Removable dentures are dentures that can be removed and put on by the dentist without help. Wearing this type of construction is appropriate when it is not possible to install implants or bridges. Even those who are missing teeth on one or both jaws can choose this type of prosthetics. Modern dentistry offers a number of models that look natural and are suitable for different types of clinical cases.
Indications for removable dentures
The doctor prescribes the wearing of removable dentures in cases where:
- The patient is missing a whole row of teeth and there are no conditions for fixing a bridge denture.
- All teeth of the upper or lower jaw are missing.
- There are absolutely no teeth in the mouth, on either jaw.
- One or more teeth are missing, but implants or bridges are postponed indefinitely.
- Chronic diseases affecting the peri-dental hard soft tissues (chronic periodontitis or periodontal disease).
The absence of even one, and even more several consecutive teeth does not pass without a trace for the structure of the jaw and the state of the tissues of the oral cavity. In place of the “gap” in the row, the bone tissue of the alveolar processes and even the jawbone itself eventually atrophies. And the more the bone decreases, the less chance there is of successfully placing implants in it without additional costly surgeries.
In addition to atrophy in the place of the missing units, another serious problem awaits the patient – shifted teeth. This is unpleasant not only because of the damage to the aesthetics of the smile. Tooth misalignment can lead to problems with chewing function, and digestive and other systems can also be impaired.
Despite the fact that dental implants are a more reliable solution to the problem, they are not always feasible. Often the cost of the surgery becomes an obstacle, which can be too high for the patient if many teeth are missing.
In this case, it is advisable to wear dentures to protect the tooth row from deformation and preserve the volume of hard tissue. If the patient decides to have implants in the future, wearing dentures prior to surgery will slow tissue atrophy and aid in the successful healing of the implants.
Sometimes implants are not recommended to the patient for medical reasons. This can be because of systemic diseases or because of local pathologies. In this case, prosthetics is the only solution for now. The installation of bridges is not always suitable, and it is not feasible when a number of teeth are missing. Fabrication and wear of modern removable dentures can be a solution.
Types of removable dentures
The following types of removable dentures can be recognized by their construction and fixation:
- In the complete absence of teeth,
- Partial dentures,
- Conditional removable dentures.
Even the complete absence of teeth is not a hopeless situation, because in this case there is a special type of prosthetic products. They are called removable lamellar or plate prostheses. Thanks to a wide base that is able to “graft” to the mucous membrane of the palate with the right sequence of actions, such a prosthesis can be held without additional attachments.
Full removable plate dentures have in their structure:
- The base, the palatal part of which is a solid plate;
- Crowns, which are tooth-shaped and inserted into the gingival part of the base.
The method of fixing the plate denture is simple. When it is pressed down, its edges are slightly submerged in the mucosa – so a closing, aka marginal, valve is formed. Then, when the teeth are pressed down, air escapes from under the denture, thus achieving a complete fit to the mucosa.
However, this category of denture has its disadvantages
- The need for replacement approximately every 3 years.
- Lack of fixation.
- The need for replacement is due to “shrinkage” of the gums. Usually, when chewing solid foods, the teeth take the load, distributing it also to the jawbone. Without them all the pressure is on the gums, whose framework is a relatively thin wall of the alveolar appendages. Because of this, their bone tissue cannot withstand the pressure and gradually diminishes.
The decrease in the height of the gums may not be too noticeable visually, especially since the plate helps distribute the load. However, the process of atrophy, although slow, is confirmed by the loss of fixation of the plate prosthesis over time. The shape of the prosthesis ceases to fit the tissues precisely, which is why the prosthesis needs to be replaced every three years.
Fixation problems are more common with plate prostheses than with partial dentures. Fixation is generally stronger on the upper jaw, while mobility is difficult to avoid on the lower jaw.
Complete fixation is achieved in this case by fabricating mini-implants specifically for the denture. An alternative, although less effective method is the use of special agents to increase the adhesion (sticking) of the denture to the mucosal surface: fixing creams, pastes and gels.
