Retention and Stability of Complete Denture

**Retention : Is resistance of the denture to displacement in the opposite direction of the insertion . Factors involved in the retention of CD : I- Physical factors : 1- adhesion : Its a physical attraction between unlike molecules. Depends on :close adaptation , fluidity of saliva. 2- cohesion : Its physical attraction between Like molecules. It depends on : area covered by denture . 3- interfacial surface tension : It depends on : oral mucosa have a low ST so ability of fluid to wet the material, close adaptation between denture and supporting tissues , the area covered by denture . 4- Capillary attraction : When there close adaptation between denture and supporting structure , the space filled by thin film of saliva as a capillary tube so help in retention of denture. This depend on : Area covered by the denture .

5- Atmospheric pressure : Ex: post dam area .

Its mainly affect the retention of the upper.

II- Anatomical factors : It mainly affect lower denture !! 1- ridge form : - haigh and flat crest and well formed >>> in recent extraction . the problem only is no space for setting of teeth . - flat one >> difficult and no retetion and stability . So in taking the impression try to extend it beyond mylohoid area to gain more stability and retention. - ridge with undercut >> more common in upper so we do surgery in one side and block out the other side (dead space ).And we have to change the path of insertion. -knife ridge >>difficult and cause lacerations and pain to the pt . - Flabby ridge >> fibrous tissue and movable , no good seal and need surgical correction. 2- Vault Form : - U shaped >>> good in retention and stability .

- V shaped >>> have retention but no stability and any pressure on it could break the seal .In this case we have special method to take an impression Which is:1-Application of wax on the border of the tray. 2-Application of alginate by finger on critical area like the palate. Then take the impression normally. - flat shaped >>> no enough depth, so no retention and stability . 3- Arch Form : Squared, ovoid , tapered and the better one is the squared .(why) Bz: 1-there is 4 point of contact with denture . 2-Resistant the lateral forces. 3-? 4- Arch relationship : Most of edentulous pt have class III >>> because of the pattern of bone resorption of the ridges . So the limited in movement only opening and closing .(no protrusive movement). Some have class II and it isn't favorable because it have small surface area,And difficult to get the upper and lower in contact.

5- Interarch distance : Small interarch space >>> more retention. 6- Tongue : If too big >> it could interfere with denture . So dislodging of the lower and upper . 7- Mucosa : We need it Firm , compressible and even thickness. Not to be thick and flabby . *Two types of mucosa :1-Thick >>>>>> movable 2-Thin >>>>>>>Pain 8- Saliva : 1- we need low surface tension >> to able to wet the denture . 2- not to be thin and scanty . 3- thick to some limitation >> good in retention.

III- MECHANICAL FACTORS : it mainly affect the lower denture !! 1- polished surface of denture :

It must follow the anatomy of muscles >> so no interferences with function . Ex : in lower ant area >> we need it to be thin >> so no interferences with the modulus .(premolar area). 2- wide coverage : 3- placing the teeth in the neutral zone : So equal forces on the both side from the tongue and cheek >>> good retention . 4- engagement of undercut : 5- denture borders : Need to be extended to the full depth of sulcus during function . Ex : in taking the upper final impression >> ask the pt to move the mandible right and left >> so we can deterimine the depth of croniod process .

IV- AIDS IN RETENSION : 1- denture adhesive :

Mainly to the upper used , in public speakers as an insurance method but the disadvantages are : Constipation , unpleasant odour , temporary seal . 2- vacuum device : -Its like a suction chamber and may cause hyperplasia of tissues >> cancer -Alternative name >>>> rubber disk or palatal window. 3- spring . 4- magnets .

If there is no success : We can do surgery : 1- ridge augmentation . 2- deepening of the sulcus .>>the denture then stitched to prevent the rebound effect of the operation . 3- dental implants : in the upper >>> spongy bone and high rate of failure . So we need to put 4 implants . In case of lower we put 2 implants cause its mainly compact bone and stable . STABILITY: Factors affects : 1- retention . 2- balanced occlusion .

3- occlusal plane .>> if we increase the occlusal plane >> increase resorption and decrease stability . 4- position of post teeth : In upper >> must be on ridge . In lower >> on ridge or lingual to it . 5- proper relief . 6-ridge form . 7- vault form. Width of the occlusal table >>must be less than normal teeth >> to get god stability and retention.

Done by : Elham Sahafi .