Dr Prince Kumar (Overdenture)

1. FACULTY OF DENTAL SCIENCES

2. Dr Prince Kumar
Deptt of Prosthodontics
Rama Dental College
OVERDENTURE

3. DEFINITIONS
 A removable partial denture or complete denture
that covers and rests on one or more remaining
natural teeth, the roots of natural teeth and/or
dental implants.
 A prosthesis that covers and is partially
supported by natural teeth, natural tooth, roots
and/or dental implants.
 Also called as overlay dentures / overlay
prosthesis / superimposed prosthesis
GPT – 8th ed

4.  An overdenture is a denture that may be
supported by soft tissue, bone, the root of a
tooth, or a modified tooth
 Also called as biologic denture, telescopes
denture
Heartwell

5. INDICATIONS
 It should be considered for patients who face the loss of the
remaining natural adult dentition. Therefore younger the
patient greater the indication.
 In cases where the retention is difficult to obtain such as:
 Xerostomia or sialorrhea
 Absence of alveolar residual ridge
 Loss of maxilla and partial loss of mandible
 congenital deformity eg cleft palate
 For patients with a poor prognosis for complete dentures.
 High palatal vault and ridge slope
 Poorly defined sublingual fold space
 Posterior Open occlusal relationship in cases of for eg.,
cleidocranial dysplasia, hpothyroidism, hypoparathyroidism6

6.  In class III tongue position
 Knife edged ridge that will provide inadequate support.
 When pronounced vertical overlap of the anterior teeth is
required to produce good esthetic results.
 Unilateral over denture can be given to provide a good
function and esthetics a large amount of bone and soft tissue
have been lost on one side of the arch.
 Patients with badly worn out teeth.
 When complete denture will be opposed by retained
mandibular anterior teeth preventing (combination
syndrome).
 Therapeutics in the form of insitu irradiation (Mobermott &
Rosenberg (1963)

7. CONTRAINDICATIONS
 Un co-operative and under motivated patients who insists on
removal of his remaining teeth. Any indicaion of patient who will
not co-operate in oral hygiene and regular office procedures, vecull
for adjustments which is required to maintain the remaining teeth
and the supporting tissue in a state of health.
 Psychologically some patients cannot accept any type of
removable denture.
 Menally and physically handicapped patiens for whom plaque
control and good oral hygiene are difficult.
 When a patient cannot economically afford.
 Periodontal Consideration:
 Periodontal inflammation, pocket formation, bony defects, and
poor zone of attached gingiva must all be eliminated before
commencing the treatment. The deleterious effect of the over
denture on the periodontium can be minimized of the over denture
on the periodontium can be minimized if one begins with an optium
state and the patient follows a meticulous home care programme
with frequent recall.

8. ADVANTAGES
 Apart from the Preservation of alveolar bone and preservation
of proprioceptive response, it also provides Support and
retention.
 It is also a simple approach to the compromised patients with
Cleft palate
Partial anodontia
Microdontia
 Patient acceptance – they experience a striking improvement in
function and esthetics while still maintaining some of their own
teeth

9. DISADVANTAGES
 Over denture treatment is more expensive than
conventional denture because of periodontal and
endodontic therapy and the subsequent restoration of
teeth with gold coping.
 Bulkier than F.P.D. (or) R.P.D.
 If oral hygiene is not maintained properly caries and
periodontal disease may still progress.
 Bony under cuts may cause either over contouring or
under containing of the denture.
 Encroachment of inter occlusal distance.
 Esthetics.
 In many cases, owing to lack of available space
sections of the over denture base are quite thin. If
metal reinforcement is not used, fracture of the base
and prosthetic teeth is common.

