BOOK
Prosthodontic Treatment for Edentulous Patients - E-Book
George A. Zarb | John Hobkirk | Steven Eckert | Rhonda Jacob
(2013)
Additional Information
Book Details
Abstract
Covering the functional and esthetic needs of edentulous patients, Prosthodontic Treatment for Edentulous Patients: Complete Dentures and Implant-Supported Prostheses, 13th Edition helps you provide complete dentures, with and without dental implant support. It addresses both the behavioral and clinical aspects of diagnosis and treatment and covers treatment modalities including osseointegration, overdentures, implant-supported fixed prosthesis, and the current and future directions of implant prosthodontics. New to this edition are full-color photographs and coverage of immediately loaded complete dental prostheses. From lead editor and respected educator George Zarb, Prosthodontic Treatment for Edentulous Patients provides an atlas of clinical procedures and emphasizes the importance of evidence-based treatment.
- Short, easy-to-read chapters cover the essentials of care for both short- and long-term patients, stressing the importance of evidence-based treatment.
- Expanded coverage of implant prosthodontics addresses the clinical protocols for implant-retained and implant-supported prosthodontic management.
- Specific chapters address the three surfaces of the complete denture: (1) an impression or intaglio surface, (2) a polished surface, and (3) an occlusal surface, the integration of which is crucial to creating a stable, functional, and esthetic result.
- Chapter on health and nutrition examines a number of systemic conditions (vesciculoerosive conditions, systemic lupus erythematosus, burning mouth syndrome, salivary dysfunction, Sjögren's syndrome, hyper/hyposalivation, diabetes) that affect the oral cavity and specifically influence the prognosis for wearing complete dentures or for accepting osseointegrated prostheses.
- Chapter on the time-dependent changes which occur in the oral cavity focuses on both time-related direct (ulcer/cheek biting, irritation hyperplasia, denture stomatitis, flabby ridge and pendulous maxillary tuberosities, hyperkeratosis and oral cancer, residual ridge reduction) and indirect (atrophy of masticatory muscles, nutritional status and masticatory function, control of sequelae) changes in the oral environment, and provides strategies to minimize the risk of such changes.
- Chapter on the techniques used to prolong the life of complete dentures focuses on the two techniques used to extend the life of dentures: relining and rebasing, also touching on denture duplication.
- Well-respected editors and contributors are the leaders in their field, lending credibility and experience to each topic.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Prosthodontic Treatment for Edentulous Patients | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | ix | ||
| Acknowledgments | x | ||
| Table Of Contents | xi | ||
| I The Patient | 1 | ||
| 1 The Edentulous State | 1 | ||
| Historical Context and Current Considerations | 1 | ||
| Biomechanical Support for the Natural Dentition | 4 | ||
| Biomechanical Support Mechanisms for Complete Dentures | 8 | ||
| Mucosal Support and Masticatory Loads | 8 | ||
| The Residual Ridges | 9 | ||
| Natural and Prosthetic Dental Occlusion: Functional and Parafunctional Considerations | 9 | ||
| Function: Mastication and Other Mandibular Movements | 14 | ||
| Parafunctional Considerations | 14 | ||
| Changes in Morphological Face Height and the Temporomandibular Joints | 15 | ||
| Temporomandibular Joint Changes | 18 | ||
| Esthetic Changes | 18 | ||
| Behavioral and Adaptive Responses | 21 | ||
| Treatment Options: Complete Dentures | 22 | ||
