OVERDENTURES

WHAT DO YOU D
O IN SUCH A CASE
?
2 OPTIONS SEEM VIABLE
THE FIRST
OPTION
TOTAL EDENTULISM !
!!
The complete denture does work ,however with passing years the
vicious cycle of bone resorption ill-fitting dentures
inflammation & further resorption even more unstable base
and so on and so forth ?
NOT A VERY HAPPY ENDI
NG !??
A tooth supported
OVERDENTURE
THE SECOND
OPTION
DDDDDDD 4DD DD4 DDDDDD DD DDD+D4D+D
DD4D4DD
D D+DDDD44DD DDDD 44DDDD4DD DD 4DD
DD+DDD D DDDDDDD4D D DDDDD4DD 4DDDDDD D
DDD4D4DD +D4D D DDDD4D DDDDD+DD DDD+ D
DDD4 DD4DD
GOALS ACHIEVED BY AN
OVERDENTURE
DDD D+DDDD44DD DDDDDDDDD D DDD
DDDDDDDDD DDD DDDDD DD D
DDDD DD DDD DDDDDDDD DDDDD
D DDD DDDD 4DDDD4 DDD
4DD DD44DD 4DD DD
D4DDD DDDDDDD
DDDDDDDDD DDDD DD DDDDDDDD
DDDD DDDDDDDDDD
DDDDDDDDDDDD DD
DDDDDDDDDDDDDD DDDD DDD
DDDDDDDDDDD DDDDDDDD D
DDDDDD D 4DD
DD4DD4D DDDD4D4D+D
DD D DDDDD 4DD
DD44DD
REQUIREMENTS OF AN
OVERDENTURE
MAINTAINENCE OF HEALTH
DDD4DDDD DD DDD4D DD 4DD 4DDDDDD 4DD4D
4D4D44DD D D4D4DD4DD 4D DDD+D4D DD
4DDD DD 4DD D+DDDD44DD
DDD DDDDDDD4D DDDD4DD DDD 4D D+D4D4DD DD
DDDDD4 DDDDD4DD DD 4D DD DDDDD4DD
REDUCTION IN CROWN : ROOT RATIO
DDD DDD4D4DD D 4DD DDD+ D DDD4 DD4DD DD D
DDDDDDD4DD DD+DDDDD DDDDD4 D 4DD 4DD4D DDDDD4D
BASAL SEAT TISSUE
DDD 4D4D DD+DDDD 4DD DDDDDDD DDD DDDD
DD4D DD DDDD DDDDDD4 D DDDDDDDD D DD
DDDDDDDDD 4D DDD+DDD DDDDDD 4DDDD4 4D 4DD
DD44DD D D D DDDDD4D DD44DD
SIMPLICITY OF CONSTRUCTION
DDD DDDDDDD DD4D DD DDD4D+DD DDDD 4D
DD4D4D4 DD DDD4DD
EASE OF MANIPULATION
DDD4D DD DDDD DDDD4D4DD DD 4DD DD4DD4
DD4D 4DD 4D DD DD+DDDD DD4DDDD DD+DDD DDD
DDD D44DDDDD4 DD 44D D44DDDDD4 D 4DD
DD4DD4 DDD 4D4DDD 4D DDD4 DD DDDD+D 4DD
D+DDDD44DD
ADVANTAGES OF AN
OVERDENTURE
1.PRESERVATION OF ALVEOLAR BONE
DDDDD+DD 4DD 4DD4D DD4DD D4 DD 4DD
D+DDDD DDD 4DDDD4DD 4DD 4DD4D D44 DD 4DD
D+DDDD DDD DDDDDD4 4D 4DD 4DD4D
2. PRESERVATION OF THE PROPRICEPTIVE RESPONSE
DDDDD+D4DD DD 4DD DDDDDDD4D DDDDDDD 4DDD 4DD
D+DDDD44DD 4DD DD4DD4 DDDDD4D4 DD4D+D
DDDD4D 4D DD D+DDD DD DDD4D DD4DD4
DDD DDD DDDDDDDD4DD DDDD
D D+DDDD44DD DD4DD4 4D
DD4DD 4DD DDDDD DD DDD4DD
D DDD4 D DDDDD DDDD D
D DD4DD4 +D4D D44DD 4DD4D
3. SUPPORT
DDD D44DD 4DD4D 4DD DD D D+DDDD44DD
DDD+DDD DDD D 4D4DD D 4DDD DDD 4DDDDDDD
DD DD DD+D4DDD DD44DD
4. RETENTION
DD4D4DD D DDDDD+DD DD DDDD D+DDDDDD 4DD
4DD4D D44 DD DD DDD4DDDD DDDDDDD DD 4DD
D44DDDDD4 D 4DD 4DD4D
5. A SIMPLE APPROACH TO A PROBLEM PATIENT
