Removable Dentures
Removable dentures, or just dentures is a removable prosthetic work that replaces some or all of our natural teeth and soft tissues that have been lost.
Advantages
* have relatively low cost compared to fixed prosthetics (crowns/bridges)
* fast and relatively easy process
* enhances facial aesthetics by replacing teeth and soft tissues that have been lost
Disadvantages
* in cases of resorption of the bone shrinkage of the gums creates a problem in their retention and stability, in this case special glue is required
* difficulty in speaking and chewing the first days after placement. Patients need to be patient until they become familiar
* removable dentures should be checked by the dentist frequently, as they wear and may need to be corrected or replaced
* care should be taken in the way you wash the dentures so that they do not break. Use a nylon toothbrush and soap to remove food remnants every day.
Removable dentures are divided into 7 categories
The total denture replaces all of your missing teeth from the dental arch
Indications:
• in all cases where there are no teeth at all in the mouth.
* as a temporary solution before implant placement
Contraindications:
* organic diseases such as: cancer, uncontrolled diabetes, parkinson’s disease, aids, etc.
* psychological disorders or dementia that prevent understanding the difficulties of treatment
* advanced age where multiple extractions are avoided
* radiation therapy due to severe risk of osteonecrosis
* patients with gag reflex
* Seizures
Advantages
* patients adaptation is relatively easy
* Aesthetic solution since it changes not only the smile but also the face in general
* Affordable
* Long duration
Disadvantages
* it takes some time to adjust to a new kind of chewing and talking.
* in case of large bone loss and therefore gum loss, retention is difficult and may require special glue.
* after some time dentures may need repairs or replacement , due to bone resorption and loss of the gums.
Direct removable total denture is the denture manufactured before the extraction of natural teeth and placed immediately after their extraction for immediate aesthetic result.
Indications:
* all cases where there are no teeth in the mouth and the patient wants immediately ‘’new’’ teeth, mainly due to aesthetic reasons.
Contraindications:
* Diseases such as: cancer, uncontrolled diabetes, parkinson’s disease, aids, etc.
* psychological disorders or dementia that prevent understanding the difficulties of treatment
* advanced age where multiple extractions are avoided
* radiation therapy due to severe risk of osteonecrosis
* patients with gag reflex
* seizures
Advantages
* patient adaptation is relatively good
* immediate aesthetic solution since it changes not only the smile but also the face in general, just after the extraction of teeth
* affordable
* long life span
Disadvantages
* Multiple extractions and direct placement of the denture create a general malaise in the mouth for a few days
* due to the presence of teeth during impressions, its fitting is usually not good and needs repairs few weeks after delivery.
Replaces the missing teeth and rest on the natural teeth with metal clasps
Contraindications:
* aesthetic reasons
* young patients
Advantages
* better retention compared to removable total dentures
* can be repaired or adjusted in case of subsequent loss of a natural tooth
* affordable
* relatively high strength
Disadvantages
* aesthetics, because metal clasps are sometimes visible
* if metal clasps rest on natural teeth, they are damaged over time, so it is always recommended to have crowns on the teeth that will clasps will rest. So additional costs.
* there are teeth that are not suitable for placing clasps on them, and the placement of a crown on them is necessary to allow the clasps to rest on them. So additional costs.
Indications
* in cases where last teeth are missing, in this case a bridge cannot be placed.
* in periodontal patients
* Economic reasons
Replaces the missing teeth and rests on crowns with special precision attachments or telescopic crowns (special removable crowns)
Advantages
* adaptation of the patient is clearly easier since they are very stable
* it is a more esthetic solution, than the other removable partial dentures, since there are no visible parts.
Disadvantages
* higher cost than a conventional partial denture
*there are many conditions in the distribution of teeth in the mouth to allow the placement of that type of denture
*in case of fracture of the braces, the patient is charged with new construction costs and adjustments to the partial denture, if possible
Indications
* in cases where the therapeutic solution is partial denture and distribution of teeth in the mouth allow it and the patient prefers aesthetic solution
Contraindications
* in periodontal patients where there is a risk of future tooth (braces) loss
* improper distribution of teeth in the mouth
The Transitional Partial aesthetic denture replaces the missing teeth and rests on the natural teeth with flexible aesthetic clasps. It is preferred for a temporary solution because of its low durability.
