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Flabby ridge

(Abused tissue)
Mohamed Ali El Maroush
Ph.D of prosthodontic & Maxillofacial
(Ain Shams University)
Flabby ridge (Abused tissue)
Hyperplasia of the mucosa

It is the abnormal multiplication or


increase in the number of normal cells
in normal arrangement in tissue
(irreversible).
Hypertrophy of the mucosa
It is a bulk of tissue beyond normal size
, caused by an increase in volume but
not in number of tissue elements
(reversible).
Forms of hyperplasia

Single or multiple
flaps or folds of
fibrous tissue
related to the
border of a
denture.
Location of Flabby Tissue
Most common:

Anterior segment
(upper & lower).
Posterior segment
(lower).
The lesion may be
localized, or
generalized over
the entire ridge
crest.
Inflammatory Papillary
Hyperplasia
‫ن رض‬
‫ب‬
‫ت‬
‫ب‬
Flabby ridge (Abused tissue)
Etiology
Old loose dentures without
serviceability.
load concentration on the anterior
segment of the ridge as a result of
decreased vertical dimension.
Badly constructed dentures such as
loose ill-fitting dentures as well as
dentures with wrong centric occluding
relation, occlusal disharmony and lack
of anterior clearance.
Complete maxillary denture opposing
natural mandibular anterior teeth.
Flabby ridge (Abused tissue)
Etiology
Dentures constructed with
anterior porcelain teeth and
posterior resin teeth.
Over-eruption of natural teeth
against edentulous span.
Not removing the dentures during
night to allow the basal seat
mucosa to regain its resting form.
Etiology of denture fissuratum

The primary
cause of this
condition is over
extension of
denture border.
‫ا ذي‬ ‫ھو ا‬
‫ر ر ظ ف إذا‬
‫أ ض و ؟؟؟؟؟؟‬
Management of flabby ridge
1- rehabilitation of abused oral
tissues.
2- surgery to remove the mobile
tissues if recovery program is not
effective.
Flabby ridge (Abused tissue)

Treatment
Remove old dentures from the
mouth for few days before making
new impressions to allow the
inflammation to subside.
Another line of treatment is to treat each
case by elimination of the cause and
then start a recovery program.
1. Detect and remove any pressure areas or sore
spots using pressure-indicating paste(PIP).
2. Correction of occlusal disharmonies by clinical
remounting.
3. Elimination of any contact between natural
anterior teeth and opposing artificial teeth.
4. Restoring the lost occlusal vertical dimension by
the help of occlusal pivots . this will help to:
- Restore the correct vertical dimension.
- Restore the correct position of the condyle.
- Eliminate the load on the anterior segment.
5- enough room should be created for
tissue conditioning material by
removing all undercuts and reducing
1mm from the fitting surface.
6- TCM mixed and applied to the dry
denture basal surface, this material
should be changed every three days.
Tempo Kit

• Powder
• Liquid
• Plastic
cup
• Steel
Spatula
Mixing
• Mix 45-60 seconds

Wait
Doughy
Seating
Treatment
Recovery Program:
1. Massage of the soft tissues two or
three times a day to stimulate the
blood supply and aid recovery.
2. Instruct the patient to dissolve one-
half teaspoon of table salt in a half
glass of warm water and rinse
vigorously.
3. Remove the dentures out of the
mouth for at least 8 hours every 24
hours.
Flabby ridge (Abused tissue)
Treatment
If the condition persists then the
treatment may be either:
Surgical removal of the flabby
tissue. OR
Prosthetic approach to the
flabby tissue as follows:
A sectional impression technique
(Two part impression technique)
A close fitting tray is
constructed in cold-curing
acrylic resin and designed so
that flabby area of the ridge is
uncovered.
The flabby area is recorded
using plaster impression
material applied with a brush
several times with the
secondary impression in place,
after set an overall impression
using stock tray is used to
remove both sections together.
Flabby ridge (Abused tissue)
Jaw Relation and Follow-up
The jaw relation is recorded using
the check bite technique with the
least possible displacement of the
supporting structures.
Teeth are placed in relation to the
neutral zone and the bucco-lingual
width should be reduced.
After denture insertion the patient is
instructed for periodic check-ups.