| Treatment Options: Implant Prosthodontics | 23 | ||
| Bibliography | 27 | ||
| 2 Systemic Health Aspects and Nutritional Considerations for Edentulous Patients | 28 | ||
| Mucosal Conditions | 28 | ||
| Vesiculoerosive | 28 | ||
| Systemic Lupus Erythematosus (SLE) | 28 | ||
| Burning Mouth Syndrome | 28 | ||
| Oral Movement Disorders | 29 | ||
| Salivary Dysfunction | 30 | ||
| Sjögren’s Syndrome | 30 | ||
| Hypersalivation/Hyposalivation | 31 | ||
| Diabetes | 31 | ||
| Nutrition and the Impact of Dental Status on Food Intake | 31 | ||
| Dietary Counseling of Patients Undergoing Prosthodontic Treatment | 32 | ||
| Summary | 33 | ||
| References | 33 | ||
| 3 The Aging Edentulous Patient | 35 | ||
| The Aging Population | 35 | ||
| Distribution and Impact of Edentulism in Old Age | 35 | ||
| Distribution | 35 | ||
| Impact | 35 | ||
| The Impact of Age on the Edentulous Mouth | 36 | ||
| Mucosa | 36 | ||
| Bone | 36 | ||
| Saliva | 37 | ||
| Jaw Movements in Old Age | 37 | ||
| Taste and Smell | 37 | ||
| Nutrition | 37 | ||
| Aging Skin and Teeth | 38 | ||
| Skin | 38 | ||
| Teeth | 38 | ||
| Concerns for Personal Appearance in Old Age | 39 | ||
| Summary | 40 | ||
| References | 40 | ||
| 4 Sequelae Caused by Wearing Complete Dentures | 42 | ||
| Control of Sequelae with the Use of Complete Dentures | 42 | ||
| Dentures in Their Oral Environment | 42 | ||
| Direct Sequelae: Changes in Local Mucosal Morphology | 42 | ||
| Traumatic Ulcers and Cheek Biting | 44 | ||
| Denture Irritation Hyperplasia | 44 | ||
| Denture Stomatitis | 44 | ||
| Candida-Associated Denture Stomatitis (Fig. 4-5) | 45 | ||
| Etiology and Predisposing Factors | 45 | ||
| Management and Preventive Measures | 47 | ||
| Flabby Ridge and Pendulous Maxillary Tuberosities (See Also Chapter 5) | 48 | ||
| Hyperkeratosis and Oral Cancer | 48 | ||
| Residual Ridge Reduction | 48 | ||
| Indirect Sequelae: Changes in Functional Morphology | 50 | ||
| Atrophy of Masticatory Muscles | 50 | ||
| Nutritional Status and Masticatory Function | 50 | ||
| Control of Sequelae with the Use of Complete Dentures | 51 | ||
| Summary | 51 | ||
| References | 51 | ||
| Bibliography | 52 | ||
| II Treatment Options | 53 | ||
| 5 History Taking, Treatment Planning, and Improving Denture-Bearing Areas for Edentulous Patients | 53 | ||
| On History Taking and Treatment Planning for Edentulous Patients | 53 | ||
| The First Visit | 53 | ||
| Patient Attitude | 53 | ||
| General Health and Dental History | 54 | ||
| Treatment Planning | 54 | ||
| Social and Behavioral Information | 54 | ||
| Psychological Considerations | 55 | ||
| Systemic Health Status | 56 | ||
| Extraoral Examination | 57 | ||
| Temporomandibular Joint | 57 | ||
| Cheeks and Lips (Fig. 5-1) | 58 | ||
| Intraoral Examination | 60 | ||
| Mucosa (Figs. 5-2 and 5-3) | 61 | ||
| Infection (Fig. 5-5) | 63 | ||
| Tongue (Fig. 5-6) | 64 | ||
| Saliva (See Also Chapter 2) | 66 | ||
| Bone Ridge Morphology | 66 | ||
| Tori (See Figs. 5-2 and 5-3) | 67 | ||
| Bony Undercuts (Fig. 5-8) | 67 | ||
| Arch Relations | 68 | ||
| Enlarged Maxillary Tuberosities (Fig. 5-9) | 69 | ||
| Existing Dentures (Fig. 5-10) | 69 | ||
| Additional Considerations with the Partially Dentate Patient | 72 | ||
| Radiographs, Photographs, Measurements | 74 | ||
| Radiographic Images (Fig. 5-13) | 74 | ||
| Photographic Images | 76 | ||
| Measurements | 76 | ||
| Diagnostic/Study Casts | 76 | ||
| Financial Implications | 77 | ||
| Development of the Treatment Plan | 77 | ||
| Summary | 77 | ||
| Improving Denture-Bearing Foundations for Edentulous Patients | 77 | ||
| Preprosthetic Nonsurgical Methods | 77 | ||
| Managing Traumatized Tissues | 78 | ||
| Occlusal Correction of the Old Prostheses | 79 | ||
| Preprosthetic Surgical Methods | 79 | ||
