Post Insertion Problems Long Essays
Question 1. Discuss post-insertion problems & their management.
(or)
Discuss post-insertion problems in edentulous patients using complete dentures. Enumerate the reason for it & their management
Or
Post-insertion instructions and problems encountered in complete dentures.
Answer:
Instruction for Insertion & Removal:
The patient is taught to insert & remove the denture along the path of insertion
Maintenance of Prosthesis:
- Patients are taught to clean the dentures regularly
- Cleansers used are:
- Chemicals: Chlorhexidine
- Ultrasonic cleaner
- Soaking & brushing the denture
- Avoid hard brushing
- Avoid excessive flossing
Night Wear of Prosthesis:
- Avoid nightwear of dentures
- Allowed to wear only in bruxers
- Report to the dentist if the denture causes any irritation even after 24 hours.
- The patient is asked to read newspapers or novels loudly during the 1st 24 hours to get adapt to the denture.
Post insertion problems:
Post insertion are
- Direct Sequelae
- Indirect Sequelae
Direct Sequelae:
1. Denture stomatitis:
It is the pathological reaction of the palatal portion of the denture-bearing mucosa
- Types:
- Type 1: Localized simple infection
- Type 2: Erythematous type
- Type 3: Granular type
Read And Learn More: Prosthodontics Question And Answers
- Etiology:
- Candida albicans
- Predisposing Factors:
- Local factors:
- Dentures
- Xerostomia
- High carbohydrate diet
- Use of broad-spectrum antibiotics
- Smoking
- Systemic factors:
- Old age
- Diabetes mellitus
- Nutritional deficiency
- Immune defect
- Malignancy
- Local factors:
- Management:
- 0.2-2% chlorhexidine
- Removal & cleaning of dentures after every meal
- Avoid night wearing of dentures
- Polishing of denture
- Administration of antifungal drugs
- Surgically: Elimination of crypts, by cryosurgery
2. Flabby ridge:
Replacement of bone by fibrous tissue
- Site: Anterior part of maxilla
- Effect: Poor support to the denture
- Causes:
- Excessive load overdenture
- Unstable occlusal conditions
- Management:
- Surgical removal
3. Denture irritation hyperplasia:
- The hyperplastic reaction of mucosa over the borders of the denture
- Cause: Trauma due to unstable dentures
- Features:
- Deep ulceration
- Fissuring
- Inflammation
- Management:
- Surgical excision
- Correction of dentures
4. Burning mouth syndrome:
Burning sensation in the structures in contact with the dentures without any visible change in the mucosa
- Features:
- Pain in the morning
- Dry mouth
- Persistent altered taste
- Generalized symptoms
- Etiology:
- Irritation by ill-fitting dentures
- Constant masticatory activity Excessive friction on the mucosa
- Candidal infection
- Nutritional deficiency
- Xerostomia
- Medication
- Management:
- Counseling
- Repair of ill-fitted dentures
5. Gagging:
The gag reflex is a normal, healthy defense mechanism to prevent foreign bodies from entering the trachea
- Causes:
- Over extended denture borders
- Unstable occlusal conditions
- Systemic conditions
- Alcoholism, smoking
- Features:
- Causes displacement of denture
- Triggered by tactile stimulation of the soft palate, posterior part of tongue & fauces
- Site:
- Posterior part of the maxillary denture
- Distolingual part of mandibular denture
- Treatment: Limiting the posterior extension of the dentures
6. Residual ridge resorption:
- It is alveolar remodeling that occurs due to a change in the functional stimulus of bone tissue
- It is a chronic progressive change in the bone structure, which results in severe impairment in the fit & function of prosthesis
- Cause: Excessive forces over nonstress bearing areas causing activation of osteoclasts
- Clinical Features:
- Decreased depth & width of the sulcus
- 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:
- Ridge augmentation to increase the height of the ridge
- Vestibuloplasty to increase the depth of the sulcus
Indirect Sequele:
1. Atrophy of masticatory muscles:
- Masticatory efficiency depends on the skeletal forces
- This force decreases with age
- Besides, denture wearers donot use their muscles to their maximum function
- Due to poor usage, atrophy of muscle occurs
- Common Muscles Effected: Medial pterygoid & masseter
- Management:
- Use of overdenture
- Use of implants
2. Nutritional deficiencies:
- Causes of Malnutrition:
- Poor general health
- Poor absorption
- Catabolic disturbance
- Anorexia
- Reduced salivary secretion
Management:
- Intake of protein-rich diet
- Encouraging patients to have good nutritious food
- It helps in the initial retention of the denture increasing the psychological comfort of the patient
Post Insertion Problems Short Essays
Question 1. Denture adhesive.
Answer:
Composition:
- Basic ingredients:
- Carbonyl methyl cellulose
- Vegetable gum
- Example: Tragacanth
- Vinyl methyl ether
- Polyethylene oxide
- Polyvinyl pyrrolidone
- Gantrez salts
- Cationic polyacrylic amide polymers
- Coloring agents-red dye
- Flavouring agents-menthol
- Wetting agents
- Preservatives-sodium borate
- Plasticizers- mineral oil
- Dispersion agents-magnesium oxide
- Indications:
- Improve retention and stability of the dentures
- To stabilize trial dentures
- For handicapped patients
- To provide a psychological sense of security
- To simplify the insertion for patients
- As an adjunct to the maxillary prosthesis
- Contraindications:
- Patients with ill-fitting dentures
- In medication-induced xerostomia
- In worn-out dentures
- As a substitute for recliner
- In patients with an inability to clean dentures
- In immediate dentures
- In case of allergy to components of the adhesive