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Maxillary denture is loose
- Lack or incorrect posterior palatal seal
- Short on hamular notches
- Dry mouth
- Posterior border too short or thin
- Inaccurate denture base
- Short labial flange or excessive notch for frenum
- Inadequate clearance for labial frenum
- Improper clearance for buccal frenum
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Maxillary denture drops when the patient opens wide
- Posterior borders too thick
- Posterior borders too long
- Interference with the coronoid process by distobuccal flange
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Maxillary denture loosens while patient speaks
- Inadequate posterior palatal seal
- Interference with coronoid process
- Posterior border too long or too thick
- Short labial flange or excessive notch for frenum
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Maxillary denture loosens at different times of the day
- Heavy secretion of mucinous saliva from palatal salivary glands
- Periods of dry mouth due to alcoholism, radiation, medication or disease
- Sjögren's syndrome
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Mandibular denture is loose
- Over extension of base
- Under extension of base
- Thickness in lingual border in molar area
- Lack of neuromuscular control
- Posterior teeth set too lingual-crowding tongue
- Dry mouth
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One or both dentures loosens when eating
- Teeth are set too far buccal to crest of ridge
- Occlusal plane higher than retromolar pads
- Occlusal interferences
- Inadequate neuromuscular control
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Excesive salivation
- Strangeness of new denture, will subside
- Can lead to swelling of the sublingual gland area if the lingual flanges are obstructing the opening of the ducts
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Sore on areas
- Excessive pressure areas
- • Over extensions
- • Errors in occlusion
- • Insufficient relief over undercuts
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Non-specific pain
- • Pressure over zygomatic process
- • Distobuccal border of denture base too wide
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Cheek biting
- Insufficient clearance of the denture bases distal to the last tooth
- • Insufficient horizontal overlap of posterior teeth
- Sharp buccal cusps
- • Teeth extend too far posteriorly
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Burning sensation of the upper lip/ nose
Impingement of the nasopalatine nerves
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Tingling or pain in the lower lip
Pressure over mental foramen
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Sore throat
- Over extension and ulceration of soft palate
- Overextension beyond hamular notch:
- distobuccal of maxillary and
- distolingual of mandibular
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Gagging
- • Posterior border of the maxillary denture too long or thick
- • Distolingual flange of the mandibular denture too long or thick
- • Maxillary occlusal plane too low
- • Mandibular teeth set too far lingual
- • Excessive increase in the vertical dimension
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Difficulty speaking
- • History of corrected speech problems as a child
- • Improper arrangement of maxillary anterior teeth
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Whistle on "s" sound
- • Maxillary anterior teeth set too far labial
- • Insufficient base material on lingual of maxillary anterior teeth
- • Posterior teeth set too far lingual
- • Posterior denture base is too thick
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"S" sound like "sh"
- • Maxillary anterior teeth set too far lingual
- • Excessive base material on lingual of maxillary anterior teeth
- • Posterior denture base is too thin, air escapes from lateral borders of the tongue
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Palatal erythema
- This happens in longer term wear:
- Excessive and long wear of dentures
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Flabby Ridge
Excessive Forces
Loss of bone from the anterior part of the maxillary ridge
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What causes extrusion of the lower anterior teeth?
Lack of posterior occlusion
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Resorption in anterior maxilla is caused by excessive, damaging forces. It may lead to
- • Dislodgment of the maxillary denture
- • Pressure on anterior nasal spine in severe cases
- • Numbness or pain in the anterior maxilla as a result of pressure on incisive nerve
- • Poor esthetics and lack of lip support.
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What is the pre treatment of the combination syndrome
- Tuberosities reduction
- Treatment of papillary hyperplasia
- Flabby ridge reduction in the anterior maxilla
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What is the predictibility of success for
1.Prevention of further bone loss
2. Restoration of posterior occlusion
- 1 is good
- 2 is only Ok if the etiology is not addressed therefore the treatment will be compromised
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How to prevent further bone loss?
- • Placement of implant fixtures “sleepers”
- • Augmentation and implant placement
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What is the drilling technique to place an implant?
- In and out motion
- Don't stop motor
- Drill to desire depth:
- → bur is 1.5 mm longer than desire depth
- → implant is 1 mm longer than desired depth
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What is a flapless flap procedure?
- Is a computer guided surgery that will be using a stent to place the implant without exposing the bone.
- It requires a lot of computer assisted planning.
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What is the maximum RPM of the handpiece when drilling into the bone?
- 800 Revolution Per Minute should be the maximum
- Also it should irrigate saline solution.
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What is the maximum RPM of the handpiece when inserting the implant?
- Use irrigation
- 25 rpm max
- 20-40 Ncm max (low torque)
if implant doesn't sit, remove and use dense bone drill (the one with the threats)
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When manually adjusting and tightening the implant, what is the Ncm (torque)?
35-45 Ncm of final torque.
manually tighten until it reached the final depth
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What are the most common implant complications?
- 1. Loosening of overdenture retention 30%
- 2. Implant loss in irradiated maxilla 25%
- 3. Hemorrhage-related surgical complication 24%
- 4. Resin-veneers fracture on complete arch FPD 22%
- 5. Implant loss with maxillary overdenture 19%
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