| Surgical Correction of Conditions that Preclude Optimal Prosthetic Function | 80 | ||
| Hyperplastic Ridge, Epulis Fissuratum, and Papillomatosis (Fig. 5-17) | 80 | ||
| Frenular Attachments and Pendulous Maxillary Tuberosities | 80 | ||
| Bony Prominences, Undercuts, Spiny Ridges, and Tori | 80 | ||
| Pressure on the Mental Foramen | 83 | ||
| Ridge Parallelism | 84 | ||
| Enlargement of Denture- Bearing Areas | 86 | ||
| Vestibuloplasty | 86 | ||
| Ridge Augmentation | 90 | ||
| Discrepancies in Jaw Size | 90 | ||
| Replacement of Tooth Roots with Osseointegrated Dental Implants | 90 | ||
| Summary | 90 | ||
| Bibliography | 92 | ||
| On History Taking and Treatment Planning for Edentulous Patients | 92 | ||
| Improving Denture-Bearing Foundations for Edentulous Patients | 92 | ||
| 6 Additional Treatment Planning Options for Both Edentulous and Potentially Edentulous Patients | 93 | ||
| Considerations for Implant Prosthodontic Treatment | 93 | ||
| Maladaptive Denture Behavior | 93 | ||
| The Scientific Era in Implant Prosthodontics | 95 | ||
| Patient Considerations | 98 | ||
| Treatment Outcome Considerations | 101 | ||
| Summary | 101 | ||
| The Potentially Edentulous Patient to be Treated with Overdentures | 102 | ||
| Advantages and Disadvantages of the Overdenture Technique | 107 | ||
| Indications and Treatment Planning | 107 | ||
| Group 1 | 107 | ||
| Group 2 | 108 | ||
| Selection of Abutment Teeth | 109 | ||
| Methods and Techniques for Enhancing the Overdenture’s Retentive Role | 110 | ||
| Loss of Abutment Teeth | 111 | ||
| Summary: Treatment Outcome Studies | 112 | ||
| The Potentially Edentulous Patient to be Treated with Immediate Dentures | 112 | ||
| Advantages and Disadvantages of Immediate Denture Treatment | 113 | ||
| Contraindications to Immediate Denture Treatment | 114 | ||
| Treatment Planning the Choice of the Immediate Denture Clinical Technique or Protocol | 114 | ||
| Explanation to the Patient | 114 | ||
| Oral Examination | 114 | ||
| Examination of Any Existing Prosthesis If it is to be Included in an Iid | 116 | ||
| Tooth/Teeth Modifications | 116 | ||
| Prognosis | 117 | ||
| Referrals/Adjunctive Care | 118 | ||
| Oral Prophylaxis | 118 | ||
| Other Treatment Needs | 118 | ||
| Bibliography | 118 | ||
| Considerations for Implant Prosthodontic Treatment | 118 | ||
| The Potentially Edentulous Patient to Be Treated with Overdentures | 119 | ||
| Immediate Dentures for Potentially Edentulous Patients | 119 | ||
| III The Materials Used | 121 | ||
| 7 Materials Used in the Management of Edentulous Patients | 121 | ||
| Impression Materials | 122 | ||
| Nonelastic Impression Materials | 123 | ||
| Impression Plaster | 123 | ||
| Zinc Oxide Eugenol (ZOE) Impression Paste | 123 | ||
| Dental Impression Compound (Types I and II) | 124 | ||
| Important Considerations for Proper Use of Impression Compound | 124 | ||
| Elastic Impression Materials | 125 | ||
| Hydrocolloids | 125 | ||
| Agar (Reversible Hydrocolloid). | 125 | ||
| Composition and Manipulation of Agar (Box 7-5). | 125 | ||
| Alginate (Irreversible) Hydrocolloid Material (Box 7-6). | 126 | ||
| Technical Considerations in the Manipulation of Alginates | 126 | ||
| Elastomeric Impression Materials | 127 | ||
| Recommended Technique for Final Elastomeric Impressions | 128 | ||
| Points of Importance When Handling Elastomers | 128 | ||
| Polysulfide Rubber | 128 | ||
| Condensation Silicone (Box 7-8) | 128 | ||
| Addition Silicones (Box 7-9) | 129 | ||
| Polyether Impression Materials | 130 | ||
| Disinfection of Elastomeric Impression Materials | 131 | ||
| Summary of Impression Material | 133 | ||
| Polymeric Denture Base Materials | 133 | ||
| Technical Considerations and Properties of Denture Base Resins | 134 | ||
