Single complete denture

part 1
Dr.Mohammed Al sayed
11/3/2008

:Definition
A single complete denture is a
complete denture that occludes
against some or all of the natural
teeth, a fixed restoration, or a
previously constructed removable
partial denture or a complete
.denture

Construction and delivery of*

single complete dentures is more
complicated than the delivery of
upper and lower complete
.dentures on a patient

:There are four reasons for this increased difficulty

The ability of the patient to generate heavy
.1
occlusal forces, due to the existence of opposing
.
natural teeth
The unsuitability of the denture foundation tissues .2
(mucosa) to resist high occlusal forces from the
opposing natural teeth, which results in advanced
.
bone loss of the residual alveolar ridges
Supraeruption of the opposing natural teeth
.3
produces an unharmonious occlusal plane, and
minimizes the vertical space for setting the
. opposing denture teeth
Mesial drifting of the opposing natural teeth results in .4
an increased mesial axial angulation (tilting) which
produce an unharmonious occlusal plane

The dentist may be able to overcome the

problems associated with the single
complete denture By Applying the
:following
a. All fundamental steps in denture
construction must be followed and
completed to perfection( without minor
. errors)
b.The occlusal plane of the natural teeth in
the opposing arch must be made
.
harmonious

Maximizing the ability of the denture

supporting tissue to withstand
:destructive occlusal forces
The denture base borders should have the.1
maximum extension within the functional
anatomical limits. In this way the forces of
occlusion will be distributed over the largest
possible area of the denture supporting
.tissue

Causes of occlusal problems and

:fracture of denture bases
Occlusal stress on the maxillary
.1
denture and the underlying
edentulous tissues from the
. opposing natural dentition
The position of the mandibular teeth, .2
which may not be probably
aligned to achieve bilateral balance
.
for stability
. Flexure of the denture base.3

Single complete denture may be

:opposed by one of the following
.Natural teeth.1
Fixed restorations.2
.A removable partial denture.3
.An existing complete denture.4

Single complete denture opposed.1

:by natural teeth
The most common complete denture is
a complete upper denture and lower
.natural teeth
In evaluating the natural dentition
:the following should be checked
.Uneven alignment of teeth.1
Example: Tipping and extrusion
.Character of the occlusal surface.2
Natural teeth often exhibit varying
steepness of the cusps and/or associated
. abrasion and wear

.Cross-bite relationship.3
Number and position of the natural.4
.teeth
The stability of the single upper denture
during function is directly
proportional to the number of
.posterior with which it occludes

Complicating factors for the single

mandibular complete denture opposing
:natural teeth
The denture supporting tissues for the
mandibular complete denture is relatively
small when compared to the maxillary
. supporting tissue
The mucosa and submucosa overlying the
periostium and bone of the lower residual
.
ridge is thin
For the above two reasons, the underlying
bone is extremely prone to resorption
. from occlusal forces of the natural teeth
Solution: consider extraction the healthy
upper teeth, since the long term health of
. the mouth is at stake

.1

.2
.3
.4

There are two situations When a

mandibular complete denture, opposing
:upper natural teeth are accepted

When the patient has a class III jaw

.1
relationship. This occur when the mandible
is larger than normal or the maxilla is
. smaller than normal
When the patient has a cleft palate, either with .2
. the cleft partially open or closed

Difficulties found with maxillomandibular

jaw relations for the single maxillary
:denture
A. The finalized maxillary wax occlusal rim may not be
parallel to the ala - tragus line, since the
opposing occlusal surfaces of the mandibular
natural teeth will dictate the angulation of the
. occlusal plane
b. The labiolingual thickness of the anterior wax
occlusal rim will interfere with establishing the
correct vertical dimension of occlusion, if the
future anterior teeth arrangement will require
vertical overlap. (fig. A)
c. Occlusal rim occlusion: The anterior-lingual
portion of the maxillary anterior wax rim must be
made thin, in order to allow the lower incisors to
produce the correct vertical overlap for
establishing the correct vertical dimension of
occlusion, which will be less than the vertical
dimension of rest. (fig. B)

Occlusal modification requirements for

the opposing mandibular natural /restored
:teeth
Assess the occlusal plane. One method is to use an .1
occlusal template, in order to assess the relation
of the occlusal surfaces of the teeth to the
.occlusal template
The occlusal surfaces of the natural teeth can be
ground or restored to give a more suitable
. occlusal plane

.2

Grossly malpositioned teeth can be considered for

. extraction or for orthodontic repositioning

.3

Occlusal modification are best experimentally

performed upon mounted diagnostic casts in
order to determine the feasibility of occlusal
.
grinding or for restorations

.4

Occlusal adjustment-Perfecting the plane

of occlusion:
:
Two methods
:1st method
a. Mount the maxillary edentulous cast and the
mandibular cast on a semi-adjustable articulator
using
an arbitrary facebow and a centric relation
record at
.the established vertical dimension of
occlusion
b. Make a protrusive record and set the horizontal
.condylar guidance ( condyle angle)
c.Set the upper artificial teeth one by one on the
denture base and adjust the lower occluding stone teeth
(by scraping) in order to establish a
harmonious occlusal plane. Mark the area of the
stone
.
teeth that have been altered

d. When a favorable occlusal plane and articulation of

the teeth have been achieved, the occlusal
adjustment are then carried out on the natural
teeth in the mouth using the marked diagnostic
. cast and the trial denture set up as guides
e. After the occlusal adjustment have been made in the
mouth ,a new impression of the natural teeth is
obtained, a new centric relation record is made,
and the new lower cast is mounted on the semi. adjustable articulator
f. The maxillary artificial teeth are rearranged for
harmony in centric relation occlusion and in
extrusive movement. The next clinical step is the
try in of the trial wax up maxillary complete
. denture

:2nd method
a. Use an occlusal metal template. The inferior surface
of the template is slightly convex. The ideal
occlusal plane is established when all the incisal
edge and occlusal cusps touch this metal
occlusal plane resulting in a slightly occlusal
.plane of the mandibular teeth
b. The metal template is placed on the incisal and
.
occlusal surfaces of the lower stone cast teeth
Cusps and incisal edges which are too high or too
. law are identified

c. The high stone cusps are reduced with sharp knife

until there is an even contact of all teeth to the
curved occlusal plane template. Reduced areas
on the stone teeth are marked on the cast by
.
pencil
d. The occlusal adjustment are then carried out on the
natural teeth in the mouth, using the pencil
. marked diagnostic cast as a guide