ABSTRACT
To review the literature on oral rehabilitation with removable full dentures. A literature review was carried out of 36 scientific articles published between 1980 and 2024, selected from the SciELO and PubMed databases. The results show the evolution in the management of edentulism and the positive impact of total prostheses on oral health and patients’ quality of life, especially among the elderly. Removable complete dentures have emerged as a viable and affordable solution, especially for the underprivileged, restoring aesthetics, chewing, and speech. Although making these prostheses requires technique, planning, and effective communication between patient and professional, the literature shows that satisfaction with these prostheses is associated with increased self-esteem and improved quality of life. The primary disadvantages of prostheses include functional, aesthetic, oral complications, and longevity. The use of removable total prostheses is a recommended alternative to mitigate the effects of edentulism, promoting psychological and functional benefits, with a positive impact on socialization and well-being. Periodic evaluation of these prostheses is essential to ensure their adaptation and durability, especially considering the retention and stability challenges presented in specific cases, such as lower prostheses.
Indexing terms
Edentulism; Rehabilitation; Total prosthesis
RESUMO
Revisar a literatura sobre reabilitação oral com prótese total removível. Foi realizada uma revisão de literatura com 36 artigos científicos publicados entre 1980 e 2024, selecionados das bases de dados SciELO e PubMed. Os resultados evidenciam a evolução no manejo do edentulismo e os impactos positivos das próteses totais na saúde bucal e na qualidade de vida dos pacientes, principalmente entre os idosos. As próteses totais removíveis surgem como uma solução viável e acessível, recuperando a estética, a mastigação e a fala. Embora o processo de confecção dessas próteses exija técnica, planejamento e comunicação efetiva entre paciente e profissional, a literatura aponta que a satisfação com essas próteses está associada ao aumento da autoestima e à melhoria da qualidade de vida. As principais desvantagens dessas próteses são funcionais, estéticas, complicações orais e longevidade. O uso de próteses totais removíveis é uma alternativa recomendada para mitigar os efeitos do edentulismo, promovendo benefícios psicológicos e funcionais, com impacto positivo na socialização e no bem-estar. A avaliação periódica dessas próteses é essencial para garantir sua adaptação e durabilidade, especialmente considerando os desafios de retenção e estabilidade apresentados em casos específicos, como nas próteses inferiores.
Termos de indexação
Edentulismo; Prótese total; Reabilitação
INTRODUCTION
The loss of one or more dental elements causes aesthetic, functional, and psychosocial changes in the individual’s life, negatively interfering with eating due to a reduction in masticatory functions, which can have nutritional impacts. In addition, there is a reduction in phonetic functionality, which can affect self-esteem and lead to social isolation. Dental prostheses can be a solution that meets the patient’s needs and expectations [1].
Epidemiological studies conducted by the Ministry of Health (MoH) in 1986, 1996, 2003, and 2010 show that edentulism is a prevalent problem and a public health challenge in the Brazilian and global population. These studies also show a positive evolution in oral health over the years. In 1986, the rate of extracted dental elements was 66% among patients aged 35 to 44, and in 1996, the rate was 65.7% in this age group. In 2003, the National Oral Health Survey (SB Brasil) showed that the percentage of missing teeth was 38.9% in young people, 13.5% in adults, and 90% in the elderly [1].
In the 2010 National Oral Health Survey (SB Brasil), there was an improvement in the rates of missing teeth, with a decline to 17.4% in adolescents, 7.4% in adults and, among the elderly, an average of 25.3% of missing teeth in partially edentulous patients and 53.7% in totally edentulous patients. Although there has been an improvement in the prevalence of edentulism in Brazil, the rate is still high, affecting more than 50% of the country’s elderly population [1].
This scenario of high rates of tooth loss results in sequelae that require interventions to effectively restore oral health [2]. Thus, there is a great demand in Brazil for prosthetic treatments, which leads part of the population to remain in a condition of edentulism or to search for alternative solutions, which can compromise the situation. Therefore, for the less privileged groups, the ideal would be access to removable total and/or partial prostheses, as this is a satisfactory and low-cost rehabilitative treatment.
