Complete dentures. Prosthetics in the complete absence of teeth - how to restore the dentition? Clasp prosthesis in the complete absence of teeth

The dental structure consists of a base and artificial teeth, fixed in the oral cavity with the help of physical adhesion. The basis of the design is pink and imitates the natural gum, the shape and color of the teeth are selected according to the wishes of the patient.

The prosthesis has many advantages: it is easy to manufacture, has an affordable cost and a long service life, and is made from various dental materials.

Features of prosthetics in the complete absence of teeth

With age, tooth loss occurs due to various reasons, the main of which are dental diseases. After the loss of teeth, the functions of the oral cavity are disturbed, and as a result, various diseases of the body can occur.

difficulty eating;
violation of speech and aesthetics of the oral cavity;
change in the appearance of the face, lips and cheeks flow into the oral cavity;
bone tissue atrophy occurs, as a result of which complications arise with further treatment;
diseases gastrointestinal tract, violation of digestion of food.

Prosthetics in the complete absence of teeth has its own characteristics, since there are no teeth in the oral cavity on which to attach and fix the prosthesis, the dentist and dental technician must take into account many points in order to ensure fixation and stabilization.

Fixation is the retention of the prosthesis on the alveolar processes of the jaws, and stabilization is the fixation of the prosthesis during the performance of the following functions:

Fixation . During treatment, the doctor takes into account the anatomy and individual characteristics of the oral cavity so that the methods of fixing complete dentures are effective. During the examination, the type of alveolar processes and mucous membrane is determined, depending on which various types of impression materials are used. In the absence of fixation conditions, it is recommended to perform surgical interventions: plastic surgery of the vestibule of the oral cavity, trimming the frenulum, removal of mucous cords, and bone augmentation. One of the options for a strong fixation of the prosthesis is the operation and the installation of implants in the jaw bone. The procedure is complicated and expensive, but it allows you to securely fix the structure. To complete it, it is enough to install four implants on one jaw.
dental material . Another feature of prosthetics is the choice of material, on which many properties of the prosthesis depend. The doctor must choose a dental material that will be strong enough, aesthetic, will not break during eating, and will correctly distribute chewing pressure. Dentures are made from acrylic, nylon, and silicone.
Adaptation period . After installing the product in the mouth for a month, the process of getting used to the new design takes place. Habituation depends on the characteristics of the oral cavity, individual sensitivity and the material of the prosthesis. Nylon and have a soft and elastic base, so getting used to them is easier.

A complete removable prosthesis for the upper jaw differs from the product for the lower jaw. There is a plate on the upper jaw - a part of the prosthesis that covers the palate and enhances the suction of the product, the prosthesis for the lower jaw has a cutout for the tongue.

Complete denture options

According to the type of fixation of the structure, there are two types:

Classic full dentures . Fixed with physical adhesion. Designs are made so that the inner surface of the product exactly meets the characteristics of the oral cavity. When a prosthesis is applied between it and the mucous membrane, a vacuum occurs and the structure is sucked. In this case, a sufficiently strong fixation occurs, but if the prosthesis is poorly fixed, experts recommend additional use of dental creams for fixation.
Prosthetics on implants in the complete absence of teeth . Carried out for a solid installation of teeth. For this, two stages of treatment are carried out: surgical and orthopedic. At the surgical stage, they carry out - the installation of metal rods in the jaw bone. After engraftment of implants, the manufacture and installation of prostheses is carried out.

According to the type of material used to make prostheses, there are:

Acrylic (plastic) dentures are suitable for everyone who is not allergic to acrylic. The structures are quite rigid, but due to this they are durable and prevent bone tissue atrophy. The product is easy to manufacture, effectively restores lost functions, has a long service life and low cost. A complete removable acrylic prosthesis has disadvantages: a long period of addiction, the risk of developing allergies, trauma to the gums.
Nylon products have high strength, good fixation, resistant to chewing pressure. The material is biocompatible with body tissues and hypoallergenic. But the main advantage is softness and elasticity, thanks to which there is a quick addiction and comfortable use. The material does not damage the tissues of the oral cavity and acquires the necessary shape during installation. The disadvantages include insufficient distribution of masticatory pressure. The risk of bone atrophy and the need to use additional hygiene products.
Silicone prostheses are very similar to nylon. They have a small size, reliable fixation, high aesthetics. Thanks to its flexibility and elasticity, it is very convenient to use. The material does not cause allergies and is resistant to food dyes. The disadvantages include uneven distribution of chewing pressure, short service life of the structure, high cost.

What are the best removable dentures to use? To choose the type of prosthesis, you need to know both the advantages and disadvantages of different designs. The dentist should select the type and material of the prosthesis, taking into account the wishes of the patient.

Stages of manufacture and installation

Removable dentures in the complete absence of teeth are made with the help of a dentist and a dental technician. The stages of manufacturing a complete removable denture are simple, but require skills from specialists and a certain amount of time.

