Single Complete Denture Techniques

Single Complete Denture

• Construction can involve various combinations, including opposing natural teeth, or a complete denture opposing another complete or partial denture.
• Maxillary complete opposing mandibular complete dentition is a common clinical scenario.
• Occlusal discrepancies often require modification, adjustment, or orthodontic intervention.
• Tooth morphology (size and shape) guides artificial tooth selection. Worn mandibular teeth necessitate cuspless artificial teeth; otherwise, anatomic ones are preferred.

Occlusal Modification

• Modifying remaining natural teeth before denture construction.
• A pre-prosthetic procedure corrects occlusal discrepancies in natural teeth.

Denture Construction Techniques

• Yurkstas technique: Uses a U-shaped metal template to detect occlusal scheme deviations.
• Swenson's technique: Mounts upper and lower casts on an articulator; problematic teeth are adjusted on the diagnostic cast.
• Bruce technique: Fabricates a clear acrylic resin template from a modified stone cast, coated with pressure-indicating paste, then placed on natural teeth.

Upper Complete Opposing Mandibular Partial Denture

• Tooth selection is crucial.
• Porcelain teeth are preferred if opposing partial denture has porcelain teeth.
• If opposing teeth have metal crowns, acrylic teeth are preferred.
• Acrylic teeth are often used when opposing normal natural teeth or partial dentures with artificial acrylic teeth.

Complications

• Combination syndrome: A result of long-term use of a mandibular distal extension partial denture against a complete maxillary denture.
  • Patient places heavy occlusal load on remaining natural teeth (mandibular anterior) to accommodate the fit of the denture.
  • This leads to maxillary bone resorption.
  • Labial flange irritates the labial vestibule and may cause epulis fissuratum and fibrous overgrowth.
  • The occlusal plane tilts anteriorly upward and posteriorly downward.
  • The mandibular area suffers resorption as the plane tilts.
  • Vertical dimension decreases, affecting denture stability.
• Fracture of Denture: Excessive load on the denture from natural teeth can cause fractures.
• Wear of Teeth: Porcelain teeth cause significant wear on opposing natural teeth.
• Occlusal wear: Results in loss of vertical dimension.
• Tooth Selection and Occlusion: Options for opposing teeth include balanced occlusion (opposing teeth have normal anatomy), monoplane occlusion (for attrited teeth), porcelain teeth, acrylic teeth (natural teeth wear), acrylic teeth with gold/amalgam surfaces (less wear but expensive).

Mandibular Single Denture

• The prognosis for a mandibular single denture opposing natural teeth, is less favorable than opposing natural lower teeth, due to greater stress on the lower ridge.

Problems of Single Denture

• Magnitude of forces: significant changes in underlying bone, with long-term denture use leading to compromised structural integrity.
• Occlusal form of natural teeth: Determines occlusal form of denture, potentially introducing unfavorable situations.
• Occlusal scheme: Occlusal schemes that create more horizontal forces can worsen the problem.
• Other issues: Single denture syndrome & loose or tilting dentures, injury or damage from mucosa or ridge resorption.

Overcoming Problems

• Proper diagnosis and treatment: Comprehensive evaluation and diagnosis are key.
• Case history, oral examination, upper/lower casts analysis, articulator use, face bow, interocclusal records, and denture construction techniques.
• Complete denture construction: Maximum base extension within anatomical limits; lip support; minimal vertical overlap; suitable occlusion and free articulation; avoid broad inclined planes.

Explore the critical techniques and considerations for constructing single complete dentures. Learn about occlusal modifications, the role of tooth morphology, and various construction methods including the Yurkstas, Swenson's, and Bruce techniques. This quiz is essential for anyone studying prosthodontics or dental anatomy.