Post-insertion Appointment

Question 1

All patients with new dentures should be appointed and seen ___ hours after insertion of the dentures

Answer 1

24-48 hours

Question 2

The most crucial time in the patient’s perception of success or failure of dentures is the ___________ period

Answer 2

adjustment period

Question 3

________________ may be the single most significant factor in the successful manipulation of complete dentures under function

Answer 3

Neuromuscular control

Question 4

What are important prognostic indicators during the post-insertion appointment?

Answer 4

tongue function
denture wearing experience

Question 5

What are the common problems of the mandibular dentures?

Answer 5

• discomfort
• poor retention and stability
• lack of support

Question 6

What are the common problems of the maxillary dentures?

Answer 6

• poor retention and stability
• esthetics and phonetics

Question 7

What are the 4 major areas to check during the post-insertion appointment?

Answer 7

• esthetics
• phonetics
• tissue irritations
• loss of retention and stability

Question 8

What is the time to remedy esthetic problems?

Answer 8

trial placement appointment

Question 9

What do you need to check with phonetics during the post-insertion appointment?

Answer 9

• check the thickness of the maxillary palatal portion
• reevaluate the position of max anterior teeth
• open vertical dimension of occlusion
• might just take time to adjust

Question 10

What can cause tissue irritation?

Answer 10

• overextension
• trauma from faulty occlusion
• pressure from the denture base
• tissue abrasion from prosthesis movement

Question 11

What are the possible causes of loss of retention and stability?

Answer 11

• occlusion
• base contours
• teeth not in neutral zone
• posterior palatal seal
• overextension or underextension
• salivary flow and character

Question 12

What is a good way to have a patient point to an area of soreness?

Answer 12

use a cotton tipped applicator to touch the area

Question 13

Soreness in depth of vestibule is usually caused by…

Answer 13

overextended border of flange

Question 14

Soreness of the crest of the ridge is usually due to…

Answer 14

• occlusion error
  or
• pressure spot (tray show through)

Question 15

What causes soreness to the frenum?

Answer 15

frenal notch is too shallow or too sharp

Question 16

What causes soreness to the tissue overlying the coronoid process?

Answer 16

too much thickness at distobuccal corner of maxillary denture

Question 17

What causes numbness or burning sensation to the anterior palate?

Answer 17

pressure on incisive papilla

Question 18

What can cause soreness when swallowing?

Answer 18

• irrtation at mylohyoid ridge
• retrmylohyoid flange extension

Question 19

What causes numbness or burning sensatio in the lower premolar areas?

Answer 19

pressure over mental nerve due to an atrophied alevolar ridge

Question 20

What is a possible problem with buccal mucosa at the occlusal plane level?

Answer 20

• biting cheek
• trapping mucosa between base

Question 21

What should you do to fix cheek biting during post-insertion appointment?

Answer 21

increase the horizontal overlap by grinding down the mandibular posterior buccal cusps

Question 22

What is the problem with teeth contacting during speaking?

Answer 22

• OVD is too far open
• IOD (freeway space is too small)
• ridges are sore due to constant pressure

Question 23

Dentures fit fine at first insertion, but loosen after wearing them for _______ hours

Answer 23

3-4 hours
- caused by occlusal errors

Question 24

If the maxillary CD dislodges when yawing or opening wide what is wrong?

Answer 24

DB corner of denture is too thick

Question 25

If smiling causes maxillary CD to dislodge what is wrong?

Answer 25

denture flange is too thick posterior to the buccal frenum

Question 26

If the maxillary CD dislodges when eating what is wrong?

Answer 26

- posterior palatal seal too deep - occlusion needs correction

Question 27

What is wrong if there is whistling with s sounds?

Answer 27

anterior palatal contours are incorrect

Question 28

What is wrong with dentures the dislodge easier than expected?

Answer 28

- Overextension of borders-”toaster denture” - Form of external flanges - Teeth locations violating “Neutral Zone”

Question 29

What is the problem if the dentures feel to large and it is difficult to eat/speak?

Answer 29

- tongue space is too small - tooth position violates the "neutral zone"

Question 30

What is the neutral zone?

Answer 30

That area where the forces applied by the tongue is equal or neutralized by the force applied by the cheeks & lips

Question 31

What can be wrong if the patient is gagging with the dentures?

Answer 31

- loose dentures - poor occlusion - incorrect extension or contour - incorrect teeth positions - an excessive OVD - psychogenic factors

Question 32

What does tissue trauma manifest as?

Answer 32

- Hyperemia - Inflammation - Ulceration - Pain

Question 33

Do you need to smooth and polish the areas of the denture that you adjust?

Answer 33

YES! Polish cameo surface & borders (lathe on SLOW SPEED) – rag wheel with pumice and then high shine