482 Patient Evaluation for Dentures

8/9/2019 482 Patient Evaluation for Dentures

1/17

DENTAL CLINICS OF NORTH AMERICAVOLUME 40 - NUMBER I - JANUARY 1996

From th U!"#r$"t% o& T'($ D!t() Br(!*h+ Ho,$to! RLE./ (!

U!"#r$"t% o& T'($ H()th S*"!* C!tr+ S(! A!to!"o RD.+ T'($

ATIENT EVALUATION AND

TREATMENT LANNIN2 FOR

COMLETE-DENTURE THERAYRo3rt L E!5)m"r+ BS+ DMD+ MS+

(! Ro!% D ho!"'+ BA+ DDS+ MS

E#(),(t"o! o& (t"!t$ &or *om)t-!t,r thr(% $ho,) 3 thoro,5h (! 7))o*,m!t A )o5"*() mtho to (**om)"$h th"$ "$ to ,$ ( *h*8)"$t O#r th

%(r$+ m(!% *)"!"*"(!$ h(# #)o *)($$"&"*(t"o! $%$tm$ &or (!(tom"* (! $%*ho)o5"*() *h(r(*tr"$t"*$ o& *om)t !t,r (t"!t$ Mo$t o& th$ $%$tm$+

ho7#r+ h(# *o!*!tr(t o! th *)($$"&"*(t"o! o& ,$t o! or o!)% ( &7 &(t,r$Th"$ (rt"*) o&&r$ ( thoro,5h *h*8)"$t to 3 ,$ ,r"!5 (t"!t #(),(t"o!

R&r!*$ (r 5"#! &or ()) *)($$"&"*(t"o!$ r(7! &rom th ro$thoo!t"* )"tr(t,r

Th"$ #(),(t"o! &orm "$ *o!&"! to ( $"!5) $ht o& (r Th *h*8)"$t &orm(tm(8$ th &orm :,"*8 (! *o!#!"!t to ,$ O!* *om)t+ th"$ &orm *(! 3 (

to th (t"!t;$ !t() r*or &or &,t,r r&r!* U$ o& th"$ *h*8)"$t ro#"$ (

5r(tr )#) o& ,!r$t(!"!5 o& th (t"!t;$ ro3)m$+ (!(tom%+ (! tr(tm!t 5o()$


2/17

F(*"() &orm ro&").= C)($$"&% (**or"!5 to A!5)=

C)($$ 1 C)($$ > C)($$ ?

Normal Retrognathic Prognathic

3 M,$*) To!= C)($$"&% (**or"!5 to Ho,$=

C)($$ 1= Th (t"!t 'h"3"t$ !orm() t!$"o!+ to!+ (! )(*m!t o& thm,$*)$ o& m($t"*(t"o! (! &(*"() 'r$$"o! No 5!r(t"# *h(!5$ (r ((r!t

Th m(or"t% o& !t,)o,$ (t"!t$ h(# 'r"!* $om 5r o& 5!r(t"o!

U$,())%+ o!)% "mm"(t-!t,r (t"!t$ h(# !orm() m,$*,)(t,rC)($$ >= Th (t"!t "$)(%$ (ro'"m(t)% !orm() &,!*t"o! 3,t $)"5ht)% "m("r m,$*)

to! M('"m,m m,$*) &,!*t"o! *(!!ot 3 ,$ &o))o7"!5 th )o$$ o& ()) !(t,r() tth

C)($$ ?= Th (t"!t 'h"3"t$ 5r(t)% "m("r m,$*) to! (! &,!*t"o! Th"$ "m("rm!t,$,())% "$ *o,) 7"th oor h()th+ "!&&"*"!t !t,r$+ (! )o$$ o& #rt"*() "m!$"o!+

7r"!8)$+ *r($ 3"t"!5 &or*+ (! roo"!5 *omm"$$,r$* M,$*) D#)om!t= C)($$"&% (**or"!5 to Ho,$=

C)($$ 1= H(#% C)($$ >= M",m

C)($$ ?= L"5ht

Com)'"o!= H("r+ %+ (! $8"! *o)or ro#" ,$&,) 5,"$ "! $h( $)*t"o! S8"!*o)or ()$o *(! r#() ,!r)%"!5 "$($ (! (tho)o5% (t"!t$ 7"th $"5!"&"*(!t $,!

