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ODQ Fact Sheet – Complete removable dentures

ODQ Fact Sheet – Complete removable dentures

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ODQ Fact Sheet – Complete removable dentures

Setting the scene

In the minds of some patients, the term braces still has a negative image of being removed. In the face of real and undeniable progress in dentistry, the question remains: is it still possible to lose your teeth today? The answer is yes. This remains a daily reality that some patients have to face. This is why the removable full denture is still an important part of the dentist’s treatment armoury. While everything led us to believe that progress in prevention in all areas of dentistry would allow the conservation of teeth, and that implant techniques would eventually provide patients with a “third dentition”, there are still clinical situations where anatomophysiological or even socio-economic conditions prohibit implants and force patients to adapt to conventional full dentures. Finally, one should not consider total edentulism as a fatality, and one should keep in mind that the conventional complete prosthesis, far from losing ground, remains omnipresent in the dentist’s daily practice.

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The prosthetic project

The prosthetic project must first of all be in harmony with the objectives shared by the patient and the dentist. The objective of a complete removable prosthesis is to ensure the natural appearance of all facial expressions. It is important that the prostheses give the illusion of natural teeth: they must harmonise with the face, age and personality of the patient. The treatment of total edentulism is based on three important points: the restoration of the masticatory function, the approval of the aesthetics by the patient and the patient’s ability to adapt. Therefore, an accurate diagnosis and evaluation of the condition of the upper and lower arches is essential. To achieve these goals, the dentist will have the following means at his disposal.

• Study models: to study the topography of edentulous areas on one arch and then of the two arches between them.

• Radiological assessment: to analyse the quality of the underlying bone.

• Osteo-mucosal assessment: an edentulous arch is not always ready to receive a prosthesis. The “conditioning” of the tissues is a very important step which must allow a prosthetic construction in optimized conditions, on supporting tissues which have become healthy again.

Once all these means have been used and the anatomical context has been analysed, the dentist can propose a treatment plan.

Mouth preparation

Because the synthesis work previously described in the prosthetic project sometimes highlights the presence of unfavourable anatomical elements, both osseous and mucosal, it may happen that in certain cases, the improvement of the functional or even aesthetic prognosis must go through a preparatory phase. This preparation may range from the simple application of a tissue conditioner, as in the case of mucosal irritation, to the need for so-called pre-prosthetic surgery. The clinical problems are different in the upper and lower jaw and the most common clinical situations are as follows :

• impacted tooth, residual root, foreign body, bone spicule, etc.: as a general rule, any tooth or debris in or near a submucosal position or with foci of infection should be removed;

• Oral exostosis, mandibular torus, palatal torus (excess bone or bony lump): as a general rule, when these represent a serious impediment to the fabrication of a prosthesis part, their surgical removal should be performed;

• frenectomy, gum hypertrophy, etc.: as a general rule, it is necessary to correct or even eliminate these risk factors of a therapeutic failure, by means of an adapted pre-prosthetic phase.

Finally, it is important to remember that if surgery is considered, the dentist must be able to predict the post-operative results. In other words, is the surgery really necessary? And will it be beneficial?

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ODQ Fact Sheet – Complete removable dentures

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