Complete

Complete Denture
Denture
Diagnosis
Diagnosis &
& Treatment
Treatment Planning
Planning
 Medical
Medical History
History

 Be
Be efficient
efficient -- don't
don't need
need extensive
extensive history
history of
of
relatives
relatives
 Follow-up
Follow-up significant
significant responses
responses
 Note
Note systemic
systemic conditions
conditions that
that impact
impact on
ontherapy
therapy
(e.g.
(e.g. angina,
angina, hepatitis,
hepatitis, Sjogren's
Sjogren's syndrome)
syndrome)
Medical
Medical History
History

 Obtain
Obtain physician
physician consultations
consultations
 IfIf some
some debilitating
debilitating disease
disease
––discuss
discuss with
with instructor
instructor
––toto ensure
ensure acceptability
acceptability
Dental
Dental History
History
 How
How many
many dentures?
dentures?
 How
How long
long worn?
worn?
 Age
Age ofof present
present set?
set?
 Satisfaction
Satisfaction with
with dentures?
dentures?
 Things
Things patient
patient likes
likes -- what
what they
they want
want
changed
changed
Clinical
Clinical Exam
Exam

 Routine
Routine clinical
clinical exam
exam
Intraoral
Intraoral Exam
Exam

 Examine
Examine one
one arch
arch at
at aa time
time
––Look,
Look, then
then write
write
Intraoral
Intraoral Exam
Exam

 General
General tissue
tissue health
health
–– Mucosa
Mucosa
•• attached
attached // non-attached
non-attached
–– Colour
Colour
–– Character
Character
–– Displaceability
Displaceability
Intraoral
Intraoral Exam
Exam
 Specific
Specific Anatomical
Anatomical considerations
considerations
–– Examine
Examine systematically
systematically
–– Note
Note significance
significance
of
of findings
findings to
to therapy
therapy
–– Visual
Visual and
and tactile
tactile exam
exam
Intraoral
Intraoral Exam
Exam

Maxilla
Maxilla
–– Form
Form ofof maxillary
maxillary arch
arch affects
affects
retention
retention
–– Advise
Advise the
the patient
patient ifif retention
retention will
will
be
be compromised
compromised
 Maxilla
Maxilla
 Posterior
Posterior border
border of
of denture:
denture:
–– Hamular
Hamular notches
notches
•• Posterior
Posterior denture
denture border
border
•• Palpate
Palpate
•• Visually
Visually deceiving
deceiving
 Maxilla
Maxilla
 Posterior
Posterior border
border of
of denture:
denture:
–– Hamular
Hamular notches
notches
•• Over
Overextension
extension--extreme
extremepain
pain
•• Under
Underextension
extension--non-retentive
non-retentive
•• Must
Mustbebecaptured
capturedininimpression
impression
 Maxilla
Maxilla
 Posterior
Posterior border
border of
of denture
denture
–– Vibrating
Vibrating line
line
•• Identified
Identified when
when patient
patient says
says "ah"
"ah"
•• Junction
Junction of
of movable
movable & & non-
non-
movable
movable soft
soft palate
palate
 Maxilla
Maxilla
 Posterior
Posterior border
border of
of denture
denture
–– Vibrating
Vibrating line
line
•• IfIftermiminate
termiminateon:on:
–– movable
movableportion
portion--displacement
displacement
–– hard
hardpalate
palate--no
noretention
retention
 Maxilla
Maxilla
 Vibrating
Vibrating line
line
•• Fovea
Fovea -- close
close to
to
vibrating
vibrating line
line
•• Throat
Throat form
form can
can affect
affect
width
width
Palatal Throat Form
Maxilla

II
III

• Flatter the soft palate, the broader the

area of the vibrating line
Maxilla
Maxilla
 Posterior
Posterior border
border of
of denture:
denture:
–– Pterygomandibular
Pterygomandibular raphe
raphe
•• Behind
Behind hamular
hamular notches
notches --
significant
significant when
when prominent
prominent
•• Have
Have patient
patient open
open wide
wide as
as
possible
possible
•• Can
Can displace
displace denture
denture ––
requires
requires relief
relief in
inextreme
extremecases
cases
Posterior Palatal Seal

Glandular
Glandular tissue
tissue

Posterior palatine salivary glands

• Permits compression of tissues
• Improves adaptation of denture to
compensate for shrinkage of resin

Posterior palatal seal

Maxilla
Maxilla

 Tuberosity
Tuberosity
–– Displaceability
Displaceability
–– Palpate
Palpate for
for
undercuts
undercuts -- ifif
extreme,
extreme, denture
denture
might
might not
not seat
seat
 Maxilla
Maxilla

 Tuberosity
Tuberosity
–– IfIf enlarged
enlarged with
with fibrous
fibrous
tissue
tissue
•• surgical
surgicalreduction
reductionto
to
make
makeroom
roomfor
fordentures
dentures
 Maxilla
Maxilla

