PROSTHODONTICS-George A. Zarb, Charles L. Bolender et al.-Prosthodontic Treatment for Edentulous Patients_ Complete Dentures and Implant-Supported Prostheses-Mosby (2003)

544 Index Denture-bearing areas (Continued)
incisive foramen, 214
Denture base (Continued) labial vestibule, 215-216, 216f, 223
labial considerations, 94 maxillary tuberosity, 214, 214f
resins pterygomandibular raphe, 217, 220f
characteristics of, 191b residual ridge, 212-214
chemically activated, 191b, 193-194, 196t sharp, spiny processes, 214
light-activated, 194-195, 196t supporting structures, 211-214
microwave-activated, 194, 196t torus palatinus, 214, 215f
modified acrylic, 195 vibrating line, 217, 219f
polymethylmethacrylate
description of, 190 description of, 211
heat-activated, 191-193 impressions
polymerization of, 190, 192
rubber-reinforced, 195 border molding, 225-227, 228f
stresses on, 192-193 boxing, 229
visible-light-activated, 190, 194-195 cast created from, 229, 230f
tissue displacement beneath, 16 custom tray for, 223, 225-230
trial elastomeric materials for, 225
acrylic, 254 final, 225-230
characteristics of, 252 irreversible hydrocolloid for, 221, 224f
resin, 252, 256f metallic oxide pastes for, 225
size of, 358 mouth preparation for, 219
“sprinkle-on” method for, 252, 256f mucostatic, 220
wax template for, 252, 255f preliminary, 221-225
principles of, 218-219
Denture-bearing areas procedures, 219-221
mandible silicone putty for, 221
anatomic considerations stock tray for, 221, 222f
alveololingual sulcus, 241, 243 technique for, 222-225, 224f-225f
buccal shelf, 232-233, 234f, 237f trays for, 220-222
buccal vestibule, 237f-238f, 238-239 limiting structures, 214-217
genial tubercles, 234, 236 peripheral structures, 214-217
labial vestibule, 236-238, 237f supporting structures for, 211-214
mental foramen, 233f, 234 nonsurgical preparations of
mylohyoid muscle, 239-241, 240f jaw exercises, 102
mylohyoid ridge, 234, 236f nutrition, 102
residual ridge crest, 232, 233f occlusal correction of old prosthesis, 102
retromylohyoid fossa, 237f-238f, 241 rest, 100-102
sublingual glands, 241, 242f tissue-conditioning materials, 100
supporting structures, 232-236 surgical preparations of
torus mandibularis, 236, 237f correction of function-precluding conditions, 102-110
description of, 232 description of, 102
distal extension, 239, 240f enlargement of areas, 110-111, 113, 116
existing denture effects on, 436f exostoses, 107, 110f-111f
impressions genial tubercles, 107, 112f
border molding, 246-248 jaw size discrepancies, 107, 114f-115f
boxing, 249, 249f mental foramen pressure, 108-110
custom tray for, 245-248, 246f objectives, 102b
final, 248-250 ridge augmentation, 116
preliminary, 243-245, 244f tooth roots replaced with osseointegrated implants, 117,
remaking of, 249-250
stock tray for, 243, 245f 120f-121f
limiting structures, 236-243 tori removal, 104, 107, 108f-109f
peripheral structures, 236-243 vestibuloplasty, 110-111, 113, 116, 118f-119f
supporting structures Denture cleansers
anatomy of, 232-236 chemical, 204
shape of, 234-236 commercially available materials, 203
maxillary description of, 202-203
anatomic considerations dilute acids, 205t
buccal vestibule, 217, 223 disadvantages of, 205t
hard palate, 211-212, 212f hypochlorite solutions, 204, 205t

Index 545

Denture cleansers (Continued) Denture teeth (Continued)
mechanical techniques, 203-204 shade guides, 298, 299f, 302
oxygenating, 204, 205t size, 302
powder/paste, 205t timing of, 302-303
requirements of, 203b trial denture base, 359
vertical orientation of, 356-361, 359f-360f
Denture-lining materials
description of, 198 arrangement of
plasticized acrylics, 200-201, 203b balanced articulation
self-administered home relines, 200 mandibular teeth, 318-320
soft liners maxillary teeth, 320
bacterial colonization prevention, 201-202 description of, 313-314
chemically activated acrylic resin, 200-201 lingualized articulation, 321-323
long-term, 200, 200b monoplane articulation, 320-321
permanent, 201-202, 202f patient’s acceptance of, 377-378
short-term, 198-200, 199b
silicone, 201 buccolingual width of, 304
composite resin, 197
Denture teeth description of, 195
acrylic resin, 195, 197-198, 198t, 303 mesiodistal length of, 304-305
anterior molds for
anteroposterior positioning of, 309f, 351-356
arch form of, 363-364 anterior teeth, 302, 302f, 308t
articulator programming for, 294 posterior teeth, 321-322
characterization of selected teeth, 303-304, 304f-307f overdenture considerations, 303
color, 301-302, 351 porcelain, 197, 198t, 303
correct positioning of, 354, 356f posterior
description of, 298 acrylic resin, 306
environmental setting, 301 arranging of
gingiva considerations, 303
horizontal orientation of, 351-356 anatomical, 315-318
incisal wear and age, 368-369, 369f-370f bilateral balanced articulation evaluations after, 317-318
inclination of, 361f, 361-362 description of, 313, 314f
lip support by, 352-354, 355f lingualized articulation, 321-323
long axes of central incisors, 364-365, 366f number of teeth, 314
mandibular, 311-313 buccolingual position of, 313
maxillary buccolingual width, 304
description of, 310-311 criteria, 304
labiolingual inclination of, 369, 371f description of, 304
mold for, 302, 302f mandibular
observation of, after removal of trial denture base, 354, 358f balanced articulation arranging of, 318-320
patient preference considerations, 303 first molar, 319
patient’s involvement in, 299-303 first premolar, 319
photographs used for, 300, 300f lingualized articulation arranging of, 321-323
placement of, 306-307, 310f second molar, 319-320
repositioning of, 350 setting of, 315-317
rotational positions of, 370 maxillary
selection of balanced articulation arranging of, 320
characterization of selected teeth, 303-304, 304f-307f first molar, 320
color, 301-302, 351 first premolar, 320
considerations for, 351 lingualized articulation arranging of, 321-323
description of, 298 second molar, 320
environmental setting, 301 setting of, 317
gingiva considerations, 303 mesiodistal length, 304-305
mold for, 302, 302f molds for, 321-322
patient preference considerations, 303 occlusal forms for, 314
patient’s involvement in, 299-303 porcelain, 306
photographs used for, 300, 300f premolars, 315-317, 316f
shade guides, 298, 299f, 302 setting of, 314
size, 302 vertical height of the facial surfaces, 306
timing of, 302-303 requirements of, 197b
selection of, 351
Depression, 22

