successful dentures part 2
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Dalhousie Continuing Education
Dr. Mark Vallee BSc MS DDS DP FRCDC
Secrets to Successful DenturesPart II
Topics! Conventional Denture Treatment:
! Trends in removable prosthodontics.!Anatomy
! Maxillo-Mandibular Relationship
! Vertical Dimension
! Tooth Selection, Arrangement, and Occlusion
! Implant Supported Overdentures:
! Overdenture abutments
! Implant Placement
! Locator Abutments
! Converting a denture into an overdenture.
! Direct Pickup
Conventional Denture Treatment
Trends in RemovableProsthodontics
! Patient Demographics
! Esthetic Awareness
! Implant treatment
Patient Demographics
!Average lifespan of patients:
10
11
12
13
14
1960 1970 1980 1990
Perc
ent
30
40
50
60
1960 1970 1980 1990
Percent Edentulous
18+ yrs old
Percent Edentulous
65+ yrs old
Trends in tooth lossTrends in tooth loss
Patient Demographics
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Patient Demographics
!! Will there be a need for complete dentures inWill there be a need for complete dentures in
2020?2020?
!! Complete dentures patients will increase fromComplete dentures patients will increase from
33.6 million adults in 1991 to 37.9 million adults in33.6 million adults in 1991 to 37.9 million adults in
2020.2020.
!! The 10% decline in edentulism experienced eachThe 10% decline in edentulism experienced each
decade for the past 30 years will be more thandecade for the past 30 years will be more than
offset by the 71% increase in the adult populationoffset by the 71% increase in the adult population
older than 55 years.older than 55 years.
Esthetic Awareness
Esthetic Awareness
!An increase in esthetic awareness has promptedan increase in patient demand for qualityremovable prosthodontic restorative treatment.
Implant Treatment
! Out of 33 million edentulous patients only 2-4% have received
implant treatment
! Estimated 60% of patients are NOT given implants as a
treatment option
! Implant supported overdentures are now the standard of care for
the edentulous mandible
Anatomy
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a. Labial frenum
b. Buccal frenumc. Labial vestibuled. Anterior buccal vestibulee. Posterior buccal vestibule
Retrozygomatic spaceCoronoid bulge
f. Hamular notchPterygomaxillary notch
g. Fovea palatinih. Vibrating line
i. Residual alveolar ridgej. Palatal rugae
k. Incisive papillal. Median palatine raphe
m. Maxillary tuberosity
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a. Labial frenumFold of mucous membraneDoes not contain muscleLabial notch in denture isnarrow
b. Buccal frenumOverlies levator anguli oris
May be moved in an A-Pdirection by the actions of the
orbicularis oris and buccinator
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c. Labial vestibuleReflection contains no muscle
d. Anterior buccal vestibuleOverlies buccinator musclewhose fibers are downward andforward and limit the height and
thickness of the buccal flangee. Posterior buccal vestibule
Thickness determined by themasseter muscle
Coronoid process of themandible encroaches on thespace during lateral excursions
Labial and buccal flanges of thedenture must contact movable tissues
in order to make a seal
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f. Hamular notchPterygomaxillary notchDoes not contain anymuscles or ligaments tointerfere with the addition
of pressure with apostdam
g. Fovea palatini2 small pits representing
mucous gland openingsUsually located just
posterior to the vibratingline
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Posterior Palatal SealArea not a lineFunctions: border seal, prevent food
impaction beneath, improve retention,compensate for shrinkage of denture
resinPressure on displaceable mucosa thatcovers palatal glandsAnterior border junction betweenhard and soft palate; blow linePosterior border (vibrating line)
junction between movable andimmovable soft palate; ah line
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h. Vibrating lineImaginary line across palate
Connects thepterygomaxillary notches
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Denture bearing areas
i. Residual alveolar ridge
Crest is primary stressbearing area
Fibrous CT leastdisplaceable and bestable to carry the stress ofmastication
j. Palatal rugaeSecondary stressbearing area