(m(5 7(rr(!t r&rr() to ( rm(to)o5"$t ()+ (!m"*-)oo8"!5 (t"!t$ m(% h(#

,!r)%"!5 $%$tm"* "$($$ (! m(% r:,"r )o!5r (,$tm!t r"o$ H(#%7r"!8)$ (t th *omm"$$,r$ (! !($o)(3"() &o) ,$,())% $,55$t *r($ Vrt"*()

D"m!$"o! o& O**),$"o! VDO. or oor $,ort o& &(*"() m,$*,)(t,r 3% th !t,r

. L"= Th *o!to,r (! ((r(!* o& th #rm"))"o! 3orr ,$,())% (r ()tr 3% tooth)o$$ R$tor(t"o! o& )" $,ort (! #rm"))"o! 3orr 7"th m,$t 3 *o!$"r ,r"!5 )(*m!t o& (!tr"or tth C)($$"&% th )" *o!to,r ($ @(:,(t)% $,ort@ or

@,!$,ort@ A)$o+ *omm!t o! th (mo,!t o& #rm"))"o! 3orr #"$"3) L"

mo3")"t% $ho,) 3 !ot (t"!t$ 7"th m"!"m() )" mo3")"t% $ho7 #r% )"tt) o& th(!tr"or tth Som $tro8 #"*t"m$ m(% h(# (r()%$"$ o& h()& th )"+ )("!5 to

,!")(tr() mo,th roo (! &(*"() ($%mmtr% (t"!t$ m,$t 3 *o,!$) r5(r"!5

tr(tm!t )"m"t(t"o!$ 7h! ()"!5 7"th $,*h h%$"*() *h())!5$ Othr7"$+ (t"!t$


3/17

m(% h(# ,!r()"$t"* '*t(t"o!$ r5(r"!5 &,!*t"o!() (! $tht"* r$,)t$ C)($$"&% )"

mo3")"t% ($ !orm() *)($$ 1.+ r,* mo3")"t% *)($$ >.+ or (r()%$"$+ *)($$ ?.

Comm!t o! (!% ,!")(tr() r,*t"o! o& mo3")"t% L" )!5th ()$o )(%$ (! "mort(!tro) "! $tht"*$ A )o!5 )" r#()$ )"tt) o& th (!tr"or tth+ 7hr($ ( #r% $hort )"

())o7$ th "$)(% o& th !t,r 3($ Mo) $)*t"o! (! !t,r *h(r(*tr"(t"o! *(!

3 *r"t"*() &(*tor$ "! th$ *($$ C)($$"&% )" )!5th$ ($ )o!5+ !orm() or m",m+ (!$hort

& Tmorom(!"3,)(r o"!t TMJ.= Not (!% *r"t,$ or *)"*8"!5 Rort (!%h"$tor% o& TMJ "$*om&ort or )o*8"!5 Comm!t o! th $mooth!$$ o& m(!"3,)(r

mo#m!t$ Not (!% #"(t"o! o& th m(!"3) S#r o"!t ("! *(! "!"*(t ( $#r

"$*r(!*% "! th VDO

5 N,rom,$*,)(r E#(),(t"o!=

- S*h= (t"!t$ 7ho (r *((3) o& (rt"*,)(t $*h 7"th '"$t"!5 !t,r$/ or

!(t,r() tth. ,$,())% h(# !o ro3)m ro,*"!5 (rt"*,)(t $*h 7"th !7!t,r$ (t"!t$ 7"th $*h "m"m!t$ or tho$ 7ho *(!!ot (rt"*,)(t ot"m())%

7"th th"r '"$t"!5 !t,r$ r:,"r $*"() (tt!t"o! 7h! th !t"$t )(*$ th(!tr"or tth (! &orm$ th ()(t() ort"o!$ o& th !t,r 3($ I& !orm() m,$*)

(*t"#"t% "$ ()tr 3% -$"5!"&"*(!t *h(!5$ "! tooth )(*m!t (! !t,r-3($

*o!to,r+ ( )o!5r (! mor "&&"*,)t r"o o& (,$tm!t m(% 3 (!t"*"(tC)($$"&% $*h ($ @!orm()@ or @(&&*t@ *omm!t o! (!% "m"m!t$.

