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POST INSERTION PROBLEMS
 aap

ne jo waday kiye woh nibhana
aap,meri zindagi ko jannat banan
aap


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.
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
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


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.
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.



Dependable method for identifying an over extesion
is through the use of an indelible pencil. FIG 3&4

FIG 3

FIG 4
•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.
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
Roughness can be corrected by pressure
indicating paste FIG 7 & 8

FIG.7

FIG 8


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
•Redness may also be caused by occlusal
discrepencies or prmaturities.
•This lack of occlusal disharmony is the
greatest factor in prosthesis related discomfort.
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.
 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.
 Use

disclosing wax. fig10

Fig 10

Disclosing wax is displaced
from an area that is
causing pressure






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
•IT IS DIFFICULT TO IDENTIFY ARTICULATING PAPER
MARKS ON HIGHLY POLISHED METAL SURFACES

12
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
ARTICULATING PAPER MARKS ARE READILY
IDENTIFIED ON A ROUGHENED SURFACE

14
ADJUSTMENTS ARE MADE USING A MULTIFLUTED BUR
IN A HIGH-SPEED HANDPIECE
15
•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
MISCELLANEOUS COMPLAINTS
GAGGING
 CAUSES
-POOR ADAPTATION


FAILURE TO MODIFY
STOCK TRAY

-FAULTY IMPRESSION TECHNIQUE
•AN INDELIBLE PENCIL IS USED TO MARK THE
POSTERIOR BORDER OF A METAL MAJOR CONNECTOR
17
•PROSTHESIS SEATED IN THE ORAL CAVITY

18

18
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
• AN OVEREXTENDED MAJOR CONECTOR MAY BE
SHORTENED USING A HEATLESS STONE IN A LOW
-SPEED HANDPIECE OR DENTAL LABORATORY ENGINE

20
• 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
PROBLEMS WITH PHONETICS
• WHEN PLACED TOO FAR PALATALLY THE
ARTIFICIAL PREMOLARS MAY INTERFERE WITH
SPEECH

22
•CORRECTING PROSTHETIC TOOTH PLACEMENT WILL
CORRECT PHONETIC DIFFICULTIES

23
CHEEK OR TONGUE BITING
• CHEEK BITE RESULTS IN LINEAR ULCERATION OF
THE BUCCAL MUCOSA

24
• CHEEK BITING MAY BE MINIMISED BY ROUNDING
THE MANDIBULAR BUCCAL CUSPS

25
• TONGUE TENDS TO FLATTEN AND BROADEN WHEN IT
IS NOT CONFINED BY POSTERIOR TEETH OR
APPROPRIATE PROSTHESES
26
o DIFFICULTY IN CHEWING
•THE SURFACES OF ACRYLIC RESIN TEETH MAY
BECOME FLATTENED AND INEFFICIENT BECAUSE OF
POOR POLISHING TECHNIQUE OR PROLONGED WEAR
27
ADITIONAL GROOVES AND SLUICEWAYS IMPROVE
MASTICATORY EFFICIENCY

28
LOOSE DENTURES
Fatigue or mishandling of clasps
 Adjust or remake
 Long term may need reline

THANK YOU

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Post Denture insertion complaints

  • 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.
  • 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. 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
  • 20. ARTICULATING PAPER MARKS ARE READILY IDENTIFIED ON A ROUGHENED SURFACE 14
  • 21. ADJUSTMENTS ARE MADE USING A MULTIFLUTED BUR IN A HIGH-SPEED HANDPIECE 15
  • 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. MISCELLANEOUS COMPLAINTS GAGGING  CAUSES -POOR ADAPTATION  FAILURE TO MODIFY STOCK TRAY -FAULTY IMPRESSION TECHNIQUE
  • 24. •AN INDELIBLE PENCIL IS USED TO MARK THE POSTERIOR BORDER OF A METAL MAJOR CONNECTOR 17
  • 25. •PROSTHESIS SEATED IN THE ORAL CAVITY 18 18
  • 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
  • 30. •CORRECTING PROSTHETIC TOOTH PLACEMENT WILL CORRECT PHONETIC DIFFICULTIES 23
  • 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
  • 35. ADITIONAL GROOVES AND SLUICEWAYS IMPROVE MASTICATORY EFFICIENCY 28
  • 36. LOOSE DENTURES Fatigue or mishandling of clasps  Adjust or remake  Long term may need reline 