Prosthetics for partially missing teeth
Partial missing teeth is when there are at least a couple of teeth on the jaw that can be used as support teeth.
The advantages of attaching a denture to the supporting teeth are as follows:
- The prosthetic structure is more securely attached and remains immobile during chewing;
- The gums are relieved of a portion of the chewing pressure that causes atrophy.
Clasps are often used as attachment devices and can be made of metal, acrylic, nylon and other materials. The clasp-type prostheses differ in terms of fixation methods – they come in the form of clasps, attachment locks and telescopic crowns.
Modern dentistry also presents dentures with anchoring to the supporting teeth in the form of “cover-crowns”. In this case the teeth are not fitted with clasps-hooks, but with slightly wider nylon crowns, which are an inseparable part of the structure. Thus, these products are removable dentures without lamellar palate for the upper jaw and dentures without clasps for the lower jaw.
Conditional removable dentures are those for which implants are placed. Implants for removable dentures are most often needed in the following cases:
- If teeth are completely missing from the lower jaw – because without support points in the form of teeth or implants, dentures cannot be securely attached to it.
- If no teeth at all on the upper jaw – when it is impossible or unwanted to wear dentures, and for a perfect fit even with intensive chewing.
- If some natural teeth are preserved, but these are not sufficiently suitable support points for the denture.
- In cases of pronounced bone atrophy, for the most secure and long-lasting retention, even when the height of the alveolar ridges is severely reduced.
A conditional implant-supported prosthesis cannot be “popped out” even under intensive masticatory pressure. It can only be removed intentionally with some effort.
Types of dentures according to material of manufacture
Depending on the material of manufacture, dentures can be:
- Of acrylic plastic;
- Acry-free, flexible, non-monomeric plastic;
- with metal arch in the base – partial denture.
Solid acrylic as a material for prostheses has both disadvantages and advantages at the same time. For example, a removable denture made of acrylic in a plate design is suitable for use with a total lack of teeth, unlike nylon constructions.
The fact is that it is the hard plastic plate that, when properly aligned with the mucosa tissue, provides the suction effect. This ensures the immobility of the prosthesis, which is not fixed with hooks or locks.
Advantages of hard acrylic dentures
- Slows down gingival atrophy – due to the even distribution of the load on the hard substrate.
- Can be anchored to the upper jaw even without natural teeth or implants.
- Relatively inexpensive.
Acrylic removable dentures have the most affordable price. Therefore, when many teeth are missing, this option is often preferred.
However, the hard plate may require a lot of time to get used to it because of discomfort during conversation, diction disorders. In addition, the taste sensation is blunted, and sensitive mucosa may be irritated by rubbing.
The ability of the plate to “graft” to the palate also has a negative side – the formation of a vacuum in the space between the denture and the mucosa when the plastic coating is displaced. With high capillary permeability, this can cause swelling and inflammation.
To eliminate irritation and avoid the development of mucosal diseases with removable dentures made of plastic it is extremely important to follow certain hygiene rules, if necessary using antiseptic and anti-inflammatory agents.
Nylon is more flexible and comfortable to use than hard acrylic. Simply wearing nylon dentures causes less discomfort due to the softness of the material. The sensation of a foreign object in the mouth is less pronounced, so it is much easier and quicker to get used to these prostheses at rest.
The main advantages of nylon prostheses
- High aesthetic qualities.
- Lightweight and flexible compared to hard plastic.
Nylon’s translucency helps the product visually blend in with the gums, including clasps designed for anchoring to the supporting teeth. Therefore, the aesthetic qualities of nylon dentures are among their strengths.
One of the main disadvantages of nylon is its excessive softness, which can cause pain during chewing. It also threatens a faster atrophy of the gums than with hard dentures, due to the uneven, point load on them when they are pressed.
The second disadvantage is the impossibility of full use of nylon dentures with a complete lack of teeth. The plate made of this material will not be able to create a suction effect, as in the case of the acrylic base, and will regularly separate from the mucosa. Therefore, if the doctor recommends removable and nylon dentures, and there are no supporting teeth, it is necessary to install implants for fixation.
