Overdenture
Overdenture is any removable dental prosthesis that covers and rests on one or more remaining natural teeth, the roots of natural teeth, and/or dental implants.[1] It is one of the most practical measures used in preventive dentistry. Overdentures can be either tooth supported (conventional / immediate) or implant supported. It is found to help in the preservation of alveolar bone and delay the process of complete edentulism.[2]
Alternative Terminologies
- Overlay Denture
- Hybrid Prosthesis
- Telescoping Denture
- Tooth Supported Denture
- Onlay dentures
- Superimposed dentures
Types
Overdentures can be classified into 2 categories, depending on the types of abutment providing support:
Tooth-supported
This type of overdenture overlies natural tooth structures. Frequently, elective root canal treatment and coronal modification are carried out on the teeth that are used as abutments. This means that the pulpal tissues and crowns of the natural teeth are removed, followed by contouring of the tooth structure above the gum. This allows even distribution of occlusal stress onto the abutment teeth and soft tissues. [3] Other than that, retention of natural teeth in the jaw helps preserve bone by delaying the process of bone resorption in the jaw. [4]
Selection of abutment teeth depends on a few factors including:[1]
- Location
To provide adequate support, there should be one abutment tooth per quadrant and the abutment should ideally be a canine.
- Prognosis
The teeth selected to provide support should be healthy i.e. not decayed and no/ manageable gum disease, thus ensuring long term retention in the jaw.
- Feasibility of endodontic treatment
Most of the time, the crown of the abutment teeth has to be removed to allow space for placement of overdenture without interfering the bite. Therefore, the pulp has to be removed. If the root canals of the abutment teeth are obliterated, endodontic treatment is not required. Teeth with non-negotiable root canals should not be selected as abutments.
Implant-supported
Edentulous patients with sufficient amount of bony ridge on their jaws can opt for implant supported overdenture.[3] This type of over denture gains support from both the dental implants and intraoral tissues. Having implant-supported overdenture provides better stability of prosthesis and reduce bone resorption.[5] However, a conventional complete denture can be considered as an alternative due to less treatment time needed.[6]
Indications
Retention and Stability
- If prescribing a removable prosthesis and there is limited remaining firm teeth in the dentition an overdenture may aid in retention and stability compared to that of a conventional removable prosthesis[7].
Preventative Dentistry
- The use of an overdenture delays the process of leaving the patient completely edentulous and assists in the preservation of bone[7].
- As a main priority for many dentists and patients, preventative dentistry is a reason for prescribing an overdenture as it retains the natural teeth for longer[8].
Patient Anatomy
- Overdentures can be useful for patients with a severe ridge defect or bone resorption[9].
- Patients who have unfavourable tongue positions and muscle attachment for a conventional removable prosthesis could find that an overdenture has increased retention and stability[8].
- If the patient has a superficially placed mental nerve, then the preferential choice of treatment may be to leave certain teeth in place in order to prevent damage to the nerve and prescribe an overdenture for any aesthetic needs[9].
Protection of Root Canal Filling
- An overdenture can be prescribed for a patient who has just had a root canal treatment completed to protect the coronal seal of the tooth if they are waiting to have fixed prosthodontics carried out on the tooth.
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Advantages
- Preservation of alveolar bone[10]
- Providing stability and retention
- Improving masticatory efficiency[11]
Disadvantages
| This section is empty. You can help by adding to it. (June 2018) |
Research & evidence
A 10 year observational period found that implants which supported overdentures in the mandible had a survival rate ranging from 91.7% to 100%.[12] Furthermore, implant survival rates with respect to their attachment system were found to be best for the ball type attachment which was an average of 95.8 - 97.5%, followed by the bar and magnet ranging from 96.2 - 100% , and 91.7% respectively.[13]
References
- ^ Glossary of Prosthodontics. Vol. Volume 117. May 2017.
{{cite book}}:|volume=has extra text (help); Cite has empty unknown parameter:|dead-url=(help) - ^ Samra, Rupandeep Kaur; Bhide, Shreenivas Vasant; Goyal, Chhavi; Kaur, Taranjit (2015-01-01). "Tooth supported overdenture: A concept overshadowed but not yet forgotten!". Journal of Oral Research and Review. 7 (1).