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k. Incisive papillaGuards the incisivecanalPressure will interfere
with the blood and nerve
supply causing a burningsensationProvide relief
l. Median palatine raphe
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a. Labial frenumb. Buccal frenumc. Lingual frenumd. Labial vestibulee. Buccal vestibulef. Residual alveolar ridgeg. Buccal shelfh. Retromolar padi. Pterygomandibular raphe
j. Mylohyoid ridgek. Alveololingual sulcus
l. Retromylohyoid space
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a. Labial frenum
Fold of mucousmembraneDoes not contain muscle
b. Buccal frenumOverlies depressor
anguli oris (VII)Movable by the
buccinator and orbicularisoris (VII) resulting in a
wide notch in the denturec. Lingual frenum
Overlies genioglossusmuscle (XII)
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d. Labial vestibule
e. Buccal vestibule
Entire periphery of denturemust end in soft tissuesStability of denture mustcome from the maximum useof all bony foundations wheretissues are firmly and closelyattached to bone
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Denture bearing areas
f. Residual alveolar ridgeg. Buccal shelf
Bounded laterally by the
external oblique ridge andmedially by the crest of the
ridgeAttachment of buccinator
muscle (VII)Buccal flange rests uponbuccinator and should extendas far as the tissues permitMasseter muscle (V3) maycrowd buccinator forwardagainst the denture causing an
indentation at the DB angle
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h. Retromolar pad
Contains:Retromolar glandPterygomandibularrapheBuccinator muscleTemporal tendon
Underlying basal bone isresistant to resorptionCoverage will provide someborder seal
i. Pterygomandibular rapheExtends from the pterygoid
hamulus superiorly to thealveolar ridge inferiorly under
the retromolar gland
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j. Mylohyoid ridgeAttachment of mylohyoidmuscle (V3) which forms themuscular floor of the mouthFibers are almost horizontal infront of the hyoid where they jointhose of the opposite side to
form a rapheAt the level of the hyoid they
pass almost vertically downwardto insert into the hyoid
k. Alveololingual sulcusSlopes toward the tongue to
permit action of the mylohyoidLength of flange distallycompared to anteriorly is greaterowing to the changed length anddirection of the mylohyoid fibers
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l. Retromylohyoid spaceDL extension determined
by styloglossus (XII)Posterolateral extension
determined by superiorpharyngeal constrictor (X)and palatoglossus (X)Overextension maycause pain on swallowing
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Maxillary Tuberosity
Coronoid Process of mandibleMandibular Condyle
Articular Eminence
Glenoid Fossa
Shadow of tongueStyloid Process
Mandibular Canal
External Oblique Ridge
Pterygomaxillary FissureNasal Septum
Hard Palate
Mental ForamenEarlobeLip Lines
Hyoid Bone
Facial Artery Notch
Cervical Vertebrae
OrbitAnterior Nasal Spine
Mandibular Foramen
Symphysis
EAMZygomatic Arch
Pharynx
Maxillo-Mandibular Relationship
Maxillary Relations! Incisal Display! Dental Midline
! Occlusal Plane Orientation! Facebow
Maxillary Relations
! Incisal edge of centralincisor in relation to
the lip line at rest
! Young woman 3 mm
below lip line at rest
! Young man 2 mm
below lip line at rest
! Middle age 1.5 mm
below lip line at rest
! Elderly (>80) 0 mm
below to 2 mm above
lip line at rest
Rest After Wax Adjustment
Maximum Smile After WaxAdjustment
Incisal Display at Rest
Natural Dentition
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Maxillary Relations
Rest After
Smile After
Dental Midline
Maxillary RelationsDental Midline
Maxillary RelationsDental Midline
Maxillary Relations
! Frontal Plane
! Parallel to
interpupillary line! Fox Plane
Occlusal Plane Orientation
Maxillary RelationsOcclusal Plane Orientation
Maxillary Relations
! Sagittal Plane! Parallel to Campers Line
! Inferior border of the ala ofthe nose to the superiorborder of the tragus of theear
! Frankfort horizontal plane! Orientation to the external
auditory meatus andorbitale
! Cephalometric landmark
Occlusal Plane Orientation
FHP
CLOP
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Mandibular Relations
!
