Complete Denture Prosthodontics – Clinical Examination

Complete Denture Prosthodontics – Clinical Examination

1. Treatment plan for complete dentures goes through 7 stages:

• Clinical examination

• Initial impression

• Second impression

• Recording jaw relation, denture installation guidance

• Try-in

• Denture insertion and balancing

• Examination and functional rehabilitation

2. Clinical Examination:

• Intraoral examination:

• Patient’s history

• Intraoral examination

• Extraoral examination:

• Patient’s history

• Extraoral examination

3. Ideal age to wear complete dentures:

• 46-60 years old

4. Palatal vault:

• High palatal vault with little adhesion

• Wide, horizontal palatal vault with good adhesion

• Short, flat palatal vault, then reduce the area of the resin base (do not increase the area)

5. Time after radiotherapy before starting rehabilitation:

• 6 months

6. Torus:

• Torus is divided into 5 types:

• 2/3 posterior to the maxillary midline

• 1/3 posterior to the maxillary midline

• 1/3 anterior to the maxillary midline

• 2/3 anterior to the maxillary midline

• Located along the entire length of the maxillary midline

• Types of 1/3 posterior to the maxillary midline are all disadvantageous because they affect the posterior border seal

7. Jaw movement:

• Normal mouth opening: 4-5mm

• >5mm has problems with ligaments

• <4mm has temporomandibular joint disorder

• Mandibular protrusive movement: 7-9mm

• Lateral movement: 5-10mm

8. Cases of torus pressure reduction:

• Unable to follow up regularly

• Opposing arch is natural teeth

• Porous bone

• Flaccid mucosa

• Full upper arch rehabilitation, lower arch is a denture

• X-ray shows insufficient bone support for prosthesis

9. Anatomical factors of the upper jaw:

• Canine eminence

• Midline

• Torus

• Eisenring area

• Schroder area

10. Torus pressure reduction should be performed a few days after denture insertion and the denture should be made thicker (not immediately after denture insertion)

11. Indication for torus surgery:

• Oversized

• Pedunculated

• 1/3 posterior to the maxillary midline

12. Maxillary ridge:

• Maxillary ridge is divided into 3 types:

• Minimal bone resorption

• Moderate bone resorption (some areas need pressure reduction)

• Severe bone resorption

13. Pterygoid hamulus:

• Pterygoid hamulus:

• Outward

• Inward

• The outer surface of the two pterygoid hamuli are parallel to each other to help retain the denture (not the inner surface)

14. A-line vibration:

• Located on the soft palate with the submucosal supporting tissue being granular tissue and no bone support

• Vibrates when the patient says “aaaa”

• Can be compressed and used as the area for the posterior border seal of the upper jaw

• To determine the A-line, close the nose and try to breathe gently through the nose, the A-line will be pushed forward

• Usually 4-12mm posterior to the hard-soft palate boundary

• The hard-soft palate boundary with the A-line forms the post-dam area

• Most dentures end 1-2mm posterior to the A-line (not anterior)

15. Early mandibular tooth extraction does not affect:

• Tooth eruption

• Mandibular movement

• Vertical dimension of the mandible

• Denture placement direction

16. Palatine fossa:

• It is two concave areas located anterior to the hard palate, on both sides of the midline

• Used as a landmark when making dentures

• It is two holes of the palatine glands

• The distance between the two fossae is 3.5mm (not 3mm)

• Impression must include the A-line and the posterior border of the denture base should completely cover the pterygoid hamulus

17. House classification:

• Type 1: The hard-soft palate boundary is horizontal, mobile tissue posterior to the post-dam >5mm, ideal for maintaining adhesion

• Type 2: The hard-soft palate boundary is at 45 degrees, mobile tissue posterior to the post-dam 1-5mm, maintaining adhesion quite well

• Type 3: The hard-soft palate boundary is >70 degrees, mobile tissue on the post-dam, this type does not have enough adhesion

18. According to House classification:

• Type 1: The posterior border of the denture extends 5mm or more from the hard-soft palate boundary or is 1-2mm thick (not 2mm)

• Type 2: The posterior border of the denture extends 2-3mm or is 2mm thick

• Type 3: The posterior border of the denture extends less than 1mm or is 3-5mm thick (not 4mm)

19. Mucosa areas that cannot withstand pressure:

• Midline

• Torus

• Anterior palatine foramen

• Posterior palatine foramen

• When compressed, it causes pain and sores

20. Mucosa areas that can withstand high pressure:

• Palatal rugae

• Ridge

• Because this area has no submucosa

• When compressing this area, it does not deform and the compressive force is transmitted directly to the underlying bone

21. Mucosa areas that can withstand low pressure:

• Schroder area: the upper jaw area contains a lot of adipose tissue, the lower jaw area contains a lot of salivary glands

• Post-dam area

22. Schroder area:

• Deformed during impression and when the patient wears the denture

• Causes denture displacement when it recovers (not no displacement)

23. Upper labial frenulum and labial vestibule:

• Similar to the lower labial frenulum

• The problem with the denture base border in this area is mainly that it is too long, too thick

• Good ridge, the denture base border in the labial vestibule should be 2mm thick or less (not 1mm)

• Severely resorbed ridge, the denture base is thicker to support the lip and achieve a tight seal

24. Modulus node:

• Including:

• Buccinator muscle

• Levator anguli oris muscle

• Orbicularis oris muscle

• Some small, narrow muscles

25. Muscles affecting the buccal frenulum:

• Canine muscle

• Orbicularis oris muscle

• Levator anguli oris muscle

• Buccinator muscle

26. Buccal vestibule:

• From the buccal frenulum backwards

• Depends on the degree of bone resorption

• Depends on the buccinator muscle

• Depends on the position of the lower jaw

27. Near-hamular area (Eisenring):

• Width is related to the activity of the pterygoid hamulus

• Determine the width by placing a dental mirror in the buccal vestibule, next to the near-hamular area, ask the patient to move their jaw to both sides

• If the mirror moves, the denture base should be thinned

28. Pterygomaxillary notch:

• It is loose connective tissue, 2mm wide, located between the maxillary tuberosity and the pterygoid process (not 3mm)

• The end of the entire upper jaw

29. Canine eminence:

• It is connective tissue covering the anterior tooth socket of the edentulous patient in the upper jaw

• When taking an impression, it is necessary to relieve pressure and not displace or deform this area

• In natural teeth, it is 8-10mm away from the outer surface of teeth 11, 21

• In a completely edentulous jaw, it is 7mm away from the outer surface of teeth 11, 21

30. Palatal rugae:

• Need pressure reduction

• There are 3 pairs of palatal rugae (not 2 pairs)

• The distance from the second palatal rugae to the tip of the canine in natural teeth is 10mm (not 8mm)

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