Podcast
Questions and Answers
What challenges might be encountered when extending the denture base into the retromylohyoid fossa region?
What challenges might be encountered when extending the denture base into the retromylohyoid fossa region?
Extending the denture base into the retromylohyoid fossa region can be difficult if the tongue is in intimate contact with the retromolar pad or if there is flabby tissue covering the retromolar pad.
Why is a pear-shaped retromolar pad important?
Why is a pear-shaped retromolar pad important?
A pear-shaped retromolar pad is important because it increases the area of the posterior border seal and contributes to stable suction.
Why is a thin string-like retromolar pad bad?
Why is a thin string-like retromolar pad bad?
A steep and thin string-like retromolar pad makes achieving a posterior border seal difficult due to its shape changing significantly between open-mouth and closed-mouth positions.
What are the four examination items for the retromolar pad?
What are the four examination items for the retromolar pad?
How is the overall condition of the retromolar pad determined?
How is the overall condition of the retromolar pad determined?
What are the categories of tongue retraction when the mouth is opened?
What are the categories of tongue retraction when the mouth is opened?
Why is it challenging to create a lingual border seal for patients with a significantly retracted tongue position?
Why is it challenging to create a lingual border seal for patients with a significantly retracted tongue position?
How can denture lifting be addressed in patients with significant tongue retraction?
How can denture lifting be addressed in patients with significant tongue retraction?
How does the position of the labial vestibule change across different jaw relationship classes?
How does the position of the labial vestibule change across different jaw relationship classes?
How does the occlusal plane relate to Camper's line and skeletal classes?
How does the occlusal plane relate to Camper's line and skeletal classes?
What is the impact of a severe overjet in class 2 cases on denture seal?
What is the impact of a severe overjet in class 2 cases on denture seal?
Why is achieving a lingual border seal difficult in class 3 jaw relationships?
Why is achieving a lingual border seal difficult in class 3 jaw relationships?
Why is achieving suction more difficult as the jaw relationship class increases?
Why is achieving suction more difficult as the jaw relationship class increases?
How does the movement of the lower lip during mouth-opening affect denture stability in class 3 jaw relationships?
How does the movement of the lower lip during mouth-opening affect denture stability in class 3 jaw relationships?
How does the jaw relationship class impact the difficulty of achieving suction?
How does the jaw relationship class impact the difficulty of achieving suction?
What happens when the mandibular position is unstable?
What happens when the mandibular position is unstable?
How can the discrepancy between the guided position and the patient's habitual occlusal position be verified?
How can the discrepancy between the guided position and the patient's habitual occlusal position be verified?
What is an alternative method for guiding the mandible to check for discrepancies in occlusal position?
What is an alternative method for guiding the mandible to check for discrepancies in occlusal position?
When is it considered that a discrepancy exists between the guided position and habitual occlusal position?
When is it considered that a discrepancy exists between the guided position and habitual occlusal position?
When is the mandibular position considered unstable?
When is the mandibular position considered unstable?
What can drastic displacement of mandibular jaw position cause?
What can drastic displacement of mandibular jaw position cause?
How can the movement of condyles be assessed?
How can the movement of condyles be assessed?
What are the Good categories of condyle movement in the temporomandibular joint?
What are the Good categories of condyle movement in the temporomandibular joint?
What are the Functional Problem categories of condyle movement in the temporomandibular joint?
What are the Functional Problem categories of condyle movement in the temporomandibular joint?
What are the Severe Functional Problem categories of condyle movement in the temporomandibular joint?
What are the Severe Functional Problem categories of condyle movement in the temporomandibular joint?
When might a treatment denture be indicated?
When might a treatment denture be indicated?
When might an implant-supported overdenture be required?
When might an implant-supported overdenture be required?
What can a pre-treatment patient questionnaire reveal about denture satisfaction?
What can a pre-treatment patient questionnaire reveal about denture satisfaction?