| Heat-Activated PMMA | 134 | ||
| The Polymerization Cycle. | 134 | ||
| Denture Base Porosity. | 134 | ||
| Rapid-Cure Type Resins | 134 | ||
| The Bond Between Heat-Cured Denture Bases and Resin Denture Teeth | 135 | ||
| Biocompatibility of Methacrylate-Based Resins | 135 | ||
| Residual Monomer Content | 135 | ||
| Radiopacity of Denture Bases | 136 | ||
| Injection Molding Technique | 136 | ||
| Chemically Activated Resins (Box 7-13) | 136 | ||
| Pour or Fluid Resin Technique | 136 | ||
| Microwave-Activated Resins (Box 7-14) | 138 | ||
| Light-Activated (VLC) Resins (Box 7-15) | 138 | ||
| Modified Resin Base Materials (Box 7-16) | 139 | ||
| Materials Used in the Fabrication of Prosthetic Denture Teeth | 139 | ||
| Methacrylate-Based (PMMA) Resin Teeth | 139 | ||
| Technical Considerations | 142 | ||
| Esthetics of Methacrylate Resin Teeth | 142 | ||
| Additional Advantages and Disadvantages of Methacrylate Resin Teeth | 142 | ||
| Composite Resin Denture Teeth | 143 | ||
| Porcelain Teeth | 143 | ||
| Additional Advantages and Disadvantages of Porcelain Teeth | 143 | ||
| Summary of Prosthetic Teeth | 144 | ||
| Denture Lining Materials | 144 | ||
| Short-Term Soft Liners (Tissue Conditioners) | 145 | ||
| Rheological and Viscoelastic Properties of Tissue Conditioners | 146 | ||
| Self-Administered Home Relines* | 146 | ||
| Long-Term Soft Liners | 147 | ||
| Methacrylate Resin and Heat-Activated Resilient Liners | 147 | ||
| Chemically Activated Methacrylate Resins | 147 | ||
| Silicone-Based Soft Liners | 148 | ||
| Heat-Activated Silicone Liners. | 148 | ||
| Chemically Activated Silicone Liners (Room Temperature Vulcanized [RTV] Silicones). | 148 | ||
| Summary of Denture Lining Material | 149 | ||
| Cast Metal Alloys as Denture Bases | 149 | ||
| Technical Considerations | 149 | ||
| Cobalt-Chromium Alloys | 151 | ||
| Cobalt-Chromium Nickel Alloys | 151 | ||
| Nickel-Chromium Alloys | 151 | ||
| Properties of Base Metal Alloys Used in Removable Prostheses | 151 | ||
| Physical Properties | 151 | ||
| Mechanical Properties | 151 | ||
| Chemical Properties | 151 | ||
| Biocompatibility | 152 | ||
| Commercially Pure Titanium and Its Alloys | 152 | ||
| Titanium Alloys | 152 | ||
| Denture Cleansers | 152 | ||
| Cleansing and Disinfecting | 153 | ||
| Mechanical Techniques | 154 | ||
| Chemical Denture Cleansers | 154 | ||
| Oxygenating Cleansers | 154 | ||
| Hypochlorite Solutions | 154 | ||
| Other Techniques and Materials | 154 | ||
| Ultrasonic Units | 154 | ||
| Dilute Acids | 155 | ||
| Enzyme-Containing Denture Cleansers | 155 | ||
| Silicone Polymers | 155 | ||
| Microwave Radiation | 155 | ||
| Adverse Reactions to Denture Cleansers | 155 | ||
| Summary of Cleansers | 155 | ||
| Denture Adhesives | 155 | ||
| Adjunctive Retention by Using Denture Adhesives | 156 | ||
| Indications and Contraindications for Denture Adhesive | 156 | ||
| Application of Denture Adhesives | 158 | ||
| Adverse Reactions to Denture Adhesive | 158 | ||
| Summary | 158 | ||
| Bibliography | 159 | ||
| IV Clinical Protocols for Diverse Treatment Scenarios | 161 | ||
| 8 Maxillary and Mandibular Substitutes for the Denture-Bearing Area | 161 | ||
| Anatomy Of Supporting Structures | 161 | ||
| Mucous Membrane | 162 | ||
| Residual Ridge | 162 | ||
| Maxilla | 163 | ||
| Peripheral Border Tissues And Contours | 164 | ||
| Mandible | 165 | ||
| Peripheral Border Tissues And Contours | 167 | ||
| Principles And Objectives Of Impression Making | 170 | ||
| Impression Procedures | 171 | ||
| Preliminary Impressions: Trays, Materials, Technique | 172 | ||
| Final Impressions: Trays, Materials, Technique | 173 | ||
| Posterior Palatal Seal | 176 | ||
| Boxing Impressions And Making The Casts | 178 | ||