Advantages
* adaptation of the patient is easier than other removable prosthetics
* generally a good temporary aesthetic solution
Disadvantages
* not amenable to repair or readjustment.
* It is not as durable as other mobile prosthetics
Indications
* in cases where certain teeth are missing and the patient asks for a temporary aesthetic solution
Contraindications
In patients seeking a durable permanent solution
A kind of Total denture applied natural teeth roots. The logic is the same as the implant supported overdenture with the only difference that in this case, natural tooth roots are used. For the upper jaw, 3 – 5 supports are required in order to reduce as much as possible the dentures palate and for the lower jaw 2 supports.
Advantage
* increased stability of the denture with better retention and support
* Relatively lower cost compared to implant supported overdenture
* Possibility of Correction or conversion in case of loss of support teeth, if possible
* lowers the bone resorption
* Better chewing ability than other removable dentures
* No adhesive glues are needed
* no risk of moving during Talking or chewing
Disadvantages
* relatively time consuming
* In case of periodontal lesions and caries, there is a chance of losing the tooth supports
* relatively high cost
Indications
Patients with satisfactory oral hygiene
Patients with extensive resorption of the alveolar bone and a conventional removable denture will not be so stable in the mouth
Patients with large tooth abrasions
Patients with few teeth
Contraindications
When another prosthetic restoration offers better results
Patients who do not maintain good oral hygiene
When teeth braces do not have a good prognosis
They are Total removable dentures applied on implants. The logic is the same as the Tooth supported Total overdenture, with the only difference that artificial (implants) roots are used. For the upper jaw, 4 – 5 implants are required so that there is no big palate at the denture and for the lower jaw 2 implants are required
Advantages
* increased stability of the dentition with better retention and support
* lowers the bone resorption
* Better chewing than other removable dentures
* No adhesive glue are needed
* No risk of moving during Talking or chewing
Disadvantages
* Microsurgical intervention in the mouth is required for the placement of implants
* Time-consuming process
* Danger of perimphyteumatitis if oral hygiene is not observed
Indications
* patients with satisfactory oral hygiene
* patients, where the total denture does not have enough stability and often is not stable even with denture glues
* Sufficient bone in the jaws
Contraindications
* when another prosthetic restoration offers better results
* patients who do not maintain good oral hygiene
* If the solution with implants does not have a good prognosis and in general all contraindications that apply for implants.
FAQ
Most frequent questions and answers
The reasons are many such as:
– Financial reasons
– Patients with moderate oral hygiene
– When teeth are not enough, or their distribution does not allow fixes prosthetics
– When there is no sufficient bone for implant placement
– When the general health of the patient does not allow us to install implants
– It is the fastest recovery solution
– Indicated in patients suffering from periodontal disease, bruxism, heavey smokers etc.
Dentures need to be checked by the dentist at least once a year because they are damaged and may need to be repaired or even replaced
There are cases of resorption of the bone resulting in the retreat of the gums, which creates a problem in the retention and stability of the dentition
There are also cases of breakage when trying to clean
It is noted that there are cases when it is not possible to repair the denture it has to be replaced
In general, however, the replacement of the denture that did not have any problems from the beginning, functional and aesthetic, is rare
You will definitely need a little practice because the way of chewing differs from the natural way. Start with soft foods, cut into small pieces, chew slowly from both sides at the same time. When you get used to it, you will start eating normally.
– Daily brushing of teeth or implants (if any), at least 2 times daily, with a soft toothbrush
– Daily thorough brushing of the denture with soap after each meal
– Place the denture every night in a glass with water and a cleaning tablet (optional). It is important that the mouth “rests” for some time from the foreign body, so during the night sleep, since it does not serve anything, the dentition should be removed.
Dentures usually last for several years, but their lifespan depends on many factors related to lifestyle, maintaining good oral hygiene, whether the teeth supports (if any) are damaged, whether the denture has become loose or has lost contact, etc.