A complete Atlas to Overdenture in Dentistry

A general guideline about Overdenture, application, and other aspects in Prosthetic Dentistry.

1. Presented By : Hein Htet Naing June 26th | 2024 Overdenture

2. introduction to overdenture what is overdenture literature view indication, benefit and drawback treatment plan for overdenture conclusion June 26th| 2024 CONTENTS 1

3. INTRODUCTION 2 “Our objective should be the perpetual preservation of what remains rather than the meticulous restoration of what is missing” 26th June / 2024

4. 3 Teeth and surrounding tissues might be lost due to many reasons. Among them, majority were due to extraction. If the patient become edentulous, there will be more difficult to fulfil the requirements for the preservation of remaining oral tissues. So, if possible, retained roots can be used as implant structure that nature can provide and, may be more compatible with the body than metallic structure .

5. June 26th | 2024 4 Overdenture can be defined as denture supported by soft tissues and a few remaining natural teeth that have been altered to fit over them. (Zamikoff,1973) What is overdenture

6. LITERATURE REVIEW 1 2 3 overdentures are the dentures that rest on both mucosa and retained roots. (Bernard levin 1972) Preserving the roots of teeth provides additional advantage of preserving periodontal ligament. (H.H. Thayer 1980). The periodontal ligament provides valuable proprioceptors that aid in sensitivity and masticatory efficacy. June 26th | 2024 5

7. LITERARY REVIEW 4 5 6 Manly et al (1952), observed that complete denture wearers were considerably less sensitive to sensory impulses than overdenture wearers. Many studies have already been reported that successful outcomes of the treatment with overdenture. However, it is very important to have proper selection of cases and proper selection of Abutments . June 26th| 2024 5

8. a patient who does not want to lose the remaining teeth but cannot be adequately treated with fixed or removable partial dentures. a patient with a few remaining teeth whose mucosa, supporting bone or general health suggests a poor prognosis for complete denture. June 26th | 2024 INDICATIONS 6

9. June 26th | 2024 people with bruxism habit are poor candidates for dentures and the support provided by a few roots can reduce their discomfort patient with maxillo-facial defect, e.g. cleft patient, have the deficiency of tissues and so, preserving a few abutment roots may increase retention and stability of overdenture. 7

10. June 26th | 2024 8 When the crown height is already diminished due to attrition, erosion or abrasion, and when they are not suitable for restorative treatment.

11. Preservation of the alveolar bone which resorbs after the loss of teeth Better support because of the presence of periodontal membrane on the remaining abutments. Improved retention June 26th| 2024 BENEFITS 9

12. BENEFITS 10 Maintenance of tactile discrimination which is otherwise diminished with the loss of teeth img ref; from iinternet

13. increased masticatory efficiency than complete denture Psychology, patient does not feel edentulous June 26th | 2024 BENEFITS 11

14. Maintenance of good oral hygiene is too difficult for some patients ( caries, periodontal disease, denture debris may lead to failure) Increased cost and length of treatment undercuts around abutment may lead to problems in insertion. difficulty in placing artificial teeth due to lack of denture space, can lead to structural weakness of overdenture. DRAWBACKS 12

15. June 26th | 2024 13 source from internet

16. evaluation of clinical and non clinical factors provisional treatment plan preliminary treatment definitive treatment plan definitive overdenture follow up June 26th | 2024 TREATMENT PLAN 14

17. condition of the remaining teeth retainable or not check - mobility, perio pocket, apical lesion retained tooth can withstand or not to the occlusal load oral hygiene June 26th | 2024 Evaluation of clinical factor 15

18. Patient attitude Socio-economic status June 26th| 2024 Evaluation of non clinical factor 16

19. the plan emerged from determination of usefullnes and/or necessity of retaining tooth that can be saved; treatment option workout and discussed with the patient the necessary preliminary treatments are initiated June 26th | 2024 Provisional treatment plan 18

20. treatment of carious lesions treatment of periodontal disease endodontic treatment surgical treatment prosthetic treatment June 26th | 2024 Preliminary treatment 19

21. June 26th | 2024 Definitive treatment plan 20 Evaluate success of provisional treatment definitive overdenture design consideration of abutment overdenture construction

22. Simple tooth modification and reduction Tooth reduction and cast copying Endodontic therapy with amalgam plug Endodontic therapy and cast copying June 26th| 2024 Overdenture construction techniques 21

23. 24

24. Any tooth or root may serve as an abutment for overdenture but canines and molars are best. In many cases, it is not possible to choose the ideal because of previous tooth loss. In selecting abutment, the need to remove the crown must be considered in relation to the possibility of endodontic treatment. June 26th | 2024 Consideration of abutment 25

25. The teeth in the opposing jaw should be considered when selecting abutment. If natural teeth is present in one jaw , then overdenture in the other jaw will help to preserve against alveolar bone loss. June 26th| 2024 26

26. June 26th | 2024 27 problem can arise if abutments are opposite to one another because, when over dentures are out of the mouth, the patient may brux on the prepared teeth and can damage them.

27. in most cases, the simpler the preparation, the better it is. the aim should be to avoid endodontic treatment and reduce the crown to a rounded supragingival dome. this takes up minimal space and can be easily clean. If the tooth need to undergo endodontic treatment, the root face need to be obturated with amalgam or glass-ionomer cement. June 26th | 2024 Abutment preparation 28 Dentine

28. June 26th| 2024 Abutment preparation 29 there are various design of abutment piece crown may be reduced in the form of a jacket preparation and yellow gold thimble cemented. Alloy

29. June 26th | 2024 29 a better preparation is the gold alloy dome attached by a cast or wrought post in the root-filled tooth

30. the increased age of population with teeth being retained longer improved techniques of tooth conservation and endodontic procedure better hygiene measures changing attitude to preservation of natural teeth improved standard of dental materials and technology June 26th | 2024 Why overdenture become popular in Nowsaday 30

31. regular recall of patient treated with overdenture is one of the most important factors in the maintenance of the integrity of the abutments,since the roots supporting the overdenture stand at risk to periodontal and endodontic problem. Patient shouid be instructed to strictly follow vigorous cleansing of the roots and related surface of the overlying denture. June 26th| 2024 as a Conclusion 31

32. one of the problems with overdenture is the maintenance of the oral health after delivery it should be noted that these patients have already lost the majority of their teeth due to poor oral hygiene Therefore, it can be expected gingivitis, caries,plaque or calculus deposits which might lead to failure of the treatment June 26th | 2024 32

33. but, these risk factors will remain low if the overdenture abutments are correctly shaped and polished patient also should be well motivated with respect to plaque control when overdenture is fitted careful instructions for plaque control of the abutments must be accompanied with proper denture hygiene June 26th | 2024 33

34. in general, overdenture should not be worn for not more than 8hr per day, intervally during eating, speaking and social hours of all the benefits derived from overdenture, patient’ psychological acceptance for not feeling edentulous could be most appreciated so, overdenture is the outstanding treatment approach and is of prime importance to “preventive prosthodontics” June 26th| 2024 34

35. references June 26th| 2024 35 Clinical dental prosthetics by Fenn, Liddelow and Gimson 2023 Final BDS lecture notes M.D.Sc . research work on overdenture

36. THANK YOU Presented By : Hein Htet Naing June 26th | 2024