Vertical Dimension! Centric Relation
Vertical Dimension
! Adjust occlusal plane! Parallel to maxillary rim
!
Clinical assessment of verticaldimension! Anatomic landmarks
! Physiologic rest position
! Pre-extraction records
! Existing prosthesis
! Esthetics
! Phonetics
! Swallowing
! Average occlusal rimdimensions
Vertical Dimension
! Anatomic Landmarks
! 2/3 up the height of the retromolar pad
Vertical Dimension! Anatomic Landmarks
! Level with the lower lipat rest
Vertical Dimension! Esthetics
Vertical Dimension! Phonetics
S F
Ch M
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Vertical Dimension! Swallowing
During swallowing After swallowing
Vertical Dimension!Average Occlusal Rim Dimensions
Maxillary 22 mm Mandibular 18 mm
Tooth Selection
Anterior Tooth Selection
Anterior Tooth Selection
!Anterior teeth areprimarily selected to
satisfy estheticrequirements
! Posterior teeth areprimarily selected to
satisfy masticatoryrequirements/
occlusion
Anterior Tooth Selection
Guides! Pre-extraction records
! Photos, diagnostic
casts, old radiographs
! Existing dentures
! Patients facialcharacteristics
! Patients gender,personality, age
!Arch size and shape
! Patients preferences
Anterior Tooth Selection
! Shape
! Square, tapering,
ovoid
! Size
! Length, width,
circumference
! Shade
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Anterior Tooth Selection
Dentogenics concept
! Gender
! Male rugged with square teethand bold central incisors
! Female pronouncedcurvatures, rounded point angles
! Personality
! Vigorous or delicate maxillarylateral varies more in size, form,
and position
! Age! Young tapered, ovoid, rounded
teeth
! Middle somewhere betweenyoung/old
! Old square, sharp corners
Shape Anterior Tooth Selection
! Ovoid! Pronounced gingivo-incisal
curvature which tends to
disperse light and create asoftened appearance
! Tapering! Rounded contours which
taper towards the cervical
ridge
! Moderate gingivo-incisal
curvature
! Square
! Central incisor is dominant and gingivo-incisal curvature is
moderate
! Offers maximum light deflection and creates a bold effect
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Shape
Anterior Tooth Selection
! Width of 6 anteriorson a curve
!Average 46-56 mm
Size Anterior Tooth Selection
Wax rim & ruler
Commissure of lips represents distal surface of canine
Size
Anterior Tooth Selection
Major rugae of palate points to canine position
Size Anterior Tooth Selection
Exaggerated Smile Length
! High smile 11%
! Reveals total length of
maxillary anterior teeth and acontinuous band of gingiva
! Average smile 69%! Reveals 75-100% of
maxillary anterior teeth and
interproximal gingiva only
! Low smile 20%
! Displays less than 75% ofmaxillary anterior teeth
Size
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Anterior Tooth Selection Size & Shape
Commercial Products
Anterior Tooth Selection
! Determine the facialoutline
! Compare form of faceto vertical lines
! Square tapering
! Determine the size of
the maxillary central! Indicator is
proportioned in a ratioof 16:1
! Width 9.25 mm
! Length 11 mm
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Size & Shape
Width
Length
Anterior Tooth Selection
Take a picture Insert it into a program
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Size & Shape Anterior Tooth Selection
! Portrait shade guide
Shade
Anterior Tooth Selection! Aim to harmonize
between color of the
skin, hair, & eyes
! Guides
! Complexion
!
