CD Long term review

Question 1

Give examples of soft tissue problems?

Answer 1

Infection
- Usually asymp until late stage
- Good OH is essential
Hyperplasia 
Neoplasia

Question 2

Signs of candidosis - soft tissue infec?

Answer 2

• • Red palate defined by denture bearing areas
• • Asymp until later stage
• • Hyperplastic tissue
• • Angular cheilitis

Question 3

Causes of candidosis?

Answer 3

• Poor OH and denture hygiene
• Leaving denture in at night
• Excessive FWS - angular cheilitis
• Unretentive dentures - rocking
• Systemic disease - diabetes, immunocompromised

Question 4

Management of candidosis?

Answer 4

Identify cause
Improve OH and denture hygiene (warm soapy water with toothbrush, leave in 1% bleach overnight, rinse)
Denture replacement
Topical antifungals - prescribe at try in stage, miconazole gel (contraindicated with warfarin), nystatin
pastilles

Question 5

Soft tissue problems - features of hyperplasia?

Answer 5

Denture granuloma - due to chronic irritation from denture
Mix of hyperplasia and inflam
Can be fixed by trimming down denture or surgical removal if larger

Question 6

Soft tissue problems - features of Neoplasia?

Answer 6

Cancer/dysplasia

• Can present as ulcers
• If suspicious or worrying lesion with no obvious cause - refer urgently
• If apparent cause obvious - manage and review in 1 week
• If not healed - refer

Question 7

Hard tissue problems?

Answer 7

All related to alveolar resorption
Protrusive overclosure
- Combination of alveolar resorption and denture wear
- Tx - reline dentures, occlusal pivots, replacement or denture duplication with moderate changes in jaw relations

Question 8

Examples of denture problems?

Answer 8

Abnormal wear
Wear of base - opposing Md tooth or against heels of Md denture
Diagnosis and management of denture fracture:
- Impact - isolated event (repair and advise), repeated fracture (reinforce denture)
- Fatigue - age of denture (replace), predisposing factors:
– Insufficient space
– Weakness
– Pronounced mx torus
– Lack of labial flange

Other solutions:

• Polycarbonate
• Injection moulded
• Tooth bonding
• Cast metal base - bonding between metal and acrylic
• Stainless steel mesh
• Vulcanite - carbon fibre, glass fibre, aramid