Overdenture

An overdenture is a removable dental prosthesis that is designed to fit over remaining natural teeth, roots, or dental implants. While conventional dentures rest directly on the edentulous ridges (gums)/mucosa, overdentures utilize any remaining anatomic structures to improve stability, retention, and support. This restoration is very important in modern restorative dentistry and is especially relevant for patients that want a functional, affordable, and restorative option for missing teeth.

The main goal of an overdenture is to restore function and aesthetics for partially or fully edentulous patients, by:

• Improving chewing function and speech.
• Preventing bone loss in the jaws with retained teeth or implant placement.
• Representing a functional and cost effective alternative to fixed prosthetics.
• Fostering psychological and social impacts by restoring normal smiles.

For patients dissatisfied with conventional dentures, or are experiencing limited retention of conventional dentures, overdentures offer a functionally better and personalized treatment option.

Overdentures can be the ideal solution for:

• Patients who may still have some natural teeth or healing roots, and are partially edentulous.
• Patients who are fully edentulous and can take advantage of implant-supported overdentures.
• Patients who have a lot of bone resorption, where conventional dentures would not have the support as well.
• Patients who want to have a removable, but stable alternative to full-arch implants.
• Elderly patients who want a long lasting, cost-effective, transition-able dental restoration.

Overdentures can be classified according to the type of underlying support:

• Tooth Supported Dentures - supported by modified natural teeth or roots.
• Implant-Supported Dentures - supported by 2-4 implants in the jaw.
• Bar-retained - the implants are attached with a metal bar to increase retention.
• Locator or Ball-retained - Attachments on implants or roots allow snap-fit dentures.

Each overdenture type will be considered based on the patient's oral health, bony support available, and patient budget.

The treatment protocol will typically include:

• Initial consultation and radiographs.
• Assessment of the remaining teeth or planning of implants.
• Any modifications for teeth or placement of an implant (if needed).
• A healing period to allow for the integration of the implant(s).
• Impressions for denture construction.
• Trial of denture and adjustments.
• Final delivery and instructions for the patient.

The treatment time will vary and could take a few weeks to several months depending on whether implants are utilized.

Overdentures provide clinical and personal benefits:

• Better stability and retention.
• Better chewing and speaking.
• Retention of jawbone density.
• Dentures sores and discomforts are reduced.
• Fit better than traditional dentures.
• Easily removable for cleaning.

If you have diabetes or are geriatric, overdentures are manageable and less invasive.

Why are overdentures better than any other options?

• Overdentures provide more retention, less movement when chewing or speaking.
• Provide more support with fewer implants than fixed prostheses, making them more affordable.
• It is easier to maintain than fixed prosthesis over time.
• Allow for improved sensory perception as some natural teeth or roots are preserved.
• They can be made quicker in local dental offices or clinics with CAD/CAM technology.

Treatment timeline depends on the type of overdenture you will need:

• Tooth supported overdentures: 2-4 weeks.
• Implant supported overdentures: 3-6 months (which includes the healing time)

Typically a patient will go through anywhere from 3-5 appointments (impressions, try-in and fitting). For more complex cases where implants are involved/restorations the patient may be provided with a temporary denture during the healing process.

The cost of overdentures in India varies by city, clinic, case complexity:

• Tooth supported overdentures: ₹15,000-₹30,000.
• Implant supported overdentures: ₹50,000-₹1,50,000 or more (this includes the cost of the implants).

Overdentures are a fairly safe treatment but there are potential risks and complications, such as:

• Irritation to the gum tissues or pressure sores.
• Implant failure or loosening of the attachment mechanism to the implant.
• Wear and or breakage of the denture components.
• Infection if oral hygiene is poor.
• An allergic reaction to a material from the overdenture (which is rare).

By attending follow-up appointments and having professional cleans, these risks and complications could hopefully stay in check.

• They are not as aesthetically natural as a fixed bridge.
• They will have to be removed and cleaned daily.
• They will periodically need maintenance or relines.
• There may be mild discomfort with the adjustments or while speaking.
• The cost and healing time involved (if surgery is required to have the implant).

About overdentures, some alternatives could be considered;

1. Complete dentures – not very costly, but not as stable. Fixed implant bridges – fixed, but costly and invasive.
2. Removable Partial dentures (RPDs) – may be possible for people with some remaining teeth.
3. All-on-4 implant systems – for a full-arch solution, using fewer implants.

All options have benefits and drawbacks relative to a patient's oral condition, age, and finances.

• Remove and clean denture daily with mild soap or denture cleaning.
• Clean and care for the underlying teeth or implant abutments with a soft toothbrush.
• Use mouthwash, and maintain oral hygiene.
• Initially avoid hard foods and carry on eating a balanced diet.
• Regular visits to the dentist every 6-12 months for check-ups and/or professional cleaning.
• When not in the mouth (sleeping) store the overdenture in clean water to keep shape.
• Educational instruction of the patient about hygiene and care routine is vital to keep out infections, or to keep the chance of the prosthetic failing to a minimum.