Hair color! Eye color
! Age
! Personality & activity
! Patient desires
! Need to educate patients
Shade Anterior Tooth Arrangement
! Position has been tentatively established during the
clinical refinement of the maxillary occlusal rim
! Adequate lip support
! Proper phonetics
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Anterior Tooth Arrangement
! Anterior teeth are set primarilyfor esthetics not function
! Considering creatingasymmetry after discussionwith patient
! Each tooth should appear asan individual tooth
! Gingival 1/3 of maxillaryincisors provide lip support
! Incisal 1/3 of maxillary incisorsprovides esthetics
! Maxillary anterior teeth are seton the smile line
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General Arrangement
Considerations
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Maxillary Anterior ToothArrangement
! Central
! Labial surfaces flush with wax rimcontour
! Long axis slightly distal to
perpendicular
! Incisal edge is at occlusal plane
! Lateral
! Long axis at an angle more distalthan central
! Incisal edge is slightly aboveocclusal plane
! Canine
! Long axis at a more distal anglethan lateral
! Cervical is prominent, incisaledge looks tucked-in
! Incisal edge is at occlusal plane
Maxillary Anterior ToothArrangement
Maxillary Anterior ToothArrangement
Labial surface of the centrals usually 5-7mm anterior to incisal papilla
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Maxillary Anterior ToothArrangement
! Ratio of 1.618:1
! Proportion between a
larger part and a smaller
part! Width of the central
incisor is in the golden
proportion to the width of
the lateral incisor
Golden Proportion
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Maxillary Anterior Tooth
ArrangementEsthetics of naturalteeth Avoid lampshade
convergence of roots!
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Mandibular Anterior ToothArrangement
Mandibular Anterior ToothArrangement
Teeth are set over bone
Anterior Tooth Arrangement Anterior Tooth Arrangement
0 mm Overbite
2-3 mm Overjet
Tooth Selection
Posterior Tooth Selection
Goals of Complete DentureOcclusion! Minimize trauma to the
supporting structures
! Preserve remaining
structures
! Enhance stability of the
dentures
! Facilitate esthetics andspeech
! Restore masticationefficiency to a reasonablelevel
! Decrease lateral forces tothe residual ridges
Right Working
Left Working
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General Concepts of Denture
Occlusion
Common Features! Functional anatomy is the main
determinant of denture tooth
position
! Simultaneous, bilateral posteriorcontact in centric relation
! Centralization of centric occlusalforces over the mandibularresidual ridges
! Buccal-lingually
! Anterior-posteriorly
Centric Relation
Occlusal Spectrum
! Anatomic! Balanced occlusion
! Lingualized
! Balanced occlusion
! Non-balanced occlusion
! Non-anatomic (Monoplane)
! Balanced occlusion
! Non-balanced occlusion
! Neutrocentric
Occlusal Spectrum
anatomic
semi-
anatomic
Lingualized
(lingual contact)
non-
anatomic(balancing
ramp)
non-
anatomic
Posterior Tooth Selection
Criteria
! Resorbed or flabby ridges
! Physical condition of the patient
! Patients who clench or brux
! Previous denture occlusion
! Ridge relationship
! Immediate dentures
! Opposing arch
Posterior Tooth SelectionIndications
Anatomic
! Good residual ridges
! Well coordinated patient
! Previously successful withanatomic dentures
! Class I ridge relationship
! Denture opposes naturaldentition
! When Lingualizedocclusion is desired
Non-anatomic
! Poor residual ridges
! Poor neuromuscular control
(Bruxers, CP, etc.)
! Previously successful with
monoplane dentures or
severely worn occlusion onprevious denture
! Arch discrepancies
! Class II or III or cross-bite
! Immediate dentures
! Except when opposing naturaldentition
! Potential poor follow-up
Posterior Tooth SelectionIndications
Anatomic
! Good residual ridges
Non-anatomic
! Poor residual ridges
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Posterior Tooth SelectionIndications
Anatomic
! Well coordinated patient
Non-anatomic
! Poor neuromuscular control(Bruxers, CP, etc.)
