Scribd
Upload
5 views19 pages

Special Techniques in Complete Dentures Compressed 1

The document discusses special techniques in complete dentures, focusing on immediate dentures, overdentures, relining, and rebasing. Immediate dentures are classified into conventional and interim types, while overdentures utilize natural teeth as abutments to reduce resorption. Relining and rebasing are procedures to improve denture fit, with relining involving resurfacing the tissue side and rebasing replacing the denture base material.

Uploaded by

businesscrandsam
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
5 views19 pages

Special Techniques in Complete Dentures Compressed 1

The document discusses special techniques in complete dentures, focusing on immediate dentures, overdentures, relining, and rebasing. Immediate dentures are classified into conventional and interim types, while overdentures utilize natural teeth as abutments to reduce resorption. Relining and rebasing are procedures to improve denture fit, with relining involving resurfacing the tissue side and rebasing replacing the denture base material.

Uploaded by

businesscrandsam
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 19

Special techniques in

complete dentures
Immediate dentures
• "A complete or removable partial denture constructed for insertion immediately following the
removal of natural teeth"—GPT”. An immediate denture is one that is fabricated before all the
remaining teeth have been removed and inserted immediately after the removal of the teeth.
• Classification of Immediate Dentures
1. Conventional (Classic) Immediate dentures (CID)
2. Interim (transitional or nontraditional) Immediate dentures (IID) "A dental prosthesis to be
used for a short interval of time for reasons of aesthetics, mastication, occlusal support, or
convenience or to condition the patient to the acceptance of an artificial substitute for
missing natural teeth until more definitive prosthetic therapy can be provided"—GPT.
• The Conventional Immediate Denture is usually selected when only anterior teeth remain or if the
patient is willing to have the posterior teeth extracted before immediate denture procedure
begins. The ridges in the posterior region are allowed to heal before the extraction of the
anterior teeth. The denture is inserted on the appointment of extraction of the anterior teeth.
• The Interim Immediate Denture is indicated when both anterior and posterior teeth are to be
extracted at the same time and immediate dentures are provided. New complete dentures are
again fabricated after the healing period.
Fabricating a custom tray on the diagnostic cast
Posterior teeth are extracted first
and the sockets are allowed to
heal

Arbitrary trimming of teeth to be replaced


in master cast

Trimmed cast

Conventional (Classic) Immediate dentures (CID)


After insertion, immediate dentures should be teeth left in the mouth for the first 24 hr.
If the dentures are removed early before 24 hr, it is very difficult to reinsert them because of
severe pain.
The occlusal corrections are done after 48 hours.
The main disadvantage of immediate denture is necessity for frequent relining and rebasing
(3-6 months) and increased chairside time. Also, there is no try in for anterior teeth.
Surgical splint or template in immediate denture is constructed after remaining teeth are
trimmed on cast.
Transparent surgical template reveals
the bony spicules on the ridge which
must be removed. Thus template will
minimize the amount of surgery
needed and helps in proper fitting of
denture.
Overdentures
• Retaining natural teeth as abutments for dentures can considerably reduce the progress
of RRR. Multiple abutments can be used for this purpose. Even abutments which are
coronally modified or restored can be used. Endodontic treatment is usually done for most
cases.
• The stress concentration can be shared between the denture-bearing areas and the
abutments.
• These overdentures can reduce the impact of RRR, loss of occlusal stability, loss of
aesthetics and compromised mastication.

Tooth supporting overdenture


Overdentures
Indications
1. Cases having few hopeless teeth unsuitableas
abutments for fixed or removable bridges
2. Patient having few remaining teeth withperiodontal
disease.
3. Patient with abnormal jaw size or position
4. Patient with congenital or acquired defects as cleft
palate ,dentinogenesis imperfecta
5. Patient with singledenture
6. Patient exhibit flat ridges
Contra-indications
1. Mentally or physically handicapped
2. Patient can’t be motivated to develop goodoral
hygiene
3. Inadequate intermaxillary space
4. Teeth with grade III mobility or insufficient zone of
attached gingiva
In overdentures anterior abutments are preferred over posterior abutments since the anterior ridge is
more vulnerable to resorption than the posterior ridge.
At least one tooth should be retained in a quadrant to maintain the health of the oral tissues.
1- submerged roots
 Abutments roots are endodontically treated (submucosal root
retention) (use of selected roots without RCT in overdenture therapy
is called as Submucosal vital root retention)
 Reduced in height to a level below gingival margin
2- dome shaped abutment with amalgam plug
 Abutments reduced to be 1-2 mm above gingival margin to reduce
lateral force & torque
 Endodontic treatment is necessary
 The root canal is filled with guttapercha
 The opening is sealed with amalgamplug.
 The abutment is contoured to attain dome-shape.
 Used in patient with low caries index & goodoral hygiene.
3- dome shaped abutments with cast copings

