Prosthodontic Treatment for Edentulous Patients: Complete Dentures and Implant-supported Prostheses

Front cover......Page 1
Inside front cover......Page 2
Prosthodontic Treatment for Edentulous Patients......Page 3
Copyright page......Page 6
Dedication......Page 7
Contributors......Page 9
Preface......Page 11
Acknowledgments......Page 12
Table of Contents......Page 13
  Historical Context and Current Considerations......Page 15
  Biomechanical Support for  the Natural Dentition......Page 18
   Mucosal Support and Masticatory Loads......Page 22
  Natural and Prosthetic Dental Occlusion: Functional and Parafunctional Considerations......Page 23
   Parafunctional Considerations......Page 28
  Changes in Morphological  Face Height and  the Temporomandibular Joints......Page 29
  Esthetic Changes......Page 32
  Behavioral and  Adaptive Responses......Page 35
  Treatment Options:  Complete Dentures......Page 36
  Treatment Options:  Implant Prosthodontics......Page 37
  Bibliography......Page 41
   Burning Mouth Syndrome......Page 42
  Oral Movement Disorders......Page 43
   Sjögren’s Syndrome......Page 44
  Nutrition and the Impact of Dental Status on Food Intake......Page 45
   Dietary Counseling of  Patients Undergoing Prosthodontic Treatment......Page 46
  References......Page 47
   Impact......Page 49
   Bone......Page 50
  Nutrition......Page 51
   Teeth......Page 52
  Concerns for Personal Appearance in Old Age......Page 53
  References......Page 54
  Direct Sequelae: Changes in Local Mucosal Morphology......Page 56
   Denture Stomatitis......Page 58
    Etiology and Predisposing Factors......Page 59
    Management and Preventive Measures......Page 61
   Residual Ridge Reduction......Page 62
   Nutritional Status and Masticatory Function......Page 64
  References......Page 65
  Bibliography......Page 66
    Patient Attitude......Page 67
    Social and Behavioral Information......Page 68
    Psychological Considerations......Page 69
    Systemic Health Status......Page 70
    Temporomandibular Joint......Page 71
     Cheeks and Lips (Fig. 5-1)......Page 72
   Intraoral Examination......Page 74
    Mucosa (Figs. 5-2 and 5-3)......Page 75
    Infection (Fig. 5-5)......Page 77
    Tongue (Fig. 5-6)......Page 78
    Bone Ridge Morphology......Page 80
    Bony Undercuts (Fig. 5-8)......Page 81
    Arch Relations......Page 82
   Existing Dentures (Fig. 5-10)......Page 83
   Additional Considerations with the Partially  Dentate Patient......Page 86
    Radiographic Images (Fig. 5-13)......Page 88
   Diagnostic/Study Casts......Page 90
   Preprosthetic Nonsurgical Methods......Page 91
    Managing Traumatized Tissues......Page 92
   Preprosthetic Surgical  Methods......Page 93
     Bony Prominences, Undercuts,  Spiny Ridges, and Tori......Page 94
     Pressure on the Mental Foramen......Page 97
     Ridge Parallelism......Page 98
     Vestibuloplasty......Page 100
   Summary......Page 104
   Improving Denture-Bearing Foundations for  Edentulous Patients......Page 106
   Maladaptive Denture Behavior......Page 107
   The Scientific Era in Implant Prosthodontics......Page 109
   Patient Considerations......Page 112
   Summary......Page 115
  The Potentially Edentulous Patient to be Treated with Overdentures......Page 116
    Group 1......Page 121
    Group 2......Page 122
   Selection of Abutment Teeth......Page 123
   Methods and Techniques for Enhancing the Overdenture’s Retentive Role......Page 124
   Loss of Abutment Teeth......Page 125
  The Potentially Edentulous Patient to be Treated with Immediate Dentures......Page 126
   Advantages and Disadvantages of Immediate Denture  Treatment......Page 127
    Oral Examination......Page 128
    Tooth/Teeth Modifications......Page 130
    Prognosis......Page 131
   Considerations for Implant Prosthodontic Treatment......Page 132
   Immediate Dentures for Potentially Edentulous Patients......Page 133
 7 Materials Used in the Management of Edentulous Patients......Page 135
  Impression Materials......Page 136
    Zinc Oxide Eugenol (ZOE) Impression Paste......Page 137
     Important Considerations for Proper Use  of Impression Compound......Page 138
      Composition and Manipulation of Agar (Box 7-5).......Page 139
      Technical Considerations in the Manipulation  of Alginates......Page 140
   Elastomeric Impression Materials......Page 141
    Condensation Silicone (Box 7-8)......Page 142
    Addition Silicones (Box 7-9)......Page 143
    Polyether Impression Materials......Page 144
    Disinfection of Elastomeric  Impression Materials......Page 145
  Polymeric Denture  Base Materials......Page 147
    Rapid-Cure Type Resins......Page 148
    Residual Monomer Content......Page 149
    Pour or Fluid Resin Technique......Page 150
    Light-Activated (VLC) Resins (Box 7-15)......Page 152