546 Index

Depressor septi nasi, 349f Edentulism (Continued)
Diagnosis decreases in, 25
dentist’s view of, 6
biomechanical considerations, 89-92 description of, 3
border tissue evaluations, 90-91 distribution of, 25
data collection and recording techniques esthetic changes, 20
etiology of, 6
description of, 77-78 facial skeleton changes secondary to, 6-8, 7f-8f
diagnostic casts, 83 facts regarding, 6
intraoral videography, 80 food intake effects, 56-58
measurements, 83 gastrointestinal functioning effects of, 58-59
palpation, 82-83 morphological changes associated with, 20b
preextraction radiographs, 79 obturator prosthesis in, 454, 454f
questions, 78 in older adults
radiography, 80-82, 81f bone mass changes, 26-27
records, 78-79 distribution of, 25
visual observations, 79-80 impact of, 25
findings mucosal effects, 25-26
interpreting of, 94 salivary changes, 27
problem list created using, 98 oral cancer and, 26
health assessments. See Health assessments perceptions associated with, 6, 8, 485-486
history-taking for. See History-taking prevalence of, 25
identification of pathoses, 77 temporomandibular disorders in. See Temporomandibular
muscle tone assessments, 92 disorders
muscular development assessments, 92-94
patient familiarity, 73 Elastomeric impression materials, 225
problem identification, 73-74 Electropalatography, 386, 386f
saliva assessments, 91-92 Emotional factors, 21-22
setting for, 73 Endosseous dental implants, 483
specific observations Environment
existing dentures, 84
soft tissue health, 84-87 communication affected by, 180
summary of, 94, 95b internal, 180
visual perception for, 73, 79-80 Epulis fissuratum, 77, 86, 103
Diagnostic casts. See also Cast Errors
description of, 83 basal surface, 402-404, 403f-404f
immediate denture uses of, 130, 132f occlusal
occlusion evaluations, 130, 132f
vertical dimension of occlusion determined using, 275, 276f in anatomical teeth, 409-412
Diet articulator correction of, 404-405
assessment of, 65 elimination of, 409-414, 472
counseling regarding, 64-68 mesiodistal relationship, 412
evaluative form for, 67f in nonanatomical teeth, 412-414
fat intake in, 59 treatment of, at insertion, 402
protein intake in, 59-60 Esthetics
for tooth extraction patients, 68-69 edentulism effects on, 20
Diffuse atrophic glossitis, 37f existing denture, 84
Dilator naris, 349f Estrogen, 531
Discontinuity mandibulectomy, 464-466, 466f Existing dentures
evaluation and examination of, 84, 502
E implant-supported overdenture-related evaluations of, 502
Eccentric relation records inadequate, tooth loss secondary to, 260-261
vertical dimension of occlusion determined from
description of, 284, 337
interocclusal, 338 measurements of, 277, 280f
protrusive Exostoses, 107, 110f-111f

for Dentatus articulator, 339-342 F
for Whip Mix articulator, 338-339 Face bow
recording of, 289
Ecology, oral, 535-536 description of, 285-287, 286f
Edentulism mandible technique, 288
behavioral responses, 20-22 maxilla technique, 287-288
Face height, 17, 18f

Index 547

Facial and functional harmony Fracture
anterior teeth denture base, 434
arch form of, 363-364 implant, 526
harmony in composition of, 362-369
horizontal orientation of, 351-356 Frenectomy, 104
inclination of, 361f, 361-362 Frenum
patient’s acceptance of arrangement of, 377-378
vertical orientation of, 356-361, 359f-360f anatomy of, 103-104
vertical overlap reductions, 375-376, 377f buccal, 216, 217f, 237f
denture teeth selection labial, 216f, 236, 237f, 238
anterior teeth. See Facial and functional harmony, anterior lingual, 237f, 241
teeth Functional impression technique, for relining or rebasing,
description of, 351
description of, 343 478-480
facial landmarks, 345-347, 348f-350f
facial support considerations, 347-348, 350, 352f-353f G
guidelines for developing, 350-377 Gagging, 44, 93, 422
incisal guidance and esthetics, 375-377 Gastrointestinal system, edentulism effects on functioning
muscles involved in, 347-348, 350, 352f-353f
natural appearance, 343-345 of, 58-59
tooth position refinement Genial tubercles, 107, 112f, 234, 236
anterior teeth variations, 369-370 Gingival disease, 162
description of, 369 Gingival irritation, 174
harmony, 372-373 Gingival line, 391f
irregularity of teeth, 370, 372 Gingivitis, 174f
spatial harmony, 372-373 Gold copings, for overdenture abutment retention, 171f,

Facial landmarks, 345-347, 348f-350f 171-172
Facial profile line, 367-368, 368f Graphic records, 287
Feedback, 380
Fixed prostheses, implant-supported H
Hamular notches
abutment considerations, 510-511
advantages of, 514b anatomy of, 91, 116, 217, 218f
bone quality considerations, 511, 513 lesions of, 420
cementation of, 525-526 Hard palate
complications of anatomy of, 211, 212f, 449
border molding of, 452-453
insertion-related, 523 evaluation of, 85
structural-related, 525f maxillary obturator prosthesis for defects of
contraindications, 511b
design considerations for, 510-513 anterior teeth positioning, 458
disadvantages of, 514b definitive, 457-459
insertion-related complications, 523 edentulous, 454, 454f
local considerations for, 511b hypernasality associated with, 460
location of, 511 impressions, 457, 457f
patient selection for, 510 indications, 453
presurgical treatment, 513 interim, 455-457
prosthetic considerations for, 511b nasal reflux, 459-460
prosthodontic protocol, 513-514 palatal contour evaluations, 458
radiographic evaluations, 510, 512f retention problems, 459, 459f
smile line considerations, 513 surgical, 453-454
speech effects, 511b Harmony
surgical stages for, 513 age of patient and, 373-375, 374f
Flabby ridge, 40, 41f arch form, 363-364
Flasking, 149, 392-393 incisal wear and age, 368-369, 369f-370f
Food intake long axes of central incisors, 364-365, 366f
assessment of, 65 opposing lines of labial and buccal surfaces, 365-367, 368f
dental status effects on, 56-58 personality factors, 373
denture-wearing influences on, 57 profile line of face, 367-368, 368f
implant effects on, 57-58 sex-based variations, 373
Fordyce’s granules, 85 smile line, 365, 367f
space between teeth, 372-373
tooth position, 372-373
Health assessments, 85-89
Heat-activated polymethylmethacrylate, 191-193