| Summary | 179 | ||
| Bibliography | 179 | ||
| 9 The Dentures’ Polished Surfaces, Recording Jaw Relations, and Their Transfer to an Articulator | 180 | ||
| Neutral Zone or Arch Form Design | 182 | ||
| Mandibular Arch | 184 | ||
| Maxillary Arch | 186 | ||
| Level or Height of the Occlusal Plane | 188 | ||
| Establishing the Desired Vertical Dimension of Occlusion | 190 | ||
| Esthetics | 190 | ||
| Phonetics (See Chapter 15) | 191 | ||
| Mechanics | 192 | ||
| The Preliminary Centric Relation Record (Box 9-1) | 192 | ||
| Relating the Patient to the Articulator | 195 | ||
| Facebow | 195 | ||
| Laboratory Steps | 196 | ||
| Articulators | 197 | ||
| Types of Patient Records | 198 | ||
| Interocclusal Records | 198 | ||
| Graphic Records | 199 | ||
| Hinge-Axis Records | 199 | ||
| On Selecting an Articulator for Making Complete Dentures | 200 | ||
| Programming the Articulator | 200 | ||
| Condylar Elements (Fig. 9-14, A) | 200 | ||
| Incisal Elements (Fig. 9-14, B and C) | 201 | ||
| Arbitrary Settings | 202 | ||
| Bibliography | 202 | ||
| 10 The Occlusal Surfaces: | 204 | ||
| On Meeting Patient Expectations When Selecting Teeth | 204 | ||
| On Guiding Patient Decisions | 205 | ||
| Additional Clinical and Technical Considerations in Anterior Tooth Selection | 208 | ||
| Patient Preferences | 208 | ||
| Overdentures and Implant Dentures | 208 | ||
| Opposing Natural Teeth | 208 | ||
| Materials for Denture Teeth | 208 | ||
| Posterior Tooth Molds and Cuspal Anatomy | 208 | ||
| Ten Landmarks for Complete Denture Teeth Setup | 209 | ||
| The “Standard Anterior” Arrangement | 209 | ||
| Arranging the Mandibular Anterior Teeth (Fig. 10-9) | 210 | ||
| Mandibular Central Incisor Positions | 211 | ||
| Mandibular Lateral Incisors | 212 | ||
| Mandibular Canines | 212 | ||
| Setting The Maxillary Anterior Teeth (Fig. 10-10) | 212 | ||
| Maxillary Central Incisors | 212 | ||
| Maxillary Lateral Incisors | 214 | ||
| Maxillary Canines | 214 | ||
| “Anteriors Only” Try-In | 215 | ||
| Arranging Posterior Teeth | 215 | ||
| Number of Posterior Teeth Set | 215 | ||
| Occlusal Concepts for Complete Denture Occlusion | 215 | ||
| Lingualized Articulation | 215 | ||
| Arranging Maxillary Posterior Teeth to Lingualized Articulation (Fig. 10-15) | 219 | ||
| Arranging Anatomical Teeth to a Balanced Articulation (Fig. 10-16) | 221 | ||
| Setting the Mandibular Teeth First | 221 | ||
| Evaluating Bilateral Balanced Articulation | 221 | ||
| Arranging Nonanatomical Teeth To Monoplane Articulation (Fig. 10-17) | 222 | ||
| Arranging Nonanatomical Teeth With A Balancing Ramp (Fig. 10-18) | 223 | ||
| Arranging Nonanatomical Teeth To Balanced Articulation (Fig. 10-19) | 223 | ||
| Setups For Retrognathic and Prognathic Facial Skeletons | 225 | ||
| The Lingual Look Test (Fig. 10-23) | 226 | ||
| Completing The Wax-Up For The Try-In Appointment (Fig. 10-24) | 227 | ||
| Summary of Tooth Selection and Arrangement | 229 | ||
| Bibliography | 229 | ||
| 11 The Try-in Appointment | 230 | ||
| Before The Try-In Appointment | 230 | ||
| At The Try-In Appointment | 232 | ||
| Explanation | 232 | ||
| Chairside Comparison | 232 | ||
| Denture Comparison | 233 | ||
| The Real Try-In | 234 | ||
| Speaking And Phonetic Assessment | 235 | ||
| Vertical Dimension Of Occlusion | 236 | ||
| Check the Dental Occlusion | 239 | ||
| Relaxing and Rehearsal of a Relaxed Jaw Closure | 239 | ||
| Single-Base Stabilization for Try-In Assessment (Fig. 11-13) | 241 | ||
| Double-Base Stabilization for Try-In Assessment (Fig. 11-14) | 241 | ||
| When Is A Remount Needed? | 242 | ||
| Remount at Increased Vertical Dimension (Fig. 11-17) | 243 | ||
| Remount at Correct Vertical Dimension (Fig. 11-18) | 243 | ||
