Simple Overdenture Technique without using implants (using root )

Simple Overdenture Technique,

MPLANTS have, in the last 15 to 20 years, paved the way to restoration of the edentulous and partially edentulous mouth. However, many patients cannot afford the time or money required to complete this treatment successfully. Making an Overdenture (OVD) using a simple ball-and-socket type of attachment for extra retention is a proven and easy alternative treatment to implants. The Flexi-Overdenture® attachment is based on the patented split-shank Flexi-Post® for the highest retention of the post in the root and the fewest problems. The ball-and-socket attachment delivers high retention for full and partial dentures, providing a simple, inexpensive overdenture at chairside. The Flexi-Overdenture supports a nylon attachment that is incorporated into an overdenture (Figure 1). Alternatively, and for great ease of replacement, a threaded version of the nylon attachment can be threaded into an EZ-Change® metal receptacle (keeper) that in turn is incorporated into the denture (Figure 2). The post allows the dentist to utilize remaining roots to support the retention of a denture. FIGURE 1 FIGURE 2 The Steps for Placement of the Flexi-Overdenture Try to retain two canine teeth in each arch for the abutments for the OVD. If canines are not available, try to use bicuspids next. However, any tooth—even just one tooth—will provide additional retention for the OVD. Determine the optimum post size by placing the plastic template over an undistorted x-ray. There should be at least one millimeter of lateral tooth structure at the most apical placement of the post. After determining the correct post size, prepare the post hole, using a sequence of Gates Glidden drills followed by the color-coded primary reamer exactly correlated to your post size (Figures 3 and 4). FIGURE 3 FIGURE 4 After using the correct primary reamer, prepare the countersink/root facer preparation with the countersink/rootfacer drill (Figure 5). FIGURE 5 Try placing the post that corresponds to your preparation. It should be fully seated (Figure 6). If the post does not seat fully, shorten the apical end of the post the appropriate amount for full seating (Figure 7). FIGURE 6 FIGURE 7 Coat the internal surface of the post hole and the shank of the post with Flexi-Flow Auto® reinforced composite cement and place the post into the root. Let set for four minutes. Place the nylon cap on the ball of the Flexi-Overdenture attachment. Make sure that the colored rubber band is on the ball of the attachment. The rubber band blocks out the undercut of the ball (Figure 8). Mark the top of the nylon cap with a disclosing paste and place the denture over the root (Figure 9). FIGURE 8 FIGURE 9 Remove the denture, noting where it has been marked with the paste (Figure 10). FIGURE 10 Relieve enough acrylic from the denture to allow the denture to sit passively over the nylon cap (Figures 11 and 12). FIGURE 11 FIGURE 12 Once you have confirmed that the denture is sitting passively supported only by the ridges, place a doughy mix of acrylic into the relieved site, place the nylon cap over the acrylic and keep it in position until the acrylic hardens (Figure 13). Remove the denture and relieve the excess underlying acrylic (Figure 14). FIGURE 13 FIGURE 14 The denture now has the added retention supplied by the ball-and-socket attachment provided by the Flexi-Overdenture attachment. Over time, the nylon attachment will wear, out reducing the amount of retention it provides. The nylon attachment can be replaced by drilling out the old attachment and cold-curing a new one in. To reduce the time and effort necessary for replacement, Essential Dental Systems, Inc., has developed the EZ-Change attachment for rapid replacement of the worn nylon attachment. To incorporate it into the denture do the following: Instead of the nylon attachment, place the EZ-Change attachment, which consists of a metal receptacle (keeper) and a threaded nylon attachment within it (Figure 15). The two components of the EZ-Change attachment are incorporated into the denture in the same manner as the original nylon cap. When the nylon attachment now wears out, it is a simple matter to use the EZ-Change wrench to unthread the worn-out nylon cap from the metal insert and thread in a new one (Figure 16). No cold-curing is necessary, the entire process taking only a few seconds. FIGURE 15 FIGURE 16 The ball-and-socket is very user-friendly for the patient. It snaps in easily, the patient can both hear and feel when the ball is seated, and there are no components to bend or break. This is a viable and time-tested alternative technique for those who cannot have implants.This technique is much more economical as compared to implant supported denture.

Fear of undergoing Dental Treatment.

