single denture may be constructed against

Natural teeth.

Removable partial denture.

A previously constructed CD.

The single complete maxillary denture opposing all or some of the mandibular natural teeth is a very common clinical situation

Problems of single denture Excessive load from the natural teeth

Single denture syndrome.

Result of the displacement of the maxillary

denture due to unfavorable occlusal relationship as a result of Tipped Malposed Supererupted natural teeth. It is presented as Mucosal irritation and Ridge resorption

Mutilated dentition
The occlusal form of the remaining natural teeth and the uneven occlusal plane

Esthetic and phonetic problems

Due to the fixed positions of the mandibular teeth lead to difficulty placement of the maxillary teeth.

Artificial teeth selection

Abrasion of the artificial teeth if acrylic resin is used or the abrasion of

natural teeth if porcelain is used.

Mandibular single denture.

Treatment
The primary consideration is the preservation of that which remains.

Diagnosis
case history
oral examination Study upper and lower casts are obtained.

The upper cast is mounted on the articulator using a face bow.

The lower cast is mounted on the articulator using a

provisional centric inter-occlusal record at an acceptable vertical dimension. Eccentric records are made

Overcome the excessive load from the natural teeth

Maximum base extension

Balancing occlusion and free articulation.

Avoid broad inclined planes.

Common occlusal disharmonies

Tilting and supereruption of second and third molars

Treatment planning
If the molars are not severely tilted,

Selective grinding

When more than a moderate amount of tooth reduction is found necessary

Gold crowns, Onlays Fixed bridge

Orthodontic repositioning

If the molars are severely tilted and modification is not possible

Root canal treatment and over denture

If the molars are severely tilted forward and supererupted, and modification is not possible

Extraction is necessary.

Method of Modifications of Natural Teeth

Modification of the mandibular occlusal plane is carried out by selective grinding, if the irregularities are not severe by one of the following methods.

During setting the maxillary artificial teeth

Adjusted on the cast and the area is marked
The natural teeth modified using the marked diagnostic cast as a guide. A new diagnostic cast is made and mounted on the articulator. If more adjustment is necessary, the procedure is repeated. the denture teeth are reset and prepared for the try-in. While this technique is simple, it can be time consuming if several impressions and mountings will be made.

Clear acrylic template

The lower diagnostic cast is mounted. The necessary modifications are made on the stone cast occlusal surfaces. A clear acrylic resin template is fabricated over the

modified stone cast. Pressure indicating paste Interferences are readily noted through the template and are removed The process is repeated until the template seats properly.

Metal template

Maxillary porcelain teeth

The maxillary artificial porcelain

teeth are arranged to obtain the occlusal balancing contacts. The interferences are removed by movement of the maxillary porcelain teeth over the mandibular stone teeth.

Denture processed a comparison of the natural teeth and

the altered stone cast is made and the areas to be reshaped are noted. The natural teeth are ground at the areas marked on the stone cast. The occlusion is refined using an archshaped layer of softened baseplate wax

Irregular occlusal plane

The most common condition of the mandibular arch is an irregular

occlusal plane. This often occurs due to a tilting and/or extrusion of teeth following the extraction of the maxillary teeth and one or more of the mandibular teeth.

Methods Used to Achieve Balanced Articulation

After adjustment of the occlusal plane of the natural mandibular teeth, a balanced articulation for the maxillary complete denture is developed by the following method

Functionally Generated Occlusal Pathways (Chew-In Technique)

This technique provides the most accurate method of recording occlusal patterns.

When insufficient mandibular teeth are left to occlude with a complete maxillary denture.

Combination Syndrome

Combination Syndrome (Kellys Syndrome)

Consists of:
1. Loss of bone from the maxillary anterior 2. 3.

4. 5.

edentulous ridge . Down growth of the maxillary tuberosities Papillary hyperplasia of the tissues of the hard palate. Extrusion of the lower anterior teeth and, Loss of bone beneath the removable partial denture bases.

ESTHETICS

OCCLUSAL MATERIALS FOR THE SINGLE DENTURE

A- Porcelain Teeth Porcelain teeth wear very slowly and therefore the occlusal vertical dimension is maintained. Disadvantages: They are predisposed to fracture and chipping when opposed by natural teeth. They are more difficult to equilibrate since their surfaces do not mark well with articulating paper. They cause rapid wear of opposing natural teeth

B- Acrylic Resin Teeth Since acrylic resin teeth cause no wear of the opposing natural teeth and since they are the easiest to equilibrate, they are the teeth of choice. Disadvantage wear, which results in loss of vertical dimension. However, wear of the occlusal surfaces is better than resorption of the alveolar ridge. New dentures can always be made.

Acrylic Resin Teeth with Gold Occlusal surfaces Gold occlusal surfaces are considered the best material to oppose natural teeth. Disadvantages: Their expense and the time involved in their fabrication make them impractical for most patients.

Acrylic Resin with Amalgam Stops

the technique is simple and much less time

consuming and less expensive than with the gold occlusal.

E- IPN Resin
This material consists of an unfilled, highly cross-linked, interpenetrating polymer network. The wear resistance of this material is higher than that of conventional acrylic resin teeth.

MANDIBULAR SINGLE DENTURES

One situation with single dentures should be avoided at

all costs. Destruction of the bone using a resilient liner in the mandibular denture in an attempt to reduce the stresses imposed upon the denturebearing tissues. Over denture In addition to the use of resilient liners, the problems of single mandibular dentures are treated as single maxillary dentures.