| The Interappointment Laboratory Procedure for the Wax Try-in Remount (Fig. 11-19) | 246 | ||
| Resetting the Dentition for Try-in | 248 | ||
| Try-In For Esthetics | 248 | ||
| The Next Level: Characterization of Individual Tooth Colors and Position | 248 | ||
| Establishment of the Posterior Palatal Seal (PPS) | 249 | ||
| Final Decision Making and Closure | 252 | ||
| The Laboratory Prescription | 253 | ||
| Summary | 254 | ||
| Bibliography | 254 | ||
| 12 Prosthesis Insertion and Follow-up Appointments | 255 | ||
| Waxing and Processing the Dentures | 255 | ||
| Development of the Proper Forms of the Polished Surfaces | 255 | ||
| Completion of Wax-Up and Festooning | 257 | ||
| Formation and Preparation of the Mold | 257 | ||
| Packing the Mold | 263 | ||
| Fabrication of Facebow Transfer Jig | 263 | ||
| Laboratory Remount and Equilibration (As | 263 | ||
| Removing Processed Dentures from the Master Casts | 264 | ||
| Finishing and Polishing Dentures | 265 | ||
| Fabrication of Clinical Remount Casts | 265 | ||
| Hydrate the Dentures | 265 | ||
| Delivery of the Completed Dentures | 267 | ||
| Elimination of Basal Surface Errors | 267 | ||
| Adjustment of Denture Base | 267 | ||
| Adjustment of Denture Borders | 268 | ||
| Errors in Occlusion | 268 | ||
| Clinical Remount and Occlusal Equilibration (As | 268 | ||
| Centric Relation Record | 269 | ||
| Remount the Mandibular Denture | 269 | ||
| Verifying Centric Relation | 269 | ||
| Protrusive Record (Optional) | 269 | ||
| Eliminating Occlusal Errors in Anatomical Teeth | 271 | ||
| Eliminating Occlusal Errors in Nonanatomical Teeth | 272 | ||
| Advantages of Balanced Occlusion in Complete Dentures | 272 | ||
| Special Instructions to the Patient | 273 | ||
| Individuality of Patients | 273 | ||
| Appearance with New Dentures | 273 | ||
| Mastication with New Dentures | 273 | ||
| Speaking with New Dentures | 274 | ||
| Oral Hygiene with Dentures | 274 | ||
| Preserving the Residual Ridges | 275 | ||
| Educational Material for Patients | 275 | ||
| Follow-Up Appointments | 275 | ||
| Twenty-Four-Hour Oral Examination and Treatment | 275 | ||
| Examination Procedures | 276 | ||
| Adjustments Related to the Occlusion | 276 | ||
| Adjustments Related to the Denture Bases | 276 | ||
| Subsequent Oral Examinations and Treatments | 278 | ||
| Periodic Recall for Oral Examination | 280 | ||
| Bibliography | 280 | ||
| 13 Modified Protocols for Immediate Dentures, Overdentures, and Single Dentures | 281 | ||
| Immediate Dentures | 281 | ||
| Preliminary Impressions | 282 | ||
| Final Impression | 282 | ||
| Posterior Palatal Seal | 282 | ||
| Maxillomandibular Relationship Records | 284 | ||
| Denture Teeth Arrangement | 287 | ||
| Laboratory Procedures | 287 | ||
| Teeth Removal and Denture Insertion | 289 | ||
| Postoperative Care | 289 | ||
| Overdentures | 290 | ||
| Treatment Planning for Overdentures | 293 | ||
| Retention | 294 | ||
| Insertion | 295 | ||
| Clinical and Laboratory Procedures | 295 | ||
| Tooth-Supported Complete Denture | 295 | ||
| Tooth-Supported Immediate Complete Denture | 295 | ||
| Maintenance | 298 | ||
| Single Denture | 298 | ||
| Diagnosis and Treatment Planning | 298 | ||
| Teeth Arrangement | 299 | ||
| Summary | 301 | ||
| Bibliography | 302 | ||
| 14 Prolonging the Useful Life of Complete Dentures: | 303 | ||
| Rebasing/Relining | 303 | ||
| Treatment Rationale | 303 | ||
| Diagnosis | 304 | ||
| Preliminary Treatment | 306 | ||
| Clinical Impression Procedures | 309 | ||
| Static Impression Technique | 309 | ||
| Functional Impression Technique | 310 | ||
| Chairside Technique | 311 | ||
| Relining/Rebasing Materials | 311 | ||
| Repairs | 312 | ||
| Denture Duplication (see Chapter 23) | 313 | ||
| Bibliography | 314 | ||