The material used to make Acry-free dentures can be called a compromise between hard acrylic and soft nylon. In this case a special type of acrylic is used – a monomer-free plastic. This makes the material hypoallergenic and optimally flexible.
Advantages of Acry-free dentures
- Thinness – the small volume of polymer allows the fabrication of dentures that are virtually invisible in the mouth.
- Reduced weight – compared to conventional acrylic, the lightness of Acry-free can be felt even when weighed on the palm of the hand, and even more so when worn and used all the time.
- Moderate flexibility – the new polymer is much more flexible than conventional acrylic, and at the same time not as soft as nylon. It provides comfort in use.
- Hypoallergenic – the absence of monomer in the plastic base largely avoids allergic reactions and toxic effects on sensitive mucosa.
Acry-free prostheses are successfully prescribed for patients who are allergic to the monomer used in conventional acrylic and to the metals used in partial dentures.
There is a disadvantage with this type of construction. Despite its moderate flexibility, the material is still not hard enough to evenly distribute the load on the gums when pressed. Therefore, intensive chewing movements will still approach gingival atrophy faster than with hard plastic-backed prostheses and partial dentures.
Clip type dentures
Crimped dentures have a metal element in their structure. It is a half-circle to which other parts are attached: a gingival bed made of plastic and ceramic crowns.
The advantages of partial denture construction
- Reliability – thanks to the metal arch (by the way, “bustel” is translated from German as “arc”), the prosthesis can withstand a strong, but irregular load.
- The possibility of making a removable denture for the upper jaw without a plastic palate, even in the absence of a large number of teeth.
- High capacity for even load distribution – it helps to slow down gum atrophy.
- Durability – the structure lasts for at least five years.
- Repairability of prostheses
Dentures can be considered the best option for removable dentures in many cases. Their benefits are mostly worth it for the sake of wearing “partial dentures” to install implants – in the absence of the supporting teeth needed for fixation.
The metal arch can completely replace the plastic denture plate on the upper jaw. This eliminates the risk of a greenhouse effect between the mucosa of the palate and the plate. This means (if you are not allergic to metal) there will be no conditions for irritation and overly active bacterial reproduction.
This is considered even better than the new palate-less denture models with “cover-crowns” for the supporting teeth that have entered the dentistry market, because these cannot distribute the pressure on the alveolar processes evenly enough and do not always ensure full retention. In addition, “shell crowns” are not suitable for anchored teeth in the smile zone, as they visually deteriorate their shape and make them appear larger.
Depending on the type of attachment, partial dentures are:
- clasp dentures,
- on clasps (attachments),
- On telescopic crowns.
Claspers are attachment devices in the form of hooks that catch the denture to the supporting teeth. The advantage of clasps is the lower cost compared to the other types.
However, if the anchoring teeth are in the anterior row, metal clasps may be visible when smiling. The solution is to use acetal, a special polymer material that is similar in color to tooth enamel.
An attachment is an attachment that consists of two parts, one inner and one outer. The inner cylindrical part is attached to the anchored tooth or implant. The outer part is also a cylindrical piece with a hole, which, like a sleeve, is attached to the inner part. The outer part of the attachment is attached to the denture.
The attachment is usually less visible than a metal clasp. The disadvantage is that attaching the inner part to the natural anchoring tooth will require the tooth to be grinded down and a crown fitted.
Telescopic crowns are the most aesthetically pleasing, but even in this case, the supporting teeth must be grinded down beforehand. Each crown has an upper and a lower part that overlap to ensure a snug fit.
First, small “caps” are placed on the prepared teeth. The hollow upper crowns are then placed on top of these caps and are an integral part of the overall restoration. The result is a secure fit and a natural looking set of teeth.
It is advisable to install such dentures when the supporting teeth already require treatment or restoration, because after the procedure remains a completely restored flat tooth row without any visible defects.
How to care of dentures
Many details are taken into consideration during the design of the denture, including the quality characteristics of its surface. Plaque and bacteria do not adhere well to a smooth material and can be easily cleaned with special products.