Posterior Tooth SelectionIndications
Anatomic
! Previously successful withanatomic dentures
Non-anatomic
! Previously successful with
monoplane dentures or
severely worn occlusion onprevious denture
Posterior Tooth SelectionIndications
Anatomic
! Class I ridge relationship
Non-anatomic
! Arch discrepancies
Class II or III or cross-bite
Posterior Tooth SelectionIndications
Anatomic
! Denture opposes naturaldentition
Non-anatomic
! Immediate dentures
Except when opposing naturaldentition
Anatomic Occlusion
Advantages
! Definite point of positiveintercuspation may be
developed
! Esthetically similar to natural
dentition
! Tooth-to-tooth and cusp-to-cusp balanced occlusion canbe achieved
! Maintains some shearingability after moderate wear
Disadvantages
! Difficult to set
! Less adaptable to archrelation discrepancies
! Horizontal force
development due to cuspinclinations
! Harmonious balancedocclusion is lost with denturebase settling
! Requires frequent follow-upand may require morefrequent relines to maintainproper occlusion
Lingualized Occlusion
Indications
! High esthetic demands
! Severe mandibular ridge
atrophy
! Displaceable supporting
tissues
! Malocclusion
! Previous successful denture
with lingualized occlusion
Advantages
! Good esthetics
! Freedom of non-anatomicteeth
! Potential for bilateral balance
! Centralizes vertical forces! Minimizes tipping forces
! Facilitates bolus penetration(mortar and pestle effect)
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Non-Anatomic Occlusion
Advantages
! Reduction of horizontal
forces
! CR can be developed as anarea instead of a point
! Freedom of movement
! Can develop solid occlusiondespite arch alignmentdiscrepancies
! Easily adapted to situationsprone to denture baseshifting
! Easy to set and adjust teeth
Disadvantages
! No vertical component to aid
in shearing during
mastication
! Occlusal adjustment impairs
efficiency unless spillways
and cutting edges restored
! Patients may complain of
lack of positive
intercuspation position
! Somewhat esthetically
limited (dont look like natural
teeth)
Is Balance Necessary?
Bolus inBolus in
Balance outBalance out
Complete Denture Occlusion
! Investigators have not shown one
type of denture occlusion to be:
! Superior in function
! Safer to oral structures
! More acceptable to patients
! Neuromuscular control may be
the single most significant factorin the successful manipulation ofcomplete dentures under function
! Tongue function and denturewearing experience
Posterior LandmarksLandmarks for the Arrangement of Posterior Denture
Teeth
! Crest of the ridge! Mandibular posterior teeth
are centered over the ridge
! Medial/lateral
! Retromolar pad! Medial/lateral
! Superior/inferior
! 2/3 height retromolar pad
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Posterior Landmarks
Three landmarks used to determine the plane of occlusion
! Retromolar pad! 2/3 height retromolar pad
! Incisal edge of the
mandibular central incisor
Mandibular Posterior ToothArrangement
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Mandibular Posterior ToothArrangement
! Horizontal Plane
! Pounds triangle
! Lingual aspect of mandibular teeth should be positioned withina triangle created by drawing 2 lines from the mesial aspect
of the canine to each side of the retromolar pad
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Mandibular Posterior ToothArrangement
! Horizontal Plane
! Central grooveof denture teeth centered over the crest of the
ridge
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Mandibular Posterior ToothArrangement
! Sagittal Plane
! Boucher
! Occlusal plane of mandibular arch should be established at !height of the retromolar pad
! Teeth are not set on the ascending area of the mandibular ridgeor the retromolar pad
! Otherwise the mandibular denture tends to shift forward
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Mandibular Posterior ToothArrangement
! Sagittal Plane
! Long axes of the teeth are perpendicular to the occlusal plane
! Marginal ridges of adjacent teeth should be at the same level
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Mandibular Posterior ToothArrangement
! Frontal Plane
! Facial view
! Buccal and lingual cusps should contact the occlusal plane
analyzer
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Mandibular Posterior ToothArrangement
! Frontal Plane
! Lingual view
! Buccal and lingual cusps should contact the occlusal planeanalyzer
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Maxillary Posterior ToothArrangement
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Maxillary Posterior ToothArrangement
98
! Lingual cusps should be
set over central fossa of
mandibular teeth
! Teeth should be set up
to, but not on top of, the
tuberosity
! Teeth should not extend
beyond the denture base
periphery on the facial
Implant Supported Overdentures
Conventional Dentures! Tooth loss increases with age
! the number of edentulous people will continue to increase for
several decades because of the increase in mean age.