| 15 Speech Considerations with Complete Dentures | 315 | ||
| Speech Production | 315 | ||
| Speech Production: The Role of Teeth and Other Oral Structures | 316 | ||
| Bilabial Sounds | 317 | ||
| Labiodental Sounds | 317 | ||
| Linguodental Sounds | 317 | ||
| Linguoalveolar Sounds | 318 | ||
| Articulatory Characteristics | 318 | ||
| Acoustic Characteristics | 318 | ||
| Auditory Characteristics | 318 | ||
| Linguopalatal and Linguovelar Sounds | 319 | ||
| Methods for Speech Analysis | 320 | ||
| Prosthetic Considerations | 320 | ||
| Special Consideration in Implant Prosthodontics | 321 | ||
| Summary | 321 | ||
| Bibliography | 321 | ||
| V Clinical Protocols Specific to Implant-Retained and Implant-Supported Prosthodontic Management | 323 | ||
| 16 The Science of Osseointegration | 323 | ||
| Osseointegrated Interface | 323 | ||
| Factors That Determine Success and Failure of Osseointegration | 324 | ||
| Implant Biocompatibility | 324 | ||
| Implant Design | 324 | ||
| Implant Surface | 326 | ||
| Host Bed | 327 | ||
| Surgical Technique | 328 | ||
| Loading Conditions | 329 | ||
| Summary | 329 | ||
| Bibliography | 329 | ||
| 17 Implant Overdentures | 330 | ||
| General Overdenture Treatment Considerations | 330 | ||
| Inclusion and Exclusion Criteria | 331 | ||
| Presurgical Evaluation and Treatment Planning | 331 | ||
| Surgical Protocol and the Osseointegration Phase | 334 | ||
| Prosthodontic Protocol | 335 | ||
| Guidelines for Selecting Attachment Systems | 335 | ||
| Indications for Ball or Magnetic Attachments | 336 | ||
| Indications for Bar Attachments | 336 | ||
| Implant Overdenture Design | 336 | ||
| Clinical and Laboratory Procedures | 336 | ||
| Maintenance | 338 | ||
| Bibliography | 339 | ||
| 18 Fixed Full Arch Implant-Supported Prostheses for the Edentulous Patient | 340 | ||
| Patient Selection | 340 | ||
| Considerations Specific to the Edentulous Mandible | 342 | ||
| Immediate Load Rehabilitation of the Edentulous Mandible | 342 | ||
| Step-by-Step Procedures | 342 | ||
| The Edentulous Maxilla | 345 | ||
| Summary | 348 | ||
| References | 349 | ||
| 19 Maxillofacial Prosthodontics for the Edentulous Patient | 351 | ||
| Form and Function | 351 | ||
| Anatomic and Physiologic Considerations: Normal Function | 351 | ||
| Functional Deficits of Speech and Swallowing | 352 | ||
| Prosthetic Considerations for Edentulous Maxillofacial Prosthesis | 353 | ||
| Facial Form | 353 | ||
| Loss of Vertical Opening and Altered Mandibular Movements | 353 | ||
| Processed Bases | 353 | ||
| Border Molding Soft Palate and Maxillary Defects | 353 | ||
| Border Molding The Velopharyngeal Area: Patient Movements | 353 | ||
| Border Molding Peripheries of Maxillary Resections and Hard Palate Defects: Patient Movements | 354 | ||
| Testing The Prosthetic “Seal” Between The Oral Cavity and The Nasal Cavity | 355 | ||
| Maxillary Obturator Prosthesis | 355 | ||
| Immediate Surgical Obturator Prosthesis | 355 | ||
| Interim Obturator Prosthesis | 356 | ||
| Definitive Obturator Prosthesis | 358 | ||
| Troubleshooting An Obturator Prosthesis | 360 | ||
| Lack of Retention | 360 | ||
| Nasal Reflux | 361 | ||
| Hypernasality | 362 | ||
| Soft Palate Obturator Prosthesis | 362 | ||
| Troubleshooting The Soft Palate Obturator Prosthesis | 365 | ||
| Prosthesis Feels Too Long | 365 | ||
| Hypernasality | 365 | ||
| Palatal Augmentation Prosthesis | 365 | ||
| Clinical Examination | 365 | ||
| Informing The Patient | 365 | ||
| Mandibular Resection Prostheses | 366 | ||
| Marginal Mandibulectomy Prostheses | 366 | ||
| Discontinuity Mandibulectomy Prostheses | 367 | ||
| Troubleshooting Prostheses For The Patient With An Edentulous Mandibulectomy | 369 | ||
| Unstable Mandibular Denture | 369 | ||
