Single denture construction technique

 In this we consider a patient with single edentulous arch. The prevalence
of the condition where one edentulous arch opposes a natural or restored
dentition is quite common. It has been estimated that for some patient
population the mandibular canines are retained four times
longer than other teeth followed by mandibular incisions. This indicates m
maxillary arch exhibits earlier tooth loss, however the reasons are
unclear but influenced by a combination of factors.
 It is important that the clinician appreciate the oral conditions that may
predispose these patients to complications following treatment with
convectional complete dentures.

 SINGLE COMPLETE DENTURES may classified to:
 1-MAXILLARY COMPLETE DENTURE OPPOSING MANDIBULAR
NATURAL DENTITION.
 2-MAXILLARY COMPLETE DENTURE OPPOSING MANDIBULAR
PARTIAL DENTURE.
 3-MANDIBULAR COMPLETE DENTURE OPPOSING MAXILLARY
NATURAL DENTITION.
 4-MANDIBULAR COMPLETE DENTURE OPPOSING MAXILLARY
PARTIAL DENTURE.

 1-In patients with discrepancies in jaw size who require a complete
denture, it is advisable to retain teeth in mandible.
 2-In patients with inoperable cleft or perforated palates, it is
advisable to retain teeth in maxillary arch. This is because the
convectional maxillary complete denture would be a failure due to
absence of peripheral seal.

 1-Malposed, tipped or supra-erupted teeth in lower arch with
interfere with balanced occlusion.
The imbalance may produce soreness mucosal changes and
ridge resorption in maxilla and the maxillary denture will
tend to get displaced.
 2-As the lower anterior are present in a fixed position it is
difficult to obtain esthetic teeth arrangement.
 3-Use of acrylic teeth opposing natural teeth will produce
abrasion of the acrylic teeth where as use of porcelain teeth
opposing natural teeth will produce abrasion of natural teeth.

 When only one arch is edentulous tooth positions in the dentate arch
may preclude occlusal biomechanics being reached.
 Unfavorable force distributions may then cause adverse tissue
changes that compromise optimum function. It is therefore, importan
t to identify such clinical changes and correct them.

 These changes includes:
 1-Extensive morphological changes in denture
formation that can result in arch relationship or occlusal
plane discrepancies.
 2-Jaw relationship extremes.
 3-Excessively displaceable denture bearing tissue.
 4-Extensive morphological change occurring following
extraction of teeth creates horizontal discrepancy
between arches anteriorly.
 5-posteriorly and makes it difficult to direct occlusal
forces to the denture bearing surfaces.
This can be corrected by placing the tooth in a reverse
horizontal overlap or cross bite arrangements.

 6-Extremes of jaw relationship also makes it very difficult to place the denture
teeth in a position that allows the denture bearing area to be in line with occlusal
support.
This can be corrected by placing the posterior teeth in an reverse horizontal overlap or
cross bite relationship.
7-Conditions in opposing arch specially irregular occlusal plane can dispose
problems to patient with single complete denture.
 8-Selective grinding of tooth can be done as a treatment procedure.

 It is a preprosthetic procedure where occlusal discrepancies in
natural teeth are corrected. It can be done in one of the following
methods:
 1-SWENSON TECHNIQUE:
A tentative teeth arrangements is done using a diagnostic caste the
occlusal discrepancies are marked and reduction is done in patients mouth.
 2-YURKSTAS TECHNIQUE:
A ‘U” shaped slightly convex metal plate is positioned over natural teeth and
the occlusal discrepancies are recorded.
These discrepancies are reduced in diagnostic cast. The reduced cast is used
as guide to reduce the natural tooth.

 3-BRUCE TECHNIQUE:
The occlusal discrepancies are arbitorly reduced in diagnostic cast. An
acrylic resin template is made over reduced cast. The natural teeth are
reduced till acrylic plate sets properly against them.
 4-BOUCHER TECHNIQUE:
The cast are articulated using a tentative jaw relation. Artificial
porcelain teeth are set on edentulous cast and this arrangement is
made to more against the teeth of opposing cast. As porcelain is hard
it will abrade the natural teeth.
The denture is processed and finished During insertion the abraded
opposing cast is used. as a guide to reduce the occlusal discrepancies
of natural teeth in patients mouth.

YURKSTAS TECHNIQUE BRUCE TECHNIQUE
BOUCHER TECHNIQUE

These dentures are maxillary complete dentures opposing a complete set of
mandibular natural teeth.
Gross occlusal discrepancies are common and require occlusal adjustments
and orthodontic correction.
 Some important points to be considered during the construction
of these dentures are:
1-The morphology of natural teeth will determine the selection of the artificial
teeth.
E.g.,. The size and shade of artificial teeth should match the natural teeth.
2-If mandibular teeth are attriated, 0° or cusp less teeth are preferred.
3-If mandibular teeth are not attriated, anatomic teeth are preferred.

These dentures are clinically very significant due to their complications. Teeth
selection is very important in fabrication of the denture.
Artificial teeth for these dentures are selected based on following factors:
1-Porcelin teeth > If opposing partial denture has porcelain teeth.
2-Acrylic teeth > If opposing natural teeth have gold or metal crowns.
3-Acrylic teeth > If opposing natural teeth or partial denture with artificial
acrylic teeth.

1-Combination Syndrome.
2-Wear of natural teeth.
3-Fracture of the denture.

It was identified by Kelly in 1972 in patients wearing a maxillary
complete denture opposing a mandibular distal extension denture
base.
SYMPTOMS:
1- Loss of bone of maxillary anterior ridge.
2- Down growth of maxillary tuberosity.
3- Papillary hyperplasia to hard palate tissue.
4- Extrusion of mandibular anterior teeth (over-eruption).
5- Loss of bone under removable partial denture.

When porcelain teeth are used, severe abrasion of the opposing natural
teeth will occur.
Thus proper selection of tooth material is important. Care to be taken
to avoid occlusal discrepancies.

This condition is common in cases with single complete denture,
as the denture with receive excessive load from the natural teeth:
1-Excessive anterior occlusal load.
2-Deep labial frenal notches.
3-High occlusal load due to excessive action of masseter.

PRECAUTIONS:
1-Check the occlusion.
2-Maintain adequate thickness of the denture base.
3-Do not deepen the labial notch.

Mandibular single dentures can either be opposing a fully dentulous maxilla or
a maxillary partial denture.
There is severe ridge resorption of edentulous mandible.
Due to two reasons:
1-Constant movement of tongue add forces on the residual ridge increasing the
amount of resorption.
2-Amount of firmly attached mucosa to the denture bearing area is less in
mandible than in maxilla.

This condition can be best treated using endo-osseous implants after through
evaluation of the patients.
When clinician is unable to provide the option of endo-osseous implants, then
treatment using single complete denture is provided.
However many clinicians believe that use of resilient liner in mandibular
dentures beneficial.
With such a procedure the dentist attempts to provide stress reducing element
in the denture base to resist the forces of functional and Para-functional loads.

Single denture construction technique

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Single denture construction technique