Important Post Delivary instructions following Denture Delivary

Here in this post we would like to share, Important Post delivery instructions following Denture delivery.

Congratulation! You have just received your finalprosthesis. We hope you will enjoy using it. There are a few things to keep inmind:

1. You may salivate more heavily for the next several days,until your mouth is accustom to the presence of the new prosthesis.

2. You may feel awkward when talking or speaking certainwords, at first. With practice, your tongue will be trained to accommodatearound the prosthesis and your phonic will become normal, again. Reading outloud may help expedite the process.

3. Sore spots are normal. Please give us a call to have yourprosthesis adjusted, as necessary. We want to make sure that you will be ableto use your new teeth, as comfortably as possible.

4. Occasionally, due to the morphology of the underlying jawbone, the use of adhesive cream or paste may be required to attain satisfactoryretention.

5. Keep your prosthesis soak in a water bath, with denturecleansing tablet, when not in use, especially during bed time.

6. Leave your new teeth out, during bed time, allowing yourgum to breath regain normal circulation.

7. Clean your denture with a toothbrush and hand/liquidsoap, over a half-filled sink or bucket of water, prior to each use.

8. Avoid chewing gum or eating sticky foods.

New full or partialDenture Instructions-in Detail

Introduction

I believe that youwill be very successful with your new full denture or removable partial denture.When you begin to wear your new prosthesis there is an adjustment period whereyour usual mouth functions may need to be relearned. These include chewing,speech, swallowing, appearance of lip posture, and ridge comfort. The followingsuggestions may help you in adapting to your new prosthesis and in maintainingit.

Discomfort

Avoid pain by startingwith easy but nutritious food to eat. Examples of a softer diet can includefish, eggs, cottage cheese, cooked potatoes, oranges and apple sauce. If you havediscomfort, remove the denture and massage the painful area with your finger.Let the gums rest and then replace the denture. Continue to use your prosthesisuntil your next visit. If you fail to wear the denture, no sore will be visibleand precise adjustments will be very difficult.

Chewing

Try to chew with foodon both sides of your mouth. If food is bilaterally placed, the denture will beless likely to tip. Try not to bite with the front teeth as this may cause the backend of the denture to move off the gums. Biting with the side teeth will givebetter stability. Holding the top denture up with the tongue while chewingrequires talent but this habit can be very useful.

Swallowing

Pain during swallowingmay simply require a minor denture base adjustment.

Saliva

With the stimulus of newdentures your mouth may have more or less saliva for a few days. Be patient andthe flow will return to normal.

Speech

Speech is a verycomplicated and dynamic process involving all parts of the airway and mouth.Your denture has been constructed to meet the demands of stability and retentionduring speech. Fortunately, people are very adaptable and speech sounds verygood at the time of delivery. If speech does not sound right to you, give it sometime and normal body adaptation will resolve your concerns. Practice readingaloud. Do not focus undue attention on the process.

Cleaning

To remove food debrisand bacterial plaque from your prosthesis, brush vigorously with a stiffdenture brush. Use either soap and water, tooth paste or a commercially availabledenture cleaning agent. The effervescent soaking solutions are also useful.Follow the manufacturer’s instructions. Wash your denture over a basin of wateror a cloth. If they are dropped on a hard surface, the acrylic portion mayfracture and any metal may bend.

Sleep

In general, take thedentures out or at least remove the lower denture for the night. This will allowthe gums to rest. If this causes the jaw joints to hurt replace the denturesand use your best judgment for comfortable

sleep.

Recall

Post deliveryfollow-up usually requires three visits. More are available as needed. Afterthe first year, annual recall visits are useful to monitor changes in the shapeof the ridges, wear of the teeth and general oral health. If there are problemswith pain, chewing, or with wear or breakage of the base or teeth, please makean appointment with the office at your earliest opportunity.

Free Download Glossary of Prosthodontic Terms

Free Download Glossary of Prosthodontic

(Prosthetic Dentistry) Terms

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Diagnostic Hierarchy for Chronic Headache and OroFacial pain free download

Diagnostic Hierarchy for Chronic Headache and OroFacial pain

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Diagnosis Chart for Oral Mucosal Lesions

Click here to Download This Chart (High Resolution)

Note on Necrotizing Sialometaplasia

Itis spontaneous condition of an unknown cause usually of the palate in whichlarge area of the surface epithelium underlying connective tissue and all theassociated minor salivary glands become necrotic while the ducts under gosquamous metaplasia. 

Clinicalfeatures:

Usuallythe location is at the junction of the hard and the soft palatebut it may alsobe present at tongue, retromolar pad and the nasal cavity.

NSMis characterized by deep seated ulceration it is punched out

Within its deep crater are the gray granular lobules which represents the necroticminor salivary glands.

Itis 2-3 cm in diameter.

Itis asymptomatic but there may be numbness or burning pain.

Histopathology:

Inthe palatal epithelium there is no zone of ulceration which replaced by fibringranulation tissue.

Thelobules of minor salivary glands undergo coagulation necrosis.

Therescattered neurophils and foamy histocytes present in zone of necrosis.

Treatment:

Notreatment is required once the diagnosis is confirmed by histologicalexamination .

Theulcer area heals by its self with in 1-3 months.