The doctor conducts an examination, diagnosis and chooses the type of future design, tells the patient about the upcoming treatment. It also treats and prepares the organs of the oral cavity: removes the roots, treats the gums and mucous membranes.

A technician is making a prosthesis in a dental laboratory. The manufacturing process consists in the interaction of a doctor and a technician, alternating clinical and laboratory stages.

Clinical and laboratory stages of manufacturing complete removable dentures:

Examination and consultation with a dentist, selection of a prosthesis. Treatment of diseases of the oral cavity, if necessary, the preparation of the alveolar bed. In case of poor fixation conditions, surgical preparation is recommended.
After preparation, the specialist takes impressions of the jaws using a standard impression tray. The procedure lasts about 20 minutes and consists in preparing a special material, applying it to the impression tray, applying it to the jaws. After the material hardens, the spoons are removed from the oral cavity, the casts are washed with water and transferred to the dental laboratory.
The dental technician makes individual impression trays for the alveolar processes. They are made to make exact copies of the jaws, which is very important for further fixation of the structure. During the manufacturing process, the technician casts a model of the jaw and models the product, the finished spoons are transferred to the clinic.
The dentist re-takes impressions, but with the help of individual spoons, which take into account all the features of the oral cavity and mucous membrane;
The dental technician makes diagnostic models - exact copies of the alveolar processes of the jaws from casts. Wax base and occlusal ridges are modeled on the models.
The dentist performs the imposition of the basis and rollers in the oral cavity to determine the central occlusion, the correct position of the jaws.
In the laboratory, the rollers are fixed in the correct position in a special apparatus - an articulator. The future wax structure with plastic teeth is being manufactured.
The model of the prosthesis is checked in the oral cavity, the doctor evaluates the position, fit of the prosthesis, occlusion, aesthetic qualities.
The technician performs the final modeling of the wax structure, gypsum the product into a cuvette and replaces the wax with plastic. Next, the plastic is polymerized and the prosthesis is removed from the cuvette. The dental technician grinds and polishes the finished product.
The dentist installs the finished prosthesis in the oral cavity, checks for defects, fixation, fit.
If necessary, the finished prosthesis is poisoned for revision to the laboratory.
During the delivery of the product, the doctor tells the patient about the rules for the care and operation of the prosthesis, gives recommendations.

How to choose a complete removable denture?

In the absence of the last teeth, it is necessary to carry out prosthetics. Specialists offer several types of prosthetics for edentulous jaws. Designs are made of various materials and can be of two types of fixation: adhesion and implants. The comfort of using the structure, the duration of the habituation period, and the shelf life will depend on the type of material.

It is necessary to choose a prosthesis together with a specialist who will assess the condition of the oral organs and advise on the design. Dentures based on implants have a strong and natural fixation. But the implantation operation can not be performed for everyone, there are many requirements for the jaw bone and contraindications to the procedure.

Each material for the manufacture of the prosthesis has its own advantages and disadvantages, the patient must know them and choose what he needs. Acrylic dentures are rigid, but strong, have a low cost, are quite aesthetic and durable. Nylon and silicone constructions are soft, flexible and stretchy. They have good fixation, comfortable use, high aesthetics.

Care and service life

You need to take care of your favorite orthopedic product. High-quality hygienic care of the prosthesis will extend the life of the product and prevent the development various diseases organism. The service life of acrylic products is about 5-7 years, soft prostheses - 3-5 years.

after eating, rinse the mouth with water or;
Remove your dentures before going to bed and clean them thoroughly. Hygiene can be carried out with the help of a paste or a soap solution;
if necessary, use a cream to fix the product;
Keep your teeth in a container with water or a special liquid.

Price

Prices for removable dentures in the complete absence of teeth will depend on several factors:

prosthesis designs;
type of fixation;
dental material;
pricing policy of the clinic;
experience of the doctor and dental technician;
city of residence.

The average cost of an acrylic product is from 12,000 to 15,000 rubles, a silicone prosthesis is from 30,000 to 40,000 rubles, and a nylon structure is from 30,000 to 50,000 rubles. Prices are current as of October 2017.

Prosthetics of the upper and lower jaw in the complete absence of teeth is a mandatory procedure after the loss of teeth. leads to the loss of functions and aesthetics, the occurrence of various diseases.

Specialists are ready to offer various types of prostheses for comfortable and functional use. You should choose the type of product together with your dentist.

Useful video about complete removable prosthetics

The complete absence of teeth (dentia), which occurs mainly in the elderly, is a common problem. Regardless of the reasons, adentia is a complete and unconditional indication for urgent prosthetics. What are the best dentures for the complete absence of teeth? This article will help you understand the many dental services aimed at restoring the dentition.

Several factors contribute to the occurrence of adentia: natural wear of enamel and dentin, periodontal disease, untimely access to the dentist, ignoring elementary hygiene requirements, injuries, and chronic diseases.

The lack of even 2-3 teeth is very noticeable and unpleasant, and when it comes to their complete absence, it can be said without exaggeration that such a condition is a serious pathology that entails many negative consequences:

Adentia can be the result of injuries, as well as various diseases.

