Complete Dentures Quiz

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Questions and Answers

What is the primary factor that reduces the chance of success for single complete dentures?

Insufficient thickness of the denture base

Inability to balance occlusion (correct)

Damage to the artificial teeth

Lack of aesthetic considerations

Which condition is specifically noted to be more problematic in maxillary total dentures?

Midline fractures (correct)

Insufficient retention

Resorption of alveolar bone

Lack of stability

How does the presence of natural teeth affect the construction of a single complete denture?

It complicates the occlusion and stability. (correct)

It improves the functional success of the dentures.

It has no impact on the denture construction.

It simplifies the design of the denture.

What restoration is typically NOT needed for a partially edentulous arch that receives a complete denture?

Natural tooth restoration (D) Signup and view all the answers

What is one of the three important factors determining the functional success of complete dentures?

Support (A) Signup and view all the answers

Which statement about mandibular single complete dentures is true?

They are limited by mobile structures affecting their stability. (C) Signup and view all the answers

What must be evaluated during the planning stage to avoid complication with single complete dentures?

Position and condition of remaining natural teeth (C) Signup and view all the answers

What is one of the primary causes of combination syndrome?

Faulty prosthesis construction (A) Signup and view all the answers

Which condition is NOT associated with combination syndrome?

Vertical dimension loss in the lower arch (A) Signup and view all the answers

What is the recommended strategy for the material used in single complete dentures to prevent resorption?

Use of high-quality acrylic teeth (D) Signup and view all the answers

How often should patients with prosthetic appliances have routine check-ups to prevent complications?

Every 6 months (D) Signup and view all the answers

Which type of teeth is contraindicated in the anterior region of maxillary dentures?

Porcelain teeth (B) Signup and view all the answers

What can happen if opposing natural tooth jaw arch is misaligned?

Cusp conflict during function (B) Signup and view all the answers

What is the primary surgical treatment for combination syndrome when there is sufficient underlying bone?

Removal of fibrous tissue (D) Signup and view all the answers

Which material provides wear resistance but may cause wear on natural teeth?

Porcelain (C) Signup and view all the answers

What specific aspect should be monitored to prevent anterior hyperfunction in combination syndrome?

Overbite and overjet relationships (C) Signup and view all the answers

Which of the following best describes the term 'Kelly syndrome'?

An alternative name for combination syndrome (D) Signup and view all the answers

What is the primary cause of fracture in single complete dentures?

Incorrect arrangement of occlusion (D) Signup and view all the answers

What should be done if there are bony prominences that cannot be surgically removed?

Relief areas should be created in the denture base (B) Signup and view all the answers

Which of the following conditions should be avoided to prevent chronic trauma to the denture?

Deep overbite with tight intercuspation (A) Signup and view all the answers

For achieving maximum stabilization during eccentric movements, what occlusion is preferred?

Bilateral balanced occlusion (D) Signup and view all the answers

When selecting teeth for a denture, how should the inclination of the natural teeth’s tubercles influence tooth selection?

Teeth with tubercle inclination similar to natural teeth should be selected (D) Signup and view all the answers

Which feature of the denture base is crucial to reduce pressure per unit area?

Covering the largest possible area (C) Signup and view all the answers

What is the consequence of not relieving soft tissues in areas with knife-edge crests?

Increased soft tissue irritation and potential fracture (C) Signup and view all the answers

Why should the incisal guidance angle be close to 0 degrees?

To prevent rotational forces on the denture (A) Signup and view all the answers

What can be used to aid denture fitting over anatomical structures like toruses?

Soft lining materials (A) Signup and view all the answers

What should be done if there is a sharp or uneven alveolar crest during the examination of the edentulous jaw arch?

Use soft lining materials if surgery is contraindicated (D) Signup and view all the answers

Which of the following represents an ideal mucosal thickness for the edentulous jaw arch?

1.5 mm (B) Signup and view all the answers

How should a frenulum that extends up to the crest be managed in denture design?

Perform a frenectomy to prevent weakness (C) Signup and view all the answers

What is the main indicator of excessive chewing force in natural teeth during examination?

