OVERDENTURES

K SAI AKHIL
II MDS
DEPT OF PROSTHODONTICS
CONTENTS
 INTRODUCTION
 DEFINITION
 HISTORY
 RATIONALE
 REQUIREMENTS
 INDICATIONS
 CONTRAINDICATIONS
 ADVANTAGES
 DISADVANTAGES
 CLASSIFICATION
 ATTACHMENTS
 DIAGNOSIS, TREATMENT PLANNING AND CASE SELECTION
 VARIOUS TECHNIQUES
 SELECTION OF ABUTMENT TEETH
 PREPARATION OF ABUTMENT TEETH
 IMPLANT SUPPORTED OVER DENTURES
 RECENT DEVELOPMENTS IN OVERDENTURE THERAPY
 LABORATORY PROCEDURES
 CONCLUSION
 REFERENCES
INTRODUCTI
ON
 DEFINITIO
N
GPT-9

Harold W.Preiskel
SYNONYMS
Overdentures

Hybrid prostheses

Overlay dentures.

Telescopic dentures.

Biologic dentures.

Overlay prosthesis.

Superimposed prosthesis.
 HISTOR
Y
Ledger (1856) : Plates Covering Fangs
Atkinson (1861) : Increasing Awareness
Evans (1888) : Method Of Using Roots Actually To Retain Restorations
Essig (1896) : Telescopic-like Coping
W. Hunter (1909) : Focal Sepsis Theory
Rothman (1976) : Hunter’s Commend Gave Dentistry A Black Eye
Gillmore & Peeso (1916) : Support Stability And Retention
Fenton AH. The decade of overdentures: 1970-1980. The Journal of
prosthetic dentistry. 1998 Jan 1;79(1):31-6.
RATIONALE FOR
OVERDENTURE
 GOAL
S
• Maintaining teeth as a part of residual ridge

• Decrease in the rate of bone resorption

• Increase in manipulative skills in handling the denture

 REQUIREMEN
TS
1. Maintenance of health

2. Reduction in crown-to-root ratio

3. Basal seat tissue

4. Simplicity of construction

5. Ease of manipulation

6. Other Requirements
INDICATIONS
CONTRAINDICATIONS

• PERIODONTAL

• ENDODONTIC
More specific contraindications are the diagnostic findings such as
Vivek R, Chaturvedi TP, Bhatnagar A. Tooth-Support over Dentures: An
approach to Preventive Prosthodontics.
ADVANTAGES

1. Preservation Of Alveolar Bone

2. Preservation Of Proprioceptive Response

3. Support

4. Retention

5. A Simple Approach To The Problem Patient

6. Periodontal Maintenance
7. Patient Acceptance

8. Convertability

9. Cost

10. Harmony Of Arch Form

11. Minimal Post Insertion Problems

12. Equally Effective Or Superior Method Of Treatment

13. Stability

14. Open Palate Possible

15. Reversibility

16. Less Trauma To The Supporting Tissues And Stabilization Of Existing Structures

17. Ease In Cleaning

18. Possibility Of Using Attachments Or Soft Liners

DISADVANTAGES:
1. Caries Susceptibility

2. Bony undercuts

3. Overcontour

4. Undercontour

5. Encroachment of the interocclusal distance

6. Esthetics

7. Periodontal breakdown

8. Expense
Dixit S1 , Acharya S2 Benefits of overdentures Journal of Nepal
Dental Association (2010), Vol. 11, No. 1, Jan.-Jun., 97-100
Crum RJ, Rooney Jr GE. Alveolar bone loss in overdentures: a 5-year
study. The Journal of prosthetic dentistry. 1978 Dec 1;40(6):610-3.
 CLASSIFICATI
ON
According to the
nature of support

Tooth Implant
supported Supported
 According To
Indication Spectrum

Immediate Transitional Definitive

Overdentures Overdentures Overdentures
 According To The
Method Of Abutment
Preparation

