Clinical Removable Prosthodontics Forth Year

1. POST INSERTION PROBLEMS

2.  aap
ne jo waday kiye woh nibhana
aap,meri zindagi ko jannat banan
aap

3. 
All the pateints receving remmovable partial or
complete dentures shoul be seen within 24 hours after
the insertion of the prosthesis.

If potential problems are detected & coreected in their
early stages,the patient may never be subjected to the
pain and discomfort that might other wise occur.

If there are any problems the patient should be
reassured that most problems can be solved rapidly &
simply.

4. COMPLAINTS
1.
2.
3.
Pain or discomfort arising from the hard &
soft tissues of the edentulous ridge
Soreness of one or more teeth.
Miscellaneousa) instabilty of the prosthesis
b) Tongue and cheek biting
c) Speech difficulties
d) Eating difficulties

5. Soft tisue irritation

Laceration or ulceration
-generally produced by an
FIG.1
overextended denture base fig
1.
•
•
•
Complaintsoreness/irritation may or may
not be accompanied with
discomfort.
Diagnosis- areas displaying
increased redness or
tranlucency(just before
ulceration starts) Fig 2
FIG.2

6. 
Degree of overextension can be determined by visual
examination

With the prosthesis in position,the buccal tisssues
should be manipulated in downward,outward,upward
and anterosuperior directions.

If the denture border is overextended,movement of
border tissues will be impeded

If interfernce with movement and a change in soft
tissue cover are evident,the denture flange must be
reduced.

7. Overextension of the denture base on the lingual
aspect of the mandibular edentulous ridge may be
identified and confirmed by manipulation of the
patients tongue
 A forward or lateral thurust of the tongue usally will
disclose the location of overextension.
 Another method is disclosing wax but use with
caution.it is usally used to verify or to isolate an area
that is under suspicion follwing visual observation.
 The use of pip is not genrally indicated.


8. 
Dependable method for identifying an over extesion
is through the use of an indelible pencil. FIG 3&4
FIG 3
FIG 4

9. •Border extension is corrected with a lab bur or
an arbor band FIG 5.
FIG 5
•Warm saline mouth washes 4hly.
•No local anestheticsif pt is seen within 24 hrs.

10. Erythema(redness)

Genrally caused by
Fig 6
-roughness of the
denture base
-by a slight rubbing
movement of the
denture base against
the soft tissues
FIG 6

11. Roughness can be corrected by pressure
indicating paste FIG 7 & 8
FIG.7
FIG 8

12. 
An excellent method of identifying irregularities on
the intaglio surface is to pass a fingertip or gauze pad
over the tissue surface of the resin FIG 9
FIG 9

13. •Redness may also be caused by occlusal
discrepencies or prmaturities.
•This lack of occlusal disharmony is the
greatest factor in prosthesis related discomfort.

14. Irritation to the teeth

After soft tissue irritation has been eliminated,teeth that are in
contact with prosthesis should be evaluated.

With the prosthesis out of mouth,mesial,distal,buccal,and
lingual pressure should be applied to the remainig natural
teeth.pressure can best be applieed using the index fingers of
each hand

If the prosthesis has exerted undesirable forces on one or more
teeth,a painful response will result.

15.  If the pt is seen
within 24 hrs of delivery he
may not be aware of discomfort untill finger
pressure is applied.
 If a longer time
may be painful.
has elapsed,the tooth aor teeth
 Leave the prosthesis ot till discomfort is over.
 Later adjusrtment should be carried.

16.  Use
disclosing wax. fig10
Fig 10
Disclosing wax is displaced
from an area that is
causing pressure

17. 


If soreness or pain is not caused by pressure from RPD the
next obiviuos cause can be occlusal trama.
One of the most common causes of discomfort for a RPD
patient is occlussal interference between a natural tooth in one
arch and the metal of the prosthesis in opposing arch.
Articulating paper is commonly used to locate the portion of
the partial denture causing the interference.11.
11

18. •IT IS DIFFICULT TO IDENTIFY ARTICULATING PAPER
MARKS ON HIGHLY POLISHED METAL SURFACES
12

19. IF ARICULATING PAPER MARKS ARE DIFFICULT TO
IDENTIFY,THE SURFACES OF THE METAL MAY BE
ROUGHENED USING A FINE STONE OR AIR BORNE
PARTICLE ABRASION SYSTEM
13

20. ARTICULATING PAPER MARKS ARE READILY
IDENTIFIED ON A ROUGHENED SURFACE
14

21. ADJUSTMENTS ARE MADE USING A MULTIFLUTED BUR
IN A HIGH-SPEED HANDPIECE
15

22. •A METAL THICKNESS GAUGE IS USED TO EVALUATE
THE THICKNESS OF REMMOVABLE PARTIAL DENTURE
COMPONENTS.
16
RESTS AND CLASPS MUST BE
AT LEAST I MM THICK

23. MISCELLANEOUS COMPLAINTS
GAGGING
 CAUSES
-POOR ADAPTATION

FAILURE TO MODIFY
STOCK TRAY
-FAULTY IMPRESSION TECHNIQUE

24. •AN INDELIBLE PENCIL IS USED TO MARK THE
POSTERIOR BORDER OF A METAL MAJOR CONNECTOR
17

25. •PROSTHESIS SEATED IN THE ORAL CAVITY
18
18

26. THE POSITION OF THE REMOVABLE PARTIAL
DENTURE,S POSTERIOR BORDER IS TRANSFERRED TO
THE PALATAL TISSUES,AND THE PLACEMENT OF
PIOSTERIOR BORDER IS EVALUATED
19
19

27. • AN OVEREXTENDED MAJOR CONECTOR MAY BE
SHORTENED USING A HEATLESS STONE IN A LOW
-SPEED HANDPIECE OR DENTAL LABORATORY ENGINE
20

28. • THE BEAD LINE THAT PREVENTS FOOD FROM
COLLECTING BETWEEN THE MAJOR CONNECTOR AND
THE PALATAL TISSUES HAS BEEN LOST AS A RESULT
OF ADJUSTMENT.THIS MAY NECESSITATE REMAKING
THE RPD
21

29. PROBLEMS WITH PHONETICS
• WHEN PLACED TOO FAR PALATALLY THE
ARTIFICIAL PREMOLARS MAY INTERFERE WITH
SPEECH
22

30. •CORRECTING PROSTHETIC TOOTH PLACEMENT WILL
CORRECT PHONETIC DIFFICULTIES
23

31. CHEEK OR TONGUE BITING
• CHEEK BITE RESULTS IN LINEAR ULCERATION OF
THE BUCCAL MUCOSA
24

32. • CHEEK BITING MAY BE MINIMISED BY ROUNDING
THE MANDIBULAR BUCCAL CUSPS
25

33. • TONGUE TENDS TO FLATTEN AND BROADEN WHEN IT
IS NOT CONFINED BY POSTERIOR TEETH OR
APPROPRIATE PROSTHESES
26

34. o DIFFICULTY IN CHEWING
•THE SURFACES OF ACRYLIC RESIN TEETH MAY
BECOME FLATTENED AND INEFFICIENT BECAUSE OF
POOR POLISHING TECHNIQUE OR PROLONGED WEAR
27

35. ADITIONAL GROOVES AND SLUICEWAYS IMPROVE
MASTICATORY EFFICIENCY
28

36. LOOSE DENTURES
Fatigue or mishandling of clasps
 Adjust or remake
 Long term may need reline


37. THANK YOU