548 Index Immediate dentures (Continued)
advantages and disadvantages of, 125
Herbal supplementation, 64 definition of, 123
Hierarchy of needs, 180 diagnostic casts, 145f
Hinge axis impressions for, 133, 136f
indications for, 125-126, 128t
description of, 283 interim denture vs., 128t
records of, 285 relining, 155
History-taking, 74-77 restorations completed before, 131
Hollow obturator prosthesis, 469-470, 470f sectional custom impression tray for, 134-137, 139f-143f
Hydroxyapatite, 493 single full arch custom impression tray for, 133-134,
Hygiene, oral 137f-138f
overdenture abutments, 173
patient instructions regarding, 417-418 definition of, 123, 130b
Hypernasality disadvantages of, 124-125
maxillary obturator prosthesis, 460 endodontic consultations, 131
soft palate obturator prosthesis, 461 imperfect results, 155
Hyperplastic ridge, 102-104 implant-retained overdentures placed under
Hypochlorite solutions, for denture cleaning, 204, 205t
Hyposalivation, 27 case study of, 157f-158f
description of, 158
I informed consent for, 130b
Iatrosedative interview insertion of
follow-up care after, 153, 155
description of, 184 patient instructions after, 153
elements of postoperative care, 153, 154f
ridge resorption after, 155
exploring the problem, 185-187 surgical technique for, 151-153, 152f
interpreting and explaining the problem, 187 sutures, 151, 152f
offering solution to problem, 187-188 interim
recognizing and acknowledging of problem, 184-185 advantages and disadvantages of, 125
Immediate dentures conventional denture vs., 128t
adjunctive care, 130-131 definition of, 123
advantages of, 124-125 diagnostic casts, 145f
anterior ridge undercut, 124 impressions for, 133, 135f
anterior teeth indications for, 126, 128t
decoronation of, 153 replacement denture for, 155
setting of, 144, 146-147 restorations completed after, 131
candidate for, 126f-127f mandibular
clinical and laboratory procedures for casts for, 136f-137f, 143f
anterior teeth setting, 144, 146-147 full-arch custom impression trays for, 138f
boil-out, 149, 150f preliminary impressions for, 135f
custom impression trays record base for, 144f
sectional custom impression tray for, 140f
sectional, 134-137, 139f-143f maxillary
single full arch, 133-134, 137f-138f casts for, 136f-137f, 143f
two-tray, 134-137, 139f-143f full-arch custom impression trays for, 138f
description of, 132 preliminary impressions for, 135f
diagnostic casts, 145f record base for, 144f
finishing, 151 sectional custom impression tray for, 140f
flasking, 149 overdenture abutments, 132
impressions, 133, 134f-136f overdenture attachment, 155, 156f, 161
jaw relation prognosis, 130
record of, 137, 139-140, 145f referrals, 130-131
verifying of, 141 restorations completed before, 131
loose teeth, 133 selection considerations, 125-126
posterior limit records, 137, 139-140, 145f tooth-supported, 175
processing, 151 treatment planning for
setting the denture teeth, 141-147 existing teeth evaluations, 129
surgical templates, 151, 152f explanation to patient, 127, 129b
tooth extractions, 132-133 lip evaluations, 129
try-in, 141, 146f, 148f
wax contouring, 148-149
contraindications, 125
conventional

Index 549

Immediate dentures (Continued) Implant-supported fixed prostheses
occlusion analysis, 130 abutment considerations, 510-511
oral examination, 127, 129 advantages of, 514b
oral prophylaxis, 131 bone quality considerations, 511, 513
tooth modifications, 130, 131f cementation of, 525-526
complications of
well-being benefits, 124 insertion-related, 523
Immediate load implants, 516 structural-related, 525f
Immune system, wound healing and, 68 contraindications, 511b
Implant(s) design considerations for, 510-513
disadvantages of, 514b
complications and problems associated with insertion-related complications, 523
abutment loosening, 520 local considerations for, 511b
abutment screw fracture, 526 location of, 511
bleeding, 517-518 patient selection for, 510
dehiscence, 519 presurgical treatment, 513
description of, 516-517 prosthetic considerations for, 511b
framework try-in, 523 prosthodontic protocol, 513-514
impressions, 521-522 radiographic evaluations, 510, 512f
infection, 518 smile line considerations, 513
postinsertion, 524-527 speech effects, 511b
prosthodontic-related, 520-523 surgical stages for, 513
screw fractures, 524-525
structural, 524-527 Implant-supported overdentures
surgically related, 517-520 advantages of, 514b
suture removal, 518 anchorage devices for, 504, 506, 506b
try-in, 522-523 bars for, 506, 507f
case study of, 157f-158f
factors that affect success and failure of complications of
bed, 496 insertion-related, 523-524
biocompatibility, 492-493 structural-related, 525f
bone quality, 532-533 considerations for, 499
bone quantity, 533-534 denture design, 504
description of, 492 description of, 158
design, 493 disadvantages of, 514b
host bone response. See Implants, host bone response exclusion criteria for, 499-500, 500b
loading conditions, 496-497 impression techniques, 504
smoking, 496, 529-531 inclusion criteria for, 499b, 499-500
surface, 493-495 insertion-related complications, 523-524
surgical technique, 496 maintenance of, 506-508
mandibular, 502, 503f
failure of osseointegration phase, 502-503
postloading, 536 presurgical evaluation, 500-503
study findings, 529t prosthodontic procedures, 503-506
radiographic evaluations, 500-502
fracture of, 526 retentive devices for, 504, 506, 506b
framework try-in, 523 single-attachment retentive system for, 506, 507f
host bone response to surgical procedure for, 502-503
treatment goals, 498-499
description of, 529 treatment planning, 500b, 500-503
irradiation therapy effects, 531
smoking effects, 530-531 Implant-supported prosthesis
systemic conditions that affect, 532 advantages of, 49
immediate loading of, 516 case study of, 157f-158f
loading of, 496-497, 516, 534-536 description of, 4-5, 5t, 483
long-term studies of, 528 fixed prosthesis. See Implant-supported fixed prostheses
osteoporosis considerations, 531 illustration of, 120f
roughness of surface, 493-495 maxillofacial, for edentulous patient, 467, 468f-469f
surface of, 493-495 objectives of, 486
teeth vs., 538t patient considerations, 485-487
Implant prosthodontics periodontal ligament considerations, 486
advances in, 484-485
description of, 4-5
reasons for popularity of, 485
treatment outcome determinants in, 487t, 487-488, 530t