Non coping coping Attachments

Morrow And Brewer
1. Immediate

2. Transitional

3. Remote

Heartwell classified overdentures on basis of abutment preparation, as

1. Non coping with simple tooth modification with endodontic treatment and
without endodontic treatment.
2. Coping.

3. Attachments
4. Submerged vital roots
Prieskel
1. Transitional overdentures.
2. Training overdentures.
3. Immediate overdentures.
4. Definitive overdenture.
 ATTACHMEN
TS
According to shape, design and primary area of use .
A) Coronal B) Radicular
- Intracoronal attachments - stud attachments
- Extracoronal attachments - Bar attachments
i. Resilient i. joints
ii. Non resilient ii. Units
Accessory
5. Auxillary attachments
Magnets
a. Screw units
b. Pawl connectors a. Permanent

c. Bolts magnet.

d. Stabilizers/Balancers b. Induced magnet.

e. Interlocks
c. Open field.
f. Pins/screws
d. Closed field.
g. Rests
A. Supporting Elements (Non Retentive)
1. Root sealed with amalgam, composite, or glass ionomer cement.
2. Gold copings without attachment.

B. Retentive Attachments
1. Single attachments.
2. Attachments mounted directly in to root canals with no copings.
3. Attachments soldered to copings.
4. Bar attachments.
5. Telescope attachments
Retentive Attachments:
Consists of two parts
• Male
• Female

Functions
Retentive Mechanism

Rigid

Non rigid

 Rigid attachment

 Non rigid attachment

Rutkunas V, Mizutani H, Takahashi H. Evaluation of stable retentive
properties of overdenture attachments. Stomatologija. 2005 Jan 1;7(4):115-
20.
 STUD ATTACHMENTS

According to Allen A. brewer,

• resilient studs
• non resilient studs:
Stud attachments are further classified into:

• Extraradicular attachments

• Intraradicular attachments
INDICATIONS
Rutkunas V, Mizutani H, Takahashi H, Iwasaki N. Wear simulation effects
on overdenture stud attachments. Dental materials journal.
2011:1111220201
Gerber Attachments
Dalbo Attachments
Ceka Attachments
Zest Anchor
Rothermann Attachments
Introfix Attachment
Schubieger Attachment
Quinlivan Attachment
Magnets
Bar Attachments
 Depending on number

Single sleeve bar Multiple bars

Depending on movement

• Bar units: permit no movement between bar and sleeve (solid/rigid).

• Bar joints: permit rotational movement between bar and sleeve (resilient)
Hader
Dolder
Morrow, R. M., et al. Immediate interim tooth-supported complete dentures.
J Prosthet Dent 30:695-700, 1973.
DIAGNOSIS, TREATMENT PLANNING
AND CASE SELECTION

• History
• Examination
• Articulated diagnostic casts
• Full mouth radiographs
• Overall patient concerns
Patient Age

Factors influencing selection of abutment teeth

• Periodontal status

• Mobility

• Location

• Endodontic considerations

• Cost
Thayer, H. H. Overdentures and the periodontium. DCNA 24:369-377,
1980.
Alnafisah AM, Mahmoud MR. Tooth Supported Overdenture as an Amazing
Solution for the Patient: A Case Report. International Journal of Dental
Sciences and Research. 2019 Apr 19;1:21-4.
 VARIOUS TECHNIQUES FOR TOOTH
PREPARATION
Simple Tooth Modification and Reduction

Tooth Reduction and Cast Coping

 SELECTION OF ABUTMENT
TEETH
Acc. to Morrow and Brewer
- Anterior teeth
- premolars
- Molar teeth
Acc. to Zarb
Most commonly used abutments
Factors – influence abutment selection

Acc to zarb

-Periodontal and mobility status

-Abutment location

-Endodontic and prosthodontic status

 PREPARATION OF ABUTMENT

• TEETH
Preparations for supporting elements with no dowel copings

• Tooth preparation for Dowel-copings

• Preparation for thimble shaped or telescope prosthesis

Kraljevic I, Glenz F, Jordi C, Zimmermann SD, Joda T, Zitzmann NU.
Long-term observation of post copings retaining overdenture prostheses. Int
J Prosthodont. 2020 Mar 1;33:169-75.
Endodontic Therapy and Amalgam Plug
 Endodontic Therapy and Cast Coping

