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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 Dr. Cecilia E. Aragón
Evaluations • From the Dentist • From the Patient • From Family/Friends CEA
Treatment at the Time of Denture Insertion • Inspection of dentures. Elimination of basal surface errors. • Dentures to be seated in healthy tissues. CEA
Elimination of Intaglio Surface Errors • Pressure Indicator Paste (PIP) to be used for every new denture!! CEA
Check occlusion CEA
Prematurity Resilient Tissue Accommodation Abused Tissues CEA
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
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
Place both dentures in the patient’s mandible is guided in a hinge movement. • Obtain interocclusal record of CR. CEA
Mount upper denture using remounting jig. • Mount lower denture CEA
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
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
Basic Tooth Positions Balancing Contacts Centric Occlusion Working Contacts CEA
Re-establishment of CO Problem: Teeth too long Solution: Deepen the fossae CEA
Re-establishment of CO Problem: Teeth too nearly end to end Solution: Grind Inclines CEA
Re-establishment of CO Problem: Too much horizontal overlap Solution: Broaden central fossae CEA
After the CO re-establishment…. • DO NOT: • Reduce maxillary lingual cusps. • Reduce mandibular buccal cusps. • Deepen the fossae. CEA
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
Correction of working side occlusal errors. Problem: Buccal and lingual cusps too long. Solution: Change inclines of balancing cusps. CEA
Correction of working side occlusal errors. Problem: Buccal cusps are too long Solution: Change lingual incline of maxillary buccal cusp CEA
Correction of working side occlusal errors. Problem: Lingual cusp too long. Solution: Change buccal incline of lingual cusp of mandibular tooth. CEA
Correction of balancing-side errors. • Reduce lingual inclines of mandibular buccal cusps; or • Decide which supporting cusp maintains CO and reduce its opponent. CEA
Correction of balancing-side errors. Grind the lingual incline of the mandibular buccal cusp. CEA
Correction of protrusive relation. Distal inclines CEA 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. CEA
Instructions to the patient • Individuality of patients • New dentures and: • Appearance • Mastication • Speech • Oral Hygiene • Education materials CEA
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
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
Overdentures Bars CEA
Locator attachments O-ring abutments CEA