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Principles of complete Principles of complete denturedenture
Lecturer Lecturer
Hatem Dousouky AhmadHatem Dousouky Ahmad
Lecture out lineLecture out line
1.1. Steps of complete denture construction.Steps of complete denture construction.
2.2. Indications and contra indications of Indications and contra indications of complete dentures.complete dentures.
3.3. Difference between natural and denture Difference between natural and denture teeth.teeth.
4.4. Retention in complete dentures.Retention in complete dentures.
5.5. Support in complete dentures.Support in complete dentures.
6.6. Stability in complete dentures.Stability in complete dentures.
11--Steps of complete denture Steps of complete denture constructionconstruction..
2- indications and contraindication 2- indications and contraindication of complete denturesof complete dentures
Indications:Indications:
All edentulous arches are All edentulous arches are indicated for complete indicated for complete dentures unless there dentures unless there is a temporary or a is a temporary or a permanent reason permanent reason preventing the preventing the treatmenttreatment
Contra indications:Contra indications: Temporary factors:Temporary factors:
1)1) Remaining roots or Remaining roots or teeth.teeth.
2)2) Local pathos's as cysts.Local pathos's as cysts.
3)3) Overwhelming disease.Overwhelming disease.
Permanent contraindications:1)Epileptic patients and other psychological disorders preventing the neuromuscular control over the denture to avoid suffocation.
33 - -difference between natural and difference between natural and artificial teethartificial teeth..
Natural teethNatural teeth Denture teethDenture teeth
Quality of complete dentureQuality of complete denture
A denture is said to be successful when it is:1)Stable in place at function and rest.2)Performs it’s masticatory and esthetic functions.3)Preserves the foundation tissues.
I- Tissue-ward movementsI- Tissue-ward movements
II- Tissue-away movementsII- Tissue-away movements
III- Horizontal movementsIII- Horizontal movements:: A) Lateral movementsA) Lateral movements
B) Antero-posterior B) Antero-posterior movementsmovements..
IV- Rotational movementsIV- Rotational movements
At least four possible movements of the dentures exist
General movements of the General movements of the denturedenture
Direction of movement
Cause of movementResisted by
Tissue away movement
Sticky foodGravity in upper
denture
Retention
Tissue ward movement
Mastication.support
Rotational movementChewing on one sidestability
Horizontal movement:A- antro-posterior.B-medio-lateral.
Chewing, clenching,side to side
movement, muscleeffect
bracing
•Mastication, Swallowing And Aimless
Tooth Contact. Biting Forces
I- Tissue-ward movements
•C.D. should be designed to resist this movement by providing adequate
supporting from the foundation tissues
•This function of the complete denture is
called “Support”
• It is the Resistance to Tissue Ward Movement
1-Support
• Obtained by adequate Distribution of Forces Over the Supporting Sttructures.
• The quality of the denture to transfer Occlusal Stresses to the Supporting Oral Structures and decrease forces / unit area
•Adequate Distribution of Forces Over the Supporting Sttructure
•Decrease forces/unit area
•The Resistance to Tissue Ward Movement
Tissue-away forces occur due to
The action of muscles acting along the periphery of the denture
•This function of the complete denture is
called “Retention”
Gravity acting on upper dentures or by
sticky food adhering to the artificial teeth or to the denture base.
1-Adhesion 2-Cohesion
4-Interfacial s.t.*Viscosity (interfacial
viscous tension)
4-At. pressure 5-Gravity
MechanicalMechanical
2-Retention
PhysiologicalPhysiologicalPhysical
• Physical condition•The physiologic molding of
the tissues around the polished surfaces
• neuromuscular control• Degree of tissue tone• Quality and quantity of
saliva• Condition of mucosa and
submucosa• Ridge characteristics
• Ridge relationship
•Parts of the denture engaging tissue undercuts.
