This document discusses common problems patients may experience after receiving removable partial or complete dentures and how to address them. Some potential early issues include pain, soreness of teeth or soft tissues, instability of the prosthesis, biting of cheeks or tongue, and speech or eating difficulties. The summary examines how to identify and resolve issues like soft tissue irritation, erythema, tooth irritation, occlusal interference, and miscellaneous complaints through examination, identification of pressure points, and making adjustments to the denture.
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
A single complete denture is a complete denture that occludes against some or all of the natural teeth, a fixed restoration, or a previously constructed removable partial denture or a complete denture.
Opposing natural teeth that are sufficient in number and do not necessitate a fixed or removable partial denture.
Opposing a partially edentulous arch in which the missing teeth have been or will be replaced by a fixed partial denture.
Opposing arch with an existing complete denture.
When treating a patient with a removable partial denture, the natural and artificial teeth, both functionally and esthetically, must co-exist in a harmonious relationship.
Occlusal harmony between a removable partial denture and the remaining natural teeth is a major factor in preservation of the surrounding structures.
In removable partial dentures, because of the attachment of the denture to abutment teeth, occlusal stresses can be transmitted directly to the abutment teeth and other supporting structures, which results in sustained stresses that may be more damaging than those transient stresses found in complete dentures.
The human mandible can be related to the maxilla in several positions in the horizontal plane. Among these centric relation is a significant position, because of its usefulness in relating the dentulous and edentulous mandible to maxilla, where the teeth , muscles and temporomandibular joint function in harmony. It is a position of occluso-articular harmony.
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Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
A single complete denture is a complete denture that occludes against some or all of the natural teeth, a fixed restoration, or a previously constructed removable partial denture or a complete denture.
Opposing natural teeth that are sufficient in number and do not necessitate a fixed or removable partial denture.
Opposing a partially edentulous arch in which the missing teeth have been or will be replaced by a fixed partial denture.
Opposing arch with an existing complete denture.
When treating a patient with a removable partial denture, the natural and artificial teeth, both functionally and esthetically, must co-exist in a harmonious relationship.
Occlusal harmony between a removable partial denture and the remaining natural teeth is a major factor in preservation of the surrounding structures.
In removable partial dentures, because of the attachment of the denture to abutment teeth, occlusal stresses can be transmitted directly to the abutment teeth and other supporting structures, which results in sustained stresses that may be more damaging than those transient stresses found in complete dentures.
The human mandible can be related to the maxilla in several positions in the horizontal plane. Among these centric relation is a significant position, because of its usefulness in relating the dentulous and edentulous mandible to maxilla, where the teeth , muscles and temporomandibular joint function in harmony. It is a position of occluso-articular harmony.
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A presentation on the instructions to be given to complete denture patients at the insertion appointment. Dealing with patients can be hard at times but with a proper approach, a strong rapport can be formed with the patient.
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Fenestration
Dehiscence: lack of cortical bone at the level of dental root, at least 4mm apical to the margin of interproximal bone, the measurement was per found by graduated probe.
Or: lowering the crestal bone margin to expose root surface.
Fenestration: localized defect in the alveolar bone that exposed the root surface usually the apical or the medium third but did not involve the alveolar margin.
Or: is isolated areas in which the root is denuded of bone and the root surface is covered only by periosteum and overlying gingiva.
Fenestration is a term derived from Latin ward fenestra, meaning window, describe area of alveolar process devoid of bone, creating a window exposing the root surface.
Gingival recession: is the apical movement of the marginal soft tissue surrounding the tooth exposing root surface.
According to some studies that irreversible recession can be caused by fixed appliances for 1.3% to 10.0% of treated cases.
We can use CBCT to measure the labial and lingual thickness of the bone related to roots.
ABT: apical buccal thickness. MBT: middle buccal thickness. CBT: cervical buccal thickness.
ALT: apical lingual thickness. MLT; middle lingual thickness. CLT: cervical lingual thickness.
== naturally occurring alveolar bone dehiscence and fenestration are common finding in different type of malocclusion especially in anterior region of class III.
== fenestration and dehiscence may lead to gingival recession and additional bone loss during orthodontic treatment in addition to large amount of labial inclination such as decompensation in class III malocclusion may pose a greater risk of periodontal complication such as:
Alveolar dehiscence, fenestration, gingival recession.
Clinically gingival recession, is always accompanied by alveolar bone dehiscence whether underlying bone dehiscence is developed before or parallel to gingival recession.
N:B- gingival recession; is described as exposure of root surface by an apical shift in the position of gingiva.
Factors affect recession increase:
1- Difficulty of plaque control due to fixed appliances
2- Proclination of teeth.
3- Coronally attached Frenum.
4- Muscle attachment.
5- Abnormal tooth position.
6- Overhanging restoration or crowns.
7- Fenestration and dehiscence.
** Classification of fenestration according to their apicocoronal location in relation to root length to:
1- At the level of the apical third of the dental root 48% all in maxilla.
2- At the level of the middle third of dental root 28% in maxilla and mandible.
3- At the level of the coronal third of the dental root 19% all in mandible.
4- Extending from the apical to the middle third of the dental root 4.3% of them located in maxilla.
** Etiology of dehiscence:
1- Ectopically positioned teeth which are outside of the bony limits of the alveolus are often lacking the normal amount of bone on the overlying facial surface.
2- Roots of the toot
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Complete dentures are prosthetic replacements for lost natural teeth and lost soft and Bony tissues which are fabricated in order to restore impaired or lost functions and appearance.
Fabrication of complete dentures comprises various variables whose precise executions of crucial importance for achieving the success with fabricated dentures.
REMOUNTING PROCEDURE is a Method used to relate restorations to an articulator for analysis and/or to assist in development of a plan for occlusal equilibrium or reshaping
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. aap
ne jo waday kiye woh nibhana
aap,meri zindagi ko jannat banan
aap
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. 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. 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.
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. 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.
Dependable method for identifying an over extesion
is through the use of an indelible pencil. FIG 3&4
FIG 3
FIG 4
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.
11. Roughness can be corrected by pressure
indicating paste FIG 7 & 8
FIG.7
FIG 8
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. •Redness may also be caused by occlusal
discrepencies or prmaturities.
•This lack of occlusal disharmony is the
greatest factor in prosthesis related discomfort.
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. 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. Use
disclosing wax. fig10
Fig 10
Disclosing wax is displaced
from an area that is
causing pressure
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. •IT IS DIFFICULT TO IDENTIFY ARTICULATING PAPER
MARKS ON HIGHLY POLISHED METAL SURFACES
12
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
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
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. • AN OVEREXTENDED MAJOR CONECTOR MAY BE
SHORTENED USING A HEATLESS STONE IN A LOW
-SPEED HANDPIECE OR DENTAL LABORATORY ENGINE
20
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. PROBLEMS WITH PHONETICS
• WHEN PLACED TOO FAR PALATALLY THE
ARTIFICIAL PREMOLARS MAY INTERFERE WITH
SPEECH
22
31. CHEEK OR TONGUE BITING
• CHEEK BITE RESULTS IN LINEAR ULCERATION OF
THE BUCCAL MUCOSA
24
32. • CHEEK BITING MAY BE MINIMISED BY ROUNDING
THE MANDIBULAR BUCCAL CUSPS
25
33. • TONGUE TENDS TO FLATTEN AND BROADEN WHEN IT
IS NOT CONFINED BY POSTERIOR TEETH OR
APPROPRIATE PROSTHESES
26
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