Re: loose denture dtp ore 2

[Guest guest]

Hi SnehaWe need to find out the reasons why the denture is loose.Normally there are some issues-old denture,dry mouth,flubby ridge,candida.If it is candida-do not take impressionEmergency is reline.Yes we give the option for the implant but say abt diabetes,smoking-anyway you will refer to specialistAbout full metalic-if the pt is allergic to acrylic,doe s not want claer acrilyc,suffer from parkinson-offer metalic,but mention the weight,less retentionPlease correct me if I am wrong SincerelyLyudmyla From: Sneha <dr_snehapandya@...> Sent: Sunday, 12 February 2012, 12:51 Subject: loose denture dtp ore 2

Hi, friends

What otpions for loose denture treatment planning?

1) Do we give relining or rebasing option?

2) do we give metal full denture in this country as a option?

3) what we do in emergency phase for loose denture?

4) will do impression on emergency phase for new denture?

5) do we give implant supported denture option if patient is poor?

6) do we ask for study models if patient is having upper full denture and lower natural teeth?

7)what investigation we ask for loose denture

Help with this dtp case:

Miss son

> > DOB; 13/07/1945

> > Actor Scenario Info

> > You have gone to see a new dentist for the following reason.

> >

> > You think your upper denture "looks horrible" and is "coming loose". You

> > have never had a lower denture and you don't think that you could cope with

> > one. You don't want to be any trouble and you think you will probably manage

> > with your denture if the dentist can adjust it.

> >

> > Medical history

> >

> > You are insulin dependent diabetic.

> >

> > Your GP has given you some tablets "for your nerves". You don't have

> > them with you and you don't remember what they are called.

> >

> > Dental history

> >

> > You have not attend the dentist since your upper teeth were extracted

> > for your wedding when you were 21

> >

> > You brush your teeth every day

> >

> > Social history

> >

> > You husband died of cancer last year and you live on your own in a

> > socially deprived town.

> >

> > You have two daughters and one son.

> >

> > Attending the surgery is a bit difficult for you. It takes an hour on

> > the bus, however you are happy to have whatever treatment the dentist deems to

> > be best.

> >

> > Further scenario info for the actor (Only if asked by the candidate)

> >

> > You are embarrassed about your dental condition and poor attendance

> > history. You have not eaten in front of anyone other than your husband for the

> > past 20 years, not even at your daughter's wedding reception. Your speech is

> > also affected.

> >

> > Examiner's Info

> >

> > Extra-oral exam

> >

> > Nothing abnormal. Decrease in lower face height

> >

> > Intra-oral exam

> >

> > Soft tissue screening; The mucosa beneath the upper denture is inflamed

> > with an appearance of chronic candidiasis. There is a large ulcer on the

> > tongue. The upper anterior ridge is

> > mobile and "flabby" and when the patient speaks, the upper denture has a

> > noticeable tendency to drop.

> >

> > Bony tissue screening; On palpation, it can be felt that there is a bony

> >

teeth present: lower:

central, lateral incisors , canine and 1 st premolars on both side,

upper teeth: 3 rd molar present on right side, loose denture

BOP; some timesGrade 1 mobility

OH; some dental plague is visible.

Special exam and other props

Study cast; not available

Photos; available OPG; not available

Periapicals of the lower anterior teeth and upper right posterior side. they are fine, just grade 1 mobility

The opg shows an impacted wisdom tooth

plz share ur treatment plaaning and clear my doubts

Regards,

sneha

[Guest guest]

hi, Lyudmyla Sorry, I have one doubt,How we can give metal denture, it is a tooth supported denture, here only 1 teeth is there, can we give full metal dentur?e in a patient with flabby ridge.?is it going to stay here?I think, in RCS course, they have said, we dont do relining . we just give new denture, I am not sure about relining.if u know , plz clear my doubt. thanks, sneha From: Lyudmyla Huhley <huhley2006@...> " " < > Sent: Sunday, February 12, 2012 1:05 PM Subject: Re: loose denture dtp ore 2

Hi SnehaWe need to find out the reasons why the denture is loose.Normally there are some issues-old denture,dry mouth,flubby ridge,candida.If it is candida-do not take impressionEmergency is reline.Yes we give the option for the implant but say abt diabetes,smoking-anyway you will refer to specialistAbout full metalic-if the pt is allergic to acrylic,doe s not want claer acrilyc,suffer from parkinson-offer metalic,but mention the weight,less retentionPlease correct me if I am wrong SincerelyLyudmyla From: Sneha <dr_snehapandya@...> Sent: Sunday, 12 February 2012, 12:51 Subject: loose denture dtp ore 2

Hi, friends

What otpions for loose denture treatment planning?