How does a patient's dissatisfaction with their existing dentures affect their appreciation for new ones?
How does a patient's dissatisfaction with their existing dentures affect their appreciation for new ones?
Why might a dentist's perspective on the fit of a denture differ from the patient's perspective?
Why might a dentist's perspective on the fit of a denture differ from the patient's perspective?
What factors should dentists consider when treating patients with dentures?
What factors should dentists consider when treating patients with dentures?
Why might some patients respond negatively to questionnaires despite having good quality dentures?
Why might some patients respond negatively to questionnaires despite having good quality dentures?
What physiological issues could contribute to patients' dissatisfaction with their dentures?
What physiological issues could contribute to patients' dissatisfaction with their dentures?
What is the purpose of therapeutic dentures?
What is the purpose of therapeutic dentures?
How do patient questionnaires complement oral examinations in understanding patient needs?
How do patient questionnaires complement oral examinations in understanding patient needs?
What is the Oral Health Impact Profile (OHIP)?
What is the Oral Health Impact Profile (OHIP)?
How many questions are included in the OHIP questionnaire?
How many questions are included in the OHIP questionnaire?
What does the score range of the OHIP indicate?
What does the score range of the OHIP indicate?
Why might inexperienced dentists assume complete denture treatment is difficult?
Why might inexperienced dentists assume complete denture treatment is difficult?
What is the consequence of dentists recommending implants against patients' preferences?
What is the consequence of dentists recommending implants against patients' preferences?
What is the purpose of the simple method of clinical diagnosis developed for less experienced dentists?
What is the purpose of the simple method of clinical diagnosis developed for less experienced dentists?
What parameters are examined in complete denture treatment?
What parameters are examined in complete denture treatment?
Why do busy practitioners need a simple but reliable method of clinical examination?
Why do busy practitioners need a simple but reliable method of clinical examination?
What might a patient require if the analysis indicates greater treatment difficulty?
What might a patient require if the analysis indicates greater treatment difficulty?
What is the first morphological feature common to suction-effective mandibular complete dentures?
What is the first morphological feature common to suction-effective mandibular complete dentures?
What is the importance of a thick denture border in the sublingual fold region?
What is the importance of a thick denture border in the sublingual fold region?
How long does the denture base extend beyond the mylohyoid ridge?
How long does the denture base extend beyond the mylohyoid ridge?
How should the denture base cover the retromolar pad?
How should the denture base cover the retromolar pad?
What are eight key intraoral anatomical features related to dentures?
What are eight key intraoral anatomical features related to dentures?
What are the key parameters to assess before commencing mandibular denture treatment?
What are the key parameters to assess before commencing mandibular denture treatment?
Why are these parameters unique and important for achieving mandibular denture suction?
Why are these parameters unique and important for achieving mandibular denture suction?
What are the three suction-inhibiting factors related to mandibular jaw position?
What are the three suction-inhibiting factors related to mandibular jaw position?
Why is the simple intraoral examination for SEMCD important in denture treatment?
Why is the simple intraoral examination for SEMCD important in denture treatment?
How does the intraoral examination contribute to estimating denture fabrication difficulty?
How does the intraoral examination contribute to estimating denture fabrication difficulty?
Why is it essential to understand the patient's needs and expectations during denture treatment?
Why is it essential to understand the patient's needs and expectations during denture treatment?
Why might dentists feel anxious about treatment outcomes?
Why might dentists feel anxious about treatment outcomes?
How can a more accurate diagnosis of the alveolar ridge condition be achieved?
How can a more accurate diagnosis of the alveolar ridge condition be achieved?
Why is it important to compare the amount of residual bone above the mental foramen on a panoramic radiograph with intraoral findings?
Why is it important to compare the amount of residual bone above the mental foramen on a panoramic radiograph with intraoral findings?
What happens to the surrounding alveolar bone when teeth are lost?
What happens to the surrounding alveolar bone when teeth are lost?
