post insertion pptx - د.رضوان

Post insertion complaints in complete dentures

Assis.Prof.Dr.Radhwan Himmadi Hasan
B.D.S , M.Sc. , Ph.D.
Prosthodontics
2018
1/7/2018
Assis.Prof.Dr.Radhwan H.Hasan 2018
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Post insertion complaints

Classification of post insertion denture problems
Management
Common
Complaints
Uncommon
Complaints
Complains on aesthetics of the denture

Complains on phonetics

Complains on comfort of the denture

1/7/2018

Assis.Prof.Dr.Radhwan H.Hasan 2018
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“ Most of the complaints associated with complete dentures are actual and not psychological, contrary to the belief of most clinicians.”

“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.”

1/7/2018

Assis.Prof.Dr.Radhwan H.Hasan 2018
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Classification of post insertion denture problems

Complaints about 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.

1/7/2018
Assis.Prof.Dr.Radhwan H.Hasan 2018
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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

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Assis.Prof.Dr.Radhwan H.Hasan 2018
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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

1/7/2018
Assis.Prof.Dr.Radhwan H.Hasan 2018
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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
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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.
1/7/2018
Assis.Prof.Dr.Radhwan H.Hasan 2018
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According to Grant.A.A

POST 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

1/7/2018

Assis.Prof.Dr.Radhwan H.Hasan 2018
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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)
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Denture Complaints in relation to time of delivery

Immediate complaints.
Delayed complaints.
Problems without complaints.

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Assis.Prof.Dr.Radhwan H.Hasan 2018
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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.

1/7/2018
Assis.Prof.Dr.Radhwan H.Hasan 2018
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Pain

Over extension of borders

Poor fitting or rough surface dentures
Error during impression making
Incorrect centric relation or cuspal interferences.

Excessive vertical dimension

Uneven occusal balance and anterior contact at CR
Inadequate relief to the prominent genial tubercle & myloid ridge
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Loose denture

PPS is not successfully made.

Lingually placed posterior teeth
Labially placed mandibular anterior teeth
Dryness of mouth
Occusal discrepancies
Inaccurate impression making
Rocking, tilting dentures (poor retention)
Nodules of acrylic- faulty impression /poor processing techniques

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Assis.Prof.Dr.Radhwan H.Hasan 2018
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Faulty esthetics:

Unrealistic expectations
Over supported or under supported dentures
Altered vertical dimension

Defective speech:

increased vertical dimension
deficiency of palatal contour
Poor PPS region
Thick lingual flanges or restricted tongue movements

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Assis.Prof.Dr.Radhwan H.Hasan 2018
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Inefficacy

Discrepancies in vertical dimension and CR
Worn off teeth
Zero degree posteriors
Lack of occlusal balance
Occusal plane se at higher level
Nausea & Gagging
Over extended posterior limit of maxillary denture
Thick posterior borders or loose denture
Uncommon belief

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Assis.Prof.Dr.Radhwan H.Hasan 2018
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Fibrous hyperplasia

Continous wearing of ill fitting denture
Usually painless

Microbial Infection

Poor oral & denture hygiene maintainance
Diabetes and oral habits
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Assis.Prof.Dr.Radhwan H.Hasan 2018
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Costen’s syndrome:

Prolonged over closure
Deafness, tinnitus,
Tenderness over the TMJ
Dryness of mouth
Neuralgic symptoms – burning sensation of tongue, throat and headache.

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Assis.Prof.Dr.Radhwan H.Hasan 2018
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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
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