Dentures in full detail

Dr. Raymond E. LaVigne practices dentistry in Palatine, Illinois. His specialties are cosmetic dentistry, dental implants, and patient education. This arcile outlines various types and sizes of dentures and which one may be right for you.

This article will describe different types of dentures; i.e. treatment options when all teeth within an arch (upper or lower) are missing already or need to be extracted. 

1. Full denture
2. Full denture retained by 2 or more remaining teeth over denture
3. Full denture retained by 2 or more mini implants
4. Full denture retained by 2 or more standard implants with bars attached
5. Full denture screwed down to multiple implants
6. Long-span fixed bridge cemented or screwed onto multiple implants

1. Full Denture

• Supported entirely by resting upon the ridge bone and palate in the case of uppers.
• Retained by fitting into undercut areas.
• -Least costly investment initially; does require relines recommended about every year at the start then about every three years on the average
• teeth wear, bone resorbs so that a new denture is typically needed after every 5 years
• May require adhesive paste to provide additional retention initially for major chewing and later for all eating and speaking

Ridge bone continues to be lost due to two reasons:

• Atrophy - lack of use since no more tooth roots embedded in bone
• Resorption - forces upon bone as denture shifts during chewing causes stress

Resorption is magnified and accelerated the longer the denture is worn without relining and the more unbalanced the bite is from the start (over bite, irregularities) or has become due to uneven wear of the teeth (especially a problem when various teeth oppose the denture - some natural enamel, some porcelain, various types of filling materials).  Dentures must be made and maintained in harmony with the surrounding muscles.The tongue is an especially important factor in having success with lower dentures.

More to consider with full dentures:

• Denture can be made to be attractive and natural looking
• When initially fitted dentures allow about 25% of the chewing force possible with strong full set of natural teeth
• Undercuts give dentures retention but also can be a source of sore spots

2. Full denture retained by 2 or more remaining teeth over denture

• Two or more teeth with reasonably healthy bone and gum tissue can be saved so that a denture can be retained over them - The denture is still completely supported by resting on the gums and underlying bone The remaining teeth provide retention only.
• Saving teeth also saves bone thus avoiding even more atrophy - the bone stays around the roots as long as forces are normal
• The denture can be retained by a variety of options: silicone rubber, O- Rings or "snap "attachments, clips on a bar.
• Teeth saved must be in good condition and must be maintained by good home care and professional cleanings in order to make this feasible.
• Attachments work well when there are poor existing undercut areas and / or very strong muscles wanting to dislodge the denture.
• The forces used when chewing should still be within the 25 - 35% range. Care should be used in type of food and force used so that the attachments and remaining tooth roots are not overloaded. A night time retainer or second denture is often made to prevent clenching upon the attachments while sleeping.

3. Full denture retained by 2 or more mini implants

• Denture is supported by the gums and bone Implants provide retention typically by silicone rubber or attachments like a snap.
• The mini implants help prevent further atrophy of the ridge bone sine the implant acts similar to a tooth root.
• Mini implants are great when teeth are not available, are in poor condition, or are poorly spaced for proper balance and stability.
• Mini implants are usually one piece - that is implant and abutment all in one.
• Mini implants are indicated in the lower front area due to their size and the type of bone density found in this area - which is typically the densest bone in the mouth.
• In some cases the denture can be fit to be retained by the implants in the same appointment due to the dense bone allowing for immediate stability.

4. Full denture retained by 2 or more standard implants with bars attached

• Four or more standard size implants are strategically placed and joined by bars that are screwed down to the implants forming a frame. The denture has retention clips that fit over the bar usually in 2 - 4 places. In this case the denture rests upon the bar and is passive to the gum and bone tissues.
• Dentures supported by bars can typically allow 50 - 60 % of maximum chewing force (based on natural teeth)
• Dentures are removed for cleaning. Implants and bars require cleaning with brush and floss with moderate effort needed. As with any implant, professional exam and cleaning are recommended every 6 months and, in some cases, every 3-4.

5. Full denture screwed down to multiple implants

• Four or more standard size implants are placed and joined by bars similar to the above clip on but removable denture over bars. In this case, however, the denture is screwed onto the bar and not removable by the patient. These appliances allow 60 - 80% of maximum chewing ability. Since they can not be removed for cleaning after each meal, the denture borders are raised off the gum tissue enough to allow floss to pass under the base. Also frequent brisk rinsing and use of an irrigator such as a "Water-Pik" are highly recommended for cleaning several times each day.
• The bar under-structure is similar to the previous over denture however the denture is not removable by the patient since it is screwed down to the bars.

