Introduction To Complete Denture
Introduction To Complete Denture
Introduction To Complete Denture
complete
denture.
INTRODUCTION TO REMOVABLE
COMPLETE DENTURE
CHAPTER CONTENT
Definition
Component Parts of a Complete Denture
Steps in the Fabrication of a Complete Denture
Definition
• More expensive.
• Difficult to fabricate.
• Cannot be rebased.
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Flange of a Denture
It is defined as, “The essentially vertical extension from the
body of the denture into one of the vestibules of the oral cavity.
Also, on the mandibular denture, the essentially vertical
extension along the lingual side of the alveolo-lingual sulcus”.
It has two surfaces, namely, the internal basal seat surface and
the external labial or lingual surface. The functions of the
flange include, providing peripheral seal and horizontal
stability to the denture. The flanges are named based on the
vestibule they extend into.
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Labial Flange
It is defined as, “The portion of the flange of the denture which
occupies the labial vestibule of the mouth”. Thickness of this flange
provides aesthetic lip support. It has a “V” shaped notch to
accommodate the labial frenum.
Buccal Flange
It is defined as, “The portion of a flange of a denture which
occupies the buccal vestibule of the mouth”. It provides the required
cheek fullness in aged edentulous patients. In the mandibular
denture it also transmits the occlusal forces to the buccal shelf area.
The buccal frenum is attached to active muscle fibres, hence,
additional relief should be provided in the buccal flange.
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Lingual Flange
It is defined as, “The portion of the flange of a
mandibular denture which occupies the space adjacent to
the tongue”. It should be in contact with the floor of the
mouth to provide peripheral seal. However, overextended
lingual flanges can lead to loss of retention due to
displacement during the activation of the muscles of the
floor of the mouth.
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Denture Border
It is defined as, “The margin of the denture base at the
junction of the polished surface and the impression
surface”.
It is responsible for peripheral seal. The denture border
should be devoid of sharp edges and nodules to avoid soft
tissue injury. Overextended denture borders can cause
hyperplastic tissue changes like epulis fissuratum. On the
other hand, the border should not be under-extended as
peripheral seal may be lost.
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Denture Teeth
It is the most important part of the complete denture from the
patient’s point of view. The functions of the denture teeth are
aesthetics, mastication and speech. They are usually made of
acrylic resin or porcelain.
There are different types of denture teeth which are classified as
follows:
Based on the material: -
• Acrylic teeth.
• Porcelain teeth.
• Inter-penetrating polymer network resin teeth (IPN resin).
• Gold occlusals.
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• Acrylic resin with amalgam stops.
Based on the morphology of the teeth: -
• Anatomic teeth.
• Semi-anatomic teeth.
• Non-anatomic teeth. Or 0o/Cusp less teeth.
• Cross-bite teeth.
• Metal insert teeth.
Types of Teeth
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Morphology of Teeth
Anatomic Teeth
It is defined as, “Teeth which have prominent pointed or rounded
cusps on the masticating surfaces, and which are designed to
occlude with the teeth of the opposing denture or natural
dentition”.
Anatomic teeth have a 33° cusp angle. Cusp angle can be defined
as, “the angle made by the slopes of the cusp with a perpendicular
line bisecting the cusp, measured mesiodistally or buccolingually”.
They are the most used of all the types available because they
resemble the natural teeth and provide good aesthetics and the
psychological benefit to the patient.
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While choosing the type of teeth for a patient, the incisal and
condylar guidance of the patient, should be analyzed.
Advantages
• They are more efficient in cutting and grinding food, so, less
masticatory effort and forces are needed.
• Balanced occlusion can be achieved in eccentric jaw positions
(Protrusive, right lateral and left lateral movement).
• The cusp-fossa relationship helps to guide the mandible into
centric occlusion.
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• Aesthetically and psychologically acceptable.
• The physical contours closely resemble natural teeth and
hence, they are more compatible to the oral environment.
The disadvantages of these teeth are that they magnify the
horizontal forces acting on the ridge and the ‘teeth setting’
is very crucial to obtain proper occlusion (i.e. they should
be placed in specified positions).
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Semi-anatomic Teeth
These teeth have cusp angles ranging between 0o and 30o. The
cusp angles are usually around 20o. They are also called modified
anatomic teeth.
Victor Sears in 1922 designed the first semi anatomic tooth,
which was called the channel tooth. This consisted of a
mesiodistal groove in all maxillary posterior teeth and a
mesiodistal ridge in all mandibular posterior teeth. These teeth
were designed for unlimited protrusive movement and limited
lateral movements.
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In 1930 Avery Brothers modified the channel tooth to
produce what was called the scissor bite teeth. This is
exactly the opposite of the channel tooth. The grooves and
ridges run buccolingually so that protrusive movement is
limited and lateral movement is free. This was designed to
shear food in the lateral direction.
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Non-anatomic or 0° or cusp less Teeth
Non-anatomical teeth are defined as, “Artificial teeth with
occlusal surfaces which are not anatomically formed but
which are designed to improve the function of mastication”.
Cusp less teeth are defined as, “They are teeth designed
without cuspal prominences on the occlusal surfaces”.
Zero degree teeth are defined as, “Artificial posterior teeth
having no cusp angles in relation to the horizontal occlusal
surfaces”.
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These teeth have 0o cusp angles. These designs evolved to over-come the
disadvantages of the normal anatomic teeth. These teeth do not provide
balanced occlusion. Balanced occlusion in dentures with these teeth is
obtained by balancing ramps and compensatory curves.
Hall in 1929 designed the first cusp less tooth and named it “inverted cusp
tooth”. The occlusal surfaces of these teeth were flat with concentric conical
depressions producing sharp concentric ridges around a central depression.
Myerson introduced the “trukusp” teeth in 1929. These had a series of
buccolingual ridges on the occlusal surfaces of both maxillary and
mandibular teeth. Here the ridges of opposing teeth were parallel to each
other.
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Advantages
• In patients with bruxism non-anatomic teeth decrease the forces acting on
the basal tissues.
• Greater range of movements is possible.
• In patients with neuromuscular disorders where accurate jaw relation
cannot be recorded, cusp less teeth are preferred.
• In cases with highly resorbed ridge, cusp less teeth are preferred as they do
not get locked and displace the denture during lateral movements.
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Disadvantages
• Flat occlusal surfaces and artificial contours give an unaesthetic
appearance.
• Masticatory efficiency is less.
• Balanced occlusion cannot be obtained.
• Occlusion is in two dimensions, whereas the mandibular movement is in
three dimensions.
• Any attempt to correct these teeth by occlusal grinding will decrease their
efficiency.
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These teeth are used in jaw discrepancy cases leading to a posterior cross
bite relationship. Here the buccal cusps of the maxillary teeth are absent.
Instead there is a large palatal cusp, which rests on the lower tooth. Gysi in