How can residual alveolar ridges be categorized based on the height of the bone above the mental foramen?
How can residual alveolar ridges be categorized based on the height of the bone above the mental foramen?
Why is it important to classify the residual alveolar ridge condition?
Why is it important to classify the residual alveolar ridge condition?
What are the issues associated with a poor residual ridge form?
What are the issues associated with a poor residual ridge form?
How does a poor residual ridge form affect occlusal forces in edentulous patients?
How does a poor residual ridge form affect occlusal forces in edentulous patients?
Why is it important to consider the residual ridge form when planning denture treatment?
Why is it important to consider the residual ridge form when planning denture treatment?
What is the impact of a favorable residual ridge on denture stability and mastication?
What is the impact of a favorable residual ridge on denture stability and mastication?
How does a severely resorbed ridge affect denture stability and masticatory force?
How does a severely resorbed ridge affect denture stability and masticatory force?
What is the long-term effect of decreased masticatory force on the overall function of the mouth?
What is the long-term effect of decreased masticatory force on the overall function of the mouth?
What is the effect of a decline in oral mucosal activity on oral function?
What is the effect of a decline in oral mucosal activity on oral function?
How does a reduction in the amount of oral mucosa impact difficult-to-treat cases?
How does a reduction in the amount of oral mucosa impact difficult-to-treat cases?
Why is it important for dentists to consider the decline in oral mucosal activity when treating patients with dentures?
Why is it important for dentists to consider the decline in oral mucosal activity when treating patients with dentures?
How is the quality of the spongy tissue in the sublingual fold region categorized?
How is the quality of the spongy tissue in the sublingual fold region categorized?
What are the two ways of examining the sublingual fold region?
What are the two ways of examining the sublingual fold region?
Why is spongy tissue in the sublingual fold region important for mandibular complete denture suction?
Why is spongy tissue in the sublingual fold region important for mandibular complete denture suction?
What are some possible causes of reduced tissue elasticity in the sublingual fold region?
What are some possible causes of reduced tissue elasticity in the sublingual fold region?
What can be done if a patient has reduced tissue elasticity in the sublingual fold region?
What can be done if a patient has reduced tissue elasticity in the sublingual fold region?
Why is it important to address reduced tissue elasticity in the sublingual fold region?
Why is it important to address reduced tissue elasticity in the sublingual fold region?
How is the retromylohyoid fossa region examined?
How is the retromylohyoid fossa region examined?
How far should the denture border extend beyond the mylohyoid ridge into the retromylohyoid fossa region?
How far should the denture border extend beyond the mylohyoid ridge into the retromylohyoid fossa region?
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Study Notes
Denture Treatment Insights
- Pre-treatment patient questionnaires reveal insights into denture satisfaction and adaptability.
- Patients dissatisfied with existing dentures show increased appreciation for new ones due to improved fit and functionality.
- Dentists might have a differing view on denture fit compared to patients, who may adapt to ill-fitting dentures over time.
Patient Considerations
- Dentists should evaluate patient dissatisfaction, adaptability, and individual needs when addressing denture treatment.
- Negative questionnaire responses can arise even with high-quality dentures, often due to underlying physiological issues.
- Common physiological problems affecting satisfaction include unstable mandibular jaw position, bruxism, and xerostomia.
Therapeutic Dentures and Assessment Tools
- Therapeutic dentures aim to resolve discomfort causes before final denture fabrication.
- Patient questionnaires complement oral examinations, providing insights into comfort and satisfaction levels.
- The Oral Health Impact Profile (OHIP) questionnaire assesses oral health perceptions with 14 questions; a lower score indicates higher satisfaction.
Clinical Diagnosis and Treatment Planning
- Inexperienced dentists may find complete denture treatment complex due to lack of experience assessing intraoral stability.
- Classifying alveolar ridge conditions helps anticipate treatment success and ascertain challenges for denture stability.
