Dentures

• Introduction
• Full Denture
• Immediate Denture
•  Over Denture
  • Tooth Supported Over Denture
  • Implant Supported Over Denture
• Removable Partial Denture
  • Conventional RPD
  • Cast Partial Denture
  • Flexible Partial Denture
• Precision Attachment Denture
• Implant Retained Precision Attachment Denture
• Flexible Denture
• Telescopic Denture
• Denture Relining
• Some Myths Regarding Dentures
• F.A.Q.
• Before & After Photographs

 

Introduction

A denture is a prosthetic appliance that replaces some or all of missing natural teeth. There are various types of dentures that can be constructed to best suit the needs of individual patients.

Full Denture

Immediate Denture

The denture is constructed before the teeth are removed, the teeth are removed and the denture is immediately placed in the mouth. The advantage is that the patient is never without teeth during the healing period.

As healing progresses in your mouth, the immediate denture will have to be periodically re-evaluated. An immediate denture will always require a reline because the tissues of the mouth will change as healing occurs.

Advantages Of  Immediate Denture

1. The form, size and arrangement of your natural teeth can more closely be duplicated when some teeth remain in your mouth.

2. When immediate dentures are inserted, they act as a bandage and help to reduce bleeding.

3. Immediate dentures protect the tissues at the sensitive extraction sites from irritation that might result from the tongue and food. This can mean less discomfort for you than with conventional denture construction.

4. Immediate dentures can enable you to establish your speech patterns more easily. You do not have to learn to speak without teeth and then relearn once dentures are made.

5. With immediate dentures you can chew better than you could without teeth during the normal waiting period for conventional dentures.

6. If dentures do not replace the natural teeth within a short time, the cheeks tend to fall in.

7. Perhaps the most important advantage is that you do not have to appear in public without any teeth.

Over Denture

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Tooth Supported Over Denture

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Maintaining a few natural teeth and replacing the missing teeth with an over denture has several advantages:

• Your natural teeth help preserve bone.
• The patient is able to retain the denture better in his/her mouth.

• Your remaining natural teeth bear some of the chewing pressure, which reduces pressure on other areas of the jaw.

• Your remaining teeth improve the stability of the denture and make it less likely to shift in your mouth.

• Your sense of where your jaw is in space and the pressure you are placing on the denture is better than the sense you have after losing all of your teeth.

• Keeping some teeth can help you psychologically accept your denture.

• Even though only roots are preserved, and they are covered by a denture, a patient still has sensory input sensations similar to that experienced with teeth, as opposed to individuals with conventional dentures and no preserved roots. Over-denture patients also appear to have a more natural perceived directional sense in their chewing activities. In other words, many patients relate that they still feel like they have teeth - - a positive comment.

Lower dentures tend to be more difficult to keep in your mouth than upper dentures. Therefore, an over denture can be particularly helpful for the lower jaw, but it is an option for almost anyone who has a few teeth remaining. However, the teeth that will be preserved must meet certain standards of health. Canines and premolars are the most common teeth selected because of their root length and position in the jaw.

Implant Supported Over Denture

In these dentures, a few implants are placed in the patient’s mouth at strategic locations. A Removable Complete Denture is then fabricated such that it derives strength & stability from the underlying dental implants.

The denture appears like a traditional prosthesis. However, that part of the denture overlying implants is modified to retain various semi-rigid attachments that receive implant extensions projecting above the gum. This arrangement helps keep a denture securely in place while eating, speaking and during other oral activities, but still allows easy self-removal of the denture for cleaning purposes.

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Benefits Of Implant Supported Over Denture

• Stability during speech and eating (provides optimum function).
• Increased preservation of alveolar bone.
• Less food accumulation under your denture.
• Superior aesthetics.
• A feeling close to that of your natural teeth.

Removable Partial Denture

The various types of RPDs are: -

Conventional RPD

Cast Partial  Denture

Flexible Partial  Denture

Precision Attachment Denture

Advantages Of  Precision Attachment Denture

Precision attachment partial dentures are the indicated in cases where fixed prosthesis are contraindicated. Some advantages of this type of dentures are

• Cosmetic Appearance, no need for ungainly looking metal clasps.
• Periodontal Health can be better maintained.
• Longevity of Abutment (Support) teeth.
• High Degree of Patient Comfort.
• Natural Tooth and/or Implant Abutments can Be Used.
• Precision Attachment Partial Dentures Can Be Adapted to Compensate for Future Changes in the Mouth.
• Prevent resorption of the bony ridges under the partial denture.

Implant Retained Precision Attachment Denture

Keep Your Life Lit With A Bright Smile

Implants are sometimes used to retain a full denture if it is not possible to place sufficient no. of implants to fabricate a full arch of fixed bridge work. Because precision attachment cases work so well on the weakest teeth imaginable, they work exceedingly well on implants, which are usually strong.

As few as three strategically placed implants are enough to make a successful attachment case. The three implants are placed in the anterior region of the mouth and an anterior fixed bridge is constructed over these. A precision attachment  posterior partial denture is fabricated in conjunction with this anterior fixed bridge.

