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What Is an Overdenture. A complete denture that is supported and often retained by the underlying teeth or implants and tissue. Abutment teeth or implants may or may not be connected to the denture via attachments. Bars. Copings . Studs. Magnets. Implants. Load bearing.

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Presentation Transcript
slide1

What Is an Overdenture

A complete denture

that is supported and often

retained by the underlying

teeth or implants and tissue

slide2

Abutment teeth or implants

may or may not

be connected to the denture

via attachments

slide3

Bars

Copings

Studs

Magnets

Implants

Load bearing

Overdenture Attachments

Posts

Teeth

Non-Load-bearing

Extraradicular

Intraradicular

Combinations

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overdenture attachments
Bar joints

Bar units

Round

Ovoid

Square

Rectangular

Radicular:

Extraradicular

Studs, magnets, ERA

Intraradicular

Zaag, Zest, Sterns root anchor

Overdenture Attachments

Bars:

objectives of the program
Objectives of the Program
  • Understand how overdentures preserve hard and soft tissue
  • Maintain proprioception
  • Understand the function of overdenture attachments and simplify attachment selection
  • Increasing crown/root ratios to preserve abutments
  • Hygiene maintenance
slide6

Carlson and Persson, Odontologist Revy, Sweeden 1967

Anterior mandible

“average bone loss first year after extractions was 4mm”

Tallgren, JPD,1972

“Bone loss continues for at least 25 years”

dentures vs overdentures chewing efficiency
Natural dentition

Complete dentures

Overdentures

90%

59%

79%

Dentures vs OverdenturesChewing Efficiency

Rissin and House, JPD, 1978

indications for overdentures
Indications for Overdentures
  • Periodontal disease
  • Few remaining teeth
  • Insufficient crown/root ratios
  • Vertical space
  • Favorable path of insertion
  • Retention
advantages of overdentures
Advantages of Overdentures
  • Maintenance of bone height around teeth by preserving roots
  • Attenuates resorption patterns of alveolar ridges
  • Gentler to the tissues
  • Increases crown/root ratios
  • Psychological security
  • Enhanced speaking ability
  • Maintains Proprioception
disadvantages of overdentures
Disadvantages of Overdentures
  • Esthetic Considerations – Bulkiness
  • Root canal therapy
  • Increase space requirements:

-interarch

-interocclusal

  • Increase costs
attachment retained overdentures
Attachment RetainedOverdentures

All the advantages of Overdentures

PLUS

  • Superior aesthetics
  • Increases proprioception
  • Stability and comfort
  • Rigidity or resiliency
  • Mechanical retention
  • Support
  • Increased psychological security and patient acceptance
overdentures attachment considerations
OverdenturesAttachment Considerations

Load Bearing

Solid / Rigid

  • Transfers stress towards the retained roots or implants and away from the ridge
  • No vertical resiliency, some hinge or rotational resiliency
  • Shares the load of occlusion with the mucosal surface

Magnets, Flexi ball, Dalbo Rotex, Bars

overdentures attachment considerations1
OverdenturesAttachment Considerations

Non- Load Bearing

Resilient

  • Transfers stress away from the retained roots or implants and towards the tissue
  • Vertical resiliency
  • Selected frequently

Dalla Bona, Rotherman, Ceka, Uni Anchor, OSO, ORS, ERA, Bars

overdenture evaluation
Partial Denture Present

Tooth position

Occlusion

Mount casts to vertical dimension

No Partial Denture

Mount cast to vertical dimension

Diagnostic denture wax up – reestablish occlusion

Silicone matrix for space evaluation

Overdenture Evaluation
direct placement
Direct Placement
  • Male or female premanufactured attachment is cemented into root
  • Denture is made and inserted
  • Corresponding male or female attachment is inserted in root
  • Attachment is picked up directly in the overdenture with cold cure acrylic

Placed by Dentist

indirect placement
Indirect Placement
  • Male or female attachment is cemented into root or may need to be cast onto coping
  • Corresponding male or female transfer analog is inserted into root attachment
  • Transfer impression is taken and models are poured with transfer in place
  • Laboratory processes denture with corresponding attachment in place

Placed by Laboratory

proceedures to follow
Proceedures To Follow
  • 5 mm or more root remaining in bone
  • Stable perio
  • Mount study models – evaluate space required
  • Select OD attachment – obtain reference manuals
  • Begin denture proceedings
  • Root canal therapy
  • Decoronate roots, extractions, insert temporary denture – reline – allow time for healing
  • Prep tooth for attachment and cement attachment
  • Insert denture, make adjustments, post placement reline
  • Pick up male attachment in denture