Transcript Denture Delivery and Follow Up

Denture Delivery
and Follow Up
Dr. Cecilia E. Aragón
Evaluations
• From the Dentist
• From the Patient
• From Family/Friends
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Treatment at the Time of Denture
Insertion
• Inspection of dentures. Elimination of
basal surface errors.
• Dentures to be seated in healthy tissues.
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Elimination of Intaglio Surface
Errors
• Pressure Indicator Paste (PIP) to be used
for every new denture!!
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Check occlusion
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Occlusion may seem okay, but…
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Prematurity
Resilient Tissue
Accommodation
Abused Tissues
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Errors in Occlusion
• Possible causes of error: inaccurate MMR
records or transfer of these, failure to use face
bow, incorrect teeth arrangement, denture
processing errors, changes in denture base
material.
• Checking for occlusion errors
– Best done in the articulator: REMOUNT
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Remounting Procedure
• Ask patient to bite on
•
•
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cotton rolls for 10
min.
Guide mandible into
CR several times.
Aluwax is placed on
the post. Teeth of the
mandibular denture.
• Place both dentures in
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the patient’s mandible
is guided in a hinge
movement.
Obtain interocclusal
record of CR.
• Mount upper denture
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using remounting jig.
Mount lower denture
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Selective spot grinding
The art of reducing
premature contacting
surfaces, so that an equal
pressure exists at all points
with interference at no
point.
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Eliminating occlusal records in
anatomic teeth
• Re-establishment of CO.
• Correction of working side occlusal errors.
• Correction of balancing-side errors.
• Correction of protrusive relation.
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Basic Tooth Positions
Balancing Contacts
Centric Occlusion
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Working Contacts
Re-establishment of CO
Problem: Teeth too long
Solution: Deepen the fossae
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Re-establishment of CO
Problem: Teeth too nearly end to
end
Solution: Grind Inclines
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Re-establishment of CO
Problem: Too much horizontal
overlap
Solution: Broaden central fossae
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After the CO re-establishment….
• DO NOT:
– Reduce maxillary lingual cusps.
– Reduce mandibular buccal cusps.
– Deepen the fossae.
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Correction of working side occlusal
errors.
• Reduce lingual inclines of buccal cusps of
maxillary teeth.
• Reduce buccal inclines of lingual cusps of
mandibular teeth.
ON WORKING SIDE ONLY!!!
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Correction of working side occlusal
errors.
Problem: Buccal and
lingual cusps too long.
Solution: Change
inclines of balancing
cusps.
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Correction of working side
occlusal errors.
Problem: Buccal cusps are
too long
Solution: Change lingual
incline of maxillary buccal
cusp
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Correction of working side occlusal
errors.
Problem: Lingual cusp
too long.
Solution: Change buccal
incline of lingual cusp of
mandibular tooth.
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Correction of balancing-side errors.
• Reduce lingual inclines of mandibular
buccal cusps; or
• Decide which supporting cusp maintains
CO and reduce its opponent.
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Correction of balancing-side errors.
Grind the lingual
incline of the
mandibular buccal
cusp.
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Correction of protrusive relation.
Distal inclines
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Mesial inclines
Eliminating occlusal errors in
nonanatomic teeth
• Interocclusal CR record is made.
• Dentures mounted and gross premature
contacts are removed.
• Final adjustments with articulating paper.
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Instructions to the patient
• Individuality of patients
• New dentures and:
– Appearance
– Mastication
– Speech
– Oral Hygiene
• Education materials
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24-hour Oral Examination (OE) and
Treatment (Tx)
• Examination procedures
• Adjustments related to:
•Occlusion
•Tissues
– Occlusion
– Denture base
• Subsequent OEs and Txs
• Periodic recall for OE……12 months
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What to look for:
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What to look for:
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What to look for:
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What to look for:
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What to look for:
Moskona D, Kaplan I. Oral lesions in elderly denture wearers.
Clin Prev Dent. 1992;14:11-4 : 500 pts. Total frequency of soft tissue
lesions was 16.7% in edentulous non-denture patients and 58.2% in
patients with poor quality dentures.
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What to look for:
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Overdentures
Bars
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Locator attachments
O-ring abutments
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