16. Tooth supported overdentures Flashcards by Nicky Tahpee

What is a tooth supported overdenture?

-Removeable dental prosthesis
-partially supported by 1 or more remaining natural teeth/roots and/or implants
-

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Advantages of a tooth supported overdenture? (5)

Preservation of alveolar bone.
Improvement of support, retention and stability.
Increased masticatory efficiency.
Preservation of proprioception.
Comfort

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Tooth supported overdenture indications? (4)

• Have teeth that are unreliable for RPDs but are in good condition for an overdenture.
• Patients that will probably have bad adaptation to
a CD.
• Extreme dental wear.
• Patient can’t pay for an implant treatment

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Tooth supported overdenture contraindications? (4)

• Unreliable teeth.
- Periodontal decease.
- Endodontic treatment.
• Bad teeth location.
• Small interocclusal space.

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Tooth supported overdenture: What is the periodontal condition required for abutment teeth? (4)

probing of less than 4mm
discard teeth of type II and III mobility
adequate crown to root ratio
atleast 50% bone attachment

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Tooth supported overdenture: What is the endodontic condition required for abutment teeth?

-ALWAYS preform endodontic treatemnt when placing attachments

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Tooth supported overdenture: When do we do endodontic retreatment? (2)

◦ Previous one is not adequate.

◦ Radiolucent periapical area.

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Tooth supported overdenture:

tooth number?

more teeth = better

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Tooth supported overdenture: tooth placement? (3)

At both sides and symmetrically placed: best
situation.
◦ Teeth are not overloaded.
◦ Less fractures.

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Tooth supported overdenture: Ideal abutment teeth?

Two anterior and two posterior teeth

- Canines are the best

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Tooth supported overdenture: What happens if abutment teeth are placed next to eachother?

Hindered hygiene

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Tooth supported overdenture: Antagonist natural dentition?

tends to load more

abutment teeth

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Tooth supported overdenture: combination syndrome? (4)

◦ Upper edentulous arch.
◦ Lower front teeth.
◦ Increased upper anterior ridge resorption.
◦ Preserve upper anterior roots as much as possible.

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Tooth supported overdenture: choice of root shape and support? (2)

Multi-rooted teeth: greatest support.

- Conical roots: least support.

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Tooth supported overdenture: root shape and hygiene?

Noticeable root concavities hinder hygiene and produce periodontal problems

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Tooth supported overdenture: What are the types of attachments? (2)

Axial

Bar

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Tooth supported overdenture: What are the types of axial attachments? (4)

◦ Coping.
◦ Ball.
◦ Locator.
◦ Magnetic attachments.

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Tooth supported overdenture: What are the types of bar attachments?

◦ Ackerman bar.
◦ Dolder bar.
◦ Hader bar.
◦ Mechanized parallel wall bar.

Tooth supported overdenture: Where should bar attachments be?

Over the edentulous ridge

Tooth supported overdenture: Bar attachments and no rotation? (3)

ex. 4 abutment teeth

- U and Parallel wall bar shapes

Tooth supported overdenture: Bar attachements and rotations? (4)

-ex. 2 abutment teeth
-shapes:
◦ Cylindrical bars.
◦ Ovoid bars.
◦ Parallel to the transverse
horizontal axis.

Tooth supported overdenture:

Endodontic treatment procedure? (4)

START WITH Gates n*1 and Peeso burs
Conical drills
min 4mm gutta percha
from smaller diameter to bigger

Tooth supported overdenture: procedure for preparation?

endodontic

2. coronal portion

Tooth supported overdenture: Procedure for coronal portion prep? (3)

Leave 2-3 mm of tooth over the gingiva. (smaller lever effect over the tooth)
◦ The coping should embrace the root (ferrule effect).
Chamfer finish line all around the tooth (0.3-0.5 mm)
Build boxes if necessary.
Round edges.

Tooth supported overdenture: | Height of abutment teeth? (2)

* Low profile to decrease the lever effect | * > 2-3 mm when doing telescopic crowns.

Tooth supported overdenture: What is the furrule effect? (2)

• If placing any kind of attachment, build a coping. - Provides metallic support to the overdenture.

Tooth supported overdenture: What do we do if the tooth is not high enough?

Place just a coping

Tooth supported overdenture: both the post and coping must have...?

an adequate path of insertion

An overdenture is weakend by...? (2)

attachments | -use a built in frame work for reinforcement

Tooth supported overdenture: What is the importance of placing copings?

Preventing root fractures

Tooth supported overdenture: What hinders hygiene?

Attachments hinder hygiene more than plain copings

Tooth supported overdenture: Post design? fractures? (4)

- Some are placed directly into the root, without laboratory coping. ◦ Higher risk of root fracture.

Tooth supported overdenture: Post material? (2)

- Should be made of a flexible alloy. | ◦ Type III gold alloys

Tooth supported overdenture: which posts are more retentive? (2)

- Parallel walls are more retentive than conical ones | - Conical posts adapt better to the root

Tooth supported overdenture: What posts do we never use?

threaded - higher fracture risk

Tooth supported overdenture: Post width?

Not to be greater than 1/3 of the diameter of the root

Tooth supported overdenture: If there are only two anterior teeth?

One then allows rotation

Tooth supported overdenture: IF there are anterior and posterior abutments?

- Attachments allow vertical resilience

Tooth supported overdenture: What must we do for attachment and prosthetic space? (3)

- Measure vertical prosthetic space. - There must be room for the attachment. - Check that the diameter of the root also provides room for the attachment.

Tooth supported overdenture: Requirements for bar attachments? (5)

- Splint abutment teeth. - Occupy more space. - Metallic framework. - More difficult hygiene. - Minimum space between bar and gingiva of 2 mm.

Tooth supported overdenture: What happens if you use putty and light body silicone?

Soft tissues would be copied under pressure

Tooth supported overdenture: Procedure for taking impressions? (3)

- Castable post. - Light-body silicone for the coping. - Monophase silicone for the soft tissue.

Tooth supported overdenture: | Alternative impression taking procedure? (3)

- Take putty and light body silicone impression. - Finish and cement the attachments. - Adapt them to the CD with acrylic resin.