Full Dentures Opposed by Natural Teeth Flashcards
Why is a complete upper denture opposed with natural lower teeth an issue?
Larger force from natural teeth is applied to the upper denture which can exert large forces against the maxillary edentulous ridge.
What are some of the issues associated with a complete upper denture opposed by lower natural teeth?
Flabby ridge- Absorption of the alveolar ridge plus hypertrophy of the mucosa.
Hypertrophy of the tuberosities- rotational force on the upper denture pulls down at the back and pulls down on the tuberosity.
Ulceration and mucous membrane damage.
Papillary hyperplasia of the hard palate.
Extrusion of mandibular anterior teeth.
Bone loss under the denture base.
Instability of the upper denture due to the uneven forces distributed from the nature lower teeth.
How can you reduce the potential trauma to the maxillary denture bearing area?
Ensure the denture cover the primary load bearing sites
- in the upper this is the tuberosity and the hard palate.
Maximise coverage of the detour bearing area.
How can you increase stability of the maxillary denture?
Optimum border seal- good primary and master casts
Effective post dam
Overdenture abutments
Reducing incisor overbite
Provide a partial lower denture if applicable
Why is a lack of lower posterior teeth with a full upper denture undesirable?
All of the force is being applied at the front of the upper denture, resorption of the ridge and hypertrophy of the mucosa, plus you also have the denture tilting and tends to break the border seal, so denture falls out all the time.
What can be done to improve the stability of an upper denture when there is a free end saddle in the lower?
Provide the patient with a partial lower denture.
Why is providing a lower partial denture desirable when you also have a complete upper denture?
It prevents the tilting effect in the upper denture
- more balanced forces along the entire occlusal surface of the upper denture.
Why is is important to reduce the incisor overbite in a complete upper denture when there are natural opposing teeth?
In function, the mandible moves forwards and if you have a large overbite, it will displace and dislodge the denture.
Better to make the patient edge to edge or just a slight overbite.
How can you reduce the incise overbite in a complete upper denture which is opposed with natural teeth?
- Reduce the incise edges of natural teeth.
- Siting of the denture.
The patient has a natural irregular occlusal plane due to drifting teeth. How would you combat this in the complete upper denture design?
Make an undulating occlusal plane on the complete upper denture to match.
- so we have even occlusal contacts between the upper and lower teeth on both sides.
If there is uneven contacts between complete upper denture and the existing natural lower teeth. What will happen during eccentric movements of the mandible?
The denture loses stability and will tilt on the side that does not have contact.
- falls out.
How would you manage an irregular occlusal plane on the natural teeth?
No adjustments- accept this.
Minimal localised occlusal grinding- only do this if you have a large restoration or crown on the tooth, or if there is lots of enamel left.
Radical occlusal adjustment
Extraction of teeth
Overlay appliance
What issues arise from having a complete lower denture with upper natural teeth?
Severe trauma to the alveolar ridge.
Pain on chewing.
Chronic instability of the denture.
What could be done to a lower denture to alleviate discomfort when it is opposed by natural teeth?
Soft lining- this is a palliative option, needs replaced every 18 months because they become hard.
Implant abutments.
