Several research reports have indicated that patients with dementia are likely to exhibit poor oral health. In the case of a 78-year-old women with Alzheimer’s disease, tooth 22 had a crown fracture. The patient had always practiced good oral hygiene self care, but her self care was diminished drastically due to care dependency. It was decided to remove the root of tooth 22 and to fabricate an adhesive bridge. The digital technology was a welcome treatment aid.

During the process of losing teeth, the fabrication of an immediate removable complete denture usually plays an important role. The path from natural to a prosthetic occlusal system separates itself into a phased and a non-phased treatment. Various patient-related factors are of importance in the decisionmaking process for a phased or a non-phased treatment, such as the patient’s time available, the medical indication, the complexity of the natural occlusal system, and the motivation for treatment. A positive result can be more confidently predicted in the case of a phased treatment than a non-phased treatment. Placement of an immediate removable complete denture requires immediate aftercare. Particularly in the case of non-phased treatment, the fabrication of a new complete removable denture will be required within 1 year.

When the fit of a removable complete denture is diminished as a result of progressive alveolar bone reduction, relining or rebasing might be indicated. In clinical practice, a degree of confusion exists concerning the concepts relining, and rebasing. Relining is resurfacing the tissue side of a denture with a new material to fill the space which exists between the original denture contour and the altered tissue contour. Rebasing is resurfacing the fitting surface of a denture by replacing the entire denture base with new material, also to fill the space which exists between the original denture contour and the altered tissue contour. In particular, attention is given to 3 specific forms of relining and rebasing which serve to restore the maxillomandibular relationship, to extend effectively the palatal denture surface of the maxillary denture and to reline or rebase an implant-supported overdenture.

Making an impression of an edentulous jaw is an essential part of producing a removable complete denture, because the proper functioning of the denture is partially dependent on the volume and form of the alveolar ridge and the surrounding soft tissue, in particular the musculature. Before the impression of the maxillary and mandibular jaw is made, insight into the anatomy of the maxilla and the mandible as well as the soft oral tissues is also essential. With respect to this, a 5-phase approach for the impressionmaking procedure is introduced, which gives guidelines for the fabrication of the preliminary impression, the preliminary cast, the individual impression tray, the final impression and the final cast. In each phase, the concern is to achieve the best possible stability of the denture. Adequate stability can only be achieved by determining the denture borders accurately.

When designing complete dentures, consideration should not only be given to the occlusal concept but also to the occlusal system as a whole. An important part of that system is the position of the artificial teeth. This prosthetic part of the occlusal system is directly related to the tongue, the floor of the mouth, the cheeks and the lips. The artificial teeth of the mandibular dentures have to be positioned in the so-called ‘ neutral zone’ of the edentulous mandible. The neutral zone is the stress-free area between the tongue on one side and, on the other side, the mimic muscles, which are responsible for the movement of the lips and cheeks. Moreover, the maxillary posterior artificial teeth and the supporting acrylic surfaces of the maxillary denture have an important function in providing support for the upper lip and cheeks in order to prevent a ‘denture look’ appearance.

Patients regularly report an alteration in taste perception after the insertion of a maxillary complete denture. It is generally accepted that changes in temperature and texture perception of the food induced by covering the hard palate are the principal factors contributing to this alteration. Besides temperature and texture, other factors contributing to taste perception are smell, age and saliva composition.

An implant-supported overdenture is a good alternative treatment to a conventional denture for patients with complaints about the retention and stability of their removable complete denture. These complaints more often have to do with the mandibular than the maxillary denture. Implant-supported overdentures offer better results in the mandible than in the maxilla. In cases of insufficient bone volume in the maxilla for inserting implants, maxillary sinus floor elevation using an autogenous bone graft from the oral cavity or the iliac crest may be carried out. Treatment of the edentulous maxilla by inserting 6 implants followed by manufacturing a bar-clip mesostructure and an implant-supported overdenture is the most successful, followed closely by the treatment option of inserting 4 implants and fabricating a similar mesostructure and overdenture. Aftercare by routine preventive examinations is required.