DentureTroubleShootingGuide

Comfort
Discomfort Sorespotinvestibule upperorlowerdenture Sorespotinupperpost dam. (posteriorlimitofupper) Singlesorespotsonthe crestoftheridge 1. 2. 1. 2. 3. 1. 2. 3. 4. Causes Overextendedborders Roughspotinbase Postdamtoodeep Sharpedgesontheposteriorseal Overextension Prematureocclusion Inaccuratedenturebase Voidsorporosityinacrylic Nodulesunderbase Solutions 1. Shortenbordersandpolish. 2. Refinishborders. 1. Reducebasecarefullyandgraduallytoavoidlossoftheborder seal. 2. Sameasabove,makesurepostdamisonsofttissue. 3. Sameasabove. 1. Newcentricregistrationoraccuratebite.Remountdentureson articulatorandadjust. 2. Takewashimpressionandrebaseaftertissuetreatment. 3. Sameasabove. 4. Removenodules. 1. Remake1ofthedenturestocorrectvertical,ifplaneof occlusioniscorrect. 2. Tryawashimpressionandrebase,orremakedentureafter tissuetreatment. 3. Seesolutions1a,1b,1cfromsolutionswhenoccludingin centric. 1. Recheckverticalandcentric.Rearticulateandremovethe interferingcuspsorchangetononinterferingteeth. 2. Shortenandpolishflange. 3. Removesecondmolars. 1. Rearticulateandchangetoothposition. 2. Shortenflangeandrepolish. 3. Recheckverticalandcentric.Checklingualflanges,shorten.

Generaloverallsorenesson ridge

1. Verticalopentoomuch 2. Totallyinaccuratedenturebase 3. Malocclusionorimproperinterdigitation

Soreunderlowerlingual flange

1. Centricoff,masticationdriveslowerforward 2. Lingualflangeoverextended 3. Posteriorstoofardistal 1. Toomuchoverbite 2. Overextendedlabialflange 3. Whenmasticatingpatientthrowslowerforward

Soreunderlowerlabial flange

BurningSensation*
Discomfort Burningfeelingonhardpalateareaoronlower anteriorridge Burningfeelinginbicuspidareatotuberosities Burningfeelingonupperanteriorridge Causes Highpressureareaintheacrylicbase* Highpressureareaintheacrylicbase* Pressureonpapillaandrugaearea* Solutions Locatethehigharea,removeandpolish. Sameasabove,grindfirstbicuspidoutofocclusion. Relieve.

*Burningsensationsareusuallycausedbypressureonanerveasitleavesnasopalatineorbyundercuredbases.Diabeticsexperienceburningoccasionally.

 BitingCheeksandTongue
Discomfort Keepsbitingcheeksand/ortongue Causes 1. Posteriorteethsetendtoend 2. Overclosed 3. Posteriorteethsettoofartothe lingualorbuccal

Solutions 1. Rearticulateandresetposteriors(waxtryinhighly recommended). 2. Rearticulateandresetallteethopeningbite. 3. Rearticulateandresetposteriorteeth.

RednessofTissue
Discomfort Tissuegettingredindenturebearingarea Causes 1. Illfittingdenturebase 2. Impropercureofdenturebase 3. Aviaminosis Denturebaseallergy(extremelyrare) Solutions 1. Takeawashimpressionandrebasedenture.Checkfor prematuritiesintheocclusion. 2. Rebase(heatcureacrylic). 3. Prescribevitamins. Changebasematerialbyhavinglabjumpavinylbasematerial. Removeallacrylicteethandreplace.Apatchtestshouldbe taken.

Alltissuesbecomingfieryredincludingcheeks andtongue

PaininMandibularJoint
Discomfort PaininMandibularjoint 1. 2. 3. 4. Causes Verticaloverclosed Centricrelationoff Arthritis Trauma 1. 2. 3. 4. Solutions Rearticulateandresetallteethtoopenbite. Takeintraoraltracingandreset.Retrialadvised. Consultpatientsdoctor Difficulttocorrect.


Instability
Instability Whennotoccluding 1. 2. 3. Causes Overextensionofbordersandposteriorlimits Underextendedborders Lossofpostdamseal a. Postdamonhardpalate b. Postdamnotoverhamularnotches c. Insufficientpostdam Dehydrationoftissueduetoalcoholismormedication. Flabbytissuesdisplacedwhentakingimpressiondueto impropertray. Lossofpostdamseal Anteriorteethtoofarlabially Flabbyanteriortissue Improperincisinghabits Lowerposteriorssetoffridge Solutions Inallcasesanewimpressionisnecessary.Besttogrindout thetissuesideandtakeawashimpression,usingcompound wherenecessarytoextendimpressiontoincludepostdam area.Rebaseentiredenture.

4. 5.

Whenchewingfood

1. 2. 3. 4. 5.

