Assessment and planning of the edentulous patient Flashcards Preview

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Flashcards in Assessment and planning of the edentulous patient Deck (14)
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1

What is the recommended standard tx for the edentulous patient?
-US?
-UK?
(2)

US:
-two-implant supported overdentures for mandible
UK: complete dentures but this is no longer most appropriate choice

2

Current indications for progressing to implant-retained overdentures on the NHS (2)

Instability despite well-adapted set of dentures
Denture intolerance
-gag reflex (reduce palatal coverage)
-ongoing pain with well-adapted dentures

3

Clinical assessment of the edentulous patient for implants (4)

Denture
-in place
-outside mouth
Mandible
-residual ridge
-mental nerve
Denture vs mandible
Radiographic assessment

4

Assessment of denture intraorally (4)

Ridge adaptation
Margins
Occlusal stability
Overclosure
-acceptable fit?

5

Importance of assessing denture thickness (4)

Min 8.5mm
Thickness for overlying denture
Thickness for locator housing
Thickness for supragingival component of locator abutment

6

Minimum space requirements for
-bar attachment
-ball attachment
-locator attachment
(3)

Bar: 15mm
Ball: 10mm
Locator: 8.5mm

7

Assessment of residual ridge (3)

Buccolingual width
Variation in crestal contour
Mentalis insertions and "exostoses"

8

Buccolingual assessment of ridge width (1)

If narrower than width of implant, may be problematic

9

Variation in crestal contour (2)

May limit available space for denture components
May need to be addressed surgically

10

Potential effect of mentalis insertion on the severely resorbed mandible (1)

Avoid placement too far labial

11

Position of mental foraminae (2)

Influences how far distal implants may be able to be placed
Superficial mental foramen may make incision crestally a risk of nerve injury

12

Mental nerve - local anatomy (3)

Between lower 4 & 5 in general population
Is apical to lower 5 in chinese subpopulations
Anterior limb if IDN curves back before exits mental foramen

13

Positioning of implants for overdentures is different to crown and bridgework (2)

Centre of denture fitting area - if anything, more lingual better
Near-parallel placement - otherwise wear of locators/ limits male units

14

Direct attachment pick-up (2)

Separator painted on fitting surface
Cold cure acrylic painted into reliefs