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Encyclopedia > Dentures
A maxillary denture.
A maxillary denture.
Occlusal view of the same maxillary denture.
Occlusal view of the same maxillary denture.

Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clipping onto teeth or dental implants. There are two main categories of dentures, depending on whether they are used to replace missing teeth on the mandibular arch or the maxillary arch. There are many informal names for dentures such as dental plate, false teeth and falsies. Image File history File links Broom_icon. ... Image File history File links Mr. ... Image File history File links Mr. ... Image File history File links Metadata No higher resolution available. ... Image File history File links Metadata No higher resolution available. ... There are numerous commonly used terms of relationship and comparison that refer to different aspects of teeth and are frequently utilized in articles about dentistry. ... A United States soldier demonstrates Foosball with two prosthetic limbs In medicine, a prosthesis is an artificial extension that replaces a missing part of the body. ... The mouth, also known as the buccal cavity or the oral cavity, is the opening through which an animal or human takes in food. ... A dental implant is used in restorative dentistry. ... The mandible (from Latin mandibÅ­la, jawbone) or inferior maxillary bone is, together with the maxilla, the largest and strongest bone of the face. ... The maxillae are the largest bones of the face, except for the mandible, and form, by their union, the whole of the upper jaw. ...

Contents

Causes of tooth loss

Patients can become entirely edentulous (without teeth) due to many reasons, the most prevalent being removal because of dental disease typically relating to oral flora control ie:periodontal disease and tooth decay. Other reasons include tooth developmental defects caused by severe malnutrition, genetic defects such as Dentinogenesis imperfecta, or trauma. Oral hygiene is the practice of keeping the mouth clean in order to prevent cavities (dental caries), gingivitis, periodontitis, bad breath (halitosis), and other dental disorders. ... Periodontitis a disease involving inflammation of the gums (gingiva), often persisting unnoticed for years or decades in a patient, that results in loss of bone around teeth. ... Types of teeth Molars are used for grinding up foods Carnassials are used for slicing food. ... Percentage of population affected by malnutrition by country, according to United Nations statistics. ... Dentinogenesis imperfecta is a genetic disorder of tooth development. ... In medicine, blunt force trauma is a type of physical trauma caused by impact from a blunt object. ...


Advantages

Dentures can help give the edentulous patient better masticatory (chewing) abilities, as well as enhance their aesthetic appeal by providing the illusion of having natural teeth, providing support for their lips and cheeks, and correcting the collapsed appearance commonly seen between the nose and the chin.


Types of dentures

Removable partial dentures

Removable partial dentures are for patients who are missing some of their teeth on a particular arch. Fixed partial dentures, better known as "crown and bridge", are made from crowns that are fitted on the remaining teeth to act as abutments and pontics made from materials to resemble the missing teeth. Fixed bridges are more expensive than removable appliances but are more stable. Occlusal view of a mandibular partial denure. ... A dental bridge is a prosthesis used in place of missing teeth and may be removable or permanently attached. ...


Complete dentures

Conversely, complete dentures or full dentures are worn in patients who are missing all their teeth in an arch (i.e the maxillary or mandibular arch).


History

Around 700BC, Etruscans, in northern Italy, made dentures out of human or other animal teeth. These deteriorated quickly but, being cheep, were popular until mid 19th century[1] Extent of Etruscan civilization and the twelve Etruscan League cities. ...


