Successful Dentures Part II - Removable Prosthodontics

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Posterior Tooth Selection Indications Posterior Tooth Selection Indications Anatomic Non-anatomic Anatomic Non-anatomic Well coordinated patient Poor neuromuscular control (Bruxers, CP, etc.) Previously successful with anatomic dentures Previously successful with monoplane dentures or severely worn occlusion on previous denture Posterior Tooth Selection Indications Posterior Tooth Selection Indications Anatomic Non-anatomic Anatomic Non-anatomic Class I ridge relationship Arch discrepancies › Class <strong>II</strong> or <strong>II</strong>I or cross-bite Denture opposes natural dentition Immediate dentures › Except when opposing natural dentition Anatomic Occlusion Lingualized Occlusion Advantages Definite point of positive intercuspation may be developed Esthetically similar to natural dentition Tooth-to-tooth and cusp-tocusp balanced occlusion can be achieved Maintains some shearing ability after moderate wear Disadvantages Difficult to set Less adaptable to arch relation discrepancies Horizontal force development due to cusp inclinations Harmonious balanced occlusion is lost with denture base settling Requires frequent follow-up and may require more frequent relines to maintain proper occlusion Indications High esthetic demands Severe mandibular ridge atrophy Displaceable supporting tissues Malocclusion Previous successful denture with lingualized occlusion Advantages Good esthetics Freedom of non-anatomic teeth Potential for bilateral balance Centralizes vertical forces Minimizes tipping forces Facilitates bolus penetration (mortar and pestle effect)
Non-Anatomic Occlusion Is ‘Balance’ Necessary? Advantages Reduction of horizontal forces CR can be developed as an area instead of a point Freedom of movement Can develop solid occlusion despite arch alignment discrepancies Easily adapted to situations prone to denture base shifting Easy to set and adjust teeth Disadvantages No vertical component to aid in shearing during mastication Occlusal adjustment impairs efficiency unless spillways and cutting edges restored Patients may complain of lack of positive intercuspation position Somewhat esthetically limited (don’t look like natural teeth) “Bolus in” “Balance out” Complete Denture Occlusion Investigators have not shown one type of denture occlusion to be: Superior in function Safer to oral structures More acceptable to patients Neuromuscular control may be the single most significant factor in the successful manipulation of complete dentures under function Tongue function and denture wearing experience Posterior Landmarks Landmarks for the Arrangement of Posterior Denture Teeth Crest of the ridge Mandibular posterior teeth are centered over the ridge Medial/lateral Retromolar pad Medial/lateral Superior/inferior 2/3 height retromolar pad 88 Posterior Landmarks Mandibular Posterior Tooth Arrangement Three landmarks used to determine the plane of occlusion: Retromolar pad 2/3 height retromolar pad Incisal edge of the mandibular central incisor 90
Page 1 and 2: Secrets to Successful Dentures Part
Page 3 and 4: Anatomy in Relation to Complete
Page 5 and 6: Anatomy in Relation to Complete
Page 7 and 8: Mandibular Relations Vertical Dime
Page 9 and 10: Anterior Tooth Selection Shape Ante
Page 11 and 12: Anterior Tooth Arrangement General
Page 13: General Concepts of Denture Occlusi
Page 17 and 18: Maxillary Posterior Tooth Arrangeme
Page 19 and 20: External-hex and Internal-hex Exte
Page 21 and 22: Locator Selection Locator Abutment
Page 23 and 24: Direct Pickup Direct Pickup Choose

Successful Dentures Part II - Removable Prosthodontics

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