Escolar Documentos
Profissional Documentos
Cultura Documentos
INTRODUCTION
INTRODUCTIONContd..
DEFINITION
Analternativewaytodefinean overdenture
Synonyms
Overlaydentures Onlaydentures Hybriddentures Superimposeddentures Telescopeddentures Biologicdentures Copingprosthesis
HISTORY
1856 LEDGER prescribed a prosthesis resembling an overdenture. His restorations were referred to as plates covering fangs, but the principle was similar. 1888 EVANS described a method for using roots to retain restorations 1896 ESSIG described a telescopiclike coping. 1870 there is also evidence to suggest that overdentures were being made in the UK.
HISTORY
1906 HUNTER said whatever the reasons for retaining roots, they were normally devitalized. This type of construction therefore lost favor when the focal sepsis scare was at its peak. 1916 PEESO was employing removable telescopic crowns at this time. Later on, the bar type of construction was developed.
GOALS Thereare3importantgoalsofoverdentures:
Maintains teeth as part of the residual ridge
1. 2.
3.
Alveolar bone exists as a support for teeth An increase in the patients manipulative skills in handling the denture
Overdentures
Tooth supported
implant supported
non Coping
coping
attachments
stud
bar
magnets
CLASSIFICATION
BASEDONTYPEOFOVERDENTURE
1.Immediateoverdenture 2.Transitionaloverdenture
ADVANTAGES,DISADVANTAGES, INDICATIONSANDCONTRAINDIATIONS
ADVANTAGES
ADVANTAGES
ADVANTAGES
ADVANTAGES
ADVANTAGES
Convertibility Conversiontocompletedenture
INDICATIONS
INDICATIONS
EXAMINATION,DIAGNOSIS,TREATMENT PLANNINGANDPROGNOSIS
EXAMINATIONOFTHE OVERDENTUREPATIENT
TREATMENTPLANNING
ABUTMENTSELECTION
Evaluatefor
1. 2. 3. 4.
Roleofendodontictreatment inthepreparationofabutment
QuadretandTripod configurations
COPINGPREPARATION
Acopingisacoverfortheexposedtoothsurface. Castmetalcopingswithadomeshapedsurfaceandachamfer finishlineatthegingivalmargin Shortcopings Longcopings
CASTCROWNCOPINGS
ATTACHMENTSFOROVERDENTURES
ATTACHMENTSINOVERDENTURES
Attachmentsaresmallprecisiondevices Theyareincorporatedtoprovidesomeadditional benefitslikeretentionandsupport Moreretentioncanbegainedbylengtheningthe postandtheuseofpins Itconsistsoftwounits: Male female
REQUIREMENTSFORTHEATTACHMENTS
Thepatientsshouldhavealowcariesindex Performproperhomecare Soundperiodontalhealth Abutmentteethwithproperbonesupport
DISADVANTAGESOFATTACHMENTS
Addedtime Maycauseincreasedstressonthetooth Moredifficulttoconstruct Requirescarefulmanipulationbythe patients.Thereforeisnotofuseforthe mentallyandphysicallyhandicapped
DISADVANTAGESOF ATTACHMENTS
STUDATTACHMENTS Malestud solderedtothe basewhichisacopingcovering thepreparedtoothstump Femalehousing thisis embeddedintheacrylicofthe ODoritissolderedto substructureintheOD Maleandfemaleattachments maybeeitherresilientornon resilient
RIGIDTYPEGERBERATTACHMENT
Mostpopularandwidelyused Malepostthreadedontoascrew attachedtoasolderingbase Female:overallhousingcontaininga retentionspring Retentionisbymeansofaspringclipin thefemaleengagingagrooveinthemale section
RESILIENTFORMGERBERATTACHMENT
Malestud:hasasolderingbasewithadifferent retentionpost Femalehousing:containsamountingring, bushing,andaretentionringwithaspring Morebulky adequateinterocclusalspacemust bepresent Complicatedtouseandfrequentreplacementof theringisessential Torquecanoccurifdenturebasesupportis inadequate