- Coor"!(t"o!= (t"!t$ 7"th 5oo !,rom,$*,)(r *oor"!(t"o! *(! 3 '*t to )(r!

to m(!",)(t !t,r$ r)(t"#)% :,"*8)% (! )"87"$ ((t r(")% to !7 !t,r$(t"!t$ 7"th oor *oor"!(t"o! or ( !,ro)o5"* &"*"t $,*h ($ &rom ( $tro8. m(%

!#r ((t to ( !t,r *om)t)% C)($$"&% !,rom,$*,)(r *oor"!(t"o! ($ &o))o7$=

C)($$ 1= E'*))!tC)($$ >= F("r

C)($$ ?= oor

h Or() C(#"t%=

- Ar*h S"= C)($$"&% (r*h $" ($ &o))o7$=

C)($$ 1= L(r5 3$t &or rt!t"o! (! $t(3")"t%.

C)($$ >= M",m 5oo rt!t"o! (! $t(3")"t% 3,t !ot "().C)($$ ?= Sm()) "&&"*,)t to (*h"# 5oo rt!t"o! (! $t(3")"t%.

- Ar*h Form= C)($$"&% (**or"!5 to Ho,$= C)($$ 1= S:,(r C)($$ >= T(r"!5 C)($$ ?= O#o"


4/17

M(!% (r*h$ (r *om3"!(t"o!$ o& th (&orm!t"o! *(t5or"$ 5+ $:,(r-t(r"!5.

-S'= 2!r())%+ ((r(!* "$ ( h"5hr r"or"t% &or 7om! th(! &or m! Tho,5h %o,!5r m! o&t! (r *o!*r! 7"th $tht"*$+ m()$ o&t! 5ro7 "!"&&r!t to th"r o7!

((r(!*$ ($ th% (5 D,r"!5 th"$ ro*$$+ m! $h"&t th"r *o!*r!$ to th *om&ort

(! &,!*t"o! o& !t,r$-R(*= R(* *(! 3 ( *r"t"*() &(*tor "! th *h(r(*tr"(t"o! o& !t,r$ "+ *ho"* o&

!t,r 3($ $h(+ )(*m!t o& !t,r 3($ $t("!$+ t*.

-O**,(t"o!= A (t"!t;$ o3 (! $o*"() $t(!"!5 o&t! trm"! th #(), h or $h )(*$ o! or() h()th+ ($ 7)) ($ th $tht"*$ (! othr :,()"t"$ $"r "! ( !t,r

-Co$mt"* I!'= C)($$"&% th (t"!t &rom *)($$ 1 h"5h *o$mt"* "!'. to *)($$ ? )o7

*o$mt"* "!'. (t"!t$ 7"th h"5h *o$mt"* "!"*$+ tho,5h o&t! '(*t"!5+ ,$,())% (r

(r*"(t"# (! *oor(t"# Co!#r$)%+ (t"!t$ 7"th )o7 *o$mt"* "!"*$ o&t! (r"!"&&r!t+ ,!*oor(t"#+ (! )(* )"tt) #(), o! th &&ort$ o& th ro$thoo!t"$t

-r$o!()"t%= C)($$"&% th (t"!t (**or"!5 to Ho,$=

- h")o$oh"*= Tho$ (t"!t$ (r ($%5o"!5+ *o!5!"()+ m!t())% 7))-(,$t+

*oor(t"#+ (! *o!&"!t "! th !t"$t ro5!o$"$ "$ '*))!t- E'(*t"!5= Th$ (t"!t$ (r r*"$+ (3o# (#r(5 "! "!t))"5!*+ "mm(*,)(t "!

r$$ (! ((r(!*+ o&t! "$$(t"$&" 7"th ($t tr(tm!t+ o,3t th (3")"t% o& th r(*t"t"o!r to $(t"$&% h"m or hr+ (! o&t! 7(!t 7r"tt! 5,(r(!t$ or rm(8$ (t

!o ("t"o!() *h(r5 O!* $(t"$&"+ (! '(*t"!5 (t"!t m(% 3*om th

r(*t"t"o!r;$ 5r(t$t $,ortr- H%$tr"*()= Th$ (t"!t$ $,3m"t to tr(tm!t ($ ( )($t r$ort+ h(# ( !5(t"#

