Retention Stability and Support in Complete Denture.pptx

Retention Stability and Support in Complete Denture,Retention is the quality of a denture that resists movement away from the tissue.
Factors affecting the retention of CD
1. Anatomical factors.
2. Physical factors.
3. Mechanical factors.
4. Muscular factors.
5. Surgical factor.
1. Anatomical factors:
The various anatomical factors that affect retention are:
Size of the denture bearing area, quality of the denture bearing area
It mainly affects the lower denture
a. Ridge form:
1. High and flat crest and well-formed in recent extraction. The problem only is no space for setting teeth
2. Flat one difficult and no retention and stability, so when taking the impression, try to extend it beyond the mylohyoid area to gain more stability and retention.
3. Ridge with undercut is more common in the upper (bilateral maxillary tuberosity), so we do surgery on one side and block out the other. We need to adjust the insertion path.
4. Knife ridge is rugged and can cause lacerations and pain, so we provide relief.
5. Flabby ridge fibrous tissue and movable, not a good seal, so we either modified the impression technique or do surgical correction.

1. Retention Stability and Support in Complete Denture

2. Retention: is the quality of a denture that resists movement away from the tissue. Factors affect in the retention of CD Anatomical factors. Physical factors. Mechanical factors. Muscular factors. Surgical factor.

3. 1. Anatomical factors: a. Ridge form: High and flat crest and well formed in recent extraction. The problem only is no space for setting of teeth Flat one difficult and no retention and stability so in taking the impression try to extend it beyond mylohyoid area to gain more stability and retention.

4. Ridge with undercut is more common in the upper (bilateral maxillary tuberosity), so we do surgery on one side and block out the other, and we have to change the path of insertion. Knife ridge difficult and cause lacerations and pain so we do relief . Flabby ridge fibrous tissue and movable , not good seal so we either modified the impression technique or do surgical correction .

5. b. Vault Form: 1.U shaped good in retention and stability. 2.V shaped have retention but no stability, and any pressure on it could break the seal. 3. flat shaped no enough depth, so no retention and stability.

6. c. Arch Form: Squared, ovoid, tapered

7. The best one is the square. This is because of: There are 4 points of contact with a denture . Resist the lateral forces. Arch relationship

8. 4. Inter arch distance : Small interarch space more retention. 5. Tongue: If too big it could interfere with denture. So, dislodging of the lower and upper. 6. Mucosa: We need it Firm , compressible and even thickness . Not to be thick and flabby.

9. 2. Physical factors: Adhesion: It’s a physical attraction between unlike molecules, like the contact of saliva to both oral tissue and denture base.

10. retention provided by adhesion is depend on: Close adaptation of the denture base type of saliva (viscosity and wettability). Area cover by the denture: The size of maxillary denture bearing area is about (24 cm²) & that of mandible is about (14 cm²)

11. Cohesion: Its physical attraction between like molecules . Factor affecting cohesion: Area covered by the denture (cohesion is directly related to the area covered by denture if all the factor are equal) Thickness of the salivary film Adaptation to denture base to mucosa Interfacial surface tension:

12. Capillary attraction : the quality that causes elevation or depression of the surface of the liquid that is in contact with the solid Close adaptation of denture base to soft tissue . Greater the size of the denture bearing area greater the capillary attraction retention.

13. Atmospheric pressure and peripheral seal: Closeness of adaptation Peripheral seal Posterior palatal seal area

14. Function of the posterior palatal seal Aids in retention by maintaining constant contact with the soft palate during functional movements like speech mastication and deglutition. Reduce the tendency for gag reflex Prevent food accumulation between the posterior border of the denture and the soft palate. Compensates for polymerization shrinkage

15. Gravity

16. Viscosity Fluid having a high viscosity resist flow more effectively than those of lower viscosity. The additional saliva will cause loss of retention of the denture because of the resultant increase in distance between the denture & mucosa

17. Wettability The wetting characteristics may be described in terms of contact angle (high contact angle indicate poor wetting).

