Prosthodontics & Occlusion · patient case question
What is the correct next step regarding the prosthesis?
Patient case: Denture wearer with uncontrolled systemic disease requiring extraction
Patient: Adult denture wearer requiring an extraction
Chief complaint: Requests removal of a broken-down tooth; also reports burning under the upper denture.
Background: Hypertension and diabetes, both treated with medication. Has worn the same maxillary prosthesis for many years and does not remove it at night.
Vital signs / labs: Blood pressure 150/100 mmHg. HbA1c 7.5%
Current findings: On removing the prosthesis, the palatal mucosa in the bearing area shows a pebbly, cobblestone appearance.
Show answer and explanation
Correct answer: A. Treat the tissue condition first, then address the prosthesis
- A. CORRECT. You cannot record an accurate impression of diseased, inflamed, distorted tissue. TISSUE CONDITIONING COMES FIRST: leave the denture out (particularly at night), institute denture hygiene, treat the candidal component, and use a tissue conditioner. Severe papillary hyperplasia may require surgical excision. Only once the mucosa has recovered can definitive prosthodontics begin.
- B. Impressing inflamed tissue guarantees an inaccurate result.
- C. A new denture made over inflamed tissue will not fit once the tissue resolves.
- D. Relining over diseased tissue records a distorted, temporary form.
Note: General principle: mucosal health before impressions. This sequencing question recurs throughout removable prosthodontics.
Practice Prosthodontics & Occlusion questions Prosthodontics & Occlusion study notes