Dentures are prosthetic devices designed to replace missing teeth and surrounding gum tissue. These custom-made appliances restore a patient’s ability to speak, chew, and smile. Dentures come in two forms: complete dentures, which replace all teeth in an arch, and partial dentures, used when some natural teeth remain. The quality and performance of any dental prosthetic depend directly on the materials chosen for the foundational base and the artificial teeth.
Materials Used for the Denture Base
The denture base is the pink, gum-colored structure that rests upon the oral tissues and holds the artificial teeth. The most widely used material for this foundation is Polymethyl Methacrylate (PMMA), commonly known as acrylic resin. Acrylic resin is lightweight, cost-effective, and easy for dental technicians to adjust and repair. It can also be tinted to match the patient’s gum shade, providing good aesthetics for the support structure.
Acrylic bases must be made thick to achieve adequate strength, which can result in a bulky or less precise fit. Conventional heat-cured acrylics undergo shrinkage during processing, affecting the final adaptation to the patient’s mouth. Newer fabrication methods, such as Computer-Aided Design and Manufacturing (CAD-CAM), have improved the precision and surface quality of these traditional acrylic materials.
For partial dentures supported by remaining natural teeth, metal alloys often provide a superior foundation. Frameworks constructed from cobalt-chrome or titanium are significantly stronger than acrylic, allowing the base to be cast thinner and less bulky. This reduced thickness improves comfort and allows the patient to feel temperature and texture more naturally. Precision casting of metal frameworks results in a better fit, offering stability and retention through specialized clasps and tooth-supported rests.
A third option, primarily for partial dentures, involves flexible resins like nylon (e.g., Valplast). These flexible bases are lightweight and nearly unbreakable, offering a comfortable fit that causes less rubbing against the gums. Flexible dentures are also highly aesthetic because they use translucent material, allowing the natural gum color to show through and eliminating visible metal clasps. However, flexible resins are generally gum-supported, which may not provide the same long-term stability as a tooth-supported metal framework.
Materials Used for Denture Teeth
The second major component is the artificial teeth, typically made from either acrylic resin or porcelain. Acrylic resin teeth are the most common choice, primarily due to their compatibility with the denture base. Since the teeth are made of a similar polymer material, they form a strong chemical bond, making them less likely to detach over time.
Acrylic teeth are softer than porcelain, which is often an advantage. Their softness makes them easier for the dentist to grind and adjust for proper bite alignment. This softer material is also less likely to damage or cause excessive wear on opposing natural teeth or existing dental work. The main drawback of acrylic teeth is their susceptibility to wear over time, which can decrease the vertical height of the teeth after five to eight years.
Porcelain teeth are made from a ceramic material that closely mimics the translucency and sheen of natural tooth enamel, providing excellent aesthetics. Porcelain is harder than acrylic, offering resistance to wear and abrasion, thus maintaining shape and length for a longer period. This hardness, however, introduces several functional considerations.
The dense material of porcelain can cause accelerated wear on opposing natural teeth or acrylic dentures. Since porcelain does not chemically bond to the acrylic base, it requires mechanical retention. This makes porcelain teeth more prone to chipping, cracking, or detaching from the base upon impact. Furthermore, the hard surface often results in an audible “clicking” sound when the patient is eating or speaking. While porcelain offers durability and appearance, acrylic teeth are generally the preferred standard for most modern applications.
Defining the “Best” Material Based on Patient Needs
Determining the “best” denture material involves selecting the combination of materials that meets the patient’s specific needs for function, comfort, and aesthetics. The optimal choice synthesizes the properties of the base and the teeth with the individual’s oral anatomy and lifestyle. For example, a patient needing a complete denture who prioritizes lower cost will find the acrylic base with acrylic teeth to be the most economical and serviceable solution.
Patients seeking a partial denture who value minimal bulk and retention often benefit most from a cobalt-chrome framework. The metal’s strength allows for a thin, precise appliance that provides stable, tooth-supported function. If the primary concern is aesthetics and avoiding visible metal, a flexible nylon base is often the best choice due to its translucent quality and lack of clasps.
When considering the teeth, porcelain is an option for patients who prioritize long-term wear resistance and aesthetics, especially if they have no opposing natural teeth. However, for the majority of patients, acrylic teeth are functionally healthier. The softer acrylic prevents excessive wear on opposing teeth and offers a quieter, natural chewing experience with a better chemical bond to the base. The best dentures are custom-designed to balance the fit of a metal or CAD-CAM base, the appropriate support mechanism, and the functional advantages of modern resin teeth.