • Patients must be instructed to divide the
normal spoonful of food into half and
place each half posteriorly and
bilaterally.
• Placing the food posteriorly in the area of
just molar.
• Avoid bringing the lower front teeth
forward and against the upper front teeth
to cut or incise foods. This protects the
delicate upper front ridge and prevents
tipping of the denture.
75

76. • If it is necessary to bite using the front teeth,
try spreading the tongue against the back of
the maxillary denture to keep it in place.
• Try to chew vertically (up and down)
rather than horizontally (side to side).
Learning to eat with dentures takes time and
requires positive effort from the patient side.
76

77. First post-insertion day
• Vegetable-Fruit group: Juices
• Bread-Cereal group: Rice cooked in either
milk or water.
• Milk group: Fluid milk may be taken in any form.
• Meat group: Eggs in eggnogs, pureed meats,
meat broths, or soups.
77

78. • Vegetable-Fruit group: Juices, Tender cooked
fruits and vegetables, (seedless and skinless)
• Bread-cereal group: Cooked cereals, softened
breads boiled, rice, noodles.
• Milk group: Fluid milk and cottage cheese.
• Meat group: Chopped beef, ground liver,
tender chicken/fish in a cream sauce,
scrambled eggs, thick soups, etc.
78

79. • By the fourth day, or as soon as the sore spots
have healed, firmer foods can be eaten in
addition to the soft foods.
• These should ideally be cut into small pieces
before eating. The menu must contain butter
and a glass of milk.
79

80. 80

81. • Patient is taught to wear and remove denture
repeatedly in clinic.
• Patient is instructed to insert denture along the
path of insertion.
• In case of unilateral undercut, patent is taught to
insert the denture into undercut first,then
rotate the prosthesis into its final position.
81

82. Inserting a denture into a
unilateral anterior undercut
Inserting a denture into a
unilateral posterior undercut
82

83. • New dentures are often interpreted as foreign
objects by oral system. This leads to stimulation of
salivary glands to produce saliva.
• If the flow is excessive, the patient may
complain of floating dentures and a general
excess of watery saliva.
• Patient should be assured that this over active
flow of saliva is normal reaction and will slowly
decrease over time. 83

84. The most common complaint of complete denture
patient is loose mandibular dentures. patients should
be educated about three basic handicaps of
mandibular denture. They are -
• Area of mandibular basal seat is 1/3 that of
maxillary basal seat.
• The mandibular denture is surrounded lingually as
well as buccally by muscles all of which disrupt the
denture base.
• The mandibular denture depends on proper
tongue position to maintain adequate peripheral
seal and stability.
84

85. •In order to determine whether the patient has normal
tongue position or an abnormal retracted tongue
position, ask the patient to open just wide enough to
accept food and observe the dorsal surface of tongue and
occlusal surfaces of the teeth.
•The tongue is in contact with lingual surface
of denture and floor of mouth is at normal level.
•The mandibular denture should be stable and able to
resist a gentle push on mandibular incisors. If not, the
denture will be unstable and easily dislodged.
•Thus the patient should be aware of the importance of
tongue position, demonstrate proper tongue positions
and subsequent increases denture retention and
stability.
85

86. •The patient must practice opening and closing
while tongue assumes normal position.
86

87. • Owing to initial feelings of bulk and accompanying
excess saliva is not unusual for patients to have
distorted speech, especially evident during formation
of sibilant sounds.
• The fluency of speech may be un-coordinated during
rapid conversation. The speech apparatus although
very precise is also very adaptive.
87

88. • The adaptability of tongue to compensate for
change is so great that most patients master
speech with new dentures within few weeks.
• Speaking with dentures requires practice.
• Patients should be advised to read abound
and repeat words that are difficult to
pronounce.
• Reading stores patients speech and removes
the intense concentration on how they sound
to themselves speech with reading practice
quickly assumes natural tone and fluency.
88

89. • There are three factors involved in the
maintenance of healthy edentulous oral tissue.
-Adequate tissue rest
-Proper denture hygiene
-Cleansing of oral tissues.
89

90. • There is no question that the healthiest policy is to
remove the dentures for at least six hours daily to
allow the soft tissues to breathe and recover.
• For most patients, the most convenient way to
accomplish this is to remove the dentures during
sleep.
• The dentures should be soaked in water or a
denture cleaning solution. Such a practice will
maintain much healthier oral tissues, preserve the
ridges and the underlying bone, and allow the
dentures to fit properly for a longer period of time. 90

91. • Patients should be instructed that extreme and
sudden movements like sneezing and coughing
can dislodge the dentures and cause
embarrassment.
• This can be avoided by covering the
mouth with a handkerchief.
91

92. 92

93. • The following cleaning solution has been advised -
1 tbs (15cc) : sodium hypochlorite
1 tbs (4cc) : calgon
4 ounces (114cc) : water
• Dentures should not be soaked in sodium
hypochlorite for periods that exceed 10 minutes.
• Longer than 10 minutes may damage dentures.
• Overnight soaking in 4 ounces/114 cc white vinegar
is recommended to remove calculus. 93

