Replacements of lost teeth have been performed for thousands of years, first known denture was made 700 BC from ivory and bone.
Various materials have been used since then: silver, gold, porcelain, vulcanized rubber etc. The major breakthrough in prosthodontics was a discovery of acrylic resin. Now, we are witnesses of a revolution in teeth replacement procedures-dental implants.
Unfortunately, restorations are frequently connected with different oral lesions and periodontal complications. Oral mucosal lesions are usually caused by partial or complete removable dentures. Periodontal health could be jeopardized mostly by fixed prosthodontics. But, in everyday clinical practice, we have to deal with complications that could be result of different etiological factors, both local and systemic. As professionals, we should be able to take all factors into consideration in order to prevent possible problems.
Mucosal lesions associated with removable dentures could be the result of mechanical injury, represent a reaction to constituents of denture base material or caused by microbial denture biofilm. Common lesions include denture stomatitis, angular cheilitis, traumatic ulcers, denture irritation hyperplasia, flabby ridges, and sometimes even oral carcinomas.
Denture stomatitis is the most common condition which affects the palatal mucosa in many complete or partial removable denture wearers. The lesions are caused by chronic fungal infection (Candida spp are able to form a biofilm on acrylic surface) with combination of mechanical injury.
Although the most types of lesions are benign and quite symptomless, they can develop in such extent to make denture wearing impossible. Also, dentures could represent a source of systemic infection especially in elderly patients. There are cases of oral squamous cell carcinomas developed on the ground of a chronic irritation of mucosa.
Dental restorations play a significant role in maintaining periodontal health. The relationship between periodontal health and the restoration of teeth is intimate and inseparable. Faults in dental restorations and prostheses are common causes of gingival inflammation and periodontal destruction. There are some characteristics of restauration that can seriously affect periodontal health. One of them is the margin of restauration, providing ideal location for the accumulation of plaque and shift in the ecologic balance of the gingival sulcus favoring growth of the gram negative anaerobic bacteria. Overconturing the restorations leads to the creation of areas in which oral hygiene procedures are unable to control plaque. The preservation of biologic width and avoidance of its violation is one of the most important steps for a maintenance of periodontal health. Residual cement material in the subgingival area will represent ideal surface for biofilm formation.
The majority of complications following tooth restorations are caused by a biofilm formation or a shift in the composition of local microflora. Thus, beside creating restauration that will allow proper plaque control, maintaining correct oral hygiene procedures, created for each patient individually are crucial for both mucosal and periodontal health.
Also, in order to prevent or minimize the extent of the lesions, our patients with dental restorations should be recalled regularly for an examination and oral hygiene should be checked and corrected if needed.
Participants will learn about common oral mucosal lesions caused by fixed or removable prosthodontic restorations. Focus of this course is on etiological factors that lead to the development of disease, as well as on preventive measures and treatment options of the established lesion. Since majority of complications are connected with biofilm build up, specific techniques of oral hygiene will be explained.
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