Removable prosthodontics

A partial denture receives its support and retention from the underlying tissues and remaining teeth that serve as abutments.It is design to distribute the forces of mastication between the abutment and the supporting tissues.

Replaces one or more teeth in the same arch

Full dentures are designed to restored the function and esthetics of the natural dentition when all of the natural teeth are missing.Full denture receives all its support and retention from the underlying tissues, alveolar ridges, hard and soft palate, and surrounding oral mucosa

Replaces all the teeth in one arch

Extraoral factors

Physical health

Certain chronic medical condition,poor health

Mental health

Severe mental disability may not be able to keep the appliance in place

Patient motivation

Patient's major motive for having removable prosthesis is for esthetic reasons

Age

Patient of different ages have different needs

Dietary habits

Patients with poor nutritional habits may have poor tissue response to the prosthesis

Social and economic factors

Patients' attitudes about their oral health and appearance will help them decide; the ability to pay for the treatment is important.

Occupation

Intraoral factors

Musculature

Facial muscle contribute to retention and functional control of the prosthesis

Salivary flow

The presence of a prosthesis in the oral cavity may stimulate an excessive flow of saliva

Residual alveolar ridge

Successful wearing of a removable prosthesis depends mainly on the support provided by the alveolar ridge

Oral mucosa

When the mucosa is altered by the patients' physical condition ,the prosthesis may cause friction and irritation

Oral habits

Clenching and grinding can cause stress on the ridges and remaining teeth; mouth breathing affect the ability to hold

Tori

Can affect the patient's ability to wear a prosthesis in that arch

The components

Framwork

the cast metal skeleton that provides support for the retaining components of the prosthesis

Connectors

or bars, join together the various parts of the partial denture

Retainer

also known as a clasp, is the portion of the framework that directly supports and provides stability to the partial denture

Rest

is a metal projection designed to control the seating of a prosthesis as it is positioned in the mouth

Artificial teeth

can be constructed from acrylic or porcelain

The appointment sequence

Appointment one-records

updated medical and dental history, prophylaxis, preliminary impressions and radiographs

Appointment two-preparation

selecting the shade and mold, preparation of the teeth, taking the final impression ,the bite and occlusal registration and lab prescription

Appointment three-try-in

the initial try-in, the appliance consists of the cast frame work and the artificial teeth set in wax

Appointment four-delivery

a 20-30 minute appointment, verify the case has been returned from the lab

Appointment five-postdelivery check

Change

Home care instructions

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

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

Carefully brush and floss the abutment teeth and the remaining teeth to keep them free of food debris and plaque

Do not adjust the partial denture. The patient should contact the dentist if he ore she has any difficulties

Bird, D.L., & Robinson, D.S. (2018). Student workbook for Modern dental assisting. St. Louis, MO: Elsevier

Repair

A patient may call the office upset because his or her denture or partial has fractured or has a missing or loose tooth.Simple repairs commonly can be fixed in the dental office laboratory. More complicated repairs are sent to the dental laboratory technician for repair.

Duplication

Having a functional denture is important to the patient, and because dentures can break or may require time for relining, the patient can opt to have a duplicate denture.

Components

Base

Designed to fit over the residual alveolar ridge and surrounding gingival area

Flange

Is the part of the base extends over the attached mucosa from the cervical margin of the teeth to the border of the denture

Post dam

Retention for maxillary and mandibular denture

Artificial teeth

Denture teeth are fabricated from acrylic or porcelain and are designed to be retained in the acrylic base of the denture

Appointment sequence

Appointment one-records

Health and dental history, preliminary impression, tray modification and radiographs

Appointment two-final impression

Before the impression is taken, a custom tray is fabricated

Appointment three-try-in of baseplate and occlusal rim

On the occlusal rims, the dentist records the vertical dimension, occlusal relationship, smile line and canine eminence

Appointment four-try-in

The wax setup consists of the baseplate with the artificial teeth set in wax that resembles gingival tissue

Appointment five-delivery

The denture are delivered to the dental office in a sealed, moist container

Appointment six-postdelivery

Check the mucosa for pressure areas and sore spots

Home care instructions

With the denture removed, thoroughly rinse the oral tissues at least once daily

On removal, thoroughly clean all surfaces of the denture; a special denture brush may be used. Avoid harsh abrasives such as toothpaste

During cleaning, carefully hold the denture over a sink half-filled with cool water.

Do not soak the denture in hot water or a strong solution such as undiluted bleach, because these liquids will damage the denture

When not in the mouth, store dentures in a moist, airtight container to prevent drying and warping.

Don' t wear the denture at night

What to expect the first month

Day 1-your adjusting to dentures journey is just beginning!

Day 2-14-may experience increased salivation, and also experience sore spots from the denture

Day 15-29-still learning to talk and eat all over again, the best time to start using an adhesive

Day 30-1 month with dentures! Visit dentist on a regular basis

Construction

Before the anterior teeth are extracted, the try-in of the wax setup includes only the posterior teeth. These teeth are aligned in the occlusal rims and are checked for their ability to occlude with the opposing teeth.The denture, complete with anterior teeth, is constructed.

Surgical template

After the anterior teeth have been extracted, the oral surgeon uses the surgical template as guide for properly contouring the remaining alveolar ridge.

Placement

The patient returns in 24 hours for a postoperative checkup.Daily visits continuing until 72 hours after surgery. During each visit, the dentist checks the soft tissue for pressure points.

An overdenture is full denture that is supported by the bony ridge and oral mucosa plus two or more remaining natural teeth or implants.First, the natural teeth are prepared by removing much of their bulk.The remaining tooth structure is protected with a coping.The posts from an implant protrude through the gingiva much like teeth, and a casting is created to fit over the posts.

Adjustment

If a denture puts too much pressure on a particular area in the mouth, the area will eventually become sore.PIP is used for diagnosing problems with partials and dentures at insertion and adjustment appointments.

Relining

Relining is accomplished by placing a new layer of denture resin over the tissue surface of the appliance. A reline resurfaces the prosthesis, and a rebase replaces the denture base.