Complete dentures

There has been a decline in both the prevalence and incidence of tooth loss within the last decades;[1][2] people retain their natural dentition for longer.

[3] Although the rate of resorption varies, certain factors such as the magnitude of loading applied on the ridge, the technique of extraction and healing potential of the patient seem to affect this.

[6] Facial muscles on the cheeks and lips also lose their support as teeth are lost, contributing to an 'aged' appearance of the individual.

[citation needed] Complete dentures are prone to a variety of displacing forces of differing magnitude as they are resting on oral mucosa and are in close proximity with tissues that are constantly changing due to the action of muscles.

Patients can, however, learn to control and coordinate their muscles so that the forces exerted are minimised or counter-acted to prevent such displacement.

[9] Such psychological effects, together with the challenges that accompany successful prosthetic wear, can make acceptance of treatment difficult.

It is, therefore, reasonable to consider different ways of transitioning into the edentate state in patients who have not yet lost all of their teeth but in which complete dentures will be required in the foreseeable future.

Alternatively, if the former is not possible, consideration should be given to whether roots of teeth can be retained in strategic locations in the maxilla or mandible to help with the stability of the prostheses.

It is important that the patient can maintain good plaque control during this period, as progression of periodontal disease will lead to further destruction of bone that will later become the foundation for denture support.

The process involves decoronation (removing the crown of the tooth) and elective root canal treatment of the overdenture abutments.

For matters of simplicity for endodontic treatment provision, single-rooted anterior teeth are preferred, with the exception of lower incisors as they lack sufficient root surface area.

[6] Despite complications, the success rate of dental implants is well established, with reports exceeding 98% in 20 years for mandibular anterior teeth.

[13] When clearance of the dentition is the only viable treatment option, immediate dentures can be constructed prior to the extractions and fitted once the teeth have been removed, at the same appointment.

Whether or not they are deemed satisfactory by the wearer or clinician, existing dentures can provide invaluable information for the construction of a new set.

Although stock trays (metallic or plastic) come in different sizes, it is very likely that some parts will be over- or under-extended and therefore have to be modified prior to impression-taking[6] to ensure that the entirety of the mucosa is recorded accurately.

The following steps can be carried out during impression-taking: There are two ways in which the soft tissues can be recorded during impression taking:[6] The ultimate goal of complete dentures is to maintain oral health and function.

To achieve these goals, it is important to obtain an accurate impression in order to design and create a denture that has adequate retention and stability.

[6][16] In an edentate patient, the OVD cannot be measured unless it was recorded prior to clearance of the dentition or pre-existing dentures provide a satisfactory value.