Search

A technique for duplication of a maxillary complete denture has been presented. This technique requires no special equipment and can be easily completed in the dental office.

Examination and diagnosis forms for edentulous patients from 46 dental colleges in the United States were used in this study. Selected data were taken from each form and compiled under four general and 15 specific entries. Some college forms use entries requiring few and succinct responses,while other forms use entries requiring many and detailed responses. It appears that a correlation does exist between the thoroughness of the examination form and the proficiency of the dental student rendering complete denture therapy. Stated in a positive manner, this survey of college complete denture examination forms suggests that most dental students: use a separate complete denture form for the examination and diagnosis; ask for the chief complaint of the patient; ask one to four questions on past dental history; record 10 to 19 entries relating to oral anatomy; record one to four entries relating to oral physiology; record the mental attitude using two to four descriptive terms; and record one prognosis. Stated in a negative manner, this survey of college complete denture examination forms suggest that most dental students: do not examine the present complete dentures worn by the patient; do not use oral diagrams to show unfavorable or abnormal areas; do not ask for a prognosis in two or more areas; do not ask if the patient wears complete dentures at night; do not ascertain the attitude of the patient after receiving complete dentures; do not ask questions on complete denture expectations; do not use an interview form; and do not work with a staff dentist who has a psychology degree. The intent of this study is to create a spectrum of awareness concerning the presence or absence of specific information on the examination forms. Complete denture examination forms would be more beneficial to the dental student if they provided a high quality of pertinent clinical information. This information would aid the dental student in making an intelligent diagnosis, treatment plan, and prognosis.

eneral considerations necessary to determine whether a complete denture reline should be attempted or a new denture constructed have been presented. Specific evaluation procedures, including the examination and diagnosis of the patient and the complete denture(s) along with a checklist of complicating factors, have been discussed. Hickey and Zarb have said: "The complicated [nature] of the conditions to be corrected makes [reline] procedures not the simple operations many patients and dentists think they are." The authors emphatically agree.

Reline procedures for complete dentures have received scant attention in the literature. Fifty-seven dental colleges responded to an 11-item survey on reline procedures. According to the tabulated data, most dental schools recommended the following (not necessarily our recommendations). Leave the denture(s) out of the mouth for at least 24 hours prior to fabrication of the reline impressions. Use tissue-conditioning material only on selected patients. Use Coe Comfort as the tissue-conditioning material of choice. Place either none or one relief hole in the maxillary denture, and place no relief holes in the mandibular denture prior to the impression(s). Place relief holes along the palatal midline of the maxillary denture. No specific size is recommended for the palatal relief holes. Place 1 mm of basal surface relief and 1 to 2 mm of border relief before the reline impression is made. Use a polysulfide rubber base material as the material of choice for reline impressions. Use a closed mouth impression technique. Remove the palate from the maxillary denture prior to processing. Use heat-cured resin (Lucitone) for processing. Use pressure-indicator paste prior to delivery of the denture(s). Remount the complete denture(s) on an articulator after processing for making occlusal corrections.

A written self-administered questionnaire aids in treating edentulous patients and greatly reduces the possibility of patient dissatisfaction and medicolegal complications. Twenty-two questions have been presented which are to be answered in writing by the edentulous patient prior to the interview and examination. Such a questionnaire has several advantages31: (1) It saves time for the dentist and reduces the cost of treatment. (2) It quickly identifies problem areas. (3) It provides background information on the patient which is useful during the oral interview. (4) It identifies patients who write more intelligently and openly than they speak. (5) It evaluates neuromuscular coordination through handwriting review. (6) It serves as a reference for postinsertion problems. (7) It has legal merit when properly dated and signed and indicates that maximum diagnostic and therapeutic efforts are intended.

The findings and philosophy as to why a purposeful interview conducted in the dental office is desirable for the problem patient have been presented. Rapport and meaningful dialogue between dentists and patients are the first steps necessary for successful treatment. Conducting the interview with problem patients in the dental operatory may lead to one-way communication, from the dentist to the patient. The finest clinical oral health procedures may be doomed to failure when patients see themselves more as spectators than as participants in their planned over-all health care.