De ntu r e C om pl ai nt

Complaints

Diagnosis Causes Treatment

Patient Denture settling Denture error

Dissatisfaction

Denture Types of
limitations patients

Philosophical Hysterical Indifferent Exacting

Problems

Occlusal
Retention Support Muscle Balance
Balance
 Complaints
1- Over extension → Movement interfere with muscle movement → ( ↓ Stability)
2- Under extension → Break the Seal → ( ↓ Retention)
3- Trimming → Thick or thin border → (ttt) Boxing.

Problems of New Denture

[ I ] Tissue irritation
 → In the form of :

Hyperemia Cut in vestibule Ulceration

→ Causes:

Over-extension Pressure by denture Movement of denture Improper occlusion

→ ttt:

Remove the cause Tissue rest

→ Types:

Generalized Localized

Acute Chronic

1) Generalized Tissue irritation

 2) Localized Tissue Irritation

Crest Vestibule Ant. lingual Median Retro Tuberosity

& Lat. Palatine Mylohyoi
buccal slop Raphe d
Border Over extension - Over - Over
(displacing extension extension
__ wax) __ __ labially → lift
the denture
- Un polished posteriorly.
(Visual&
digital)
*D.D.→
Aphsus ulcer
Basal -Ridge - Pressure - ↓ relief → - pressure - Bilateral
(x ray & (Denture undercut →
Seat visual *Ex) rocking) (Relief)

-Spicules& __ - ↓ support - Pressure

remaining of 1ry stress area
roots bearing
(Visual Ex) area → - Dimensional
(Relining or changes →
- Denture Rebasing) (Relief –
pressure Rebase)
*(P.I.P.)

Occlusion - Deflective - Tooth off - Deflective - Anterior - Occlusal

occlusal ridge occlusal contact contact in interference
contact 7 7 C.R. → *ttt on opposite
(Reset) side→Denture __
- *C.O. ≠ *C.R. move in
Loose denture opposite
anteriorly direction.

• D.D. → Differential Diagnosis.

• Ex. → Examination.
• P.I.P. → Pressure Indicating Paste.
• C.O. → Centric Occlusion.
• C.R. → Centric Relation.
• ttt → Treatment.
• C.C. → Chief Complaint.
 [ II ] Poor Denture Fit
• Cause: Lack of retention& Support.
• Lower denture more than Upper. Why?

↓ Support ↑ Saliva Tongue

• Chief complaint (C.C.):

Loose denture Too bulky Rocking denture

• Related symptoms:

Normal Abnormal

- Open wide (Yawing) → Coronoid process. - Speaking.

- Cough& sneezing → ↑ the pressure. - Eating.
- New denture → Saliva. - Pain.
 [ III ] Pain

[ IV ] Esthetic problem
• Color :
a) Teeth → too dark or too yellow.
b) Acrylic resin.

• Size:
a) Too larger.
b) Too smaller.

• Arrangement:
a) Too even or Irregular.
b) Visibility of anterior teeth (Too for forward) or (Too for backward).
c) Cheeks& lips Falling-in → Unsupported lip& cheek → Plumping (Building-out
the upper denture to compensate for the loss of muscular tone).

• Nose& Chin approximation (closed bite):

- Due to ↓ Vertical dimension.

• General dissatisfaction:
- Who? → Female / middle age.
- Need → Kindness& Patience.

[ V ] Spee ch d if ficul tie s

• Anterior teeth:
a- ↑ Vertical overlap → "S" sound.
b- Improper Labio-lingual positioning → "S" sound → (Whistling or lisping).
• Encroachment on tongue space:
a- Posterior teeth placed too far lingually.
b- Too great Bucco-lingual width of posterior teeth.
c- Excessive thickness of the lingual flange.
d- Poor palatal contour (Rugae area) → "S" sound → P.I.P.
• Poor denture retention.
• Excessive salivation.
• Vertical dimension → P, B, F, V.
N.B. When pronouncing letter "S" the lateral margins of the tongue Contact the lingual
surface of posterior teeth, and the tip of the tongue contact with the palate in rugae area
forming a slit like channel.
a. Whistling: If anterior teeth placed too forward, the channel will be to large& the
air will escape with a whistling sound → Resetting the teeth backward or
thickening the denture base behind these teeth.
b. Lisping: If anterior teeth placed too backward, the channel will be obliterated&
the patient may lisp → Resetting the anterior teeth forward or reducing the
denture base in the Rugae area.
 [ VI ] Nausea
• Cause: Contact of the denture with the soft palate or the tongue.

Posterior Periphery of upper denture Loose denture

Over-extension Under-extension ↑ Thickness

[ VII ] Inef fic ient e ating

• Borders → Improper.
• Basal seat → Unstable denture.
• Occlusion

Teeth Vertical dimensions

Blunt Flat cusps ↑ V.D.O. ↓ V.D.O.

Elevate the muscle& don't work. Patient can't open to get food.

[ VIII ] Cheek, Lip& Tongue Biting

a) Cheek& Lip biting:

↓ Overlap → ↓ Lower buccal cusp or Reset.

Laxity of muscle (loose of muscle tone).

↓ Vertical dimension → sagging of cheek.

b) Tongue biting:
Teeth set lingual → Rounding the lower lingual cusps or Reset.

[ IX ] Alter taste

[ X ] Clattering teeth

Unfamiliarity with ↑ Vertical dimension Cuspal interference Unstable denture

New denture.
- Teeth contact sooner.

Problems of Old Denture