Significantly worn occlusal surfaces (B) Signup and view all the answers

What should be done with small toruses during the examination of the edentulous jaw arch?

They can be tolerated if they cause no problems (C) Signup and view all the answers

Which action can positively affect the stability of a denture regarding natural teeth occlusion?

Reducing the slope of high tubercle inclination (B) Signup and view all the answers

What is a possible issue when the opposing jaw has excessively worn teeth?

Decreased stability due to increased buccolingual distance (C) Signup and view all the answers

What is a common issue associated with thicker and mobile mucosa during examination?

Potential increase in denture fractures (B) Signup and view all the answers

What is the impact of having a frenulum that limits the denture during its function?

Weakens the denture structure (A) Signup and view all the answers

What procedure should be employed to address irregularities on the incisal edge and cusp tips of lower teeth?

Minor abrasions at the enamel level (C) Signup and view all the answers

What is the consequence of a lack of parallelism in occlusal planes?

Unbalanced force distribution and instability of the prosthesis (C) Signup and view all the answers

In Class III cases, which issue is likely to affect the stability of removable complete dentures?

Narrow area where the upper denture is attached (D) Signup and view all the answers

What must be ensured in cases of mandibular total dentures made against maxillary natural dentition?

Balanced occlusion is ensured (D) Signup and view all the answers

What is a significant risk when a dentist agrees to fabricate a new single complete denture over an existing one?

The dentist assumes responsibility for both prostheses (A) Signup and view all the answers

Study Notes

Single Complete Dentures

Single complete dentures are a treatment for cases where only one jaw is restored with a full prosthesis.
Maxilla (upper jaw) is more frequently treated with this method.
Opposite Jaw Dentition:
- A complete arch with enough natural teeth and fixed restorations, requiring no additional prosthesis.
- A partially-dentate arch where missing teeth are replaced with removable, fixed partial, or implant-supported fixed prostheses,
- Mucosa-supported, tooth-supported or implant-supported full dentures.
Complete dentures should restore lost function and aesthetics, maintaining the remaining tissues.
Success depends on stability, retention, and support.
In constructing both upper and lower complete dentures, teeth are aligned for a balanced occlusion.
A single denture is usually more complex than when both jaws are restored simultaneously, as balancing occlusion with natural teeth is difficult.
Tooth loss can cause bending, elongation, and rotation of remaining teeth, making occlusion difficult to stabilize.
The inability to balance occlusion is the primary factor that reduces the success of single complete dentures.
Issues must be evaluated during treatment planning
If the fabrication of the prosthesis fails to overcome these problems, horizontal forces on the opposing jaw, exceeding physiological limits, can result in traumatic occlusion.
Maxillary single complete dentures tend to be more successful than mandibular due to a larger chewing pressure area in the maxilla.
Mandibular dentures are more difficult due to greater mobility.

Problems Encountered

Lack of Stability
Damage to mucosa and resorption of alveolar bone
Unsatisfactory function
Fractures in the denture base
Wear on artificial/natural teeth, depending on material

Midline Fractures

More common in maxillary total dentures.
Often due to lack of relief in the median palatine suture region.
Failure to achieve occlusal harmony (inappropriate contact points, positioning of teeth outside ridges, focal concentration of occlusal contacts, thin acrylic base).

Alveolar Bone Resorption

Severe bone resorption is a major factor limiting success of single complete dentures.
Preserving the continuity and integrity of remaining tissues is crucial.

Patient Examination

Examination of the edentulous jaw arch
Examination of the opposing jaw arch
Features of the denture base (thickness, structure of mucosa)
Occlusion
Types of artificial teeth

Examination of Edentulous Jaw Arch

Resorption degree and shape of the alveolar arch
Address uneven/sharp crests (sores, pain)
Consider using soft lining materials if surgery is not an option.
Thickness and structure of the mucosa (should be 1.5mm ideally)
Address toruses (small ones can be tolerated; large ones should be surgically removed).

Occlusal Surfaces of Teeth

Natural teeth with high cusps: low chewing force, little eccentric movement.
Worn teeth: high chewing force, excessive eccentric movement.
Reduce the slope of teeth with high tubercle inclination.

Occlusal Surfaces of Teeth (cont.)

