PROSTHO 3 SURGICAL AND NON-SURGICAL PREPARATION FOR COMPLETE DENTURE Risk in wearing a denture - Adverse cgange in denture foundation

Several conditions must be corrected or treated before construction - Patient not aware of damage or deformed tiddues caused by old prosthesis Treatments To Improve Denture Foundation & Ridge Relation: 1. Non-Surgical Methods A. Rest for the denture supporting tissues B. Occlusal correction of old prosthesis C. Good nutrition D. Conditioning of patients musculature A. Rest for the denture supporting tissues - Removal of denture for extended period - Use of temporary soft liner (for several days) - Regular finger or toothbrush of denture bearing mucosa especially edematous and enlarged Temporary Soft Liners - Used a s tissue treatment or conditioning materials - These are soft resins that maintain their softness for several days while the tissue recovers - Consists of polymer powder and aromatic esterethanol mixture Uses: 1. Tissue treatments 2. Liners for surgical splints 3. Trial denture base stabilizers 4. Optimal arch form 5. Neutral zone determinants 6. Used as functional impression materials Many denture failed because: - Dentures made when tissues are distorted - Denture are relined without tissue rest or treatment B. Occlusal correction of old prosthesis - T restore vertical dimension using interim resilient lining material - Correction of the extent of the stissue coverage by the old denture base using resin border molding materials with stissue condioner C. Good nutrition - Good nutrition program must be emphasized Nutrition Guidelines o Eat a variety of food o Build carbohydrates: fruits vegetables, whole grain and cereals o Atleast 5 servings of vegetables and fruits daily

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Select fish pultry, lean meat or dried peas and beans everyday Adequate calcium Limit intake of bakery product high in fat and simple sugars Consume 8 glasses of water daily

Oral signs of nutrient deficiencies: Nutrients: Oral Symptoms Proteins - Decreased salivary flow - Enlarged parotid glands Vit. B complex, Iron, Lips: cheilosis, angular Protein stomatitis, angular scars, inflammation Tongue: edema, magenta tongue, atrophy of the filliform papillae, burning sensation, pale, bald - Edematous oral mucosa Gingiva: tender, red and spongy, continuous bleeding

Vit. C

D. Rest for the denture supporting tissues - Use of jaw exercise can permit relaxation of the muscles of mastication and strengthen their coordination - Stretch relax exercise o Open wide, relax o Move to the left, relax o Move to the right, relax o Move forward, relax *Do it 4x in each (4 sessions/day) 2. Surgical Methods (Pre-prosthetic Surgery) Designed to facilitate fabrication or to improve the prognosis of prosthodontics care Classification: 1. Related to the development of a retentive denture 2. Related to the development of provision of a stable denture 3. Those which allow the establishment of a correct vertical dimension Surgical Procedures 1. Improve the bony foundation 2. Improve the soft tissue foundation 3. Improve the ridge relationship 4. Implant procedure Procedures to Improve Bony Foundation Unerupted teeth or retained roots Removal of cysts or tumors Removal of alveolar excess o Alveoplasty, tuberosity reduction, sharp & irregular ridges, genial tubercle reduction or reattachment, removal of torus & exostoses and alveolar repositioning

Techniques to deal with excessive resorption: overlay denture ridge augmentation vestibuloplasty lowering of the mental foramen Torus Mandibularies Prevent proper extension of the denture base Border seal cannot be made Soreness can occur due to thin tissues Fracture of the denture base Torus Palatinus Affect denture stability May cause sore spot Interfere with tongue function Affects post-damming May fracture denture Indications for Removal of Torus 1. Extremely large torus that prevents the formation of an adequately extended and stable denture 2. Traps food debris due to undercuts causing chronic inflammatory conditions 3. Torus that extends past the junction of the hard and soft palate (prevents formation of posterior palatal seal) 4. Patients concer (cancerophobia) Bony Exostosis Creates discomfort Genial Tubercle Creats discomfort causing displacement Pressure in Mental Foramen Present in extreme mandibular resorption causing pain Vestibuloplasty Vertical extension of the denture flanges Repostion muscle attachment from the crest of the ridge Ridge Augmentation Increase the bulk of the ridge onlay grafts from iliac, ribs particulate bone and marrow hydroxyapatite crystals (nonresorbable and non osteogenic tricalciom phosphate (resorbable and osteogenic Visor or vertical osteotomy Horizontal or sandwich osteotomy Hyperplastic Ridge Interfere with optimal seating of the denture Affects denture stability

Epulis Fissuratum Interfere with optimal seating of the denture Papillomatosis Harbors microorganisms Removal using electrosurgery or microabrasion Frenular Attachment (Close to the ridge crest) Difficult to obtain ideal extension Affects peripheral seal Pendulous Fibrous Maxillary Tuberosities Enroachment are obliteration of interarch space 3. Procedures to Improve Ridge Relationship Maxillary advancement procedures Maxillary retrusion procedures Mandibular advancement procedures Mandibular retrusion procedures Discrepancies in Jaw Size Places considerable stress and unfavourable leverages on the basal seat 4. Dental Implants