Complete Overdenture

Question 1

What is the definition of a complete over denture?

Answer 1

An over denture is one which gains its support partly or wholly from the roots of retained, decoronated or crown modified teeth

Question 2

What are the 5 advantages of retaining roots?

Answer 2

1. RR preserves the associated alveolar bone
2. root face gives extra support
3. extra retention via attachment
4. Psychological benefit
5. Retained proprioception from PDL and tactile discrimination

Question 3

How is preserving alveolar bone advantageous?

Answer 3

Enhance stability

Prevent resorption

Question 4

How does retaining root face help with support?

Answer 4

Tissue support greater occlusal loads and protect soft tissue against mechanical trauma
Denture sit on non compressible tissue

Question 5

How can attachments provide extra support?

Answer 5

CEKA and magnetic attachment provide +ve retention

Will need maintenance / repair

Question 6

How can retained roots provide psychological benefit?

Answer 6

Knowing have remaining teeth

Lost teeth associated social inequality

Question 7

How can retaining roots be good for systemic health?

Answer 7

Pt on bisphosphonates

Balance between risk and disease

Question 8

What are the 5 disadvantages of retaining roots?

Answer 8

1. Expensive
2. Failure can occur
3. Balance issues
4. Time intensive
5. Maintenance

Question 9

Why is retaining roots expensive?

Answer 9

Carrying out RCT

May need denture reinforcement

Question 10

Why can failure occur in retained roots?

Answer 10

Caries

At placement - roots hidden - cariogenic process can be accelerated

Question 11

Why can balance be an issue with retained roots?

Answer 11

If single/ poorly matched roots on either side = problem with balance

Question 12

Why can retained roots make process take longer?

Answer 12

Need prep work (RCT), aftercare (caries prophylaxis) and more prolonged tx

Question 13

Why is maintenance an issue w/ retained roots?

Answer 13

More risk of disease

Question 14

4 cases where over dentures specially indicated?

Answer 14

1. Thought alveolar bone resorption will be significant
2. Repeated alterations to dentures might be undesirable and extraction contraindicated
3. Increase in face height is needed in case of tooth wear/ hypodontia
4. Thought adaptation might be poor/ extra retention is desirable

Question 15

When may alveolar bone resorption be significant?

Answer 15

Unopposed mandibular anterior teeth - predispose maxillary atrophy

Question 16

What factors must you consider when selecting teeth?

Answer 16

Simply root canal shape - endo
Adequate tooth size (e.g canine)
Sufficient support
Bone - no buccal undercut

Question 17

What would the ideal tooth arrangement be?

Answer 17

Bilateral tripod of support
Opposed if possible
Not in close contact - proximity

Question 18

What are the 3 types of over denture?

Answer 18

1. Immediate (type I or type II)
2. Transitional - by addition to partial
3. Permanent

Question 19

Difference between immediate type I and type II?

Answer 19

Type I - XLA needed

Type II - non-extraction (preserve teeth - may need to be RCT/ decoronated)

Question 20

Why are transitional dentures useful?

Answer 20

Assess tolerance, caries rate and outcome

Question 21

What are associated problems with permanent over dentures?

Answer 21

1. Endo- over dentures of RF filled teeth more successful
2. Functional contact
3. Abutment form
4. Additional retention
5. Aftercare