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Removable Prosthodontics

Complete dentures are a common type of the Removable Prosthodontics devices. A complete denture is a set of plastic or porcelain teeth placed on an acrylic/metal base which resembles the soft tissue of the maxillary or mandibular arch. They are made to sit on the alveolar mucosa and underlying bony structures. It is held in place by a mucostatic suction of the tissue to the denture base.

INDICATIONS

The basic indication for the necessity of a Removable Prosthodontics complete denture is the absence of all permanent teeth in a dental arch. The arch, either maxillary or mandibular, must be free from disease or pathosis. Also, adequate bone structure and soft tissue thickness are necessary. The patient’s total physical and mental health also play an important role in the consideration of a complete denture. The patient must possess both the physical and mental capabilities to adequately manipulate the complete denture.

CONTRAINDICATIONS

There are several contraindications to be considered in making the decision to utilize a complete Removable Prosthodontics denture. For example, if upon inspection, adequate bone height and soft tissue are not present, the use of a complete denture may not be recommended. Any problem will need to be addressed and possibly corrected prior to prosthetic construction.

If the patient is not physically or mentally capable of wearing a full prosthesis, he or she will not receive the benefits from it. Problems such as partial paralysis from a stroke may complicate the use of a denture.

PARTS OF COMPLETE DENTURE

A full denture consists of two basic parts, the acrylic base and the denture teeth.

Denture Base

The denture base is generally made of acrylic resin and it Sits on the soft tissues covering the alveolar bone. It is usually a shade of pink that complements the patient’s gingival tissues. This will help to create a natural looking replacement of the patient’s dentition.

Denture Teeth

Denture teeth are made to simulate the size, shape, colour, and contour of natural teeth. Thus they are available in a variety of different forms and colors. Choosing the correct design is vital to the creation of an esthetically and functionally correct restoration. There are two types of denture teeth: plastic and porcelain.

Plastic teeth are made from a hard, heat- processed acrylic resin material. There are more widely used in full dentures due to their very lifelike appearance. They are held in the denture base by a cohesive bond between the denture base and the tooth. Plastic teeth can be utilized in a variety of denture situations. They can be used adjacent to natural teeth, other plastic denture teeth, or even placed in occlusion against porcelain teeth.

Porcelain teeth, as the name suggests, are made from a dense porcelain material. Porcelain teeth are slightly more difficult to manipulate due to the nature of porcelain.

They are mechanically held in the denture base by a small metal pin on the gingival side of the tooth. Porcelain teeth are usually employed in a full set of dentures where maxillary porcelain teeth occlude with mandibular porcelain teeth or in a complete denture that opposes porcelain- fused-to-metal restorations on the other arch. These situations provide the least occlusal wear of the porcelain teeth.

PARTIAL DENTURE

A removable partial denture is a Removable Prosthodontics device used to replace one or more missing teeth as well as any soft tissue which has been lost through trauma, surgery, or the normal remodeling of bone that occurs following tooth loss. It is constructed of cast metal, pink aciylic resin, and artificial teeth.

The cast metal part is fabricated to fit around the remaining natural teeth, utilizing these teeth for retention and to support the artificial teeth on the denture base. The denture base is made of the pink acrylic resin and is made to fit the alveolar ridge in the edentulous area. As with the complete denture, the artificial teeth may be plastic or porcelain depending on the conditions that exist in the patient’s mouth.

INDICATIONS FOR PARTIAL DENTURE

There are certain criteria which must be met in order for a Removable Prosthodontics partial denture to work well for a patient. These are as follows:

1. The patient must be only partially edentulous in the arch to be restored, with key teeth remaining.

2. These remaining teeth must be free from disease and possess adequate bone support.

3. The gingiva and surrounding structures must be within normal limits of oral health.

CONTRAINDICATIONS FOR Removable Prosthodontics PARTIAL DENTURE

Contraindications for a Removable Prosthodontics partial denture would include basically any unresolved oral pathosis. If any oral disease is present, it must be addressed prior to the start of any reconstructive work. One of the most common problems is the presence of periodontal disease. The bone loss associated with such disease may weaken the remaining dentition to the point where they can not sustain the load of a partial denture.

PARTS OF A Removable Prosthodontics PARTIAL DENTURE

Metal Framework

The metal framework is the basic substructure of the Removable Prosthodontics partial denture. It is constructed directly from a master cast by a casting procedure in the dental laboratory. The master cast is made from an intraoral impression. The framework is designed by the prosthodontist to meet the needs of each individual case.

The Saddle

The saddle is the part of the partial denture that sits in the edentulous area. This is where the artificial teeth are placed. The saddle area consists of both cast metal and pink acrylic resin components. The cast framework is the foundation of the saddle and is covered with the pink acrylic resin base which houses the denture teeth.

Clasps

Clasps are a part of the cast framework. They are designed to extend from the framework and wrap around the teeth. The teeth that they fit around are termed “abutments.” Their main function is retention and stabilization of the denture. There are various designs and types of clasps, which is selected on evaluation of each individual case.

Rests

Rests are the supportive portions of the cast metal framework. They extend from the framework and transverse the lingual aspect of the tooth. The rests then sit on a specially prepared feature on the occlusal surface of the tooth. It provides resistance to the vertical forces of occlusion and mastication. Rests are placed on certain teeth for optimal support.

Denture Teeth

Denture teeth are the artificial teeth which are placed on the denture base of the Removable Prosthodontics partial denture. These teeth restore the patient’s occlusion and can provide an esthetic replacement of missing teeth. The teeth can be made up of either dense acrylic resin material or porcelain; and are available in different sizes, shapes, and colours.

HOME CARE OF COMPLETE OR PARTIAL DENTURE

Any patient who receives a complete or partial denture should be instructed on the proper care of the new prosthesis. The dentures are susceptible to stains and plaque buildup much like the natural dentition. They must be cleaned on a daily basis to ensure proper maintenance and good oral health. The denture should be cleaned using a denture cleaning toothbrush and a denture cleanser.

It is important for the denture wearer not to neglect oral hygiene. The patient should use a soft toothbrush and toothpaste to clean the underlying oral tissues. The tongue, alveolar ridge, and palate should be gently brushed. This will promote oral health by removing debris and bacteria which can cause disease and infection.

The patient should have a denture checkup with the dentist at least once a year. At this time, an inspection of the oral cavity and denture fit is completed. The denture is cleaned in an ultrasonic cleaner and polished. It’s then returned to the patient.

RELINING OF DENTURE

When a partial or complete Removable Prosthodontics denture is worn over an extended period of time, changes in the soft tissue may cause the denture to become illfithng, which can be treated with relining of the denture base. Relining of a denture involves a refilling of the space between the denture base and the underlying soft tissue.

About Dr. Muna

Dr. Muna Taqi is a Dental surgeon from India who has more than 10 years of experience in the field of Oral & Maxillofacial surgery, Endodontics, & Pedodontics. She has worked in multinational medical corporates in Middle East and is also a consultant dental surgeon for many. She has authored many articles for medical journals & websites and is a consultant dental expert for Healthdrip.

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