Professional Documents
Culture Documents
&
treatment planning
in
complete dentures
The patients
expectations
and psychological
situation.
Evaluation of
the existing
dentures
Predictable results
Evaluation of the
patients general
and oral health
conditions &
History.
3.
4.
5.
PATIENT ASSESSMENT
NAME
AGE
SEX
Occupation
Gait
Mental attitude
Philosophical
Exacting
Hysterical
Indifferent
CHIEF COMPLAINT
-
Clinical history
DIABETES MELLITUS
Nutritional disorders
Blood dyscrasias
Anemia
Leukemia
Oral complications of leukemia frequently
include gingival hypertrophy, petechiae, Ecchymosis,
mucosal ulcers, and hemorrhage
Multiple myeloma
-
Joint disorders
Osteoarthritis :
- Difficulty in inserting ,Removal and
Cleaning of dentures.
- If TMJ is involved , mouth opening is
restricted , painful movements of the jaw
necessitates the use of special impression
trays.
Scleroderma
- Lips become rigid and the aperture narrows , and
presents mask like expression.
- Restricted mandibular movements are seen.
- Management includes improving the mouth opening by
stretching exercises and sectional impression trays.
- Dentures can be designed with midline hinge , so that
they care collapsible and can be easily inserted and
removed.
Cardiovascular Disorders
Hypertension
- Mild to moderate primary hypertension is
usually asymptomatic .
- Severe or later stage hypertension may lead to
the potential cardiovascular, cerebrovascular ,
and renal complications of the disease.
Xerostomia,
Gingival overgrowth,
Salivary gland swelling or pain,
Taste sense alteration, and
Paresthesia .
Pulmonary Diseases
Bronchial
Asthma
- Ask about concerned precipitating factors ,
Considerations
Shorter appointments +/- sedation (preferably late
mornings)
Antihistamines .
Avoid aspirin containing drugs .
Minimize use of epinephrine .
Neurological Disorders
Radiation Therapy
MEDICATIONS
CLIMACTERIC CHANGES
Dental history
Year of edentulous
Clinical Examination
- Extra oral
- Intra oral
Extra oral
FACIAL FORM
Square
Tapering
Ovoid
Square tapering
FACIAL PROFILE
Class II - Retrognathic
FACIAL HEIGHT
LOWER
FACIAL HEIGHT
Length of lips
Short .
Long .
Lip Fullness
Lip thickness
Thin lips.
Thick lips.
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a
N
ia
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l
MUSCLE TONE
According to House classified asClass I - Normal tension, tone .
Class II - Normal muscle function with
slightly reduced muscle tone .
Class III Decreased muscle tone and
function .
RANGE OF MANDIBULAR
OPENING/MOVEMENTS impaired
mobility
Intra oral
MUCOSA
RESIDUAL ALVEOLAR RIDGE
PALATE
FRENAL ATTACHMENTS
- TONGUE
- SALIVA .
Mucosa
Colour
coral pink
- Redness indicates inflammatory change, inaccurate impression
- Pigmented lesions- light to dark brown or blue
- White patches frictional keratosis, cheek biting
- Fordyce's granules
Classified as
Class 1 - Healthy
Class 2 Irritated
Class 3 - Pathologic .
Inflamed mucosa
Thickness
A mucosa with medium uniform
thickness and uniform resiliency offer the most
favorable prognosis.
Classified as Class 1
Normal density of mucosal tissue ( 1 mm- ideal
cushion for basal seat) .
Class 2
Soft tissue with mucous membrane twice the
thickness
Class 3
Excessively thick investing membrane filled with
redundant tissue. Requires surgical treatment
Arch size
CLASS- I
- Large :
ideal retention
and stability .
Class II
-
Medium:
good retention
and stability .
Class III
-
Small :
difficult to
achieve good retention
and stability .
Arch form
- Denture support
- Tooth selection .
SQUARE
TAPERED
OVOID
- Offers little or no
resistance to movement of
dentures.
Ridge contour
- High ridge with flat crest and parallel sides .
Flat
ridge
Knife edged
ridge / V
shaped
Ridge relation
Class I- Normal
Class II
RetrognathiC
Class III
Prognathic
Parallelism of ridges
-
Class II
- Mandibular ridge
divergent anteriorly .
Class III
- Maxillary ridge diverts
anteriorly/both ridges
divergent .
Class I
Ideal, 16-18 mm
Class II
Excessive inter arch space
Class III
Reduced
inter arch
space
Hard Palate
Shape of vault examined :
U shaped Ideal for retention and stability with well
defined incline of rugae .
Flat
Reduced resistance to lateral and rotatory forces
Soft palate
Class I :
Soft palate is horizontal as it
extends posteriorly with
minimal muscular activity .
Class II
Soft palate make a 45
degree angle with hard
palate
1 to 5mm of movable
tissue available for post
damming.
Good retention is usually
possible.
Class III
Most acute contour about
70 degrees .
Class II :
Between I and III
Class III :
Small and unfavorable
Palatal sensitivity/Gag
reflex
-
BONY UNDERCUTS
-
Tori
-
Class II
Class III
Tongue
Examination of position , size and coordination .
SIZE
Large Tongue - decreases the stability of denture and hinders
impression making.
Small Tongue - leads to inadequate peripheral seal .
Movement & Coordination :
Good movements for peripheral tracing and
maintaining denture during functional activities .
Class III
Excessively large
tongue all teeth absent
for an extended period
of time allowing for
abnormal development
of tongue.
Class I
Normal
(favorable) Tongue
lies in floor of
mouth tip forward
and slightly below
incisal edge of
Most ideal position as floor of
lower incisors .
mouth is at ideal height ,the
lingual flange contacts it and
maintains peripheral seal .
Class II
Tongue flat and broad ,but tip in normal position
Class III
Tongue retracted
and depressed in
floor of mouth with
tip curled upward
or assimilated into
body of tongue .
Saliva
-Viscosity should be determined .
CLASS I : Normal quality and quantity saliva with
Radiographic Examination
TREATMENT PLANNING
The process of matching possible treatment options with
patient needs and systematically arranging the treatment in
order of priority but in keeping with a logical or
technically necessary sequence
Elimination of infection
Elimination of pathosis
Pre-prosthetic surgery- to improve denture
support & space
Tissue conditioning
Nutritional counseling .
PROSTHODONTIC CARE
Patients destined to be edentulous ::
REMOVABLE PARTIAL DENTURE :
Conventional
Interim
Hybrid complete denture / RPD
Transitional .
COMPLETE DENTURE :
-