What Is an Overdenture

A complete denture
that is supported and often
retained by the underlying
teeth or implants and tissue

Abutment teeth or implants

may or may not
be connected to the denture
via attachments

Bars

Studs
Load bearing

Magnets

Copings
Implants

Overdenture Attachments
Teeth
Extraradicular
Combinations

Posts
Non-Load-bearing
Intraradicular

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Overdenture Attachments
Radicular:

Bars:

Extraradicular
Studs, magnets,

ERA

Intraradicular
Zaag, Zest,

Sterns

root anchor

Bar joints
Bar units
Round
Ovoid
Square
Rectangular

Objectives of the Program

Understand how overdentures preserve
hard and soft tissue
Maintain proprioception
Understand the function of overdenture
attachments and simplify attachment
selection
Increasing crown/root ratios to preserve
abutments
Hygiene maintenance

Carlson and Persson, Odontologist Revy, Sweeden 1967

Anterior mandible
average bone loss first year after extractions was 4mm

Tallgren, JPD,1972
Bone loss continues for at least 25 years

Dentures vs Overdentures
Natural
dentition
Chewing

90%
Efficiency

Complete dentures

59%

Overdentures

79%

Rissin and House, JPD, 1978

Indications for Overdentures

Periodontal disease
Few remaining teeth
Insufficient crown/root ratios
Vertical space
Favorable path of insertion
Retention

Advantages of
Overdentures
Maintenance of bone height around teeth by
preserving roots
Attenuates resorption patterns of alveolar
ridges
Gentler to the tissues
Increases crown/root ratios
Psychological security
Enhanced speaking ability
Maintains Proprioception

Disadvantages of Overdentures
Esthetic Considerations Bulkiness
Root canal therapy
Increase space requirements:
-interarch
-interocclusal
Increase costs

Crown / Root Ratios

Attachment Retained
Overdentures
All the advantages of Overdentures

PLUS
Superior aesthetics

Increases proprioception

Stability and comfort

Mechanical retention

Rigidity or resiliency
Support

Increased psychological security

and patient acceptance

Overdentures
Attachment Considerations
Load Bearing
Solid / Rigid
Transfers stress towards the retained
roots or implants and away from the ridge
No vertical resiliency, some hinge or
rotational resiliency
Shares the load of occlusion with the
mucosal surface
Magnets, Flexi ball, Dalbo Rotex, Bars

Overdentures
Attachment Considerations
Non- Load Bearing
Resilient
Transfers stress away from the
retained roots or implants and towards
the tissue
Vertical resiliency
Selected frequently
Dalla Bona, Rotherman, Ceka, Uni Anchor, OSO,
ORS, ERA, Bars

Overdenture Evaluation
Partial Denture
Present
Tooth position
Occlusion
Mount casts to vertical
dimension

No Partial Denture
Mount cast to vertical
dimension
Diagnostic denture wax
up reestablish
occlusion
Silicone matrix for
space evaluation

Direct Placement
Male or female premanufactured attachment
is cemented into root
Denture is made and inserted
Corresponding male or female attachment is
inserted in root
Attachment is picked up directly in the
overdenture with cold cure acrylic

Placed by Dentist

Indirect Placement
Male or female attachment is cemented into
root or may need to be cast onto coping
Corresponding male or female transfer
analog is inserted into root attachment
Transfer impression is taken and models
are poured with transfer in place
Laboratory processes denture with
corresponding attachment in place

Placed by Laboratory

Proceedures To Follow

5 mm or more root remaining in bone

Stable perio
Mount study models evaluate space required
Select OD attachment obtain reference manuals
Begin denture proceedings
Root canal therapy
Decoronate roots, extractions, insert temporary
denture reline allow time for healing
Prep tooth for attachment and cement attachment
Insert denture, make adjustments, post placement
reline
Pick up male attachment in denture