550 Index Intercuspation
intraoral observation of, for centric relation verification,
Impressions 330-331
chairside, 480 maximum, 324, 324f
complications of, 521-522
functional, 478-480 Interfacial force, 437-438
immediate denture, 133, 134f Interocclusal distance insufficiencies, 425-426
implant-supported overdentures, 504 Interocclusal records
mandibular denture-bearing areas
border molding, 246-248 centric relation, 406-407
boxing, 249, 249f description of, 287
custom tray for, 245-248, 246f eccentric, 338
final, 248-250 lateral, 338
preliminary, 243-245, 244f plaster, 338
remaking of, 249-250 protrusive
stock tray for, 243, 245f
materials for making, 133 for Dentatus articulator, 339-342
maxillary denture-bearing areas for Whip Mix articulator, 338-339
border molding, 225-227, 228f remounting of denture using, 405-406
boxing, 229 Intraoral radiography, 82
cast created from, 229, 230f Irradiation, effects on osseointegration, 496, 531
custom tray for, 223, 225-230 Irreversible hydrocolloid, 221, 224f
elastomeric materials for, 225 Irritation hyperplasia, denture-related, 40, 41f, 418
final, 225-230
irreversible hydrocolloid for, 221, 224f J
metallic oxide pastes for, 225 Jaw movement. See also Mandible, movement of
mouth preparation for, 219
mucostatic, 220 age-related changes in, 27-28
preliminary, 221-225 articulator for recording, 265
principles of, 218-219 condylar, 269, 284
procedures, 219-221 description of, 268-269
silicone putty for, 221 envelope of motion, 271-272, 272f-273f
stock tray for, 221, 222f factors that regulate, 269
technique for, 222-225, 224f-225f muscles involved in, 270
trays for, 220-222 neuromuscular regulation, 270-271
objectives of, 218 opposing tooth contact influences on, 269
obturator prosthesis, 457, 457f rotational, 269
principles of, 218-219 sagittal plane, 269, 269f
relining, 476-480 temporomandibular joint effects on, 269-270
static, 476-478 tracing of, 271f
translatory, 269
Incisal guide table, for articulator programming, Jaw relations
294-295, 295f articulator for recording, 265
assessments of, 89-92
Incisal wear and age, 368-369, 369f-370f horizontal
Incisive foramen, 213f, 214
Incisive papilla centric relation. See Centric relation
description of, 283
anatomy of, 260, 261f terminology associated with, 283-284
anterior teeth placement guided by, 306-307, 310f maxillomandibular, 274-283
vertical dimension of occlusion measurements, 276 record of, 137, 139-140, 145f
Incisors records of
central centric relation records, 265-266, 288-289
face bow, 285-287
long axes of, 364-365, 366f graphic records, 287
mandibular, 371f hinge axis, 285
maxillary, 309-311, 369 horizontal, 283-284
mesial rotation of, 373f interocclusal, 287
square arch, 362, 364f mandibular movement. See Mandible, movement of
lateral maxillomandibular relations, 274-283
harmony of, 375, 375f transfer to articulator, 284-285
mandibular, 311, 371f vertical dimension of occlusion. See Vertical dimension of
maxillary, 311, 370
Inflammatory papillary hyperplasia, 86 occlusion
Inner dialogue, 182 rest position

Index 551

Jaw relations (Continued) Lips (Continued)
description of, 272-274, 274f vertical orientation determinations, 357-358
physiological, 277-278, 281f
registration of, 277-278 muscles of
anatomy of, 216, 238
size discrepancies in, 107, 114f-115f evaluation of, 93-94
in swallowing cycle, 280
vertical. See Vertical dimension of occlusion orbicularis oris, 216, 236, 309-310, 347-348, 349f
“Jiffy” denture, 123-124 speech-related movement of, 354f, 356
upper
K
Kinematic analysis of speech, 386 estimating length of, in relation to residual ridge, 357, 359f
incline of, 347, 351f
L vertical dimension of occlusion increases for, 279
Labial flange, 238f Listening, 182
Labial frenum, 216f, 236, 237f, 238 Loading
Labial notch, 237f effects of, 9
Labial sulci, 90 implant, 496-497, 516, 534-536
Labial vestibule masticatory, 10
occlusal forces, 534
anatomy of, 215-216, 216f, 236-238, 237f prosthodontic, 534-536
impression taking of, 223 responses to, 101f
Labiodental speech sounds, 382t, 383
Lamina propria, 211 M
Lateral incisors Magnesium, 60
harmony of, 375, 375f Malnutrition. See also Nutrition
mandibular, 311, 371f
maxillary, 311, 370 causes of, 48
Lateral relations, 335-336 in older adults, 28, 56
Lekholm-Zarb classification, 533f risk factors, in denture wearers, 64b
Levator anguli oris, 216 signs and symptoms of, 56
Light-activated resins, for denture base, 194-195, 196t xerostomia and, 48b, 58
Liners, soft Malocclusion, 86
bacterial colonization prevention, 201-202 Mandible. See also Jaw movement
chemically activated acrylic resin, 200-201 anatomy of, 232-236, 233f
long-term, 200, 200b articulator relation of, 291, 291f
permanent, 201-202, 202f bone-grafted, prostheses for, 466-467, 467f
short-term, 198-200, 199b bone mass in, 61
silicone, 201 bone quality in, 532
tissue tolerance to, 202 bone resorption, 86
Lingual flange, 440 face bow technique, 288
Lingual frenum, 237f, 241 movement of
Lingualized occlusion, 412-413
Lingual notch, 238f alterations in, 451-452
Linguoalveolar speech sounds, 382t, 384-385 description of, 268-269
Linguodental speech sounds, 382t, 383-384 envelope of motion, 271-272, 272f-273f
Linguopalatal speech sounds, 382t, 385 factors that regulate, 269
Linguovelar speech sounds, 382t, 385 muscles involved in, 270
Lips neuromuscular regulation, 270-271
age-related changes, 28, 30f, 261, 261f, 343-344 opposing tooth contact influences on, 269
anatomic variations in, 346, 348f rotational, 269
anterior teeth support of sagittal plane, 269, 269f
temporomandibular joint effects on, 269-270
correct positioning, 355f tracing of, 271f
description of, 352-354 translatory, 269
excessive support, 354, 357f types of, 269
vertical orientation determinations, 357-358 resection of
contours of, 345 description of, 451-452
immediate denture evaluations, 129 prostheses for, 463-467
incorrect contouring of, 353f residual ridge of
lower parallelism of, 276-277
smile line of, 365, 367f resorption of, 235f
rest position of
description of, 272-274, 274f

552 Index

Mandible (Continued) Maxilla (Continued)
physiological, 277-278, 281f denture-bearing areas. See Denture-bearing areas, maxillary
registration of, 277-278 face bow technique for, 287-288
mucous membrane of, 211
retromolar pad of, 220f, 237f-238f, 239, 240f, 263, 264f palatine processes of, 211, 212f
ridge resorption, 90 residual ridge of
Mandibular arch, occlusion rim designed for, 259-260, 260f parallelism of, 276-277
Mandibular dentures resorption of, 235f
immediate sharp, spiny processes on, 214
vertical or horizontal deficits of, 165f-166f
casts for, 136f-137f, 143f
full-arch custom impression trays for, 138f Maxillary arch, occlusion rim designed for, 260-261, 261f
preliminary impressions for, 135f Maxillary denture
record base for, 144f
sectional custom impression tray for, 140f anatomic considerations
impressions buccal vestibule, 217, 223
border molding, 246-248 hard palate, 211-212, 212f
boxing, 249, 249f incisive foramen, 214
custom tray for, 245-248, 246f labial vestibule, 215-216, 216f, 223
final, 248-250 maxillary tuberosity, 214, 214f
preliminary, 243-245, 244f pterygomandibular raphe, 217, 220f
remaking of, 249-250 residual ridge, 212-214
stock tray for, 243, 245f sharp, spiny processes, 214
loss of bone structure effects on, 473-474, 475f supporting structures, 211-214
remounting of, 407-408, 408f torus palatinus, 214, 215f
rotational movement of, 473-474, 475f vibrating line, 217, 219f
single, 434-435
Mandibular molars, 317, 319-320, 322-323, 431f description of, 211
Mandibular overdentures, 162, 167f flange of, 424
Mandibular tori impressions
definition of, 88
surgical removal of, 104, 108f border molding, 225-227, 228f
Mandibulectomy boxing, 229
discontinuity, prostheses for, 464-466, 466f cast created from, 229, 230f
edentulous, 466 custom tray for, 223, 225-230
marginal, prostheses for, 463f-464f, 463-464 elastomeric materials for, 225
Marginal mandibulectomy, 463f-464f, 463-464 final, 225-230
Maslow, Abraham irreversible hydrocolloid for, 221, 224f
hierarchy of needs, 180 metallic oxide pastes for, 225
human nature as viewed by, 181 mouth preparation for, 219
self as defined by, 181 mucostatic, 220
Mastication preliminary, 221-225
choking caused by inadequacies in, 59 principles of, 218-219
denture effects on, 15-16, 48, 416-417 procedures, 219-221
denture movements during, 16 silicone putty for, 221
digestion functions of, 15 stock tray for, 221, 222f
factors that affect, 57 technique for, 222-225, 224f-225f
forces generated during, 10, 17t trays for, 220-222
functions of, 15, 59 limiting structures, 214-217
occlusal movements during, 15-16 palatal alveolar surface in, 390
physiology of, 15, 450 peripheral structures, 214-217
regulation of, 270-271, 271f single
teeth position during, 16 description of, 430, 432
tongue movement during, 450 rationale for, 434, 435f
Masticatory mucosa, 85, 211 speech considerations, 390
Masticatory muscle atrophy, 47-48 supporting structures for, 211-214
Masticatory system, 8-10, 258 Maxillary teeth
Maxilla molars, 320
anterior denture teeth placement, 310-311 natural irregularities of, 372
articulator relation of, 289-290, 290f premolars, 320
bone resorption, 86 Maxillary tori
description of, 104
surgical removal of, 104, 107, 109f

