AL Advanced proth

  1. 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
  2. Maxillary denture drops when the patient opens wide
    • Posterior borders too thick
    • Posterior borders too long
    • Interference with the coronoid process by distobuccal flange
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. Sore on areas
    • Excessive pressure areas
    • • Over extensions
    • • Errors in occlusion
    • • Insufficient relief over undercuts
  9. Non-specific pain
    • • Pressure over zygomatic process
    • • Distobuccal border of denture base too wide
  10. 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
  11. Burning sensation of the upper lip/ nose
    Impingement of the nasopalatine nerves
  12. Tingling or pain in the lower lip
    Pressure over mental foramen
  13. Sore throat
    • Over extension and ulceration of soft palate
    • Overextension beyond hamular notch:
    • distobuccal of maxillary and
    • distolingual of mandibular
  14. 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
  15. Difficulty speaking
    • • History of corrected speech problems as a child
    • • Improper arrangement of maxillary anterior teeth
  16. 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
  17. "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
  18. Palatal erythema
    • This happens in longer term wear:
    • Excessive and long wear of dentures
  19. Flabby Ridge
    Excessive Forces
    Loss of bone from the anterior part of the maxillary ridge
  20. What causes extrusion of the lower anterior teeth?
    Lack of posterior occlusion
  21. 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.
  22. What is the pre treatment of the combination syndrome
    • Tuberosities reduction
    • Treatment of papillary hyperplasia
    • Flabby ridge reduction in the anterior maxilla
  23. 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
  24. How to  prevent further bone loss?
    • • Placement of implant fixtures “sleepers”
    • • Augmentation and implant placement
  25. 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
  26. 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.
  27. 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.
  28. 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)
  29. 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
  30. 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%
Card Set
AL Advanced proth
Remount, Dowel, Immediate denture, relining and rebasing, perio of implants, QA, post insertion problems, combination syndrome, oseointegration, maxillofacial prosthesis, cad-cam zirconia, implants complications, cad-cam implats