   Methacrylate-Based (PMMA)  Resin Teeth......Page 153
    Additional Advantages and Disadvantages  of Methacrylate Resin Teeth......Page 156
    Additional Advantages and Disadvantages  of Porcelain Teeth......Page 157
  Denture Lining Materials......Page 158
   Short-Term Soft Liners  (Tissue Conditioners)......Page 159
   Self-Administered Home Relines*......Page 160
    Chemically Activated Methacrylate Resins......Page 161
     Chemically Activated Silicone Liners (Room Temperature Vulcanized [RTV] Silicones).......Page 162
   Technical Considerations......Page 163
    Chemical Properties......Page 165
  Denture Cleansers......Page 166
   Cleansing and Disinfecting......Page 167
    Ultrasonic Units......Page 168
  Denture Adhesives......Page 169
   Indications and Contraindications  for Denture Adhesive......Page 170
  Summary......Page 172
  Bibliography......Page 173
  Anatomy Of Supporting Structures......Page 175
   Residual Ridge......Page 176
  Maxilla......Page 177
   Peripheral Border Tissues  And Contours......Page 178
  Mandible......Page 179
   Peripheral Border Tissues  And Contours......Page 181
  Principles And Objectives  Of Impression Making......Page 184
   Impression Procedures......Page 185
  Preliminary Impressions:  Trays, Materials, Technique......Page 186
  Final Impressions: Trays, Materials, Technique......Page 187
   Posterior Palatal Seal......Page 190
   Boxing Impressions  And Making The Casts......Page 192
  Bibliography......Page 193
 9 The Dentures’ Polished Surfaces, Recording Jaw Relations, and Their Transfer to an Articulator......Page 194
  Neutral Zone or Arch  Form Design......Page 196
   Mandibular Arch......Page 198
   Maxillary Arch......Page 200
  Level or Height of  the Occlusal Plane......Page 202
   Esthetics......Page 204
   Phonetics (See Chapter 15)......Page 205
  The Preliminary Centric Relation Record (Box 9-1)......Page 206
   Facebow......Page 209
   Laboratory Steps......Page 210
  Articulators......Page 211
   Interocclusal Records......Page 212
   Hinge-Axis Records......Page 213
    Condylar Elements (Fig. 9-14, A)......Page 214
    Incisal Elements (Fig. 9-14, B and C)......Page 215
  Bibliography......Page 216
  On Meeting Patient  Expectations When  Selecting Teeth......Page 218
  On Guiding Patient Decisions......Page 219
  Posterior Tooth Molds  and Cuspal Anatomy......Page 222
  The “Standard Anterior” Arrangement......Page 223
   Arranging the Mandibular Anterior Teeth (Fig. 10-9)......Page 224
    Mandibular Central Incisor Positions......Page 225
    Maxillary Central Incisors......Page 226
    Maxillary Canines......Page 228
   Lingualized Articulation......Page 229
    Arranging Maxillary Posterior Teeth  to Lingualized Articulation (Fig. 10-15)......Page 233
    Evaluating Bilateral Balanced Articulation......Page 235
   Arranging Nonanatomical Teeth To Monoplane Articulation (Fig. 10-17)......Page 236
   Arranging Nonanatomical Teeth To Balanced Articulation (Fig. 10-19)......Page 237
  Setups For Retrognathic and Prognathic Facial Skeletons......Page 239
   The Lingual Look Test (Fig. 10-23)......Page 240
   Completing The Wax-Up For  The Try-In Appointment (Fig. 10-24)......Page 241
  Bibliography......Page 243
  Before The Try-In Appointment......Page 244
   Chairside Comparison......Page 246
   Denture Comparison......Page 247
  The Real Try-In......Page 248
   Speaking And Phonetic Assessment......Page 249
   Vertical Dimension Of Occlusion......Page 250
   Relaxing and Rehearsal  of a Relaxed Jaw Closure......Page 253
   Double-Base Stabilization  for Try-In Assessment  (Fig. 11-14)......Page 255
   When Is A Remount Needed?......Page 256
    Remount at Correct Vertical Dimension  (Fig. 11-18)......Page 257
    The Interappointment Laboratory Procedure for the Wax Try-in Remount (Fig. 11-19)......Page 260
    The Next Level: Characterization of Individual Tooth Colors and Position......Page 262
  Establishment of the Posterior Palatal Seal (PPS)......Page 263
  Final Decision Making  and Closure......Page 266
   The Laboratory Prescription......Page 267
  Bibliography......Page 268
   Development of the Proper Forms of the Polished Surfaces......Page 269
   Formation and Preparation  of the Mold......Page 271
   Laboratory Remount  and Equilibration (As # 2 Remount in Table 11-2)......Page 277
   Removing Processed Dentures from the Master Casts......Page 278
   Hydrate the Dentures......Page 279
   Adjustment of Denture Base......Page 281
   Clinical Remount and  Occlusal Equilibration  (As #3 Remount in Table 11-2)......Page 282
   Protrusive Record (Optional)......Page 283
    Eliminating Occlusal Errors  in Anatomical Teeth......Page 285
   Advantages of Balanced Occlusion in Complete Dentures......Page 286
