Diagnostic criteria and principles of overdenture construction design in patients with mandibular single remaining teeth

  • R. R. Bratus-Hrynkiv Danylo Halytskyi Lviv National Medical University
Keywords: mandibular single remaining teeth, occlusal factors, artificial teeth arrangement scheme, overdentures, chewing load distribution


Partial loss of teeth and associated functional disorders have a direct impact on patients’ psycho-emotional status and their quality of life, therefore the timely dental arch defects replacement and rational choice of denture design is the actual problem of prosthetic dentistry.

 The aim of the study – to improve dental prosthetic treatment results by optimizing treatment plannig due to direct diagnostic criteria in patients mandibular single remaing teeth.

 Materials and methods. 25 patients (13 women and 12 men) aged 50–76 years with lower mandibular remaing teeth in the frontal area were examined. Based on a comprehensive assessment of the prosthetic conditions according to PDI criteria and orthopantomography data (Dent Navi, Yoshida, Japan) in 15 patients indications were determined for treatment with use of overdentures. Centric relation was determined and fixed by the anatomical-functional method using Fox plane and gnathometer (Сentrofix, Amann Girrbach). The artificial teeth (Yamahachi Dental) arrangement was made according to one of the main occlusion schemes: bilatheral balanced, lingualized, monoplane. Occlusal relalationships were obtained by Bausch method and analyzed according to S.J.Davies scheme. Functional rehabilitation grade was evaluated with use of H. Miura, K. Sato questionnaire.

 Results and Discussion. In 3 (20 %) of the examined patients chewing ability was unobstructed, both in 1 and after 6 months of use. After conducting occlusal correction, 8 (53.3 %) patients evaluated the chewing ability with minor discomfort in 1 month after delivery and as unobstructed after 6 months of use. In 3 (20 %) patients, the complicated chewing ability was reported after 1 month and with minor discomfort after 6 months of use. After 1 and 6 months of usage 1 (6.7 %) patient with a complete removable upper denture and fixed by swaged crowns on a single remained tooth 42 overdenture had chewing ability complicated.

Conclusions. In the examined patients with absence of occlusal supporting areas, single remaining teeth (roots) location and residual ridge resorption type were determining criteria for treatment plan elaboration. In overdentures with semi-rigid attachment to abutment teeth and tissue-tooth chewing load distribution sufficient chewing ability was achieved by the establishment of bilateral occlusal contacts while artificial teeth arrangement.


Nakaz MOZ Ukrainy vid 04.01.2018 № 13 “Pro deiaki pytannia zastosuvannia Ukrainomovnoho variantu Mizhnarodnoi klasyfikatsii pervynnoi medychnoi dopomohy (ICPC-2-E)” [Order of the Ministry of Health of Ukraine dated January 4, 2018 No. 13 "On some issues of the Ukrainian-language version of the International Classification of Primary Health Care (ICPC-2-E)"]. [in Ukrainian].

Korol, D.M., Korol, M.D., Skubii, I.V.,

Kindii, D.D., Toncheva, K.D., & Yarkovyi, V.V. (2016). Zhuvalna efektyvnist yak kryterii otsinky funktsionalnoho stanu zuboshchelepnoi systemy [Chewing efficiency as a criterion for evaluating the functional state of the dental-maxillofacial system]. Ukrayinskyi stomatolohichnyi almanakh – Ukrainian Dental Almanac, 3, 59-62 [in Ukrainian].

Inukai, M., John, M., Igarashi, Y., & Baba, K. (2010). Association between perceived chewing ability and oral health-related quality of life in partially dentate patients. Health Qual Life Outcomes, 19 (8), 118.

McGarry, T.J., Nimmo, A., Skiba, J.F., Ahlstrom, R.H., Smith, Ch.R., Koumjian, J.H., & Arbree, N.S. (2002). Classification system for partial edentulism. J. Prosthodont., 11 (3), 181-193.

Davies, S.J., & Gray, R.M.J. (2001). Occlusion: The examination and recording of the occlusion: why and how. Brit. Dent. J., 191 (6), 291-302.

