Yes, but how would you deside on the length of the flange? What influences the length of the flange while taking into consideration the fact that stability needs to be taken into consideration?
Flange Extension 1. Denture bases for tooth-tissue supported partial dentures (Class I and II) should be extended to provide the greatest available surface area for support and retention, without overextension or impingement on movable border tissues.
2. Tooth supported partial dentures (Class III and IV) need not necessarily be extended maximally, since most of the support for these dentures comes from the teeth.
3. Maxillary distal extension denture bases should terminate in the hamular notches.
4. Mandibular distal extension denture bases should terminate on the pear-shaped retromolar pads.
5. Occasionally, the path of insertion can cause the denture flanges to impinge on the mucosa above undercut portions of the residual ridge, when the partial denture is being seated. In these instances, it is usually preferable to shorten the flange, rather than relieving the internal surface. If the internal surface is relieved significantly, a space will exist between the denture base and the tissues when the denture is fully seated. Food may become trapped in the space and work its way under the partial denture. Deep lingual undercut Do not relieve internally Shorten flange (difficulty seating, pain) (food trap) (maintain usable undercut) (for retention)
id recommend a full flanged denture for an immediate denture, as it speeds up the healing process of the just extracted teeth, it also assits in forming blood clots which also assists in healing. I'd suggest a full flange because the bone still has to resorb, once the bone starts resorbing there will be sufficient retention and stability with regard to the denture, and the denture can then easily be rebased on a later stage. a fully flanged denture provides greater aesthetics and functionality, this can be improved at the extraction stage where the extracted area's alveolar bone is reshaped for these reasons.
you guys have to remember that we as technicians should be able to judge the undercut available to us, by just looking at the models. Which undercut can be used and which ones would mean bone reduction. When refering to horizontal and vertical relief what is refered to?
In an immediate denture with a 2mm undercut or less over the ridge to the flanges we can still make the full flange but if it is more than that then a part flange is advised which is more natural and will not hurt the patient, and it still has retention and stability. The open faced immediate is when the retention and stability of the denture is enough by that given by the denture bearing area, like if the patient has a deep palate.Clinically some times the bone reduction is made by a precess called alveoloplasty and sometimes a technician has to reduce on the palatal area of the socket avoiding cutting the incisive papilla and again facially the ridge is to be rounded to get read of the undercut. then a full flange can be made.
horizontal relief is when one relief the undercut by shortening the flange lenght. vertical relief is when one relief the anger cut bu blocking out or by decreasing the thickness of the flange from the tissue side. The flange lenght is determand by the amount of undercut availible is.
the length of the flange can be determined by the undercut provided on the model. in some cases of immediate dentures there are still natural teeth evident. amongst the natural teeth the flanges needs to be relieved. If the patient has a bulky alveolar ridge with plenty of undercuts, it can be relieved either horizontally or vertically. vertical relief can be described as thinning out the flange amongst the undercut area. horizontal relief is simply by shortening the length of the flange. thus the flange does not necessarily extends pass the undercut.
Undercuts and tissue condition are the two most important factors governing the flange length for an immediate denture. The flange should ideally engage slight undercuts combined with compressable tissue as this will add retntion to the denture. The flange should be trimmed short of severe undercuts as this may cause problems when placing the denture.
With regard to determining the undercut it is important to determine the resoption the alveolar bone will undergo and to be able to determine where the soft tissue would be and in doing so accommodate for the lee way the tissue provides for the denture.
It is important to evaluate the insertion and removal of the dentures. This should be done with a surveyor to establish the most favourable line. One must remember that bone is covered by soft tissue which permits the denture to pass over minor projections, and also to keep in mind that a full flange denture gives better retention. Where severe undercuts prevent the seating of complete denture, the labial flange should only be extended to the height of contour of the labial process the labial flanges are extended when natural process has eliminated the undercuts.
