The Single Denture Flashcards
the most common situation (2)
Maxillary arch is edentulous
Mandibular arch has natural / restored teeth
natural teeth opposing a CD (4)
natural teeth generate greater chewing force against opposing denture
natural teeth do not move in function as denture does
cannot control placement of opposing teeth
drifting/tilting puts natural teeth far from optimal positions
centripetal resorption (2)
Routine resorption pattern following
extraction of teeth results in a smaller maxilla
when compared to dentate arch.
Maxilla resorbs UP and INWARD!
arch discrepancy (2)
a horizontal arch discrepancy is created when the max arch narrows and becomes shorter in the AP direction
a crossbite may be required to direct occlusal forces to the bearing area
uncontrolled occlusal forces
Maxillary CD opposed by mandibular
anterior natural teeth:
“THE COMBINATION SYNDROME”
“THE COMBINATION SYNDROME”
(5)
max ant tissue mobile/hyperplasia
inflammatory palatal hyperplasia (IPH)
max tuberosities enlarged
mand poster bone resorption
mand anterior teeth supraerupted
curve of monson
(4)
combo of curve of spee and wilson
coronal and sagittal planes
concave for the mand arch and convex for the max arch
the CO form a segment of a sphere of 4 inches radius with the center of the sphere at the glabella
occlusal plane
reduce restore remove
occlusion on the single denture
Interdigitation……cusp in fossa
occlusion
a reciprocal arrangement of elevations and depressions
single denture fractures
Biting force of natural dentition is approx 5
times that of the denture wearers (160 vs 35
lbs)
the edentulous mandible opposing max natural dentition
Rapid loss of mandibular alveolar bone
natural/edentulous mandible (3)
Discuss the likely poor outcome
Resilient liner in mandibular denture
Osseointegrated implants in mandible
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 — for overdentures
preserved alveolar bone
mandibular canines
overdenture adv (4)
denture support is increased and soft tissue trauma is decreased
stability of the denture is increased
maintenance of periodontal proprioception improves chewing efficiency
psychological benefit to the pt
adv of 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 overdentures? (3)
When a conventional denture would have a
poor prognosis
When opposing an arch of natural teeth
When “Combination Syndrome” is a factor
disadv overdentures (8)
llikely time dependent transition to CD depends on patients oral hygiene and nature of selected abutments
age related inability to follow proper hygiene
presence of refractory PD
caries
frequent reall appointments, expense (endo and restoration)
available interarch space
weakness of acrylic denture base
cast coping -increases lab procedures/expeneses
overdentures disadv (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)
PD and mobility status (horizontal bone loss)
abutment location (canine/premolars), at least one tooth per quad, no adjacent teeth
endo and prosth status
endo and prosth status
anteriors easy for endo,
in cases of cacification -endo can be avoided
crowns can be modified -sealant/fluoride tray,
use of copings, composite / alloy restorations
retention attachment system
— treatment is recommended for
most overdenture abutments
Root canal
perio eval (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 the tooth
abutments canines most frequently selected (3)
Canines have large roots
Amenable to RCT
Strategic location at corner of arches
Abutment failure –
Denture fracture –
caries or periodontal
metal base ?
loss of abutment teeth
after 5-6 yrs about –% of abutments were lost
causes: PD, caries, endo complications
motivation for hygienic care - mechanical toothbrushes
one tooth overdentures were not tolerated
fluoride gel for daily application
10
gingivities around abutment (3)
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
— requred
surgical guide
implant bars
design for hygeine
implant-retained, implant-supported
no pressure on the ridge
