Retention, stability and support

for complete denture

C.D. is a mechanical object in a biological environment

to ensure success of C.D. dentist must understand

physical, mechanical and biological .

Treatment objectives :

• Pt. education…..clean…expectation…

• Restoration of esthetic…smiling, facial form,

lip, cheek, wrinkles.

• Improvement of mastication…chewing (dif.)

• Improvement of speech

• Preservation of remaining oral structure….ill fitting denture…resorption

• Maintenance of health and comfort of mouth…sharp borders od

denture …injury…recall pt.

• Health of TMJ …all above in general

Pattern of restoration in the maxilla and mandible.

• Mandible: downward and outward.

• In maxilla : upward and inward.

• End result
• Mandible : becomes wider
• Maxilla : becomes smaller
Retention:
• If the denture has to function well ………..it must be retentive.

• Retention is the means by which the denture held in mouth if

denture is easily dislodged during speech eating it would be very
embarrassing

• Retention : is the resistance to removal in direction opposite that

of its insertion
Dislodging forces:
• The act of chewing of foods
• Adhesive nature of certain foods
• Gravity
• Surrounding musculature (cheek, tounge, soft palate)
• Premature contact
Primary retention:
• Physical means
• Mechanical means

Secondary retention :
• Factors contribute to stability indirectly also
contributes to retention.
Physical forces in denture retention:

• Two glass plates….not stick…at microscopic level there are

imperfections between the two glass plates
• Two glass plate with film of water between …difficult to
separate …..
The physical forces involved are:

• Adhesion
• Cohesion
• Interfacial surface tension
• Atmospheric pressure
• Capillary
• Gravity
Adhesion:
• Is the physical force involved in the attraction between two
unlike molecules.

In case of denture
• It is the attraction between the denture and saliva and between
saliva and oral mucosa.
Cohesion:
• It is the physical attraction of like molecules to each other
…molecules of the same substance together .

In complete denture :
• Saliva needs to be cohesive
Interfacial surface tension:
• It is the tension or resistance to separation developed between
two well adapted surface separated by thin film of fluid.

• Molecules on the inside attract the surface molecules inward

resulting in potential energy called surface tension

In the mouth:
prevent denture from separation at its borders.
• Atmospheric pressure:
It is the pressure caused by the weight of the atmospheric on the
earth surface.

Denture:
when an attempt is made to separate the denture, a –ve pressure
develops between denture and base and surrounding mucosa .
This activates outside atmospheric pressure which pushes denture
back toward to basal seat
Capillarity or capillary attraction:

• Causes liquid to rise in a capillary tube:

Denture:
• The space between the denture and the basal tissue acts as
capillary with saliva as liquid
Gravity:

good or bad ??

Gold denture …weight ?

Factors affecting the physical forces:

• Saliva:
Quantity/quality
Serous saliva/mucous saliva/mixed

• Surface area:
Larger surface area …better….vestibuloplasty

• Intimate contact
Good impression…good retention

• Peripheral seal:
No air ….cheek tongue
Mechanical aids in denture retention:

Undercuts:
Is the depressed portion of the sides of a ridge that flanges of denture
can engage and mechanically will retain denture.

within limit ….difficult insertion and removal

should be: unilateral undercut/mild bilateral undercuts
• Overdenture attachments
• Implants
• Mucosal inserts
• Magnetics

• Rubber suction discs

• Suction chambers
Secondary retention :
• Factors contribute to stability indirectly also contributes to
retention.

Surrounding musculture:
Should be in harmony with the denture……failure….…dislodge force
Cheek muscle:
Dislodgment if teeth placed to far buccally
flange over extended.
Lips:
unseat if teeth to far forward.

Tounge:
Teeth placed too far lingually.
Floor of the mouth:
Will raises during swallowing…instability of lower denture.
Soft palate:
If overextended or over postdammed
will cause unseating of upper denture
Neutral zone:
Is a potential space between lips and cheeks on one side and the
tongue on the other side.

The area or position where the forces between lip , cheeks and
tongue are equal teeth should be located in this space…..outside
this zone will cause dislodge of denture
Over extended denture bordes:

Cause:
• Dislodgment
• Irritation of tissue
Prevent by accurate border moldeing of the spacial tray
Coronoid process:
Dist bucca;l portion of upper denture….

dislodge when mouth opened

Occlusal schemes:

Should be smooth and harmonious even during lateral movement.

(balanced occlusion)
any interference known as (premature contact).
Another occlusal scheme is use of (zero degree or monoplane
teeth) to manimize horizontal force.
Stability:
Many of the factors affecting retention would affect stability the
main difference between retention and stability ………………

is the direction in which the dislodging forces act.

retention: the denture resist dislodging force pulling the denture

away from basal seat in a vertical direction.

The stability: denture resist forces acting in a horizontal or lateral

direction
Factors affecting stability :
• Intimate contact….with ridge…good impression
• Residual ridge size and contour
• Palatal vault
• Neutral zone and surrounding muscle
• Flange shape and contoured
• Abnormal ridge relationship
• Direct bone anchorage
Support :
• Without support denture cannot maintain retention and stability.
Support is that property which resists vertical movement or
displacement of the dentures toward the basal seat .

Importance of the support :

 By preventing tissue ward movement.
 Good support needed to improve masticatory force.
 Good support needed to maintain occlusal relationship.
Requirements of the support:

• Tissue capable of support should be firm resilient tissue covered by

keratinized tissue and which is firmly attached to the underling
bone.
• Should be uniform thickness.
• Underling bone should be resistant to bone restoration.
• The support area should be at right angle or near as possible to
occlusal force
• All area of the denture bearing area should contribute to support
except relief areas.

A greater area coverage puts less force per

unit area.Based on principle snow shoe

There are certain areas are capable of providing more support than
others(primary stress bearing area).
Factors affecting support:

• Surface area: larger…better

• Nature of supporting mucosa: resilient firmly attached better
• Impression procedure.
• Accuracy of fit
• Direct bone anchorage