    Mastication with New Dentures......Page 287
    Oral Hygiene with Dentures......Page 288
   Twenty-Four-Hour Oral Examination and Treatment......Page 289
    Adjustments Related  to the Denture Bases......Page 290
   Subsequent Oral Examinations and Treatments......Page 292
  Bibliography......Page 294
  Immediate Dentures......Page 295
   Posterior Palatal Seal......Page 296
   Maxillomandibular  Relationship Records......Page 298
   Laboratory Procedures......Page 301
   Postoperative Care......Page 303
  Overdentures......Page 304
   Treatment Planning  for Overdentures......Page 307
   Retention......Page 308
   Tooth-Supported Immediate Complete Denture......Page 309
   Diagnosis and Treatment Planning......Page 312
   Teeth Arrangement......Page 313
  Summary......Page 315
  Bibliography......Page 316
  Treatment Rationale......Page 317
  Diagnosis......Page 318
  Preliminary Treatment......Page 320
   Static Impression Technique......Page 323
   Functional Impression Technique......Page 324
   Relining/Rebasing Materials......Page 325
  Repairs......Page 326
  Denture Duplication  (see Chapter 23)......Page 327
  Bibliography......Page 328
  Speech Production......Page 329
  Speech Production: The Role  of Teeth and Other  Oral Structures......Page 330
   Linguodental Sounds......Page 331
    Auditory Characteristics......Page 332
   Linguopalatal and  Linguovelar Sounds......Page 333
  Prosthetic Considerations......Page 334
  Bibliography......Page 335
  Osseointegrated Interface......Page 337
   Implant Design......Page 338
   Implant Surface......Page 340
   Host Bed......Page 341
   Surgical Technique......Page 342
  Bibliography......Page 343
  General Overdenture  Treatment Considerations......Page 344
  Presurgical Evaluation  and Treatment Planning......Page 345
  Surgical Protocol and  the Osseointegration Phase......Page 348
   Guidelines for Selecting Attachment Systems......Page 349
   Clinical and Laboratory Procedures......Page 350
  Maintenance......Page 352
  Bibliography......Page 353
  Patient Selection......Page 354
    Step-by-Step Procedures......Page 356
  The Edentulous Maxilla......Page 359
  Summary......Page 362
  References......Page 363
   Anatomic and Physiologic Considerations:  Normal Function......Page 365
   Functional Deficits of Speech and Swallowing......Page 366
   Border Molding The Velopharyngeal Area:  Patient Movements......Page 367
   Border Molding Peripheries  of Maxillary Resections  and Hard Palate Defects:  Patient Movements......Page 368
   Immediate Surgical  Obturator Prosthesis......Page 369
   Interim Obturator Prosthesis......Page 370
   Definitive Obturator Prosthesis......Page 372
    Lack of Retention......Page 374
    Nasal Reflux......Page 375
  Soft Palate Obturator Prosthesis......Page 376
   Informing The Patient......Page 379
   Marginal Mandibulectomy Prostheses......Page 380
   Discontinuity Mandibulectomy Prostheses......Page 381
  Maxillofacial Implant-Assisted Prostheses For The  Edentulous Patient......Page 383
   Risks and Benefits  Assessment of Implants  In Irradiated Tissues......Page 384
    Hyperbaric Oxygen Therapy......Page 386
    Timing of Denture Placement......Page 387
  Bibliography......Page 388
  Problems......Page 390
    At Stage I Surgery......Page 391
    Interval Between Stage I and Stage II......Page 393
    Abutment Related......Page 394
    Impression Related......Page 395
    Implant-Supported Fixed Prosthesis......Page 396
    Mechanical/Prosthodontic Complications......Page 397
  Bibliography......Page 399
 21 Immediately Loaded Complete Dental Prostheses......Page 401
  Immediate Load Complete Denture Technique......Page 403
  References......Page 407
  Systemic Health and Host  Bone Response......Page 409
   Smoking......Page 412
   Osteoporosis......Page 413
   Bisphosphonate Therapy......Page 414
  Imaging Protocol......Page 415
   Bone Quality......Page 416
  Prosthodontic Loading......Page 417
  Oral Ecological Concerns......Page 420
  Summary......Page 421
  Bibliography......Page 422
 23 The Impact of Socioeconomic, Cultural, and Technological Changes and the Notion  of Standards of Care and Alternative Protocols......Page 423
  An “Appropriatech” Method  For Complete Dentures In  Four Clinical Sessions......Page 424
    Impressions......Page 425
    Recording the Horizontal Jaw Relationship......Page 426
  Reproducing Complete Dentures......Page 430
   First Clinical Session......Page 431
   First Laboratory Session......Page 432
  References......Page 433
  Bibliography......Page 434
 A......Page 435
 B......Page 437
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 I......Page 447
 L......Page 449
 M......Page 450
 O......Page 454
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 Z......Page 466