1) Do we give relining or rebasing option?

2) do we give metal full denture in this country as a option?

3) what we do in emergency phase for loose denture?

4) will do impression on emergency phase for new denture?

5) do we give implant supported denture option if patient is poor?

6) do we ask for study models if patient is having upper full denture and lower natural teeth?

7)what investigation we ask for loose denture

Help with this dtp case:

Miss son

> > DOB; 13/07/1945

> > Actor Scenario Info

> > You have gone to see a new dentist for the following reason.

> >

> > You think your upper denture "looks horrible" and is "coming loose". You

> > have never had a lower denture and you don't think that you could cope with

> > one. You don't want to be any trouble and you think you will probably manage

> > with your denture if the dentist can adjust it.

> >

> > Medical history

> >

> > You are insulin dependent diabetic.

> >

> > Your GP has given you some tablets "for your nerves". You don't have

> > them with you and you don't remember what they are called.

> >

> > Dental history

> >

> > You have not attend the dentist since your upper teeth were extracted

> > for your wedding when you were 21

> >

> > You brush your teeth every day

> >

> > Social history

> >

> > You husband died of cancer last year and you live on your own in a

> > socially deprived town.

> >

> > You have two daughters and one son.

> >

> > Attending the surgery is a bit difficult for you. It takes an hour on

> > the bus, however you are happy to have whatever treatment the dentist deems to

> > be best.

> >

> > Further scenario info for the actor (Only if asked by the candidate)

> >

> > You are embarrassed about your dental condition and poor attendance

> > history. You have not eaten in front of anyone other than your husband for the

> > past 20 years, not even at your daughter's wedding reception. Your speech is

> > also affected.

> >

> > Examiner's Info

> >

> > Extra-oral exam

> >

> > Nothing abnormal. Decrease in lower face height

> >

> > Intra-oral exam

> >

> > Soft tissue screening; The mucosa beneath the upper denture is inflamed

> > with an appearance of chronic candidiasis. There is a large ulcer on the

> > tongue. The upper anterior ridge is

> > mobile and "flabby" and when the patient speaks, the upper denture has a

> > noticeable tendency to drop.

> >

> > Bony tissue screening; On palpation, it can be felt that there is a bony

> >

teeth present: lower:

central, lateral incisors , canine and 1 st premolars on both side,

upper teeth: 3 rd molar present on right side, loose denture

BOP; some timesGrade 1 mobility

OH; some dental plague is visible.

Special exam and other props

Study cast; not available

Photos; available OPG; not available

Periapicals of the lower anterior teeth and upper right posterior side. they are fine, just grade 1 mobility

The opg shows an impacted wisdom tooth

plz share ur treatment plaaning and clear my doubts

Regards,

sneha

[Guest guest]

Here is some info abt denturesI did not really follow the case,loose dentures need to be relined as an emergency.This case has been discussed previously,just check emails-you will find all options from other peopleA metal-based denture is one in which a portion of the denture body is made of a substantial metal casting rather than all plastic (acrylic resin). This procedure is usually done on the lower denture.

There are two types of metal-based dentures.

Standard metal-based denture

The metal base portion of the denture is in direct contact with underlying supporting tissues.

The base is fabricated from a special medical grade alloy that is hypoallergenic and very biocompatible with tissues. Generally, tissues in contact with this type of material are very healthy in appearance.

Modified metal-based denture

The metal base portion of the denture is not in direct contact with underlying supporting tissues.

A soft or hard plastic liner may be interposed between the metal and supporting tissues.

A soft liner is generally preferred to hard plastic since it is more comfortable to wear; however, the soft liner usually should be replaced on an annual basis.

The Rationale for a Metal-Based Denture

Facilitates the avoidance of disruptive forces

Sometimes it is necessary to construct a very narrow denture in order

to avoid any structures that would loosen the prosthesis, such as muscles flexing, and so forth. In addition, necessary surgical procedures to reposition a muscle attachment (called a frenum) can sometimes be avoided with these narrow type dentures.

However, such narrow dentures are weak and tend to break quite easily

when fabricated just from plastic. A metal base provides the needed strength to design a very narrow denture in order to follow the confines

of a patient's lower resorbed alveolar ridge (the remaining bony ridge). In addition, the metal base provides long-term dimensional stability and strength that is not enjoyed with an all-plastic denture base.

Provides a more natural feeling

The added weight of the metal base provides a more natural perception

for many patients. Many patients prefer the additional weight on the lower jaw.

A private study measured the actual weight of cadaver jaw ridges and teeth that would normally be lost after the extraction of teeth and associated natural shrinkage of the jawbones. It was found that the weight of these tissues closely approximated the weight of a metal base.

