Single complete denture

Kashyap Sawant
contents
• Introduction
• Combination syndrome
• Types of single complete denture
• Complications / problems associated
• Common occlusal disharmonies
• Methods to achieve balanced occlusion
• Recent advances
• summary
Introduction
• Edentulous single arch with opposing complete or partial dentulous
arch
• Single complete denture fabricated
• Primary consideration  preservation of remaining natural teeth
• Occurs more in maxillary arch
Combination syndrome
• The characteristic features that occur when an edentulous maxillae is
opposed by natural mandibular anterior teeth and a mandibular
bilateral extension-base removable partial denture.
Characteristics
1) loss of bone  anterior maxillary ridge
2) hyperplasia of the tuberosities
3) papillary hyperplasia hard palate’s mucosa
4) supraeruption of the mandibular anterior teeth
5) loss of ridge height beneath mandibular RPD
Types of single complete denture
• It opposes :-
1. Natural teeth that are sufficient not to necessitate a prosthesis
2. partially edentulous arch in which the missing teeth have been
replaced by a fixed partial den­ture.
3. partially edentulous arch in which the missing teeth have been
replaced by a removable partial denture.
4. existing complete denture.
• first 3 types  the max­illary arch is usually the edentulous arch.
• more stable
• easier to retain in position
• tolerated better by patients
Mandibular single complete denture
• Usually it is maxilla
• Mandible difficult to stabilize
• proximity of tongue
Single complete maxillary denture
• More frequently encountered
• Difficult to have harmonious occlusion Malposed ,tipped and
supraerupted teeth
• Problem of wear of teeth
• Balanced occlusion should be provided in terminal hinge position and
eccentric movements
• Occlusal form of natural teeth acts as a guide for selection for occlusal
form of maxillary posterior teeth
• Presence of anterior interferences in eccentric movements
• Repositioning of natural teeth OR altering the clincal crowns
Single maxillary denture opposing partially
edentulous arch with FPD
• FPD must be planned prior to denture
• Occlusal scheme of FPD must be determined beforehand
• Consideration regarding material used on occlusal surface
of denture

• Prepare tooth to get proper plane of occlusion: mesial

cusp of molar raised and distal cusps lowered to get
correct plane of occlusion.
Single maxillary denture opposing partially
edentulous arch with RPD
• Remaining mandibular teeth must be in acceptable health
• RPD must meet requirements of an acceptable prosthesis
• Occlusal plane must be such that an acceptable complete denture can
be fabricated
• Replacement of missing teeth in lower arch will improve the
prognosis of upper denture.
• But according to Sharry:
• if there is class II jaw relation a complete denture can be fabricated
against lower anteriors and premolars
• But if class III jaw relation situation is different  because
mandibular premolars would apply occlusal forces against the
anterior part of the maxillary ridge.
Single CD opposing an existing CD
• This decision can be approached in a systematic manner by answering
these 5 questions :-
1) How long has the existing CD been in use ?
2) Was it an Immediate denture ?
3) Does the denture meet requirements of an acceptable denture?
4) Has the denture opposed another CD/RPD and partial arch? If so
can the occlusal harmony be established
5) Is the operator satisfied to institute a CD utilizing the existing CD?
Condition of the teeth:
a) Appearance
b) Alignment with regard to residual ridge.
c) Is occlusal plane Desirable?
d) Occlusal surface worn out
Condition of denture base
a) Accuracy of tissue adaptation and border extension
b) Any fracture repairs
c) Esthetic contouring and thickness adequate to support the perioral
structures.
d) Stability and retention.
Problems associated
• magnitude of force delivered or resisted :-
• Natural teeth (198lbs)
• Complete denture (288lbs)
• Occlusal form of natural teeth dictates occlusal form of denture
• Maybe unsuitable due to :-
• Supraeruption , tilting,

• cause horizontal forces on the denture base causing more damage to

the residual ridge
• causes occurrence of “Single denture syndrome”
• - loose or tilting denture
• -damage of mucosa
• - ridge resorption.
Common occlusal disharmonies
• Mostly occur in anterior teeth and in last molars.
• Mostly 2nd and 3rd molars have mesial tilting
• Tend to drive the denture anteriorly
• No occlusion in protrusive and lateral excursions
Adjustments for tilted molars
1) If not severe  selective grinding
2) Distal half ground flat and kept in occlusion
3) When severe and more tooth structure required  FPD
Rehab
4) Large edentulous span mesial to molar  RPD with onlay
rest on mesial half
5) Orthodontic repositioning
Adjustment for lower anterior teeth
• Grind them as much as practicable
• Orthodontic repositioning
• Cuspid  provide a definite distal slope
Methods for balanced occlusion
• Two methods:-
1) Functionally generated path
2) Articulator equilibration technique
Functionally generated path
• Most accurate method
• Given by Stansbury (1951)
• Balanced occlusion  natural teeth not grinded, artificial teeth
grinded
Procedure
• Casts mounted on articulator in centric relation
• Record base and occlusal rim removed
• Adaptation of new baseplate
• Compound rims fabricated (twice the width of natural molars)
• Compound occlusal rim heated  placed in articulator
• Closed imprint of all fossae of lower teeth recorded
• Rims trimmed buccolingually with level of cusps
• a compound extension is left in central fossa
• Place in patients mouthPt asked to make chewing slowly 
• Excess compound wears off Free action in lateral movement.
• Soft wax is added buccally and lingually.
• Again placed in patients mouth and patient asked to perform
eccentric chewing movements
• Lower teeth cut their paths in soft wax and compound acts as a
vertical stop
• Intra oral procedure repeated for protrusive
• Occlusal rim removed stone poured into wax paths.
• Stone is secured in the articulator
• Original mandibular cast remounted and teeth setting done
Articulator equilibration technique
• Maxillary occlusal rims fabricated
• face bow transfer done
• maxillary casts mounted .
• This allows cusp-to-fossa relation between upper and lower
teethmakes balancing easy
• Teeth set acc. to eccentric records
• Followed by wax try in
Recent advances
Summary
References
• Syllabus of Complete Denture- Heartwell 4th Edition
• Dental laboratory procedures. Volume one. Robert. M. Marrow
• Stansbury CB. Single denture construction against a nonmodified
natural dentition. Journal of Prosthetic Dentistry [Internet]. 1951 Nov
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