Dr.

Mahmoud Ramadan I

Rem. Prosthodontics
502
Dr. Mahmoud Ramadan II

Remote Over-denture
-:Metal base Over­denture →
-:Advantages *
.( Strong ( i.e. less susceptible to breakage -1
.( More rigid ( i.e. resist the dimensional changes of the denture base -2
.Supporting tissues responds more favorable to the metal base -3
.(It is excellent in jaw relation recording ( i.e. highly stabilized& highly supported -4

-:Disadvantages *
.High cost& ↑ time -1
.Relining gives more technical problems -2
.Occupy a space → so, interfere with positioning of artificial teeth -3
.Give poor esthetic effects -4

-:Indications *
.Pt. who respond favorably to an interim Overdenture for 8-12 month -1
.Pt. who have the motivation -2
.Pt. who have proper oral hygiene -3
.Pt. who break resien interim Overdentures repeatedly -4

-:Contraindications *
.Poor oral hygiene -1
.Lack of motivation -2

-:Abutment coping ♥
-:Advantages →
.Caries protection for abutment teeth -1
.Reinforce the endodontically treated teeth -2
.Preserve abutments contours -3
.Produce specific abutment contours& obtain excellent psychological results -4
-:Disadvantages →
.time& ↑ cost of treatment ↑ -1
.Irritate the gingival tissue -2
.Marginal caries can occur -3

-:Preparation of the abutment teeth ♥
Incisal or occlusal surface of the coping for metal base Overdenture is convex → →
in order to provide rounded contact. →
Periodontal, Endodontic, Restorative& Surgical procedures are completed before
.teeth prepared for coping
Dr. Mahmoud Ramadan III

-:Sufficient tooth structure is removed 2 or 3mm above the gingival margin for →
.A favorable C/R ratio -1
.Placement of artificial tooth similar in size& shape to natural one -2
-:The basic principals in Full crown preparation →
a- Occluso-gingival reduction of clinical crown to provide advantage of periodontal
.support
b- Reduction of the axial surfaces to provide sufficient space for esthetic placement
.of denture teeth of proper size& contour
.A dowel 5:7mm in root canal is used to achieve the desired retention →
Parallel tapered groove can be place in buccal or lingual surface of the canal →
preparation to counter rotational forces& to identify the buccal side from the
.lingual side during cementation
Pins may used for retention instead of a post. ( 2 or 3 pins 4 -5mm long are →
.( adequate

-:Making abutment impression ♥
.Full arch impression is made by alginate or rubber base impression →
.Impression material is injected carefully around the post preparation →
.After setting, the impression is removed& examined →
Abutment is treated with fluoride containing solution to inhibit caries & canal →
.opening sealed with Gutta-percha
It is preferable to cement coping within few days& the interim prosthesis used →
.during this period
.Impression is poured& die obtained →

-:Wax pattern ♥
Contour should be hemispheric with convex upward& smoothly rounded axial →
.surfaces
.All abutments copings should be 2:4mm above gingival margin →
.Pattern then are sprued, invested, burned out& casted in type III gold →

-:Adaptation of interim Overdenture ♥
By removing resien from coping indentation to permit the denture to seated over →
.the coping without interference
Acrylic resien is added to the indentation& adapted to coping contour & →
.finished
.It can be used until pt.'s new denture is completed →

-:Make the impression ♥
.Base plate wax is used to create a space for impression material →
.Impression compound used to border molding the tray →
.Tray is perforated to ↑ retention of the impression material& to minimize voids →
Dr. Mahmoud Ramadan IV

.Then, impression should be poured soon as possible →

-:Design consideration for the denture base

Metal base shouldn't extent into pronounced tissue undercut. Because, this →
.would interfere with seating the base on master cast
Posterior tilt minimize the presence of anterior undercut& facilitate extension of →
.the base to this area

-:Mandibular metal base design consideration ♥

-:Extension of metal base (1
.The metal base should extend sufficiently to allow it for jaw relation recording →
Displaceable residual ridge tissue& undercut areas may required modifications →
.in base extension
The base should extend over the ridge portion of the cast& the coping far enough →
.to approximate the area covered by the attached gingiva
The borders of the metal base should be short enough& completed with resien to →
.permit adjustments

-:Relief for copings (2

The relief area should extend approximately 2/3 of the distance up the abutment →
and taper in thickness from about 0.5mm at the gingival margin to 0.0mm at the
.Incisal extent of the relief