PRE PROSTHETIC PREPARATION OF THE DENTURE FOUNDATION

METHODS OF MOUTH PREPARATION Non surgical methods Treatment of abused soft tissues Rest of denture supporting tissue Occlusal correction of old prosthesis Good nutrition Conditioning of patient musculature

Rest of denture supporting tissue Removal of prosthesis from the mouth. Tissue conditioner. Regular finger massage of denture bearing mucosa. Occlusal correction of old prosthesis Correction of loss vertical dimension of occlusion.

Conditioning of patient musculature Good nutrition Great attention to geriatric patients. Conditioning of patient musculature Jaw exercise to facilitate the jaw relation records.

METHODS OF MOUTH PREPARATION II. surgical methods a. Conditions involving the oral mucosa b. Conditions involving the bone

a. Conditions involving the oral mucosa Denture fissuratum Multiple hyperplastic tissue associated with an old denture It looks like leaves of a book. Mostly requires surgical removal.

a. Conditions involving the oral mucosa 3. Granular hyperplasia Resorption of the alveolar ridge leading to excessive pressure bear on the center of the palate. fungicides such as nystatin, clotrimazole in the usual doses for oral candidiasis. Good oral and denture hygiene may help. The denture should fit well and not be worn at night. In cases of excessively redundant papillary hyperplasia, surgical reduction may provide a better denture base.

a. Conditions involving the oral mucosa 2. Flabby fibrous ridges Lack of bony support on palpation and displaceable on pressure. Mainly due to lateral stresses and excessive bone resorption (ex. Single upper denture opposing class I mandibular foundation). Advanced periodontal disease and bone resorption prior to extraction.

a. Conditions involving the oral mucosa 4. Frenal attachments Frenum close to the crest Frenectomy

a. Conditions involving the oral mucosa 5. Sulcus deepening (vesibuloplasty) Related to reduction in the ridge height Designed stent (modified old denture) to reduce post-operative scaring.

b. Conditions involving the bone Retained roots and unerupted teeth Pathological changes. Remaining tooth with no alteration in the follicular cavity or surrounded bone not removed. If amelobastic transformation detected showed be removed.

b. Conditions involving the bone 2. Maxillary tubrosity. Severe undercut covered with a thin layer of mucous membrane surgical correction. bulbous portion very close to the mandible composed of soft tissue removal of soft tissue

b. Conditions involving the bone 3. Bony prominence (tori, exostosis, undercuts) Mandibular tori severe undercut and improper porder seal. Maxillary tori removed if: very large and interfere with stability. extend to junction of hard and soft palate and interfere with palatal seal. Patient concern because of cancerophopia.

Bony specules or exostosis relief or removed surgically (alveoloectomy). Undercuts are removed only if interfere with path of insertion and removal or with stability of the denture.

b. Conditions involving the bone 4. Knife edge ridge Soft liner on the fitting surface or surgical roundation of sharp margin. 5. Abnormal jaw relation Mandibular osteotomy to create proper alignment and improve the esthetic.

b. Conditions involving the bone 6. Reduced residual ridge Ridge augmentation, implants or ridge distraction.