Endodontic Therapy with Cast Coping Utilizing Some Form of

Attachment
Dodge CA. Prevention of complete denture problems by use of
“overdentures”. The Journal of Prosthetic Dentistry. 1973 Oct 1;30(4):403-
11.
Ettinger RL, Qian F. Abutment tooth loss in patients with overdentures. The
Journal of the American Dental Association. 2004 Jun 1;135(6):739-46.
IMPLANT-SUPPORTED
OVERDENTURES
Implant Supported Overdentures And Its Advantages
Implant Overdenture treatment options

Maxillary Implant Overdentures

Mandibular Implant Overdentures

Toolson LB, Smith DE. A five-year longitudinal study of patients treated with
overdentures. The Journal of Prosthetic Dentistry. 1983 Jun 1;49(6):749-56.
TOOTH-BORNE MANDIBULAR
OVERDENTURES
Burns DR. The mandibular complete overdenture. Dental Clinics. 2004 Jul
1;48(3):603-23.
Sadowsky SJ. Treatment considerations for maxillary implant overdentures:
a systematic review. The Journal of prosthetic dentistry. 2007 Jun
1;97(6):340-8.
Sadowsky SJ. Mandibular implant-retained overdentures: a literature
review. The Journal of prosthetic dentistry. 2001 Nov 1;86(5):468-73.
 RECENT DEVELOPMENTS IN OVERDENTURE
THERAPY
Submucosal Vital Root Retention
Patient and tooth selection

Presurgical requirements

Surgical procedure

Post surgical care

 Laboratory Procedures

Coping Fabrication
Impression For The Denture
Record Bases And Occlusal Rims Recording Maxillo Mandibular Relations