Disorders of the gastrointestinal tract (GIT), as a result of poor chewing of food and malnutrition.
Negative changes in appearance - a patient with a complete absence of teeth acquires a characteristic elongated oval of the face, a protruding chin, sunken cheeks and lips, pronounced nasolabial folds.
Significant violations in colloquial speech: teeth are the most important and integral part of the articulatory apparatus, and their shortage, and even more so the absence, lead to the appearance of diction defects that are very noticeable to the ear.
Bone tissue degeneration of the alveolar processes (gums), which, in the absence of roots, become thinner and smaller in size, which in the most advanced cases makes it difficult or impossible for high-quality implantation (prosthetics).

The cumulative result of all the above problems is significant psychological discomfort, communication disorders, limiting oneself in vital needs: communication, work, good nutrition. The only way to return to a quality life is to get dentures.

Contraindications for prosthetics

Cases in which dental prosthetics are prohibited are rare, and nevertheless, a qualified dentist must make sure that his patient does not suffer from one of the following ailments:

individual allergic reaction to the chemical components that make up the material;
intolerance to local anesthesia (important for implantation);
any viral disease in the acute stage;
severe form of diabetes;
oncological disease;
mental and neurological disorders during the period of exacerbation;
blood clotting disorders;
severe lack of weight and depletion of the body (anorexia, cachexia).

Obviously, many contraindications are temporary, while others lose their relevance with the right choice of restoration method.

Removable dentures in the complete absence of teeth: difficulties and features

Another negative point with adentia is a very small choice. possible ways restoration of teeth. Existing methods are either expensive or have many disadvantages. A nylon prosthesis is in great demand in the complete absence of teeth. But choosing best way prosthetics, it should be remembered that a complete removable restoration of the entire dentition has a lot of features:

The main feature of complete dentures is that they do not have fasteners.

Does this mean that it is better not to resort to this method of restoration? Certainly not. Though best method restoration with absolutely missing teeth is, the use of a covering prosthesis also has a reason. It will help those who do not have the financial ability to put implants, as well as patients whose bone tissue is loose, which is a contraindication to implantation.

Types of complete dentures

Orthopedic products used to restore completely missing teeth have approximately the same design. These are arched prostheses, which on the lower jaw are held only on the gums, and on the upper jaw they also rest on the palate. The teeth in dentures are almost always plastic, and the base can be made of different materials. It is on this basis that they are classified.

Expert opinion. Dentist Yanovsky L.D.: " named after the name of the polymer from which their basis is made. Nylon is a translucent, strong, flexible and elastic material with good wear-resistant qualities. Its advantages include good aesthetic performance and hypoallergenicity, which favorably distinguish this type of dental structures from others. Considering that two out of ten people on the planet suffer from allergies to acrylic or various types of metals, for many, a nylon prosthesis in the absence of teeth is a panacea in terms of convenience and quality.

Made of acrylic - a more modern and perfect variety of plastic. It is distinguished by resistance to wear and aggressive acid-base environment, which makes acrylic a fairly popular material in dental practice. However, he has a number shortcomings, which put it an order of magnitude lower than nylon:

Both nylon and acrylic prostheses do not have any attachments - this causes difficulties in fixing them. The use of special glue, which lasts for 3-4 hours, can slightly improve the situation, but this also brings only temporary comfort. The only way to get rid of discomfort is to install polymer prostheses on implants.

Prosthetics on implants in the complete absence of teeth: advantages and types of procedures

The main advantage of implantation is reliable fixation, thanks to which the patient does not have to worry that the prosthesis will fall off at the most inopportune moment. Chewing food is also greatly facilitated: there is no need to limit oneself in taking solid and viscous foods, and this has a positive effect on the state of the gastrointestinal tract and intestinal motility.

One of the first questions of interest to people who decide on implantation is the required number of implants. In each specific clinical case, this is decided individually, and the decisive factor is the condition of the patient's bone tissue. On average, at least two implants should be installed on each jaw to hold the entire structure.

If the patient is determined to undergo surgery, and the condition of the alveolar processes does not allow it, he can undergo a sinus lift - a technique for building up bone tissue using special materials. Modern dentistry has several ways to implant implants, however, in the complete absence of teeth, it is rational to use only two of them - beam and push-button.

Button implants- a fairly reliable and relatively inexpensive method of restoration. During the operation, two implants are implanted into the gums, which end in a ball that looks like a clothes button. On the side of the prosthesis, there are holes, which are the second part of the attachment. This device allows the patient to remove the prosthesis daily for thorough cleaning.

Implantation on beams provides for the implantation of 2 to 4 implants interconnected by metal beams that increase the support area for a more thorough fixation of the prosthesis. Just like button implantation, it requires periodic removal, but at the same time pleases with good functionality.

Today, people's attitude towards complete removable dentures is largely negative - many associate them with "false jaws" that need to be removed at night and stored in a glass of water. It is generally accepted that they are very uncomfortable to wear, violate diction and can even fall out of the mouth when eating or talking.