DD4DD4 +D4D DDDDD4D DDDDD4 4DD D DDD4
DDD4D D DDD4DD DDDD4DDD DDDDDDD4DD DD DD
DDD+DDDD +D4D D DDDDDDD D DDD4D+DD DD4 DD
DDDDDD+D DDDD DD 4DDD4DD4
6. PERIODONTAL MAINTAINENCE
DDDD4D 4DD DD44DD4 4DD4D DDD DDDD DDDDDDD D
4DD DD4DD4 D DDD 4D DDD4DD 4DD DDDDDDD4D
DDD4D 4D D DD4DD4D D+D
7. PATIENT ACCEPTANCE
DD4DD4 DDD DD4
DDDDDDDD4D+D DD 4DD
4DDD4DD4 DDDD4D DD 4DD
4DDDDD DDDDD+DDD4 D 4DD
D4D4DD D D4DD4DD +DDD
4D DDD4DDDD DDD DD
4DDDD D+ 4DD4D
8. COST
D4DD4DD 4DD 4DDD4DD4 D DDDD44D+D +D4D
DDDDD4DDD DDDDDDD4D D DDD4DDDD4DD DDDDDD4D
4DD 4D4D DD+DDD D+D+DD D 4DD DDD DD
DDD4DDDD D D+ DDDDD4DDD DD DDDDDD DDD4DDDD
DDDD 4DD DD4 DD D D+DDDD44DD +DDD DD+DDDDD
9. HARMONY OF ARCH FORM
DD4DDDD DDD DD 4DD D44DD 4DD4D D 4DD DDDD
DDD4DD 4DD DDD4DD DDDD DDD D DD DDDDDD DD
4DDD
DISADVANTAGES OF AN
OVERDENTURE
1. CARIES SUSCEPTIBILITY
DDDDD4 DDDDDDD+ DD D+DDDDD DD44DD4 4DD4D D D
DDDD4 DDDDDD DD 4DDD DD D4 DD+D DD4 DDDDD
DDD DD4DD4 DD 4D DDD4DD DD4DD4D4 DDD
DDDDDD DD DD 4D 4DDDDD D D4DDDDD 4DDD4DD4
D4 DDDDDDDD D4DD+D
2. BONY UNDERCUTS
DDD 4DDDD44 DDDDDDD 4DDD DD4D DDDDDD4
4D 4DD DD44DD4 4DD4D
D 44DD D4DDDD D DDD DDD D DDDDDD 4D
DDDDDD4 DD 4DD DDDD DD44DD DDDD D DDD
DDDDDDDDD4DD 4D 4DD 4D4D 4DDDDDD 4DD DDD
4DDDD44
DDD 4DDDD44 DDD DDD 4D DD DDDDDD D44
DDDDDD 4DD D4DDD DD DDDD DDDD D+DD DDDD 4DD
4D4D DDDD4DD D DDDD 4DDD DD D4DDDDDDD +D4D
DDDDDDDDD DD
D4DDD DD4DD D 4D DDDD 4DD DD44DD DDDD
DDD4 DDDDDDDDDD 4DD D4DD4DD
3. OVERCONTOUR
DDDDD+D DDDDDD D44 DD 4DDDD44 DDD DDD
4D 4DDDD D44 DD 4DD DDDD DDDD DD+DD
DDDDD+D DD D4D DD D+DD DD4D4DDD
DDDDDDDDD DDDDDDDDDD 4DD D4DD4DD
4. UNDERCONTOUR
DD DD D DDD4 DDDDD DD44DD 4D D+DDD D+DDD
DDD 4DDDD44 DDD DDD 4D D 4DDDD DD4D4DDD
DD44DD DDDDDDDDDD 4DDDD4D D DD4D4DD DD
D4DD4DD DD 4DD D+DDDD44DD
5. ENCROACHMENT OF THE INTEROCCLUSAL SPACE
DD4DDDD 4DD 4DD4D 4DDD 4DD D+DDDD44DD
DDDDDDD DD DDD DDDD DD D44DDDDD4 D 4DDD
DDDDDDDD 4DD 4DD D4DDDDD4D DD4DDD
DDD DDDDDDDDD 4DD
4DDDDD DD 4DD
DD44DD DDDDDDD
4DD DDD DD DD44DD
DDDD44DD
DDDD 4DD
DDDDDDDD4 DD
DD4DDDDDD 4DD4D
DDDDDD44
6. ESTHETICS
D+DDDD4D4DDD DD 4DDDDD4D4DDD DD44DD DDDD
DD DDDDDDDDD D4DD4DD
7. PERIODONTAL BREAKDOWN OF ABUTMENT TEETH
DD 4DD DD4DD4 DDD 4D
DDD4DD D DDDDD DDD DDDDDD
DDDDDDD D DDD4D DDD4D4D4DD D
DDDDDD4DD DDDDDD4 DDDDD4DD D
D DD 4DDDD4DD DDD DDD DDD4D
PATIENT SELECTION
1. POSSIBILITY OF FIXED OR REMOVABLE PATIAL DENTURES
DD 4DD DDDDDDD D44DD 4DD4D DDD DDDDDD DD
4DDDD4DD D DDDDD DD DDDD+DDD DDD4DD DDDDDDD