The first European sets of dentures date from the 15th century and most probably existed before that time. They were carved from bone or ivory, or made up of teeth sourced from graveyards, the recent dead or living donors who exchanged their teeth for profit. These dentures were uncomfortable, attached visibly to a base supported by any remaining teeth with a thread of metal or silk. The false teeth were often made with ivory from the hippopotamus or walrus, and usually rotted after extended use. [citation needed]London's Peter de la Roche is believed to be one of the first 'Operators for the Teeth', men who fashioned themselves as specialists in dental work. Often these men were professional goldsmiths, ivory turners or students of barber-surgeons.[2] A European is primarily a person who was born into one of the countries within the continent of Europe. ... Grays Anatomy illustration of a human femur. ... This article or section does not cite its references or sources. ... Binomial name Linnaeus, 1758[2] Range map[1] The hippopotamus (Hippopotamus amphibius), from the Greek ‘ιπποπόταμος (hippopotamos, hippos meaning horse and potamos meaning river), is a large, mostly plant-eating African mammal, one of only two extant species in the family Hippopotamidae (the other being the Pygmy Hippopotamus). ... Binomial name (Linnaeus, 1758) Distribution of Walrus Subspecies Walruses (Odobenus rosmarus) are large semi-aquatic mammals that live in the cold Arctic seas of the Northern Hemisphere. ... This article is about the capital of England and the United Kingdom. ... A goldsmith creating a new ring A goldsmith is a metalworker who specializes in working with precious metals, usually to make jewelry. ... The barber surgeon was one of the most common medical practitioners of medieval times - generally charged with looking after soldiers during or after a battle. ...


The first porcelain dentures were made around 1770 by Alexis Duchâteau. In 1791 the first British patent was granted to Nicholas Dubois De Chemant, previously assistant to Duchateau, for De Chemant's Specification, "a composition for the purpose of making of artificial teeth either single double or in rows or in complete sets and also springs for fastening or affixing the same in a more easy and effectual manner than any hitherto discovered which said teeth may be made of any shade or colour, which they will retain for any length of time and will consequently more perfectly resemble the natural teeth." He began selling his wares in 1792 with most of his porcelain paste supplied by Wedgwood.[citation needed] Single teeth in porcelain were made since 1808. Later dentures were made of vulcanite and then, in the 20th century, acrylic resin and other plastics. In Britain in 1968 79% of those aged 65-74 had no natural teeth, by 1998 this proportion had fallen to 36%.[citation needed] “Fine China” redirects here. ... Wedgwood is a British pottery firm, originally founded by Josiah Wedgwood, and possibly the most famous name ever associated with pottery in any form, which in 1987 merged with Waterford Crystal to become Waterford Wedgwood. ... Acrylic resins are a group of related thermoplastic or thermosetting plastic substances derived from acrylic acid, methacrylic acid or other related compounds. ... This article or section does not cite any references or sources. ...


Problems with complete dentures

Problems with dentures include the fact that patients are not used to having something in their mouth that is not food. The brain senses this appliance as "food" and sends messages to the salivary glands to produce more saliva and to secrete it at a higher rate. New dentures will also be the inevitable cause of sore spots as they rub and press on the mucosa. A few denture adjustments for the weeks following insertion of the dentures can take care of this issue. Gagging is another problem encountered by some patients. At times, this may be due to a denture that is too loose fitting, too thick or not extended far enough posteriorly onto the soft palate. At times, gagging may also be attributed to psychological denial of the denture. (Psychological gagging is the most difficult to treat since it is out of the dentist's control. In such cases, an implant supported palateless denture may have to be constructed or a hypnotist may need to be consulted). Sometimes there could be a gingivitis under the full dentures, which is caused by accumulation of dental plaque. In animals, the brain or encephalon (Greek for in the head), is the control center of the central nervous system, responsible for behaviour. ... The salivary glands produce saliva, which keeps the mouth and other parts of the digestive system moist. ... Saliva is the watery and usually somewhat frothy substance produced in the mouths of humans and some animals. ... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ...


Another problem with dentures is keeping them in place. There are three rules governing the existence of removable oral appliances: support, stability and retention.


Prosthodontic principles of dentures

Prosthodontics is one of the nine dental specialties recognized by the American Dental Association (ADA). ...

Support

Support is the principle that describes how well the underlying mucosa (oral tissues, including gums and the vestibules} keeps the denture from moving in the vertical plane towards the arch in question, and thus being excessively depressed and moving deeper into the arch. For the mandibular arch, this function is provided by the gingiva (gums) and the buccal shelf (region extending laterally from the posterior ridges), whereas in the maxillary arch, the palate joins in to help support the denture. The larger the denture flanges (part of the denture that extends into the vestibule), the better the support. The gingiva (sing. ... The term lateral can refer to: an anatomical definition of direction. ...


