1. Introduction to Complete Dentures ✅

What Is a Complete Denture?

a removable dental appliance that replaces all of the natural teeth in either the
upper (maxillary) or lower (mandibular) jaw — or both.

it restores a patient’s ability to chew and speak, and re-establishes the facial support lost when natural teeth are gone.

Two Arches, Two Appliances

Maxillary (upper) denture — replaces the upper arch

Mandibular (lower) denture — replaces the lower arch

Key Features & Retention

Full Arch Replacement

• Used when no natural teeth remain in the jaw.

Acrylic Base

• Typically made from acrylic resin that mimics the appearance of the gums.

• PMMA
  

Artificial Teeth

• Usually fabricated from acrylic resin or porcelain.

How Upper Dentures Stay in Place

Held in place primarily by suction against the roof of the mouth (palate), aided by the post dam seal.

How Lower Dentures Stay in Place

Rests on the gum tissue and is more prone to movement; often benefits from adhesives or implant support for extra stability

Purpose of Complete Dentures

1. Restore Function
   Chewing and speaking are re-established as the dentition is rebuilt.

2. Improve Esthetics
   Smile and facial structure are supported, restoring a natural appearance

Types of Complete Dentures: Conventional Complete Denture

Made and placed after all teeth have been removed and the gums have fully healed — typically 8–12 weeks post-extraction.

Definitive fit

Types of Complete Dentures: Immediate Complete Denture

Inserted immediately after tooth extraction; serves as a temporary option while tissues heal, until a conventional denture is fabricated.

No edentulous period

Parts of a Complete Denture

1. Denture Base
The pink acrylic portion that rests on the oral tissues and supports the artificial teeth.

2. Artificial Teeth
Simulate the natural dentition; fabricated from acrylic resin or porcelain

Denture Anatomy — Upper vs. Lower

Flanges: extend into the cheeks/lips/tongue for retention (above teeth)

• on mandible you will have buccal and lingual

Palate: covers the roof of the mouth for suction, maxillary only

Post Dam: raised posterior seal that boosts retention

Border: outer edge shaped for fit/comfort

Occlusal Surface: chewing surface that restores the bite

Polished Surface: visible outer surface

DO NOT TOUCH intaglio surface (inside where the gums sit)

Trends in Removable Prosthodontic Dentistry

1. Patient Demographics: we are living longer As the population ages, more patients
live long enough to experience significant tooth loss — sustaining, not shrinking, the need for complete denture care

2. Esthetic Awareness: Increased esthetic awareness among patients has prompted greater demand for quality removable prosthodontic restorative treatment. Facial profile before and after treatment: restoring lip support reduces the sunken, aged appearance associated with untreated edentulism

3. Implant Treatment: Implant-supported dentures are becoming increasingly common in modern prosthodontic care

4. The Geriatric Patient: Elderly patients require special consideration due to compromised oral anatomy, medical and nutritional status, and
   reduced physiologic reserve and adaptive capacity.

*DO NOT KNOW #s on slide

Why Older Adults Skip Routine Dental Care

1. Perceived Need
   They don’t believe they need care.

2. Transportation
   Cannot get to the dental office.

3. Affordability
   Routine care is often not covered by Medicare or insurance.

4. Awareness
   Unaware of oral disease risk; early symptoms may be masked by age-related
   changes.
   

maxilla resorbs

up + back

mandible resorbs

down + out

In geriatric pts, Clinicians should expect a decrease in:

Denture support area

Neuromuscular control

Chewing force

Salivary flow (often medication- related)

Healing capacity

Quality of denture-bearing tissues

Consequences of Tooth Loss

Residual Ridge Resorption (RRR)

Changes in intraoral structures

Decreased masticatory function

Loss of facial support and muscle tonus

Psycho-social effects

Denture wearers are, in a sense, “oral invalids” — they must relearn how to function without natural dentition

Residual Ridge Resorption: The Physiology

Physiologic Tension → Apposition
Normal levels of tension — such as that transmitted by loading the periodontal ligament (PDL) through natural dentition — result in bone apposition (growth).

Non-Physiologic Compression → Resorption
Non-physiologic compression, such as that which may occur under denture bases, instead results in bone resorption over time

Patterns of Ridge Resorption: Maxilla

vertical & palatal direction, ~0.1 mm/year (sustained).

Initial-year loss is greater but variable.

Patterns of Ridge Resorption: Mandible

vertical, oriented along the cross-sectional shape of the mandible — resorption is roughly 4x the maxillary rate (varies)

can hit mental nerve

Atrophic Changes in the Edentulous Patient

landmarks of CD *KNOW

Changes in Intraoral Structures

Atrophic changes in the residual ridge lead to unfavorable changes in vestibular attachments

Atrophic changes in the mucosa compromise the denture- bearing surface

Loss of teeth removes functional “fulcrums” for tissue support

Support, stability, and the patient's ability to manipulate the denture during function are all affected

what is on the maxillary surface

maxillary tori/ exostosis

Psychosocial Effects: The House Classification

Clinical Sequence of Care *know

Materials used

Acrylic resins: for the denture base, PMMA

Artificial teeth: acrylic or porcelain types

Impression materials: for primary & final impressions

Common Issues & Troubleshooting

Sore spots: localized tissue irritation

Poor retention/stability: dentures shift during function

Speech & esthetic concerns: adaptation period for the patient

Maintenance & Patient Education

Cleaning Instructions
Daily brushing and soaking protocols to keep the prosthesis free of plaque and stain.

Follow-Up Schedule
Routine recall visits to monitor tissue health and denture fit over time.

Longevity & Replacement
Dentures typically need relining, rebasing, or replacement as the ridge continues to resorb

Key Takeaways

Complete dentures replace all teeth in one or both arches, restoring function and esthetics.

Demographic and clinical trends — an aging population, esthetic demand, and implant options — keep this treatment clinically relevant.

Tooth loss triggers ongoing residual ridge resorption, so anatomy and support must be reassessed at every stage.

A patient's psychosocial profile (House Classification) shapes the treatment prognosis as much as the clinical anatomy.

Success follows a defined clinical sequence: evaluation → impressions → records → try-in → delivery → follow-up