One of the biggest mistakes denture wearers make is neglecting maintenance: many people use a regular toothpaste and toothbrush to clean them. This results in a loss of that all-important smoothness. Even if visually the denture looks like it used to be, in reality it’s covered in tiny scratches from such intense cleaning.
Unlike living tissue, the denture material does not repair micro-damage. Bacterial plaque immediately begins to adhere to the rough surface of the denture, and the germs multiply with all their might and transfer to the already vulnerable mucosa in the denture area.
The result is a bad odor, hard deposits may even form on the denture, causing damage to the living tissues of the mouth. All of these problems can be avoided by following the care instructions for the prosthesis and using specific products for cleaning.
Care instructions for removable dentures
- After each meal, rinse under running water and clean with a toothbrush.
- Use only a toothbrush with soft bristles.
- Use non-abrasive products – regular toothpaste is not an appropriate solution because its abrasivity index is too high.
- Regularly perform a complete disinfection of dentures with ultrasound or in a special solution – at least several times a week, and better daily.
During rinsing under running water, you need to hold the construction firmly, as a bad fall can lead to breakage. It is better to do this over a sink with a towel on the bottom to soften the impact.
In addition to rinsing the denture, you should brush your teeth, palate, and tongue after every meal. A soft toothbrush should also be used so that frequent brushing does not damage the mucosa.
For nylon and Acry-free denture material, either special products or pastes and gels that state that the RDA (abrasion coefficient) is zero should be used.
Hard acrylic dentures can be cleaned with a children’s toothpaste with an RDA of 25 or less or with a dishwashing liquid. Even when cleaning with a soft brush, you must be careful to touch the clasp and other places that can bend.
Depending on the type of dentures and the complexity of the work, the price can vary significantly. The table below shows approximate prices for dentures in the United States.
|Complete Dentures||$1,300-$3,000 (upper or lower, not both)|
|Temporary (Immediate) Dentures||$1,500-$3,200 (upper or lower, not both)|
|Partial Removable Dentures||$650-$2,500 (upper or lower, not both)|
|Implant-Retained Dentures (Overdentures)||$1,500-$4,000 (upper or lower, not both)|
|Snap-In Dentures||$1,500-$4,000 (upper or lower, not both)|
Which are the best dentures to wear?
It is impossible to say that any denture is uniquely the best: much depends on the doctor’s indication and the patient’s individual reaction to the material. Of course, it matters how many teeth are missing and in which areas.
There are advantages and disadvantages to both nylon and plate dentures. In most cases, partial dentures can be considered the best removable dentures. They are great for the lower jaw, providing a snug fit even with constant movement and tongue entrapment. They also distribute the load best.
But when several teeth are missing at the end of a row, i.e. when there is an end defect, partial dentures may not always be suitable. In this case or if the jaw is missing any teeth at all, partial dentures require the placement of several implants to support them.
Conclusion: clasp dentures can be considered the most reliable and successfully slow down atrophy. Because of the metal arch, standard models cannot be worn by those in whom metal in the mouth causes an allergic reaction. But in this case, partial dentures made of acetal, a polymeric semi-crystalline material used in modern dentistry, should be suitable.
Dentures, even removable ones, should be made of quality materials, strictly follow the technology of manufacture, perfectly repeat the shape of an impression. At a relatively low cost compared to implants, if even one of these conditions is not met, it means that your money is wasted.
Low quality materials are more likely to have a toxic effect and cause an allergic reaction. And a mismatch in the edges of the denture base of the transitional fold will cause tissue trauma.
That is why dentures should be ordered only from trustworthy clinics with modern dental laboratories and highly qualified staff, including dental technicians and orthopedists.
In our clinic you can get an accurate diagnosis of the state of your mouth and competent consultation with a specialist, as well as order any type of removable and conditional dentures.
We provide affordable prices for prosthetic constructions and select the most suitable options for each client. Call us and make an appointment now, so you don’t have to put off taking care of your smile until later.