10. CLASSIFICATION
Broadly classified into
 Tooth-supported denture
 Implant Supported Over Denture

11. Heartwel’s classification of tooth supported
denture
Based on the method of abutment
preparation.
 Simple tooth modification and
reduction
 Tooth reduction and coping
 Endodontic treatment and amalgam
plug / composite
 Endodontic treatment and coping
 Endodontic therapy with cast coping
utilizing some form of Attachments
 Submerged vital roots.
Coping Attachments

12. Treatment planning :
The sequence and technical procedures of preparatory
treatment remains the same for all kinds of tooth
supported dentures
The only difference is in the design of the abutment teeth
The following sequence can be used as a general guide but
not necessarily in all situations
Construct an immediate Rx claspless denture & cast from
irreversible hydrocolloid impression
Remove the hopeless teeth & insert the removable prosthesis
During healing period institute the periodontal and
endodontic treatment

13. PREPARATION OF RETAINED TEETH
►Tooth preparation for minimal retention
Sufficient tooth structure is removed to provide favorable
root crown ratio to allow the insertion of the artificial
prosthesis in an acceptable esthetic position & in a
favorable occlusal relation with the teeth of opposing
arch
Extend a chamfer type margin slightly beneath the free
gingival margin
Taper the preparation in occlusogingival direction
The finished tooth with attached coping is the male
member of the denture & the female member is a part of
the denture base
The occlusal or incising surface must be a dimension
suitable to provide an area for placing of a concavity in
the coping to accommodate CoCr bearing with radius of
the concavity slightly more than the radius of curvature
of the bearing

15. Patients who benefit from
mandibular Overdentures
 Are usually elderly (65 to
80+ years)
 Are edentulous in the
maxilla and mandible
 Have worn complete
dentures for many years
 Are uncomfortable with a
complete mandibular
denture
 Demand stabilization of
denture
 If not yet edentulous, they
exhibit extremely reduced
residual dentition that
cannot be maintained
Patients who benefit from
maxi Overdentures
• Are in the younger segment Of
older patients (50 to 60 years)
• Have no experience with
maxillary removable prosthesis
• Exhibit hopeless residual
maxiliary dentition
• Are fearful of becoming
edentulous
• Have high esthetic demands
• Have natural teeth or fixed
mandible
• Desire fixed reconstruction
IMPLANT OVERDENTURE
INDICATIONS

16.  Minimum anterior bone loss; prevents bone loss
 Improved esthetics
 Improved stability (reduces or eliminates prosthesis
 movement)
 Improved occlusion (reproducible centric relation
 occlusion)
 Decrease in soft tissue abrasions
 Improved chewing efficiency and force
 Increased occlusal efficiency
 Improved retention
 Improved support
 Improved speech
 Reduced prosthesis size (eliminates palate flanges)
 Improved maxHlofacial prostheses
Implant Overdenture Advantages

18. Implant Overdenture Disadvantages
 Abutment crown height space required
 Long term maintainence
 Food impaction
 Continued posterior bone loss

19. REFERENCES
 Sheldon Winkler : Essentials of complete denture.
Philadelphia W.B. Saunders Co. 1977.
 Harold W. Preiskel : Precision Attachments in
prosthodontics : Over dentures and Telescopic
prosthesis vol. 2. Chicag, Quintessence Publishing
Co., Inc. 1985.
 Judson C. Hickey., George A. Zarb, and Charls L.
Bolender : Syllabus of complete dentures. 12th edition,
St. Louis, The C.V. Mosby Company 1985.
 Charles M. Heartwell, Jr., and Arthur O. Rahn :
Syllabus of complete denture. Fourth edition.
Philadelphia. Lea and Febiger 1986.

20.  Glossary of Prosthodontics terms, 8th edition
 Castillo, LaMar Jr, and Carlo Ercoli. Maxillary and
mandibular overlay removable partial dentures for the
treatment of posterior open-occlusal relationship: A
clinical report J Prosthet Dent 2002;87:587-92
 Carl E. Misch. Dental implant Prosthodontics, 2005.
 Feine & Carlson. Implant Overdentures, 2003.
 Removable Overdenture. Dental Clinics North
America 1990.
 Complete denture. Dental Clinics North America
1977.