94. a.Dentures should be cleaned daily by soaking
and brushing with an effective , nonabrasive
denture cleanser.
b. Denture cleansers should ONLY be used to
clean dentures outside of the mouth.
c.Dentures should always be thoroughly rinsed after
soaking and brushing with denture-cleansing
solutions prior to reinsertion into the oral cavity.
Always follow the product usage instructions.
94

95. •Although the evidence is weak, dentures should be
cleaned annually by a dentist or dental
professional by using ultrasonic cleansers to
minimize biofilm accumulation over time.
•Dentures should never be placed in boiling water.
•Dentures should be stored immersed in water after
cleaning, when not replaced in the oral cavity, to
avoid warping.
95

96. 96
Patients usually need special attention on behalf of their
dentists during the first few days after insertion of their
complete dentures.

97. 97

98. Recall appointments may be scheduled as follows:
• First recall :
• Second recall :
• Third recall :
• Maintainance :
1-3 days after insertion (if no problem with
denture, then 10 days after placement)
1 week after first visit
3-4 months after second visit
Every 1 year
This is a general recall programme , which may need to be
modified depending on the postinsertion problems. 98

99. • In many instances the most critical time in success or
failure of dentures is the adjustment period. The
dentist is responsible for care of patient throughout
this period and occasionally requires a number of
appointments.
• 24-hours-oral examination and treatment-
An appointment for 24 hours adjustment should
be made routinely.
• The dentist must listen carefully to the patients on the
basis of these comments can learn approximately
where to look for trouble.
99

100. • Check for peripheral overextensions which will have a
red line or even an ulcerated area if severe.
• Check for pressure areas on the ridge.
• Check the centric occlusion with the carbon paper.
• Evaluate the thickness of the flanges and make
corrections if indicated.
• Polish the denture base and teeth well after any
correction .
• Make the second adjustment 48 hours later and
repeat the above.
• The next appointment (the third adjustment) should be
about 1 week after the initial insertion but see the patient
sooner if problems are anticipated or by patient request.
100

101. • During first 2 months, acrylic resin absorbs water
which changes the size and shape of denture.
• These small amount of change causes occlusal
discrepancies which leads to soreness of
mucosa.
• Accordingly correction of occlusal errors should be
done by remounting with new interocclusal records
and selective grinding.
• Every denture patient should be placed on recall
program ay 3-4 months intervals as changes in
the mouth continue to occur.
101

102. 102
DENTURE
CLEANSERS

103. • It should demonstrate anti biofilm activity and should
be anti-bacterial as well as anti-fungal.
• It should be non-toxic.
• It should be compatible with denture materials and
should not modify (roughen) or degrade the
surface of the acrylic resin denture base or
prosthetic teeth.
• It should be short acting (8 hours).
• It should be easy to use for the patient or caregiver.
• It should have an acceptable (or no) taste.
• It should be cost effective.
103

104. 104

105. • Brushing with pastes reduced the biofilm mass
than with brushing with water.
105

106. • Commercially available denture cleansers use various
active agents including hypochlorite, peroxides, enzymes,
acids and oral mouth rinses to remove biofilm from
dentures.
• Each of these immersion cleansers has a different mode
of action and they differentiate in efficacy for removal of
adherent denture biofilms.
106

107. 107
Denture soaked in a commercially available denture cleansing tablet

108. • Employ vibratory energy, not ultrasonic.
• Effective in removing calculus, cigarette and coffee
stains.
• It is more effective when used with sodium
hypochlorite.
108

109. • In 2008, the U.S. Food and Drug Administration
(FDA) issued a requirement for manufacturers of
denture cleansers to revise their labeling regarding
contents and to consider alternatives to the types of
ingredients present in this class of products.
• The specifically identified ingredient persulfate is
known to cause allergic reactions. Persulfates are
used in denture cleansers as part of the cleaning and
bleaching process.
109

110. • Irritation of the tissues
• Tissue damage
• Rash
• Gum tenderness
• Breathing problems
• Low blood pressure
110

111. • Damage to the esophagus
• Abdominal pain
• Burns
• Low blood pressure
• Seizures
• Bleaching of tissues
• Internal bleed
• Nausea and vomiting
111

112. • Brushes specifically designed for denture cleaning should be
recommended.
• The features are-
-wide handle for easy gripping,
-stiff bristles of one length on one side of the head
(for use against broader, flatter denture surfaces
such as facial, palatal, and lingual surfaces)
-bristles set in a pyramidal arrangement on the
other side (for cleaning the tissue surface of the
denture).
112

113. • Patients should be cautioned not to use toothpaste
as the high abrasivity of non-denture toothpaste
will scratch denture base and acrylic teeth, thereby
dulling and removing anatomic and esthetic details
from the denture surface.
• Mouth should be rinsed after having food and
dentures should be cleansed with a small hand
brush using soap and cold water.
113