More recently, there has been a move to increase denture stability with implants. When pressure is applied to alveolar bone bereft of teeth (alveolar bone is the bone in which teeth normally reside), the bone reacts to this pressure by resorbing. After many years of denture wearing, the ridges upon which the dentures rest deteriorate and can easily all but disappear. The insertion of implants into the bone below the dentures can help to seriously combat this unfortunate occurrence. The implants are strategically placed to bear the brunt of the pressure when the denture is used for chewing, keeping the bone from melting away. When implants are integrated into treatment, the denture is now referred to as being an implant supported overdenture and the implants are referred to as overdenture abutments. The term implant has different meanings: in Scientology, see Implant (Scientology) in medicine, see prosthesis This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ...


Stability

Stability is the principle that describes how well the denture base is prevented from moving in the horizontal plane, and thus from sliding side to side or front and back. The more the denture base (pink material) runs in smooth and continuous contact with the edentulous ridge (the hill upon which the teeth used to reside, but now consists of only residual alveolar bone with overlying mucosa), the better the stability. Of course, the higher and broader the ridge, the better the stability will be, but this is usually just a result of patient anatomy, barring surgical intervention (bone grafts, etc.).


Retention

Retention is the principle that describes how well the denture is prevented from moving in the vertical plane in the opposite direction of insertion. The better the topographical mimicry of the intaglio (interior) surface of the denture base to the surface of the underlying mucosa, the better the retention will be (in removable partial dentures, the clasps are a major provider of retention), as surface tension, suction and just plain old friction will aid in keeping the denture base from breaking intimate contact with the mucosal surface. It is important to note that the most critical element in the retentive design of a full maxillary denture is a complete and total border seal in order to achieve 'suction'. The border seal is composed of the edges of the anterior and lateral aspects AND the posterior palatal seal. The posterior palatal seal design is accomplished by covering the entire hard palate and extending beyond and ending onto the soft palate. Occlusal view of a mandibular partial denure. ...


As mentioned above, implant technology can vastly improve the patient's denture-wearing experience by increasing stability and saving his or her bone from wearing away. Implant can also help with the retention factor. Instead of merely placing the implants to serve as blocking mechanism against the denture pushing on the alveolar bone, small retentive appliances can be attached to the implants that can then snap into a modified denture base to allow for tremendously increased retention. Options available include a metal Hader bar or precision balls attachments, among other things.


Complications and recommendations

The fabrication of a set of complete dentures is a challenge for any dentist, including those who are experienced. There are many axioms in the production of dentures that must be understood, of which ignorance of one axiom can lead to failure of the denture case. In the vast majority of cases, complete dentures should be comfortable soon after insertion, although almost always at least two adjustment visits will be necessary to remove sore spots. One of the most critical aspects of dentures is that the impression of the denture must be perfectly made and used with perfect technique to make a model of the patient's edentulous (toothless) gums. The dentist must use a process called border molding to ensure that the denture flanges are properly extended. An endless array of never-ending problems with denture may occur if the final impression of the denture is not made properly. It takes considerable patience and experience for a dentist to know how to make a denture, and for this reason it may be in the patient's best interest to seek a specialist, either a Denturist or a Prosthodontist, to make the denture. A general dentist may do a good job, but only if he or she is meticulous and usually he or she must be experienced. It has been suggested that this article or section be merged into Dental prosthetist. ... Prosthodontics is one of the nine dental specialties recognized by the American Dental Association (ADA) and requires 3-4 years of additional formal training in an ADA approved program. ...


The maxillary denture (the top denture) is usually relatively straightforward to manufacture so that it is stable without slippage. The lower full denture tends to be the most difficult because there is no "suction" holding it in place. For this reason, dentists in the late 1990s have come to a general conclusion that a lower full denture should or must be supported by 2-4 implants placed in the lower jaw for support. A lower denture supported by 2-4 implants is a far superior product than a lower denture without implants, held in place with weak lower mouth muscles. It is routine to be able to bite into an apple or corn-on-the-cob with a lower denture anchored by implants. Without implants, it is quite difficult or even impossible to do so.