! Complete dentures have been the traditional standard ofcare for edentulous patients for more than a century.
! Complete denture wearers are usually able to wear anupper denture without problems, but many struggle with
the complete lower denture because they are loose.
! Conventional dentures have a bite force of 25% and 20%chewing efficiency of natural teeth.
66.7 %25.6 %
7.7 %
Fully SatisfiedModeratelySatisfied
Dissatisfied
Patient satisfaction also depends uponPatient satisfaction also depends upon
expectations and some patients may have veryexpectations and some patients may have very
unrealistic expectations. For this reason it isunrealistic expectations. For this reason it is
important to guide and educate the patient.important to guide and educate the patient.
Patient Demographics Implant Supported Overdentures! Patients are significantly more satisfied with 2-implant
overdentures than with new conventional dentures
regardless of the type of attachment system used
! bar, ball, magnet, locator.
! Implant overdentures increase the bite force to 60%
of natural teeth.! Patients find implant overdentures significantly more
stable,
! their ability to chew various foods are significantly
easier,
! they are more comfortable
! and speak more easily.
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Implant Supported Overdentures! Studies of several populations have shown that ratings of
quality of life are significantly higher for patients whoreceive 2-implant mandibular overdentures opposingcomplete maxillary conventional dentures than for thosewith conventional dentures.
! People who receive mandibular 2-implant overdenturesmodify their diets which improves their nutritional state.
! Such improvements may have a strong positive impact ongeneral health, particularly for senior adults who arevulnerable to malnutrition.
! 2-implant overdenture are becoming the first choice oftreatment for the edentulous mandible.
Overdenture Attachments
! Ball attachments
! Ball and rubber o-rings and/or metal housings
! Used to be the attachment of choice
! Wear quickly, not as retentive
Overdenture Attachments
! Bar Attachments
! 1-3 bars with 1-3 clips
! Retentive at first, get loose or break over time.
! Hard to adjust and fix
! Not as popular anymore
Overdenture Attachments
! Locator
! Lowest vertical height of 3.17mm.
! Self aligning
! Durable
! Up to 40 angle correction
! Retention flexibility
Overdenture Attachments
! Can also have a bar with locators cast or tapped into the framework.
! Usually have 3 - 4 locators incorporated.
! Framework can be gold (cast) or titanium (milled).
! Framework must be passively attached to the implants.
! Returns the bite-force of the edentulous to approximately 80% of naturalteeth.
! Implant supported and retained.
Fixed Full-arch Restorations
! Returns the bite-force of the edentulous pt close to natural teeth
! Must have enough space for restoration, minimum of 10mm.
! Framework can be gold (cast), titanium or zirconia (milled).
! Prosthesis can be metal-ceramic, or metal-acrylic.
! Framework must be passive.
! Patient must be able to clean underneath framework
! Implant supported and retained.
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External-hex and Internal-hex! External-hex Implants
! More common in the past
! Good for multiple unit restorations
! Rely more on the screw for retention of
single unit restorations.
! Internal-hex Implants
! More common now
! Good for single tooth restorations
! Can use for multiple unit restorations -cement retained or need specific
abutments.
! Rely more on the connection for
retention of single unit restorations.
Overdenture Attachments
! Md Implants usually placed in position of:
! 2 implants - 33, 43
! 4 implants - 32, 34, 42, 44
! Mx Implants usually placed in position of:
! 4 implants - 13, 23, 16, 26
! 6 implants - 13, 23, 15, 25, 17, 27
! Tissue supported, implant retained.
0#, 4)2$#"9+ ?1%& $;+&)4,)"+
! -+"$+1 %? $;+ 1)4:+ @0AB)
! C%% ?#1 #.#1$D
!
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Panoramic Radiograph Panoramic Radiograph
Panoramic Radiograph Panoramic Radiograph
Panoramic Radiograph Locator Abutments
! Diameter of Locatorretention top 3.85mm.
