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Questions and Answers
What effect does broad area coverage have on dentures?
What effect does broad area coverage have on dentures?
What nutritional deficiency is commonly associated with excessive residual ridge resorption (RRR)?
What nutritional deficiency is commonly associated with excessive residual ridge resorption (RRR)?
What is the benefit of immediate dentures following tooth extraction?
What is the benefit of immediate dentures following tooth extraction?
How do overdentures support oral health compared to conventional complete dentures?
How do overdentures support oral health compared to conventional complete dentures?
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What impact do dental implants have on residual ridge resorption?
What impact do dental implants have on residual ridge resorption?
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What is the classification of residual bone height measuring 11 - 15 mm in the mandible?
What is the classification of residual bone height measuring 11 - 15 mm in the mandible?
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How does bone resorption in the maxilla primarily occur?
How does bone resorption in the maxilla primarily occur?
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Which statement accurately describes the direction of bone resorption in the mandible?
Which statement accurately describes the direction of bone resorption in the mandible?
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What ratio represents the projected maxillary denture area compared to the mandibular denture area?
What ratio represents the projected maxillary denture area compared to the mandibular denture area?
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What is a key factor contributing to the difference in resorption rates between the maxilla and mandible?
What is a key factor contributing to the difference in resorption rates between the maxilla and mandible?
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What characteristic of cancellous bone aids in force dissipation?
What characteristic of cancellous bone aids in force dissipation?
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Where does the anterior mandible resorb in comparison to the anterior maxilla?
Where does the anterior mandible resorb in comparison to the anterior maxilla?
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In the maxillary arch, how are the teeth arranged?
In the maxillary arch, how are the teeth arranged?
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What happens to muscle attachments as a result of residual ridge resorption?
What happens to muscle attachments as a result of residual ridge resorption?
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Which factor contributes to the rate of resorption of the residual ridge?
Which factor contributes to the rate of resorption of the residual ridge?
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How does residual ridge resorption affect the vertical dimension of occlusion (VDO)?
How does residual ridge resorption affect the vertical dimension of occlusion (VDO)?
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What morphological changes can occur in the residual ridge due to resorption?
What morphological changes can occur in the residual ridge due to resorption?
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What systemic factor is associated with increased bone resorption?
What systemic factor is associated with increased bone resorption?
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Which of the following factors does NOT influence residual ridge resorption?
Which of the following factors does NOT influence residual ridge resorption?
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What is a consequence of the resorption of the mandibular canal wall?
What is a consequence of the resorption of the mandibular canal wall?
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Which statement best describes the relationship between ridge dimensions and resorption rates?
Which statement best describes the relationship between ridge dimensions and resorption rates?
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What is the primary function of osteoclasts in bone physiology?
What is the primary function of osteoclasts in bone physiology?
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Which order of residual ridge configuration indicates that there is marked narrowing of the labiolingual diameter of the crest?
Which order of residual ridge configuration indicates that there is marked narrowing of the labiolingual diameter of the crest?
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What is the outcome when resorption continues after a knife-edged ridge forms?
What is the outcome when resorption continues after a knife-edged ridge forms?
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Which order describes a residual ridge that is low and well-rounded as a result of progressive narrowing?
Which order describes a residual ridge that is low and well-rounded as a result of progressive narrowing?
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In the context of the pathogenesis of residual ridge resorption, what happens immediately after tooth extraction?
In the context of the pathogenesis of residual ridge resorption, what happens immediately after tooth extraction?
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What happens to the residual ridge after reaching a depressed state?
What happens to the residual ridge after reaching a depressed state?
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According to the classification by the American College of Prosthodontists, what defines Type I residual bone?
According to the classification by the American College of Prosthodontists, what defines Type I residual bone?
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What aspect of the residual ridge configuration is noted during order II?
What aspect of the residual ridge configuration is noted during order II?
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What is the impact of constant pressure on bone?
What is the impact of constant pressure on bone?
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Which of the following factors contribute to bone formation and resorption?
Which of the following factors contribute to bone formation and resorption?
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How does Wolff’s Law relate to bone function?
How does Wolff’s Law relate to bone function?
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What is a potential consequence of habitual gum chewing on bone health?
What is a potential consequence of habitual gum chewing on bone health?
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What is a recommended practice for denture patients experiencing bruxism?
What is a recommended practice for denture patients experiencing bruxism?
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Which movement is associated with the lateral grinding movement during mastication?
Which movement is associated with the lateral grinding movement during mastication?
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What is the role of rest periods between meals for alveolar bone health?
What is the role of rest periods between meals for alveolar bone health?
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What does a sharp cusp do compared to a flat occlusal form during mastication?
What does a sharp cusp do compared to a flat occlusal form during mastication?
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What is the main goal of achieving balanced occlusion?
What is the main goal of achieving balanced occlusion?
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Which factor contributes to the prevention of residual ridge resorption?
Which factor contributes to the prevention of residual ridge resorption?
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How can excessive stress from dentures be minimized?
How can excessive stress from dentures be minimized?
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What is a necessary condition for the impression procedures when designing dentures?