Tooth selection

Trying the denture

Denture Insertion
Maintenance And Follow Up Care

• Oral Hygiene Instruction

• Care Of The Abutment Teeth

• Care Of The Overdenture

• Recall Visits And Examinations

Thomason JM, Lund JP, Chehade A, Feine JS. Patient satisfaction with
mandibular implant overdentures and conventional dentures 6 months after
delivery. International Journal of Prosthodontics. 2003 Sep 1;16(5).
Andreiotelli M, Att W, Strub JR. Prosthodontic complications with implant
overdentures: a systematic literature review. Int J Prosthodont. 2010 May
1;23(3):195-203.
CONCLUSIO
N
REFERENCES:
• Sheldon Winkler. Essentials of complete denture prosthodontics. 2 nd ed. Ishiyaku Euro
America, inc; 1996.
• Prosthodontic treatment for edentulous patients- Zarb-Bolender 12 th edition
• Arthur O. Rahn, Charles M. Heartwell, Jr. Textbook of complete dentures. 5 th ed. Lea
& Febiger, 1993.
• Allen A.Brewer,Robert M.Morrow:overdentures,C.V.Mosby company 1990
• Harold W. Preiskel Overdentures Made Easy A Guide to implant and root supported
prostheses
• Fenton AH. The decade of overdentures: 1970-1980. The Journal of prosthetic
dentistry. 1998 Jan 1;79(1):31-6.
• Sadowsky SJ. Mandibular implant-retained overdentures: a literature review. The Journal
of prosthetic dentistry. 2001 Nov 1;86(5):468-73.
• Maeda Y, Horisaka M, Yagi K. Biomechanical rationale for a single implant ‐retained
mandibular overdenture: an in vitro study. Clinical oral implants research. 2008
Mar;19(3):271-5.
• Van Kampen FM, Van Der Bilt A, Cune MS, Fontijn-Tekamp FA, Bosman F. Masticatory
function with implant-supported overdentures. Journal of dental research. 2004
Sep;83(9):708-11.
• Thomason JM, Lund JP, Chehade A, Feine JS. Patient satisfaction with mandibular implant
overdentures and conventional dentures 6 months after delivery. International Journal of
Prosthodontics. 2003 Sep 1;16(5).
• Andreiotelli M, Att W, Strub JR. Prosthodontic complications with implant
overdentures: a systematic literature review. Int J Prosthodont. 2010 May 1;23(3):195-
203.
• Crum RJ, Rooney Jr GE. Alveolar bone loss in overdentures: a 5-year study. The Journal
of prosthetic dentistry. 1978 Dec 1;40(6):610-3.
• Sadowsky SJ. Treatment considerations for maxillary implant overdentures: a systematic
review. The Journal of prosthetic dentistry. 2007 Jun 1;97(6):340-8.
• Jallad WA, Owda J. Implant Overdenture-A Review to High-light the Concept. J Dent
Oral Health Cosmesis. 2020;5:015.
• Ettinger RL, Qian F. Abutment tooth loss in patients with overdentures. The Journal of
the American Dental Association. 2004 Jun 1;135(6):739-46.
• Kraljevic I, Glenz F, Jordi C, Zimmermann SD, Joda T, Zitzmann NU. Long-term
observation of post copings retaining overdenture prostheses. Int J Prosthodont. 2020
Mar 1;33:169-75.
• Vivek R, Chaturvedi TP, Bhatnagar A. Tooth-Support over Dentures: An approach to
Preventive Prosthodontics.
• Samra RK, Bhide SV, Goyal C, Kaur T. Tooth supported overdenture: a concept
overshadowed but not yet forgotten!. Journal of Oral Research and Review. 2015 Jan
1;7(1):16.
• Rutkunas V, Mizutani H, Takahashi H. Evaluation of stable retentive properties of
overdenture attachments. Stomatologija. 2005 Jan 1;7(4):115-20.
• Gulizio MP, Agar JR, Kelly JR, Taylor TD. Effect of implant angulation upon retention
of overdenture attachments. Journal of Prosthodontics: Implant, Esthetic and
Reconstructive Dentistry. 2005 Mar;14(1):3-11.
• Chen IC, Brudvik JS, Mancl LA, Rubenstein JE, Chitswe K, Raigrodski AJ. Freedom
of rotation of selected overdenture attachments: an in vitro study. The Journal of
prosthetic dentistry. 2011 Aug 1;106(2):78-86.
• Rutkunas V, Mizutani H, Takahashi H, Iwasaki N. Wear simulation effects on
overdenture stud attachments. Dental materials journal. 2011:1111220201-.
• Alnafisah AM, Mahmoud MR. Tooth Supported Overdenture as an Amazing Solution
for the Patient: A Case Report. International Journal of Dental Sciences and Research.
2019 Apr 19;1:21-4.
• Dixit S1 , Acharya S2 Benefits of overdentures Journal of Nepal Dental Association
(2010), Vol. 11, No. 1, Jan.-Jun., 97-100
• Burns DR. The mandibular complete overdenture. Dental Clinics. 2004 Jul
1;48(3):603-23.
• Miller, P. A. Complete dentures supported by natural teeth. J Prosthet Dent 8:924-
928, 1959.
• Morrow, R. M., et al.
Tooth-supported complete dentures: An approach to preventive prosthodontics. J
Prosthet Dent 21:513-522, 1969.
• Morrow, R. M., et al. Immediate interim tooth-supported complete dentures. J
Prosthet Dent 30:695-700, 1973.
• Dodge, C. A. Prevention of complete denture problems by the use of overdentures. J
Prosthet Dent 30:403-411, 1973.
• Thayer, H. H. Overdentures and the periodontium. DCNA 24:369-377, 1980
• Toolson, L. B. and Smith, D. E.
A five-year longitudinal study of patients treated with overdentures. J Prosthet Dent
49:749-756, 1983
• Ullo, C. A. and Renner, R. P. Design considerations for a removable partial overdenture.
Compend Contin Educ Dent 5:15-19, 1984.
• Casey, D, M. and Lauciello, F. R. A review of the submerged root concept. J Prosthet Dent
43:128-132, 1980.