Prosthodontics 3: Complete Denture Prosthodontics Flashcards

A comprehensive set of 100 flashcards covering the biomechanics, morphology, and patient management of the edentulous state and complete dentures.

What does the face embody in terms of social interaction?

Social identities and one of the major vehicles for interpersonal communication.

What is the consequence of facial appearances that depart from culturally acceptable attractiveness?

They have been shown to be disadvantageous to the individual, especially when deviations are significant.

Who perceives negative changes in facial appearance?

The persons affected as well as those around them.

What are dentists managing besides oral biomechanics when treating edentulous patients?

Their individuality.

What does success in treating edentulous patients demand besides technical expertise?

Empathy with the patient’s fears and aspirations.

What factors combine to cause edentulism?

Dental disease together with cultural, financial, and attitudinal determinants, as well as previous dental treatment.

What does the edentulous state represent regarding the masticatory system?

A loss of the integrity of the masticatory system.

Teeth function properly only if they are adequately supported by what structure?

The periodontium.

What is the primary function of the periodontium regarding the bone of the jaws?

It attaches the teeth to the bone of the jaws, providing a resilient suspensory apparatus resistant to functional forces.

Which hard connective tissues comprise the periodontium?

Cementum and bone.

Which soft connective tissues comprise the periodontium?

The periodontal ligament and the lamina propria of the gingiva.

What covers the soft connective tissues of the periodontium?

Epithelium.

How is the periodontium attached to the dentin?

By cementum.

How is the periodontium attached to the jawbone?

By the alveolar process.

What structures maintain continuity between the hard tissue components of the periodontium?

The periodontal ligament and the lamina propria of the gingiva.

What does the periodontium allow teeth to do in response to stress?

Change their positions.

What are the two principal functions of the periodontium?

1. Support and 2. Positional Adjustment of the Tooth.

What is the secondary and dependent function of the periodontium?

Sensory Perception.

What are the three characteristics of physiological occlusal forces exerted on the teeth?

Intermittent, rhythmic, and dynamic in nature.

What mechanisms control the physiological occlusal forces?

Neuromuscular mechanisms of the masticatory system.

What regulates mandibular movements and functional forces transmitted to the periodontal structures?

Reflex mechanisms with receptors in the muscles, tendons, joints, and periodontal structures.

Under what three conditions are teeth in occlusion in healthy dentitions?

During deglutition, occasionally while masticating, and during the clenching and grinding associated with parafunction.

In a $24-hour period$, what is the total calculated time the teeth are subjected to functional forces?

$17.5\,minutes$.

What are the two categories of functional forces of mastication and deglutition?

Vertical forces and Horizontal forces.

According to the calculation, what are the two specific activities that apply direct functional occlusal force in a day?

Mastication and deglutition.

Approximately how many times does deglutition occur per day?

$500x/day$.

How does the duration of tooth contact during swallowing compare to chewing?

Tooth contacts during swallowing are usually of longer duration than those occurring during chewing.

What are the two horizontal forces acting toward the tongue (Linguolabial/Linguobuccal)?

The tongue.

What are the two horizontal forces acting toward the teeth (Labiolingual/Labbiobuccal)?

The lips and cheeks.

Which horizontal forces appear to exceed the other during activity?

Lingual forces appear to exceed buccolabial forces.

What is the approximate surface area of the periodontal ligament in each arch?

$45\,cm^2$.

What three factors allow the dentition to cope with diverse occlusal loading?

Viscoelastic properties, sophisticated sensory mechanisms, and the potential for bone remodeling.

How are the tissues used to support complete dentures characterized in contrast to the periodontium?

They are inherently unsuited to this role.

What is the basic challenge in the treatment of edentulous patients?

The differences between the ways natural teeth and their artificial replacements are supported.

What is the mean surface area of mucosa available for denture support in the edentulous maxilla?

$22.96\,cm^2$.

What is the mean surface area of mucosa available for denture support in the edentulous mandible?

$12.25\,cm^2$.

What is the synonym for the denture-bearing area?

Basal seat.

What happens to the denture-bearing area as residual ridges resorb?

It becomes progressively smaller.

In which directions does the maxillary arch resorb?

Buccal and labially.

What is the result of maxillary arch resorption on its perimeter?

A reduction in perimeter or circumference of the arch.

In which directions does the mandibular arch resorb?

Labial and lingual direction.

What is the result of mandibular arch resorption posteriorly?

Widening of the arch posteriorly.

What ridge relationship develops in longstanding edentulous situations due to arch resorption patterns?

Pseudo-Class III Ridge Relationship.

What is the average masticatory force during occlusion in a natural dentition?

$200\,N$.

What is the average masticatory force during occlusion with a complete denture?

$60$ to $80\,N$.

How do patients with prostheses frequently limit the loading of supporting tissues?

By selecting food that does not require masticatory effort exceeding their tissue tolerance.

What are the four components of the residual ridge?

1) Mucosa, 2) Submucosa, 3) Periosteum, and 4) Alveolar bone.

