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Denture Delivery and Follow Up

Denture Delivery and Follow Up. Dr. Cecilia E. Arag ón . Evaluations. From the Dentist From the Patient From Family/Friends. 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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Denture Delivery and Follow Up

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  1. Denture Delivery and Follow Up Dr. Cecilia E. Aragón

  2. Evaluations • From the Dentist • From the Patient • From Family/Friends CEA

  3. Treatment at the Time of Denture Insertion • Inspection of dentures. Elimination of basal surface errors. • Dentures to be seated in healthy tissues. CEA

  4. Elimination of Intaglio Surface Errors • Pressure Indicator Paste (PIP) to be used for every new denture!! CEA

  5. Check occlusion CEA

  6. Occlusion may seem okay, but… CEA

  7. Prematurity Resilient Tissue Accommodation Abused Tissues CEA

  8. 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 CEA

  9. Remounting Procedure • Ask patient to bite on cotton rolls for 10 min. • Guide mandible into CR several times. • Aluwax is placed on the post. Teeth of the mandibular denture. CEA

  10. Place both dentures in the patient’s mandible is guided in a hinge movement. • Obtain interocclusal record of CR. CEA

  11. Mount upper denture using remounting jig. • Mount lower denture CEA

  12. CEA

  13. Selective spot grinding The art of reducing premature contacting surfaces, so that an equal pressure exists at all points with interference at no point. CEA

  14. 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. CEA

  15. Basic Tooth Positions Balancing Contacts Centric Occlusion Working Contacts CEA

  16. Re-establishment of CO Problem: Teeth too long Solution: Deepen the fossae CEA

  17. Re-establishment of CO Problem: Teeth too nearly end to end Solution: Grind Inclines CEA

  18. Re-establishment of CO Problem: Too much horizontal overlap Solution: Broaden central fossae CEA

  19. After the CO re-establishment…. • DO NOT: • Reduce maxillary lingual cusps. • Reduce mandibular buccal cusps. • Deepen the fossae. CEA

  20. 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!!! CEA

  21. Correction of working side occlusal errors. Problem: Buccal and lingual cusps too long. Solution: Change inclines of balancing cusps. CEA

  22. Correction of working side occlusal errors. Problem: Buccal cusps are too long Solution: Change lingual incline of maxillary buccal cusp CEA

  23. Correction of working side occlusal errors. Problem: Lingual cusp too long. Solution: Change buccal incline of lingual cusp of mandibular tooth. CEA

  24. Correction of balancing-side errors. • Reduce lingual inclines of mandibular buccal cusps; or • Decide which supporting cusp maintains CO and reduce its opponent. CEA

  25. Correction of balancing-side errors. Grind the lingual incline of the mandibular buccal cusp. CEA

  26. Correction of protrusive relation. Distal inclines CEA Mesial inclines

  27. Eliminating occlusal errors in nonanatomic teeth • Interocclusal CR record is made. • Dentures mounted and gross premature contacts are removed. • Final adjustments with articulating paper. CEA

  28. Instructions to the patient • Individuality of patients • New dentures and: • Appearance • Mastication • Speech • Oral Hygiene • Education materials CEA

  29. 24-hour Oral Examination (OE) and Treatment (Tx) • Examination procedures • Adjustments related to: • Occlusion • Denture base • Subsequent OEs and Txs • Periodic recall for OE……12 months • Occlusion • Tissues CEA

  30. What to look for: CEA

  31. What to look for: CEA

  32. What to look for: CEA

  33. What to look for: CEA

  34. 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. CEA

  35. What to look for: CEA

  36. Overdentures Bars CEA

  37. Locator attachments O-ring abutments CEA

  38. CEA

  39. CEA

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