Intraoral Features and Parameters
- Key intraoral anatomical features for denture success include ridge form, sublingual fold tissue quality, and jaw relationship stability.
- A favorable residual ridge supports denture stability and increases occlusal forces, while a poor ridge form leads to reduced occlusal efficiency.
- An effective suction seal for mandibular dentures is achieved by considering oral soft tissue parameters, including tongue position and elasticity.
Residual Ridge Conditions
- Residual bone above the mental foramen categorizes ridge conditions as good, moderate, or poor, impacting treatment outcomes.
- Dentures can dislodge easily from a severely resorbed ridge, decreasing masticatory force and overall oral function.
Evaluation of Soft Tissues
- The quality of spongy tissue in the sublingual fold region is crucial for denture suction; categorized as good, fair, or poor based on its physical attributes.
- Reduced tissue elasticity can be addressed through therapeutic denture reshaping, improving suction and overall function.
Retromolar Pad Examination
- Examination criteria for the retromolar pad include tissue firmess, size, angle, and shape change during mouth movement.
- A pear-shaped retromolar pad increases suction seal effectiveness, while a thin pad hinders posterior border sealing, risking denture dislodgment.
Importance of Patient Needs
- Understanding patients' needs and expectations is vital for successful treatment planning, enhancing satisfaction and outcome predictability.
- Dentists must remain conscious of declines in oral mucosal activity, as these may complicate denture effectiveness and patient comfort long-term.
Conclusion
- Accurate intraoral diagnosis via examination and radiographic assessments leads to successful denture treatment outcomes.
- Tailoring treatment plans according to alveolar ridge conditions and soft tissue evaluations is essential for optimizing patient care in denture therapy.### Denture Border Seals and Jaw Relationships
- Creating a lingual border seal is challenging for patients with retracted tongues due to differences in the denture's form and potential air invasion from the lingual flange.
- To address denture lifting in patients with significant tongue retraction, increasing the thickness of the lingual denture border helps expand the sealing area.
- The position of the labial vestibule varies by jaw relationship class: it's below the incisal papilla in class 1, posterior in class 2, and anterior in class 3.
- Typically, the occlusal plane is parallel to Camper's line, with the anterior portion lower in skeletal class 2 and higher in class 3.
Impact of Jaw Relationship on Denture Stability
- Severe overjet in class 2 cases creates a large functional range, leading to a broken border seal as air invades when the denture slides.
- Class 3 jaw relationships often feature low tongue posture, complicating the establishment of a stable lingual border seal.
- Achieving suction is increasingly difficult with higher jaw relationship classes due to larger functional ranges and lower tongue posture.
- In class 3, lip movement during mouth opening contributes to denture dislodgment, impacting the sublingual denture seal.
Mandibular Position and Occlusion
- An unstable mandibular position causes the border seal to break as air invades, often triggered by occlusal interference.
- Discrepancy between the guided and habitual occlusal positions is indicated by more than a 2mm difference, verified by guiding the mandible backward while the patient holds the denture.
- An alternative method for checking occlusal position discrepancies involves having the patient touch their tongue to the palate while closing their mouth, allowing observation of mandible movement.
- The mandibular position is unstable if the tapping point in the guided position is also unstable.
Assessing Condyle Movement
- Drastic displacement of the mandibular jaw position can disrupt occlusal relationships and break the denture-mucosa seal, potentially causing clicking sounds.
- Condylar movement can be assessed by palpating in front of the ear while the patient opens and closes their mouth.
- Good condyle movement involves simultaneous, smooth movements of both condyles.
- Functional problems in condyle movement occur when one condyle leads or deviates, while severe problems involve clicking or pain, indicating abnormal disc movement.
Treatment Dentures and Overdentures
- Treatment dentures are indicated to normalize mandibular position when significant suction-inhibiting factors are present due to mandibular placement.
- An implant-supported overdenture may be necessary in cases of severe functional disorder, enhancing stability and comfort for the patient.
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