Prof. Dr.

Ahlam El-Sharkawy

Introduction
Extraction of teeth followed by continuous ridge resorption & poor denture foundation Loss of periodontal receptors responsible for proper masticatory function & accurate jaw movements

Retention of few remaining teeth to support denture will preserve alveolar bone & preserve periodontal receptors

Definition of overdentures
Complete or partial denture constructed over existing teeth, roots or implants for providing additional support, stability & retention

Called also: Overlay denture Overlay prosthesis Superimposed prosthesis

Types 0f over-Dentures.
-Tooth supported over-dentures.

- Implant supported over- denture.

Prof. Dr. Ahlam El-Sharkawy

Indications
1. 2.

3.
4. 5.

6.
7.

Cases having few hopeless teeth unsuitable as abutments for fixed or removable bridges Patient having few remaining teeth with periodontal disease. Patient with abnormal jaw size or position Patient with congenital or acquired defects Patient with single denture Patient exhibit flat ridges Prof. Dr. Ahlam El-Sharkawy

Contraindications
Mentally or physically handicapped 2. Patient cant be motivated to develop good oral hygiene 3. Inadequate intermaxillary space 4. Teeth with grade III mobility or insufficient zone of attached gingiva
1.

1- submerged roots
Abutments roots are endodontically treated .

Reduced in height to a level below gingival margin

2- dome shaped abutment with amalgam plug mmmmmm

Abutments reduced to be 1-2 mm above gingival margin to reduce lateral force & torque Endodontic treatment is necessary The root canal is filled with gutta percha
The opening is sealed with amalgam plug.

The abutment is contoured to attain dome- shape. Used in patient with low caries index &good oral hygien.

3- dome shaped abutments with cast copings

Abutment are endodontically treated & reduced to 1-2 mm above gingival margin Metal dome shaped cast coping constructed to cover abutment

The metal coping has a short post cemented into root canal to retain the coping

4- abutments with telescopic crowns

Abutment teeth are either vital or endodontically treated & contoured to tapered configuration Tapered metal copings constructed &cemented over abutments

Denture constructed with metal crowns having veneered facings

5- abutments with slight tooth reduction & cast copings

Abutments are minimally reduced
With or without endo treatment

Covered with cast metal coping long coping abutment. This type is rarely followed because it
requires adequate ridge space

6- abutments with simple reduction & slight modification

Abutments slightly reduced & contoured to eliminate undercuts
Rarely used, cases with partial anodontia or enough inter ridge space

7- abutments with an added form of attachment

Endodontically treated, reduced & covered with metal coping Coping has a long post to help retention Attachment added either by soldering or during wax pattern

Types of tooth supported Over-dentures

1.

Immediate over-denture

2. Interim over-denture

3. Remote or definitive over-denture

4. Attachment retained over-denture

Immediate overdenture
Constructed prior to preparation of abutment teeth & ready for insertion after preparation& reduction It enhances patients ability & adaptability to wear dentures

Interim overdenture
Used for patients in transition or preparation phase until permanent overdenture constructed Patient old partial denture can be modified & used by extending the denture & add new artificial teeth using self cure acrylic resin

Remote or definitive over-denture

Conventional complete over-denture constructed over 1 or more abutment teeth Could be made entirely of acrylic resin or in conjunction with metal bases

Attachment retained over-denture

Constructed with an incorporated attachment to improve retention More expensive & more time for construction Indicated for patient with good oral hygiene & low caries index The abutment teeth should have good periodontal condition & adequate bone support

Types of Attachments
a) Rigid attachment

Doesnt allow movement of denture base Provide adequate retention May induce more torque on abutment b) Resilient attachment Allows some control of movements. Induces less torque on abutments.

Over-Denture Attachment could be in the form of:

1- Stud Attachments.

2- Bar attachments.

3 Magnetic Attachments.

1- Stud attachment
Consists of 2 parts

The stud usually attached to metal coping cemented over prepared abutment Housing embedded in the fitting surface of overdenture

1- Stud attachment
Extra-Radicular : The stud is attached to the metal coping cemented over the prepared abutment, while the housing is embedded in the fitting surface of the denture. e.g : Ceka , Rotherman, Gerber

1- Stud attachment
B- Intra-Radicular: The stud is attached to the fitting surface of the denture and the housing is incorporated in the abutment. e.g : Zest Anchor eg

2-Bar attachment
A bar contoured to connect abutment teeth together , run parallel & overlie residual ridge Provide support & retention for overdenture & splint abutment teeth

Bars may be in form of preformed metal or plastic

A- Bar units
Rigidly fixed to copings, dont allow any movement between bar & sleeve Transmits occlusal stresses totally to abutments tooth born

B- Bar joints
Resilient attachments allowing movement between bar & sleeve Support provided by both residual ridge & abutment teeth tooth tissue born

3- magnetic attachments
Small, strong mini magnets

One of poles cemented in a prepared cavity in endodontically treated abutment & the other attached to denture base