(tt"t,+ (r o&t! "! oor h()th+ (r oor)% (,$t+ o&t! ((r @'(*t"!5@ 3,t

7"th ,!&o,! *om)("!t$+ h(# &(") (t ($t (ttmt$ to 7(r !t,r$+ (! h(#

,!r()"$t"* '*t(t"o!$ h%$tr"*() (t"!t$ o&t! m(! $tht"*$ (! &,!*t"o!:,() to or 5r(tr th(! !(t,r() tth. ro5!o$"$ "$ oor

- I!"&&r!t= Th$ (t"!t$ (r !ot *o!*r! 7"th ((r(!*+ o&t! 5o 7"tho,t

!t,r$ &or %(r$ or 7(r oor or 7or!-o,t !t,r$ &(r 3%o! $r#"*(3")"t%.+o !ot r$#r+ (! o !ot ((t 7)) S,*h (t"!t$ h(# !o $"r to 7(r

!t,r$ (! o !ot #(), th &&ort$ or $8"))$ o& th !t"$t

11 MEDICAL HISTORY

- 2!r() H()th= A thoro,5h (! (**,r(t m"*() h"$tor% m,$t 3 o3t("! ,r"!5 th

"(5!o$t"* h($ o& *om)t-!t,r thr(% (! m,$t 3 ,(t ($ !*$$(r% Thm"*() h"$tor% ro#"$ "mort(!t "!$"5ht$ r5(r"!5 th (t"!t;$ !t() ro5!o$"$

Not $,rr"$"!5)%+ (t"!t$ 7ho 'h"3"t 5oo h()th 5!r())% (r 3ttr ro$tht"* r"$8$

th(! tho$ "! oor h()th H!*+ th r(*t"t"o!r m,$t 3 (7(r o& )o*() (! $%$tm"*&(*tor$ (! m,$t *o!$"r thm ,r"!5 tr(tm!t )(!!"!5 S%$tm"* &(*tor$ th(t m(%

(&&*t *om)t-!t,r thr(% "!*),= (!m"(/ (rthr"t"$/ B));$ ()$%/ *(r*"!om($/

"(3t$/ ),,$ r%thm(to$,$/ !"*ot"!"* $tom(t"t"$/ (5t;$ "$($/ (r8"!$o!;$"$($/ mh"5,$ #,)5(r"$/ ),mmr-V"!$o! $%!rom/ $*)rorm(/ t,3r*,)o$"$/

(! "$($$+ *o!"t"o!$+ or thr("$ )("!5 to 'ro$tom"( Lo*()" )$"o!$+ &*t$+

(! (3!orm()"t"$ ro#" ( 7" (rr(% o& *)"!"*() $"t,(t"o!$ th(t (r !ot (r$$


5/17


6/17

- r-E'tr(*t"o! R*or$= r-'tr(*t"o! hoto5r(h$+ r("o5r(h$+ *($t$+ (! &(*"()

m($,rm!t$ m(% ro# h)&,) "! !t,r thr(% Th$ (,!*t$ m(% 3 ,$ to

r*r(t (!tr"or $tht"*$ (! &(*"() $,ort+ ($ 7)) ($ to (" "! th #(),(t"o! o& #rt"*()"m!$"o! o& o**),$"o!

IV CLINICAL EVALUATION

( F(*"() Form &ro!t().= C)($$"&% (**or"!5 to Ho,$ (! Loo+ Fr,$h (! F"$hr (!


7/17

M(!"3,)(r R"5 Form= M(!"3,)(r r"5 &orm "$ *)($$"&" ($ &o))o7$=

C)($$ 1= I!#rt @U@ $h( C)($$ >= I!#rt @U@ $h(

(r())) 7())$ &rom m",m to $hort 7"th &)(t *r$t.

t()) 7"th 3ro( *r$t.

