effects of edentulism
loss of masticatory function
appearance
self esteem
quality of life
speech
ridge resorption
soft tissue changes to lip & chin
reduction in face height
post xla resorption
occurs rapidly after xla particularly in 1st 6 mths
individually variable
may be dependent on pre xla status of teeth
occurs throughout life
cawood & howell’s classification
1 = pre xla
2 = post xla
3 = high well rounded ridge
4 = knife edge ridge
5 = low well rounded ridge
6 = depressed bone level
can have so much resorption that it rests on mental nerve causing discomfort
main reasons for needing complete denture
caries (rampant)
perio disease - advanced, hopeless teeth
tooth wear - severe & debilitating
failing dentitions - overambitious tx, cycles of replacement
occlusal relapse - often secondary to above
appearance - often secondary to above
other reasons for making ptx edentulous
- head & neck cancer; chemo/radiotherapy
- head & neck cancer; dentition lost in maxilla or mandible due to cancer resection or reconstruction
- pre chemo in some cancers e.g. leukaemia & need for bone marrow transplant
- pre transplant when poor quality dentition & infection risk
- pre cardiac surgery e.g. prosthetic heart valve; when poor quality dentition & infection risk
- at ptx request; consent
