Ch52, denture

Copyright 2003, Elsevier Science (USA). All rights reserved.

Removable ProsthodonticsRemovable ProsthodonticsChapter 52Chapter 52

Copyright 2003, Elsevier Science (USA).

All rights reserved. No part of this product may be reproduced or transmitted in any form or by any means, electronic or mechanical, including input into or storage in any information system, without permission in writing from the publisher.

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ISBN 0-7216-9770-4


IntroductionIntroduction Removable prosthodontics is the

specialty of dentistry that replaces missing teeth with a removable prosthesis.

Removable partial denture, also referred to as a partial, replaces one or more teeth in the same arch.

Removable full denture, also referred to as a denture, replaces all of the teeth in one arch.

Removable prosthodontics is the specialty of dentistry that replaces missing teeth with a removable prosthesis.

Removable partial denture, also referred to as a partial, replaces one or more teeth in the same arch.

Removable full denture, also referred to as a denture, replaces all of the teeth in one arch.


Fig. 52-1 Removable partial denture.Fig. 52-1 Removable partial denture.


Fig. 52-2 Full denture.Fig. 52-2 Full denture.


Extraoral Factors that Influence the Choice of a Removable Prosthesis Extraoral Factors that Influence the Choice of a Removable Prosthesis

Physical health Mental health Motivation Age Dietary habits Socioeconomic factors Occupation

Physical health Mental health Motivation Age Dietary habits Socioeconomic factors Occupation


Musculature Salivary flow Residual alveolar ridge Oral mucosa Oral habits Tori

Musculature Salivary flow Residual alveolar ridge Oral mucosa Oral habits Tori

Intraoral Factors that Influence the Choice of a Removable Prosthesis Intraoral Factors that Influence the Choice of a Removable Prosthesis


Indications for a Removable Partial Denture Indications for a Removable Partial Denture To replace several teeth in the same quadrant

or in both quadrants of the same arch. As a temporary replacement for missing teeth

in a child. To replace missing teeth for patients who do

not want a fixed bridge or implants. For the patient who finds it easier to maintain

good oral hygiene. To serve as a splint to support periodontally

involved teeth.

To replace several teeth in the same quadrant or in both quadrants of the same arch.

As a temporary replacement for missing teeth in a child.

To replace missing teeth for patients who do not want a fixed bridge or implants.

For the patient who finds it easier to maintain good oral hygiene.

To serve as a splint to support periodontally involved teeth.


Contraindications for a Removable Partial Denture Contraindications for a Removable Partial Denture

A lack of suitable teeth in the arch to support, stabilize, and retain the removable prosthesis.

Rampant caries or severe periodontal conditions that threaten the remaining teeth in the arch.

A lack of patient acceptance for esthetic reasons.

Chronic poor oral hygiene.

A lack of suitable teeth in the arch to support, stabilize, and retain the removable prosthesis.

Rampant caries or severe periodontal conditions that threaten the remaining teeth in the arch.

A lack of patient acceptance for esthetic reasons.

Chronic poor oral hygiene.


Components of a Partial Denture Components of a Partial Denture

Framework• The cast metal skeleton that provides

support for the remaining components of the prosthesis.

Connectors• Join various parts of the partial together

• Major connector• Minor connector

Framework• The cast metal skeleton that provides

support for the remaining components of the prosthesis.

Connectors• Join various parts of the partial together

• Major connector• Minor connector


Retainer• Known as a clasp, it supports and

provides stability to the partial denture by partially circling an abutment tooth.

Rest• A metal projection designed to control

the seating of the prosthesis. Artificial teeth

• Constructed from either acrylic or porcelain.

Retainer• Known as a clasp, it supports and

provides stability to the partial denture by partially circling an abutment tooth.

Rest• A metal projection designed to control

the seating of the prosthesis. Artificial teeth

• Constructed from either acrylic or porcelain.

Components of a Partial Denture-cont’d Components of a Partial Denture-cont’d


Appointment Sequencing for a Partial Denture Appointment Sequencing for a Partial Denture

Appointment 1: Records• Updated health and dental history. • Prophylaxis. • Preliminary impressions.• Radiographs. • Photographs.

Appointment 1: Records• Updated health and dental history. • Prophylaxis. • Preliminary impressions.• Radiographs. • Photographs.


Appointment 2: Preparation• Prepare the teeth. • Take the final impression. • Take the occlusal registration. • Select the shade and mold of the

teeth. • Prepare the laboratory prescription.

Appointment 2: Preparation• Prepare the teeth. • Take the final impression. • Take the occlusal registration. • Select the shade and mold of the

teeth. • Prepare the laboratory prescription.

Appointment Sequencing for a Partial Denture-cont’d Appointment Sequencing for a Partial Denture-cont’d


Appointment 3: Try-in• Evaluate the fit, comfort, and function

of the appliance.• Evaluate the shade, mold, and

arrangement of the teeth.• Take new occlusal registration.• Note any changes on the laboratory

prescription.

