Tutorial 1

Complete dentures: anatomy of

the supporting tissues
 Psychological and biomechanical
consequences of tooth loss
 Reduction of total facial height and mandibular prognathism
 Distortion on soft tissue shape. –Reduction of concavity of
lip, -flattening of philtrum,- deepening of nasiolabial
grooves,- sagging look to middle third of face, -hallowing
of cheeks, -drooping of upper lip
 Functional discomfort
 Compromised reflex adaptability
 Poor motor coordination and weak muscles
 Loss of alveolar height in mandible 9-10mm, maxilla 2.5-
3mm after 25 years
 Retention (complete dentures)
 Definition: The resistance of a denture to vertical
movement away from the tissues along the path of insertion
 Maximising retention:
 Achieve border seal (including postdam posteriorly)
 Close adaptation of base to underlying tissues.
 Saliva viscosity
 Time: duration of separation of denture and mucosa
 Surface tension
 Border seal
 Finish on displaceable but non mobile tissues
 Maximum functional sulcus extension height & width

-Precision attachments
 Stability
 Definition: Resistance of the denture to lateral
forces and therefore resistance to lateral
movement (as a result of functional forces).
 Factors that influence:

-ridge height
-flange height
-Teeth position
 Maximising stability:
 Occlusion:

-Balanced articulation
-teeth positioned in their neutral zone (biometric
guides)
 Engage vertical surfaces – lateral aspects of
ridges, tuberosities and retromylohyoid fossae
 Well formed ridges
 Support
 Definition: Resistance of the movement of the denture
towards the underlying tissues (along the path of
insertion)
 Supporting tissues
 Primary denture bearing areas – areas of tissue supported by
basal bone which does not resorb in response to denture
loading including the vault of the hard palate posteriorly and
the buccal shelf
 Secondary denture bearing areas – areas of tissue supported
by alveolar bone which resorbs after extraction of teeth and
under load from dentures (e.g. slope of residual ridge).
Factors:
 Maximal coverage of tissues without
encroaching on displacing musculature
 Consideration of primary and secondary
support areas
 Roots/implants: if overdentures
Anatomical landmarks
Landmarks – maxillary impression

 Residual alveolar ridges, Tuberosities, hamular

notches, Vault of palate
 Frenae – labial & two buccal, Sulcus reflection
 Junction of hard & soft palate, vibrating line,
fovea palatini, hamular notches
 Incisive papilla, rugae, palatal gingival
remnant.
 Landmarks – mandibular
impression

 Residual alveolar ridges, Buccal shelves, retromolar

pad
 Frenae – lingual, labial & two buccal, Sulcus
reflection, Post mylohyoid fossae
 Floor of mouth, sublingual folds, submandibular
gland, submandibular fossae
 In patients with advanced resorption – mylohyoid
ridges and genial tubercles
A Maxillary Torus
Why is a post dam added to an
upper denture after processing?

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Polymerization contraction of acrylic resin

Variable displacablity of soft tissue at the

posterior denture border

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 Post dam can be either added to the denture
chairside or by the laboratory

Chairside – self-cured autopolymerising resin

e.g. GC Reline
- light-cured resin
e.g. Triad
Laboratory – greenstick compound
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