Post Insertion Problems of Complete Denture م.م. منار اياد عبد اللطيف

Classification of Problems Time of Delivery Immediate Delayed With out complaint Sharry Common Un Common Comfort Function Aesthetic Phonetics Grant Discomfort Looseness Support Others (Adaptrive)

1) Discomfort Related to impression surface of the denture. Related to polished surface of the denture. Related to occlusal surface of the denture. Related to systemic association.

Discomfort Related to Impression Surface of the Denture 1) Discrete painful areas. Pearls or sharp ridges of acrylic. 2) Pain on insertion and removal (inflamed mucosa). Denture not relieved in area of under cut.

Discomfort Related to Impression Surface of the Denture 3) Over-extension of lingual flange (denture lifts on tongue protrusion, painful mylohyoid ridge, painful to swallow). 4) Lack of relief for frena or muscle attachments Peripheral overextension resulting from impression stage/technical error. 5) Too Deep Post Dam (Palatal soreness)

Discomfort Related to Polished Surface of the Denture 1) Pain at posterior aspect of upper denture on opening (too thick buccal flange constraining coronoid process)

Discomfort Related to Occlusal Surface of the Denture 1) Pain on eating with occlusal imbalance. anterior or posterior prematurity, incisal locking, or lack of balanced articulation. 2) Pain on labial aspect of mandibular ridge. lack of incisal overjet.

Discomfort Related to Occlusal Surface of the Denture 3) Pain about periphery of dentures. (accompanied by pain in masseter and posterior temporalis muscles which tends to intensify as day progresses). Increase VD 4) Cheek biting. width of sulcus is not restored.

Discomfort Related to Occlusal Surface of the Denture 5) Lip biting. Poor lip support/inadequate anterior horizontal overlap. 6) Tongue biting. Teeth generally placed lingual to lower ridge.

Discomfort Related to Systemic Factors Burning mouth syndrome. Frictional lesions. Herpetic ulcers. Patient allergic to denture material. Denture stomatitis. Angular cheilitis. Soft tissue hyperplasia (Flabby ridge, denture hyperplasia). Temporomandibular disorders.

Discomfort Related to Systemic Factors 1)Burning mouth syndrome (burning and painful sensations in a mouth with normal mucosa). local, systemic, and psychogenic factors. 2) Frictional lesions. Xerostomia as a side effect of prescribed drugs. 3)Herpetic ulcers. Herpes simplex or herpes zoster. 3) Patient allergic to denture material. Higher residual monomer content of acrylic

Discomfort Related to Systemic Factors 4)Denture stomatitis (burning or itching sensation of palatal mucosa associated). Candidal infection, with ill fitted denture 5)Angular cheilitis (inflammation of the corners of the mouth). Reduced VDO, general health factors such as nutritional deficiencies and immune dysfunction seem to be of greater importance.

Discomfort Related to Systemic Factors 7) Soft tissue hyperplasia (Flabby ridge, denture hyper- plasia). long-term denture wearers and clearly related to the degree of residual ridge resorption. Chronic irritation from an overextended and/or ill-fitting denture. 8)Temporomandibular disorders. Change in VD, TMDs.

Decreased Retentive Forces 2) Looseness Decreased Retentive Forces Lack of seal Air beneath the impression surface Xerostomia Neuromuscular control problems Increased Displasive Forces Overextension of denture borders Poor fit Occlusal problems

Decreased Retentive Forces Lack of seal. Border underextension. 2) Air beneath the impression surface (Denture may rock under finger pressure, may see gap between periphery of flange and ridge). Deficient impression, Damaged cast, Warped denture, Over-adjustment of Impression surface).

Decreased Retentive Forces 3)Xerostomia. Medication, irradiation of head and neck region, salivary gland disease. 4)Neuromuscular control problems Change in shape relative to old dentures, high occlusal plane on mandibular denture.

Increased Displasive Forces Overextension of denture borders. 2) Poor fit. Poor/inappropriate impression technique especially in posterior lingual area. 3) Occlusal problems. inter-cuspal and retruded contact positions not coincident, lack of occlusal balance in protrusive, lateral excursions and excessive vertical overlap of anterior teeth

3) Problems Associated With Support 1) Denture sink into and tilt on supporting tissues. Forces of mastication is exerted on fibrous displaceable. 2) Bony prominence covered by thin mucosa. Denture rock over the prominence. 3) Ridge resorption. Resorbed ridge results in little resistance to forces in lateral and antero-posterior directions.