!Available in a variety
of cuff heights and for
most implant typesand sizes.
! 1.5 mm of the topshould be
supragingival to beable to retain theoverdenture.
! Recommended torque
mm
height mm
Height mm 1 2 3 4 5
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Locator Selection
! Select the correct Locator Abutment based on thelevel of tissue indicated when using the Abutment
Depth Gauge.
! Appropriate abutment height keeps the top 1.5
mm extended above the soft tissue.
Locator Abutment Delivery
! Seat the Locator Abutment using the LocatorAbutment Driver, part of the Core Tool.
! For final tightening, use the Torque Wrench Bittogether with a Torque Wrench, or insert a driver
into the Abutment Driver.
! The recommended seating torque is 20-25 Ncm.
Next steps
! Make a new denture start to finish
! Initial impression
! Final impression with your choice of implant
impression
! Wax Rim adjustment
! Wax try-in
! Delivery
! Convert an existing denture into an overdenture
! With a reline impression (indirect approach)
! Direct pickup of Locator housings with a chairside
reline.
Implant ImpressionsOpen Tray Impression
Coping
Closed Tray Impression
Coping
Locator Pickup
Impression Coping
I)6$01+ B+J+,
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Converting a denture into anoverdenture.
! Identify the positionsof the Locator
Abutments in thedenture base.
! Relieve the denturebase to obtain
adequate space forthe impressionmaterial and the
Locator AbutmentPick-up.
Converting a denture into anoverdenture.
! Make an impressionusing an elasticimpression material
! Make a reline if
needed.
Converting a denture into anoverdenture.
! Firmly place theLocator AbutmentReplica in theimpression copings,
which, if indicated, are
then repositioned inthe impression
Converting a denture into anoverdenture.
! Fabricate a workingmodel with the Locator
Abutment Replica andhigh-quality stone
material.
! Complete the reliningand convert theexisting denture into a
Locator attachmentretained overdenture
Converting a denture into anoverdenture.
! Replace the processing insert with the required
retentive insert.
! Remove the Locator Insert by using the InsertRemoval Tool portion of the Locator Core Tool.
! Press a new Locator Insert over the Insert Seating
Tool, and press the Locator Insert into the housing
Converting a denture into anoverdenture.
! Five types of LocatorInserts are available toobtain the requiredretention for the
prosthesis.
! The inserts come withdifferent retentiveholding force levels:
! Clear 5 Pounds
! Pink 3 Pounds
! Blue 1.5 Pounds
! Green 3-4 Pounds*
! Red 1.5 Pounds*
(*for angled implants)
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Direct Pickup
! Choose, insert, and tighten correct Locator
abutments
! Place processing ring and locator housingwith black processing insert on the abutments.
Direct Pickup
! Identify position and relieve denture base, create vent
for excess acrylic.
! Apply acrylic and seat denture, allow for adequate
curing.
! Trim and polish, remove processing ring, and replace
insert with appropriate retentive insert.
Locator Core Tool
Insert Removal Tool Insert Seating Tool Abutment Driver
Locator Core Tool UseGap
Loosen the Insert Removal Toola full 3 turns counter clockwise.You will see a visible gap.
To remove an insert from the titanium metal housing;simply insert the tip into the insert assembly and pushstraight in to the bottom of the nylon insert.Then tilt the tool so that the sharp edge of the tip willgrab hold of the insert and pull it out of the cap.
To discard the insert from the new tip on the Locator Core Tool;point the tool down and away from you and tighten theInsert Removal Tool clockwise back onto the Locator Core Tool.This will activate the removal pin and dislodge the insert from
the tip end of the Insert Removal Tool.
Separate the Insert Removal Tool section fromthe Locator Core Tool and use the Insert Seating Toolend of the remaining two sections to place anew insert into the empty titanium metal housing.
Gap
1. Loosen Insert Removal Tool 2. Remove the Insert
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3. Discard the Insert4. Remove the Insert Removal
Tool
5. Place a New Insert
Insert Seating Tool end
Questions?
top related