Index 553

Maxillary tuberosities 4-Methacryloxyethyl trimellitic anhydride, 197
anatomy of, 214, 214f, 220f Microwave-activated resins, for denture base, 194, 196t
description of, 90 Modified acrylic resin, 195
pendulous, 104, 104f Modiolus, 262-263, 263f
surgical reduction of, 104f-106f, 104-107 Molars
vertical height of, 105f
mandibular, 317, 319-320, 322-323, 431f
Maxillofacial prosthodontics maxillary, 320
anatomical and physiological considerations, 449-450 Monomer, 396
bone-grafted mandible prostheses, 466-467, 467f Monoplane articulation, 320-321
border molding Mouth, 85-86
hard palate, 452-453 Mucosa
velopharyngeal area, 452 abnormalities of, 85
facial form changes, 451 color of, 86
focus of, 449 complete denture requirements, 10-11
implant-supported prosthesis, 467, 468f-469f edentulism effects on, in older adults, 25-26
laboratory procedures for, 468 fibrous tissue excesses beneath, 86-87
mandible movement alterations, 451-452 health assessments, 85
mandibulectomy prostheses keratinization of, 213
discontinuity, 464-466, 466f masticatory, 85, 211
edentulous, 466 maxillary, 211
marginal, 463f-464f, 463-464 Mucostatic impressions, 220
obturator prosthesis Mucous membrane
hollow, 469-470, 470f attached vs. unattached, 213f
maxillary buccal shelf, 233
anterior teeth positioning, 458 labial vestibule, 215
definitive, 457-459 residual ridge
edentulous, 454, 454f
hypernasality associated with, 460 crest, 232
impressions, 457, 457f description of, 213, 213f
indications, 453 Muscle tone
interim, 455-457 age-related changes in, 27
nasal reflux, 459-460 assessment of, 92
palatal contour evaluations, 458 Muscular skill, 21
retention problems, 459, 459f Myerson Lingualized Integration molds, 321
surgical, 453-454 Mylohyoid muscle, 239-241, 240f
soft palate, 460-461 Mylohyoid ridge, 234, 236f
palatal augmentation prosthesis
clinical examination for, 462 N
description of, 461-462 Nares, 348f
patient adjustment to, 462-463 Nasalis, 349f
processed bases, 452, 452f, 468 Nasal reflux, from obturator prosthesis, 459-460
prosthetic seal testing, 453 Nasolabial fold, 261, 261f, 346
vertical opening losses, 451 Nasolabial sulcus, 346, 348f-349f
Neuromuscular control and coordination, 76, 92
Maximum contact mold, 321, 323 Neurosis, 75
Maximum intercuspation, 324, 324f Neutral zone
Medial pterygoid muscle, 241, 242f
Median rhomboid glossitis, 37f definition of, 252, 439
Mediolateral compensating curve determination of, 260
illustration of, 254f
for balanced articulation, 318-319, 319f importance of, 259-260
for lingualized articulation, 322 Nickel-chromium alloys, for denture base, 206
Mental foramen Noise, communication affected by, 180
anatomy of, 233f, 234 Nonverbal language, 182
pressure on, 108-110 Nutrition. See also Malnutrition
Mental health assessments, 75-76 age-related declines in, 28, 48
Mentalis, 236 calcium intake, 61-62
Mental nerve, 88 counseling regarding, 64-68
Mentolabial sulcus, 346, 348f-349f deficiencies
Mentum, 348f
Metabolic bone diseases, 87-88 description of, 48-49
in older adults, 60

554 Index Occlusion rims
anterior portion of, 259
Nutrition (Continued) anteroposterior tooth positioning using, 310
signs of, 60t arch form
description of, 258-259
dental status effects on, 56-58 mandibular, 259-260, 260f
description of, 56 maxillary, 260-261, 261f
factors that affect, 56, 57f soft tissue considerations, 259
goals for, 65-66 beeswax, 331, 331f
herbal supplementation, 64 centric relation record, 265-266
history-taking questionnaire, 66f contouring of, 262f
older adult description of, 252
indications for, 254
deficiencies in, 60 level of occlusal plane, 262-263
food selections, 59-60 mandibular, 264f
vitamin supplementation, 62-64 sequences for, 257-258
single denture, 430
O vertical dimension of occlusion determinations, 263, 265,
Obturator prosthesis 282-283

