Post insertion complaints in complete dentures

Vinay Pavan Kumar.K2nd year P G student

Dept of ProsthodonticsAECS Maaruti College of Dental Sciences

Post insertion complaints

Classification of post insertion denture

problems

Management

CommonComplaints

UncommonComplaints

Complains on aesthetics of the denture

Complains on phonetics

Complains on comfort of the

denture

“ Most of the complaints associated with complete dentures are actual and not psychological, contrary to the belief of most clinicians.”

Verma.M ,Post Insertion Complaints in Complete Dentures - a never Ending Saga; Journal of Academy of Dental Education, Vol 1, No 1 (2014), Pg: 1-8

“There was no statistically significant relationshipbetween patient age, gender, systemic health and denture complaints; but statistically significant relationship exist between types of denture, denture faults and complaints.”

Ogunrinde.T.J, The Influence Of Demographic Factors And Medical Conditions On Patients Complaints With Complete Dentures. Ann Ibd. Pg. Med 2012. Vol.10, No.2 16-21

Classification of post insertion denture problems

Complaints abut comfort of the denture:- Sore spots- Burning sensation- Redness- Pain in TMJ- Tongue & cheek biting- Swallowing & sore throat- Nausea & gagging- Deafness- Fatigue of the muscles of mastication.

Complaints about function of the denture:- Instability or poor fit- Interference

a) When swallowing b) Clicking

• Complaints about esthetics:- Fullness under the nose- Depressed philtrum or naso-labial sulcus- Upper lip sunken in- Too much of teeth exposed- Artificial look

Complaints about phonetics:- Whistle on “S” sounds- Lisp on “S” sounds- Indistinct “TH” & “T” sounds- “T sound like “TH”- “ F” & “V” sounds indistinct

www.medkaau.com

According to Sharry Frequent Complaints : - Excessive bulk - Speech difficulties - Masticatory shortcomings - Insufficient retention - Mucosal irritation - Unattractive Apperence

Sharry.J.J Complete denture Prosthdontics, 3rd edition, chapter 17, pg 358

Uncommon Complaints: - Whistling - Rough & sharp surfaces - Ear ache - Dull teeth - Difficult swallowing - Halitosis - Loss of taste sensation - Dry mouth - Saliva under the dentures - Noisy teeth - Peculiar taste - cheek, lip & tongue biting - Food under the denture - nausea & gagging - Dislodgement on sneezing - tingling of the lower lip - Dislodgement on drinking - burning of mouth - Drooling at the corner of the mouth - Inability to chew with equal vigor on both side.

According to Grant.A.APOST INSERTION PROBLEMS CAN BE BROADLY

GROUPED INTO: Looseness of dentures i. Decreased retentive forces ii. Increased displacing forces.

Discomfort associated with dentures i. Related to impression surface of denture ii. Related to occlusal surface iii. Related to polished surface iv. Related to possible systemic association

Support problems

Problems associated with retention and stability Other difficulties i. Noise on eating and speaking. ii. Speech problems. iii. Eating difficulties. a. Altered taste sensation. b.Gagging (nausea).

A.A.Grant, J.R.Heath, J.F.McCord- complete prosthodontics problems, diagnosis & management (1994)

Denture Complaints in relation to time of delivery

Immediate complaints.Delayed complaints.Problems without complaints.

Presentation of patient with complaints

Informed patient of possible problems.

Un-informed patient:Sense of pain.Sense of loss (waste of time and money).Sense of deceit.

Pain Over extension of bordersPoor fitting or rough surface denturesError during impression makingIncorrect centric relation or cuspal interferences.

Excessive vertical dimensionUneven occusal balance and anterior contact at CRInadequate relief to the prominent genial tubercle &

myloid ridge

Loose denture

PPS is not successfully made.Lingually placed posterior teethLabially placed mandibular anterior teethDryness of mouthOccusal discrepanciesInaccurate impression makingRocking, tilting dentures (poor retention)Nodules of acrylic- faulty impression /poor

processing techniques

Faulty esthetics:Unrealistic expectationsOver supported or under supported denturesAltered vertical dimension

Defective speech:increased vertical dimensiondeficiency of palatal contourPoor PPS regionThick lingual flanges or restricted tongue

movements

InefficacyDiscrepancies in vertical dimension and CRWorn off teeth Zero degree posteriorsLack of occlusal balanceOccusal plane se at higher level

Nausea & GaggingOver extended posterior limit of maxillary dentureThick posterior borders or loose dentureUncommon belief

Fibrous hyperplasia

Continous wearing of ill fitting dentureUsually painless

Microbial Infection

Poor oral & denture hygiene maintainanceDiabetes and oral habits

Costen’s syndrome:

• Prolonged over closure• Deafness, tinnitus,• Tenderness over the TMJ• Dryness of mouth• Neuralgic symptoms – burning sensation of

tongue, throat and headache.

Uncommon complaintsWhistling : high vault palate

Ear ache : TMJ problem

Food & saliva under denture : may be deficient of borders

Loss of taste

Cheek biting : lack of horizontal overlap, decreased VD

or buccal placement of teeth

Drooling saliva : inadequate VD

Allergy : pigment or residual monomer of denture resin

CONCLUSION

References • Nair KC, A primer on complete denture fabrication, 1st

edition, 2013, Ahuja publication, India Pp 158 -166

Winkler S, Essentials of complete denture Prosthodontics 2nd edition, 2012, AITBS Publishers, pp 318 – 330

Sharry JJ, Complete Denture Prosthodontics, 3rd edition, USA, Mcgraw-Hill Book Company, 1974, pp 289-294.

Heartwell C M , Syllabus of complete dentures, 4th edition, 1984, Varghese Publishing House, 407 – 420

GrantA.A, Heath.J.R, McCordJ.F, complete prosthodontics problems , diagnosis& management (1994)

McCord J. F. and Grant A. A. , Identification of complete denture problems: a summary, British Dental Journal 2000; 189: Pp:128–134

Jethlia.H, Post Insertion Problems And Their Management In Complete Denture journal of Evolution of Medical and Dental Sciences.Vol 2(3) Jan, 2013 pp 194-99

Verma.M ,Post Insertion Complaints in Complete Dentures - a never Ending Saga; Journal of Academy of Dental Education, Vol 1, No 1 (2014), Pp: 1-8