Therefore, it is likely that the more natural feeling perceived by persons wearing metal-based dentures is probably real rather than imagined.

The additional weight of a metal base also contributes to lower denture stability by causing the denture to settle down onto a jaw ridge.

Advantages of Metal-Based Dentures

Very biocompatible and hypoallergenic with healthy-appearing supporting tissues

May include a soft liner

Can be relined easily

Provides added strength for easily broken narrow dentures

Facilitates fabrication of stable narrow-based dentures that are designed to avoid contact with disrupting muscle forces

Sometimes facilitates the avoidance of surgical procedures to reposition frenum

Patients perceive a more natural feeling from the added weight

Weight may contribute to additional denture stability

Dimensionally very stable when compared to all-plastic-based dentures during fabrication and over time

Disadvantages of Metal-Based Dentures

Generally difficult to reline standard metal-based dentures; modified metal-based dentures (described earlier above) are easier to reline

More costly to fabricate

by ph J. Massad, D.D.S.

SincerelyLyudmyla From: Sneha Pandya <dr_snehapandya@...> " " < > Sent: Sunday, 12 February 2012, 17:04 Subject: Re: loose denture dtp ore 2

hi, Lyudmyla Sorry, I have one doubt,How we can give metal denture, it is a tooth supported denture, here only 1 teeth is there, can we give full metal dentur?e in a patient with flabby ridge.?is it going to stay here?I think, in RCS course, they have said, we dont do relining . we just give new denture, I am not sure about relining.if u know , plz clear my doubt. thanks, sneha From: Lyudmyla Huhley <huhley2006@...> " " < > Sent: Sunday, February 12, 2012 1:05 PM Subject: Re: loose denture dtp ore 2

Hi SnehaWe need to find out the reasons why the denture is loose.Normally there are some issues-old denture,dry mouth,flubby ridge,candida.If it is candida-do not take impressionEmergency is reline.Yes we give the option for the implant but say abt diabetes,smoking-anyway you will refer to specialistAbout full metalic-if the pt is allergic to acrylic,doe s not want claer acrilyc,suffer from parkinson-offer metalic,but mention the weight,less retentionPlease correct me if I am wrong SincerelyLyudmyla From: Sneha <dr_snehapandya@...> Sent: Sunday, 12 February 2012, 12:51 Subject: loose denture dtp

ore 2

Hi, friends

What otpions for loose denture treatment planning?

1) Do we give relining or rebasing option?

2) do we give metal full denture in this country as a option?

3) what we do in emergency phase for loose denture?

4) will do impression on emergency phase for new denture?

5) do we give implant supported denture option if patient is poor?

6) do we ask for study models if patient is having upper full denture and lower natural teeth?

7)what investigation we ask for loose denture

Help with this dtp case:

Miss son

> > DOB; 13/07/1945

> > Actor Scenario Info

> > You have gone to see a new dentist for the following reason.

> >

> > You think your upper denture "looks horrible" and is "coming loose". You

> > have never had a lower denture and you don't think that you could cope with

> > one. You don't want to be any trouble and you think you will probably manage

> > with your denture if the dentist can adjust it.

> >

> > Medical history

> >

> > You are insulin dependent diabetic.

> >

> > Your GP has given you some tablets "for your nerves". You don't have

> > them with you and you don't remember what they are called.

> >

> > Dental history

> >

> > You have not attend the dentist since your upper teeth were extracted

> > for your wedding when you were 21

> >

> > You brush your teeth every day

> >

> > Social history

> >

> > You husband died of cancer last year and you live on your own in a

> > socially deprived town.

> >

> > You have two daughters and one son.

> >

> > Attending the surgery is a bit difficult for you. It takes an hour on

> > the bus, however you are happy to have whatever treatment the dentist deems to

> > be best.

> >

> > Further scenario info for the actor (Only if asked by the candidate)

> >

> > You are embarrassed about your dental condition and poor attendance

> > history. You have not eaten in front of anyone other than your husband for the

> > past 20 years, not even at your daughter's wedding reception. Your speech is

> > also affected.

> >

> > Examiner's Info

> >

> > Extra-oral exam

> >

> > Nothing abnormal. Decrease in lower face height

> >

> > Intra-oral exam

> >

> > Soft tissue screening; The mucosa beneath the upper denture is inflamed

> > with an appearance of chronic candidiasis. There is a large ulcer on the

> > tongue. The upper anterior ridge is

> > mobile and "flabby" and when the patient speaks, the upper denture has a

> > noticeable tendency to drop.