•Occlusion•Leverage•Contour of
denture bases
3- Bracing3- BracingHorizontal movementsHorizontal movements
Horizontal forces developed when the mandible moves from side to side
during function while the teeth are in contact
Lateral movements have a
destructive effect
This Function Is Mainly Provided By:
Adequate extension of the flanges
4-Stabilization
Is the Resistance of the Denture
to rotational forces (Tipping -
Rocking)
1-Adhesion 2-Cohesion
4-Interfacial s.t.*Viscosity (interfacial
viscous tension)
4-At. pressure 5-Gravity
MechanicalMechanical
2-Retention
PhysiologicalPhysiologicalPhysical
• Physical condition•The physiologic molding of
the tissues around the polished surfaces
• neuromuscular control• Degree of tissue tone• Quality and quantity of
saliva• Condition of mucosa and
submucosa• Ridge characteristics
• Ridge relationship
•Parts of the denture engaging tissue undercuts.
•Occlusion•Leverage•Contour of
denture bases
11--Physiologic factorsPhysiologic factors
1.1. Physical condition of the tissues and the patient(the Physical condition of the tissues and the patient(the
better the physical condition the better is the better the physical condition the better is the
retention.retention.
2.2. Degree of tissue toneDegree of tissue tone
3.3. Quality and quantity of salivaQuality and quantity of saliva
4.4. Condition of mucosa and submucosaCondition of mucosa and submucosa
5.5. Neuromuscular controlNeuromuscular control
6.6. Ridge characteristicsRidge characteristics
7.7. Ridge relationshipRidge relationship
PhysiologicalPhysiological
Oral And Facial MusculatureOral And Facial Musculature
The Polished Surfaces Are Properly The Polished Surfaces Are Properly ShapedShaped , ,
The Teeth Are Positioned In The The Teeth Are Positioned In The Neutral Zone AndNeutral Zone And
The Denture Bases Are Properly The Denture Bases Are Properly Extended To Cover The Maximum Area Extended To Cover The Maximum Area PossiblePossible , ,
Muscular control is an important aspect of successful complete denture therapy. providing that :
The Polished Surface The Polished Surface ContourContour
22--Physical factorsPhysical factors
1-Adhesion 2-Cohesion
4-Interfacial s.t.*Viscosity (interfacial
viscous tension)
4-At. pressure 5-Gravity
MechanicalMechanical
2-Retention
PhysiologicalPhysiologicalPhysical
• Physical condition•The physiologic molding of
the tissues around the polished surfaces
• neuromuscular control• Degree of tissue tone• Quality and quantity of
saliva• Condition of mucosa and
submucosa• Ridge characteristics
• Ridge relationship
•Parts of the denture engaging tissue undercuts.
•Occlusion•Leverage•Contour of
denture bases
Adhesion and Adhesion and
CohesionCohesion
Adhesive failure refers to the interface between two
bodies; cohesive failure to within a material itself .
Note: the cohesive strength of saliva is much greater than
the adhesion of mucosa to PMMA
AdhesionAdhesion AAdhesion of saliva to the mucous dhesion of saliva to the mucous
membranemembrane and the denture base is achieved and the denture base is achieved
through through ionic forces between charged ionic forces between charged
salivary glycoprotein and surface salivary glycoprotein and surface
epithelium epithelium
CohesionCohesionPhysical attraction of like molecules for each otherPhysical attraction of like molecules for each other
creates retentive force and usually occurs with creates retentive force and usually occurs with
saliva that is present between the denture base and saliva that is present between the denture base and
the mucosathe mucosa . .
Normal salivaNormal saliva is not very cohesive, and unless the is not very cohesive, and unless the
interposed saliva is modified with the use of denture interposed saliva is modified with the use of denture
adhesive, retentive force cannot be achievedadhesive, retentive force cannot be achieved..
Retention supplied by Retention supplied by Adhesion depend onAdhesion depend on: :
1)1) The area covered by the dentureThe area covered by the denture
2)2) the close adaptation of the the close adaptation of the
denture to the supporting tissuesdenture to the supporting tissues
3)3) The fluidity of salivaThe fluidity of saliva
Atmospheric pressureAtmospheric pressure
If The Dentures Have If The Dentures Have An Effective SealAn Effective Seal
Around Their Borders. Around Their Borders. This Is Called This Is Called
‘Suction’‘Suction’ Because It Is The Resistance To Because It Is The Resistance To
Removal In A Direction Opposite To That Removal In A Direction Opposite To That
Of Insertion. But Of Insertion. But There Is No Suction Or There Is No Suction Or
Negative Pressure, Except When Negative Pressure, Except When
Another Force Is AppliedAnother Force Is Applied
Displacement of a sealed bellows-like device results in a vacuum in the emergent space, the displacing force being
balanced by that from atmospheric pressure. There is no static retaining force otherwise. Comparable conditions
are unlikely to occur in the mouth
Atmospheric pressure
All valve and suction retention systems are similar: a
spring of some description attempts to maintain a region
of lowered pressure.