6. Long-span fixed bridge cemented or screwed onto multiple implants

• Multiple single crowns allow best appearance and easiest flossing.
• Implants can also be abutments for several bridge sections or one long span bridge for the entire arch.
• These restorations allow maximum cosmetic appearance since the crowns are made from porcelain which has natural translucency, many shades are available and shades can be custom blended.
• These restorations are the strongest and can deliver 80 - 90% chewing force.

Excellent daily home care is needed just like when a patient has many remaining natural teeth heavily restored by crowns or bridges. That means flossing between the implants.

Implants help maintain jaw bone since they give the bone a purpose - the bone in use with normal amount of force stays healthy - similar to exercising for muscles and joints.

In many cases a patient wears a partial or full denture as a temporary when they ultimately plan to have implants as their long term tooth replacement. Having good fitting and nice appearing partial or full dentures prevents further damage to remaining teeth and also protects implants as they heal within the bone. Having a good partial or full denture and also a dentist who knows how to customize and modify them, can be a great advantage when a patient desires implants but will need a year or even much longer before completion.

Thank you for reading,

Dr. Ray

Dr. Raymond E. LaVigne DDS is a practicing dentist in the Chicagoland area for over 30 years.
Please call our Palatine, IL dental office for an appointment: 847-359-1292.

Premium partial and full dentures

Dr. Raymond E. LaVigne practices dentistry in Palatine, Illinois. His specialties are cosmetic dentistry, dental implants, and patient education. This article, with detailed images of dentures, provides an in-depth explanation of dental temporaries, premium, partial and full dentures.

Not all removable appliances are created equal nor should they all be called "plates".

On the contrary, removable partial or full dentures can be part of a complete "makeover". Any denture, even the most economical and temporary variety, will provide a better look than multiple missing teeth or rampant decay and infected gums.

While temporary, first dentures placed immediately after extractions are certainly an improvement over the previously poor teeth and gum conditions, they are only average compared to what can be created when a second, customized appliance is made. Once the gum and bone tissues have adequately healed, new impressions are made which assure a better fit to the current conditions. When the second denture is made there are several benefits that were not feasible when the initial denture was made:

1. Impressions made with the "guess work" removed on how the fit will be after tooth extractions.
2. Second denture can be made without rush and tried in before completion.

3. Time is allowed for treatment of other remaining teeth and problems within the same arch as well as the opposing arch.

4. Some changes in the bite (occlusion) are possible (and highly desired for optimum stability) when the mouth is now considered as a whole and modifications are planned.

5. Some changes in shade and size and arrangement of the teeth are possible.

All of the above can be possible with standard dentures.

When even more customization and best possible fit and durability are desired, a premium full or partial denture is the right choice.


Premium dentures include higher quality tooth material and details in the pink gum area to look most natural.

Standard dentures are nice but ordinary when compared with the premium option.


(Above) Another view of a premium full upper denture showing the nicely finished and detailed work in the base as well as the setting of teeth. Attention is paid to adequate thickness for strength while making optimum room for the tongue to feel comfortably at home. Speech as well as chewing and smiling are all considered.

The tooth size, shape, color and arrangement can be varied within a range. Custom made removables can create a nice natural look with a personal touch. This means that teeth match other existing teeth and the arrangement of the teeth is fairly straight and definitely assuring a balanced bite. However, there are minor imperfections making a realistic result. When there are no other teeth that need to be matched, then a nice clean but neutral shade is chosen. On the other hand, if desired by the patient they can be made very white and very straight (supernatural).

Here are the main features of premium denture appliances:

1. Quality teeth with greater durability and natural variations in opacity and translucency Varied shade and contour of the artificial gums ( rather than very smooth and very pink)

2. High quality lab work

3. Minimum two step custom impression technique for optimum fit

4. Additional time and attention by your dentist in planning and tooth set-up

5. Even greater ability to correct cosmetic problems, stabilize bite and correct alignment when entire mouth (both upper and lower arches) are being considered.

Additional time and steps are taken during the transition period from initial dental problems through final restoration. Temporaries are made and modified as needed in order to accommodate additional extractions, fillings, healing and cosmetic changes.