Many patients experience anxiety while undergoing dental procedures. Some individuals even skip out on their dental needs simply because they are too afraid to receive the dental care they require.
Sedation dentistry provides an opportunity for patients to receive dental treatment while completely and safely asleep. Dental phobia is a common occurrence in many dental patients which ultimately handicaps individuals from preventing and treatment oral health problems. The Dental Organization for Conscious Sedation reports that 30% of patients deny themselves the dental care they require for fear of undergoing treatment.
Sedation dentistry is safe, comfortable, anxiety-free, and best of all can allow you to receive the dental care you need minus the apprehension. With sedation dentistry apprehensive patients will find themselves smiling more and fearing less. Don’t compromise your oral health for fear of treatment.

What Is Sedation Dentistry?

A sedative is a drug that is administered to the body to create a relaxed, calm state similar to sleep. In dentistry, sedation can be used for a variety of procedures to help the patient feel more at ease during treatment. Traditionally the options for sedation have been limited to the inhalation of nitrous oxide (more commonly known as laughing gas) or intravenous sedation where the sedative is injected via needle through the blood vessels found in the hand or arm. However, today’s dental technology brings with it the option of oral sedation requiring no needles at all. Patients who chose to undergo oral sedation are prescribed a pill (Halcion) which they are to take one hour prior to their visit. When they arrive at their ‘ dentist, they will be awake but feeling relaxed and very drowsy. The patient is then immediately escorted and seated in the dental chair where their vital signs are monitored throughout the entire appointment. Patients will not be permitted to drive after sedation. When the patient is fully awake they will feel stress free and relaxed.

Remember: Sedation is NOT an anesthetic and so sedation alone will not provide any pain relieving qualities. A local anesthetic will also be administered in addition to the sedative to ensure patient comfort and safety. The anesthetic will be injected into the mouth after the patient is already sedated so patients will not be bothered or even remember having the injection.

Patients opting for oral sedation must arrive and leave their appointment accompanied by a responsible caregiver providing transportation to and from dental clinic. It is advised that the caregiver also remain with you following the procedure for two to four hours in the comfort of your home.

Why Sedation Dentistry ?

Many patients chose sedation dentistry during extensive dental procedures such as smile makeovers or other restorative treatment requiring multiple appointments. Sedation dentistry allows complex procedures to be performed in fewer visits as the patient does not experience the time frame of the procedure. Patients often feel as though their appointment lasted but a few minutes when in fact it may have taken hours to perform. Some patients may have denied themselves the dental procedures they’ve either always wanted or required for fear or anxiety of undergoing treatment. Sedation dentistry offers the means of achieving and maintaining your best smile possible without the stress. Sedation dentistry allows patients to overcome their fear of dental treatment and so patients are more likely to come for routine care. If you experience dental phobia or anxiety, don’t place your oral health on the back burner. Neglecting to treat any problems you may have, can allow them to develop into more serious complications. Oral health is important. Contact your dentist about sedation dentist.

Sedation or Sleep Dentistry?
Sedation dentistry is sometimes incorrectly referred to as sleep dentistry. This term is misleading as the patients never actually ‘sleep’ during the procedure. The effects of the sedative cause the patients to feel the effects of sleep, but in fact they are awake the entire procedure. In sedation dentistry, the body is relaxed and patients are not likely to remember much from the treatment.

Laser Use in Dentistry

Laser technology had entered the field of dentistry by 1994 itself. The lasers used for dental treatment are not the cold lasers, which are used for treating inflammation, headache, and pain, and also used in phototherapy. Though it is useful in treating many dental problems, laser is yet to be fully accepted by the American Dental Association. The treatment mode does have FDA’s acceptance, but not that of ADA, whose standards appear to be more exacting. ADA is still not fully convinced of the efficacy and safety of using lasers for dental treatment.

However, the technology is being used by some in treating the following problems:

• Tooth decay. Lasers are useful in removing the decayed portion from the tooth and readying the remaining enamel for the fresh filling. It is also useful in hardening the filling.
• Gum problems. For removing bacteria during a root canal treatment, and reshaping gums, lasers are useful.
• Biopsy. For removing a lesion, or any tissue from the mouth, lasers are used. Tissue removal sometimes becomes necessary for cancer testing. Lasers are also effective in the treatment of mouth ulcers.
• Teeth whitening. Some teeth whitening procedures nowadays employ lasers. Whitening is basically done by the application of a bleaching solution on the surface of the teeth, but the action of this peroxide solution is enhanced by employing lasers.