Dentures replace lost teeth, restoring balance to the masticatory system and improving the patient’s quality of life. As well as restoring masticatory function and phonetics, prosthetic rehabilitation offers aesthetic enhancement, giving the individual self-esteem and security [3]. The search for aesthetics often outweighs the need for masticatory function and is a significant motivation for increasing self-esteem. Girundi [4]. reports that a lack of aesthetics can cause noticeable facial changes, making individuals feel excluded from society.
According to the Ministry of Health, in 2003, around 85% of the adult Brazilian population and almost 99% of the elderly needed or used some kind of dental prosthesis. Given this scenario, this study aimed to carry out a literature review on oral rehabilitation with removable full dentures.
METHODS
This literature review was conducted through an active search in the Scientific Electronic Library Online (SciELO) and PubMed databases, using the following descriptors: edentulism, total prosthesis, and rehabilitation, in both Portuguese and English. The inclusion criteria were articles, dissertations, course conclusion papers, and theses, complete and with free access. Incomplete studies, abstracts, and those that did not directly address the topic were excluded. All the articles found were read and classified according to the theme of the study.
RESULTS
The thematic analysis of the studies selected was based on content evaluation and organized according to the proposed objective. A total of 36 studies related to the topic were found, published between 1980 and 2024 (Chart 1).
DISCUSSION
Edentulism causes alterations in the stomatognathic system, making it difficult to eat properly by chewing, reducing phonetic capacity, altering the tension of the orofacial muscles, limiting movements of the temporomandibular joint, and causing aesthetic, psychological, and social problems [5]. This highlights the need for oral rehabilitation to resolve the damage caused by tooth loss.
Tooth loss is a public health problem that encourages the emergence of oral diseases and the need for ongoing dental treatment [6-8]. The most common causes of tooth loss are progression of caries, periodontal disease, injuries, and difficult access to dental care [9].
In Brazil, tooth loss has worrying indicators, affecting around 16 million Brazilians. According to Polzer et al. [10] and Barroso [11], the prevalence of edentulism in the elderly ranges from 1.3% to 78% in women. Therefore, various treatment modalities are indicated for the management of edentulous patients, whether partial or total, and among these options, removable total prostheses are eligible as described in the literature [6,7,12,13].
Removable complete dentures are indicated for patients who have completely missing teeth. They belong to the group of removable prostheses and allow the complete replacement of the dental arch, both upper and lower, by replacing the dental structures [14,15]. The first complete dentures date back to 1692 and were made from pieces of hippopotamus molars. In 1830, they were made from ivory. Initially, these prostheses were essentially handmade, combining sculpted materials with natural or ivory teeth. With the advent of plaster, it became possible to carve the ivory in such a way as to allow more intimate contact with the basal area; to make it, the ivory was pressed onto the plaster model of the dental arch and then carved [16-18].
In the 1880s, dental morphology began to be valued, and teeth were sculpted into shapes typical of the time [19]. The artificial teeth and the base of the prosthesis have different colors, and it is necessary to maintain aesthetics and resistance to abrasion. The base of the prosthesis is manufactured by cutting, and the teeth are adhered to this base using adhesives, such as resin cements [20]. In 1875, the resinous paste “godiva” was introduced, making it possible to replicate dental structures and adjacent tissues [18].
The success or failure of rehabilitation with prostheses depends on different factors, such as the relationship between patients and professionals, the patient’s attitude towards using the prosthesis, their personality, and factors related to the quality of the prosthesis. Rehabilitation with prostheses makes it possible to maintain the vertical dimension of occlusion (VOD), prevent tongue expansion, develop function, guide speech, correct wrinkles, and improve self-esteem and social interaction [15,21,22].
Genari Filho [23] also reports that complete dentures have the function of restoring patients’ self-esteem, both due to aesthetic factors and those related to function, such as retention, stability, deglutition, efficient chewing, and balance of the stomatognathic system and phonetics. Michaud et al. [24] reported a positive assessment of the relationship between the satisfaction of patients wearing complete dentures and the quality of life associated with oral health.