Appointment 3: Try-in• Evaluate the fit, comfort, and function

of the appliance.• Evaluate the shade, mold, and

arrangement of the teeth.• Take new occlusal registration.• Note any changes on the laboratory

prescription.



Appointment 4: Delivery Have patient place partial. Check occlusion. Detect any pressure points. Check retainers for tension on the natural

abutment teeth. Polish partial. Give patient home instructions.

Appointment 4: Delivery Have patient place partial. Check occlusion. Detect any pressure points. Check retainers for tension on the natural

abutment teeth. Polish partial. Give patient home instructions.



Home Care Instructions for a Partial Denture Home Care Instructions for a Partial Denture Store prosthesis in water or a moist airtight

container when not wearing it. After eating, remove from mouth and brush or

rinse the retainers, rests, and complete partial.

Brush and floss abutment teeth and natural teeth to keep them free of food debris and plaque.

Advise patient not to adjust the partial denture.

Store prosthesis in water or a moist airtight container when not wearing it.

After eating, remove from mouth and brush or rinse the retainers, rests, and complete partial.

Brush and floss abutment teeth and natural teeth to keep them free of food debris and plaque.

Advise patient not to adjust the partial denture.


Appointment 5: Postdelivery check• Evaluate the fit.• Check the mucosa for pressure areas

and sore spots.• Evaluate the function of the

prosthesis.

Appointment 5: Postdelivery check• Evaluate the fit.• Check the mucosa for pressure areas

and sore spots.• Evaluate the function of the

prosthesis.



Indications for a Full Denture Indications for a Full Denture

The patient is edentulous. The remaining teeth cannot be saved. The remaining teeth cannot support a

removable partial denture, and no acceptable alternatives are available.

The patient refuses alternative treatment recommendations.

The patient is edentulous. The remaining teeth cannot be saved. The remaining teeth cannot support a

removable partial denture, and no acceptable alternatives are available.

The patient refuses alternative treatment recommendations.


Contraindications for a Full Denture Contraindications for a Full Denture

Another acceptable alternative is available.

Physical or mental illness affects the patient's ability to cooperate during the fabrication of the denture and to accept or wear the denture.

The patient is hypersensitive to denture materials.

The patient is not interested in replacing missing teeth.

Another acceptable alternative is available.

Physical or mental illness affects the patient's ability to cooperate during the fabrication of the denture and to accept or wear the denture.

The patient is hypersensitive to denture materials.

The patient is not interested in replacing missing teeth.


Components of a Full Denture Components of a Full Denture

Base• Designed to fit over the residual

alveolar ridge and surrounding gingival area.

Flange• Part of the base that extends over the

attached mucosa from the cervical margin of the teeth to the border of the denture.

Base• Designed to fit over the residual

alveolar ridge and surrounding gingival area.

Flange• Part of the base that extends over the

attached mucosa from the cervical margin of the teeth to the border of the denture.


Post dam• Retention of a maxillary denture

depends on the suction seal. Artificial teeth

• Fabricated from acrylic or porcelain.

Post dam• Retention of a maxillary denture

depends on the suction seal. Artificial teeth

• Fabricated from acrylic or porcelain.

Components of a Full Denture-cont’d Components of a Full Denture-cont’d


Appointment Sequencing for a Full Denture Appointment Sequencing for a Full Denture

Appointment 1: Records • Updated health and dental history. • Preliminary impressions. • Radiographs. • Photographs.

Appointment 1: Records • Updated health and dental history. • Preliminary impressions. • Radiographs. • Photographs.


Appointment 2: Final impression• Essentials of a final impression for dentures

• Landmarks of the dental arches are accurately reproduced.

• Maxillary should include the hamular notches, post dam, tuberosities, and frenum attachments.

• Mandibular should include the retromolar pads, oblique ridge, outline of the mylohyoid ridge and the genial tubercles, plus the lingual, labial, and buccal frena.

• Laboratory prescription

Appointment 2: Final impression• Essentials of a final impression for dentures

• Landmarks of the dental arches are accurately reproduced.

• Maxillary should include the hamular notches, post dam, tuberosities, and frenum attachments.

• Mandibular should include the retromolar pads, oblique ridge, outline of the mylohyoid ridge and the genial tubercles, plus the lingual, labial, and buccal frena.

• Laboratory prescription

Appointment Sequencing for a Full Denture-cont’d Appointment Sequencing for a Full Denture-cont’d


Appointment 3: Try‑in of baseplate‑occlusal rim• Occlusal rim records

• Vertical dimensions evaluated.• Occlusal relationship.• Smile line. • Canine eminence.

• Select artificial teeth

Appointment 3: Try‑in of baseplate‑occlusal rim• Occlusal rim records

• Vertical dimensions evaluated.• Occlusal relationship.• Smile line. • Canine eminence.