• The cast is studied for areas that might interfere with the easy and comfortable insertion of the denture in the mouth. • Undercuts of less that 1 to 2 mm are of no great significance because of a similar compressibility of soft tissues which should allow the insertion of the denture. • Similarly undercuts composed entirely of soft tissue, as sometimes occurs in the tuberosity areas, can be utilized for retention and will not complicate insertion of the denture. • If undercuts of a depth greater than 2mm are still present, analysis of the cast indicates where the flange should be relieved or shortened. • Vertical relief refers to a shortening of the flange to avoid it entering an undercut area. • Horizontal relief refers to a modification of a fully extended flange so that the degree of horizontal undercut engaged is reduced. • A shortened or part flange is indicated in the anterior region where in the interests of conversation of alveolar bone it is considered undesirable to create room for a complete flange by alveoloplasty. • Provided a part flange gives adequate retention of the denture, it is in general to be preferred to excessive horizontal relief of a flange in order to allow the denture to reach the sulcus beyond a deep undercut area. • As a result of horizontal relief of the flange the border becomes thin and sharp, there is a real danger of trauma of the sulcus. • This is particularly so in the case of the lower denture where the foundation is triangular in cross-section and where the denture tends to sink as result of bone resorption during the first few months after extraction. • To achieve horizontal relief of a denture flange in an undercut area, the technician may be asked to block out the appropriate areas on the cast, after surveying, with plaster. • Alternatively he may be requested to thicken the flange near the border so that subsequent relief of the fitting surface will not leave the border of the denture knife-edged.
Immediate dentures will gradually become loose because of bone shrinkage as the jaw continues to heal. They are inserted immediately after the removal of the remaining teeth, and are based on an impression taken by your denturist prior to removing your teeth. Do not expect your immediate dentures to have perfect fit and retention.
A flange add to stability and would aid healing of the extracted area.
ReplyDeleteYes, but how would you deside on the length of the flange? What influences the length of the flange while taking into consideration the fact that stability needs to be taken into consideration?
ReplyDeleteFlange Extension
ReplyDelete1. Denture bases for tooth-tissue supported partial dentures (Class I and II) should be extended
to provide the greatest available surface area for support and retention, without overextension
or impingement on movable border tissues.
2. Tooth supported partial dentures (Class III and IV) need not necessarily be extended
maximally, since most of the support for these dentures comes from the teeth.
3. Maxillary distal extension denture bases should terminate in the hamular notches.
4. Mandibular distal extension denture bases should terminate on the pear-shaped retromolar
pads.
5. Occasionally, the path of insertion can cause the denture flanges to impinge on the mucosa
above undercut portions of the residual ridge, when the partial denture is being seated. In
these instances, it is usually preferable to shorten the flange, rather than relieving the
internal surface. If the internal surface is relieved significantly, a space will exist between
the denture base and the tissues when the denture is fully seated. Food may become
trapped in the space and work its way under the partial denture.
Deep lingual undercut Do not relieve internally Shorten flange
(difficulty seating, pain) (food trap) (maintain usable undercut)
(for retention)
id recommend a full flanged denture for an immediate denture, as it speeds up the healing process of the just extracted teeth, it also assits in forming blood clots which also assists in healing. I'd suggest a full flange because the bone still has to resorb, once the bone starts resorbing there will be sufficient retention and stability with regard to the denture, and the denture can then easily be rebased on a later stage. a fully flanged denture provides greater aesthetics and functionality, this can be improved at the extraction stage where the extracted area's alveolar bone is reshaped for these reasons.
ReplyDeleteyou guys have to remember that we as technicians should be able to judge the undercut available to us, by just looking at the models. Which undercut can be used and which ones would mean bone reduction.
ReplyDeleteWhen refering to horizontal and vertical relief what is refered to?
