TOPIC: INSERTION AND TROUBLESHOOTING IN COMPLETE DENTURE PROSTHESIS
🎯 KEY FACTS:
🔹An occlusal pivot is an elevation placed on the occlusal surface of the molars to limit the mandibular closure by acting as a fulcrum.
🔹The occlusion of the complete denture should be checked after 24 h.
🔹Burning sensation of the anterior palate in a new denture wearer is due to insufficient relief of the incisive papilla.
🔹Midline fracture of the dentures is mainly because of thick frenum not relieved in the denture, wide deep notch in the midline, teeth set too far buccally and excessive resorption.
🔎 DEFINITIONS:
🔸Denture Placement or Insertion: The process of directing a prosthesis to the desired location’. (GPT 8th Ed)
🔸Clinical Remount Procedure: is defined as ‘any method used to relate restorations to an articulator for analysis and/or assist in development of a plan for occlusal equilibration or reshaping’. (GPT 8th Ed)
🔸Selective Grinding: The intentional alteration of the occlusal surfaces of teeth to change their form’. (GPT 8th Ed)
🔎 Objectives of The Dentures Placement:
🔸To identify and correct potential areas of denture base that will cause soreness or discomfort to the patient
🔸To identify and correct any portion of the denture that interferes with the retention and stability of dentures
🔸To identify and correct any part of the dentures that is aesthetically unpleasing
🔸To refine the occlusion
🔸To deliver the dentures to the patient
🔎 Objectives of Selective Grinding
🔸To correct occlusal discrepancy in centric and eccentric positions
🔸To develop contacts bilaterally when anatomic teeth are used and balanced occlusion is desired
🔸To alter cuspal inclines to develop maximum intercuspation in centric relations.
🔸To obtain balanced occlusion.
📌 Types of Occlusal Errors and Their Corrections:
💡Occlusal errors can occur in three positions:
1. Centric occlusion
2. Working side
3. Balancing side
📌 Denture Cleansing Agents
🔸Chemical cleaning agents
🔸Mechanical cleaning agents
🔸Sonic cleaners
📌 Intraoral Methods To Correct Occlusal Disharmony
💠Articulating paper
💠Central bearing device
💠Occlusal wax
💠Abrasive paste
📌 Troubleshooting In Complete Denture Prosthesis
👉 Causative Factors:
🔸Adverse intraoral anatomical factors (e.g. atrophic mucosa)
🔸Clinical factors (e.g. poor denture stability)
🔸Technical factors (e.g. failure to preserve the land area on the master cast)
🔸Patient adaptational factors
📌 Troubleshooting can be broadly divided into the following categories:
(i) Discomfort or pain with the dentures
🔸Discomfort related to impression surface of dentures
🔸Discomfort related to the occlusal and polished surfaces of dentures
🔸Discomfort related to possible systemic factors
(ii) Looseness of the denture
🔸Due to decreased retentive factors
🔸Due to increased displacive factors
(iii) Inability to adapt to dentures