114. • While cleaning, the dentures
should be held over a basin of
water to prevent breakage in case
of accident from the hands.
• If the dentures are left out of the
mouth for any length of time, they
should be placed in a clean water.
This affords them safe and
effective storage.
114

115. 115
DENTURE
ADHESIVES

116. • Definition: A material used to adhere a denture
to the oral mucosa (GPT8).
• Denture adhesive is a non-toxic, water-soluble
material that is placed between the denture and
the tissues to enhance the normal physiological
forces that hold dentures in place.
116

117. • Cream form- it is long lasting
• Powder form- it is not long lasting but it is easier to
clean out, used in smaller quantity.
117

118. • Basic ingredient- carbonyl methyl cellulose, vegetable
gums eg., karaya, polyethylene oxide polymer.
• Binder-Petrolatum gel, mineral oil, polyethylene oxide.
• Dispersion agent (Minimize powder clumping)-
Silicon dioxide, calcium stearate, sodium phosphate,
• Flavouring -Menthol, peppermint oil.
• Preservatives -Sodium borate and methylparaben
• Colouring agent -Red dye
118

119. • patients who place severe demands on their prostheses
such as musicians, public speakers, teachers, social
workers etc.
• Those who feel the need for the additional sense of
security conferred by use of the product.
• useful for mal-adaptive patients such as -severely
compromised residual ridge morphology, xerostomia,
undergone maxillofacial jaw resection or are
neurologically compromised due to stroke, multiple
sclerosis, or closed-head injury.
• To stabilize trial bases during fabrication and insertion of
trial dentures.
119

120. • Patient with open cuts or sores in mouth.
• Patient having an ill-fitting denture.
• Medication-induced xerostomia as adhesives
requires ample saliva.
• Should not be used as substitute to a reliner or
tissue conditioner.
• A denture that has not recently been evaluated by
a dentist.
• A patient who cannot or will not maintain adequate
oral and prosthesis hygiene.
• A patient with a known allergy to any product
ingredient. eg,.karaya
120

121. • Improved retention and stability of both ill-fitting and
well-fitting dentures.
• Significantly improve the bite force.
• Improved patient satisfaction.
• Increased security and confidence while chewing.
• Decreased movement of the denture during mastication
and speech.
• Reduces vertical and horizontal movement of the
denture.
• Can be used as a vehicle to apply medication on the oral
mucosa along with denture. 121

122. • Can increase vertical dimension and occlusal
discrepancies with improper use.
• Cannot be used as a remedy for pain and discomfort.
• May be messy, grainy and difficult to remove for
some patients.
• If oral hygiene is not maintained, bacterial growth
can occur which leads to oral pathosis.
122

123. • Clean and dry the intaglio (tissue side) surface of the
dentures.
• For the maxillary denture, apply three or four pea-sized
increments of denture creams to the anterior ridge,
midline of the palate, and posterior border.
• For the mandibular denture, apply three pea-sized
increments of denture cream to several areas of the
edentulous ridge.
• If using powder adhesive (instead of cream as noted
above), wet the base with water. Apply a thin film of
powder to the entire tissue-contacting surface and shake
off any excess.
123

124. 124

125. Powder Form 125

126. • If using pad adhesives, place the correct size onto the
denture and cut off any excess that extends beyond the
denture border with sharp scissors.
• Seat the dentures independently. Hold each firmly in
place for 5 to 10 seconds.
• Remove any excess material that expresses into the
cheek or tongue space.
• Bite firmly to spread the adhesive and remove any
additional excess that expresses into the cheek or tongue
spaces.
• Use the minimum amount necessary to provide the
maximum benefit.
126

127. • Patients must be instructed to remove the adhesive
daily using a brush or gauze under running water.
• Patient should be advised that denture discomfort
would not be corrected by using adhesives. They should
seek professional consultation in this regard.
• An increase in quantity of adhesive used by patients,
suggests that they need professional help.
127

128. • Denture insertion is the culmination of extensive and
sometimes difficult treatment procedures.
• Doctors should not have the casual attitude of “ Here
they are. I hope you like them ,” but rather should adopt
the more serious and considered approach of “Here we
are. Let us both do what we can to make you look good,
be comfortable, and enjoy what we have created .”
• This will point up the factor of coresponsibility and co-
therapy, which the patient should consider as his from
the onset of treatment.
• It will certainly lead to more mutually advantageous
results.
128

129. • Boucher’sprosthodonticrx for edentulous patient 10th edition.
• Essentials of complete denture prosthodontics by sheldon winkler-
2nd edition.
• Post-insertion problems and management in complete denture
patients by deviprasad nooji and mayank lunia.
• Complete denture prosthodontics 3rd edition by john j. Sharry.
• Evidence-based guidelines for the care and maintenance of complete
dentures a publication of the american college of
prosthodontists,david felton, dds, ms; lyndon cooper, dds, phd, ms.
• Complete denture prosthodontics ,a manual for clinical procedures,
bernard levin
• Syllabus of complete dentures charles M. Heartwell.
129

130. 130
THANK YOU!