Complete dentures can often meet a patient’s needs and allow very good function.
No matter how good the function, however, there will likely be continued changes in the ridges which support dentures. Since there are no tooth roots in the alveolar bone (to stimulate bone growth), the ridges will continue to resorb with time. This typically results in looseness of the dentures and affects the way they come together (occlusion). This condition can be corrected by relining or remaking the dentures.
By adding implants to support the dentures, the function of the dentures can be improved and the supporting bone can be maintained.
Crowns are restorations that cover an entire single tooth. They are usually made of gold, porcelain or a combination of both.
Also called jackets or caps, crowns are used when the remaining natural tooth is insufficient to retain and support a filling. They wrap around the entire tooth and cover the biting surface.
The biting position and the shape of the tooth can be improved when the crown is made. Individual crows are often required to provide appropriate support for removable partial dentures. As long as there is an adequate root in solid bone, a crown can be made to be supported by that root. Often, a post is cemented into the root with an extension into the crown area to form a core which will support and retain the crown.
Dental implants can be used in all areas of prosthodontics. They are used, very successfully, to provide “artificial roots” which can support crowns, bridges, removable partial dentures and removable complete dentures. They can even be utilized to support and retain complete fixed dentures.
Systems have been developed to provide quite predictable results implant placement. Most patients without severe medical issues can expect to have highly successful results with dental implants.
Dental implant surgery is generally quite limited and relatively minor. In the occasional complex situations, rebuilding the deficient ridges with bone grafting can provide rehabilitation which, just a few years ago, was possible only in the imagination.
Removable Complete Dentures
When all the teeth in either the upper or lower arch are missing, an artificial denture can be made to rest on the entire ridge and act as a replacement for all the teeth of that arch. The base of the denture is usually made of plastic (acrylic resin) and the teeth of the dentures are made or porcelain or resin.
The function of a complete denture is expected to be somewhat less than that of natural teeth as complete dentures have no boney support. They rest entirely on the soft tissues of the gums which cover the bone of the alveolar ridges. Just how well the dentures can function depends on many factors:
• The thickness, quality and amount of gum.
• The number, shape and contour of alveolar ridges.
• The way in which the upper and lower ridges line up with one another.
• The position and size of the tongue.
• The coordination and dexterity of the patient.
• The amount and quality of saliva, etc.
Removable Partial Dentures
When teeth are missing and there is inadequate support for a cemented, fixed, partial denture, removable partial dentures may be used.
These dentures may be supported entirely by teeth; but, usually, there is a combination of tooth and gum tissue support. When ideally made and properly used, they can be adequate (and , often, very good) replacements for missing teeth.
Removable partial dentures routinely require adjustment and refitting if material weaken and/or as the supporting gums and alveolar bone (ridges) change with time and function. Clasps which wrap around the supporting teeth to provide retention must be designed and placed in positions so that they minimize adverse forces placed on the teeth and so that they are not easily visible.
These dentures must be removed regularly so that debris can be cleaned away.