 Abutment are endodontically treated & reduced to 1-2


mm above gingival margin
 Metal dome shaped cast coping constructed tocover
abutment
 The metal coping has a short post cemented into root
canal to retain the coping
4- abutments with telescopic crowns

 Abutment teeth are either vital orendodontically


treated & contoured to tapered configuration
 Tapered metal copings constructed &cemented over
abutments
 Denture constructed with metal crowns having
veneered facings
Relining
Relining is defined as, "A procedure to resurface the tissue surface of the
denture with new base material to make the denture fit more accurately"—
GPT. It is process of adding some material to tissue side of denture. It
corrects the base tissue relationship.
Indications for Relining
• Immediate dentures after 3-6 months where maximum residual ridge
resorption would have occurred.
• When the adaptation of the denture to the ridge is poor due to residual
ridge resorption.
• Economical reasons where the patient cannot afford a new denture.
• Geriatric or chronically ill patients who cannot withstand physical and
mental stress of construction of new dentures
Contraindications of relining
• When the residual ridge has resorbed excessively.
• Abused soft tissues due to an ill-fitting denture.
• Temporomandibular joint problems.
• Patient dissatisfied with the appearance of the existing dentures.
• Unsatisfactory jaw relationships in the denture.
• Dentures causing major speech problems.
• Severe osseous undercuts.
• Centric relation and centric occlusion don’t coincide
• Excess or reduced vertical dimension
Advantages of relining
• Eliminates frequency of patient visits.
• Economical for the patient.
• Improves fit of the denture.
• A soft liner can be incorporated in this denture, if necessary

Disadvantages of relining
• Likelihood of altering the jaw relationship during the process (most
common error during relining max denture is changed centric occlusion)
• Cannot correct aesthetics, or jaw relations.
• Cannot correct occlusal arrangement.
• Cannot be used when excessive resorption has occurred.
• Hence it cannot be a substitute for a new
• Methods of relining a denture
• Clinical procedures:
- Static methods:
Open-mouth technique (Boucher’s technique)
Closed-mouth technique.
- Functional methods
- Chair-side technique
• Laboratory procedures:
- Articulator method
- Jig method
- Flask method
• In Boucher’s technique both the upper and lower dentures are
relined at the same time
• Zinc oxide Eugenol is used as an impression material.
• Winkler’s functional relining method utilizes tissue conditioner as
impression material
• One drawback of functional relining method is that occlusion is
usually affected due to addition of new layer to surface of denture
• Chairside relining method uses acrylic that is added to the denture →
acrylic is allowed to set in mouth to produce instant relining
Tissue conditioner
• Ill-fitting dentures may cause inflammation and irritation of the soft tissues
in the denture bearing areas and may also cause burning sensation in the
residual ridge, tongue, cheeks and lips → Tissue conditioners may be
given to provide a cushioning effect on the tissues → It is a soft material
that is applied temporarily to the tissue surface of a partial denture →
tissue conditioner dissipates the forces occurring against the denture, thus
permitting the soft tissues to return to their normal form and function
• The tissue conditioner material undergoes some physical changes during
its use, which help the dentist to use it for different purposes. In its plastic
and elastic stages it is used as tissue conditioner, whereas in its firm stage
it is used as reline impression material.
• Hence, for relining procedures, it should be left in place for about 10-14
days to allow them to become firm and then reline procedure is carried out.
They have to be replaced periodically.
REBASING
• "A process of refitting a denture by the replacement of the denture base material"—GPT.9
• Sharry defined as, "It consists of replacing all of the denture base with new material.“
• Rebasing is similar to relining except that there is extensive replacement of the denture base
material.
• Actually, it’s a laboratory technique similar to relining, wherein the bulk of denture base material (all
most total base) is removed along with the impression material and replaced by new resin
• Indications :
1. When denture borders don’t extend to cover all the supporting tissue
2. When denture is fractured in the denture base
3. When the denture is stained or discoloured
Main risk in rebasing complete dentures is change in bite

You might also like