| Inability to Chew or Inability to Chew Beyond a Soft Diet | 369 | ||
| Prostheses For Reconstructed Mandibles | 369 | ||
| Maxillofacial Implant-Assisted Prostheses For The Edentulous Patient | 369 | ||
| Risks and Benefits Assessment of Implants In Irradiated Tissues | 370 | ||
| Risk of Osteoradionecrosis | 372 | ||
| Hyperbaric Oxygen Therapy | 372 | ||
| Irradiation of Existing Implants | 373 | ||
| Prosthodontic Treatment Considerations For The Irradiated Edentulous Patient | 373 | ||
| Timing of Denture Placement | 373 | ||
| Salivary Consideration for the Irradiated Edentulous Patient | 374 | ||
| Occlusal Forms | 374 | ||
| Delivery and Postinsertion Care | 374 | ||
| Bibliography | 374 | ||
| 20 Managing Problems and Complications | 376 | ||
| Problems | 376 | ||
| Complications | 377 | ||
| Surgically Related Complications | 377 | ||
| At Stage I Surgery | 377 | ||
| Interval Between Stage I and Stage II | 379 | ||
| At Stage II Surgery | 380 | ||
| Prosthodontic-Related Complications (Table 20-2) | 380 | ||
| Abutment Related | 380 | ||
| Impression Related | 381 | ||
| Try-in of Tooth Arrangement | 382 | ||
| Framework Try-in | 382 | ||
| Insertion Of Prosthesis | 382 | ||
| Implant-Supported Fixed Prosthesis | 382 | ||
| Implant-Supported Overdenture | 383 | ||
| Postinsertion | 383 | ||
| Biological Complications | 383 | ||
| Mechanical/Prosthodontic Complications | 383 | ||
| Summary | 385 | ||
| Bibliography | 385 | ||
| 21 Immediately Loaded Complete Dental Prostheses | 387 | ||
| Immediate Load Complete Denture Technique | 389 | ||
| References | 393 | ||
| 22 Current and Possible Future Directions in Implant Prosthodontics | 395 | ||
| Systemic Health and Host Bone Response | 395 | ||
| Smoking | 398 | ||
| Osteoporosis | 399 | ||
| Bisphosphonate Therapy | 400 | ||
| Irradiation Therapy | 401 | ||
| Other Systemic Conditions | 401 | ||
| Imaging Protocol | 401 | ||
| Surgical Protocols | 402 | ||
| Bone Quality | 402 | ||
| Bone Quantity And Site Improvement | 403 | ||
| Prosthodontic Loading | 403 | ||
| Oral Ecological Concerns | 406 | ||
| Summary | 407 | ||
| Bibliography | 408 | ||
| VI Additional Considerations in the Management of Edentulous Patients | 409 | ||
| 23 The Impact of Socioeconomic, Cultural, and Technological Changes and the Notion of Standards of Care and Alternative Protocols | 409 | ||
| Standards Of Care | 410 | ||
| Minimum Acceptable Protocols | 410 | ||
| An “Appropriatech” Method For Complete Dentures In Four Clinical Sessions | 410 | ||
| First Clinical Session | 411 | ||
| Impressions | 411 | ||
| Position of Maxillary Anterior Teeth | 412 | ||
| First Laboratory Session | 412 | ||
| Second Clinical Session | 412 | ||
| Establishing the Vertical Dimension of Occlusion | 412 | ||
| Recording the Horizontal Jaw Relationship | 412 | ||
| Second Laboratory Session | 416 | ||
| Third Clinical Session | 416 | ||
| Remount and Occlusal Adjustment | 416 | ||
| Counseling the Patient | 416 | ||
| Fourth Clinical Session | 416 | ||
| Summary | 416 | ||
| Reproducing Complete Dentures | 416 | ||
| First Clinical Session | 417 | ||
| First Laboratory Session | 418 | ||
| Second Clinical Session | 419 | ||
| Second Laboratory Session | 419 | ||
| Third Clinical Session | 419 | ||
| Adaptation And Advancing Technology | 419 | ||
| Summary | 419 | ||
| References | 419 | ||
| Bibliography | 420 | ||
| Index | 421 | ||
| A | 421 | ||
| B | 423 | ||
| C | 424 | ||
| D | 426 | ||
| E | 429 | ||
| F | 430 | ||
| G | 431 | ||
| H | 432 | ||
| I | 433 | ||
| J | 435 | ||
| K | 435 | ||
| L | 435 | ||
| M | 436 | ||
| N | 440 | ||
| O | 440 | ||
| P | 442 | ||
| Q | 445 | ||
| R | 445 | ||
| S | 447 | ||
| T | 449 | ||
| U | 451 | ||
| V | 451 | ||
| W | 452 | ||
| X | 452 | ||
| Z | 452 |