Textbook Of Complete Dentures Pdf Free Download
Desmond Hutchins
This is a state-of-the art electronic program covering all aspects of complete dentures (CDs). It is designed to meet the needs of dental students, practicing dentists, dental laboratory technicians, and educators at all levels. This one-of-a-kind evidence-based eBook transcends traditional textbooks through the integration of digital technology, 3D resources, color images, and evidence based referencing. It is the ultimate resource for treating edentulous patients with complete dentures.
1. Complete Dentures containing 35 richly illustrated chapters with hundreds color images, animations, and videos.
2. The 3D animations and videos are linked to specific locations in the text.
3. The content is scientifically referenced with links in the text that reveal the complete citation.
4. The program provides foundational and advanced concepts, covering all aspects of complete denture clinical procedures from examination, diagnosis, and prognosis to the identification, management, and troubleshooting of clinical complications.
5. It contains the most comprehensive description of edentulous hard and soft tissue anatomy along with specific clinical applications of the knowledge. The anatomy content is supported by interactive visual quizzes with reference libraries.
6. The different philosophies of occlusion can be easily understood and visualized using the 3D animations supported by detailed textual descriptions with figures and videos.
7. A richly illustrated, unique chapter that traces the history of complete dentures is included in the program.
8. The materials used with complete dentures and their handling guidelines are described and richly illustrated.
9. CAD/CAM fabrication procedures are described and illustrated.
10. Over 2,000 reference links within the text rather than selective reading.
11. There is nonlinear programming and ease of navigation.
12. Image gallery
13. Animation and video gallery
14. Gallery of patient treatment examples
15. Resource appendices with classic content
16. Content provided by a large number of authors with special expertise
Covering the functional and esthetic needs of edentulous patients, Prosthodontic Treatment for Edentulous Patients: Complete Dentures and Implant-Supported Prostheses, 13th Edition helps you provide complete dentures, with and without dental implant support. It addresses both the behavioral and clinical aspects of diagnosis and treatment and covers treatment modalities including osseointegration, overdentures, implant-supported fixed prosthesis, and the current and future directions of implant prosthodontics. New to this edition are full-color photographs and coverage of immediately loaded complete dental prostheses. From lead editor and respected educator George Zarb, Prosthodontic Treatment for Edentulous Patients provides an atlas of clinical procedures and emphasizes the importance of evidence-based treatment.
The dentures move relative to the underlying bone during their functioning. Most principles of denture construction have been formulated to minimize the off-vertical forces transmitted to the supporting structure, as the toleration of vertical forces is better. The instability has the potential of being traumatic to the supporting tissues. Thus, with complete denture philosophies and techniques, maximum stability and retention appear to be the major objective throughout the clinical procedure. Stability is usually the distinguishing factor between success and failure. Modification on impression surface, occlusal surface, polished surface, and even on the compromised mandibular residual ridge have been devised to improve stability and retention in the mandibular denture.[3][4]
The production of a good fitting surface depends primarily upon the impression. There is general agreement that all complete dentures should cover the maximum area possible along with close adaptation to the underlying surface, but great care is necessary to confine the area of the impression so that it does not impinge into the zones of muscle attachments.
Lingual flange design (sublingual crescent extension): It involves a lingual wing (horizontal extension of the lingual flange) placed in a biologically acceptable fashion by increasing the area of the denture, which enhances retention and stability.[5][6][7]
Posterior lingual extension: The posterior part of the alveolingual sulcus (the retromylohyoid fossa) divides into two parts: anteroinferior and posterosuperior. The lingual flange of the mandibular denture should be turned into the anteroinferior part to produce maximum stability for the denture since no muscle lies directly underneath.
Ridge shape and size: Denture stability is increased in square, parallel-sided broad ridges than the small narrow tapered ridges. The former provides greater resistance to the functional horizontal dislodging forces.
Interarch space: The appropriate vertical dimension enhances denture stability. If there is excessive interridge distance, the stability decreases because of increased leverage. In case of excessive resorption, the interridge space increases, putting the occlusal surface of teeth farther from the supporting area, which results in biomechanical disadvantage for the denture due to increased leverage.
