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Multiple Failure Causes
Dentures and partials can fail for any one of several reasons. Failures in impressions and fabrication processes are not uncommon.
Product failures involving the acrylic properties and sizing of the denture prosthesis can occur from time to time. Different types of fabrication processes tend to yield different degrees of fabrication accuracy due to certain shrinkage factors in the molding process. Inexpensive dentures tend to be created with less expensive fabrication methods.
Improper monitoring of the intial try-in of a new denture for full arch extractions can cause discomfort, unusual shrinkage or damage to gum tissues. Uncontrolled swelling can sometimes render a new denture unusable for some patients.
Errors in correcting and/or matching occlusal surfaces of the upper and lower jaw can cause discomfort, severe pain, tmj-tmd issues, accelerated wear of gum tissues and possible bone loss.
Delaying of certain corrective denture adjustments can lead additional soft tissue lesions and potentially cause the development of compensatory shifts and positioning of the lower jaw structure, resulting in overbite or underbite conditions, similar to the maladaptive adjustments tmj joints undergo with other types of bite and malocclusion problems associated with natural teeth.
Lastly, dentures wear out just like normal teeth. Failure to replace dentures at recommended intervals can cause accelerated loss of bone and gum tissues, loss of vertical dimension and new, acquired, conditions of collapsed bite.
This gallery contains examples of denture failures caused by one or more of the causal factors mentioned above.
This picture represents several elements of what denture treatment shouldn't be. Notice that the arching of the biting surfaces is nearly the exact opposite of what it should be. This is an extreme example of what we call a reverse smile line and a reverse curve of Spee. Secondly, the size of the upper arch does not match the size of the lower arch. Several biting surfaces are out of occlusion. Under normal circumstances where an experienced dentist is providing treatment, these types of errors (if fabrication related) would have been detected immediately during a wax try-in and then corrected.
Treatment recommendations would include new denture products being fabricated from new, accurate impressions, possible sizing adjustments to restore lost vertical dimension (bite collapse) and suspected loss in lip support.
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Faulty Denture - Partials Treatment
Mitchell Pohl, DDS |
Broken denture teeth can occur for a variety of reasons. Worn out, poor eating habits, malocclusion due to bone loss issues. All acrylic dentures that have broken teeth are usually replaced with an entirely new denture. Some denture prosthetics however are made with porcelain teeth, which oftentimes can be repaired on a tooth by tooth basis.
Most common treatment choices include denture replacement, implant supported dentures, fixed bridge, possible bone grafting. Occlusal treatment may also be required.
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Broken Denture Teeth
Richard Winter, DDS MAGD |
Oral health habits cause bacterial build up on dentures to the extent they become severely stained. Mandibular jaw shows extensive bone loss after multiple extractions of teeth. Four remaining teeth are diseased and require treatment.
Treatment recommendations could include replacement dentures, implant supported dentures, periodontal treatment, possible bone grafting, occlusal realignment, custom partials.
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Denture Replacement
Mitchell Pohl, DDS |
Poor oral health habits can cause structural changes in remaining teeth in a partially edentulated lower jaw. Bacteria seepage eventually caused remaining anchor tooth structures and bridgework to fail. Note how lateral forces caused all lower jaw teeth to tilt, further accelerating damage, especially to whatever amount of healthy bone is left.
Treatment recommendations would involve removal of remaining teeth and could include possible bone grafting, dental implants, mini implants, denture prosthetics or fixed bridge.
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Partial and Crown Failures
Ara Nazarian, DDS |
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