Well, all these "horror stories" are not without certain grounds, but to a large extent they are remnants of the Soviet era, when the situation with the quality of manufactured dentures was far from being the best.

On a note

As the name implies, a complete denture is called a denture, used in the complete absence of teeth in oral cavity. Such prostheses are removable - when the patient himself can remove them (for example, for hygiene procedures), and conditionally removable - when the prosthesis can only be removed by a doctor with the help of special tools.

Fortunately, medicine does not stand still, and today, even with the complete absence of teeth in the oral cavity, quite convenient orthopedic solutions can be found that will not only restore the ability to chew food normally, but also restore the long-lost beauty of a smile.

And last but not least, a full denture today does not have to be uncomfortable to wear, rub the gums, cause a gag reflex or disrupt diction. For example, there are conditionally removable dentures without a palate, fixed on implants, which radically change the idea of the possibilities of prosthetics in "toothless" patients. The combination of surgical and orthopedic treatment allows not only to improve the aesthetic qualities of prostheses, but also to ensure their secure fixation with a significant improvement in functional characteristics that provide comfort while eating, talking, singing, etc.

There are interesting options for prosthetics without implantation, when for a relatively small amount you can get a completely comfortable and outwardly attractive complete removable denture.

What types of complete removable dentures are in the arsenal of dentists

Complete removable prosthetics is considered one of the most difficult areas of orthopedics - after all, the prosthesis needs to be somehow fixed in the oral cavity, where, it would seem, there is simply nothing to attach it to. Partial dentures can be attached to the remaining (supporting) teeth, but with full dentures, alternative methods of attachment have to be sought.

In this case, the orthopedic dentist has to take into account the following nuances:

Causes of tooth loss. For example, difficulties with complete removable prosthetics can arise when teeth are removed against the background of severe generalized periodontitis (the situation is much easier with the planned removal of relatively strong “roots” that cannot be restored);
Time since tooth extraction. If all the teeth were removed a long time ago (for example, more than 10 years ago), then the degree of atrophy of the bone tissue of the alveolar process of the jaw will be significant, and the conditions for prosthetics are worse than if it were carried out soon after the extraction of teeth (1-2 years);
Past and current diseases and operations on the jaws. A number of somatic diseases (especially severe ones) can worsen the conditions for complete removable prosthetics, forcing the prosthodontist to look for suitable alternatives. This applies primarily to elderly patients and people with combined pathologies (blood diseases, endocrine pathologies, oncological, musculoskeletal, etc.).

During prosthetics, the orthopedic dentist takes into account the condition of the temporomandibular joint (TMJ), mucous membranes (their compliance, mobility), the degree of bone tissue atrophy, checks the condition of the strands and the presence of scars, as well as the depth of the palate (deep, medium, flat) and a number of other factors that, in the case of a complete removable denture, can play a decisive role.

On a note

Having determined the conditions for complete removable prosthetics (favorable or difficult) and the financial capabilities of the patient, the doctor can offer the best option for the future prosthesis, explaining the pitfalls of each of the possible options.

It is clear that not everyone can afford full dentures without a palate with attachment to implants (that is, conditionally removable), although they are as convenient and aesthetic as possible. When choosing more budget options, preference, again, if there are financial opportunities, it makes sense to give products made from the most modern materials. The least comfortable prostheses are made of rigid acrylic plastic.

Complete removable dentures of teeth, depending on the material used in their manufacture, are:

Acrylic;
Nylon;
Silicone;
Polyurethane.

All these removable dentures are attached in the oral cavity due to the adhesive mechanism (they stick to the palate and gums - therefore they are sometimes called suction cup dentures, although there are no suction cups as such in their design).

As for the types of fastening of conditionally removable prostheses fixed on pre-installed implants, the following options are distinguished here:

Cover;
Button;
With beam-type clamps.

Each of the dentures, from the simplest (acrylic) to any conditionally removable, has its own advantages and disadvantages. The choice of option largely depends on the financial capabilities of the patient. At the same time, it is important to keep in mind that regardless of the type of complete denture chosen, the result of treatment will directly depend on the level of training of the orthopedist, the dental technician and the logistics of the clinic.

From the practice of a dentist

If you go to order a prosthesis in the dentistry in the basement of an apartment building, where the doctor accepts crowns from the "supplier" wrapped in a bag of newsprint, then it is difficult to count on first-class work. In very many cases, patients then cannot get used to such prostheses - due to manufacturing errors, they greatly interfere and rub the mucosa. As a result, the prosthesis gathers dust on the shelf, since the patient does not wear it.

Complete removable acrylic dentures

The first technologies for the manufacture of complete removable dentures made of acrylic plastic (AKP-7) were introduced in the early 1940s and are still widely used in the production of bases for various modern designs in orthopedic dentistry.

The basis is the base of a complete removable denture, on which artificial teeth are fixed. On the upper jaw, the basis is a plate covering the mucous membrane of the hard palate and the alveolar process, and on the lower jaw - the mucous membrane of the alveolar part from the outside and inside.

