overdentures

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OVERDENTURES : 

OVERDENTURES A removable partial denture or complete denture that covers & rests on one or more remaining natural teeth, the roots of natural teeth, &/or dental implants; a prosthesis that covers & is partially supported by natural tooth roots, &/or dental implants , called also overlay denture, overlay prosthesis, superimposed prosthesis, hybrid dentures Praveen V Badwaik

Preservation of alveolar ridge integrity : 

Preservation of alveolar ridge integrity a-b = reduction of ridges TE ----CD, inexpensive & permanent solution,----- RRR

Occlusal forces can be reduced : 

Occlusal forces can be reduced Coronally modified / restored & frequently endodontically treated, distributes stress & manages RRR, increases stability & masticatory function

Advantages of Overdentures : 

Advantages of Overdentures Residual ridge integrity– improved stress distribution Stability & retention Patient’s perception of preserved natural teeth Viable & simple alternate technique to CD Application is virtually unlimited

Disadvantages of Overdentures : 

Likely time dependent transition to CD, depends on patient’s oral hygiene & nature of selected abutments Age-related inability to follow proper hygiene Presence of refractory periodontal disease Caries Frequent recall appointments, expense (endo & restoration) Available interarch space Weakness in Acrylic denture base Cast coping – increases lab procedures / expenses Disadvantages of Overdentures

Indications : 

Indications Patients with few remaining natural teeth (coronally intact / malpositioned / morphologically compromised) Patients with mutilated / severely compromised dentitions

Congenital anomaly rehabilitated : 

Congenital anomaly rehabilitated Conical crowns

Facial profile : 

Facial profile

Congenitally missing teeth : 

Congenitally missing teeth

Case managed without orthognathic surgery : 

Case managed without orthognathic surgery

Esthetics & masticatory function improved : 

Esthetics & masticatory function improved

Periodontal disease : 

Periodontal disease Oral hygiene & Fluoride gel use – has yielded in good treatment outcome

Subgingival root planing & RCT : 

Subgingival root planing & RCT

Selection of Abutment teeth : 

Selection of Abutment teeth Periodontal & Mobility Status (horizontal bone loss) Abutment location (canines / premolars), atleast one tooth per quadrant, no adjacent teeth. Endodontic & Prosthodontic status: anteriors easy for endo, in cases of calcification – endo can be avoided crowns can be modified – sealant / fluoride t/t use of copings, composite / alloy restorations retention attachment system

Preparing Abutment teeth : 

Preparing Abutment teeth Maximum reduction of coronal portion – for better Cr:Rt Need for gold coping / crown & sleeve coping retainer (shoulder/chamfer margin) Provision of Attachment mechanism on cast coping (intra/extra coronal, chairside / indirect, resilient / nonresilient designs)

Wear & Pulpal recession : 

Wear & Pulpal recession

Gold copings : 

Gold copings

Attachments – can improve support, stability & retention : 

Attachments – can improve support, stability & retention Dalbo Rotex Ceka – Revax attachment system (soldered)

Loss of Abutment teeth : 

Loss of Abutment teeth After 5-6 yrs, about 10% of abutment were lost Causes : periodontal disease, caries, endodontic complications Motivation for hygienic care – mechanical toothbrushes One tooth Overdentures were not tolerated Fluoride gel for daily application

Gingivitis around abutment : 

Gingivitis around abutment Movement of denture base Poor oral hygiene Excess space in prosthesis (dead space) Use of tissue conditioner Use of hard Acrylic resin

Summary : 

Summary Tooth supported CD Tooth supported Immediate-insertion CD Desire to prolong useful life of few teeth Acts as an effective alternative to CD Implant – supported Overdentures are being highlighted nowadays

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