The technique of rehabilitation with removable full dentures is simple and attractive to patients, as well as being an affordable alternative. This technique allows rapid adaptation to the new smile; however, it requires careful assessment of the patient, proper planning, excellent execution, and post-operative follow-up [25]. Furthermore, communication between the professional and the patient is essential to improve acceptance rates. The patient should be instructed on their responsibility when handling the prosthesis and eating food, to avoid overloading the ridge, damaging the alveolar mucosa, and inappropriate bite movements [26,27].
The selection of the material, the most appropriate technique, and compliance with each manufacturer’s recommendations for taking impressions are all part of the process of making dental prostheses [28]. Regis et al. [29] demonstrated that, during functional impression taking, functional movements made by the patient should be carried out; recording the tissues in a compressive position will allow the force of tissue displacement and the retention of the prosthesis to be observed, and there should be a balance between the two. The authors also report that reproducing the anatomical structures of the appliance area is one of the most important points when making a removable total prosthesis.
Marcinak et al. [30] recommend that the template be poured after it has been disinfected for a maximum of thirty minutes. When silicone is the material of choice, a high-quality copy is obtained if the indicated proportion and correct spatulation are respected. Robert and John [31] report that elastic materials provide an excellent copy of the soft and hard tissues of the oral cavity, as well as offering greater comfort for both the professional during manipulation and the patient when being molded. These factors make silicone the most widely used material in clinical practice.
During recording, it is always recommended to keep the patient’s head balanced to avoid alterations during the procedure, guiding them to open and close their mouth widely a few times and to swallow. In this way, the muscle fatigue method is used, in addition to the use of the facial arch [32].
The stage that requires the most attention when making prostheses is determining the vertical dimension of occlusion, as this directly influences the final result of the treatment. The VOD measurement allows the stomatognathic system to restore harmonious function to the muscles of the lower third of the face, improving appearance. Consequently, to ensure aesthetics, the VOD, the median line, the canine line, and the high smile line should be taken into account, minimizing oral lesions caused by iatrogenic prostheses [27,33,34].
In terms of the stability and retention of complete dentures, these can be compromised by the inadequate distribution of forces generated by chewing, swallowing, and parafunctional habits, which are favored by the contact between the maxillary and mandibular teeth. These unfavorable displacements can cause discomfort and trauma to the underlying mucosa. Barbosa et al. [26] state that, for adequate retention, the plating area must be comprehensive; however, the retention of a prosthesis does not always directly influence its stability.
Total removable prostheses are contraindicated in patients undergoing radiotherapy, with exostoses, muscle insertions, hypertrophy, and hyperplastic mucous membranes [11]. Lee and Saponaro [35] add that prolonged use of these prostheses can lead to sequelae such as residual ridge resorption, ulcers, lesions, prosthetic stomatitis, candidiasis, angular cheilitis, and soft tissue hyperplasia. Lower complete dentures also have a higher failure rate and lower longevity when compared to upper dentures, as they have a smaller support area, alveolar ridge resorption, and unbalanced distribution of occlusal forces. The longevity of these prostheses depends directly on the approach of the dental surgeon and the patient, and follow-up is essential to assess the installation of the prostheses, to check for adjustments, irregularities, and roughness [36].
CONCLUSION
Increased self-esteem, improved chewing functions, and satisfaction are all benefits achieved with the use of removable complete dentures in patients who have lost all their teeth throughout their lives. Removable complete dentures are, therefore, an excellent alternative for reducing the effects of edentulism, as they have a psychological, functional, and social impact on people’s lives, contributing to their quality of life.
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How to cite this article
Santos DA. Oral rehabilitation with a total removable prosthesis: a literature review. RGO, Rev Gaúch Odontol. 2025;73:e20250029. http://dx.doi.org/10.1590/1981-86372025002920240090
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Artigo alinhado ao objetivo Boa saúde e Bem-estar dos Objetivos de Desenvolvimento Sustentável (ODS)
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Edited by
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Assistant editor:
Luciana Butini Oliveira
Publication Dates
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Publication in this collection
19 Sept 2025 -
Date of issue
2025
History
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Received
29 Nov 2024 -
Reviewed
19 Mar 2025 -
Accepted
24 Apr 2025
