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This, the fifth and final article in the series, addresses the diagnoses and treatment of problems which may arise following provision of removable partial dentures (RPDs). These include difficulties seating the denture, pain and discomfort, looseness and functional problems.
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Explore the source record for details and available documents.
PATIENT: The patient is a 71-year-old woman who had undergone a gingivectomy due to a gingival carcinoma of right maxillary sinus and a denture was made for the defected jaw. DISCUSSION: During three years and six months, |3 serves as the guidance tooth had suffered from various symptoms, from the detachment of the neighboring tooth to the use of an OP anchor followed by a partial fracture of the cuspid root. However, |3 has not been removed in accordance to the patient's request. In addition, a relining provided indirectly to the denture, it is still maintained and used for mastication, pronunciation and swallowing functions without difficulty. CONCLUSION: This is a case that a denture was made for the defected jaw. However, it is important ot take measures in the future, as the remaining tooth is not expected to be preserved for long.
PURPOSE: This study investigated the relationship between the degree of mandibular alveolar ridge resorption and the number of denture adjustments after insertion of dentures in complete denture wearers. METHODS: The subjects were 77 complete denture patients (34 males, 43 females, mean age 69.1+/-8.1 years). Using bite plates of Gothic arch tracing for new denture production, the width, height, and inclination toward the tentative occlusal plane of the mandibular alveolar ridge corresponding to the canine areas (C), first premolar areas (P1), second premolar areas (P2), and first molar areas (M1) were measured bilaterally, and the relationship with the number of denture adjustment was evaluated. RESULTS: The mean of number of denture adjustments was 4.4+/-1.8 times (male 3.8 times, female 5.0 times), showing a significant difference between males and females (p<0.01). The alveolar ridge mean width was C: 9.7 mm, P1: 10.4 mm, P2: 11.5 mm, and M1: 13.0 mm respectively. The alveolar ridge mean height was C: 4.3 mm, P1: 4.6 mm, P2: 4.9 mm, and M1: 5.2 mm. The alveolar ridge mean inclination was C: 11.2 degrees, P1: 13.5 degrees, P2: 15.4 degrees, and M1: 18.8 degrees. The width and height of the mandibular alveolar ridge in C, P1, P2, and M1 were significantly larger in males than in females (p<0.05). The height of mandibular alveolar ridge was significantly lower in high number of denture adjustment than in low number of denture adjustment (p<0.05). CONCLUSION: Complete denture wearers showed a high relation between the number of denture adjustment and the mandibular alveolar ridge height.
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The effect of prosthetic restoration of masticatory ability on dietary selection was evaluated in 23 edentulous patients with denture adaptation problems. The patients were first given optimal complete dentures and then a fixed prosthesis on tissue-integrated implants in the lower jaw. Changes in dietary selection were evaluated from 4-day records obtained before prosthetic treatment and on six occasions up to 78 months after treatment. With the method used, no significant changes in food selection were recorded during the rehabilitation period, except for a slight increase in intake of crisp bread and fresh fruit after treatment with fixed tissue-integrated prostheses in the mandibular jaw. It is concluded that an improved oral function will not in itself lead to a change in dietary selection and that dietary changes probably require professional and individually given dietary advice by a trained dietitian.
The clinical usefulness of continuous E-glass partial fiber reinforcement of acrylic resin removable dentures was evaluated an average 13 months after the insertion of the fibers. Twelve removable complete dentures and ten removable partial dentures with a history of recurrent fracture were selected for this study. The partial fiber reinforcement was incorporated into the denture at the time of repair. One complete denture and one removable partial denture fractured in the region of reinforcement during the examination period. These fractures were most likely caused by faulty placement of the fiber reinforcement in the denture in the dental laboratory. In six dentures, new fractures occurred in regions without partial fiber reinforcement. The results revealed the importance of both the correct positioning of the partial fiber reinforcement in the denture and the use of accurate laboratory techniques.
The goal of this study was to provide evidence to support simplified treatment of mandibular edentulism using denture fabrication and implant placement to circumvent the need for second-stage surgeries or prosthodontic superstructures. A 5-year prospective clinical trial is reported, which involved treatment of mandibular edentulism using the single-stage surgical placement of a TiOblast microthreaded titanium screw implant with immediate replacement of a relieved mandibular overdenture and eventual retention of the overdenture with reduced ball abutments. Fifty-eight patients were treated; 116 implants were placed using a single-stage surgical approach, with a duplicate mandibular denture as the tomographic/surgical template. Mandibular dentures were relieved and relined with a tissue conditioning material and placed immediately after implant surgery. After 3 months, Conical Seal Design ball abutments were placed and attachments were secured in the overdentures by heat-polymerizing laboratory reline methods. Five of the 116 consecutively placed implants failed at 2 to 4 months, providing an immediate implant survival rate of 95.69% at the time of attachment connection. Pain and inflammation were not common to all failures, and infection was not reported in any of the 5 failures. The immediate placement of implants by a single-stage surgical procedure in the parasymphyseal region of the mandible, followed by placement of a relined mandibular denture, results in predictable and asymptomatic healing of implants that display the clinical and radiographic features of osseointegration. Encouraging results at the immediate observation period (attachment connection) must be tempered by the need for prudent and detailed clinical and radiologic evaluation over the 5-year trial period.
A remounting method in which after polymerization, total dentures together with the original models are replaced into the articulator and are ground in there, does not produce the accuracy we are aiming at when determining the intermaxillary relation by means of registration with a central pin. On the patient it was demonstrated that grinding-in after intraoral registration of the finished mandibular and maxillary total dentures by means of the central pin registration, interlocking, and placement into the articulator produces more accurate results.
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Flabby ridge and twofold lips shouldn't exist. As far as removable muco supported prosthesis is concerned, a perfect balanced occlusion respects maximally the integrity of the osseous tissues and the soft covering tissues. Clinical situations responsible for flabby ridge and the twofold lips are described. To prevent these problems, the solution is double: the dentist has to work "lege artis" and the negligence of the patient with dental prosthesis has to be avoided. An immediate treatment is necessary modifying the existing dental prosthesis. Some advice for the manufacturing of the new prosthesis is given.