Ishikawa, Y., Watanabe, I., Hayakawa, I., Minakuchi, S., & Uchida, T. (2007). Evaluations of masticatory performance of complete denture wearers using color-changeable chewing gum and other evaluating methods. J. Med. Dent. Sci., 54 (1), 65-70.

Fueki, K., Yoshida, E., & Igarashi, Y. (2011). A structural equation model relating objective and subjective masticatory function and oral health-related quality of life in patients with removable partial dentures. J. Oral Rehabil, 38 (2), 86-94.

Jeyapalan, V., & Krishnan, C.S. (2015). Partial edentulism and its correlation to age, gender, socio-economic status and incidence of various Kennedy’s classes – a literature review. Journal of Clinical and Diagnostic Research, 9 (6), 14-17.

Kasperski, J., Żmudzki, J., & Chladek, G. (2010). Denture foundation tissues loading criteria in evaluation of dentures wearing characteristics. Journal of Achievements in Materials and Manufacturing Engineering, 43 (1), 324-332.

Keyf, F. (2001). Frequency of the various classes of removable partial dentures and selection of major connectors and direct/indirect retainers. Turk. J. Med. Sci., 31 (5), 445-449.

Nakatsuka, Y., Yamashita, S., Nimura, H., Mizoue, S., Tsuchiya, S., & Hashii, K. (2010). Location of main occluding areas and masticatory ability in patients with reduced occlusal support. Aust. Dent. J., 55 (1), 45-50.

Marković, D., Petrović, L., & Primović, S. (1999). Specifics of mastication with complete dentures. Med. Pregl., 52 (11-12), 464-468.

Muneeb, A., Khan, B.M., & Beenish, J. (2013). Causes and pattern of partial edentulism / exodontia and its association with age and gender: semi rural population. IDJSR, 1 (3), 13-18.

Yoshino, K., Watanabe, H., Fukai, K., Sugihara, N., & Matsukubo, T. (2011). Number of occlusal units estimated from number of present teeth. Bull. Tokyo Dent Coll., 52 (3), 155-158.

Yoshino, K., Kikukawa, I., Yoda, Y., Watanabe, H., Fukai, K., Sugihara, N., & Matsukubo, T. (2012). Relationship between Eichner Index and number of present teeth. Bull. Tokyo Dent Coll., 53 (1), 37-40.

Olofsson, J.B., Ljungqvist, O., Stjernfeldt, P.E., Wardh, I., Odlund Olin, A. (2017). Relationships between oral health-related quality of life and objective and subjective masticatory ability in geriatric patients: A Pilot Study. J. Dent. Oral Health, 3 (1), 57-62.

Montero, J., Castillo-Oyagüe, R., Lynch, C.D., Albaladejo, A., & Castaño, A. (2013). Self-perceived changes in oral health-related quality of life after receiving different types of conventional prosthetic treatments: a cohort follow-up study. Journal of Dentistry, 41 (6), 493-503.

Sutton, A.F., Glenny, A.M., & McCord, J.F. (2005). Interventions for replacing missing teeth: denture chewing surface designs in edentulous people. Cochrane Database Syst. Rev., 25 (1), 1-17.

Tarkowska, A., Katzer, L., & Ahlers, M.O. (2017). Assessment of masticatory performance by means of a color-changeable chewing gum. J. Prosthodont. Res., 61 (1), 9-19.

Witter, D.J., van Palenstein Helderman, W.H., Creugers, N.H., & Käyser, A.F. (1999). The shortened dental arch concept and its implications for oral health care. Community Dent Oral Epidemiol., 27 (4), 249-58.

Żmudzki, J., Chladek, G., & Kasperski, J. (2015). Biomechanical factors related to occlusal load transfer in removable complete dentures. Biomech. Model Mechanobiol., 14 (4), 679-691.

How to Cite
Bratus-Hrynkiv, R. (2019). Diagnostic criteria and principles of overdenture construction design in patients with mandibular single remaining teeth. Clinical Dentistry, (4), 56-62. https://doi.org/10.11603/2311-9624.2018.4.9752
Ortopedic stomatology