C)($$ ?= U!&(#or(3)=

I!#rt @= C)"!"*() '(m"!(t"o! r#()$ tor" o& mor(t $" S,*h tor" o&&r m")

"&&"*,)t"$ "! !t,r *o!$tr,*t"o! (! ,$ S,r5r% "$ !ot r:,"r

C)($$ ?= L(r5 tor" (r r$!t Th$ tor" *omrom"$ th &(3r"*(t"o! (! &,!*t"o! o&!t,r$ S,*h tor" ,$,())% r:,"r $,r5"*() r*o!to,r"!5 or rmo#()


8/17

I!tr(*h S(*= C)($$"&% "!tr(*h $(* ($ &o))o7$=

C)($$ 1= I() "!tr(*h $(* to (**ommo(t th (rt"&"*"() tth

C)($$ >- E'*$$"# "!tr(r*h $(* C)($$ ?= I!$,&&"*"!t "!tr(r*h

$(* to (**ommo(t th

(rt"&"*"() tth

R"5 (r()))"$m= C)($$"&% r"5 (r()))"$m ($ &o))o7$= C)($$ 1= Both r"5$ (r (r()))to th o**),$() )(!

C)($$ >= Th m(!"3,)(r r"5 "$ "#r5!t &rom th o**),$() )(! (!tr"or)%


9/17

C)($$ ?= Th m('"))(r% r"5 "$ "#r5!t &rom th o**),$() )(! (!tr"or)% or 3oth

r"5$ (r "#r5!t (!tr"or)%+

R"5 R)(t"o!$h"= C)($$"&% (**or"!5 to A!5)=

C)($$ 1= Norm() C)($$ >= Rtro5!(th"* C)($$ ?= ro5!(th"*

Bo! ,(!t"t%= C)($$"&% (**or"!5 to Br(!m(r8 t () ($ #"7 o! r("o5r(h"*

'(m"!(t"o!.=

C)($$ A= M('"))( M(!"3)$

C)($$ B= M('"))( M(!"3)$

C)($$ C= M('"))( M(!"3)$


10/17

C)($$ D= M('"))( M(!"3)$

C)($$ E= M('"))( M(!"3)$

Bo! ,()"t%= C)($$"&% (**or"!5 to Br(!m(r8 t () ($ $! o! r("o5r(h"*

'(m"!(t"o!.+

C)($$ 1= C)($$ >=

C)($$ ?= C)($$ 4=


11/17

L(tr() Thro(t Form= C)($$"&% (**or"!5 to N")=

C)($$ 1= C)($$ >=

C)($$ ?=

()(t() Thro(t Form= C)($$"&% (**or"!5 -Ho,$=

C)($$ 1= L(r5 (! !orm() "! &orm+ 7"th ( r)(t"#)% "mmo#(3) 3(! o& r$")"!t t"$$,

to 1> mm "$t() to ( )"! r(7! (*ro$$ th "$t() 5 o& th t,3ro$"t"$

C)($$ I


12/17


13/17


14/17


15/17

- o$t (m= Th o$tr"or 3orr o& th m('"))(r% !t,r $ho,) 3 '(m"! L"87"$+

$o&t t"$$,$ "! th #"*"!"t% o& th @#"3r(t"!5 )"!@ $ho,) 3 o3$r# Th $() o&

th '"$t"!5 m('"))(r% !t,r $ho,) 3 #(),(t *)"!"*())% O&t!+ &"*"!*"$"! rt!t"o! o& th m('"))(r% !t,r m(% 3 tr(* to "mror o$t-(mm"!5

Th o$t (m $ho,) 3 r(t @(**t(3)@ or @,!(**t(3)@

- B($ A(t(t"o!= Th &"t o& m('"))(r% (! m(!"3,)(r 3($$ $ho,) 3 ($$$$ ,$"!5

(! (ror"(t "$*)o$"!5 m",m+ A(t(t"o! $ho,) 3 r(t @(**t(3)@ or

@,!(**t(3)@

- M")"!= M('"))(r% (! m(!"3,)(r m")"!$ $ho,) 3 o3$r# A)tho,5h

"$*r(!*"$ 3t7! m('"))(r% (! m(!"3,)(r m")"!$+ m(% 3 r$!t+ "t "$

*r"t"*() th(t th m('"))(r% m")"! *o"!*" 7"th th &(*"() m")"! D"$*r(!*"$"! m")"! )(*m!t *r(t !ot"*(3) &(*"() "$h(rmo!"$ Th '"$t"!5

m('"))(r% m")"! $ho,) 3 #(),(t ,$"!5 "!tr(or() 5+ "!*"$"# ("))(. (!

