immediate complete denture

Question 1

reactive tissue growth usually developing under a denture
-occurs on hard palate beneath denture base

Answer 1

inflammatory papillary hyperplasia (IPH)

Question 2

asymptomatic red or pink nodules on mucosa of hard palate and occasionally the residual ridge
-directly related to constant wearing of ill-fitting denture and poor oral hygiene

candida frequently present

Answer 2

IPH
inflammatory papillary hyperplasia

Question 3

immediate dentures, 2 popular protocals

Answer 3

conventional and interim/transitional

Question 4

reline the immediate denture after healing and ridge stable (6 months)

ONE DENTURE

Answer 4

conventional

Question 5

aim is to use for short period, then it is REPLACED by the definitive prosthesis when healing is complete

TWO DENTURES

Answer 5

interim/transitional

Question 6

fabricated prior to extracting natural teeth

Answer 6

immediate dentures

Question 7

immediate denture advantages

Answer 7

prevent patient embarrassment
provide guide for optimal esthetics
provide guide for OVD

Question 8

maintenance of a patient’s appearance, support, tongue will not spread out as a result of tooth loss, less pain since extraction sites are protected, easier to duplicate, speech and mastication rarely compromised, availability of tissue-conditioning material, patient’s psychological and social well being preserved

Answer 8

advantages of immediate dentures

Question 9

lack of clinical evaluation of trial denture- anterior esthetics

Answer 9

immediate denture disadvantages

Question 10

immediate denture disadvantages

Answer 10

increased complexity- impressions, CJR
increased maintenance
greater # of visits= more cost
**lack of clinical evaluation of trial denture- anterior esthetics

Question 11

more challenging, anterior ridge is UNDERCUT, recording of incorrectly the CR position, more chair time

Answer 11

disadvantages of immediate dentures

Question 12

explanation to the patient concerning immediate dentures:

Answer 12

1. do not fit as well as normal complete dentures
2. sore spots and pain from extractions will make first 2 weeks difficult
3. difficult to eat and speak initially
4. esthetics may be unpredictable since anterior try-in not possible

Question 13

having an existing RPD abutment teeth: two phase surgical regimen:

Answer 13

phase 1: remove posterior teeth, alveoloplasty, tuberosity reduction

fabricate denture

phase 2: extract anterior teeth at denture insertion appointment

Question 14

remove all posterior teeth
surgical correction of tuberosities
wait 6-8 weeks before fabricating the immediate denture

Answer 14

phase 1 surgery

Question 15

extract anterior teeth
labial frenectomy if needed

Answer 15

phase 2 surgery at denture insertion

Question 16

3 benefits of 2-phase surgery

Answer 16

simplifies clinical procedure, reduces post-placement care, improves denture comfort and retention

Question 17

stock tray
custom impression tray
combination
campagna technique

Answer 17

secondary impression techniques

Question 18

max-mand registrations

presence of ______ may make OVD determination easier

malposed, drifted, mobile teeth would make________ more difficult

Answer 18

anterior teeth easier

CJR registrations more difficult

Question 19

no anterior esthetic verification

Answer 19

immediate dentures

Question 20

confirm correct mounting of casts, confirm OVD is correct, midline and incisal plane location (mark cast for reference)

Answer 20

posterior trial placement

Question 21

midline and incisal plane marked, alternate tooth arrangement (set every other tooth), minimal alveolar ridge modification

Answer 21

set anterior teeth

Question 22

jerbi’s rule of thirds

Answer 22

minimal cast trimming

Question 23

-required if any alveoloplasty or bone smoothing is anticipated

-fabricated at wax elimination stage of processing

Answer 23

surgical template

Question 24

denture insertion:

Answer 24

PIP
relieve any pressure areas
bilateral occlusal contacts

Question 25

with immediate overdenture, reduce abutments and place ____ prior to extractions

Answer 25

amalgam

Question 26

immediate dentures must be worn for the first ___ hours. if removed, may not be able to be reinserted for ______days. immediate dentures will _____ during healing, tissue conditioning will be required. _____months after insertion at least a reline will need to be done, possibly a remake.

