Medical History & Diagnosis Summary PDF

Medical History Importance: - A thorough health questionnaire is necessary to identify systemic conditions that may affect treatment, such as: - Diabetes: multiple small abscesses accompany uncontrolled diabetes, reduced salivary output - Vitamin deficiencies: causes inflamed and bleeding g...

Medical History Importance: - A thorough health questionnaire is necessary to identify systemic conditions that may affect treatment, such as: - Diabetes: multiple small abscesses accompany uncontrolled diabetes, reduced salivary output - Vitamin deficiencies: causes inflamed and bleeding gingiva - Cancer: most common oral manifestations are xerostomia & mucosal irritation - Blood diseases: pale mucosa, red tonguue, and gingival bleeding - Transmissible diseases: hepatits, etc... - Epilepsy: construction of RPD is contraondicated when eplictic patient with sudden attack Patient Attitudes Towards Dentures: - Patient psychology significantly influences treatment success. - Types of patients: - Philosophical: Adapt well to well-designed prostheses. - Exacting: Demand perfection; should not be promised comfort without inconvenience. - Hysterical: Emotionally unstable; may complain without valid reasons. - Indifferent: Lack motivation and are often uncooperative. Dental History Considerations: - Cause of Tooth Loss: Understanding whether due to caries or periodontal disease is crucial for treatment planning. - Previous Dentures: Assessing past experiences with removable partial dentures is important. - Patient Expectations: Educating patients about realistic outcomes is necessary. - Chewing and Parafunctional Habits: These habits affect denture support and retention. Oral Examination Components: - Teeth and Periodontium: Check for caries, restorations, sensitivity, mobility, electric pulp tester, and periodontal health. - Alveolar Ridge and Mucoperiosteum: Evaluate the height, shape, any ulceration/swelling, and resiliency of the ridge and mucosa. *Old Denture Assessment: Most common tissue reactions: 1) Palatal papillary hyperplasia: poorly fitting, wart-like/papillary growth 2) Epulis fissuraturn: ill-fitting/over-extended borders, tumor-like hyperplastic growth 3) Denture stomatitis: associated with general erythema & candida albicans * Hard tissue abnormalities: A) Torus palatinus: removal not necessary, major connector can be designed to circumvent B) Torus mandibularis: exostosis, usually occurring bilaterally C) Undercuts & Bulbous maxillary tuberosity: effect can be minimized by: Change in path of insertion of RPD (in case of unilateral undercut) Relieving the denture base Surgical correction D) Mylohyoid ridge *Soft tissue abnormalities: A) Labial Frenum B) Hypertrophic lingual frenum C)Hypermobile gingiva(flabby) *Occlusal relationships is examined for: A) The space available for artificial teeth B) degree of anterior vertical overlap C) Supereruption & Tilting of remaining teeth D) Cuspal interference *Sign of TMJ Disorder: A) Reduced interincisal opening (normal is 55mm)( ±15mm) B) Pain & Tenderness at rest and movement C)Clicking D) Midline deviation during wide opening E) Headache & Ear pain Salivary Output Evaluation: - Factors like nervousness, age, and medications can reduce salivary output, affecting comfort with dentures. Oral Hygiene Assessment: - Evaluating a patient’s oral hygiene is critical for predicting treatment success. Caries Susceptibility: - Indicators of caries susceptibility include a high number of restored teeth and signs of recurrent caries. Space for Major Connectors: - A minimum of 7 to 8 mm of space is required for a mand. lingual bar major connector. Diagnostic Aids: - Radiographs (periapical and bitewing) are essential for identifying pathologic conditions, carious lesions, Root canal fillings, Unerupted third molars, and evaluating abutment teeth. - Root length, size, and form: - Favorable abutment teeth have long, cylindrical roots; unfavorable teeth have tapered or conical roots. Crown/ Root Ratio If less than 1:1 then the tooth has poor prognosis Mounted diagnostic casts A)it provides visual access from all directions B)enable the dentist to analyze interarch distance: caused by large max. tuberosity / opp. Teeth overeruption occlusal plane: irregular due 1 or more unopposed teeth extruded