The Post-Insertion Appointment

Question 1

post insertion (2)

Answer 1

all patients with new dentures should be appointed and seen 24-48 hours after insertion of the dentures

patient should wear the dentures for several hours prior to appointment to better evaluate mucosal irritations

Question 2

patients who are seen for denture adjustment appointment — hours post-insertion do better with dentures

Answer 2

24-48

Question 3

in many instances, the most crucial time in the patients perception of success or failure of dentures is the

Answer 3

adjustment period

Question 4

—- may be the single most significant factor of CD under function

Answer 4

neuromuscular control

Question 5

(2) are important prohnostic indications

Answer 5

tongue function

denture wearing experience

Question 6

common problems w mand denture (3)

Answer 6

discomfort
poor retention and stability
lack of support

Question 7

common problems w max denture (2)

Answer 7

poor retention and stability

esthetics and phonetics

Question 8

post insertion 4 major areas

Answer 8

esthetics
phonetics
tissue irritations
loss of retention and stability

Question 9

esthetics

vague complains about the dentures- pnt may be

Answer 9

unhappy w esthetics

Question 10

the time to remedy esthetic problems is at the

Answer 10

trial placement appointment

Question 11

most patients adapt and learn to speak with new dentures quickly unless

Answer 11

the teeth are improperly located in the vertical, horizontal or frontal plane

Question 12

problems w phonetics (4)

Answer 12

check the thickness of the max palatal portion. a common problem is excessive thickness
reevaluate the position of the mac anterior teeth
if everything appears normal it may be a matter of time for the patient to adapt
open OVD

Question 13

tissue irritations

Answer 13

sore spot may be far removed from its cause

Question 14

tissue irritation causes (4)

Answer 14

overextension
trauma from faulty occlusion
pressure from the denture base
tissue abrasion from prosthesis movement

Question 15

loss of retention and stability

many possible causes (6)

Answer 15

occlusion
base contours 
teeth not in neutral zone
posterior palatal seal
overextension or underextension
salivary flow and character

Question 16

Post insertion (2)

Answer 16

Check occlusal contacts

Remount to adjust occlusion if error is detected

Question 17

much of the selective grinding done in mouth according to articulating paper marks made actually — the amount of error in occlusion

Answer 17

increases

Question 18

Post-insertion (2)

Answer 18

Remove dentures and evaluate palate and residual ridges throughout
Evaluate vestibular reflections for red areas

Question 19

Post insertion appnt.

Ask patient to

Answer 19

point to area of soreness
Cotton tipped applicator (not their finger) –touch area
Address the most urgent area first

Question 20

Soreness in depth of vestibule is usually caused by

Answer 20

overextended border

of flange.

Question 21

Soreness in vestibule is usually caused by

Answer 21

overextended border of the

flange (due to an overextended final impression).

Question 22

Sore on crest of ridge or ridge slope (2)

Answer 22

• occlusion error usually

- pressure spot (tray show through) in secondary impression

Question 23

Frenal notch too (2)

Answer 23

shallow or sharp

Question 24

Soreness of tissue overlying coronoid process –

Answer 24

too much thickness at

distobuccal corner of maxillary denture; PIP on cameo surface

Question 25

Numbness or burning sensation in anterior palate –

Answer 25

pressure on incisive | papilla

Question 26

Swallowing soreness (2)

Answer 26

Irritation at mylohyoid ridge | Retromylohyoid flange extension

Question 27

Numbness or burning in lower premolar areas –

Answer 27

pressure over mental | nerve due to an atrophied alveolar ridge

Question 28

Buccal mucosa at occlusal plane level (2)

Answer 28

- - biting cheek - Increase horizontal overlap | - - trapping mucosa between bases

Question 29

Teeth contact during speaking

Answer 29

OVD is too far open. Too little IOD | (freeway space). Ridges are sore due to constant pressure!

Question 30

Dentures fit fine at first insertion, but loosen after wearing them for

Answer 30

3 | or 4 hours –Occlusal errors likely

Question 31

Maxillary CD dislodges when yawning or opening wide - -

Answer 31

DB corner too thick

Question 32

Smiling causes maxillary CD to | dislodge

Answer 32

Denture flange too thick posterior to buccal frenum

Question 33

Maxillary CD dislodges when eating | Suspect: (2)

Answer 33

posterior palatal seal too deep | Occlusion needs correction

Question 34

Whistling with /S/ sounds

Answer 34

Anterior palatal contour(s) are incorrect. Uses PIP on the cameo surface to check phonetics/tongue contact on the denture.

Question 35

Dentures dislodge easier than | expected (3)

Answer 35

Overextension of borders-”toaster denture” Form of external flanges Teeth locations violating “Neutral Zone”

Question 36

The “Neutral Zone”

Answer 36

That area where the forces applied by the tongue is equal or neutralized by the force applied by the cheeks & lips

Question 37

gagging may result from (6)

Answer 37

loose dentures poor occlusion incorrect extension or contour of dentures incorrect teeth positions (too far lingual or occlusal plane too low) an excessive OVD psychogenic factors

Question 38

Tissue trauma: | Manifests as: (4)

Answer 38

Hyperemia Inflammation Ulceration Pain

Question 39

zinc oxide paste (PIP)

Answer 39

used to detect improper adaptation

Question 40

PIP spray

Answer 40

used in patients w xerostomia to prevent the PIP from sticking to the mucosa

Question 41

Dry denture and brush thin layer of PIP on --- surface.

Answer 41

intaglio

Question 42

Spray with --- if mouth is dry and insert denture.

Answer 42

separator

Question 43

Dry the tissue and denture with ---

Answer 43

gauze

Question 44

Touch irritated area with indelible marker-

Answer 44

Thompson marker

Question 45

Insert denture to transfer --- to denture base

Answer 45

mark

Question 46

Denture adjustment (3)

Answer 46

Acrylic resin cutters #8 round bur Scrapers (not used)

Question 47

Smooth all adjusted surfaces with a

Answer 47

rubber wheel/point

Question 48

Polish cameo surface & borders (lathe on SLOW SPEED) –

Answer 48

rag wheel | with pumice and then high shine

Question 49

complaints about looseness (2)

Answer 49

``` denture may lack retention displacing forces (occlusion, muscle action) are significant enough to overcome normally adequate retention ```

Question 50

lack of retention | disgnosed when

Answer 50

denture offers little or no resistance to removal along a path approx perp to occlusal plane

Question 51

complaints denture feels too large feels like a mouthful difficult to speak or eat suspect:

Answer 51

tongue space is too small and dentures crowd the tongue, problem could be tooth position, denture base contours or both. think neutral zone

Question 52

The Neutral Zone

Answer 52

".....that area or position where the forces between the tongue and the cheeks/lips are equal.” A zone of equilibrium.