Denture Delivery and Follow Up

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Denture Delivery and Follow Up

• Dr. Cecilia E. Aragón

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Evaluations

• From the Dentist
• From the Patient
• From Family/Friends

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Treatment at the Time of Denture Insertion

• Inspection of dentures. Elimination of basal
  surface errors.
• Dentures to be seated in healthy tissues.

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Elimination of Intaglio Surface Errors

• Pressure Indicator Paste (PIP) to be used for
  every new denture!!

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Check occlusion
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Occlusion may seem okay, but
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Prematurity
Resilient Tissue
Accommodation
Abused Tissues
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Errors in Occlusion

• Possible causes of error inaccurate MMR records
  or transfer of these, failure to use face bow,
  incorrect teeth arrangement, denture processing
  errors, changes in denture base material.
• Checking for occlusion errors
• Best done in the articulator REMOUNT

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Remounting Procedure

• Ask patient to bite on cotton rolls for 10 min.
• Guide mandible into CR several times.
• Aluwax is placed on the post. Teeth of the
  mandibular denture.

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• Place both dentures in the patients mandible is
  guided in a hinge movement.
• Obtain interocclusal record of CR.

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• Mount upper denture using remounting jig.
• Mount lower denture

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Selective spot grinding
The art of reducing premature contacting
surfaces, so that an equal pressure exists at all
points with interference at no point.
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Eliminating occlusal records in anatomic teeth

• Re-establishment of CO.
• Correction of working side occlusal errors.
• Correction of balancing-side errors.
• Correction of protrusive relation.

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Basic Tooth Positions
Balancing Contacts
Centric Occlusion
Working Contacts
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Re-establishment of CO
Problem Teeth too long Solution Deepen the
fossae
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Re-establishment of CO
Problem Teeth too nearly end to end Solution
Grind Inclines
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Re-establishment of CO
Problem Too much horizontal overlap Solution
Broaden central fossae
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After the CO re-establishment.

• DO NOT
• Reduce maxillary lingual cusps.
• Reduce mandibular buccal cusps.
• Deepen the fossae.

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Correction of working side occlusal errors.

• Reduce lingual inclines of buccal cusps of
  maxillary teeth.
• Reduce buccal inclines of lingual cusps of
  mandibular teeth.
• ON WORKING SIDE ONLY!!!

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Correction of working side occlusal errors.
Problem Buccal and lingual cusps too
long. Solution Change inclines of balancing
cusps.
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Correction of working side occlusal errors.
Problem Buccal cusps are too long Solution
Change lingual incline of maxillary buccal cusp
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Correction of working side occlusal errors.
Problem Lingual cusp too long. Solution Change
buccal incline of lingual cusp of mandibular
tooth.
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Correction of balancing-side errors.

• Reduce lingual inclines of mandibular buccal
  cusps or
• Decide which supporting cusp maintains CO and
  reduce its opponent.

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Correction of balancing-side errors.
Grind the lingual incline of the mandibular
buccal cusp.
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Correction of protrusive relation.
Distal inclines
Mesial inclines
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Eliminating occlusal errors in nonanatomic teeth

• Interocclusal CR record is made.
• Dentures mounted and gross premature contacts are
  removed.
• Final adjustments with articulating paper.

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Instructions to the patient

• Individuality of patients
• New dentures and
• Appearance
• Mastication
• Speech
• Oral Hygiene
• Education materials

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24-hour Oral Examination (OE) and Treatment (Tx)

• Occlusion
• Tissues

• Examination procedures
• Adjustments related to
• Occlusion
• Denture base
• Subsequent OEs and Txs
• Periodic recall for OE12 months

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What to look for
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What to look for
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What to look for
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What to look for
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What to look for
Moskona D, Kaplan I. Oral lesions in elderly
denture wearers. Clin Prev Dent. 19921411-4
500 pts. Total frequency of soft tissue lesions
was 16.7 in edentulous non-denture patients and
58.2 in patients with poor quality dentures.
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What to look for
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Overdentures
Bars
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Locator attachments
O-ring abutments
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