D 4DD D+DDDD44DD 4DDD4DD4 DD DD DDDD
D+DDDDD
2. ENDODONTIC THERAPY
DDDD4D D DD44DD4 DDD 4DD D+DDDD44DD D44
DD 4DDD4DD DDDDD4DDDD 4D DD+ DDD 4DDDDDD4
DDD4D4DD DD 4DD DDDDD DDD+ D D4 D44 DD
DDDD4DDDD 4DD4 4DDDD4 DDDDD4DD DD DD
DDDDDDDDD
DDDDDD DD4DD4 +D4D DDD DDD4DD 4DD4D +D4D
DD DDD 4DD4 DD DD DDDD DDD4DD4DD D DDD
4DD DD4 DDDDDD4D 4D DD 4DD D DD44DD4 4DD4D
3. PERIODONTAL CONDITION OF THE ABUTMENTS
DDDDDDD4D D+D4D4DD D D DDD4DDD 4DDD D
4DD DD4D4D4DD DD D D+DDDD44DD
DDDDDD4DDD DDDDD4 DDDDD4DD D DDD DDDDD4 DD
D DDDD DDD DD D44DDDDD DDDD+D D44 DD
DDDDD4DD DDDDDD DDDDDDDD 4DDD4DD4
4. CARIES
DDD DDDDDD DD D DDDDD DDDD D DD 4DD DD44DD4
4DD4D DDD DDDDD DDDD D 4DD DDDDDD 4D DD D
D+DDDD44DD DD4D DD DDDD4D D4D4DDDD
DDDD+DD DDDDD DDDDD DDDD DD44DD4 4DD4D
DD4D DD 4DD D DD4D DD DDDDD4DDDD
4DDD4DD DD DD+DDDD +D4D DD4 DDDDD
D DD4DD4D4 DDD DDDD
DDDDDDD DD D4DDDDD
4DDD4DD4 DD4D DD DDD+DDDD
5. YOUNG PATIENTS
D DD4D DD4DD4 +D4D DDDDD4D DD DDD4DDDD
DDDDDD D D+DDDD44DD 4DDDDDD +D4D DDD4DDDDD
DD 4DD4D DD 4DDDD4DD DDD D DD4D DD
DDDDDDDD D+DD DD4DDD4DD DD 4DD4D
6. LOCATION OF ABUTMENT TEETH
DDD 4DD4D DDD DD4 4DD4 D DDDD DD DDDDD4D
DDD4D DDDDD DD DDDDD DDDDD4DD DD4D4DD
DDD D4DDDDD DDDD4 DD 4DD DDDD4D DDDDD
DDDDDDD DDDDD4DDD D +DDD 4DDD4DDD 4D
DDDDD D D DDDD DD DDDDDDD DDD +D4DDD
4DD4D 4D DD DDDDD+DD D 4DD DDDD
DDDDD4DD DDDD DDD DD4 DD4D 44DDDDD
DDDD4D 4DDD DDD 44DD 4DD4D +DDDD DDDDD DDDD
DDDDD+D4DD DD 4DD4D D DD4D DDDDD DDD
D+DDDD44DD D4DD DD44DD 4DDDD4 D DDD
DDDDD+D4DD D +D D DDD4DDDD 4DD DDD4D
+DD4DDD DDDDDD
7. ECONOMICS
DDD DD4 DD D+DDDD44DD 4DDDDDD D DDD4D+DD
D 4DD D4DDD DDDD DD DDDDDD DD4DDD4D+D
4DDD4DD4
DD+D+DD +DD +D DDDDDD DDDDD4DDD DDDDDDD D
D+DDD 4DD4DD DDDDDDD4D 4DDDDDD D 4DD
DDDDDD4D DD DD4 DDDDD D D44DDDDD4D4DD DD4
DD 4DD DDDD DD 4DDDDDD DD DDDDDDD4
DDDDDDDDD D4D 4DDD4DD4 DD DD4D DD DDDDD4D
D+D4D4DD D 4DD4 4DD 4DDD4DD4 DD DD D DDDD
D4DDD4D+D 4D DDDDD4D DD44DD DDD D4D
DD4DD4
VARIOUS TECHNIQUES
1. SIMPLE TOOTH MODIFICATION & REDUCTION
2. TOOTH REDUCTION & CAST COPING
3. ENDODONTIC THERAPY WITH AMALGAM PLUG
4. ENDODONTIC THERAPY WITH CAST COPING
5. ENDODONTIC THERAPY AND CAST COPING UTILIZING
SOME FORM OF ATTACHMENT
SIMPLE TOOTH MODIFICATION & REDUCTION
In this procedure remaining teeth are merely reshaped to eliminate undercuts
and reduced in vertical height , if necessary , to create more interridge space
for the overdenture
However , care should be taken that the teeth will not become sensitive to the