Presence of excessively worn opposing teeth can affect denture stability
Worn teeth cause buccolingual distance increase, thus requiring occlusal surface restoration to previous functional width (buccal and lingual surfaces must be abraded first)

Inter-occlusal Relations of Teeth

Posterior teeth that align outside the crest create harmful forces.
Centrally aligning maxillary teeth with lingual cusps of mandibular teeth and inclined buccal cusps can improve stability.

Features of Denture Base

Must be within physiological tolerance and cover largest possible area.
Address toruses/bony prominences through relief if they cannot be surgically removed.
Sof lining can address knife-edge crests, protruding anatomical structures.

Occlusion

Incorrect placement of teeth causes denture fractures.
Bilateral balance occlusion is important during eccentric movements so there are no premature contacts in the posterior teeth.

Occlusion (cont.)

Opposing arch morphology should be considered in tooth selection.
Select teeth with appropriate tubercle inclination
Shallow surfaces and point contacts are preferable over deep overbites
Contact between anterior teeth should be avoided to prevent rotation of the denture

Combination Syndrome

Excessive load concentrated in the maxillo-anterior region can cause bone loss, overgrowth of tubercles, hyperplasia of palatal mucosa, and elongation of lower teeth.
Can occur in cases with upper-total, lower Kennedy 1 cases.

Prevention

Anterior teeth should not touch each other.
Use high-quality acrylic teeth instead of porcelain in upper and lower edentulous Kennedy cases
Routine check-ups every six months.
Surgical removal of fibrous tissue if there's sufficient underlying bone
Surgical removal of fibrous tissue if there's enough underlying bone

Types of Teeth

Acrylic teeth are mostly used (resist forces, reduce resorption)
Porcelain teeth are wear-resistant but do not form chemical bonds with the base, and can wear the opposing natural teeth

Occlusally Reinforced Teeth

Amalgam applied to the occlusal surfaces of artificial teeth improves wear prevention

Strategies/Methods

Use new generation acrylic/composite resin denture teeth.
Periodic examinations are useful.
Important to consider the occlusion plane of the existing single denture

Examination of opposing Natural Teeth

Malpositioned teeth can cause cusp conflicts with artificial teeth, leading to the denture tipping.
The lower and upper teeth should ideally be in the same horizontal plane (parallel)

Procedures to resolve occlusion / alignment issues

Teeth can be abraded and Irregularities can be corrected at the enamel level only.
Natural teeth may be replaced with crowns, inlays, or onlays.
Orthodontic treatments can be employed
Extraction of problematic teeth may be an option.

Analysis

Reported by Yurtstas (1962), based on Monson's Galot Theory (combining Spee and Wilson curves).

Class III Cases

Difficulties with denture fabrication due to underdeveloped maxilla and a narrow attachment area.
Could experience negative effects on denture stability.
Alignment difficulties can result in pain at the crest of the ridge/lips.

Mandibular Total Denture

Irregularities in the opposing arch should be addressed.
Ensuring balanced occlusion is essential.
To distribute forces evenly, the prosthesis should be spread as widely as possible.

Removable Full Denture against Fixed Partial Prosthesis

First steps for maxilla: anatomical size, functional impression, vertical dimension detection, appropriate preparation, metal try-in, finishing, final occlusal alignment.

Single Complete Denture Considerations

Easier and more reliable to make both dentures at the same time rather than making one over an existing one.

Conditions for new opposing Single Complete Denture

Well aligned teeth on the crest of the ridge for proper stability and better chewing efficiency
Ideally, aesthetics appropriate
Sufficient tissue support
Suitable cusp heights
Properly sized denture base supporting surrounding tissues
Good stabilization and retention of the denture

Conclusion

Proper occlusal plane alignment is crucial in single complete denture construction.
Pre prosthetic mouth preparation is necessary.
Select appropriate denture base, materials, and teeth.
Regular checkups are important.
Consider implant-supported options if other methods fail.

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Description

Test your knowledge on the factors affecting the success of complete dentures. This quiz covers crucial concepts such as the influence of natural teeth, common complications, and essential evaluation strategies. Perfect for dental students and professionals alike!