When there are cavities, gum problems, etc. with the anchor teeth or the opposing teeth then these problems are addressed prior to making the final restoration.

In order to create the best possible esthetic results and create long term stability, the bite is refined in all dimensions in order to obtain greatest chewing ability while assuring the least amount atrophy of ridge bone.
Teeth are best able to withstand normal chewing forces (and abnormal clenching forces) when there are many teeth with long roots firmly embedded in bone and with no spaces between them. Having roots in vertical alignment is also a key factor.

Bone can be lost from too much force as well as from lack of use. Ridge bone also lost due to the same two reasons. Atrophy is loss of bone due to lack of use - since there are no longer teeth with roots supported within bone, the bone weakens and "melts away" from disuse. Resorption of jaw bone happens due to too much force such as when dentures are rocking and rubbing causing irritation. In order to maintain healthy bone for as long as possible the following are needed:

1. Optimum fit from the start

2. Refitting via relining as needed and as early as needed

3. Establishing an optimum occlusion (bite) Dentures must have balanced forces to prevent tipping. Denture teeth must be aligned over the bony ridge to reduce adverse leverage:




4. The bite must be maintained and checked for uneven wear periodically. This is extremely important when there are a variety of tooth materials - natural enamel, porcelain, metal or plastic.

Dentures work best when the bite is well balanced. Missing teeth in one area causes overload and tipping forces. Teeth that are irregular like "mountains and valleys" will also cause very unstable conditions.

Bone is lost around teeth due to periodontal infection. Habitual clenching due to stress especially happening during sleep also contributes to recession of gum and bone. When some teeth are already missing the amount of force upon the remaining teeth is increased.

Sometimes it is recommended to have a night guard retainer when a patient has a full or partial denture. The Denture is worn during the day for normal eating and speaking. The retainer worn while sleeping protects from damage due to night clenching. This is especially beneficial when a patient has only a few remaining teeth. Without a night retainer, they are highly likely to grind the remaining teeth loosening more bone and also frequently bite their tongues and cheeks while asleep.

More time and quality materials are used in every step.
See the image below: the denture on the left is average while the right one shows excellent
fit that can only be possible with custom impressions.


Lower dentures are notorious for being loose and easily dislodged by the tongue. Note how the borders are established to avoid interference with muscles.  Also note how the denture is fashioned with a "cavern" to accommodate the tongue. The tongue actually helps weigh down the denture instead of constantly lifting the denture upward.


Examples of customized partial dentures

Use of flexible nylon denture bases and silicone retention surrounding natural teeth have many benefits including: Easy to place by first time denture patients and patients who have limited strength and dexterity in their hands. Effective but gentle retention on the anchor teeth. Little or no preparation of anchor teeth required compared to traditional metal frames and clasps. They are light weight and easily modified. The disadvantage is being less strong than a partial with a metal framework.

See these images of customized partial dentures:
CuSil Silicone retention (left)
Flexi Nylon base and clasps (right)



Nylon tooth shade clasps on standard frame partial denture:



When there are only a limited number of remaining teeth that are strong enough to serve as anchor teeth, traditionally a partial denture is made that has visible metal clasps. As an alternative, tooth shade nylon clasps can be placed in areas that would otherwise show metal. Nylon clasps have the additional benefit of being gentle to the anchor tooth. Flexible partial dentures can be made that are held in place by the necks of the teeth so that there is virtually no artificial material above the gum line. Another method of saving worthwhile teeth, few in number and giving more support to a denture than resting solely upon the gum tissue is to make an over denture. In this case the anchor teeth and anchors are completely invisible under the denture base.

In many cases, a patient wears a partial or full denture as a temporary when they ultimately plan to have implants as their long term tooth replacement. Having good fitting and nice appearing partial or full dentures prevents further damage to remaining teeth and also protects implants as they heal within the bone. Having a good partial or full denture and also a dentist who knows how to customize and modify them, can be a great advantage when a patient desires implants but will need a year or even much longer before completion.

We will be happy to show further examples and give you further information.

We can provide you with an estimate for comparison when you have the ability to choose between Economy, Standard and Premium restorations for your individual situation.

Thank you for reading,

Dr. Ray

Dr. Raymond E. LaVigne DDS is a practicing dentist in the Chicagoland area for over 30 years.
Please call our Palatine, IL dental office for an appointment: 847-359-1292.