Post Insertion Problems

Of Complete Denture
Done by:
Dr.Farah Ragheed
5th Stage
Fabrication of complete dentures is dependent on technical, biological, and
psychological interplay between the clinician and the patient. Paramount to the
patient is factors as esthetics, comfort, and masticatory ability. The overall
success of complete denture therapy depends on patient’s comfort and
acceptance of the dentures. The problem with complete dentures is that they are
foreign bodies. Though they are compatible with oral environment, they require
learning for tissue accommodation. Tissue response varies from individual to
individual and from time to time in the same individual.
Factors of general health, resistance to disease, pain threshold, diabetes, hyper
tension, habits such as smoking, medication of long duration, anemia, wasting and
old age alter tissue response and create problems associated with denture use.

Majority of the problems associated with denture are real and not psychosomatic
or psychological. A careful analysis based on a thorough understanding of usual
and unusual tissue response as well as of the basic principles of complete denture
prosthesis is crucial in eliminating the problems associated with complete denture
use.
Complete denture fabrication tech. and placement of a complete denture are not
the final steps in the treatment of edentulous, patients and patient’s visit to the
dentist continues long after that. Two thirds of the denture wearers surveyed in a
study reported that they were “ very satisfied” with their maxillary denture as
compared with 51% for mandibular dentures, of the individuals who wore their
dentures “all day” 5% were “ very dissatisfied” with at least one of their dentures.
Pain in the Labial, Buccal and Lingual Sulcus and Frenum

• Localized reduction of the overextended flange.

• Create allowance for frenum movement.

• Rounding off the sharp margins and smoothening the borders

Localized Tender or Painful Area on the Denture-bearing Surface

• Identify and eliminate the blow out nodules, spikes and sharp ridges, pearls or
sharp edges of acrylic.
Burning Sensation in the Anterior Region of the Lingual Sulcus

• The overextension in the lingual sulcus should be identified and corrected.

Difficulty in Swallowing

The overextension in the distolingual sulcus should be corrected.

Cheek, Lip and Tongue Biting

This can be caused due to decreased vertical dimension, inadequate overjet of

posterior teeth and increased overjet in anterior teeth, width of sulcus is not restored.
Tongue biting generally the teeth placed lingual to lower ridge which should be
identified and corrected.
Gagging
• The overextended posterior border and distolingual flange should be corrected.

• The excessive thickness of the palatal aspect of the denture should be reduced.

• Posterior palatal seal area should be corrected.

• Topical anesthetics can be advised.

• Psychological counselling. • Maintenance of hygiene.

Reduced Masticatory Efficiency

• Occlusal correction should be accomplished.
Poor Appearance
• If there is excessive bulk on the buccal or labial aspect, it can be reduced.

• The treatment should be repeated. in case of other problems like midline off-center,
faulty vertical dimension, improper selection of teeth.

Difficultly in Speech
The patient should be educated that since denture is a foreign body it will take some time
for the patient to get accustomed to it. Patient should be instructed to read newspaper or
magazines aloud to get accustomed to the new denture. If the patient still complains of
speech problems, the thickness of the palatal aspect should be reduced. If it is due to
faulty arrangement of teeth, the treatment will need to be repeated.
Creases at corners of mouth

Labial fullness and anterior tooth position may be inaccurate. OVD may be
inadequate. Adjust tooth position as appropriate. If OVD problem, re-register jaw
relations.

Too much visibility of teeth

Level of occlusal plane unacceptable, teeth placed on upper anterior ridge and
no/poor lip support. Accurate prescription to laboratory via optimally adjusted
occlusal rim.
Cannot open mouth wide enough for food

May be speech problems and facial pain especially over masseter region due to
excessive OVD. Can remove up to 1.5 mm from occlusal plane by grinding, but if
more is required, remake dentures.

Jaws close too far

Due to lack of OVD, so that mandibular elevator muscles cannot work efficiently.
May increase up to 1.5 mm by relining but if deficiency is greater, remake denture.
Noise on eating/speaking

May be apparent on first insertion or may appear as resorption causes dentures to

loosen. May be lack of skill with new dentures, excessive OVD, occlusal
interference, loose dentures, or poor perception of patient to denture wearing.
Where unfamiliarity present, reassurance and persistence recommended. Address
specific faults or remake as required.
Pain on insertion and removal (inflamed mucosa).
Denture not relieved in area of under cut.

Palatal soreness: Too Deep Post Dam.

Lack of relief for frena or muscle attachments
Peripheral overextension

resulting from impression

stage/technical error.
Pain at posterior aspect of upper denture on opening: too thick buccal
flange constraining coronoid process.

Pain on eating with occlusal imbalance.

anterior or posterior prematurity, incisal locking,

or lack of balanced articulation.

Pain about periphery of dentures: accompanied by pain in masseter and posterior
temporalis muscles which tends to intensify as day progresses) and Increase VD.

Discomfort Related to Systemic Factors

Burning mouth syndrome, Frictional lesions, Xerostomia as a side effect of prescribed

drugs, Herpetic ulcers, Patient allergic to denture material, Denture stomatitis.

Angular cheilitis. (inflammation of the corners of the mouth): Reduced VDO, general
health factors such as nutritional deficiencies and immune dysfunction seem to be of
greater importance.

Soft tissue hyperplasia (Flabby ridge, denture hyperplasia).

Temporomandibular disorders.
Thank u