• Select artificial teeth



Appointment 3: Try‑in of baseplate‑occlusal rim-cont’d• Occlusal registration measurements

• Centric relation.• Protrusion. • Retrusion. • Lateral excursion.

Appointment 3: Try‑in of baseplate‑occlusal rim-cont’d• Occlusal registration measurements

• Centric relation.• Protrusion. • Retrusion. • Lateral excursion.



Appointment 4: Try-in• Denture is evaluated for fit, comfort, and

stability. • Appearance of the denture, including the shade,

mold, and alignment of the teeth, is verified. • Retention of the denture setup is checked as the

patient verbalizes the f, v, s, and th sounds; swallows; and yawns.

• Occlusion of the denture is checked. • Laboratory prescription for the completion of the

denture is prepared.

Appointment 4: Try-in• Denture is evaluated for fit, comfort, and

stability. • Appearance of the denture, including the shade,

mold, and alignment of the teeth, is verified. • Retention of the denture setup is checked as the

patient verbalizes the f, v, s, and th sounds; swallows; and yawns.

• Occlusion of the denture is checked. • Laboratory prescription for the completion of the

denture is prepared.



Appointment 5: Delivery• New denture is inserted into the patient's

mouth. • Shade and mold of the artificial teeth are

checked for natural appearance. • Patient is requested to perform facial

expressions and the actions of swallowing, chewing, and speaking, using s and th sounds.

• Occlusion is checked. • Home instructions are given.

Appointment 5: Delivery• New denture is inserted into the patient's

mouth. • Shade and mold of the artificial teeth are

checked for natural appearance. • Patient is requested to perform facial

expressions and the actions of swallowing, chewing, and speaking, using s and th sounds.

• Occlusion is checked. • Home instructions are given.



Thoroughly rinse the oral tissues at least once daily.

All surfaces of the denture should be thoroughly cleaned with a denture brush and mild abrasive.

When dentures are not in the mouth, they must be stored in a moist, airtight container to prevent drying and warpage.

Thoroughly rinse the oral tissues at least once daily.

All surfaces of the denture should be thoroughly cleaned with a denture brush and mild abrasive.

When dentures are not in the mouth, they must be stored in a moist, airtight container to prevent drying and warpage.

Home Care Instructions for a Full Denture Home Care Instructions for a Full Denture


Appointment 6: Postdelivery of a full denture • Check the mucosa for pressure areas

and sore spots.• Schedule recall appointment.

Appointment 6: Postdelivery of a full denture • Check the mucosa for pressure areas

and sore spots.• Schedule recall appointment.



Immediate Dentures Immediate Dentures Type of denture that is placed

immediately after the extraction of a patient's remaining anterior teeth. This type of denture serves as a compress and bandage to protect the surgical site.

Type of denture that is placed immediately after the extraction of a patient's remaining anterior teeth. This type of denture serves as a compress and bandage to protect the surgical site.


Construction of an Immediate Denture Construction of an Immediate Denture

Occlusal wax rims are completed with posterior teeth and tried in before extraction of anterior teeth. The denture, complete with the anterior teeth, is constructed, sterilized, and ready for placement at the time of surgery.

Surgical template• Clear plastic impression tray of the anterior

area that the surgeon uses as a guide in properly contouring the remaining alveolar ridge.

Occlusal wax rims are completed with posterior teeth and tried in before extraction of anterior teeth. The denture, complete with the anterior teeth, is constructed, sterilized, and ready for placement at the time of surgery.

Surgical template• Clear plastic impression tray of the anterior

area that the surgeon uses as a guide in properly contouring the remaining alveolar ridge.


Denture ReliningDenture Relining Relining is accomplished by placing a

new layer of denture resin over the tissue surface of the prosthesis.• Impression is taken with the present

denture used as the impression tray. • Patient is instructed to close-in

normal occlusion.• Denture and written prescription are

sent to the laboratory technician for relining.

Relining is accomplished by placing a new layer of denture resin over the tissue surface of the prosthesis.• Impression is taken with the present

denture used as the impression tray. • Patient is instructed to close-in

normal occlusion.• Denture and written prescription are

sent to the laboratory technician for relining.


Denture RepairsDenture Repairs

Simple repairs can be handled in the dental office laboratory by using cold‑cured acrylics.

Complicated repairs, particularly those involving the replacement of teeth or the complex fracture of the denture, are usually sent to the dental laboratory technician.

Simple repairs can be handled in the dental office laboratory by using cold‑cured acrylics.

Complicated repairs, particularly those involving the replacement of teeth or the complex fracture of the denture, are usually sent to the dental laboratory technician.


Fig 52-19 Broken denture. Fig 52-19 Broken denture.


Denture Duplication Denture Duplication

Because dentures can break or require time for relining, the patient should have a duplicate denture made.

Because dentures can break or require time for relining, the patient should have a duplicate denture made.

Health & Medicine

Ch52, denture