The Single Denture

Question 1

the most common situation (2)

Answer 1

 Maxillary arch is edentulous
 Mandibular arch has natural / restored teeth

Question 2

natural teeth opposing a CD (4)

Answer 2

natural teeth generate greater chewing force against opposing denture
natural teeth do not move in function as denture does
cannot control placement of opposing teeth
drifting/tilting puts natural teeth far from optimal positions

Question 3

centripetal resorption (2)

Answer 3

 Routine resorption pattern following
extraction of teeth results in a smaller maxilla
when compared to dentate arch.
 Maxilla resorbs UP and INWARD!

Question 4

arch discrepancy (2)

Answer 4

a horizontal arch discrepancy is created when the max arch narrows and becomes shorter in the AP direction
a crossbite may be required to direct occlusal forces to the bearing area

Question 5

uncontrolled occlusal forces
 Maxillary CD opposed by mandibular
anterior natural teeth:

Answer 5

“THE COMBINATION SYNDROME”

Question 6

“THE COMBINATION SYNDROME”
(5)

Answer 6

max ant tissue mobile/hyperplasia
inflammatory palatal hyperplasia (IPH)
max tuberosities enlarged
mand poster bone resorption
mand anterior teeth supraerupted

Question 7

curve of monson
(4)

Answer 7

combo of curve of spee and wilson
coronal and sagittal planes
concave for the mand arch and convex for the max arch
the CO form a segment of a sphere of 4 inches radius with the center of the sphere at the glabella

Question 8

occlusal plane

Answer 8

reduce restore remove

Question 9

occlusion on the single denture

Answer 9

Interdigitation……cusp in fossa

Question 10

occlusion

Answer 10

a reciprocal arrangement of elevations and depressions

Question 11

single denture fractures

Answer 11

Biting force of natural dentition is approx 5
times that of the denture wearers (160 vs 35
lbs)

Question 12

the edentulous mandible opposing max natural dentition

Answer 12

Rapid loss of mandibular alveolar bone

Question 13

natural/edentulous mandible (3)

Answer 13

 Discuss the likely poor outcome
 Resilient liner in mandibular denture
 Osseointegrated implants in mandible

Question 14

Mandibular anterior resorbs approx – times
as fast as maxillary anterior

Answer 14

4

Question 15

Rapid bone loss emphasizes the need for any
procedure which will

Answer 15

slow the bone loss.

Question 16

A 5-year study showed that retaining — for overdentures
preserved alveolar bone

Answer 16

mandibular canines

Question 17

overdenture adv (4)

Answer 17

denture support is increased and soft tissue trauma is decreased
stability of the denture is increased
maintenance of periodontal proprioception improves chewing efficiency
psychological benefit to the pt

Question 18

adv of overdentures (5)

Answer 18

residual ridge integrity - improved stress distribution
stability and retention
patients perception of preserved natural teeth
viable and simple alternative technique to CD
application is virtually unlimited

Question 19

when overdentures? (3)

Answer 19

 When a conventional denture would have a
poor prognosis
 When opposing an arch of natural teeth
 When “Combination Syndrome” is a factor

Question 20

disadv overdentures (8)

Answer 20

llikely time dependent transition to CD depends on patients oral hygiene and nature of selected abutments
age related inability to follow proper hygiene
presence of refractory PD
caries
frequent reall appointments, expense (endo and restoration)
available interarch space
weakness of acrylic denture base
cast coping -increases lab procedures/expeneses

Question 21

overdentures disadv (4)

Answer 21

Cost– more $ than conventional denture-
RCT, copings
 Denture is bulkier in some areas
 Denture more subject to fracture
 Caries / perio sequelae

Question 22

selection of abutment teeth (3)

Answer 22

PD and mobility status (horizontal bone loss)
abutment location (canine/premolars), at least one tooth per quad, no adjacent teeth
endo and prosth status

Question 23

endo and prosth status

Answer 23

anteriors easy for endo,
in cases of cacification -endo can be avoided
crowns can be modified -sealant/fluoride tray,
use of copings, composite / alloy restorations
retention attachment system

Question 24

— treatment is recommended for
most overdenture abutments

Answer 24

Root canal

Question 25

perio eval (2)

Answer 25

tooth mobility does not eliminate a tooth for use as an abutment
crown/root ratio is improved (mobility lessened) when crown is reduced on the tooth

Question 26

abutments canines most frequently selected (3)

Answer 26

 Canines have large roots
 Amenable to RCT
 Strategic location at corner of arches

Question 27

Abutment failure –
 Denture fracture –

Answer 27

caries or periodontal
metal base ?

Question 28

loss of abutment teeth
after 5-6 yrs about –% of abutments were lost
causes: PD, caries, endo complications
motivation for hygienic care - mechanical toothbrushes
one tooth overdentures were not tolerated
fluoride gel for daily application

Answer 28

10

Question 29

gingivities around abutment (3)

Answer 29

movement of denture base
poor oral hygiene
excess space in prosthesis (dead space)

use of tissue conditioner
use of hard acrylic resin

Question 30

restorations (2)

Answer 30

 Amalgam
 Cast gold copings

Question 31

— requred

Answer 31

surgical guide

Question 32

implant bars

Answer 32

design for hygeine

Question 33

implant-retained, implant-supported

Answer 33

no pressure on the ridge