Clinical indications for flexible bases "permanent"

Despite the many advances in dental disciplines, the denture still has its place: the hope and the environment deviates growing medical have resulted in an increase of very elderly patients and more and more difficult to sail.

The major indication of utilisationdes flexible bases "permanent" is represented by a class of partially or totally edentulous patients in whom surgery is any cons-indicated or refused either temporarily or permanently. The surgery will be against-indicated with:

- The major risks of osteoradionecrosis;

- Specific disease states changing;

- Too large a senescence;

- un refus psychologique (phobie ou traumatisme).

For these patients, in whom surgery is not feasible, ilfaudra any time to address the following issues:

• mucous membranes thin and fragile that do not support the touch of a hard resin: the flexible base will provide a better tolerance of dentures and comfort;

• irregular peaks (Fig. 1) on which it is very difficult due to lack of surgical correction, the appropriate distribution pressures: the prosthesis combined with a flexible base will minimize overpressure assurantune better stress distribution;

• the strong resorption in the mandible, with the emergence of the mental nerve: the damping produced by the flexible material will improve the confortet preserve the remaining bone support

Fig. 1 - irrégulièresne peaks can be in this case managed by surgery.

• a reduced bone support against a natural dentition (Fig. 2) aggravated by a class II of England: the flexible base will allow the patient to have little contact with concentrated support and preserve the tissue desoutien

• after fracture, the establishment of an osteosynthesis system (Fig. 3) makes it difficult to wear a prosthesis. The use of a flexible leads to decreased pain phenomena and the stress transmitted to the bone, while making a bet based on "soft" bone;

• loss of substance with skin graft (Fig. 4) are essentially of consecutive patients operated on oncological but also due Ades ballistic trauma (biological context more favorable for the healthy and stable). In these cases, a prosthesis doubléed'une flexible base is the only alternative.

These situations show what trade-off will not be easy to get a functional prosthetic rehabilitation, especially as the use of a flexible base can not, under any circumstances, overcome technical failure [1] or permit to waive the performance criteria of complete dentures in general.

There are other indications of the use of soft denture bases:

• Pedodontics: young edentulous patients, the denture lined with a flexible base allows some adaptation to tissue remodeling and growth

• in partial denture when there is persistence of the block-incisivo canine and resorption very important sectors lateral and rear base makes a flexible support of non-traumatic support ostéomuqueux deficient

Fig. 2 - facing natural teeth a support surface mandibular very weak.

Fig. 3 - allow flexible bases pressing the osteosynthesis device.

Fig. 4 - On skin grafts, permetun support a flexible non-traumatic.

• in maxillofacial prosthesis: in the transient phases, this type of prosthesis promotes the acquisition of compensatory reflexes before the final prosthesis;

• In case of refusal following a psychological phobia or, most often, injuries to many interventions: the flexible base while providing an alternative (and only) non-aggressive and therefore accepted by the patient.

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