toothwear - overdentures Flashcards
How does lack of posterior support affect toothwear?
A modifying factor of tooth wear
Increases severity of wear
Increases rate of progression of wear
Ultimately can lead to occlusal collapse
Creates functional and aesthetic problems
What are the reasons for lack of posterior support?
Denture intolerance
Denture refusal
Neglect
Why should compete dentures be avoided in bruxists?
Bruxism will continue leading to fractured dentures, more ridge resorption, pain and ulceration under complete dentures
What is an overdenture?
Any removable prosthesis that rests on one or more remaining natural teeth, the roots of natural teeth and/or dental implants
Give 6 advantages of overdentures
Any from:
- correction of occlusion and aesthetics
- support
- toothwear management - when lost >2/3 of crown height
- preservation of ridge form
- proprioception - can sense food in mouth
- denture retention
- can be used with precision attachments
- MRONJ and radiotherapy patients - avoids XLA
- psychological benefits
- useful in elderly pts - avoids XLA
- eases transition to edentulism
Give 6 disadvantages of overdentures
Any from
- need for good OH
- increased caries and periodontal risk
- care homes
- more likely to fracture
- discomfort
- infection
- potentially more traumatic XLA required
How are overdentures cared for?
Good OH
Fluoride application to roots
Regular exam and radiographs of remaining roots
Denture hygiene
How are transitional dentures used to treat toothwear?
Can increase OVD in cases where poor posterior support to create space for restorations
Pt wears for a few months in attempts to cope with transitional dentures and increase the OVD
What are the steps of preparing the mouth for definitive dentures with transitional ones?
Get rid of the impossible and XLA
Make crown with rest seats and undercuts
Definitive dentures with the same OVD as the transitional
Why are metal based dentures sometimes used in toothwear?
Can have metal backing on teeth and a metal palate to make denture more retentive and indestructible
Often well tolerated
What can be used to simplify small saddles?
Bridgework
When does conforming to the occlusion work best?
In a stable occlusion with sufficient index teeth
Ensure your prosthesis and restoration doesn’t alter the occlusion
When should the occlusion be changed?
Also called rehabilitation - often happens in toothwear
Occlusion is unstable and lack of sufficient index teeth
What may you need to do before either conforming or changing the occlusion?
Impressions and facebow
Mounted articulated casts on semi-adjustable articulator
High quality interocclusal record
Stents
Transitional dentures
Clinical photographs
Radiographs
