Overdentures Flashcards
Mandibular anterior resorbs approx – times
as fast as maxillary anterior
4
Rapid bone loss emphasizes the need for any
procedure which will
slow the bone loss
A 5-year study showed that retaining
mandibular canines for overdentures
preserved
alveolar bone
overdenture advantages (4)
denture support is increased and soft tissue trauma is decreased
stability of denture is increased
maintenance of periodontal proprioception improves chewing efficiency
psychological benefit to patient
more advantages to overdentures (5)
residual ridge integrity-improved stress distribution
stability and retention
patients perception of preserved natural teeth
viable and simple alternative technique to CD
application is virtually unlimited
when to use overdentures (3)
When a conventional denture would have a
poor prognosis
When opposing an arch of natural teeth
When “Combination Syndrome” is a factor
disadvantages to overdentures (8)
likely time dependent transition to CD, depends on patients oral hygiene and nature of selected abutments
age related inability to follow proper hygiene
caries
frequent recall appointments, expense (endo and restoration)
available interach space
weakness in acrylic denture base
cast coping- increases lab procedures/expenses
overdenture disadvantages (4)
Cost– more $ than conventional denture- RCT, copings Denture is bulkier in some areas Denture more subject to fracture Caries / perio sequelae
selection of abutment teeth (3)
periodontal and mobility status (horizontal bone loss) abutment location (canines/premolars), at least one tooth per quadrant, no adjacent teeth endodontic and prosthodontric status
endodontic and prosthodontric status
anteriors easy wor endo, in cases of calcification- endo can be avoided
crowns can be modified- sealant/fluoride t/t use of copings, composite/ alloy restorations
retention attachment system
Root canal treatment is recommended for
most
overdenture abutments.
periodontal evaluation (2)
tooth mobility does not eliminate a tooth for use as an abutment
crown/root ratio is improved (mobility lessened) when crown is reduced on teeth tooth
central incisors:
advantages (2)
disadvantages
ideal location, provide protection of the premaxilla
proximity and alveolar prominence may complicate utilization
lateral incisors:
advantages (4)
disadvantages
widely separated, facilitating plaque control
tissue undercuts do not pose a problem
path of placement/removal is not compromised
ability to create a flange/peripheral seal
diminished root surface area
canines:
advantages
disadvantages (6)
longest root of the anterior teeth
diverging facial tissue undercuts
overcontoured flanges
excessive lip support
potentially uncomfortable placement/removal of prosthesis
complicates placement of prosthetic teeth
internal relief to accommodate canines may weaken, create a food trap, compromise the peripheral seal
why are canines most frequently selected? (3)
Canines have large roots
Amenable to RCT
Strategic location at corner of arches
Abutment failure –
caries or periodontal
Denture fracture –
metal base ?
loss of abutment teeth (5)
after 5-6 yrs, about 10% of abutment were lost
causes: periodontal disease, caries, endodontic complications
motivation for hygienic care- mechanical toothbrushes
one tooth overdentures were not tolerated
fluoride gel for daily applicaiton
gingivitis around abutment (3)
use of (2)
- movement of denture base
- poor oral hygiene
- excess space in prosthesis (dead space)
use of tissue conditioner
use of hard acrylic resin
restorations (2)
Amalgam
Cast gold copings
flexi-overdenture
root attachment
the locator root attachment is a supra radicular design that gives you the choice of a straight post and two angles (10 and 20 degrees) to accommodate divergent roots and a special cast-to version
what is required for an implant overdenture?
surgical guide
implant bars-
design for hygiene
implant-retained, implant supported-
no pressure on the ridge
