.
In this
section, guidelines to the diagnosis of complete denture problems are presented
in tabular form. Suggestions to the management of these problems are listed.
There is, inevitably, the potential
for problems to arise subsequent to the insertion of complete dentures. These
problems may be transient and may be essentially disregarded by the patient or
they may be serious enough to result in the patient being unable to tolerate
the dentures. Factors causing problems may be grouped, essentially into four
causes.
• Adverse intra-oral anatomical
factors eg
atrophic mucosa.
• Clinical factors eg poor denture
stability.
• Technical factors eg failure to
preserve the
peripheral roll on a master cast.
• Patient adaptional factors.
By far the most critical factors
are the patient adaptional factors. Many patients with positive stereotypes may
overcome errors of prescription.Some patients, however, are unable to adapt
physically and/or psychologically to dentures that satisfy clinical and
technical prosthodontic norms. Clearly it would be in the best interests of the
clinician and the patient to determine this at the assessment stage, and was
referred to in Part 2.The prescribing clinician is responsible for planning
complete dentures after diagnosing potential problems; be they anatomical,
physiological, pathological or
emotional. Once a denture-wearing problem becomes apparent, it is important
that it is addressed in a logical and systematic way.
That is to say, an adequate history
of the problem must be obtained and a careful examination of the mouth carried
out so that an accurate diagnosis can be made, and an appropriate treatmentplan
devised.
Without doubt listening to the patient
(as their difficulties are described) is the most important first step in the
process, and its importance cannot be overemphasised.Because of the plethora of
potential complete denture problems, this section is largely confined to those
that are most commonly encountered at the time of insertion of replacement
dentures or during review appointments in the days and weeks after insertion.
For a comprehensive overview of the diagnosis and management of complete
denture problems, readers are referred to standard prosthodontic texts
Here below is the link to download
the pdf of the important tables that will help you to sort out the various
problems that are encountered in your daily clinical practice.
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