Post Insertion Problems In Complete Denture

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 and their management
Or
Post-insertion instructions and problems encountered in complete dentures.
Answer:

Instruction For Insertion And Removal:

The patient is taught to insert And 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

Read And Learn More: Prosthodontics Question And Answers

Night Wear Of Prosthesis:

• Avoid nightwear or 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 adapt to the denture.

Post Insertion Problems: Post insertion are

• Direct Sequelae
• Indirect Sequelae

Direct Sequelae:

1. Denture Stomatitis:

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

• Denture Stomatitis Types:
  • Type 1: Localized simple infection
  • Type 2: Erythematous type
  • Type 3: Granular type

• Denture Stomatitis Etiology:
  • Candida albicans
• Denture Stomatitis 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
• Denture Stomatitis 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
• Flabby Ridge Causes:
  • Excessive load overdenture
  • Unstable occlusal conditions
• Flabby Ridge Management:
  • Surgical removal

3. Denture Irritation Hyperplasia:

• The hyperplastic reaction of mucosa over the borders of the denture
• Denture Irritation Hyperplasia Cause: Trauma due to unstable dentures
• Denture Irritation Hyperplasia Features:
  • Deep ulceration
  • Fissuring
  • Inflammation
• Denture Irritation Hyperplasia 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

• Burning Mouth Features:
  • Pain in the morning
  • Dry mouth
  • Persistent altered taste
  • Generalized symptoms
• Burning Mouth Etiology:
  • Irritation by ill-fitting dentures
  • Constant masticatory activity Excessive friction on the mucosa
  • Candidal infection
  • Nutritional deficiency
  • Xerostomia
  • Medication
• Burning Mouth 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

• Gagging Causes:
  • Over-extended denture borders
  • Unstable occlusal conditions
  • Systemic conditions
  • Alcoholism, smoking
• Gagging Features:
  • Causes displacement of denture
  • Triggered by tactile stimulation of the soft palate, posterior part of tongue & fauces
• Gagging Site:
  • Posterior part of the maxillary denture
  • Distolingual part of mandibular denture

• Gagging Treatment: Limiting the posterior extension of the dentures

6. Residual Ridge Resorption:

• 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
• Residual Ridge Resorption Cause: Excessive forces over non-stress bearing areas causing activation of osteoclasts
• Residual Ridge Resorption Clinical Features:
  • Decreased depth and 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

• Residual Ridge Resorption Treatment:
  • Ridge augmentation to increase the height of the ridge
  • Vestibuloplasty to increase the depth of the sulcus

Indirect Sequel:

1. Atrophy Of Masticatory Muscles:

• Masticatory efficiency depends on the skeletal forces
• This force decreases with age
• Besides, denture wearers do not use their muscles to their maximum function
• Due to poor usage, atrophy of muscle occurs
• Common Muscles Effected: Medial pterygoid and masseter
• Muscles Management:
  • Use of overdenture
  • Use of implants

2. Nutritional Deficiencies:

• Causes Of Malnutrition:
  • Poor general health
  • Poor absorption
  • Catabolic disturbance
  • Anorexia
  • Reduced salivary secretion

Nutritional Deficiencies 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:

Denture Adhesive Composition:

1. Basic Ingredients:
   • Carbonyl methylcellulose
   • 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
2. Denture Adhesive  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
3. Denture Adhesive  Contraindications:
   • Patients with ill-fitting dentures
   • In medication-induced xerostomia
   • In worn-out dentures
   • As a substitute for a recliner
   • In patients with an inability to clean dentures
   • In immediate dentures
   • In case of allergy to components of the adhesive