 Ridge
Ridge form
form
–– U-shape
U-shape best
best
–– Non-moveable
Non-moveable best best
–– Advise
Advise patient
patient ifif poor
poor
–– Affects:
Affects:
•• retention
retention
•• stability
stability
 Maxilla
Maxilla
 Labial/Buccal
Labial/Buccal vestibule
vestibule
–– 2-4
2-4 mm
mm width
width
–– Zygomatic
Zygomatic process
process
•• can
can be
be prominent
prominent
 Maxilla
Maxilla
 Labial/Buccal
Labial/Buccal vestibule
vestibule
–– Flat
Flat ridges
ridges
•• maximize
maximize retention
retention by
by
accurately
accurately registering
registering
the
the vestibule
vestibule
Maxilla
Maxilla
 Frena
Frena -- check
check prominence:
prominence:
–– Buccal
Buccal frenum
frenum
•• Usually
Usually broader
broader
–– Thin
Thin labial
labial frenum
frenum
Maxilla:
Maxilla: Midline
Midline
 Tori
Tori
 Mid
Mid palatal
palatal suture
suture
–– Eliminate
Eliminate binding
binding oror
fulcruming
fulcruming
–– Discomfort,
Discomfort, loss
loss of
of
retention
retention and
and possible
possible
fracture
fracture of
of the
the denture
denture
 Mandibular Support Areas

Retromolar Pad Buccal Shelf Alveolar Process

 Mandible
Mandible
 Ridge
Ridge form
form more
more critical
critical
–– Less
Less surface
surface area
area for
for
retention
retention
–– Moveable
Moveable tongue
tongue & &floor
floor
–– Displacement
Displacement ifif denture
denture isis
overextended
overextended
•• Inform
Informpatients
patients
 Mandible
Mandible
 Retromolar
Retromolar pad
pad
–– Terminal
Terminal border
border of
of the
the
denture
denture base
base
–– Compressible
Compressible soft
soft tissue
tissue
•• Comfort
Comfort
•• Peripheral
Peripheral seal
seal
–– Must
Must be
be captured
captured in
in
impression
impression
Mandible
Mandible
 Buccal
Buccal shelf
shelf
–– Custom
Custom tray,
tray, border
border
molded
molded -- should
should not
not
feel
feel edge
edge extraorally
extraorally
–– External
External oblique
oblique ridge
ridge
•• do
donot
notcover
cover
•• Alginate
Alginatewill
willalmost
almost
always
alwaysoverextend
overextend
••PPainful
ainful
Mandible
Mandible
 Labial/Buccal
Labial/Buccal
vestibule
vestibule
–– Easy
Easy to
to overextend
overextend
–– Check
Check with
with minimal
minimal
manipulation
manipulation ofof lips
lips
Mandible
Mandible
 Masseter
Masseter
–– affects
affects distobuccal
distobuccal border
border
–– ifif more
more prominent
prominent --
concave
concave border
border of
of denture
denture
Mandible
Mandible

 Frena
Frena
–– Labial
Labial and
and buccal
buccal frena
frena
•• Narrow
Narrow &
&wide
wide respectively
respectively
–– Lingual
Lingual frenum
frenum
•• Must
Must allow
allow for
for movement
movement -- or
or
displaces
displaces easily
easily
Lingual frenum

Buccal frenum
 Mandible
Mandible

 Retromylohyoid
Retromylohyoid fossa
fossa
–– Need
Need to
to capture
capture
–– Especially
Especially with
with severely
severely resorbed
resorbed ridge
ridge
Lateral Throat Form

Class III
Class II
Class I
 Mandible
Mandible
 Mylohyoid
Mylohyoid Ridge
Ridge
–– Palpate
Palpate
•• IfIfprominent,
prominent,may
mayneed
needrelief
relief
 Mylohyoid
Mylohyoid muscle
muscle
•• Raises
Raisesfloor
floorof
ofmouth
mouth
•• Differences
Differencesbetween
betweenrest
restand
and
activity
activity
•• Affects
Affectslength
lengthof
offlanges
flanges
Residual Ridge Resorption (RRR)

Mylohyoid ridge

Mucosa in this region is poorly

keratinized and prone to trauma
Mylohyoid ridge can cause ulcers if it is a
sharp
Mandible
Mandible
 Tori
Tori
–– Rarely
Rarely need
need surgery
surgery unless
unless large
large
–– May
May require
require relief
relief once
once dentures
dentures
are
are delivered
delivered -- advise
advise patient
patient
Mandible
Mandible
 Genial
Genial tubercles
tubercles
–– Bony
Bony insertion
insertion for
for the
the
genioglossus
genioglossus muscle
muscle
–– May
May be
be projecting
projecting
above
above thethe residual
residual
ridge
ridge ifif there
there has
has been
been
severe
severe resorption
resorption
Summary
Summary

 Anatomy:
Anatomy:
–– Affects
Affects complete
complete denture
denture
retention
retention & & stability
stability
–– Should
Should be be captured
captured in in
preliminary
preliminary & & final
final impressions
impressions
–– IfIf poor,
poor, advise
advise patient
patient
–– Exercise
Exercise today
today
Materials
Materials for
for Border
Border Moulding
Moulding
Signout:
Signout:
 RPD
RPDtray
tray
 Bunsen
Bunsenburner
burner
 Low
Low temperaturewater
temperature waterbath
bath
 Slow speed lab handpiece
Slow speed lab handpiece
 Acrylic
Acrylicadjustment
adjustmentburs
burs

Your
Yourown:
own:
 Hanau
Hanautorch
torch( (filled
filledwith
withalcohol
alcohol) )
 Ice
Icewater
waterininaamixing
mixingbowlbowl
 Partner’s
Partner’scustom
customtray tray

Supplied:
Supplied:
 Compound,
Compound,gloves,
gloves,masks,
masks,scalpel
scalpelblades
bladesand
andwill
willbe
besupplied.
supplied.