What may cause a previous perfect complete denture to now become painful and unretentive?
- What may cause a previous perfect complete denture to now become painful and unretentive?
- Ill fitting may be due to changes in boen support
- Reduction in ridge height can lead to over extendion
- Mental nerve may be exposed
- Ridges may be sharp and bony
- Saliva reduction may reduce lubraication of denture making it unstable and painful
- Patient may develop parafuncitonla habits
- If upper denture is loose then patient may develp a clenching habit leading to discomfort
- Occlusal wear of teeth eladign to uneven contacts
- Patient may have an unerupted root that is coming to surface
- Ulceration or cancer may leed to pathology affecting fit of denture or causign pain
- Has the patietns developed any prominent anatomical dentures such as a tori distruptignt eh denture
- Atrophic mucosa
Explain how excessive occlusal forces may contribute to periodtnla disease progression
- Can make bushing harder for patients
- Can lead to trauma of gingiva if pt has a deep overbite which can be sore and difficult to clean
How do we assess occlusion
- Assess pt in ICP and RCP
- Can use articulating paper
- Look for wear facets occlusal interferences
- Assess incisor molar and canine relationship
- Assess for canine vs group function
What mechanisms can lead to discolouration in root filled teeth
- Inadequate coronal seal
- Remnants of pulp tissue left behind
- Bacteria is canal
- Inadequate apical preparation
- Caries
- Material choice; may be too dark
Discuss the principles of flap design
- Base must be bigger than width
- incision on sound bone
- axial blood supply
- preserve vital structures
- Width of base should be bigger than length of flap
- simple
- Good access
- Uncomplicated closure
Discuss the indications of a porcelain veneer
- Discolouration
- Adequate Tooth tissue remaining
- Good OH and periodontal condition
- Hypoplastic teeth
- Fractured insciors
- Pegged lateral
List some contra indications for porcelain veneers
- Poor oH
- Inadequate tooth tissure
- Caries
- Crowding
- parafunctional habits
- Excessive interdental spacing
Discuss the rationale behind border moulding
- It is used to reproduce the contours of the buccal and labial vestibules by manual manipulation of the cheeks and to capture the shape of the matierla that will form th peripheral seal
- Important for stability as it limits horizontal movmetns
- Support as it provides max coverage
- Provides a peripheral seal which aids retention
- Restores facial lip and contour aiding aesthetics in the final denture
Describe features of erosion
- Proud restoraitons
- Loss of contour
- Cupping defects
- Palatal hollows
- Thinning of incisal edge
- Chipping of enamel
- etched appearance to the teeth
Describe some features of attrition
- Wear facets
- Loss of crown height
- Surfaces of teeth meet precisely
- Enamel and dentine are wearing at the same rate
Discuss the aetiology of erosion
- Internal acid source eg GORD, Vomittign, bulimia, acid reflex, ulcerative colitis
- External acid source from diet
What is endosolv
It softens GP and removed zinc eugenol cement for Endo re treatment
What is file eze
EDTA chelating agent that removed the smear layer and inorganic debris
List some factors that may contribute to denture stomatitis
- Wearing dentures at night
- Ill fitting dentures
- Poor denture hygiene
- Diet
- Immunocompromised pts
How would you treat denture stomatitis
- Local measures trying to improve fit of denture
- Improve denture hygiene
- Leave dentures out at nigth
- Miconazole gel
Describe the process of examining and evaluating any existing dentures a patient may have prior to the provision new ones
- Assess retention and stability
- Assess post dam
- Amount of plaque on dentures
- Signs of tooth wear
- Is the surface rough
What is success in relation to root canal therapy
- Absence of swelling, pain and sinus tract
- Retention of tooth as a functional unit
- Normal pPDL space on radiogrpah
- Followed up annually for 4 years
What are the clinical signs of failure of an RCT
- Persistent symptoms
- TTP
- Recurrent sinus/ swelling
- Evidence of fracture
- Excessive mobility
- Inability to chew on food
- Increased width of pDL on radiogrpah
- Evidence of resorption
- Radiolucency
List factors that affect retention of a denture
- Border seal
- Saliva
- Muscular forces of the lip, cheeks tongue and shape of flange
- Denture in neutral zone
- large surface area