On a note

Due to the fact that the basis of a complete removable denture is a plate, such dentures are also called laminar.

A complete removable denture does not have the ability to "cling" to the teeth, as they are completely absent. Therefore, in these structures on the upper jaw, the effect of "sucking" to the sky is used, as well as some effect that keeps from displacement is provided by natural anatomical folds and the alveolar ridge.

The prosthesis for the lower jaw does not have such a large “suction” area as in the case of the prosthesis for the upper jaw adjacent to the palate. The design is held due to natural anatomical formations - largely due to a snug fit to the alveolar part.

Among the advantages of a complete removable acrylic prosthesis are:

Low price compared to other designs;
Possibility of repair various types damage;
Ease of operation;
Acceptable aesthetics, taking into account the relatively low bill for the service.

However, these prostheses are not without serious drawbacks:

Allergy to residual monomer in acrylic bases (although in more expensive options there are ways to eliminate the monomer from plastic);
The relative fragility of the plastic and the risk of fracture under a large simultaneous load;
Low elasticity due to hard acrylic plastic;
Frequent inconsistency of the relief of the inner surface of the base with the prosthetic bed of the mucous membrane (as a result, the reliability of fixing the structure in the oral cavity decreases).

On a note

Acrylic resin dentures can be quite high tech. For example, in 2015, technologies from the Swiss company CANDULOR appeared in Russia, offering a line of high-quality acrylic removable dentures. High aesthetics is achieved, among other things, through the use of plastic, which imitates the gingival capillary system in detail.

The situation is similar with prostheses based on other polymers (polyurethane, silicone, nylon): there are budget products, and there are also more expensive and technologically advanced ones. For example, for the manufacture of the base of a complete removable denture, the Dentalur material based on polyurethane can be used. He was awarded the Gold Medal of the ninth International Forum of High Technologies of the 21st Century and other awards. Dental dentures based on Dentalur are strong, quite elastic (due to this they are comfortable) and have a significant cosmetic advantage over standard acrylic dentures.

Nylon dentures: their pros and cons

Full removable dentures made of nylon are perhaps at the peak of their popularity over the past 10 years today - and there are a number of reasons for this.

Here are some of the main advantages of nylon dentures:

No allergy to the material. In the case of using a nylon prosthesis, unlike acrylic, there is no risk of developing an allergic reaction to the plastic monomer. Against this background, nylon greatly benefits from acrylic plastic, especially in complete removable prosthetics;
High aesthetic values. This parameter could even be put in the first place. Compared with the same acrylic prostheses, nylon ones look “rich”, and, if I may say so in relation to a full denture, they are chic (it is not for nothing that they are sometimes called invisible prostheses);
Wearing comfort. In most cases, these prostheses are easier to get used to and adapt to than standard acrylic ones;
Resistance to mechanical damage. This quality is largely due to some elasticity of the prosthesis - it is not fragile, unlike acrylic plastic. Breaking a nylon prosthesis or somehow severely damaging it is quite difficult.

However, for all their advantages, nylon dentures retain a number of disadvantages that are useful to know about in advance (in many ways, these disadvantages are typical for complete removable dentures in general):

Gradual atrophy of the prosthetic bed. With the complete absence of teeth, the alveolar ridges, experiencing an uneven load from the prosthesis, strongly “sink”. The process can take years, but is almost inevitable;
Fairly rapid loss of aesthetic qualities. Over the years, a change in the color of the prosthesis is possible, which sooner or later will require replacement of the product;
Repairing a nylon prosthesis (unlike acrylic) is almost impossible - it will be easier to make a new product.

It is interesting

Thanks to Acry Free prostheses, it was possible to combine the positive properties of acrylic and nylon prostheses, getting rid of a number of disadvantages that create obstacles for free prosthetics with acrylic and nylon. Acry-free has a good fit ("stickiness") to the mucous membrane, which improves the possibility of fixation in the complete absence of teeth in the upper and lower jaws. The prosthesis is light, non-allergenic, can be corrected, and most importantly, it provokes the phenomena of atrophy of the alveolar bone to a lesser extent.

The photo below shows the Acry-Free prosthesis:

Features of prosthetics with conditionally removable structures

Against the background of the above, a number of well-founded questions arise:

Are such methods of fixation of full dentures as “suction” and anatomical retention (retention due to anatomical formations) sufficient for reliable attachment of the structure in the oral cavity and comfortable use?
Is it possible to somehow improve the reliability of fixation of the prosthesis and increase the degree of comfort when wearing it?

For active elderly people, not only beautiful, but also securely “sitting” prostheses are especially important, capable of chewing almost any food normally.

From the practice of a dentist

Not all patients have the patience to use a removable prosthesis, which, although it does not “rub”, does not “press”, does not “press”, but there is still a feeling of the presence of a foreign object in the oral cavity. And what is most unpleasant is that there is no certainty that this “foreign object” will suddenly one day not fall out of the mouth, for example, when sneezing ...

