Prosthetic Covering Areas and Construction of Complete Dentures
Classified in Medicine & Health
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Prosthetic Covering Areas
Primary (maxilla: palatal vault, retromolar tuberosity; Mandible: retromolar trigone, masseter and buccinator insertion, sublingual area). Secondary (alveolar process in PM and M area)
Preprosthetic Preparation
Non-surgical treatment: take a break from dentures; use tissue conditioners (hydroalcoholic resins, plastic, resilient, soft; non-irritant/non-toxic; liner over resin/hard prosthetic base; good recovery of irritated tissues by providing stability and uniform force distribution). Characteristics (low EM; dimensionally stable; good detail reproduction; deforms to compression; temporary material; aids retention; fungal atmosphere)
Patho Related to CD
Prosthetic Stomatitis - bad denture adaptation, poor oral hygiene, Candida albicans. Treatment: check and correct fitting; improve oral hygiene; don't wear at night; topical antifungal 3x/day; rinse with bicarbonate for alkaline environment
Angular Cheilitis - Candida albicans, decreased vertical dimension, HIV. Treatment: remove underlying factors; increase vertical dimension; improve oral hygiene; topical antifungals 3x/day
Epulis Fissuratum - bad fitting. Treatment: don't wear prosthesis; surgical resection; make new/modify old prosthesis
Allergic Stomatitis - Treatment: allergic test; hypoallergenic resin/Titanium; topical corticosteroids
Traumatic Ulcers - bad fitting, occlusal problems. Treatment: correct occlusion and denture extension; chlorhexidine solution 7-10 days
Construction of CD
Retention can be basal (active and passive) or marginal seal. Active basal - adhesion (denture base and mucosa), cohesion (saliva - thinner means more retention), atmospheric pressure and OC muscles (tongue). Marginal seal (external face of ridge inside buccal vestibule) - capillary force, atmospheric pressure, and mechanical borders
Impressions
Mucostatic - cover the potential denture-bearing surfaces, recording only the mucosa or the attached gingiva
Functional/Dynamic - record denture base supporting area, attached/mobile gingiva, active muscular elements
With Pressure - records supporting areas as if the denture was under functional loading and in movement
Without Pressure - covering of the future denture base area, made up by the inserted mucosa