Complete Dentures instructions and insertion Di. Muaiyed. Mahmoud. Buzayan, BDS MClinDent Malaysia AF AAMP USAto Insertion stage Inspection of the finished denture Clinical evaluation of the denture . Checking the border extension. Checking the support. Checking the stability. . Checking the retention. Checking the occlusion Checking the esthetic . Checking the speech Refinement of the occlusion. Post-Insertion care and Instruction. QmAmMonw>1- Inspection of the finished denture Evaluating Tissue Side | ‘ 4 5 Evaluation of the tissue side of the denture base for under- cut areas and accuracy of tissue contact The fitting surface must show no irregularities The entire periphery should be rounded and highly polished The edges of the relief area should be rounded Each denture should be evaluated individually. Before inserting the denture, paint the entire tissue side of the denture base with a thin coat of pressure disclosing paste, insert and remove the denture, when tissue undercuts are present, the paste will be voided from the denture base in the area of tissue contact When the under cut area is positively established, relive the ture by grinding with an acrylic bur.Clinical evaluation of the denture aluating of borders CHECKING FOR ADAPTATION 1 Checked at the posterior palatal seal using mouth mirror- there should be no space 2 Patient is asked to say ‘Ah’ in unexaggerated short bursts CHECKING FOR BORDER EXTENSION 1. Cheeks are elevated and borders are examined. Buccal and labial mucosa are stretched to check for denture displacement CHECKING FOR FRENAL RELIEF 1 Labial frenum is very thin and require a deep notch A shallow relief should be given for buccal frenaEvaluating Borde 1- Maxillary Arch a Apply disclosing wax to the border of the maxillary denture in the same manner as the impression compound was applied during the border molding procedures. b. Instruct the patient to open the jaw as in yawning, push the lower jaw forward, and move the lower jaw from right to left. Therefore overextension can be determined. Relive any existing over extension by grinding and polish the relieved area 2- Mandibular arch a Apply disclosing wax to the mandibular denture borders. b. Instruct the patient to repeat the same movements that were made in border molding. Relive by grinding any over extending areas, ind polish the relieved surface.Juating the retention and stability of denture » Retention: by applying dislodging forces as attempting to remove the denture y Posterior palatal seal is checked by gently pressing the anterior teeth perpendicular to the path of insertion, if adequate we can feel the resistance. Stability: using the finger’s pad, applying pressure on the occlusal surface at the premolar region on each side alternatively. If that caused the denture to tilt (rock) and dislodge from the ridge at other side, this may indicates that there is a problem in stability (as if the teeth was positioned buceally). ~ Anterior seal is checked by pulling against the path of insertion.Jaw relations are once again verified 1) Centric relation is verified 2) Vertical dimension is verifiedEVALUATION OF DENTURE ESTHETICS | Lip Support, 2. Cheek Support, 3 Vertical Height, 4 Low Lip Line, s. High Lip Line, o Smile Line Are Examined. —Evaluating of Speech The patient is asked to speak or read aloud. If there is any error in the denture, patient will have difficulty in pronounciation of certain words. 1. Paper baby sixty six fifty five 2. Counting from fifty to sixty ——POST INSERTION INSTRUCTIONS —Appointment schedule 1. First appointment within 48 hours of delivery. we Second appointment within 3 days 3 . Third appointment within | week of 2nd visit —De Different experiences & discomforts to be explained to patient First oral feelings of fullness Retention comparison between natural & artificial teeth Saliva (increase of salivation) Speech (change) Eating (specific type and manner) Tongue position & problems with the lower denture in contrast with the upper dentureLIST OF INSTRUCTIONS Wearing Of Dentures And Habituation Denture Hygiene And Care Eating Habits Speech Gagging vsene —WEARING OF DENTURES and HABITUATION: Within 24 hrs of wearing dentures, little discomfort will be their leading to soreness and their will be excessive salivation, which has to be swallowed. Denture removed 8 hours every 24 hours the, resulting force can be damaging to the tissue ( during the rest period the denture should be kept in water or diluted mouth antiseptic ). If any pain , ulceration or burning sensation after wearing denture occurs consult dentist. Before sleeping soak the denture overnight in fresh clean water. Dentures should not be soaked in hot water ; this can cause thermal changes and can distort dentures.SPEECH Speaking with new dentures requires practice so read out loud and repeat the words those which are difficult to pronounce. With time speech will be better with dentures. The acts of coughing and sneezing often dislodges the denture and result in an embarrassing situation. Embarrassment can be avoided by covering the mouth with a hand to prevent denture from coming out.DENTURE HYGIENE Rinse mouth properly before wearing dentures. Dentures must be cleaned properly before and after meals , using denture brushes. Clean tongue and skin over the bone properly and massage the skin over bone gently using clean finger. Inside surface of dentures must be cleaned delicately using clean finger, wet cotton. Pt should not use any abrasive or detergents to clean the dentures. Pt should not make any adjustment or repair by himself.DENTURE HYGIENE Poor denture hygiene can result in 1) Mucosal irritation 2) Inflammatory papillary hyperplasia ») Denture stomatitis 4) Chronic candidiasis s) Stain retention HalitosisChemical denture cleansers Commercial preparations - Most preparations contain sodium hypochlorite - Tablets are also there which effervesce when dropped in water releasing bubbles - Dentures are left for 15 mins or even night - Boucher recommended that a 30 min soaking is sufficient to remove stains + Caution- Na hypochlorite not indicated in dentures containing chrome cobalt or other metals Sonic cleansers » Use vibratory energy to clean the dentures - It is very effective in removing calculus as well as cigarette and coffee stainsManual cleansing (_brushing - Used with a mild detergent or a denture paste and water. - Use of regular paste is contraindicated — abrasives can cause wear of denture Caution 1)Stiff bristles can cause severe abrasion 2) Impression surface should not be brushed too aggressivelyEATING: For 2-3 weeks take soft food and chew small bites simultaneously from both sides (balanced). Foods type: requiring minimum force in chewing such as well- cooked cereals, boiled eggs. Avoid sticky food (such as pizza with cheese and gum eating). Food must be chewed from back teeth Biting from front teeth should be avoided as it would dislodge the denture. Cut fruits into small pieces and then eat. Drink water by sipping and do not lift glass for drinking water , this will dislodge the denture.GAGGING “vomiting sense’ is a rare , but normal healthy reaction when any foreign object is placed in mouth In old denture wearers it may be symptom of a disease or disorder of intestinal tract , respiratory tract , excess alcoholism and severe smoking. Many dentures are lost during the nausea or sea sickness when vomiting seems, the dentures should be removed and kept in water until the patient recover. In case gagging persist for long time , causing discomfort to wear the denture , consult the dentist.Thank You —