Whenoccludingincentric

1. Malocclusion a. Prematureindividualteethhitting b. Highocclusionononesideofarch c. Bicuspidareaprematurecontact 2. Upperdentureridingonhardpalatesurface 3. Flabbytissuesoverridge 4. Teethsettoofarbucally 5. Centricocclusionnotinharmonywithcentricrelationship

1. Sameasabove. 2. Remountandresetbringinganteriorsbacklingually. 3. Surgerytoremovepoordenturefoundationand rebase. 4. Patienteducationistheanswer. 5. Resetandcorrectposterioralignment. 1. a.Remountgrind,andmillinselectiveteeth. b.Remountandreset. c.Trychairsidemillinorremountandset. 2. Relievepressurearea 3. Removeflabbytissuewithsurgeryandrebase. 4. Remountandresetlingual. 5. Remakeonedenture.

 Interference
Interference Whenswallowing Causes 1. Upper a. Overextensionintheposteriorbuccalflanges b. Toothickinlingualposteriorflanges 2. Lower a. Overextensioninthelingual b. Toothickinposterior 3. Overclosedvertical 4. Toomuchvertical 5. Posteriorstoofarlingual,crowdingtongue Solutions 1. Upper a. Carefullyreducedistalbuccalflange. b. Adjustbythinningdenturesfromtheoutside,not thetissueside. 2. Lower a. Carefullyreduceflange b. Reducefromoutsidedonotgrindtissueside. 3. Remountandreset,correctingvertical. 4. Sameasabove. 5. Remountandresetopeningarchtoallowmore tongueroom.

Gagging
Gagging Immediateoninsertion Causes 1. Upper:Overextensiontoothickposteriorborder 2. Lower:distallingualflangetoothick Solutions 1. Denturemustbedoublepostdammedandcutback toanteriorpostdam. 2. Carefullyreducefromtheoutside.Donotgrindtissue side. 1. Grindoutpostdamareaandtakewashimpression forlabrebase. 2. Remountandmillin,sometimesnecessarytoreset theteeth.

Delayedgagging:2weeks to2monthsafterdelivery

1. Faultypostdamallowingsalivaunderdenture 2. Malocclusionallowingdenturetoloosencausessaliva seepage

Esthetics
Esthetic Toobulkyundernose Sinkinginundernose 1. 2. 1. 2. Causes Labialflangeofuppertolongortoothick Upperanteriorteethsettoofarout Upperlabialflangeneedsmorebulk Upperlabialflangeneedsmorelength Solutions 1. Reducebulkand/orlengthandrepolish. 2. Resetanteriorslingually. 1. Addwaxtobuilduptopropercontourandhavelabbuild outbase. 2. Grindouttissuesideoflabialflange,addcompound borderandtakewashimpression. 3. Resetanteriorsforlipsupport. Addwaxonteethtopropercontourandhavelabsetteethmore labialforlipsupport. 1. Havelabresetallteethclosingvertical.Maintainesthetics bydeterminingtoraiseorlowerupperorlowerteeth. 2. Havelabresetallteethraisingocclusalplane. 3. Replacecuspidsandlateralswithsmallerteethandrotate themin. 4. Resetteethbacktoridge. 1. Trysculpturinganteriorincisalstogiveabraded appearance.Rotateandstaggerteethinsetup. 2. Changetocharacterizedanteriorteeth. 3. Havelabprocessnewbasewithanatomicalfinishand characterizedbase.

Upperlipsinksintoofar Showstoomuchteeth

Upperanteriorteethsettoofarlingual 1. 2. 3. 4. Verticaltoogreat. Occlusalplanetoolow Cuspidsandlateralssettooprominent Upperanteriorteethsetouttoofar

Justlookstoofalse

1. Settooregular;techniquetypesetup 2. Allteethappeartobethesameshade 3. Nogingivalcontouringorstaggeringofgingival depth.

Phonetics*
PhoneticSound WhistleonSsound Causes 1. Notenoughroomfortonguebetweenupper bicuspids 2. Spacebetweencentral Toomuchspacefortonguebetweenupperbicuspids 1. Notenoughroomindenturesfortongue 2. IfThandTsoundaliketheanteriorsaretoo farlingual Improperpositionofupperanterioreitherverticallyor horizontally. Solutions 1. Removeandmovebicuspidstothebuccalorifroom grindoutmoreareaforthetongue. 2. Closespace. Narrowpalatespacebetweenupperbicuspidsbyaddingledgeof acrylic. 1. Thinoutdenturesfromlingualsidesdontgrindtissue side. 2. Remountandmoveanteriorsouttothebuccal. Difficultadjustmentmustdecodeandtrytocorrect.

LispingonSsound ThandTsoundsindistinct

FandVsoundindistinct

*Phoneticsoundsdonotreacttoaregulartrialbaseplatethesameasthefinaldenture.Aunibaseonyourtryinwillduplicatefinaldenturephonetics.