Post on 16-Nov-2014
description
Post insertion complaints in complete dentures
Vinay Pavan Kumar.K
2nd year P G student
Dept of Prosthodontics
AECS Maaruti College of Dental Sciences
Post insertion complaints
Classification of post insertion denture
problems
Management
CommonComplaints
UncommonComplaints
Complains on aesthetics of the denture
Complains on phonetics
Complains on comfort of the
denture
“ Most of the complaints associated with complete dentures are actual and not psychological, contrary to the belief of most clinicians.”
Verma.M ,Post Insertion Complaints in Complete Dentures - a never Ending Saga; Journal of Academy of Dental Education, Vol 1, No 1 (2014), Pg: 1-8
“There was no statistically significant relationship
between patient age, gender, systemic health and denture complaints; but statistically significant relationship exist between types of denture, denture faults and complaints.”
Ogunrinde.T.J, The Influence Of Demographic Factors And Medical Conditions On Patients Complaints With Complete Dentures. Ann Ibd. Pg. Med 2012. Vol.10, No.2 16-21
Classification of post insertion denture problems
Complaints abut comfort of the denture:
- Sore spots
- Burning sensation
- Redness
- Pain in TMJ
- Tongue & cheek biting
- Swallowing & sore throat
- Nausea & gagging
- Deafness
- Fatigue of the muscles of mastication.
Complaints about function of the denture:
- Instability or poor fit
- Interference
a) When swallowing
b) Clicking
• Complaints about esthetics:
- Fullness under the nose
- Depressed philtrum or naso-labial sulcus
- Upper lip sunken in
- Too much of teeth exposed
- Artificial look
Complaints about phonetics:
- Whistle on “S” sounds
- Lisp on “S” sounds
- Indistinct “TH” & “T” sounds
- “T sound like “TH”
- “ F” & “V” sounds indistinct
www.medkaau.com
According to Sharry Frequent Complaints :
- Excessive bulk
- Speech difficulties
- Masticatory shortcomings
- Insufficient retention
- Mucosal irritation
- Unattractive Apperence
Sharry.J.J Complete denture Prosthdontics, 3rd edition, chapter 17, pg 358
Uncommon Complaints:
- Whistling - Rough & sharp surfaces
- Ear ache - Dull teeth
- Difficult swallowing - Halitosis
- Loss of taste sensation - Dry mouth
- Saliva under the dentures - Noisy teeth
- Peculiar taste - cheek, lip & tongue biting
- Food under the denture - nausea & gagging
- Dislodgement on sneezing - tingling of the lower lip
- Dislodgement on drinking - burning of mouth
- Drooling at the corner of the mouth
- Inability to chew with equal vigor on both side.
According to Grant.A.APOST INSERTION PROBLEMS CAN BE BROADLY
GROUPED INTO: Looseness of dentures
i. Decreased retentive forces
ii. Increased displacing forces.
Discomfort associated with dentures
i. Related to impression surface of denture
ii. Related to occlusal surface
iii. Related to polished surface
iv. Related to possible systemic association
Support problems
Problems associated with retention and stability
Other difficulties
i. Noise on eating and speaking.
ii. Speech problems.
iii. Eating difficulties.
a. Altered taste sensation.
b.Gagging (nausea).
A.A.Grant, J.R.Heath, J.F.McCord- complete prosthodontics problems, diagnosis & management (1994)
Denture Complaints in relation to time of delivery
Immediate complaints.Delayed complaints.Problems without complaints.
Presentation of patient with complaints
Informed patient of possible problems.
Un-informed patient:Sense of pain.Sense of loss (waste of time and money).Sense of deceit.
Pain Over extension of bordersPoor fitting or rough surface denturesError during impression makingIncorrect centric relation or cuspal interferences.
Excessive vertical dimensionUneven occusal balance and anterior contact at CRInadequate relief to the prominent genial tubercle &
myloid ridge
Loose denture
PPS is not successfully made.Lingually placed posterior teethLabially placed mandibular anterior teethDryness of mouthOccusal discrepanciesInaccurate impression makingRocking, tilting dentures (poor retention)Nodules of acrylic- faulty impression /poor
processing techniques
Faulty esthetics:Unrealistic expectationsOver supported or under supported denturesAltered vertical dimension
Defective speech:increased vertical dimensiondeficiency of palatal contourPoor PPS regionThick lingual flanges or restricted tongue
movements
InefficacyDiscrepancies in vertical dimension and CRWorn off teeth Zero degree posteriorsLack of occlusal balanceOccusal plane se at higher level
Nausea & GaggingOver extended posterior limit of maxillary dentureThick posterior borders or loose dentureUncommon belief
Fibrous hyperplasia
Continous wearing of ill fitting dentureUsually painless
Microbial Infection
Poor oral & denture hygiene maintainanceDiabetes and oral habits
Costen’s syndrome:
• Prolonged over closure• Deafness, tinnitus,• Tenderness over the TMJ• Dryness of mouth• Neuralgic symptoms – burning sensation of
tongue, throat and headache.
Uncommon complaints
Whistling : high vault palate
Ear ache : TMJ problem
Food & saliva under denture : may be deficient of borders
Loss of taste
Cheek biting : lack of horizontal overlap, decreased VD
or buccal placement of teeth
Drooling saliva : inadequate VD
Allergy : pigment or residual monomer of denture resin
CONCLUSION
References • Nair KC, A primer on complete denture fabrication, 1st
edition, 2013, Ahuja publication, India Pp 158 -166
Winkler S, Essentials of complete denture Prosthodontics 2nd edition, 2012, AITBS Publishers, pp 318 – 330
Sharry JJ, Complete Denture Prosthodontics, 3rd edition, USA, Mcgraw-Hill Book Company, 1974, pp 289-294.
Heartwell C M , Syllabus of complete dentures, 4th edition, 1984, Varghese Publishing House, 407 – 420
GrantA.A, Heath.J.R, McCordJ.F, complete prosthodontics problems , diagnosis& management (1994)
McCord J. F. and Grant A. A. , Identification of complete denture problems: a summary, British Dental Journal 2000; 189: Pp:128–134
Jethlia.H, Post Insertion Problems And Their Management In Complete Denture journal of Evolution of Medical and Dental Sciences.Vol 2(3) Jan, 2013 pp 194-99
Verma.M ,Post Insertion Complaints in Complete Dentures - a never Ending Saga; Journal of Academy of Dental Education, Vol 1, No 1 (2014), Pp: 1-8