Answer 26

24 hours 3-4 days 6-9 months

Question 27

patient instructions for immediate dentures:

Answer 27

soft diet some bleeding swelling for 3-4 days return to clinic the next day, 24 hour post-op

Question 28

post-insertion care at 24-hour appt

Answer 28

remove and rinse denture, relieve any obvious pressure areas, evaluate retention and occlusion

Question 29

post insertion care at 72 hour appt

Answer 29

evaluate extraction sites, evaluate tissue, denture retention, oral hygiene

Question 30

as tissue shrinks from denture contact, retention will usually decrease and require tissue conditioner

Answer 30

retention

Question 31

post insertion. occlusal correction - remount - done. when: tissue conditioner changed as needed decision to _____/____/____ is made after 4-6 months

Answer 31

patient is comfortable (2-3 weeks) decision to reline/rebase/remake

Question 32

complete denture therapy is not a

Answer 32

definitive treatment

Question 33

the major etiological factor:

Answer 33

the presence of the denture

Question 34

physiologic process after teeth extracted variable process, dependent upon individual factors

Answer 34

residual ridge resorption

Question 35

solutions to residual ridge resorption:

Answer 35

overdenture-tooth and implant prostheses

Question 36

common with NEW dentures, if generalized on CREST OF RIDGE- suspect occlusal discrepancies, if in vestibule, suspect overextended or sharp border

Answer 36

traumatic ulcers

Question 37

if traumatic ulcers are on crest of ridge

Answer 37

suspect occlusal discrepancies

Question 38

if traumatic ulcers are in vestible

Answer 38

suspect overextended or sharp border

Question 39

if ulcers are on crest of ridge, the solution would be to:

Answer 39

clinical remount

Question 40

IPH treatment:

Answer 40

remove dentures at least 8 hours, clean denture well, tissue massage reline, rebase or remake dentures for better fit possible nystatin or other antifungals

Question 41

IPH....avoid surgery. for most patients, _______treatment is adequate prior to making new dentures

Answer 41

conservative treatment

Question 42

15% of denture wearers

Answer 42

angular cheilitis (perleche)

Question 43

inflammation of lip/lips with redness and fissures radiating from angles of mouth. candida albicans fungal infection

Answer 43

angular cheilitis

Question 44

angular cheilitis is associated with

Answer 44

loss of OVD and candida albican and S. aureus

Question 44

chronic inflammation of denture-bearing mucosa may or may not be painful redness; possible burning sensation cause uncertain: poor oral hygiene, 24 hour wear without removing, clenching, xerostomia, medications???

Answer 44

denture stomatitis

Question 44

angular cheilitis is caused by: treated with

Answer 44

decreased OVD and vitamin deficiencies usually see poor-fitting denture and abused tissue nystatin

Question 44

bizarre symptoms: may be itching, may be burning, may be pain visual clinical signs often ABSENT cause: may be metabolic, nutritional or psychologic *consider lack of interocclusal space or clenching

Answer 44

denture sore mouth

Question 45

mobile tissue

Answer 45

fibrous hyperplasia

Question 46

"denture hyperplasia" "inflammatory fibrous hyperplasia"

Answer 46

epulis fissuratum

Question 47

single or multiple fold(s) of hyperplastic tissue in vestible associated with the flange of an ill-fitting denture or flange is sharp/unpolished

Answer 47

epulis fissuratum

Question 48

where do you usually see epulis fissuratum?

Answer 48

on facial/buccal in anterior area of mouth

Question 49

epulis fissuratum is usually found in

Answer 49

women

Question 50

treatment for epulis fissuratum

Answer 50

shorten denture border often require surgical correction reline, rebase or remake dentures

Question 51

yeast-like fungus

Answer 51

candida

Question 52

common oral microbe -predisposing conditions: HIV, diabetes

Answer 52

candida

Question 53

candida is more common on

Answer 53

max arch

Question 54

candida- 3 presentations with HIV

Answer 54

angular cheilitis, erythematous candidiasis, pseudomembranous candidiasis

Question 55

complete denture therapy is

Answer 55

NOT a definitive treatment