denture trouble

[Hayden40]

Hi everyone,

This morning I was so confused because I have denture problem its deffrent than the others.
I finished full upper denture and RPD for the lower in the past two week.
The patient showed up today and she saied that she is loosing the top suction and fells down when the patient talks or bites the dector and I checked the flange it was a little bit over I reduced it the patient feels better and the denture doesn't fell down, but i think something els might be makes the denture fell down.
What do you think about that specially when the patient chews side way.

thank you

 

[JKraver]

Hi everyone,

This morning I was so confused because I have denture problem its deffrent than the others.
I finished full upper denture and RPD for the lower in the past two week.
The patient showed up today and she saied that she is loosing the top suction and fells down when the patient talks or bites the dector and I checked the flange it was a little bit over I reduced it the patient feels better and the denture doesn't fell down, but i think something els might be makes the denture fell down.
What do you think about that specially when the patient chews side way.

thank you

Reline, make sure you have a proper palatal seal. Flat wide palate? Non retentive ridge? If so you could try a luckman post dam.

 

[JKraver]

Reline, make sure you have a proper palatal seal. Flat wide palate? Non retentive ridge? If so you could try a luckman post dam.

Could also be occlusion based. Were proper excursions run through? Are their balancing contacts?

 

[Doris A]

Was her impression for the denture taken in the morning? Sometimes patients tissues are swollen in the morning and when the final denture is seated it winds up being loose.

 

[Hayden40]

after i trimmed and reduced the flange, I asked the Dr. to make the soft reline to check for one week then I will make the hard one.
the suction its really good as long as the patient doesn't speak even when i try to remove the denture off from the patient's mouth that makes me confuse.

 

[kcdt]

after i trimmed and reduced the flange, I asked the Dr. to make the soft reline to check for one week then I will make the hard one.
the suction its really good as long as the patient doesn't speak even when i try to remove the denture off from the patient's mouth that makes me confuse.

You're on the right track with tissue conditioning.
Make sure the bead of the PPS doesn't cross over the hamular notch.
Check your occlusion.

 

[JKraver]

Sounds to me like a PPS issue

 

[araucaria]

xerostomia?

 

[JKraver]

xerostomia?

Nice! A little out of the box.

 

[Yourgoes]

It's a real pain to deal with Xerostomia. Artificial saliva is only so effective. Sjögren's syndrome patients and people who have had radiation therapy are some of the hardest to treat. Besides the challenges with suction, if anything causes the denture to move (occlusal or overextension) it can easily damage the dry tissues because of the lack of lubrication. It's akin to your car engine not having oil.

 

[araucaria]

Hi everyone,

This morning I was so confused because I have denture problem its deffrent than the others.
I finished full upper denture and RPD for the lower in the past two week.
The patient showed up today and she saied that she is loosing the top suction and fells down when the patient talks or bites the dector and I checked the flange it was a little bit over I reduced it the patient feels better and the denture doesn't fell down, but i think something els might be makes the denture fell down.
What do you think about that specially when the patient chews side way.

thank you

Agree with JKraver about the posterior seal, and perhaps the patient is contributing to instability with a protrusive biting position from old habit. PPS can be checked with a temporary application of impression compound or wax, or even some silicone putty or heavy, then converted to a hard addition if successful.
Chewing is normally up and down only. A combination of teeth & tongue to manage mastication. If the patient is chewing sideways then I'd say that's not normal and perhaps they can try to relearn their eating movements (practice, practice....) It could be that the patient is destabilising the denture by their chew technique/habit. Seen this plenty of times, sometimes circular slide motion, left & right, slide and sometimes it's also anterior/posterior shifts like sheep or camel.

 

[denturist-student]

You may need to ask the dr to do a functional impression....Reline with Tempo or alternative tissue conditioner for a few days and then reline....Some cases I will just reline and leave the tissue conitioner in place and replace it every six months to a year...Best TC is Tempo but it has a bitter aftertaste...You can't just do a regular reline. Far better to make a model and mount it on a reline jig and then do the first press with Tempo or alternative material untill it sets up a bit....A bit more work but far superior result that way....See vitalearning.com and look at the Turbyfill technique for doing relines and tissue conditioning. He uses Hydrocast however does his first layer on the ridge with microseal....I have done just that and it works quite well...Using the hydrocast you will get a beautiful impression....and far more accurate...then process using Ivobase or ivocap. You do not want to do all that work and just press it....