The Working of Lasers

All forms of laser appear as light and provide energy in the way in which it is required for different operations. When used for hardening the tooth filling, the laser binds together the filling and the tooth. During teeth whitening, it acts as a source of heat which increases the activity of the whitening agents. In surgical use, sometimes it functions as a vaporizer for annihilating tissues. At other times it functions as a cutting implement.

What Are the Pros and Cons of Using a Laser in Dentistry?

Pros
Compared to the traditional dental drill, lasers:

• May cause less pain in some instances, therefore, reducing the need for anesthesia
• May reduce anxiety in patients uncomfortable with the use of the dental drill
• Minimize bleeding and swelling during soft tissue treatments
• May preserve more healthy tooth during cavity removal

Cons
The disadvantages of lasers are that:

• Lasers can't be used on teeth with fillings already in place.
• Lasers can't be used in many commonly performed dental procedures. For example, lasers can't be used to fill cavities located between teeth, around old fillings, and large cavities that need to be prepared for a crown. In addition, lasers cannot be used to remove defective crowns or silver fillings, or prepare teeth for bridges.
• Traditional drills may still be needed to shape the filling, adjust the bite, and polish the filling even when a laser is used.
• Lasers do not eliminate the need for anesthesia.
• Laser treatment tends to be more expensive since the cost of the laser is much higher than a dental drill. Lasers can cost between $39,000 and $45,000 compared to about $600 for a standard drill.

How to Keep Your Kids Cavity-Free

Wipe baby gums. A quick once-over with a damp cloth before bed removes bacteria that can harm soon-to-erupt teeth.

Brusha brusha. Once those pearly whites pop, brush once (realistically) or twice (ideally) a day with a soft, toddler brush. Use a pea-size drop of non-fluoridated toothpaste until age 4, or when your kid can reliably spit it out (swallowing fluoride regularly could make him sick and cause spots on the adult teeth).

Floss. Okay, we might as well be asking you to trim a wild bear's claws. But start using those plastic flossers now and your kid just might get used to it. Give your child a batch of colorful plastic flossers to encourage her to clean between her teeth. Even if she does only a few teeth a night it will help.

Ditch the bedtime bottle. The milk or juice can pool in your child's mouth as he dozes off, causing serious decay known as "bottle mouth."

Visit the dentist by age 1. Ask your doctor for a referral or find one at the American Academy of Pediatric Dentistry website: Aapd.org.

Say cheese! And eat some, too. The protein in it -- casein -- helps prevent tooth decay, so pass the cheese sticks. Another tasty idea: lollipops with xylitol (for kids over 4), a natural sweetener that prevents plaque buildup.

Spin it. Get her a battery-operated spin brush for more effective plaque- and bacteria-removing motion (a cheap model is just fine).

Brush to the beat. Have your kid scrub along to her favorite song to get her to hang in there for the recommended two minutes.

Finish up. If your child is younger than 8, do a final sweep with the brush after she's done to hit all the nooks and crannies -- and especially the back molars.

Be snack savvy. It's not just sugary foods you have to watch out for. Any starchy or processed high-carb food can get stuck in the crevices of teeth. Some surprising offenders: potato chips, wholewheat bread, crackers, and cereal bars. Follow with a glass of water to rinse them out.

Do You Have Tooth Enamel Erosion?

Tooth erosion forms from the process where acidic chemicals erode, or melt away, the enamel from your teeth. It is different from tooth abrasion or tooth attrition which are caused from brushing with too hard of a toothbrush, grinding your teeth, or eating a rough diet of foods. Both processes lead to enamel loss, but the patient with enamel erosion is usually unaware of the cause of the problem, or even that there is a problem.

Acidic chemicals can come into tooth contact from many different avenues such as consuming acidic foods and beverages, gastroesophageal reflux disease (GERD), bulimia, and swimming in chlorinated swimming pools, among others.

Let's look at some common foods that are highly acidic.

FOOD	pH
Lemon/Limes	1.8-2.4
Oranges/Juice	2.8-4.0
Apples	2.9-3.5
Grapefruit	3.0-3.5
Black Coffee	2.4-3.3
Wines	2.3-3.8
Coke	2.7
Vinegar	2.4-3.4
Pickles	2.5-3.0

Your risk for tooth erosion increases if you consume these highly acidic foods often, or in large quantities. If you are concerned that you may be at risk, please have your teeth checked for enamel erosion with your dentist. Enamel erosion can make your teeth sensitive and increase your chances of tooth decay.