What is the fate of the alveolar ridge following teeth loss?

Ongoing resorption, resulting in its gradual reduction and virtual disappearance.

What is the first physical factor involved in denture retention controlled by the dentist and technician?

Optimal extension of the denture base.

What is the second physical factor involved in denture retention controlled by the dentist and technician?

Maximally intimate contact of the denture base to its basal seat.

Which muscles play an important role in retaining and stabilizing complete dentures?

Orofacial and tongue muscles.

What is the "neutral zone" in the edentulous mouth?

A zone determined by the functional balance of the orofacial and lingual musculature where artificial teeth are arranged.

What is the first functional difference between natural dentition and complete dentures?

The mucosal mechanism of support as opposed to support by the periodontium.

What is the second functional difference between natural dentition and complete dentures?

The movements of the dentures during mastication.

What is the third functional difference between natural dentition and complete dentures?

The progressive changes in maxillomandibular relations and the eventual migration of dentures.

What is the fourth functional difference between natural dentition and complete dentures?

The different physical stimuli to the sensory motor systems.

List the five types of movements manifested by complete dentures.

Displacing, lifting, sliding, tilting, and rotating.

To what are denture-bearing tissues constantly exposed during function?

Frictional contact of the overlying denture bases.

How is bruxism defined?

An increase in the tonic activity in the jaw muscles (tooth grinding).

What psychosocial factors may cause bruxism?

Stress, anxiety, or reactions to strong emotions like anger and frustration.

Which specific medical conditions are associated with bruxism?

Oral tardive dyskinesia and Parkinson’s Disease.

What two biological processes determine the morphological changes in the maxilla and mandible over years?

The balance of osteoblastic and osteoclastic activity.

What causes the reduction in the vertical dimension of occlusion in edentulous patients?

Resorption of the residual ridges supporting complete dentures.

The reduction in vertical dimension of occlusion tends to cause a decrease in what?

Total face height.

What appearance results from the reduction of total face height in edentulous patients?

Mandibular prognathism.

What happens to the nasolabial groove in the edentulous state?

It deepens.

What occurs to the labiodental angle due to the edentulous state?

Loss of labiodental angle.

What happens to the horizontal labial angle in the edentulous state?

Decrease in horizontal labial angle.

Describe the change in the lips associated with the edentulous state.

Narrowing of lips.

What happens to the columella-philtral angle in the edentulous state?

It increases.

What general appearance change is associated with the edentulous state and vertical dimension loss?

Prognathic Appearance.

How are edentulous patients often expected to adapt to their dentures?

More or less instantaneously.

What states must be considered regarding a patient's adaptation to dentures?

Oral, systemic, emotional, and psychological states.

Successful management of edentulous patients begins with what identification?

Identification of anticipated difficulties before treatment starts.

What is the purpose of careful planning before starting treatment?

To meet specific needs and problems.

What three skills must dentists train themselves in during patient interaction?

Reassure the patient, perceive their wishes, and know how and when to limit the patient’s expectations.

What process accompanies the acceptance of complete dentures?

Habituation.

How is habituation defined?

Gradual diminution of responses to continued or repeated stimuli.

What are the two primary treatment options listed for the edentulous state?

Complete Denture or Implant Supported Prosthesis.

What are the two major categories of consequent effects of tooth loss?

Morphological changes and behavioral and adaptive responses.

What does cementum attach the periodontium to?

Dentin.

What connects the hard tissue components of the periodontium?

The periodontal ligament and the lamina propria of the gingiva.

Is the periodontium resistant to functional forces?

Yes, it is a resilient suspensory apparatus resistant to functional forces.

What regulates functional forces transmitted to periodontal structures?

Reflex mechanisms.

How many minutes of functional mastication and deglutition occur in a day?

$17.5\,minutes$.

What happens to the perimeter of the maxillary arch as it resorbs?

It reduces.

What happens to the width of the mandibular arch posteriorly as it resorbs?

It widens.

Is mucosal support better or worse than periodontal support for masticatory loads?

Inherently unsuited (worse).

Which arch has a smaller mean surface area for denture support?

The edentulous mandible ($12.25\,cm^2$).

What is the unit of measure used for masticatory force?

Newtons ($N$).

What is the result of tooth grinding activity?

Bruxism.

What is oral tardive dyskinesia?

A medical condition that may result in bruxism.

What is the name for bone-building activity?

Osteoblastic activity.

What is the name for bone-resorbing activity?

Osteoclastic activity.

How long does it take for morphologic bone changes to occur?

Slowly over a period of years.

What leads to a pseudo-Class III ridge relationship?

Confinement of the maxillary arch within the mandibular arch in longstanding edentulous situations.

What describes the decrease in responses to repeated stimuli?

Habituation.

Which muscle group determines the neutral zone along with the tongue?

Orofacial muscles.

Why do complete denture patients select specific foods?

To avoid exceeding their tissue tolerance.

What specific facial groove deepens in the edentulous state?

Nasolabial Groove.