What Is an Overdenture

A complete denture
that is supported and often
retained by the underlying
teeth or implants and tissue
Abutment teeth or implants
may or may not
be connected to the denture
via attachments
Overdenture Attachments
Studs
Bars
Teeth
Implants
Magnets
Copings
Posts
Combinations
Intraradicular
Extraradicular
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Load bearing
Non-Load-bearing
Overdenture Attachments
Bar joints
Bar units
Round
Ovoid
Square
Rectangular
Radicular:
Extraradicular
Studs, magnets,
ERA
Intraradicular
Zaag, Zest,
Sterns root
anchor





Bars:

Objectives of the Program
Understand how overdentures preserve
hard and soft tissue
Maintain proprioception
Understand the function of overdenture
attachments and simplify attachment
selection
Increasing crown/root ratios to preserve
abutments
Hygiene maintenance

Carlson and Persson, Odontologist Revy, Sweeden 1967
Anterior mandible
average bone loss first year after extractions was 4mm
Tallgren, JPD,1972
Bone loss continues for at least 25 years
Dentures vs Overdentures

Chewing Efficiency
Natural dentition

Complete dentures

Overdentures
90%

59%

79%
Rissin and House, JPD, 1978
Indications for Overdentures
Periodontal disease
Few remaining teeth
Insufficient crown/root ratios
Vertical space
Favorable path of insertion
Retention
Advantages of
Overdentures
Maintenance of bone height around teeth by
preserving roots
Attenuates resorption patterns of alveolar
ridges
Gentler to the tissues
Increases crown/root ratios
Psychological security
Enhanced speaking ability
Maintains Proprioception

Disadvantages of Overdentures
Esthetic Considerations
Bulkiness
Root canal therapy
Increase space requirements:
-interarch
-interocclusal
Increase costs
Crown / Root Ratios
Attachment Retained
Overdentures
All the advantages of Overdentures
PLUS
Superior aesthetics
Stability and comfort
Mechanical retention

Increased psychological security
and patient acceptance
Increases proprioception
Rigidity or resiliency
Support
Overdentures
Attachment Considerations



Transfers stress towards the retained
roots or implants and away from the ridge
No vertical resiliency, some hinge or
rotational resiliency
Shares the load of occlusion with the
mucosal surface

Magnets, Flexi ball, Dalbo Rotex, Bars


Load Bearing
Solid / Rigid
Overdentures
Attachment Considerations


Transfers stress away from the
retained roots or implants and towards
the tissue
Vertical resiliency
Selected frequently
Dalla Bona, Rotherman, Ceka, Uni Anchor, OSO,
ORS, ERA, Bars
Non- Load Bearing
Resilient
Overdenture Evaluation
Partial Denture
Present
Tooth position
Occlusion
Mount casts to vertical
dimension

No Partial Denture
Mount cast to vertical
dimension
Diagnostic denture wax
up reestablish
occlusion
Silicone matrix for
space evaluation

Direct Placement
Male or female premanufactured attachment
is cemented into root
Denture is made and inserted
Corresponding male or female attachment is
inserted in root
Attachment is picked up directly in the
overdenture with cold cure acrylic


Placed by Dentist
Indirect Placement
Male or female attachment is cemented
into root or may need to be cast onto
coping
Corresponding male or female transfer
analog is inserted into root attachment
Transfer impression is taken and models
are poured with transfer in place
Laboratory processes denture with
corresponding attachment in place

Placed by Laboratory
Proceedures To Follow
5 mm or more root remaining in bone
Stable perio
Mount study models evaluate space required
Select OD attachment obtain reference manuals
Begin denture proceedings
Root canal therapy
Decoronate roots, extractions, insert temporary
denture reline allow time for healing
Prep tooth for attachment and cement attachment
Insert denture, make adjustments, post placement
reline
Pick up male attachment in denture