'tr(or() )(!m(r8$ 5+ !($"o!+ &")tr,m+ m") o& th *h"!. Th m")"! $ho,)

3 r(t @(**t(3)@ or @,!(**t(3); D#"(t"o!$ o& th m('"))(r% m")"!$ho,) 3 r*or 3% "r*t"o! (! (mo,!t 5+ m('"))(r% m")"! > mm to th

r"5ht o& th &(*"() m")"!.

- B,**() V$t"3,)= Th 3,**() #$t"3,) "$ (! "mort(!t $tht"* (! &,!*t"o!()

*omo!!t "! *om)t !t,r $r#"* Co!$:,!t)%+ th"$ $(* $ho,) 3($$$$ *(r&,))% Th 3,**() #$t"3,) $ho,) 3 ,5 @(**t(3)@ or

@,!(**t(3)@ Corr*t"# (*t"o!$ $ho,) 3 roo$

- Cro$$3"t= Th r$!* o& ( ,!")(tr() or 3")(tr() *ro$$3"t o&t! r$!t$ (*h())!5"!5 $"t,(t"o! Cro$$3"t$ $ho,) 3 !ot (! th"r &&*t$ o! tooth

)(*m!t (!t"*"(t Th"$ "!&orm(t"o! m(% 3 !tr "!to th "(5!o$t"* r*or

,$"!5 th *(t5or"$ @!o! + ,!")(tr()+@ or @3")(tr()@

- Ch(r(*tr"(t"o!= Ch(r(*tr"(t"o! or $t("!"!5 o& '"$t"!5 !t,r 3($$ $ho,) 3

#(),(t (! r*or E'"$t"!5 !t,r 3($$ m(% 3 *)($$"&" ($@*h(r(*tr"@ or ; ;,!*h(r(*tr"@

- Com&ort= Th (t"!t $ho,) 3 :,$t"o! r5(r"!5 th *om&ort o& m('"))(r% (!

m(!"3,)(r !t,r$ Com&ort &or th r$*t"# (r*h$ $ho,) 3 *)($$"&" ($@(**t(3)@ or @,!(**t(3)@ (t"!t$ 7ho 'r"!* "$*om&ort $ho,) 3

:,$t"o! to trm"! th !(t,r (! $o,r* o& th "$*om&ort

- H%5"!= Th (t"!t;$ (3")"t% (! mot"#(t"o! to *)(! th !t,r$ $ho,) 3 ($$$$

,r"!5 th *)"!"*() #(),(t"o! Th (t"!t ()$o $ho,) 3 :,$t"o! (3o,t h"$ or

hr !t,r *)(!$"!5 r5"m! Th$ &(*tor$ m(% (&&*t !t,r-3($ *o!to,r"!55+ *)o$ "!tr!t() *o!to,r$ #r$,$ o! "!tr!t() *o!to,r$. (! tooth

(rr(!5m!t 5+ r$!* or (3$!* o& "($tm(t(. H%5"! $ho,) 3

*)($$"&" ($ 1. 5oo+ >. &("r+ or ?. oor


16/17

- . mor(t+ or ?. $#r

- Att(*hm!t$ (! H(r7(r= Att(*hm!t$ (! h(r7(r ,$,())% (r )"m"t to

o#r!t,r $"t,(t"o!$


17/17

2"# th ro5!o$"$ (! )"$t th r($o!$ &or th ro5!o$"$

SUMMARY

A *h*8)"$t "$ r$!t &or ,$ "! #(),(t"!5 (! )(!!"!5 th tr(tm!t o& (t"!t$ &or

*om)t-!t,r thr(% A thoro,5h ')(!(t"o! o& (*h "tm (! *)($$"&"*(t"o!"!*), "! th *h*8)"$t )"$t ()$o "$ r$!t C)($$"&"*(t"o!$ &rom th *)($$"*

ro$thoo!t"* )"tr(t,r (r ,$ 7hr#r o$$"3) (! th"r $o,r*$ (r r&r!*

(ror"(t)%

Documents

482 Patient Evaluation for Dentures