An implant- supported precision attachment partial denture is far superior to an implant-supported full denture for the following reasons:

• Superior Comfort and Self-Esteem. The posterior bar can be made thin and only covers a small area of the palate, while a denture usually covers the entire palate. The patient wearing an attachment case has anterior (front) teeth that do not come out, unlike the patient wearing a denture.
• Superior Function. Unlike a denture, the posterior bar of an attachment case frees the tongue for normal speech and allows taste buds on the anterior palate to function normally. Patients with an attachment case on implants can bite into anything.
• Increased Longevity. A precision attachment case does not place lateral forces on implants, which can be destructive to implants as well as natural teeth.

Flexible Denture

A New Reason to Smile

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As the name itself suggests, these dentures are not rigid like the conventional dentures.

 

These dentures are made with a special flexible acrylic resin that makes these dentures extremely comfortable to wear.

Advantages Of Flexible Denture

1. Extremely comfortable.

2. The unsightly metal clasps are not needed so when you smile, the only thing that’s visible is, Your Beautiful Smile.

3. Non-Invasive.

4. Very Durable.

5. Affordable.

Telescopic Denture

(Also known as Hybrid Prostheses, Bar Joint Denture)

The advantages of telescopic over dentures are: -

• Prevention of bone loss.

• Esthetic superiority.

• Improved speech as compared to other types of dentures

• Proper jaw alignment and improved chewing efficiency.

• Improved esthetics as compared to conventional dentures.

• Best suited for patients who do not want or cannot have implant surgery due to any reason.

• In case of tooth loss there is no need to make a new bridgeas the framework can be  extended to accommodate the change.

Compared to conventional complete dentures, Telescopic over denture systems can increase chewing power  up to 300%. Also, these over dentures can last a lifetime.

The Telescopic Bridge

The telescopic bridge or prosthesis is a dual supported( teeth and gums) removable coverage prosthesis designed to fit over natural teeth and gum areas in order to replace missing teeth.

The telescopic denture consists of:

1. The primary crowns or caps made of precious or non precious dental alloys that are cemented on the prepared teeth.
2. The secondary crowns (dental alloys) that slip over the primary caps and maintain the bridge tightly on the teeth through sliding friction the teeth. The secondary crowns have facings of acrylic resin with ceramic fillers, ( the framework made out of non precious dental alloy is embedded in acrylic resin and supports the acrylic teeth which will replace the your missing teeth. )

Advantages

• Replace missing teeth.

• Improved appearance compared to clasp retained partial dentures.

• Improved chewing ability.

• Provides support to the periodontal structures.

• Cheaper than comparable implant sustained bridges.

• Can be easily fabricated and applied when there are at least two or three teeth left on the jaw. Ideally it would be fitted on 4 to 6 teeth to achieve best results.

• Does not need clasps or other visible metallic parts on the front teeth.

• The bridge sits tight although it can be easily removed in order to practice the regular mouth hygiene.

• Prevents future tooth loss- The secondary framework can prevent further tooth loss especially when teeth are weakened by periodontitis (gum disease).

• Maintenance, repairs and extension can be easily done at low costs.

Disadvantages

• It needs to be taken out of the mouth at least once a day for cleaning. This may be bothersome for some patients.

• Wearing a removable denture might be hard to overcome psychologically, giving a sense of ageing.

• The telescopic crowns are slightly larger (bulky) than similar ceramic crowns.

• Requires more appointments for completion when compared to fixed bridges.

• It often requires a palatine (roof of the mouth) metal bow in the upper jaw that spans across the palate, and in the lower jaw a thin metal bow behind the front teeth.

• At the beginning it may look expensive than comparable fixed bridges. But seen on a long term basis it is definitely the best choice.

Denture Relining

There are two different types of denture relines commonly available, hard relines and soft relines.

Hard Relines:

A Hard Reline is considered the best type of reline available and the longest lasting. The plastic is processed and cured in the laboratory in the same way that the plastic of the original denture is cured.

Soft reline: 

In some cases, it might become necessary to line the denture with a soft relining material. The soft reline helps in the healing of gums that might have become inflamed due to the denture base.
A soft reline can be performed either in office or chairside or in the lab. It is not considered as long lasting as a hard reline.

Some Myths Regarding Dentures

There are many common myths and misconceptions regarding dentures that are accepted as fact. It is better to dispel the myths and get the facts straight.

"Dentures last forever!"

Dentures are long lasting but like anything man made, they do wear out. They are made from plastic and dropping them can cause them to break. Depending on the individual oral environment, the rate of wear out of the teeth and the amount of change occurring in the oral cavity may vary. 

"Once you have dentures, you don't need to see a dentist anymore."

The mouth changes constantly. Dentures that become loose and do not fit as well as they should, may require a reline. People with dentures can still develop oral cancer and should be examined regularly by a dentist.  

"Everyone can tell when you're wearing dentures."

Well fitting dentures made with meticulous care and attention to detail are difficult to recognize as dentures. They should provide a natural appearance and function well. You should be able to eat and speak normally. Dentures that fit well should not require adhesives to hold them in place.

To know more about dentures please visit www.dentures.net