What is a necessary condition for the impression procedures when designing dentures?
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Which of the following is NOT a prosthetic factor that can lead to alveolar resorption?
Which of the following is NOT a prosthetic factor that can lead to alveolar resorption?
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What design feature helps enhance denture stability during mastication?
What design feature helps enhance denture stability during mastication?
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Which approach is least effective in preventing residual ridge resorption?
Which approach is least effective in preventing residual ridge resorption?
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What is an optimal way to maintain alveolar bone health as per occlusal principles?
What is an optimal way to maintain alveolar bone health as per occlusal principles?
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Study Notes
Residual Ridge Resorption (RRR)
- Alveolar bone is the bony portion of the maxilla or mandible where teeth roots are held.
- Residual ridge is the shape of the alveolar ridge after tooth extraction and healing.
- Post-extraction, inflammatory reactions are triggered, with blood clotting initially sealing the socket.
- Epithelial tissue proliferates and migrates within a week, restoring tissue integrity.
- Bone formation in the extraction socket is evident within 2 weeks, progressively filling the socket over 6 months with newly formed bone.
- Residual ridge alveolar bone constantly remodels throughout.
- Resorption is most rapid in the first 6 months but continues slower, leading to substantial jaw structure loss throughout life.
- Rates vary between individuals and over time within the same person.
- Overall health affects ridge resorption, influencing removable prosthetic function.
- Treatment of edentulous patients requires continuous maintenance to manage RRR.
- RRR is a chronic, progressive, irreversible, and cumulative process.
Structural Characteristics of Alveolar Bone
- Alveolar bone has a hard, compact outer layer atop a spongy, resilient inner structure.
- Spongy bone spaces intercommunicate throughout.
- Bone undergoes dynamic changes in response to functional demands.
Structural Elements of Bone
- Osteocytes: Cells responsible for bone metabolic activity.
- Intercellular substance (bone matrix): Fibrils and calcified cementing substance. It contains mineral salts such as calcium carbonate and phosphates bonded to protein.
Pathology of RRR
- RRR primarily involves a reduction in the size of bone just under the mucoperiosteum.
- Often results in residual ridges of varied shapes and sizes, sometimes leaving redundant or excess mucoperiosteum.
- Common residual ridge configurations categorized by Atwood Order.
Atwood Order of Residual Ridge Configuration
- Order 1: Lower central incisor in its socket with thin labial and lingual cortical plates and lamina dura
- Order 2: Healing period includes clot formation, clot organisation, filling of socket to cortical plates with new trabecular formation and epithelial formation over the socket
- Order 3: High, well-rounded ridge. Narrowing of ridge crest begins, Internal trabecular structure remodeled.
- Order 4: Knife-edged Residual Ridge. Marked narrowing of labiolingual diameter.
- Order 5: Low, well-rounded Residual Ridge. Progressive labiolingual narrowing, leading to broader but considerably lower ridge.
- Order 6: Depressed Residual Ridge. Resorption continues below the level of the genial tubercle.
Pathogenesis of RRR
- Immediately following tooth extraction, sharp edges are rounded off by osteoclastic resorption, resulting in a high, well-rounded ridge (order III).
- Continued resorption results in a progressively narrower ridge (order IV), eventually becoming knife-edged. This process progresses further, and the ridge becomes lower, well-rounded, or flat (order V), eventually resulting in a depressed ridge (order VI).
Maxilla vs. Mandible Resorption Patterns
- Maxilla resorbs inward and upward, becoming progressively smaller.
- Oppositely, the mandible resorbs outward, becoming wider.
- This differing pattern makes the edentulous maxilla appear smaller and the mandible wider.
Consequences of Residual Ridge Resorption (RRR)
- Reduced sulcus width and depth.
- Displacement of muscle attachments.
- Rotation of the mandible.
- Altered relationship between the ridges.
- Potential appearance of sharp, uneven ridges.
- Exposure of mandibular nerve.
- Location of mental foramen affected.
- Problems in denture support, stability, and retention.
Etiology and Factors Affecting RRR
- Anatomic factors: Bone amount and quality influence resorption rate, with denser bone resorbing slower.
- Metabolic factors: Systemic and local factors affect bone resorption and formation. Underlying general health and various metabolic processes have substantial influence on this process.
- Hormonal factors: Hormones like PTH, thyroid hormones influence skeletal metabolism impacting bone structure.
- Mechanical factors: Frequency, intensity, and direction of forces affecting the bone influence bone remodeling. These factors stem from function (chewing/speech), dentures and other habits.
- Prosthetic factors: Factors involved in denture design and fabrication, like denture fit and stress distribution on the ridges, impact residual ridge resorption.
- Nutritional factors: Insufficient protein, vitamins, or calcium can impair bone formation, contributing to resorption.
Additional Factors
- Implants (dental): Implants can aid in preventing further ridge resorption.
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Description
This quiz focuses on the process of Residual Ridge Resorption (RRR) following tooth extraction. It covers the biological changes in the alveolar bone and the implications for dental prosthetics. Gain insights into how post-extraction healing and resorption can affect dental treatment in edentulous patients.