hollow, 469-470, 470f Older adults. See also Age; Aging
maxillary alcohol abuse by, 60-61
bite force in, 47
anterior teeth positioning, 458 dehydration in, 58
definitive, 457-459 dietary modifications for, 49
edentulous, 454, 454f edentulism in, 25, 26t
hypernasality associated with, 460 energy consumption by, 59
impressions, 457, 457f jaw movements in, 27-28
indications, 453 malnutrition in, 28, 56
interim, 455-457 muscle tone decreases in, 27
nasal reflux, 459-460 nutrition for
palatal contour evaluations, 458 caloric intake, 59
retention problems, 459, 459f changes in, 28
surgical, 453-454 deficiencies, 60
Occlusal force, 9, 106 food changes, 59
Occlusal index, 401f, 409 recommendations, 59-61
Occlusal plane personal appearance concerns, 30-31
anterior, 313 saliva production in, 27
height of, posterior teeth placement and, 313 skin changes, 28, 30
inclination of, 313 smell sense decreases, 28, 58
irregularity of, 430, 431f taste sense decreases in, 28, 58
level of, 262-263 teeth color changes, 30
Occlusion xerostomia in, 27, 58
adjustments, 420
balanced, 414 Oral cancer
Beyron’s determinants of physiological/therapeutic, 534b denture-related tissue irritation and, 42
centric, 19, 90, 283 edentulism and, 25
complete denture, 19 racial predilection of, 25
components of, 14 risk factors for, 42
deglutition and, 19
development and adaptation of, 14f Oral cavity, 449-450. See also specific anatomy
diagnostic cast evaluation of, 130, 132f Oral ecology, 535-536
errors in Oral environment
in anatomical teeth, 409-412
articulator correction of, 404-405 complete denture in, 34
elimination of, 409-414, 472 prosthetic material interactions in, 34b
mesiodistal relationship, 412 Oral hygiene
in nonanatomical teeth, 412-414 overdenture abutments, 173
follow-up examinations, 420 patient instructions regarding, 417-418
historical studies of, 15 Orbicularis oculi, 349f
immediate denture evaluations, 130 Orbicularis oris
lingualized, 412-413 anatomy of, 216, 236, 309-310, 347-348, 349f
mutually protected, 283 repositioning of, 348, 350
vertical dimension of. See Vertical dimension

of occlusion

Index 555

Orofacial dyskinesia, 444 Overdentures (Continued)
Osseointegration immediate, 155, 156f
immediate complete dentures vs., 161
age of patient considerations, 496 implant-supported
benefits of, 528, 529b advantages of, 514b
contraindications, 496 anchorage devices for, 504, 506, 506b
definition of, 489 bars for, 506, 507f
description of, 4-5 case study of, 157f-158f
failure of, 519, 520f, 524 complications of
implants, factors that affect success and failure of insertion-related, 523-524
structural-related, 525f
bed, 496 considerations for, 499
biocompatibility, 492-493 denture design, 504
description of, 492 description of, 158
design, 493 disadvantages of, 514b
loading conditions, 496-497 exclusion criteria for, 499-500, 500b
smoking, 496 impression techniques, 504
surface, 493-495 inclusion criteria for, 499b, 499-500
surgical technique, 496 insertion-related complications, 523-524
implant-supported overdentures, 502-503 maintenance of, 506-508
interface created by, 489-492 mandibular, 502, 503f
irradiation effects, 496, 531 osseointegration phase, 502-503
long-term studies of, 529b presurgical evaluation, 500-503
mechanism of action, 490-492 prosthodontic procedures, 503-506
principles of, 485 radiographic evaluations, 500-502
success rates with, 489 retentive devices for, 504, 506, 506b
timing of, 516, 534-535 single-attachment retentive system for,
tooth roots replaced with implants, 117, 120f-121f 506, 507f
Osteomalacia, 87 surgical procedure for, 502-503
Osteoporosis treatment goals, 498-499
definition of, 87 treatment planning, 500b, 500-503
description of, 27, 531 indications, 164, 166
implant placement considerations, 531 mandibular
residual ridge resorption as indicator of, 45 description of, 162, 167f
risk factors for, 61 implant-supported, 502, 503f
Osteosclerosis, 87 monitoring programs for, 49
Overdentures objectives of, 160, 162f
abutments oral hygiene for, 47
attachment mechanisms, 172f, 172-173 outcome studies of, 175
caries associated with, 46-47, 162, 174 treatment planning, 164, 166
coronal reduction of tooth, 169, 171, 175 versatility of, 160, 163f-170f
endodontic status of, 168
gingivitis around, 174f Ovoid dental arch, 363, 363f-364f
gold copings for retention of, 171f, 171-172 Oxidized implants, 491
hygiene of, 173 Oxygenating denture cleansers, 204
location of, 167-168
long-term monitoring of, 173-174 P
loss of, 172-174 Palatal vault, 363
maxillary teeth as, 169t Palate
periodontal status of, 166-167
preparation of, 168-173 augmentation prosthesis
selection of, 166-173 clinical examination for, 462
telescopic crowns for retention of, 173 description of, 461-462
tooth mobility considerations, 167 patient adjustment to, 462-463
advantages of, 161-162
anterior teeth selection, 303 evaluation of, 85
caries associated with, 46 hard. See Hard palate
description of, 46 soft
designing of, 160
disadvantages of, 162 anatomy of, 91, 449
historical uses of, 160, 163f-164f evaluation of, 85
illustration of, 121f obturator prosthesis for, 460-461
swallowing physiology, 449
vibrating line, 217, 219f, 342, 342f

556 Index

Palatine bone, 211, 212f Polymethylmethacrylate (Continued)
Palpation heat-activated, 191-193, 196t
microwave-activated, 194, 196t
salivary glands, 85 polymerization of, 190, 192
submucosal structure, 82 rubber-reinforced, 195, 196t
Papilla, incisive, 260, 261f
Papillary hyperplasia, 86 Porcelain denture teeth
Papillomatosis, 103 anterior, 197, 303
Parafunction posterior, 306
forces generated during, 17t
habits associated with, 16-17 Posterior limit records, 137, 139-140, 145f
mandibular movements in, 269 Posterior palatal seal, 342f-346f, 342-343
Passavant’s ridge, 461f Posterior teeth, of denture
Patient
anterior teeth arrangement accepted by, 377-378 acrylic resin, 306
denture evaluated by, 401 arranging of
education of, 22, 98f, 99
expectations by, 74, 76 anatomical, 315-318
history-taking information about. See bilateral balanced articulation evaluations after,

History-taking 317-318
interview with, 22 description of, 313, 314f
maladaptive reactions mandibular, 315-317, 316f
maxillary teeth, 317
description of, 183 number of teeth, 314
iatrosedative interview for dealing with. See Iatrosedative buccolingual position of, 313
buccolingual width, 304
interview criteria, 304
motivation of, 21-22, 77 description of, 304
preparation of, 99 mandibular, 318-323
psychological preparation for treatment, 77 maxillary, 320, 323
reaction to denture, 183 mesiodistal length, 304-305
referral of, 78 molds for, 321-322
Periimplantitis, 536 occlusal forms for, 314
Periodontal disease, 162 porcelain, 306
Periodontal ligament premolars, 315-317, 316f
alveolar bone integrity and, 12, 160 setting of, 314
description of, 9 vertical height of the facial surfaces, 306
implant-supported prostheses considerations, 486 Poverty, 24
natural dentition support area, 10, 11f Premolars
Periodontium maxillary, 320
anatomy of, 8-9 posterior, 315-317, 316f
functions of, 9 setting of, 315-317, 316f
Person centeredness, 183 Premylohyoid eminence, 237f-238f
Philtrum, 346, 348f-349f Pressure indicator paste, 421
Phonetic tests, for vertical dimension of occlusion Pressure spots, 403f, 421
Procerus, 349f
determinations, 278-279 Processed bases, for maxillofacial prosthodontics, 452, 452f,
Pinpoint hyperemia, 36f 468
Plaque, overdenture-related accumulation of, 46-47 Profile line of face, 367-368, 368f
Plasticized acrylics, 200-201, 203b Prosthodontics
Platysma, 349f, 352f implant
Polishing surfaces advances in, 484-485
description of, 4-5
overview of, 389-390 reasons for popularity of, 485
waxing of, 390-392 treatment outcome determinants in, 487t,
Polymethylmethacrylate. See also Acrylic resin
characteristics of, 196t 487-488, 530t
chemically activated maxillofacial. See Maxillofacial prosthodontics
Protein deficiency, 60t
denture base fabricated from, 191b, Protrusive contacts, 325-327, 327f
193-194, 196t Protrusive interocclusal records
for Dentatus articulator, 339-342
soft liners, 200-201 for Whip Mix articulator, 338-339
denture teeth fabricated from, 195, 197-198 Protrusive relations, 335-336
description of, 190 Proxemics, 182
disadvantages of, 205
fiber-reinforced, 195, 196t

