CONSEQUENCES OF TOOTH LOSS

OBJECTIVES OF A PROSTHESIS
 Consequences of tooth loss
• Loss of Function
– Mastication
– Speech
• Loss of Facial Support (Esthetics)
• Residual Ridge Reduction
– Variable amount and rate in
• Different individuals
• Different parts of mouth
• Different times
Extra oral changes
Intra oral changes
WHAT ARE THE OBJECTIVES OF A PROSTHESIS?

• Preservation of remaining natural tissues.

• Rehabilitation of Function
• Aesthetics
• Adequate support
• Stability
• Retention
PRESERVATION

Preservation of what remains in the oral cavity by avoiding

• Dentist and prosthesis induced trauma to the tissues
• Promoting oral hygiene and health
 The artificial dentition
should restore
REHABILITATION Mastication
OF FUNCTION,

Speech
ESTHETICS

•Artificial teeth should look

normal and natural

•Shade, Shape, form, texture,

lip and cheek supports
STABILITY AND SUPPORT
STABILITY AND SUPPORT

• Stability: Ability of a prosthesis to resist the horizontal

and oblique forces

• Support: Ability of a prosthesis to resist the tissue

ward movements
Supporting structures

❑ Bone
❑Mucosa
❑Teeth (in partially dentate patients)
What are the primary stress bearing areas in
maxilla and mandible ?
STABILITY
Design of the denture

• Polished surfaces
• Mandibular lingual flange
• Occlusal plane
• Quality of impression
STABILITY IN FIXED PROSTHESIS (RESISTANCE FORM)
CHECKING STABILITY

• Pressure is applied with the finger on premolar and molar

regions of each side
• Pressure must be given at right angles the denture base
• Lack of stability is when the pressure applied on one side
causes the denture to move to other side
WHAT ARE THE OBJECTIVES OF A PROSTHESIS?

• Preservation of remaining natural tissues.

• Rehabilitation of Function
• Aesthetics
• Adequate support
• Stability
• Retention
RETENTION
It is the ability of a denture to resist vertical forces of
displacement,
Or
The quality of a prosthesis to resist the forces of
dislodgment/displacement along the path of insertion
or removal

The quality of the prosthesis to resist the forces that tend to

move it away from the tissues
 TYPES OF RETENTION
1.Physical
2. Physiological (Muscular control)
3.Psychological
4. Mechanical
5. Adjunctive
 PHYSICAL FORCES OF
RETENTION
COHESION AND ADHESION
ATMOSPHERIC PRESSURE
INTERFACIAL SURFACE TENSION
GRAVITY
 2. Physiological means of retention
(Muscular control of prosthesis)

Depends on
1.The ability of the patient to acquire the necessary
skill to keep the denture in place
2. The design of the dentures.
DESIGN OF THE DENTURE
• Maximum extension within the physiological limits

• Correct placement of the occlusal plane

• Buccal and lingual flanges should be so shaped that the

musculature fits automatically
 BUCCAL FLANGE DESIGN
TO ACCOMMODATE BUCCINATOR MUSCLE)
Maxillary
Flange slopes
upwards and
outwards from
occlusal plane
Mandibular
Depression in
Flange Slope down
labial flange to
and out from
accommodate
occlusal plane
the mentalis
muscle
TONGUE ;lingual flange should slope towards the
center of floor of the mouth.
OCCLUSAL PLANE
Cheeks

Neutral zone

Tongue
3. PSYCHOLOGICAL MEANS OF RETENTION

• Behavior
• Intellect
• Internal
Motivation
4.MECHANICAL MEANS OF RETENTION
ANATOMY OF THE DENTURE BEARING AREA

Undercuts, Rotational insertion paths and Parallel walls

• Mild to moderate undercuts of the
• Maxillary tuberosities,
• Maxillary premolar areas and
• Distal lingual areas
very effective in enhancing retention
• Changing the path of insertion or
• Giving rotational path of insertion
CLASPS AND PRECISION ATTACHMENTS
MECHANICAL
RETENTION IN FIXED
PROSTHESIS
• Retention form in
the preparation
(shape of the crown
preparation)
• Luting Cements
5. ADJUNCTIVE MEANS OF RETENTION
DENTURE ADHESIVES
• powder, cream or liquid
• applied to the tissue surface
of the denture to increase
denture retention, stability
and performance
INDICATIONS FOR DENTURE ADHESIVE

• When technically correct well made dentures do not

satisfy the patient’s perceived retention and stability
• Patients with salivary dysfunction
• Neurological disorders
• Patients with surgical/traumatic resections or
modifications of oral cavity
CONTRAINDICATION

• Poorly fitting or improperly fabricated prosthesis

• Hypersensitivity to any components