Considerable assistance in reliable fixation of complete dentures is provided by conditionally removable prosthetics with fastening of the prosthesis on implants. The use of dental implants makes it possible not only to significantly reduce the size of the future prosthesis, making it as comfortable and easy to use as possible, but also completely eliminates the option of the prosthesis “sticking off” during chewing or talking.

On the this moment There are different types of implantation systems in order to fix a removable prosthesis:

Classical - classical implants are installed in the spongy bone of the alveolar processes. Usually, prosthetics are stretched for several months, while the implants take root in the bone tissue;
Basal - in a dense bone, which is deeper than spongy, basal implants are installed. In this case, even with significant atrophy of the bone of the alveolar processes, there is no need to increase it (that is, a sinus lift is usually not required);
Mini-implantation - in this case, narrow mini-implants are installed in the bone, designed to secure the prosthesis. Unlike classic and basal implants, mini-implants are not designed for a significant load, so a full prosthesis must also distribute the load to other parts of the oral cavity (palate, gums).

According to the methods of fixing complete removable dentures on implants, a significant niche in orthopedic dentistry is occupied by:

Micro locking;
Beam fastenings;
Magnetic clamps;
Spherical (spherical) types of fastening;
silicone rings;
Combined options.

On a note

Pre-installation of implants makes complete removable prosthetics as reliable and comfortable as possible, especially in difficult cases (with significant atrophy of the alveolar ridge, strands, etc.), when wearing almost any prosthesis (acrylic, nylon, Acry-free) promises endless trips to the dentist - an orthopedist, suffering during addiction and, as the most extreme option, sending a "puller" to the shelf.

Bar fixation on classic or basal implants is considered one of the most reliable and durable - it provides a secure fit and fixation of the prosthesis even under non-ideal prosthetic conditions.

Magnetic retainers (attachments) hold the prosthesis due to magnetic attraction. This mounting option, compared with other methods, does not provide maximum reliability in holding the prosthesis.

As for ball-shaped attachments, some experts argue that the materials of this type of attachment tend to abrasion and failure (although there are systems that have replaceable wearable parts - their replacement does not require a lot of time and money).

Currently, mini-implantation is actively used (and promoted in advertising by many clinics) for fixing prostheses on the edentulous jaw, however, a number of experts believe that mini-implants are suitable only for temporary prosthetics, but not for permanent ones. Dental mini-implants differ from others in simplified surgical and orthopedic protocols, as well as low cost. They can be installed even in clinical cases when the use of classical implants is impossible without additional preparatory operations, which may be difficult to tolerate or contraindicated, especially in the elderly.

As for implant-supported dentures, they can be made from all the same materials as removable dentures (usually nylon, Acry-Free, polyurethane).

Principles of manufacturing complete removable dentures and their installation in the oral cavity

One of the most important stages of prosthetics is the examination of the patient - it includes the study of the state of general health, possible allergies to certain drugs (materials), as well as an assessment of the condition of the prosthetic bed in many ways.

Much attention is paid to assessing the degree of atrophy of the alveolar processes in the upper and lower jaws. The condition of the mucous membrane is checked: mobility, color, “looseness”, the condition of the folds along the ridge and other points. All this allows us to clarify the important nuances of the design of the future prosthesis.

Below, using the example of a complete removable denture made of acrylic plastic, the main stages of manufacturing this design are considered:

Taking impressions and sending them to the laboratory for dental technicians;
Model casting;
Making individual spoons (as needed);
Creation of a basis with bite rollers;
Determination of central occlusion according to wax rollers;
Making a basis for bite rollers (relief modeling);
Setting teeth on glass or on a plane;
Model plastering;
Evaporation of wax;
Mixing and "packing" of plastic;
Finishing the prosthesis;
And, finally, the delivery of the prosthesis to the patient - fitting in the oral cavity.

It is interesting

Standard removable acrylic dentures are made as follows: a liquid material is poured into the mold, where it polymerizes and hardens. In the process of this, a large shrinkage of the material occurs, that is, a decrease in its volume, as a result of which the prosthesis may not correspond to the prosthetic bed and inaccurately adhere to it. In addition, micropores often form in the base, where bacterial plaque will accumulate in the future, provoking bad smell from mouth.

A new technique for creating acrylic prostheses using the IVOCAP system (Ivocap) by IVOCLAR (Switzerland) made it possible to eliminate these problems using the injection molding method - plastic is dosed in capsules and pressed under constant pressure and temperature. With this method of manufacturing, the characteristics of the prosthesis are improved.

How to take care of your dentures to make them last longer

After the patient receives a complete removable denture, the orthopedist always explains the nuances of its fixation in the oral cavity, and sometimes also teaches special speech exercises for quick adaptation to the product. Much attention is also paid to the rules for the care of the prosthesis in order to increase its service life and minimize the loss of aesthetics.

It's important to know

Complete removable dentures need daily cleaning, if only because they fit snugly against the mucous membranes and create zones that are poorly washed by saliva.

