Removable Complete and Partial Dentures

Removable dentures are dental appliances that replace one or more missing teeth in the upper or lower jaw. They are called “removable” because they can be taken out of the mouth for cleaning and maintenance. The components of a denture include

Before we get into further details of its make let’s have a better idea of what happens exactly when teeth are lost.

The stages of edentulousness are

Pre-edentulous

Teeth are still present but are at risk of being lost due to decay, periodontal disease, or other factors.

Partially edentulous

Some teeth are missing, but others remain. This stage can further divided into:

Unilateral : Teeth are missing on one side of the mouth.
Bilateral : Teeth are missing on both sides of the mouth.
Anterior : Teeth are missing in the front of the mouth.
Posterior : Teeth are missing in the back of the mouth.

Completely edentulous

All natural teeth have been lost.

Immediate post-extraction

The stage immediately after tooth extraction, where the socket is still healing.

Step 5

Your tooth will require a crown or permanent restoration to replace all the missing tooth structure.

Early edentulous

Within the first few months after tooth loss, where the gums and jawbone are still adapting.

Established edentulous

After the initial healing period, where the gums and jawbone have stabilized.

Advanced edentulous

The jawbone has significantly resorbed, and the facial structure has changed.

Terminal edentulous

The final stage where the jawbone has severely resorbed, and the patient is at risk of facial collapse.

Why is it important to replace a tooth?

Several aspects contribute to the relevance of replacement of missing teeth.

The primary function of our teeth is chewing, by which food is broken down for proper digestion.Missing teeth can lead to difficulty chewing and digesting food, which can affect overall health. In the long run as and when a tooth is missing, surrounding teeth may gradually shift or tilt into the gap, leading to orthodontic issues and bite problems which leads to temporomandibular joint issues.

Gaps in teeth can also impact pronunciation and speech clarity and when coming to the disease part , missing teeth can create areas prone to plaque accumulation and infection. Apart from that, any tooth loss is associated with bone resorption . So loss of mandibular teeth lead to jawbone resorption, leading to changes in facial structure and appearance. This stage attributes itself to aesthetic concern and a good smile.The patient loses self-confidence and self-esteem.

To add on to above mentioned consequences, some research suggests links between tooth loss and systemic health issues like heart disease, diabetes, and cognitive decline.

Types of Dentures

Acrylic Denture (APD): Temporary or transitional partial or complete denture

These are a type of removable partial denture made from acrylic resin. They are a cost-effective and temporary solution for replacing missing teeth. These are most affordable and easily fabricated and adjustable It is composed of:

When it is indicated to give rpds?

Temporary replacement of missing teeth
Transitional denture during implant or bridge placement
Economic alternative for patients with limited budget
Patients with low occlusal forces
Patients with sensitive teeth or gums

Contraindications:

High occlusal forces
Patients with severe gum recession or bone loss
Patients with allergies to acrylic materials
Long-term use (may lead to bone resorption or tissue irritation)

Cast partial denture (CPD): Metal framework and artificial teeth.

CPDs are a type of removable partial denture made from a metal framework, typically cobalt-chromium or titanium, and artificial teeth. They are a more durable and long-lasting option compared to acrylic partial dentures. They are less likely to stain and withstand high occlusal forces.However it requires more chair time and laboratory work and additional procedures (e.g., impressions, try-ins) for its processing. Patient may need an adjustment period before it’s use.

Components of cpds are:

Indications for it’s usage are:

Long-term replacement of missing teeth
Patients with high occlusal forces
Patients with moderate to severe gum recession or bone loss
Patients seeking a more durable and stable option
Patients with sufficient space for the metal framework

Contraindications include:

Patients with allergies to metal materials
Patients with limited budget
Patients with minimal tooth loss
Patients with poor oral hygiene
Patients with unrealistic expectations

Flexible partial denture (FPD): Valplast or nylon-based partial or complete

Flexible dentures are a type of removable partial denture made from a flexible material, such as nylon or valplast. They are a comfortable and aesthetically pleasing option for replacing missing teeth. As the name suggests they are flexible and unbreakable. Moreover they are metal free and easy to clean and maintain.

But it has a limited durability compared to cast partial dentures.

These consists of:

Indications

Patients seeking a comfortable and aesthetically pleasing option
Patients with sensitive gums or teeth
Patients with limited budget
Patients with realistic expectations

Contraindications

Patients with high occlusal forces
Patients with severe gum recession or bone loss
Patients with limited space for the flexible material
Patients with unrealistic expectations
Patients with poor oral hygiene

Overall, flexible dentures are a suitable option for patients seeking a comfortable and aesthetically pleasing solution for replacing missing teeth. However, they may not be suitable for everyone, and your dentist will help determine the best option for your specific needs.

Implant-supported Partial and Complete denture:

Implant-supported removable partial and complete dentures are a type of denture that combines the benefits of dental implants and removable partial dentures. They are a popular option for patients who are missing multiple teeth and want a more secure and stable solution.

They have an improved stability and retention enhancing increased chewing efficiency. It has a reduced gum irritation as it is implant supported and can be used in conjugation with other dental treatments (e.g., crowns, bridges).

Above all it is the most durable and long-lasting replacement of missing teeth.

It has following components:

Dental implants (titanium or zirconia)
Implant-supported framework (metal or ceramic)
Artificial teeth (acrylic or ceramic)
Clasps (hooks) to hold the denture in place
Rests (supports) for distribution of forces

Indications

Patients with multiple /all missing teeth
Patients with sufficient bone density for implants
Patients seeking a more stable and secure solution
Patients with a history of denture instability or discomfort
Patients with realistic expectations

Contraindications

Patients with insufficient bone density for implants
Patients with poor oral hygiene
Patients with unrealistic expectations
Patients with certain medical conditions (e.g., uncontrolled diabetes)
Patients with limited financial resources

Procedure:

Consultation and treatment planning
Implant placement
Framework design and fabrication
Artificial tooth selection and placement
Final denture delivery and adjustment

Overall, these offer a reliable and aesthetically pleasing solution for patients with multiple missing teeth. However, they may not be suitable for everyone, and your dentist will help determine the best option for your specific needs.

What are the benefits of Removable Dentures?

As a replacement of missing teeth, it restores chewing and speaking functions supporting adjacent teeth and gums. Moreover, these removable dentures enhance appearance and self-confidence. When compared to fixed bridges or implants it’s more cost effective and they can be easily adjusted or relined as needed.

Care and maintenance of

Clean the denture daily with mild soap and water

Soak denture in denture cleaner overnight once in 2 weeks

Rinse thoroughly before replacing

Store the denture in a protective case when not worn

Regular dental check-ups and adjustments as needed

Why choose Implant over Removable Dentures?

Removable dentures may take time to get used to wearing. These can indeed cause discomfort or irritation. When it comes to maintenance, a well charted cleaning and maintenance protocol is needed for it. Further there are chances of it affecting taste or speech. The durability is also not as much as fixed restorations.

Though dentures are a cost-effective and practical solution for replacing missing teeth, implants emerge as the most durable and sustaining solution. But it’s essential to consult us to determine the option best for you.