These all fail to be effective in the long run for
physiological reasons
vacuum
For atmospheric pressure to For atmospheric pressure to
be effective, the denture be effective, the denture
must havemust have
a perfect seala perfect seal around its around its
entire borderentire border
Interfacial Surface Interfacial Surface TensionTension
It is attributed to the It is attributed to the
attractive forces or attractive forces or
cohesion of the surface cohesion of the surface
molecules of the liquidmolecules of the liquid..
Interfacial Surface Interfacial Surface TensionTension
Is A Resistance To Separation By The
Film Of Liquid Between The Denture
Base And Supporting Tissues .
It Combines The Actions Of Adhesion
And Cohesion And Is Similar To
Capillary Attraction.
Bulging liquid surfaces imply a Bulging liquid surfaces imply a higher pressure within the liquid; higher pressure within the liquid;
incurving surfaces imply a lowered incurving surfaces imply a lowered
pressurepressure
Surface tension
•When is interfacial surface tension most effective ?
•When the salivary film is very thin,
there is a perfect adaptation of the
denture base and the soft tissues are
firmly attached to underlying bone and
not distorted.
What effect does distance between the
denture base and the mucous membrane
have on retention and what is it called ?
"Capillary attraction"
Simplified
cross-section
to illustrate
the seal
arising from
compliant
tissue, flow
restriction in
narrow spaces,
and the effect
of surface
tension in a
well-fitting
denture
ViscosityViscosityIt is the resistance by one part of A liquid in moving over It is the resistance by one part of A liquid in moving over
another partanother part..The rate of separationThe rate of separation of two surfaces under an applied of two surfaces under an applied
forceforce,,Very Very thin watery salivathin watery saliva does not seal the denture well and does not seal the denture well and
the seal can be easily brokenthe seal can be easily broken..The need for a The need for a good base adaptationgood base adaptation to the tissues to the tissues
Full surface Full surface area coveredarea covered by the denture. This may be by the denture. This may be
relevant to the maxillary denturerelevant to the maxillary denture . .The mandibular denture are bathed in salivaThe mandibular denture are bathed in saliva, surface , surface
tension, viscosity and film thickness may not play a role in tension, viscosity and film thickness may not play a role in
lower denture retentionlower denture retention
Gravity•The weight of a lower prosthesis
constitutes a negligible gravitational force and is insignificant in comparison with the other forces acting on a denture .
•this may be beneficial in cases where other retentive forces and factors are marginal.
Base AdaptationBase Adaptation
the narrowness of the gap the narrowness of the gap
contributes a retentive force contributes a retentive force
through the effects of surface through the effects of surface
tension, via the curvature that tension, via the curvature that
results in the liquid surfaceresults in the liquid surface
Border sealBorder sealAttention was drawn under 'Surface Tension' to the fact that along most of the border of a denture there is double contact of acrylic and soft tissue such that displacing the denture in the separation sense does not open a gap along that border
Soft tissue
Denture retention is therefore a dynamic issue as it mostly depends on factors controlling the flow of the interposed fluid .
The better the fit to the tissue, and the better the linear extent of the seal at the border, the better the denture will resist short term displacing forces.
Ultimately, the central factors for
the success of a denture depend
primarily on the quality of the fit of
the denture to soft tissue. This in
turn hinges on the impression
technique and subsequent denture
base design and fabrication
1. Have less surface area.
2. Are bathed in saliva.
The effect of physical forces is less applicable to lower
dentures than upper because:
3. Strong movements of the tongue
This Function Is Mainly Provided By:
1-Mechanical -- Undercuts
2 -physiologic forces on polished surfaces of denture bases
3 -physical forces on fitting surfaces of denture
bases
Thank youThank you