The most common care products for complete removable dentures are:

Standard denture care regimen:

In the morning and evening, clean from food particles and bacterial plaque with toothpaste and a brush. At the same time, attention should be paid to cleaning not only the outer surface of the prosthesis, but also the inner one, which is in contact with the gums and palate;
Rinse your mouth after each meal and rinse the denture under running water;
Clean the prosthesis before going to bed with special solutions.

For some, it may seem surprising, but dental plaque and even tartar can also be deposited on dentures, so it is useful to apply for preventive examinations at least once a year. In case of significant contamination of the prosthesis, it is given to the dental laboratory, where the dental technician processes the prosthesis to perfect condition.

Proper care of the prosthesis is the key not only to its long service life, but also to an important factor that determines the health of the mucous membranes, the absence of putrid breath and the preservation of aesthetic characteristics (you don’t want the artificial teeth of the prosthesis to turn brown, and the plastic to become unnatural for the gums). shade?)

How much is a complete "puller" now?

The cost of a complete removable denture is determined by a number of factors, among which the most important are the following:

The material from which the denture is made (for example, an acrylic denture will be cheaper than a nylon one);
The presence in the clinic of its own dental laboratory;
Staff qualification level;
The territorial location of dentistry (prices in megacities are usually higher than in small towns);
Individual characteristics of the patient (some anatomical nuances can complicate the manufacture of a high-quality prosthesis).

To put it simply, today only complete removable dentures made of ordinary acrylic plastic are relatively cheap - their use is considered the most budgetary option for complete prosthetics.

“I have been wearing acrylic upper and lower prostheses for only 2 weeks. The top sits great, and the bottom walks. One has only to move the tongue, as the prosthesis rises immediately. I don’t even know what it is about…”

Inna, Moscow

Here are examples of prices for full-removable dentures in one of the St. Petersburg clinics:

Acrylic prosthesis - from 8 thousand rubles;
Prosthesis from Dentalur - from 12 thousand rubles;
Lamellar prosthesis (Ivoclar plastic) - from 14 thousand rubles;
Nylon prosthesis - from 20 thousand rubles;
Nylon prosthesis (materials made in Germany), Acry Free - from 25 thousand rubles;
Removable prosthesis (materials made in Switzerland) "Kandulor" - from 40 thousand rubles.

The combination of orthopedic and surgical care greatly increases the price of treating a patient with a complete absence of teeth - when it comes to conditionally removable prosthetics, the cost of implantation itself makes the main contribution to the final price.

if you have personal experience the use of a removable prosthesis in the complete absence of teeth in the upper or lower jaw - please share the information by leaving your feedback at the bottom of this page (in the comments field).

What you need to know about nylon dentures (not advertised)

Interesting nuances of full removable prosthetics

A person who is forced to resort to the installation of prostheses in the absence of teeth imagines that he will have to wear a terrible “false jaw” that will have to be placed in a glass of water on the bedside shelf at night.

All these unfounded misconceptions come from Soviet dentistry, when things were bad with prosthetics. Now, even with the complete absence of teeth, you can get a high-quality, comfortable and realistic prosthesis.

Complete absence of teeth

Briefly about prosthetics in the complete absence of teeth

Complete loss of teeth, or a large number of them, is by no means rare. There can be many reasons for such an ailment, and, unfortunately, due to the current environmental situation and living standards, there are more and more of them. Most often, the patient loses all his teeth for one of the following reasons:

Advanced diseases of gum tissues and periodontium.
Late treatment of caries or complete lack of therapy.
Natural wear of tooth enamel.
Increased abrasion of fabrics.
Severe injuries to a large number of teeth or the entire jaw.
Violation of metabolic processes.
Diseases of the internal organs.

Even if only a few teeth are missing, this is already felt and affects the chewing functions of the jaw. What can adentia lead to? If you do not correct the situation in a timely manner with the help of dentures, you may encounter irreversible consequences:

Disorders of the gastrointestinal tract. A person without teeth is unable to fully experience hard food, and therefore his diet is poor and limited to soft foods. Monotony leads to nutritional deficiencies and poor digestion.
Distortion of the facial oval - sunken cheeks, protruding chin, pronounced nasolabial folds and thinned lips.
Distortion of speech due to the fact that in the absence of teeth, the ability to pronounce many letters and sounds is lost.
Atrophy of bone tissue, thinning of the alveolar processes, as a result of which subsequent implantation becomes simply impossible.

The complete absence of teeth significantly reduces the quality of life and gives rise to a lot of complexes. Only complete prosthetics can solve the problem.

This procedure does not have many contraindications, however, for patients with the following diseases full prosthetics will not be available:

Intolerance to any type of anesthesia (important when installing implants).
Infectious diseases, mucous membranes and oral cavity in particular. Initially, you need to cure the disease and only then proceed to prosthetics.
Diabetes.
Oncology.
Mental disorders.
Poor blood clotting.
Anemia or anorexia, as well as any other diseases that indicate the exhaustion of the body.

What prostheses can make up for the complete or almost complete absence of dental units?

