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EDENTULOUS STATEBucher 2013

Chap.1 part 2 DR.Ansarifard

اول بی كردن درمان اثرات:سوال بیماراندندان؟

یابد؟( .... 1 می جویدن کارائی2 ....... یابد؟( می اکلوژن زمانهای( 3 ماهیچه فعالیت میزان

یابد؟ می الواتور

: در پارافانکشن افزایشحرکات دوم سوالگیرد؟ می صورت مرحله کدام

1)The edentulous state2)Deteriorating dentition3)Healthy adult dentition

4)Developing dentition

Parafunctional Considerations

Parafunction

clenching is common

etiology : stress, anger,parkinson,sleep parasomnia……

In the denture wearer, parafunctional habits can cause additional loading on the denture bearing tissue & tooth wear

1) pain2) oral lesions3) xerostomia 4) discomfort with prostheses or

occlusion

1)functional movements:(mastication and deglutition)

mainly vertical intermittent & light Diurnal only

2)Parafunctional movements:(clenching,bruxism)Vertical & horizontalProlonged & excessiveDiurnal & nocturnal

Sore tongue

Unusual pattern of behavior in surrounding musculature

( lower lip)

New Denturer

The relationship between parafunction and residual ridge reduction has not been

investigated

reduction in total face Height and a mandibular prognathism

anterior region mandibule : four times greater than the maxillary process

CHANGES IN MORPHOLOGICAL FACE HEIGHT

Morphological Changes Associated with the Edentulous State

1. Deepening of nasolabial groove2.Loss of labiodental angle3.Decrease in horizontal labial angle4.Narrowing of lips5.Increase in columella-philtral angle6.Prognathic appearance

Centric Relation

Centric relation :

is defined as the most posterior position of the mandible relative to the maxilla at the

established vertical dimension

It is regarded as a very useful reference or starting point for establishing jaw relationships in any prosthodontics treatment, particularly in

complete denture fabrication

In the vast majority of patients, unconscious swallowing is carried out with the mandible at

or near the centric relation position .

occlusions must be compatible with the forces developed during deglutition to prevent disharmonious occlusal contacts that could cause trauma to the basal seat of dentures

Accurate records are repeatable

Condyles & muscles are in a stable position

CRO during swallowing helps denture stability

Muscular loads are vertical at CR

ACentric Relation occlusion

Mandibular border movement Posselt's Diagram: sagittal

RCP( retruded contact position) ~ CR

ICP (intercuspal position) ~ CO

Border of movement Border of function

Behavioral and Adaptive Responses

:Success adaptation of learning, muscular skill, and motivation and is related to the patient's expectations

Habituation

"gradual diminition of responses to continued or

repeated stimuli

stimuli must, be specific and identical to achieve habituation

New dentures needs reorganization of tongue musculature shape & activity

Long-term complainer

causes : Anatomical ,physiological or psychological

Regressive changes in supporting area & neuromuscular control

“Maladaptive “ patients

Treatment :

o surgery to enlarge denture- bearing area

oImplant

“Maladaptive “ patients

The end… Thanks for your patienceAny question? …

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