journal club BDJ 2000 vol 189

1. JOURNAL CLUB
DEVI
2nd
MDS
Amrita School of Dentistry

2. CONTENTS
• Introduction
• Conclusion 2

3. Introduction
3

4. • Adverse intra oral anatomic factors
• Clinical factors
• Technical factors
• Patient adaptional factors
4

5. List of factors resulting in discomfort related
to the impression surface of dentures
5
1

6. • 2
6

7. • 3
7

8. 8
4

9. • 5
9

10. 6.
10

11. Factors resulting in discomfort-relating
to occlusal and polished surfaces
11
1

12. • 2
12

13. • 3
13

14. • 4
14

15. • 5. Cheek and or lip biting
• For cheeks-likely that functional width of
sulcus was not restored ; for lips-poor lip
support/inadequate anterior horizontal
overlap
• for cheek biting – restore functional width
of sulcus and/or reset; for lips-grind
incisors to provide a more appropriate
incisal guidance angle
15

16. 6. Tongue biting
• Lack of lingual overjet-teeth generally
placed lingual to lower ridge
• Remove lower lingual cusps, or reset teeth
16

17. Related polished surfaces
17
Symptoms :
Causes :
Treatment :

18. Factors resulting in discomfort-factors with
possible systemic associations
1. Burning sensation
2. Beefy red tongue
3. Frictional lesions
4. Tongue thrusting
5. Herpetiform ulcers
6. Painful click to TMJ
7. Allergy to dental material
8. Painless erythema of mucosa
18

19. Looseness of dentures
19

20. Factors resulting in looseness of dentures-
arising from decreased retention factors
20
A. Lack of Peripheral Seal

21. • B
• Inelasticity of cheek tissue
• Aging
• Softened tracing compound
21

22. c. Air beneath the impression surface
• Causes:
o deficient impression,
o damaged cast,
o warped denture,
o over adjustment of
impression surface,
o RRR,
o under cut,
o excessive relief ,
o change in fluid content of
supporting tissue.
22
Treatment :
Reline
Remake
Stabilise fluid content of
tissue & use minimal
pressure impression
method.

23. d. Xerostomia
• Medication
• Radiation H & N region
• Salivary gland disease
Design denture to maximise retention
Artificial saliva
23

24. Neuromuscular control
• Essential
• Correct design faults
24

25. Factors resulting in looseness of dentures :
arising from increased displacing force
25

26. Factors resulting in looseness of dentures : arising from
increased displacing force
-occlusal and anatomical factors
• 1. occlusal errors :
Causes :
• uneven tooth contact – tilting of dentures,
prevents seating
• lack of freedom in ICP- denture will shift
26

27. • 2.ulceration labial to lower ridge
 Excessive vertical overlap of anterior teeth
 Last mandibular molars placed too far
posteriorly
27

28. • 3. fibrous displaceable ridge
 Masticatory forces tend to cause denture
to sink into and tilt towards supporting
tissues
Reline
28

29. • 4.bony prominences covered with thin
mucosa
o Denture rocks over prominences
29

30. • 5. Non-resilient soft tissue
Does not adapt to impression surface of
denture reducing support and retention
factors
Reline , use low viscosity imp. material
30

31. • 6. pain avoidance mechanisms :
 Use of excessive amounts of fixative , or
self-applied reline material
 Eliminate the cause of pain.
31

32. List of denture problems associated with
problems of adaptation
32
Noise on eating or speakingNoise on eating or speaking
Eating difficultiesEating difficulties
Blunt
teeth
Blunt
teeth
Jaws close too farJaws close too far
Not wide enoughNot wide enough
Speech problemsSpeech problems
GaggingGagging
AppearanceAppearance
Too much visibility of
teeth
Too much visibility of
teeth
Creases at corners of
mouth
Creases at corners of
mouth
Colour of denture base
material ‘unnatural’
Colour of denture base
material ‘unnatural’

33. 1. Noise on eating /speaking
• Increased OVD
• Occlusal interferences
• Poor perception of patient to denture
wearing
• Loose denture
33

34. 2.Eating difficulties
• Unstable denture
34

35. 3.Blunt teeth
• Broad posterior occlusal surface
• Non anatomical type teeth
35

36. 4. Jaw close too far
• Lack of OVD
• May increase up to 1.5mm by relining /
remake
36

37. 5. Cannot open mouth wide enough for food
• Excessive VDO
• Can remove up to 1.5mm from occlusal
plane /remake
37

38. 6. Speech problems
• Unfamiliarity
• Retention & Stability ???
38

39. 7. gagging
• Loose dentures
• Thick distal border of upper denture
• Lingual placement of upper posteriors
• Low occlusal plane
39

40. 8. Appearance
• Patient failed to comment at trial stage
• Replacement ?
• Teeth – too light /dark !!
_ too small / big !!
_ arrangement-too even / irregular
or lacking diastema
 “ Accurate assessment of patient’s
requirements “ 40

41. 9.Too much visibility of teeth
• Level of occlusal plane – unacceptable
• Placed on upper anterior ridge
• No proper lip support
41

42. 10. Creases at corners of mouth
• Labial fullness and anterior tooth position
• OVD
42

43. 11. ’ Unnatural’ colour of denture base
material
43

44. 44

45. References
• J.F.McCord, A.A. Grant. BDJ vol 189 no 3
august 12 2000
• Complete denture prosthodontics –sharry
• Essentials of complete denture prosthodontics –
sheldon winkler 2nd
edition
• Complete denture : swenson
• Syllabus of complete denture: Heartwell
• Bouchers prosthodontic treatment for
edentulous patients
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