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1. retrognathism

2. 2 Lip Health Lips should be examined for cracking, fissuring at the corners and ulceration. These changes could be caused by: Vitamin B-complex deficiency Candida albicans Excessive overclosure of an existing denture Neoplastic

3. LIPS CAN BE CLASSIFIED INTO 4 TYPES Competent lips – lips are in slight contact when the musculature is relaxed Incompetent lips – morphologically short lips which do not form a lip seal in a relaxed state Potentially incompetent lips – normal lips , fail to form lip seal Everted lips – hypertrophied lips with weak muscular tonocity. 3

4. TMJS & MASTICATORY MUSCLES EXAMINATION TMJ plays a major role in the fabrication of a Complete Denture. The joint should be examined for range of movements, pain, muscles of mastication, joint sounds upon opening and closing. Severe pain in the TMJ indicates increased or decreased VD. • Class I: Co - ordinated • Class II: Jerky • Class III: Restricted

5. NEUROMUSCULAR EVALUATION Patients gait, coordination of movements, ease with which he moves noted Uncontrolled tremors of mandible and tongue may lead to prosthesis instability. SPEECH COORDINATION

6. COORDINATION Patients with good neuromuscular coordination can be expected to learn to manipulate dentures relatively quickly and likewise adapt readily to new dentures . Patients with poor coordination or a neurologic deficit (such as from a stroke) may never adapt to a denture completely . Classify neuromuscular coordination as follows: Class 1: Excellent Class 2: Fair Class 3: Poor

7. INTRA ORAL EXAMINATION