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Overdenture: Definition, Types & Treatment

An overdenture is a removable dental prosthesis anchored over remaining natural tooth roots or dental implants, providing improved stability and comfort compared to conventional dentures.

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Things worth knowing about "Overdenture"

An overdenture is a removable dental prosthesis anchored over remaining natural tooth roots or dental implants, providing improved stability and comfort compared to conventional dentures.

What is an Overdenture?

An overdenture is a removable dental prosthesis that is fitted over and supported by remaining natural tooth roots or dental implants. Unlike a conventional complete denture, which rests solely on the gum tissue, an overdenture is retained by special attachment systems that provide significantly improved stability and comfort. It is a well-established treatment option for patients who have lost most or all of their teeth but can still use suitable roots or implants as anchors.

Types of Overdentures

Root-Supported Overdenture

In this type, one or more natural tooth roots are preserved in the jaw and used as anchors for the denture. The roots are treated with a root canal procedure and fitted with special attachments onto which the prosthesis snaps. Keeping the roots in place helps preserve the jawbone, as the roots continue to transmit chewing forces to the bone and prevent resorption.

Implant-Supported Overdenture

An implant-supported overdenture is anchored on two or more dental implants that are surgically placed into the jawbone. This type offers particularly strong retention and is frequently used in the lower jaw, where conventional dentures often have poor fit. In the upper jaw, four or more implants are usually required to achieve adequate stability.

Attachment Systems

Overdentures are secured using various types of connecting elements. The most common systems include:

Ball Attachments: A simple and cost-effective system in which a ball-shaped cap on the implant or root snaps into a corresponding socket in the denture.
Bar Attachments: A metal bar connects multiple implants, and the denture clips onto this bar for high stability.
Magnetic Attachments: Magnets embedded in both the denture and the implant abutment hold the prosthesis in place through magnetic force.
Telescopic Crowns: Precision-fitted double crown systems that slide together to provide very stable and accurate retention.

Indications – When is an Overdenture Recommended?

An overdenture may be the appropriate treatment option in the following situations:

Extensive tooth loss with remaining healthy roots still present
Poor retention of a conventional complete denture, especially in the lower jaw
Significant bone loss in the jaw
Patients who desire implant-based treatment but are not suitable for a fully fixed implant restoration
Improving quality of life and daily function for existing denture wearers

Advantages of an Overdenture

Significantly better retention compared to a conventional denture
Improved chewing function and speech clarity
Preservation of jawbone volume through force transmission via roots or implants
Increased wearing comfort and greater confidence in daily life
More cost-effective than a fully fixed implant-supported restoration
Easy cleaning due to the removable design

Disadvantages and Risks

Regular professional check-ups and maintenance of the attachment components are required
Bone augmentation may be necessary before implant placement if bone volume is insufficient
Higher cost compared to a conventional complete denture
Surgical procedure required for implant-supported variants

Treatment Process

Treatment with an overdenture begins with a thorough examination and planning by the dentist or specialist. For implant-supported overdentures, the implants are placed surgically and typically require a healing period of several months before the attachments and prosthesis are fitted. The denture is fabricated individually and adjusted over several appointments to ensure optimal fit and function.

Care and Maintenance

An overdenture should be removed and cleaned daily. The implants and any remaining teeth are cleaned using a toothbrush and appropriate cleaning products. The attachment components and matrices are subject to wear and must be regularly checked by a dentist -- typically every one to two years -- and replaced as needed to maintain optimal function.

References

Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde (DGZMK) - Guidelines on Implant Prosthodontics (2022). Available at: www.dgzmk.de
Mericske-Stern R. et al. - Implant-supported overdentures: a review of the literature with special emphasis on clinical and patient-reported outcome measures. Clinical Oral Implants Research, 2012.
Misch CE - Contemporary Implant Dentistry, 3rd Edition. Mosby Elsevier, 2008.

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