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IVAN JOJO OBED

OBEHI EROMOSELE

JULIANA UNICORNIBIJOKE SMITH

DAVID AMEYAW

Clinical year III, UGDS

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Introduction to Complete Dentures

Definition

Complete denture prosthodontics or full dentureprosthetics is defined as The replacement of the

natural teeth in the arch and their associated

parts by artificial substitutes. It can also be

defined as The art and science of therestoration of an edentulous mouth. Complete

denture is also defined as A dental prosthesis

which replaces the entire dentition and

associated structures of the maxilla and

mandible

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Generally complete dentures are fabricated for

geriatric patients. Some young patients who are

borne with congenitally malformed teeth oredentulous arches require complete dentures. It is

essential for the dentist to evaluate the patient

before treatment.

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Functions of a Complete Denture

A complete denture functions to restore

aesthetics, mastication and speech.

1. Aesthetically: the complete denture shouldrestore the lost facial contours, vertical

dimension. Artefacts like stains can be

incorporated in order to improve the aesthetics.

2. Functionally (Mastication): A completedenture should have proper balanced occlusion

in order to enhance the stability of the denture.

3. Phonetics: One of the most important

functions of a complete denture is to restore

the speech of the patient.

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HABITUATIONThis is the gradual diminution of responses to repeated/

continued stimuli.When new dentures are placed in the mouth they stimulate

mechanoreceptors in the oral mucosa.

Touch and pressure impulses from these receptors aretransmitted to the sensory cortex for the patient to feelthe dentures.

Dentures are foreign bodies in the mouth and when fitted for thefirst time most muscular actions tend to expel them.

With time the receptors adapt to the new environment andthe patient loses conscious awareness of the denture

If replacement dentures are constructed whose shape is dissimilar tothe existing one, a new set of stimuli will be evoked and the processof habituation starts all over again

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The successful manipulation of denturesdepends on purposeful muscular activitywhich in turn is related to adequatesensory feedback..

The patients ability to control denturesinvolves a learning process which initiallyis conscious

However as a result of repetitivestimulation new reflex arcs are set upand the conscious effort is replaced bysubconscious behaviour.

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Thus, gradually ,the denture wearer

learns to differentiate between the foodand the dentures and, at first consciouslybut later subconsciously , to control andto stabilize them with the tongue andcheek.

The tongue by resting on the lowerdenture and pressing it downwards and

forwards, can control its tendency to rise,and also counterbalance to a largedegree destabilizing masticatory forces.

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The tongue can also be unconsciously

trained to prevent the back edge ofthe upper denture dropping while thefront teeth are incising.

The muscular cheeks can be trained,again unconsciously to pressdownwards on the buccal flanges of

the denture, while still carrying outtheir function of placing foodbetween the teeth.

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The ability to adapt is difficult when

a previous denture wearer gets a newdenture. Controlling dentures that are

different in shape from what theyhad, particularly the contours of thepolished surfaces is difficult.Therefore the basis for copy dentures

is the maintenance of conditionedneuromuscular control.

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Through a copy denture techniquetherefore it is possible to reproduce

the polished surfaces of dentures

together with the introduction ofselective changes.

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Definition

A copy denture is a second denture

intended to be a replica of the firstdenture.

Synonyms

Duplicate dentures, Template dentures,Replica dentures.

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The transfer of contours from old tonew dentures for maintenance ofneuromuscular control.

Any modifications done to the basicshape of the old denture shouldtherefore be only those necessary tocorrect the loss of fit i.e., (patients

complaint) and those consideredessential by the operator, e.g., slightincrease in the OVD and worn dentureteeth.

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1. When it is desirable, especially for the

older patients, to provide replacement

dentures (with improved fit) similar in

most aspects to those to which patients

are already accustomed. It is not easy fora geriatric patient to get used to a new

denture with altered polished surface

contours readily.

2. Renewal of old deteriorated and stained

denture base material.

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3. If it is desired by a patient to have a spare

denture in case of accidental fracture or loss

of the original denture. The patients often

are concerned about being without dentures

during required repair or relining process.

4. If the need to experiment interchanging

occlusal relationship of the dentures forclinical or research reasons. This could be

carried out on the spare denture, without

changing the original one.

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A denture is not duplicated unless its

examination reveals satisfactory findings asregards to esthetic, physiologic, and

psychologic needs of a patient.

The denture(s) should be evaluated for anyprevious fractures, craze lines, missing or

replaced teeth, esthetics, phonetics, accuracy

of fit, and vertical & centric relations.

On the basis of this examination, the patient

is then advised whether the existing denture

should be duplicated or remade.

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If the polished surfaces of

the dentures are incorrect

i.e. not in the neutral zone.If the previous dentures are

not available.

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A number of methods or techniques have beenreported for producing a template for aduplicate or copy denture. All these techniquesare similar except in the use of mould containerand materials. Some of these methods are,

Modified denture flask method

Duplicating flask method

Pour resin flask method

Cup flask methodSoap container method

Agar container method

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Basically, a mould of the old denture is

produced in an elastic material, such as alginateor silicon putty supported in a rigid container.

The wax or auto-polymerizing resin template is

fabricated from this mould. Any necessarymodifications to the old denture are performed

on this template denture and tried in the

patients mouth before finishing the prosthesis.

In some of the techniques, auto-polymerizingresin teeth are also fabricated instead of using

available ready-made moulds.

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This visit includes duplication of the olddenture in auto-polymerizing acrylic resin,recording the centric jaw relation, and selectionof the shade, size, and form of the denture teeth,

if the previous selection (old denture) is notaccepted by the dentist and the patient.

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This visit includes try in of the dentures

verification of the jaw relations and tooth positions for

esthetics and phonetics.

A relining / rebase impression is then obtained as inthe conventional reline technique.

Laboratory Procedure

The dentures are now processed, finished and polished

with routine laboratory procedures.

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This visit includes all the necessary clinicalprocedures performed at the insertionappointment of a complete denture including this

includes occlusal adjustments.

A clinical remount procedures should also becarried out to perfect the occlusion of theduplicated dentures.

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1. Rigidity of the Box

The container used for fabricating the alginatemold must be rigid to avoid distortion of the

alginate and subsequently the self-cured acrylicresin template. Precautions must be taken so asthe rubber bands used to hold two halves of themold must not distort the soap container.

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2. Distortion of the Alginate ridge

Immediately after pouring the wax to from

template teeth, the mold should bereassembled to check that the alginate

impression of the ridge does not indent the

soft wax. Wax is removed if necessary to

avoid any possible distortion of the

alginate ridge and production of a base

plate without an intact all-acrylic resin

impression surface.

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3. Impression & Jaw relation records

These steps should be performed with utmostcare. Silicone impression material is

recommended for obtaining the relineimpressions as the template dentures have tobe re-inserted in the mouth for recording theOVD and Centric Relation.

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R.M.Basker, J.C.Davenport, H.R.Tomlin,Prosthetic Management of the edentulous

patient, second edition,1990,Macmillan , pg

9-10,81-89.

A.A. Grant, W. Johnson, Removable Denture

Prosthodontics, second

edition,1992,Churchill Livingstone, pg 299-

302

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