DALBOATTACHMENT
Rigid,resilientorthestressbreakertype Malepartissolderedtothetoothandthe housingtothebase Therigidtypehasacylindricalmaleunitwith aroundedhead Theresilientisthesmallestandthemost commonlyused. Rotationalandverticalmovementpossible becauseofreliefspacersbetweentheunits Retentioninthisisbytheflexiblearmsofthe femaleunitfittingovertheundercutheadof themaleunit
CEKA ATTACHMENT
Malepartaffixedtothetoothandhas aroundedshapewideratthetopand splitverticallyinto4sections.They areflexibleandcanbecompressed Femalehousingfitsoverthis Theattachmentcanalsobe constructedwithadifferenttypeof retentionmalethathasaspace betweenthepartstoallowboth rotationalandverticalmovements
ZESTANCHOR
Idealforinterimoverdenture Derivesitsretentionfromwithintheroot Apostprepismadewithintherootandthe femalesleeveiscementedintoplace Maleportionconsistsofanylonpostanda ballheadattachmenttotheoverdentureasa chairsideprocedure. Thepostisplacedinthesleeveandthe overdentureisplacedoveritwithaselfcure resin
ADVANTAGES
Overcomes any space problem Leverage to the abutment tooth is reduced Attachment procedure is simple Parallelism is not necessary if more than one tooth is used due to the flexibility of the nylon
DISADVANTAGES
Caries susceptibility as no coping placed Nylon stud can bend preventing seating To correct this frequent recall visits are necessary When eating foods without the OD can cause food to stagnate in the female part
ROTHERMANATTACHMENT
Types:resilientandnonresilient Resilientallowsbothverticalandrotational movement Themalepartconsistsofagroovedeeperat oneendthantheother ThehousingcontainsaCshapedringthe endsofwhichfitinthedeepestpartofthe retaininggroove Adv : noneedforparallelismwhen>1copings areused Attachmentiseasy Disadv: Duetolingualbulk,thedentureisthin andthisleadstodenturefracture
INTROFIXATTACHMENT
Tallstudattachmentcomposedofasolder baseanadjustablesplitmalepostanda femalehousing Designissimpleandprovidesfrictional attachmentbetweenthetwoparts Malestudhasalongitudinalsplitthatcanbe attachedtoprovidemoreorlessretention Thisisreplaceableasitisscrewedtothesolder base Thelengthystudcanproduceatorque potential Sousedinonlyatotallytoothsupported systemorODwithexcellentsupport
OTHERATTACHMENTS
Theotherattachmentsofimportance:
Schubigerattachment Ancrofixattachment Quinlivanattachment
BARATTACHMENTS Thepurposesofusingbarsare: Splintingofabutmentteeth Retentionandsupportoftheprosthetic appliance Thereare2types: Barunits whicharetherigidtype Barjoints whichallowsomemovementofthe rotationaltype.utilizestheresidualridgefor support
BARATTACHMENTS
DOLDERBAR
Barunit:
preformedbarwithparallelsidesand roundedtopsolderedtothecoping Sleeveispresentinthedenturebases Retentionisduetofriction Ifthepostofthecopingscannotbemade paralleltoseatthesolderedbarthena schubigerunitisused Becauseoftheparallelwallsandclose adaptation,rotationisnotpossible
Barjoint:
Eggshapedbarwithaspacer.Thisallows somemovement Difficulttoadapttotissuecontourand bulky
ACKERMANCLIPANDCMCLIP
Itconsistsofaroundbarsolderedtothepost copings Theclipfitsoverthebar Itinadditionhasretentionwingsfor engagementoftheclipintotheresinifthe overdenture Spacerissupplied,sobothrotationaland verticalmovementsareallowed Itisanexcellentchoicebecauseoftheease offixationandthesmallsize
Advantageanddisadvantageofrigidandresilient typeofattachment
MAGNETS