oral environment including the contact of the overdenture
This technique is used when the interocclusal space is greater and the patient
has a low caries index
TOOTH REDUCTION AND CAST COPING
In this technique, the teeth are reduced and covered with cast copings to
prevent sensitivity and for caries control
Endodontics is not done on these teeth
This approach is possible only when the teeth have an adequate bone support
and a good periodontal prognosis, because with this method there is only a
minimum reduction in the crown : root ratio
There should be adequate interocclusal space to accommodate the height of
the tooth
ENDODONTIC THERAPY & AMALGAM PLUG
The technique is indicated when there is normal coronal height to the teeth &
normal interocclusal distance with little or no loss of vertical dimension
In order to create enough space for the overdenture without increase in the
VD, the teeth have to be drastically reduced (usually to the gingival level) ---
endodontic therapy is required
After the endodontic therapy , the tooth is sectioned around 1-2 mm above the
gingival level and an amalgam restoration is placed into the exposed root canal
ENDODONTIC THERAPY & CAST COPING
The procedure and indications are similar to the previous technique with the
exception that a casting is placed on the endodontically treated tooth
The casting is made shallow dome shaped with the margin slightly
supragingival
Retention is gained from a short post that is placed within the root canal
ENDODONTIC THERAPY WITH CAST COPING UTILIZING SOME FORM OF
ATTACHMENT
This approach is reserved to situations which require significant improvement in
stability and retention
Low caries index, proper home care and periodontal health (adequate bone
support) are extremely essential
The use of attachments require sufficient interocclusal space
STUD ATTACHMENTS
BALL ATTACHMENT WITH O RING
Posts with ball shaped heads are
cemented in the root canals
DDDD DDDDDDDDDD DDDD DDDD DDDDDDD
GERBER ATTACHMENT
DALBO ATTACHMENTS
DDDDD
DDDDDDDDD DDDDDD DDDDDD
CEKA ATTACHMENTS ( MALE & FEMALE PORTIONS)
ZEST ANCHOR ATTACHMENTS
MAGNETS
BAR ATTACHMENTS
DOLDER BAR ATTACHMENTS
ACKERMAN BAR & CLIP ATTACHMENTS
HADER BAR ATTACHMENT
THE THIRD
OPTION
AN IMPLANT SUPPOR
TED
OVERDENTURE the
3
rd
dentition
Framework for Implant supported overdentures
THE FINAL IMPLANT
SUPPORTED
OVERDENTURE