Removable

Nylon

Dentures made of nylon are elastic and look very realistic, however, they do not restore the chewing function. In addition, these types of prostheses are not fixed securely enough in the mouth.

Removable nylon dentures

Acrylic

The design is made of acrylic plastic - a fairly durable material that is compatible with mucous tissues and looks as natural as possible.

With a competent approach, a specialist can manufacture and deliver a completely realistic design with imitation of the color of the gums and enamel.

The basis can cover both part of the gum and close it all, depending on the size of the structure.

This design is ideal for permanent wear, and at the end of the adaptation period, it almost does not feel like something foreign.

Acrylic prosthesis can be left in the mouth overnight!

Based on beam fixation

This type of structure is based on a beam that takes on all the vertical load.

In order for the pressure on the implants to be distributed evenly, they are connected by a horizontal beam, in which there are places for fixing the orthopedic structure.

Prostheses based on bar fixation

In the prosthesis itself, recesses are made under the shape of this beam, and when the two parts are connected, special locks are snapped into place, which ensure a secure fit.

With the help of a beam prosthesis, it is possible to restore both the entire dentition and part of it.

The bar prosthesis is only conditionally referred to as removable, however, it should be removed only if it is necessary to clean or replace it.

fixed

Metal-ceramic

In order to make a fixed prosthesis in the complete absence of teeth in the mouth, it is necessary to initially install 4 dental implants, on which the denture will be based.

A fixed structure made of high-quality metal ceramics will be much more convenient than a removable denture, as it serves as an imitation of a full-fledged dentition.

Gum deficiency will be filled with ceramics, which are painted in the color of the oral mucosa.

Fixed denture

Based on zirconia

This type of prosthetics is considered the highest quality and modern, due to the fact that the material itself is highly durable and lightweight. The weight of a zirconium dioxide prosthesis is several times less than the weight of a metal structure.

This material has a translucency that is identical in depth to natural tooth enamel, so that dentures cannot be outwardly distinguished from real teeth.

Clasp prosthetics

Most orthopedists agree that clasp prostheses are a successful combination of reliability, strength and beauty. Before installing a prosthesis of this type, supports are implanted in the patient. Clasp prostheses of the new generation have 3 types of fixation:

Fixation with metal hooks or fastening on clasps.
Fastening removable prosthesis with the help of micro-locks installed on the implant.
Fixation of the structure on telescopic crowns - after the implant is implanted into the bone, a primary crown is placed on it, and removable prosthesis- secondary. It is worn on implants and securely fastened in the oral cavity.

Clasp prosthesis

Are there any differences between complete dentures of the upper and lower jaw

Upper jaw teeth

Making a prosthesis for the upper jaw is somewhat easier than for the lower. Insofar as the upper jaw has more points of support of the basis, for example, the sky.

Thanks to the large valve area, the prosthesis can be securely fixed on the gum, and the chewing load can be distributed much more evenly.

Even with the complete absence of the dentition, the prosthesis of the upper jaw will not move during meals and cause discomfort to the owner. For its manufacture, both flexible nylon and rigid acrylic can be used.

lower jaw teeth

The need to make up for the complete absence of teeth in the lower jaw presents certain difficulties for the prosthetist, since the area for the basis is extremely small. Due to the abundance of folds of mucous tissues and the tongue frenulum, the prosthesis cannot be fixed using valve mechanisms. Located near the tongue and cheeks can push and displace the structure, causing discomfort to the patient.

Therefore, if at least one healthy tooth has been preserved in the lower jaw, the best solution would be to install a conditionally removable prosthesis. The peculiarity of structures of this kind is as follows:

The prosthesis is securely fixed in the oral cavity on implanted in bone tissues titanium screws.
There is no need to implant all the roots of the dentition - a few supporting ones are enough.
The denture can be removed at the dental office for a quick cleaning.

In the absence of teeth on the upper and lower jaws at the same time, the doctor can offer 2 different prostheses. The opinion that only structures made of the same material should be used is erroneous.

How to carry out prosthetics in the complete absence of teeth

Before proceeding with prosthetics, the patient must undergo a complete examination of the state of health, check the condition of the oral cavity and the prosthetic bed.

cast of teeth

The specialist first of all pays attention to how atrophied the alveolar processes and mucous membranes are. All this allows you to determine the nuances in the design of the future prosthesis. The main stages in the manufacture of a prosthesis are approximately the following:

Removal of impressions of the jaw for the subsequent work of dental technicians.
The casting of the prosthesis.
Basis manufacturing.
Determination of central occlusion thanks to impressions.
Relief modeling.
Finishing processing.
Delivery of the resulting prosthesis to the patient and the first fitting.

These are approximate steps in the manufacture of a prosthesis. The exact sequence depends on the specific type of prosthetic construction.

Conclusion

Of course, the complete loss of teeth is a difficult and painful situation for the person who had to deal with it. However, a high-quality and professionally made denture can be outwardly indistinguishable from real teeth, restoring not only the aesthetic appearance of a smile, but also chewing functions.