Complete dentures: Complete denture treatment is a way of replacing all the teeth in either upper or lower arches with a cost effective removable prosthesis that is both esthetic and convenient. Once it has been determined that the remaining teeth in an arch are going to be removed, there are two ways of proceeding with complete dentures. Immediate dentures involve having the denture fabricated before the removal of teeth and then delivering them on the day the teeth are removed. This has the advantage of not having to be without teeth. Standard or delayed dentures involve removing the teeth and shaping the bone first and then beginning the denture fabrication process after a period of healing (typically 6-8 weeks). Although this means that there is a period of time with no teeth, it has the advantage over immediate dentures of being able to visualize and test the wax-up stage of the denture in the mouth and get the benefit of a more stable form of the healed supporting tissues prior to denture delivery.
Partial dentures: When several teeth are missing, an economically favorable way to replace them can be removable partial denture or removable dental prosthesis (FDP). There are three basic types of removable partial dentures which are available. A metal framework RDP has a cast metal framework which supports the resin flanges and teeth and typically has cast assemblies surrounding teeth for support stability and retention. A resin RDP has only polymethylmethacrylate (PMMA) resin and no metal framework. Resin partials typically have wrought wires on either side for retention. A flexible frame RDP has a flexible resin such as nylon and gingival colored clasps. Sometimes alternative support structures are used for retaining the RDP such as dental implant attachments or tooth supported extracoronal resilient attachments (ERAs) which are connected to crowns. These permit the retention stability and support of the partial without visible clasps.
Implant overdentures: When teeth are missing, so is the stability, retention and support which is typically provided by their anchorage in the jawbone. Implants can compensate for this loss of function by providing new bony anchorage by means of precision attachments. These are studs which protrude from the gingival and connect to the removable or complete denture by means of a nylon insert (Locator) or by a direct metal to metal tapered cylindrical connection (Conus attachment). By this means additional stability, retention and support is provided to the removable prosthesis. This can sometimes allow an upper denture palate or a visible tooth-borne clasp assembly to be removed thereby improving the appearance and function of the removable denture.
Over time the configuration of the supporting soft tissues change as the alveolar bone remodels, reducing denture support. Dentures become loose as a result of the gum tissue at the ridge receding from the denture. Relining a denture is often a good way to regain lost support and stability and can significantly improve denture function.
The reline process usually involves two appointments on the same day. First thing in the morning, the denture is filled with impression material and used as a tray supporting a reline impression. The impression is sent to the lab which replaces the impression material with new acrylic using a reline jig. The denture is then finished and polished and returned in time for a late afternoon appointment for delivery that same day.