Trouble shooting in complete denture prosthesis: Part II. Lesions of the oral mucosa and their correction

Abstract

The study of the various sites of the oral mucosa, in relation to its degree of tolerance of or vulnerability to dentures, should emphasize the importance of investigating carefully any complaint of pain. It should not be concluded too hastily that reduction of the base material is the remedy, but every effort should be exerted to determine the source of the trouble before undertaking corrective measures. The classification of the oral mucosa according to degree of cornification follows a definite pattern. Listed in order from the highest to the lowest degree of cornification, there are: (1) the masticatory mucosa, (2) the specialized mucosa of the dorsum of the tongue, (3) the mucosa of the cheeks and soft palate, and (4) the mucosa under the tongue. Nature's design of the pattern of keratinization of the oral mucosa for natural dentitions is also suited admirably to the function of artificial dentures, and its application should be learned. A clear concept of the histologic structure and morphologic perculiarities of the oral mucosa and the physiology of the underlying muscle attachments is required to be able to extend denture borders properly during construction and to reduce these borders correctly during adjustments. Acute and chronic inflammatory conditions of the oral mucosa can be classified on the basis of their respective etiological factors: 1. Neuromuscular traumatic injuries arising from dentures with or without balanced occlusion. 2. Traumatic injuries of the oral mucosa resulting from traumatic occlusion of various kinds. 3. Inflammatory conditions of the oral mucosa resulting from the mere presence and action of the denture as a foreign body. 4. Poor oxidation and ventilation of oral mucosa covered by dentures. 5. Inflammatory conditions of the oral mucosa resulting from inadequate retention of the dentures. 6. Inadequate resistance of the oral mucosa caused by various systemic diseases. 7. Inflammatory conditions of the oral mucosa induced by endocrinologic and nervous disturbances of various kinds. 8. Inflammatory conditions of the oral mucosa caused by accumulation of infectious material on the undersurface of the dentures. 9. Chemicotoxic injuries to the oral mucosa caused by denture-base materials. 10. Poor nutrition and avitaminosis of various kinds. 11. Allergic reactions of the oral mucosa to denture-base materials.