Support - Complete denture

8/10/2019 Support - Complete denture

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SUPPORT

INCOMPLETE DENTURES

Completedenture


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INTRODUCTION

If the dentures and their supporting tissues are to coexistfor a reasonable length of time ,the dentist must fully

understand the anatomy of supporting and limiting

structures involved.

Incorporation of certain biological and physical factorsare necessary to ensure optimal complete denture

support.


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COMPLETE DENTURE SUPPORT IS,

Resistance to vertical movement of

the denture base towards tissue.

Counteracts forces towards ridges.

Support relationship between

denture base & tissue surface

Maintain established - occlusal

relation ,promote optimal function,

with minimal tissue ward movement

& base settling.


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DEFINITION

GPT The foundation area on which the denture

prosthesis rest.

BOUCHER The resistance to the vertical forces of

mastication, occlusal forces & other forcesapplied in a direction towards the denturebearing area.


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TYPES OF SUPPORT

CONSIDERED IN POINTS OF VIEW;

1.Dentures should confine to the underlying

tissues so that the occlusal forces can

correctly oppose to one another at initial

closure & under functional loading.

2.The denture should maintain this for a period

of time for the longevity of the dentures


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SUPPORT IS ACHIEVED ,

INITIALLY

By impression procedures that provide optimal

extension & functional loading of the supporting

tissue which vary in their resiliency.

LONG TERM

Directing the forces of occlusal loading towards

those tissue most resistant to remodeling &

resorptive changes.


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FACTORS AFFECTING

SUPPORT

1. Contour & quality of the residual ridge .

2.Extent of residual ridge coverage by denture

base.

3.Type & accuracy of the impression registration

4. Accuracy of the fit of the denture base .

5.Total occlusal load applied.


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EFFECTIVE SUPPORT IS REALIZEDWHEN,


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SNOWSHOE PRINCIPLE

Of maximal extension is that

given a constant occlusal force,

broader denture bearing area

decreases the stress per unit area

under the denture base, decreases

tissue displacement ,reduces

denture base movement.


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NATURE OF THE SUPPORTING

TISSUES

1.SOFT TISSUE

2.HARD TISSUE

3.BONE FACTOR


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SOFT TISSUES Supporting soft tissues must be capable of

withstanding the pressure induced through normalfunction of prosthesis.

Presence of keratinized, firmly bound mucosa

permits the tissue to better resist stress.


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Presence of layer of resilient submucosa permits

moderate compressibility without mechanical

impingement of mucosa between the denture base &

underlying bone

The fatty & glandular mucosa acts as a hydraulic

cushion


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HARD TISSUES Requirement of ideal support

is the presence of tissue thatare relatively resistant to

remodeling and resorptive

changes.

In case of over denture,

preserving teeth retains not

only alveolar bone

supporting teeth but also

alveolar bone adjacent to

teeth.


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BONE FACTOR

It can be determined by studying the previous

response of patients bone to stress.

Such stress may be in the form of extractions,

surgical trauma, forces generated by functioning

prosthesis.


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Bone responds to force by remodeling-WOLFS LAW

The supporting alveolar bone may differ in its

response to stress as compared to basal residual

ridge bone.

Response of bone to stress is related to local

anatomic and physiologic variations within and

between individuals

Pressure tension concept:

pressure stimulates resorption ; tension maintains the

integrity or deposition


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Cortical bone more resistant to resorption

Hence used in support of denture as recorded

relations are maintained over longer periods oftime.

Muscle fiber attachments ensure tension on

bone. This minimizes resorptive changes.


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ANATOMIC CONSIDERATION OF

DENTURE BEARING AREA

AS EDWARDS & BOUCHER NOTED;

Sincethe success of the complete denture depends

largely on the relation of the dentures to anatomic

structures which support & limit them, familiarity with

the location & character of these structures is

essential.


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Support - Complete denture