Introduction To Complete Denture

Introduction To Complete Dentures

Definitions Of Complete Dentures

1. Complete Denture: A removable dental prosthesis that replaces the entire dentition and associated structures of the Maxilla or mandible.
2. Residual Ridge Resorption:
   • Residual Ridge Resorption is alveolar remodeling that occurs due to changes in the functional stimulus of bone.
   • Residual Ridge Resorption diminishes the quality and quantity of the residual ridge after teeth are removed.

Read And Learn More: Prosthodontics Question And Answers

Complete Dentures Important Notes

• Surfaces Of Complete Denture:
  • Occlusal surface
  • Impression surface
  • Polished surface
• Parts Of Complete Denture:
  • Denture base
  • Denture flange
  • Denture borders
  • Denture teeth
• Objectives Of Complete Denture:
  • Should be compatible with the surrounding oral environment
  • Should restore oral function
  • Should be in harmony with the function of speech respiration and deglutition
  • Should be aesthetically acceptable
  • Should preserve the remaining oral tissues.
• Direction Of Residual Ridge Resorption:
  • Maxillary ridge – Upward and lingual direction
  • Mandibular anterior ridge  – Downward and lingual direction
  • Mandibular posterior ridge – Downward and buccal direction.
• Angular Stomatitis Occurs Commonly Due To:
  • Decreased VDO or
  • Deficiency of ‘Riboflavin or Thiamine’ or
  • Due to Candida infection.
•  Denture Stomatitis:
  • Denture Stomatitis refers to pathological reactions of the denture-bearing palatal mucosa
  • Stomatitis Types:
    • Type 1 – Localized inflammation
    • Type 2 – Generalized inflammation
    • Type 3 – Granular type
• Predisposing Factors For Candida-Associated Denture Stomatitis:
  • Aging
  • Malnutrition
  • Immunosuppression
  • Radiation therapy
  • Diabetes
  • Antibiotics

8. Epulis Fissuratum:

• Epulis Fissuratum is a soft tissue reaction that appears in the sulcular area due to over-extension of the denture flanges
• Epulis Fissuratum is treated by shortening and smoothening the denture border

9. Papillary Hyperplasia:

• Papillary Hyperplasia results from Candida infection and improper relief of the palatal area in the denture
• Small lesions are treated by curettage
• Large lesions are treated by split-thickness suprapenosteal excision

Complete Dentures Short Essays

Question 1. Denture induced hyperplasia
Answer:

The hyperplastic reaction of mucosa over the borders of the denture

Cause Of Hyperplasia:

• Trauma due to unstable dentures:

Features Of Hyperplasia:

• Deep ulceration
• Fissuring
• Inflammation

Management Of Hyperplasia:

• Surgical excision
• Correction of dentures

Question 2. Epulis fissuratum
Answer:

Epulis Fissuratum is a soft tissue reaction that appears in the sulcular region due to overextension of the denture flange.

Question  3. Indications and contraindications of complete denture

Answer:

Complete Denture Indications:

• Presence of adequate edentulous ridges with sufficient vertical space
• Serious loss of masticatory functions
• Impairment of aesthetics, speech, and psychological well-being
• In patients where remaining teeth cannot be retained

Complete Denture Contraindications:

• An edentulous patient who has not worn dentures in many years
• Unmanageable mechanical problems
• Patient with no salivary function due to radiation
• Altered systemic health
• Allergic to acrylic resinPatient with severe or total paralysis of motor nerves of tongue, cheeks, lips, or floor of the mouth
• Excessive loss of maxilla or mandible
• Large maxillary or mandibular tori.

Question 4. Residual ridge resorption.
Answer:

• Residual Ridge Resorption is alveolar remodeling that occurs due to a change in the functional stimulus of bone tissue
• Residual Ridge Resorption is a chronic progressive change in the bone structure, which results in severe impairment in the fit & function of the prosthesis

Cause of Residual ridge:

• Excessive forces over non-stress-bearing areas cause the activation of osteoclasts

Clinical Features of Residual Ridge:

• Decreased depth & width of sulcular
• Decreased vertical dimension at occlusion
• Reduced lower facial height
• Anterior rotation of mandible
• Increase in relative prognathism
• Increased mandibular arch
• Decreased maxillary arch
• Effects support, stability & retention of dentures

Treatment Of Residual Ridge:

• Ridge augmentation to increase the height of the ridge
• Vestibuloplasty to increase the depth of the sulcus

Question 5. Burning mouth syndrome
Answer:

Burning sensation in the structures in contact with the dentures without any visible change in the mucosa

Question 6. Denture stomatitis
Or
Denture sore mouth
Answer:

Denture Stomatitis is the pathological reaction of the palatal portion of the denture-bearing mucosa

Types Of Denture Stomatitis:

1. Type I: Localized simple infection
2. TypeII: Erythematous type
3. Type III: Granular type

Etiology Of Denture Stomatitis:

• Candida albicans

Predisposing Factors Of Denture Stomatitis:

1. Local Factors:
   • Dentures
   • Xerostomia
   • High carbohydrate diet
   • Use of broad-spectrum antibiotics
   • Smoking
2. Systemic Factors:
   • Old age
   • Diabetes mellitus
   • Nutritional deficiency
   • Immune defect
   • Malignancy

Treatment Of Denture stomatitis:

• Good oral hygiene
• Keep the denture as clean as possible
• Avoid wearing dentures at night
• Clean the dentures by brushing, soaking, and then brushing again
• If the denture contains metal work do not use anything that contains bleach.

Management Of Denture Stomatitis:

• 0.2-2% chlorhexidine
• Removal & cleaning of dentures after every meal
• Avoid night wearing of dentures
• Polishing of denture
• Administration of anti-fungal drugs
• Surgically: Elimination of crypts, by cryosurgery

Complete Denture Viva Voce

1. Surfaces of complete dentures are described by Fish.
2. The Fit of the denture depends on the accuracy of the impression surface.
3. Occlusal surface aids in mastication
4. The polished surface is the external surface of the complete denture
5. Result of residual ridge resorption
   • Prognathic appearance
   • Wide mandible, narrow maxilla
   • Concave profile
6. The ratio of anterior maxillary residual ridge resorption to anterior mandibular residual ridge resorption is 1:4.
7. Factors affecting residual ridge resorption (RRR)
   • RRR – directly proportional to bone resorption fac- tor/bone formation factor
   • RRR directly proportional to the pressure/ damping factor
   • RRR directly proportional to the anatomic factor
8. The cause of Epulls fissuratum is over-extension of the denture flange
9. Treatment of Epulis fissuratum is shortening and smoothening the denture
10. The cause of papillary hyperplasia is a candidal infection
11.  Treatment of papillary hyperplasia
    • Small lesions curettage
    • Large lesions split thickness subperiosteal exclsion
12. A diffuse erythematous zone under denture covered area is a sign of denture stomatitis
13. Cause of flabby ridge excessive load on the residual ridge
14.  Cause of traumatic ulcer
    •  Overextended flanges
    • Occlusal imbalance
15. Burning mouth syndrome is common in females older than 50 years.