18. 3.Mechanical factors: The varicose mechanical factors which aid in retention are: 1) Undercuts 2) Magnetic force 3) Denture adhesion 4) Suction chambers and suction discs.

19. Mode of action of adhesives Increasing the adhesive , cohesive properties and viscosity of the interposed medium . Eliminating the voids between the denture base and its basal seat.

20. Increases the viscosity of saliva. Hydrated material swells up in the presence of saliva /water. Hydrated material formed by adhesives sticks readily to the tissue surface and the mucosal surface of the denture.

21. Side effects of denture adhesive: • High or elevated zinc blood levels. • Symptoms of nerve damage. • Numbness or tingling in the arms and legs, Paraesthesia. • Anaemia • Bone Marrow Failure

22. 4. Muscular factors: (1) The denture bases must be properly extended to cover the maximum area possible, without interfering with the health and function of the structures that surround the denture; (2) The occlusal plane must be at the correct level . (3) The arch form of the teeth must be in the " neutral zone " between the tongue and the cheeks.

23. The muscles that affect retention are: A- Buccinators B- Orbicularis oris C- muscles of the tongue

24. Denture surface: Occlusal surface: Polished surface: Impression surface:

25. Stability: that quality of maintaining a constant position in the presence of forces that threaten it ; The quality of a denture to be firm , stable or constant and to resist displacement by functional stresses & not to be subject to change of position when forces are applied.

26. Factors that affecting the stability are: Vertical height of the residual ridge Quality of the impression Occlusal rims Arrangement of the teeth Contour of the polished surface Shape of the Palatal Vault Retention Proper relief

27. The width of the occlusal table must be less than that of normal teeth to get good stability and retention.

28. Vertical height of the residual ridge The residual ridge should have sufficient vertical height to obtain good stability. Highly resorbed ridges offer the least stability.

29. Quality of the impression: An impression should be as accurate as possible . The impression surface should be smooth and duplicate all the details accurately. It should be devoid of voids and any rough surfaces . The impression should not warp on removal . The impression should be dimensionally stable, and the cast should be poured as soon as possible .

30. Occlusal plane: The occlusal plane should be oriented parallel to the ridge . If the occlusal plane is inclined, then the sliding force may act to reduce its stability. The occlusal plane should divide the interarch space equally .

31. Teeth arrangement ( balanced occlusion and neutral zone ): Balanced occlusion facilitates the even distribution of force across the denture. Absence of the balanced occlusion may produce an unbalanced lever-type force at any one side of the denture, leading to loss of stability. The teeth in the denture should be arranged in the neutral zone .

32. Contour of the polished surface: The polish surface of the denture should be harmonious with the oral structures. They should not interfere with the action of the oral musculature.

33. Shape of palatal vault: A steep palatal vault may enhance stability by providing greater surfaces area of contact & long inclines approaching a right angle to the direction of force .

34. Stability decreases with: Loss of vertical height of the ridge , Increase in the movement of flabby tissue.

35. Support

36. The resistance to vertical forces of mastication , occlusal forces & other forces applied in a direction towards the denture bearing area.

37. The soft tissues should be: the mucosa covering the hard palate and the crest of the residual ridge, including the residual attached gingiva, is classified as masticatory mucosa . 2. The submucosa is firmly attached to the periosteum of the underlying supporting bone and will usually withstand successfully the pressures of the dentures. It is characterized by a well-defined keratinized layer on its outermost surface that is subject to changes in thickness depending on whether dentures are worn and on the clinical acceptability of the dentures.

38. When the submucosal layer is thin , the soft tissues will be non-resilient , and the mucous membrane will be easily traumatized . When the submucosal layer is loosely attached to the periosteum or it is inflamed or oedematous , the tissue is easily displaceable , and the stability and support of the dentures are adversely affected .

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