Denture Trouble Shoo g Guide. Comfort. 1. Reduce base carefully and gradually to avoid loss of the border dam.

Transcription

1 ARKLIGN L A B O R A T O R I E S Denture Trouble Shoog Guide Comfort Discomfort Causes Sore spot in v- 1. Overextended borders 1. Shorten borders and polish. upper or lower denture 2. Rough spot in base 2. borders. Sore spot in upper post 1. Post dam too deep 1. Reduce base carefully and gradually to avoid loss of the border dam. 2. Sharp edges on the posterior seal seal. (posterior limit of upper) 3. Overextension 2. Same as above, make sure post dam is on so e. 3. Same as above. Single sore spots on the crest of the ridge General overall soreness on ridge Sore under lower lingual Sore under lower labial 1. Premature occlusion 2. Inaccurate denture base 3. Voids or porosity in acrylic 4. Nodules under base 1. open too much 2. Totally inaccurate denture base 3. Malocclusion or improper interdion 1. Centric o, drives lower forward 2. Lingual ange overextended 3. Posteriors too far distal 1. Too much overbite 2. Over extended labial ange 3. When nt throws lower forward 1. New centric registraon or accurate bite. Remount dentures on and adjust. 2. Take wash impression and rebase e treatment. 3. Same as above. 4. Remove nodules. 1. Remake 1 of the dentures to correct ver if plane of occlusion is correct. 2. Try a wash impression and rebase, or remake denture treatment. 3. See 1a, 1b, 1c from when occluding in centric. 1. Recheck verl and centric. Rearculate and remove the interfering cusps or change to non-interfering teeth. 2. Shorten and polish e. 3. Remove second molars. 1. and change tooth posin. 2. Shorten ge and repolish. 3. Recheck verl and centric. Check lingual es, shorten. Burning Sensaon* Discomfort Causes Burning feeling on hard palate area or on lower High pressure area in the acrylic base* Locate the high area, remove and polish. anterior ridge Burning feeling in bicuspid area to tubero High pressure area in the acrylic base* Same as above, grind rst bicuspid out of occlusion. Burning feeling on upper anterior ridge Pressure on papilla and rugae area* Relieve. are usually caused by pressure a as it lees la or by ercured bases. Diabecs experiece occasilly.

2 BitingCheeksandTongue Discomfort Causes Solutions Keepsbitingcheeksand/ortongue 1. Posteriorteethsetendtoend 2. Overclosed 3. Posteriorteethsettoofartothe lingualorbuccal 1. Rearticulateandresetposteriors(waxtryinhighly recommended). 2. Rearticulateandresetallteethopeningbite. 3. Rearticulateandresetposteriorteeth. RednessofTissue Discomfort Causes Solutions Tissuegettingredindenturebearingarea 1. Illfittingdenturebase 2. Impropercureofdenturebase 3. Aviaminosis 1. Takeawashimpressionandrebasedenture.Checkfor prematuritiesintheocclusion. 2. Rebase(heatcureacrylic). 3. Prescribevitamins. Alltissuesbecomingfieryredincludingcheeks andtongue Denturebaseallergy(extremelyrare) PaininMandibularJoint Changebasematerialbyhavinglab jump avinylbasematerial. Removeallacrylicteethandreplace.Apatchtestshouldbe taken. Discomfort Causes Solutions PaininMandibularjoint 1. Verticaloverclosed 2. Centricrelationoff 3. Arthritis 4. Trauma 1. Rearticulateandresetallteethtoopenbite. 2. Takeintraoraltracingandreset.Retrialadvised. 3. Consultpatient sdoctor 4. Difficulttocorrect.

3 Instability Instability Causes Solutions Whennotoccluding 1. Overextensionofbordersandposteriorlimits 2. Underextendedborders 3. Lossofpostdamseal a. Postdamonhardpalate b. Postdamnotoverhamularnotches c. Insufficientpostdam 4. Dehydrationoftissueduetoalcoholismormedication. 5. Flabbytissuesdisplacedwhentakingimpressiondueto impropertray. Inallcasesanewimpressionisnecessary.Besttogrindout thetissuesideandtakeawashimpression,usingcompound wherenecessarytoextendimpressiontoincludepostdam area.rebaseentiredenture. Whenchewingfood Whenoccludingincentric 1. Lossofpostdamseal 2. Anteriorteethtoofarlabially 3. Flabbyanteriortissue 4. Improperincisinghabits 5. Lowerposteriorssetoffridge 1. Malocclusion a. Prematureindividualteethhitting b. Highocclusionononesideofarch c. Bicuspidareaprematurecontact 2. Upperdenture riding onhardpalatesurface 3. Flabbytissuesoverridge 4. Teethsettoofarbucally 5. Centricocclusionnotinharmonywithcentricrelationship 1. Sameasabove. 2. Remountandresetbringinganteriorsbacklingually. 3. Surgerytoremovepoordenturefoundationand rebase. 4. Patienteducationistheanswer. 5. Resetandcorrectposterioralignment. 1. a.remountgrind,andmillinselectiveteeth. b.remountandreset. c.trychairsidemillinorremountandset. 2. Relievepressurearea 3. Removeflabbytissuewithsurgeryandrebase. 4. Remountandresetlingual. 5. Remakeonedenture.