Ridge parallelism: Parallelism of the edentulous ridges favors seating of the denture bases during tooth contact because of favorable directions of forces, thus increasing the stability. Deviation from the parallelism of the ridges adversely affects stability.
Ridge resorption can result in a prominent and sharp mylohyoid ridge, limiting the denture extension below the mylohyoid area, potentially affecting denture stability. Mylohyoid ridge reductions can aid in the success of mandibular denture by permitting the increased surface area coverage by the denture. In highly resorbed ridges with shallow sulcus depth, adequate stability is not achievable through non-surgical procedures. Pre-prosthetic surgery measures, including sulcus deepening and/or ridge augmentation procedures, are to be adopted to ensure the stability of the mandibular denture.
The polished surface of a mandibular denture extends from the denture border in the vestibular depth upwards to the occlusal surface of the teeth. This surface should be shaped to accommodate the musculature contacting the surface around the denture, which in turn aids in the denture stability. In case the direction of muscle contraction is not respected and is against the shape of the contacting surface. The muscular force serves as a dislodging factor and results in impaired denture stability.
Seating action on the mandibular denture occurs if the tongue rests against the lingual flange inclined away from the mandible medially and is concave. In general, the labial and buccal flanges of the maxillary and mandibular dentures should be concave to permit positive seating by the musculature of cheeks and lips.
Posteriorly, similar conditions govern the shape of the polished surface. When the natural teeth are present, they lie in a neutral zone of muscle activity enclosed by the buccinator and tongue. Following the loss of teeth and resorption, the neutral zone area gets reduced. Accordingly, it is essential to record the neutral zone and use narrow posterior teeth set over the residual ridge in the premolar region but deviating to little buccal in the molar region.
The modiolus or tendinous node is an anatomic landmark near the corner of the mouth that is formed by the intersection of various muscles (Orbicularis oris, depressor anguli oris, levator anguli oris, quadratus labii superioris, quadratus labii inferioris, buccinators, risorius, and zygomaticus major) of the cheeks and lips. The mandibular denture base must be contoured to permit the modiolus to function freely. This hub of muscles adds to denture stability.
Although every aspect of denture construction is important, there can be no doubt that establishing the correct occlusal relationship of the opposing teeth is the most important. Even the skilfully made retentive and stable mandibular dentures will become unstable and cause irritation due to interfering occlusal contacts. Any tooth interference during function should be removed to achieve occlusal equilibration. The functional range of movements refers to the positions through which the lower jaw moves horizontally during normal speech, swallowing, and mastication.
Ideally, the dentures should be fabricated so that all the posterior teeth have simultaneous contact in the eccentric positions as well as in centric relation, i.e., dentures should have bilateral balanced occlusion.
In the monoplane occlusal scheme, positioning zero degrees (cuspless/flat) teeth slightly lingual to the mandibular ridge crest enhances the denture stability. The lingualized occlusion limits the range of excursive balance and direct forces to the lingual side of the mandibular ridge during working side contacts. These contacts may reduce the horizontal stresses, thereby enhancing denture stability by controlling the leverages induced by lateral/protrusive (eccentric) tooth contacts.
Artificial teeth arrangement should be as close as possible to the position previously occupied by the natural teeth. Only slight modifications should be made to improve leverages and esthetics. Complete stability is often difficult to achieve due to the yielding nature of the supporting structures. The wider and larger the ridge and closer the teeth are to the ridge, the greater is the lever balance.
More lingual the teeth placed relative to the ridge crest, greater is the balance. The more buccal the placement of teeth, the poorer is the balance. More centered is the force of occlusion anteroposteriorly, greater is the stability of the denture base.
There is a general tendency to regard the occlusal plane as being related mainly to esthetic and occlusion. However, the occlusal plane is also an important factor of stability. Ideally, the best stability occurs when the occlusal plane is parallel and anatomically oriented to the ridges. An occlusion plane that is too high forces the tongue into a new position. This can disrupt the normal position of the floor of the mouth resulting in partial loss of the border seal.
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