Necrotizing Sialometaplasia

Necrotizing Sialometaplasia

A Apical Diagnosis Flowchart

Apical diagnosis flowchart

Notes on Sialolithiasis-Clinical features, Investigations, Histopathology and Treatment

Sialolithiasis

Thereis presence of one or more round or oval calcified structures in the duct ofthe major or minor salivary glands( salivary stones)

Howthe stone is formed:

Itis assumed that mucin proteins and desquamated ductal epithelial cells form asmall nidus on which the calcium salts are precipitated, this nidus then allowsconcentric lamellar crystallizations to occur and thus sialolith increases insize as a layer by layer gets deposited on it

Clinicalfeatures of sialolithiasis:

About80%of sialolith affects the major salivary glands and there is more predilectionsfor the submandibular gland.

Stonesare rare in children the average age is the 4^th decade with no sex preference.

Theyare asymptomatic discovered on dental radiographs.

Ifsymptomatic the chief complains are pain and swelling . Swelling is results asthere is ductal dilatation caused by the ductal blockade.

Thepain is described as pulling drawing or stinging.

SialolithiasisInvestigations:

Panoramicradiograph.

Ultrasound imaging

orsailography

Histopathologyof sialolithiasis:

Stone: On gross examination moststones are yellow or white in colour. they may be round to oval

  - some of the stones are nodular

  - after decalcification the stone showsconcentric rings as of the annual rings of a tree trunk

   -The stone is acellular and amorphous innature and may contain microbial colonies.

Ducts: the ductal lining thatsurrounds sialolith shows variety of reactive changes.

   - there is squamous and mucus cell

     metaplasia and changes to stratifiedsquamous epithelium with numerous mucous goblet cells

Sialolithiasistreatment:

• Manyof the major salivary gland sialoliths can be removed by manipulation of thestone through major duct orifice
• Whenmanipulation fails then a surgical cut is made into the main duct
• Intriangular, or multiple stones and long standing obstructions removal of thestone and sialadenectomy is done.

Notes on Mucocele and Mucous Retention cyst-Etiology,Clinical Features,Differential Diagnosis and Treatment

Salivary glands react to injury or obstruction by undergoing atrophic degeneration and necrosis with replacement of the parenchyma byinflammatory cells and ultimately fibrous scar formation

Mucocele

It is a tissue swelling composed of pooled mucus thatescapes into the connective tissue from several excretory ducts

Mucocele

Whensalivary duct is severed the acinar cells will continue to secrete saliva intothe severed duct.

Atthe site of the cut/severance the secretory product escape into the connectivetissue forming a pool of mucus that distends the surrounding tissue.

Etiology:

Minorglands of the lip are most prone to severance as a result of injury or bitingthe mucosa.

Intraoral minor salivary can also be effected as result of some irritation as well.

Clinicalfeatures

Mostlyencountered in children and young adults.

Twothird of the mucoceles occur in the 3^rd decade of life.

Bothmales and females are effected equally.

Site:mucosal surface of the lower lip

              buccal mucosa

              floor the mouth

              ventral of the tongue and palate

Clinicalappearance of the mococele depends on its location within the submucosa

Moresuperficial zones of mucous extravasations presents a fluctuant mass withbluish translucent appearance.

Patientusually feels the mucocele and the fluctuation in its size

Painis quite rare .

Initiallythe mucocels are well circumscribed but with repeated truma they become nodular,more diffuse and firm on palpation.

Themucoceles have finely vascularized and distended, appearance often referred toas frogs belly that’s why they are also called Ranulas

Whenpart of this ranula is deep seated in to the sumental or submandibular spacethen the term used is the” Plunging Ranula”

Differentialdiagnosis

• Mucoepidermoidcarcinoma
• Cavernoushemangeoma (when there is hemorrhage)
• Blistersseen in some bullous and desqumative disease.

Histopathology:

Underlyingpool of mucin distends the sarface epithelium.

Themucin is walled of by the rim of granulation tissue or in long standing casesby condensed collagen.

Anepithelial lining is lacking

Themucinous material  basophilic oracidophillic and contains  neutrophilsand large oval foam cells the histocytes .

Thebase of the mucocele will reveal feeder duct.

Longstanding mucoceles will show acinar degeneration with fibrosis and minimalinflammation .

Treatment:

Minorsalivary gland mucocele will not resolve on its own it must be surgicallyexcised.

Tominimize the chances of recurrence the feeder gland should also be removed.

Postsurgical parasthesia might occur when the branches of the mental nerve aresevered

Surgical Removal of Mucocele-Video

Mucusretention cyst

Itis a swelling caused by an obstruction of a salivary gland excretory ductresulting in an epithelial lining cavity containing mucus. Mucus retention cystis sometimes also referred as Sialocyst

Themucus retention cyst is lined by epithelium and rarely occur in the majorsalivary gland, when they do occur they are multiple i.e. poly cystic diseaseof the parotid gland

Clinicalfeatures:

Encounteredin adults from 3^rd -5^th decade.

Thelesion is painless and fluctuant and at times bluish in appearance.

Site:parotid cysts are located in the   superficial lobe as fluctuant well defined mass.

    -with in the oral cavity the floor of themouth is the most common place.

    -this is followed by the lip and the buccalmucosa

Histopathology:

Theepithelium of the cyst is stratified cuboidal or columnar duct like epithelium.

Thecytoplasm in the of these cells is either clear or eosinophlic and my show somefeatures mucous differentiation

70%of these cyst are unilocular rest of the 30% have multilocular pattern.

 

Treatment:

Simpleexcision is the treatment of choice with caution of rupturing the cystic sacs.

Recurrenceis rare.

Howeverdamage to the adjacent gland may result in a mucocele formation.