4 Interference Interference Causes Solutions Whenswallowing 1. Upper a. Overextensionintheposteriorbuccalflanges b. Toothickinlingualposteriorflanges 2. Lower a. Overextensioninthelingual b. Toothickinposterior 3. Overclosedvertical 1. Upper a. Carefullyreducedistalbuccalflange. b. Adjustbythinningdenturesfromtheoutside,not thetissueside. 2. Lower a. Carefullyreduceflange b. Reducefromoutsidedonotgrindtissueside. 4. Toomuchvertical 3. Remountandreset,correctingvertical. 5. Posteriorstoofarlingual,crowdingtongue 4. Sameasabove. 5. Remountandresetopeningarchtoallowmore tongueroom. Gagging Gagging Causes Solutions Immediateoninsertion 1. Upper:Overextensiontoothickposteriorborder 2. Lower:distallingualflangetoothick 1. Denturemustbedoublepostdammedandcutback toanteriorpostdam. 2. Carefullyreducefromtheoutside.Donotgrindtissue side. Delayedgagging:2weeks to2monthsafterdelivery 1. Faultypostdamallowingsalivaunderdenture 2. Malocclusionallowingdenturetoloosencausessaliva seepage 1. Grindoutpostdamareaandtakewashimpression forlabrebase. 2. Remountandmillin,sometimesnecessarytoreset theteeth.

5 Esthetics Esthetic Causes Solutions Toobulkyundernose 1. Labialflangeofuppertolongortoothick 2. Upperanteriorteethsettoofarout 1. Reducebulkand/orlengthandrepolish. 2. Resetanteriorslingually. Sinkinginundernose 1. Upperlabialflangeneedsmorebulk 2. Upperlabialflangeneedsmorelength 1. Addwaxtobuilduptopropercontourandhavelabbuild outbase. 2. Grindouttissuesideoflabialflange,addcompound borderandtakewashimpression. 3. Resetanteriorsforlipsupport. Upperlipsinksintoofar Upperanteriorteethsettoofarlingual Addwaxonteethtopropercontourandhavelabsetteethmore labialforlipsupport. Showstoomuchteeth Justlookstoofalse 1. Verticaltoogreat. 2. Occlusalplanetoolow 3. Cuspidsandlateralssettooprominent 4. Upperanteriorteethsetouttoofar 1. Settooregular;techniquetypesetup 2. Allteethappeartobethesameshade 3. Nogingivalcontouringorstaggeringofgingival depth. Phonetics* 1. Havelabresetallteethclosingvertical.Maintainesthetics bydeterminingtoraiseorlowerupperorlowerteeth. 2. Havelabresetallteethraisingocclusalplane. 3. Replacecuspidsandlateralswithsmallerteethandrotate themin. 4. Resetteethbacktoridge. 1. Trysculpturinganteriorincisalstogiveabraded appearance.rotateandstaggerteethinsetup. 2. Changetocharacterizedanteriorteeth. 3. Havelabprocessnewbasewithanatomicalfinishand characterizedbase. PhoneticSound Causes Solutions Whistleon S sound 1. Notenoughroomfortonguebetweenupper bicuspids 2. Spacebetweencentral 1. Removeandmovebicuspidstothebuccalorifroom grindoutmoreareaforthetongue. 2. Closespace. Lispingon S sound Toomuchspacefortonguebetweenupperbicuspids Narrowpalatespacebetweenupperbicuspidsbyaddingledgeof acrylic. Th and T soundsindistinct F and V soundindistinct 1. Notenoughroomindenturesfortongue 2. If Th and T soundaliketheanteriorsaretoo farlingual Improperpositionofupperanterior eitherverticallyor horizontally. 1. Thinoutdenturesfromlingualsides don tgrindtissue side. 2. Remountandmoveanteriorsouttothebuccal. Difficultadjustment mustdecodeandtrytocorrect. *Phoneticsoundsdonotreacttoaregulartrialbaseplatethesameasthefinaldenture.Aunibaseonyourtryinwillduplicatefinaldenturephonetics.