> >

> > Bony tissue screening; On palpation, it can be felt that there is a bony

> >

teeth present: lower:

central, lateral incisors , canine and 1 st premolars on both side,

upper teeth: 3 rd molar present on right side, loose denture

BOP; some timesGrade 1 mobility

OH; some dental plague is visible.

Special exam and other props

Study cast; not available

Photos; available OPG; not available

Periapicals of the lower anterior teeth and upper right posterior side. they are fine, just grade 1 mobility

The opg shows an impacted wisdom tooth

plz share ur treatment plaaning and clear my doubts

Regards,

sneha

[Guest guest]

instead of searching through emails,I saved it and attached for you,plz check it SincerelyLyudmyla From: Sneha Pandya <dr_snehapandya@...> " " < > Sent: Sunday, 12 February 2012, 17:04 Subject: Re: loose denture dtp ore 2

hi, Lyudmyla Sorry, I have one doubt,How we can give metal denture, it is a tooth supported denture, here only 1 teeth is there, can we give full metal dentur?e in a patient with flabby ridge.?is it going to stay here?I think, in RCS course, they have said, we dont do relining . we just give new denture, I am not sure about relining.if u know , plz clear my doubt. thanks, sneha From: Lyudmyla Huhley <huhley2006@...> " " < > Sent: Sunday, February 12, 2012 1:05 PM Subject: Re: loose denture dtp ore 2

Hi SnehaWe need to find out the reasons why the denture is loose.Normally there are some issues-old denture,dry mouth,flubby ridge,candida.If it is candida-do not take impressionEmergency is reline.Yes we give the option for the implant but say abt diabetes,smoking-anyway you will refer to specialistAbout full metalic-if the pt is allergic to acrylic,doe s not want claer acrilyc,suffer from parkinson-offer metalic,but mention the weight,less retentionPlease correct me if I am wrong SincerelyLyudmyla From: Sneha <dr_snehapandya@...> Sent: Sunday, 12 February 2012, 12:51 Subject: loose denture dtp ore 2

Hi, friends

What otpions for loose denture treatment planning?

1) Do we give relining or rebasing option?

2) do we give metal full denture in this country as a option?

3) what we do in emergency phase for loose denture?

4) will do impression on emergency phase for new denture?

5) do we give implant supported denture option if patient is poor?

6) do we ask for study models if patient is having upper full denture and lower natural teeth?

7)what investigation we ask for loose denture

Help with this dtp case:

Miss son

> > DOB; 13/07/1945

> > Actor Scenario Info

> > You have gone to see a new dentist for the following reason.

> >

> > You think your upper denture "looks horrible" and is "coming loose". You

> > have never had a lower denture and you don't think that you could cope with

> > one. You don't want to be any trouble and you think you will probably manage

> > with your denture if the dentist can adjust it.

> >

> > Medical history

> >

> > You are insulin dependent diabetic.

> >

> > Your GP has given you some tablets "for your nerves". You don't have

> > them with you and you don't remember what they are called.

> >

> > Dental history

> >

> > You have not attend the dentist since your upper teeth were extracted

> > for your wedding when you were 21

> >

> > You brush your teeth every day

> >

> > Social history

> >

> > You husband died of cancer last year and you live on your own in a

> > socially deprived town.

> >

> > You have two daughters and one son.

> >

> > Attending the surgery is a bit difficult for you. It takes an hour on

> > the bus, however you are happy to have whatever treatment the dentist deems to

> > be best.

> >

> > Further scenario info for the actor (Only if asked by the candidate)

> >

> > You are embarrassed about your dental condition and poor attendance

> > history. You have not eaten in front of anyone other than your husband for the

> > past 20 years, not even at your daughter's wedding reception. Your speech is

> > also affected.

> >

> > Examiner's Info

> >

> > Extra-oral exam

> >

> > Nothing abnormal. Decrease in lower face height

> >

> > Intra-oral exam

> >

> > Soft tissue screening; The mucosa beneath the upper denture is inflamed

> > with an appearance of chronic candidiasis. There is a large ulcer on the

> > tongue. The upper anterior ridge is

> > mobile and "flabby" and when the patient speaks, the upper denture has a

> > noticeable tendency to drop.

> >

> > Bony tissue screening; On palpation, it can be felt that there is a bony

> >

teeth present: lower:

central, lateral incisors , canine and 1 st premolars on both side,

upper teeth: 3 rd molar present on right side, loose denture

BOP; some timesGrade 1 mobility

OH; some dental plague is visible.

Special exam and other props

Study cast; not available

Photos; available OPG; not available

Periapicals of the lower anterior teeth and upper right posterior side. they are fine, just grade 1 mobility

The opg shows an impacted wisdom tooth

plz share ur treatment plaaning and clear my doubts

Regards,

sneha

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