Diagnostic criteria and principles of overdenture construction design in patients with mandibular single remaining teeth
DOI:
https://doi.org/10.11603/2311-9624.2018.4.9752Keywords:
mandibular single remaining teeth, occlusal factors, artificial teeth arrangement scheme, overdentures, chewing load distributionAbstract
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.
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