Tooth wear, dentures, overdentures and rehabilitation

Question 1

How can lack of posterior occlusal support affect toothwear patients?

Answer 1

Modifying risk factor of toothwear
Increases severity
Increases rate
Can lead to occlusal collapse
Functional and aeshtetic problems

Question 2

What is the problem with prescribing full dentures to toothwear patients?

Answer 2

Bruxism does not stop
Fractures dentures
Ridge resoprtion
Pain and ulceration under complete dentures

Question 3

What may cause a person to have lack of posterior support?

Answer 3

Absence of posterior teeth or prosthesis
Denture intolcerance
Denture refusal
Supervised neglect

Question 4

What are overdentures?

Answer 4

Any removable prostehsis that rests on one or more remaining natural teeth, roots of natural teeth, and/or implants.

Question 5

What are the advantages of overdentures?

Answer 5

Correction of occlusion
Restoration of aesthetics
Support
Toothwear management
Preservation of ridge form
Proprioception
Denture retention
Eases transition into eduntulism

Question 6

What are the disadvantages of overdentures in toothwear cases?

Answer 6

Needs good oral health
Increased caries/perio problems
Care homes
Denture fracture
Discomfort/infection
MH
Potentially more traumatic extractions

Question 7

What are the important aspects of caring for overdentures?

Answer 7

Good oral hygiene
Fluoride toothpaste application to roots
Regular examinations & radiographs
Denture hygiene

Question 8

What are transitional dentures?

Answer 8

Temporary dentures, which can be used to increase OVD when there is poor posterior support.

They act to prop open the bite and allow for space to create restorations.

Question 9

What are the benefits of transitional dentures?

Answer 9

Patient can wear for a few months to see if they can cope with dentures, and an increased OVD. You can then make the defentive denture to that OVD and restore away.

Question 10

What are the benefits/drawbacks of metal backed dentures?

Answer 10

Metal overlaying heavy contact points. Good retention and resistant to bruxism. Often well tolerated.

Very technically demanding, requires wax trial of teeth before making the CoCr. Won’t be able to alter them once chrome is cast.

Question 11

What are important aspects to the treatment planning process for toothwear patients?

Answer 11

Impressions & facebow
Mounted articulated casts on semi-adjustable articulator
High quality Interocclusal record
Diagnostic wax up(s)
Stents – mock-up – temporaries
Temporary (transitional) dentures
Clinical photographs
Radiographs