Index 557

Pterygomandibular notch, 237f, 342f Residual ridge (Continued)
Pterygomandibular raphe, 217, 220f, 237f, 261 parallelism discrepancies, 109
patient instructions regarding, 418
Q periodontal ligament health and, 12
Quadratus labii inferioris, 349f, 352f rate of reduction, 12f-13f
Quadratus labii superioris, 349f, 352f resorption of
anterior mandibular alveolar ridge susceptibility to, 167
R characteristics of, 44-45, 89
Radiographs control of, 49
denture movement secondary to, 473, 475f
bone quality assessments, 80 description of, 25, 27, 61, 160, 212-213, 471
diagnostic and evaluative uses of, 80-82, 81f factors associated with, 45
extraoral, 80 gender predilection, 61
implant-supported fixed prosthesis implant-supported overdenture considerations, 502
mandibular ridge, 235f
evaluations, 510, 512f maxillary ridge, 235f
implant-supported overdenture evaluations, 500-502 mental foramen pressure caused by, 108-110
intraoral, 82 pathogenesis of, 45, 45b
preextraction, 79 patient satisfaction and, 45
profile, vertical dimension of occlusion determined from, undercuts on
description of, 88-89
275, 275f illustration of, 113f
Rebasing removal of, 107, 113f
stability uses of, 107, 113f
description of, 472 upper lip length in relation to, 357, 359f
impression techniques for
Resins
chairside, 480 characteristics of, 191b, 196t
functional, 478-480 chemically activated, 191b, 193-194, 196t
static, 476-478 light-activated, 194-195, 196t
Referral of patient, 78 microwave-activated, 194, 196t
Relining modified acrylic, 195
closed-mouth, steps involved in, 477b polymethylmethacrylate. See Polymethylmethacrylate
conventional immediate dentures, 155 stresses on, 192-193
description of, 471 visible-light-activated, 190, 194-195, 479-480
impression techniques for
chairside, 480 Respiration, 449
functional, 478-480 Retention
static, 476-478
maxillary denture, 223 complete denture
need for, 223 adhesion, 438
open-mouth, 477 adhesives for. See Denture adhesives
preliminary treatment before, 476 atmospheric pressure, 441
rationale for, 471-472 cohesion, 438-439
reasons for, 472-476 description of, 12-13
tissue conditioners for, 476, 479f factors that affect, 437-442
Remodeling of bone, 45 gravity, 442
Remounting interfacial force effects, 437-438
cast for, 399, 400f oral and facial musculature effects, 439-441
interocclusal records for, 405-406 parallel walls for, 442
mandibular dentures, 407-408, 408f psychological effects on, 14
Residual ridge rotational insertion paths for, 441
anatomy of, 212-214 surface tension effects, 437
complete denture support by, 11-13 tongue base, 441
crest of, 213, 232, 233f, 235f undercuts, 441
definition of, 11
harmony of form of, 362-364, 363f-364f implant-supported overdentures, 504, 506, 506b
mandibular obturator prosthesis, 459, 459f
parallelism of, 276-277 Retinol, 63
resorption of, 235f Retromolar pad of mandible, 220f, 237f-238f, 239, 240f,
maxillary
parallelism of, 276-277 263, 264f
resorption of, 235f Retromylohyoid fossa, 91, 237f-238f, 241
mucous membrane of, 213, 213f Rima oris, 348f-349f
overdenture benefits for, 161-162 Risorius, 349f, 352f

558 Index Speech
analysis of, 385-386
Root indication lines, 392f-393f anatomy of, 379, 380f
Rubber-reinforced polymethylmethacrylate, 195, 196t complete denture adaptation, 386, 417
control of, 380
S description of, 93, 379
Saliva electropalatography evaluations, 386, 386f
functional deficits of, 450-451
cohesive properties of, 438-439 hearing loss effects on, 380
factors that affect, 91-92 implant-supported fixed prosthesis effects, 511b
high-mucin, 439 lip movement during, 354f, 356
medications that affect, 27 neurophysiological background of, 380
normal flow rate, 91 physiology of, 379, 380f
in older adults, 27 prosthetic considerations, 386-387
pretreatment evaluations of, 76, 91-92 teeth effects on, 380-385
sialogogues for increasing production of, 58 vertical dimension of occlusion evaluations, 387
Salivary glands, 85
Self-awareness, 181 Speech sounds
Self-disclosure, 182 bilabial, 381-383, 382t
Shingles, 31 labiodental, 382t, 383
Sialogogues, 58 linguoalveolar, 382t, 384-385
Silicone soft liners, 201 linguodental, 382t, 383-384
Single dentures linguopalatal, 382t, 385
adverse outcomes of linguovelar, 382t, 385
overview of, 381
denture base fracture, 434
natural tooth wear, 432f-434f, 432-434 Square dental arch, 362, 363f-364f
clinical and laboratory procedures for, 430, 432 Staphylococcus aureus, 38
description of, 427 Static impression technique, for relining or rebasing, 476-478
diagnosis, 428-430 Stefan’s law, 438
displaceable tissue considerations, 429-430 Stellite alloys, 205
edentulous arch, 427 Stock tray
mandibular, 434-435
maxillary mandible impressions, 243, 245f
description of, 430, 432 maxillary impressions, 221, 222f
rationale for, 434, 435f Stomatitis
occlusal plane irregularity, 430, 431f Candida-associated
support variations, 427-428
treatment planning, 428-430 angular cheilitis and, 37f, 38
Sinus lift, 88 antifungal drugs, 39
Skin, 28, 30 clinical features of, 36, 37f
Smell, age-related declines in, 28, 58 management of, 39-40
Smile line, 365, 367f, 513 predisposing factors, 38b
Smoking, 496, 529-531 preventive measures, 39-40
Soft liners classification of, 35-36
bacterial colonization prevention, 201-202 description of, 25-26
chemically activated acrylic resin, 200-201 diagnosis of, 36
long-term, 200, 200b etiology of, 36, 38-39
permanent, 201-202, 202f illustration of, 29f
short-term, 198-200, 199b management of, 39-40
silicone, 201 predisposing factors, 36, 38b, 38-39
tissue tolerance to, 202 preventive measures, 39-40
Soft palate type I, 36f
anatomy of, 91, 449 type II, 36f
evaluation of, 85 type III, 37f, 40f
obturator prosthesis for, 460-461 Streptococcus, 46
swallowing physiology, 449 Sublingual glands, 241, 242f
vibrating line, 217, 219f, 342, 342f Submandibular gland, 27
Soft palate erythema, 37f Submucosa
Soft tissue anatomy of, 211
health assessments of, 84-87 maxillary, 211
mucosa. See Mucosa palpation of, 82
Solar lentigines, 28 radiographic evaluation of, 80-82, 81f

