Removable Prosthodontics - Complete Dentures
Complete denture prosthodontics examines how you use anatomy and records to build a prosthesis that stays put, supports the face, and functions without damaging the residual ridge. The board tests border control, jaw records, and occlusal scheme more than memorized numbers.
Core rules
- Retention depends on border seal, adhesion, cohesion, and atmospheric pressure; stability depends on ridge form, polished surface contours, and tooth position.
- Border mold with a custom tray; stop when the material is rounded and smooth, not when it is forced into movable tissue.
- Record VDO with 2–4 mm of freeway space and record CR before tooth arrangement.
- Set teeth in the neutral zone, especially on resorbed mandibular ridges.
- Use bilateral balanced or lingualized occlusion so contacts occur in excursion.
Worked example
A patient with a flat mandibular ridge has a loose lower denture. The border is rounded at the retromylohyoid area, the polished surfaces are contoured to the tongue, and the teeth are set slightly lingual to the crest. Reasoning: seal and neutral-zone placement improve stability; moving teeth lingually uses tongue force instead of fighting it.
Traps
Overextension into the vibrating line or retromylohyoid causes soreness and dislodgement. Underextension loses seal. Arbitrary VDO causes speech and comfort problems. Setting teeth on the crest ignores the neutral zone. Skipping a CR record produces interceptive contacts.