In an immediate denture with a 2mm undercut or less over the ridge to the flanges we can still make the full flange but if it is more than that then a part flange is advised which is more natural and will not hurt the patient, and it still has retention and stability. The open faced immediate is when the retention and stability of the denture is enough by that given by the denture bearing area, like if the patient has a deep palate.Clinically some times the bone reduction is made by a precess called alveoloplasty and sometimes a technician has to reduce on the palatal area of the socket avoiding cutting the incisive papilla and again facially the ridge is to be rounded to get read of the undercut. then a full flange can be made.
ReplyDeletehorizontal relief is when one relief the undercut by shortening the flange lenght. vertical relief is when one relief the anger cut bu blocking out or by decreasing the thickness of the flange from the tissue side. The flange lenght is determand by the amount of undercut availible is.
ReplyDeletethe length of the flange can be determined by the undercut provided on the model. in some cases of immediate dentures there are still natural teeth evident. amongst the natural teeth the flanges needs to be relieved. If the patient has a bulky alveolar ridge with plenty of undercuts, it can be relieved either horizontally or vertically. vertical relief can be described as thinning out the flange amongst the undercut area. horizontal relief is simply by shortening the length of the flange. thus the flange does not necessarily extends pass the undercut.
ReplyDeleteUndercuts and tissue condition are the two most important factors governing the flange length for an immediate denture. The flange should ideally engage slight undercuts combined with compressable tissue as this will add retntion to the denture. The flange should be trimmed short of severe undercuts as this may cause problems when placing the denture.
ReplyDeleteWith regard to determining the undercut it is important to determine the resoption the alveolar bone will undergo and to be able to determine where the soft tissue would be and in doing so accommodate for the lee way the tissue provides for the denture.
ReplyDeleteIt is important to evaluate the insertion and removal of the dentures. This should be done with a surveyor to establish the most favourable line. One must remember that bone is covered by soft tissue which permits the denture to pass over minor projections, and also to keep in mind that a full flange denture gives better retention.
ReplyDeleteWhere severe undercuts prevent the seating of complete denture, the labial flange should only be extended to the height of contour of the labial process the labial flanges are extended when natural process has eliminated the undercuts.
• The cast is studied for areas that might interfere with the easy and comfortable insertion of the denture in the mouth.
ReplyDelete• Undercuts of less that 1 to 2 mm are of no great significance because of a similar compressibility of soft tissues which should allow the insertion of the denture.
• Similarly undercuts composed entirely of soft tissue, as sometimes occurs in the tuberosity areas, can be utilized for retention and will not complicate insertion of the denture.
• If undercuts of a depth greater than 2mm are still present, analysis of the cast indicates where the flange should be relieved or shortened.
• Vertical relief refers to a shortening of the flange to avoid it entering an undercut area.
• Horizontal relief refers to a modification of a fully extended flange so that the degree of horizontal undercut engaged is reduced.
• A shortened or part flange is indicated in the anterior region where in the interests of conversation of alveolar bone it is considered undesirable to create room for a complete flange by alveoloplasty.
• Provided a part flange gives adequate retention of the denture, it is in general to be preferred to excessive horizontal relief of a flange in order to allow the denture to reach the sulcus beyond a deep undercut area.
• As a result of horizontal relief of the flange the border becomes thin and sharp, there is a real danger of trauma of the sulcus.
• This is particularly so in the case of the lower denture where the foundation is triangular in cross-section and where the denture tends to sink as result of bone resorption during the first few months after extraction.
• To achieve horizontal relief of a denture flange in an undercut area, the technician may be asked to block out the appropriate areas on the cast, after surveying, with plaster.
• Alternatively he may be requested to thicken the flange near the border so that subsequent relief of the fitting surface will not leave the border of the denture knife-edged.
Read Anderson and Storer, Immediate and replacement dentures, Ch 5
ReplyDeleteImmediate dentures will gradually become loose because of bone shrinkage as the jaw continues to heal. They are inserted immediately after the removal of the remaining teeth, and are based on an impression taken by your denturist prior to removing your teeth. Do not expect your immediate dentures to have perfect fit and retention.
ReplyDeleteImmediate Dentures Las Vegas