Index 559

Surgical template, 151, 152f Tongue
Swallowing complete denture retention and, 441
denture-related discomforts, 17
functional deficits of, 450-451 denture-related effects, 17, 21
physiology of, 449 diffuse atrophic glossitis, 37f
vertical dimension of occlusion determinations from, 280- health assessments, 85
masticatory positioning of, 450
281, 282f median rhomboid glossitis, 37f
muscular development assessments, 92-93
T palpation of, 82
Tactile sense, vertical dimension of occlusion determinations retruded position of, 92-93
stability of denture and, 417
using, 281-282, 282f
Tapering dental arch, 362, 363f-364f Tooth contacts, effect on mandible movement, 269
Tardive dyskinesia, 445 Tooth extractions
Taste, age-related declines in, 28, 58
Teeth. See also specific teeth dietary management for, 68-69
indications for, 87
age-related changes, 30 Tooth position
asymmetrical symmetry of, 366, 368f refinement of, for functional harmony
biting forces on, 9
buccal lines of, 365-367, 368f anterior teeth variations, 369-370
complete denture vs., 16 description of, 369
deglutition effects on, 9 harmony, 372-373
denture. See Denture teeth irregularity of teeth, 370, 372
development of, 14, 14f single maxillary denture, 430
extractions of. See Tooth extractions spatial harmony, 372-373
health assessments of, 87 speech production effects, 380-381
labial lines of, 365-367, 368f Tori, 88
loading of, 9 mandibular
natural surgical removal of, 104, 108f
maxillary
implants vs., 538t description of, 104
occlusal vertical dimension, 274 surgical removal of, 104, 107, 109f
structural continuity of, 537f Torus mandibularis, 236, 237f
zone of equilibrium, 259 Torus palatinus, 214, 215f
natural irregularities of, 370, 372 Trays. see Custom impression trays; Stock trays
occlusal forces on, 9-10, 10b Treatment planning
shade of, 129 definition of, 76, 94
Telescopic crowns, for overdenture abutment retention, 173 description of, 74
Temporomandibular disorders elements of, 94-95
age-related increases in, 51-52 financial considerations, 77
arthritic conditions associated with, 53 immediate dentures
definition of, 51 existing teeth evaluations, 129
in edentulous populations, 51-54 explanation to patient, 127, 129b
management of, 52-53 lip evaluations, 129
pain associated with occlusion analysis, 130
description of, 52 oral examination, 127, 129
pharmacotherapy for, 53 oral prophylaxis, 131
symptoms of, 92 tooth modifications, 130, 131f
Temporomandibular joint implant-supported overdentures, 500b, 500-503
edentulism-related changes, 19-20 overdenture, 164, 166
mandible movement influenced by, 269-270 problem-solving uses of, 95
morphological face height changes secondary to, 17 reasons for, 95, 96f
vertical height of, 19 schematic diagram of, 97f
Terminal hinge axis single dentures, 428-430
description of, 283 treatment options developed by, 95, 96b
records of, 285 Trial denture base
Tissue conditioner, 198-199, 199b, 476, 479f, 519b acrylic, 254
Tissue hyperplasia characteristics of, 252
denture-related, 40, 41f resin, 252, 256f
evaluation of, 86 size of, 358
Titanium, for denture base, 206-207
Titanium implants, 484-485, 492-493

560 Index Vertical dimension of occlusion (Continued)
temporomandibular disorders and, 51
Trial denture base (Continued) tests to determine, 263, 265
“sprinkle-on” method for, 252, 256f try-in appointment verification of, 329-330
wax template for, 252, 255f verification of, 329-330

Triangularis, 349f, 352f Vestibule
Try-in appointment buccal
anatomy of, 217, 237f-238f, 238-239
centric relation verification impression taking of, 223
extraoral articulator method for, 331-335 impression taking of, 223
intraoral observation of intercuspation, 330-331 labial
anatomy of, 215-216, 216f, 236-238, 237f
description of, 329 impression taking of, 223
environmental factors, 336-337
facial and functional harmony. See Facial and functional Vestibuloplasty, 110-111, 113, 116, 118f-119f
Vibrating line, 217, 219f, 342, 342f
harmony Visible-light-activated resins, 190, 194-195, 479-480
immediate dentures, 141, 146f, 148f Vitamin E, 60
implant, complications during, 522-523 Vitamin supplementation, 62-64
lateral relations, 335-336
posterior palatal seal, 342f-346f, 342-343 W
protrusive interocclusal records Water-soluble vitamins, 64
Wax contouring, 148-149
for Dentatus articulator, 339-342 Waxing
for Whip Mix articulator, 338-339
protrusive relations, 335-336 gingival line, 391f
vertical dimension of occlusion verification, 329-330 mold
Tuberosities, 90
formation and preparation of, 392-396
U packing of, 396-397
Ulcers, denture-related, 41, 42f root indication lines, 392f-393f
Undercuts orientation relations, 398
overview of, 389-390
complete denture retention and, 441 polished surfaces, 390-392
remounting cast, 399, 400f Wax record, 335f
residual ridge Wax spacer, 245
Wettability, 437
description of, 88-89 Whip Mix articulator, protrusive interocclusal records for,
illustration of, 113f 338-339
removal of, 107, 113f “Witch’s chin,” 113
stability uses of, 107, 113f Women
calcium intake by, 61
V osteoporosis risks, 87-88
Velopharyngeal closure Working contacts, 324-325, 326f
Wound healing, immune system functioning and, 68
definition of, 449-450, 450f
disruption of, 450 X
Vertical dimension of occlusion Xerostomia
determination of
burning mouth syndrome and, 43
description of, 274-275, 465 definition of, 58
diagnostic casts, 275, 276f denture base adhesion and, 438
facial measurements, 275-276, 276f malnutrition and, 48b, 58
former denture measurements, 277, 280f management of, 58
jaw rest position, 277-278, 281f medication-induced, 58
mechanical methods, 275-277 in older adults, 27, 58
parallelism of ridges, 276-277, 278f-279f
phonetic tests, 278-279, 387 Z
profile radiographs for, 275, 275f Zygoma, 217, 218f
ridge relations, 276-277 Zygomatic head, 349f
speech patterns, 387 Zygomaticus, 346, 349f
swallowing threshold, 280-281, 282f Zygomaticus major, 352f
tactile sense, 281-282, 282f
esthetic considerations, 279-280
illustration of, 31f
measurement of, 83
occlusion rim for determining, 263, 265, 282-283
restoration of, 102
supporting structure loss effects on, 473