- ^ a b Bansal, Siddharth; Aras, Meena A.; Chitre, Vidya (December 2014). "Tooth Supported Overdenture Retained with Custom Attachments: A Case Report". Journal of Indian Prosthodontic Society. 14 (Suppl 1): 283–286. doi:10.1007/s13191-013-0340-0. ISSN 0972-4052. PMC 4502008. PMID 26199532.
{{cite journal}}: CS1 maint: PMC format (link) - ^ Samra, RupandeepKaur; Bhide, ShreenivasVasant; Goyal, Chhavi; Kaur, Taranjit (2015). "Tooth supported overdenture: A concept overshadowed but not yet forgotten!". Journal of Oral Research and Review. 7 (1): 16. doi:10.4103/2249-4987.160172. ISSN 2249-4987.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Lambade, Dipti; Lambade, Pravin; Gundawar, Sham (May 2015). "Implant supported mandibular overdenture: a viable treatment option for edentulous mandible". Journal of clinical and diagnostic research: JCDR. 8 (5): ZD04–06. doi:10.7860/JCDR/2014/7711.4332. ISSN 2249-782X. PMC 4080073. PMID 24995252.
{{cite journal}}: CS1 maint: PMC format (link) - ^ Visser, Anita; Meijer, Henny J. A.; Raghoebar, Gerry M.; Vissink, Arjan (May 2006). "Implant-retained mandibular overdentures versus conventional dentures: 10 years of care and aftercare". The International Journal of Prosthodontics. 19 (3): 271–278. ISSN 0893-2174. PMID 16752625.
- ^ a b Samra, Rupandeep Kaur; Bhide, Shreenivas Vasant; Goyal, Chhavi; Kaur, Taranjit (2015-01-01). "Tooth supported overdenture: A concept overshadowed but not yet forgotten!". Journal of Oral Research and Review. 7 (1).
- ^ a b http://www.thejpd.org/pb/assets/raw/Health%20Advance/journals/ympr/Castillo.pdf.
{{cite web}}: Cite has empty unknown parameter:|dead-url=(help); Missing or empty|title=(help) - ^ a b Bansal, Siddharth; Aras, Meena A; Chitre, Vidya (2014-01-01). "Guidelines for treatment planning of mandibular implant overdenture". Journal of Dental Implants. 4 (1).
- ^ Dodge, Charles A. (1973-10). "Prevention of complete denture problems by use of "overdentures"". The Journal of Prosthetic Dentistry. 30 (4): 403–411. doi:10.1016/0022-3913(73)90161-3. ISSN 0022-3913.
{{cite journal}}: Check date values in:|date=(help) - ^ Awad, Manal A.; Feine, Jocelyne S. (1998-12). "Measuring patient satisfaction with mandibular prostheses". Community Dentistry and Oral Epidemiology. 26 (6): 400–405. doi:10.1111/j.1600-0528.1998.tb01978.x. ISSN 0301-5661.
{{cite journal}}: Check date values in:|date=(help) - ^ Kim, Ha-Young; Lee, Jeong-Yol; Shin, Sang-Wan; Bryant, S. Ross (2012-11). "Attachment systems for mandibular implant overdentures: a systematic review". The Journal of Advanced Prosthodontics. 4 (4): 197–203. doi:10.4047/jap.2012.4.4.197. ISSN 2005-7806. PMC 3517957. PMID 23236571.
{{cite journal}}: Check date values in:|date=(help) - ^ Kim, Ha-Young; Lee, Jeong-Yol; Shin, Sang-Wan; Bryant, S. Ross (2012-11). "Attachment systems for mandibular implant overdentures: a systematic review". The Journal of Advanced Prosthodontics. 4 (4): 197–203. doi:10.4047/jap.2012.4.4.197. ISSN 2005-7806. PMC 3517957. PMID 23236571.
{{cite journal}}: Check date values in:|date=(help)