"Simple - The way it was meant to be"

lower overdenture
A simple yet highly effective treatment

	Patient presents with unstable lower denture. We have made her a new complete upper and lower denture. The upper is stable but the lower denture has always been a problem. Now we have a lower denture with good support, we can easily gain retention with two implants.
	The implants are in and the fitting surface of the denture adjusted to avoid loading the wound.
	The stent used at the first stage surgery is replaced to confirm the positions of the implants. We can now limit the second-stage incisions.
	A very small incision reveals the black healing plug in the implant. This is removed by engaging the hollow plastic with a 110 engine reamer
	Guide pins inserted into the well of the implants confirms integration and angulation
	Two straight o-ring abutments are inserted into the implant wells, assessed for position and tapped into place to engage the locking taper.
	A closer view of the abutment in position
	The relative position of the abutment to the fitting surface of the denture can be confirmed by the indentations on the carding wax.
	Place an o-ring housing onto each abutment
	Bore out the inside of the denture so that it'll seat correctly over the housings without binding. Now it's time to cold-cure the housings into the denture.
	Punch a hole in two small pieces of rubber dam and place over the abutments. This will act as a skirt and will prevent the flow of acrylic into undercuts. This is very important!
	Now the housings are replaced. In this picture the old-type housing is on the patient's left. The new-style housing has a dome shape which prevents acrylic from flowing into the top of the housing. Until now we've had to block the open housing with wax - as on the patient's right. The holes in the denture are now filled with a runny mix of self cure resin.
	With the denture correctly seated, the patient is instructed to close down onto cotton rolls.
	If a different coloured acrylic is used to reline the denture it makes it easier to trim the excess. Here is the denture as delivered to the patient.
	The finished denture in place
	The patient telephoned the day after the denture was retro-fitted to say that she'd been eating salad - for the first time in decades. However, we didn't see her again for 18 months. This is the appearance of one abutment.
	The o-rings were worn but still quite retentive
	The clinical situation after 18 months
	The denture with new o-rings. It takes 30 seconds to change each.
	The dentures replaced
	A happy patient. eating comfortably and well, no soreness. Geoffrey Pullen did the surgery. Brendan Grufferty made the dentures. Henry Bergerano supplied the technical work.