Some patients who believe they have "bad teeth" may think it is in their best interests to have all their teeth extracted and full dentures placed. However, statistics show that the majority of patients who actually receive this treatment wind up regretting they did so. This is because full dentures have only 10% of the chewing power of natural teeth, and it is difficult to get them fitted satisfactorily, particularly in the mandibular arch. Even if a patient retains one tooth, that will contribute to the denture's stability. However, retention of just one or two teeth in the upper jaw does not contribute much to the overall stability of a denture, since a full upper denture tends to be very stable, in contrast to a full lower denture. It is thus advised that patients keep their natural teeth as long as possible, especially their lower teeth.


Conclusion

As can be expected with any removable appliance placed in the mouth, there will be some problems (in respect to the three principles mentioned above) with dentures no matter how well they are made. This is because the best the dentist can do is fabricate the upper denture to work in harmony with the lower denture when the patient is at rest. If the only variables in the equation are the patient's edentulous ridges and the two dentures, the dentist can set the teeth in certain ways to help prevent dislodgement during opening, closing and swallowing. Once food enters into the picture, though, the stability of the denture bases is not impervious to disruption. During chewing, the denture bases will sometimes act as class 1 levers, and when the patient bites down on the anterior, or front, teeth, the posterior, or rear, teeth are bound to move away from the ridge. Although the ideals of denture design will have it that the intaglio surface is in perfect, intimate contact with the ridge and the margins of the denture base will create a perfect suction seal (the seal is actually only on the maxillary denture), ideals are rarely if ever met in this imperfect world, and thus some movement is to be expected. Denture adhesive can then be utilized to compete against the forces trying to pull the denture base away from the mucosa. In a perfect world, a patient with a perfect edentulous ridge with a perfectly fitting denture would require no adhesive, as the actual form of the denture base should work in tandem with the three principles mentioned above, thus precluding movement in any way, shape or form. The principle of the lever tells us that the above is in static equilibrium, with all forces balancing, if F1D1 = F2D2. ... In zootomy, several terms are used to describe the location of organs and other structures in the body of bilateral animals. ... The English word POSTERIOR is identical to the original Latin adjective, and has two different uses : as an ADJECTIVE, it indicates that someone or something is behind another, either spatially or chronologically it also became a SUBSTANTIVE, indicating the rear-end, especially of a person, i. ...


See also

X-Ray picture of two rectangular dental implants inserted into the jaw. ... Crown A crown, or full-coverage restoration (sometimes incorrectly called a cap) is a prosthetic tooth designed by a dentist and usually created by a lab technician (or more recently, a CAD-CAM machine). ... A dental bridge, otherwise known as a fixed partial denture, is a prosthesis used to replace missing teeth and is not removable by the patient. ... This article does not cite any references or sources. ...

External links

  • Dentures - Information, Resources and Forums
  • Dentures Quest - Personal Experience, Questions and Answers

References

  1. ^ The inventions that changed the world, Reader's Digest (1982) [Portuguese edition of 1983]
  2. ^ The strange story of false teeth by John Woodforde

  Results from FactBites:
 
DENTURE (513 words)
The denture is constructed before the teeth are removed, the teeth are removed and the denture is immediately placed in the mouth.
In the case of a partial denture, It should be removed before brushing your teeth and cleaned before placing it back into your mouth.
When the denture is not in your mouth it should be soaked so that it will not dry out and warp.
Denture (619 words)
A denture is made of acrylic resin, sometimes in combination with various metals, and comes in two types; complete denture or partial denture.
Cleaning the denture is also important and requires the removal and brushing of the denture daily, preferably with a brush designed specifically for cleaning dentures.
Dentures are no longer the only way to restore a mouth that has little or no non-restorable teeth.
  More results at FactBites »


 
 

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