Manuals_files/CD Manual 12.pdf - Removable Prosthodontics

Post-Insertion Problems - 71
Differential Diagnosis of Post Insertion Problems
- Minimal problems if remount
- Most problems will be occlusal if denture base has been adjusted properly
Principles
Never adjust unless you can see exactly where to adjust on denture – Use indicator medium
(PIP, indelible marker, articulating paper, etc.)
Patients frequently wrong in exactly locating source of problem
Spend time to look and think
Ask patient to describe in detail:
Where?- dentist needs to locate (PIP, tip of instrument,indelible stick)
When? (chewing only?)
How long?
Anything makes it better or worse?
Have patient demonstrate problem if you have difficulty diagnosing the cause.
Limited number of problems:
1. Denture base
2. Occlusion - interferences - esp protrusive
3. Retention
4. Vertical Dimension
5. Allergies and Infections
6. Tooth Position
1. Denture base
- impingements, spicule, sharp edges.
- Dx - PIP (never adjust unless marks)
- sore all time; if changes throughout day, think occlusion
- may still be occlusal, if inflammation causes swelling
2. Occlusion
ONE OF THE MOST COMMON POST-INSERTION PROBLEMS
- May require time to adjust to CR
- difficult to determine, intraorally - reflex
- interferences – especially in protrusive
- fingers on canines –should feel smooth
- sore when bite
- fit changes or comfort deteriorates through day
- remount again - be prepared this morning
3. Retention Problems
Short flanges
- PIP - still streaky
- fingers on canines outwards (post palatal seal).
- look for space