Removable Dentures — What Are They and When Are They Necessary?
A removable denture is an orthopedic appliance that the patient can insert and remove independently. According to the 2026 clinical recommendations of the Spanish Society of Prosthetic Dentistry (SEPES), removable prosthetics remain a relevant rehabilitation method for partial or complete tooth loss. Contrary to stereotypes, modern removable dentures are prescribed to patients of all age groups: from young individuals with post-traumatic defects to elderly patients with total edentulism. Main indications include: absence of one or several consecutive teeth, multiple defects in the dental arch, complete absence of teeth, as well as temporary prosthetics during the osseointegration period of dental implants. In the Mediterranean climate of Barcelona, with its high insolation and hot, dry summers, the selection of materials resistant to thermal stress and ultraviolet radiation becomes particularly important.
Types of Removable Prosthetics: 2026 Classification
Contemporary orthopedic dentistry in Spain employs a two-level classification of removable dentures. Based on the extent of replacement, partial (replacing 1 to 14 teeth) and complete (for total edentulism) constructions are distinguished. Based on material and manufacturing technology, five main types of partial dentures are differentiated: acrylic (plastic), nylon, Acry Free, clasp-retained (with a metal framework), and Quattro Ti. For complete removable prosthetics, acrylic, nylon dentures, and Acry Free are available — clasp-retained systems and Quattro Ti are not used in cases of complete tooth absence due to the lack of abutment elements. The choice of a specific construction type is determined by the clinical picture, the condition of the abutment teeth periodontium, the degree of bone tissue atrophy, and the patient's expectations. SEPES 2026 protocols emphasize the necessity of the patient's informed consent regarding all advantages and disadvantages of each prosthetic type.
Partial Removable Dentures — Comparative Analysis of Modern Systems
Acrylic dentures represent the basic technology of removable prosthetics. They are manufactured from acrylic resin using injection molding or cold polymerization. Fixation is achieved through metal or flexible clasps encircling the abutment teeth. Advantages: affordability, repairability, rapid laboratory fabrication (48–72 hours), long history of clinical application. Disadvantages: presence of residual monomer (risk of allergic reactions), porous surface promoting bacterial plaque accumulation, fragility under point loads. According to the Spanish Agency of Medicines and Medical Devices (AEMPS), the frequency of allergic reactions to acrylates is less than 3% of cases.
Nylon dentures (Valplast, Flexite, Deflex) are manufactured from thermoplastic polyamide using injection molding. They are characterized by high elasticity, base translucency, and complete hypoallergenicity (absence of methyl methacrylate). Advantages: maximum aesthetics, wearing comfort, light weight. Disadvantages: elastic deformation of the base during chewing causes painful sensations and accelerates atrophy of the underlying bone tissue; impossibility of repair (relining, tooth addition, crack repair); adsorption of water and pigments leading to discoloration. SEPES 2026 protocols recommend prescribing nylon dentures only in cases of documented allergy to acrylates and absence of alternatives.
Acry Free — an injection molding technology using the thermoplastic material Perflex® (acrylic resin copolymer). In terms of physical-mechanical properties, it occupies an intermediate position between acrylic and nylon: stiffer than nylon, but more elastic than acrylic. Advantages: high fit precision (minimal shrinkage during molding), hypoallergenicity, repairability, low hygroscopicity, color retention. Disadvantages: contraindications in bruxism, chronic periodontitis, pronounced bone tissue atrophy; inability to transfer masticatory load to abutment teeth. According to studies from the University of Barcelona (2025), Acry Free demonstrates the best indicators according to the «patient satisfaction» criterion among metal-free dentures.
Quattro Ti — a metal-free clasp-retained system made of Dental-D polymer (acrylic resin reinforced with ceramic microparticles). The construction includes a framework and clasps made of the same material, ensuring high aesthetics. Advantages: absence of metal, biocompatibility, compactness, stain resistance. Disadvantages: elastic clasps provide insufficient retention in extensive defects; the construction does not transfer masticatory load to abutment teeth; in pronounced dental arch defects, the base covers a significant part of the palate, impairing taste sensitivity and diction. Contraindicated in cases of abutment tooth mobility and generalized periodontitis.
Clasp-retained (framework) dentures — the most physiological type of partial removable prosthetics. The basis is a cast metal framework made of cobalt-chromium alloy or titanium, to which the base with artificial teeth is attached. The fixation system includes support-retaining clasps (metal or elastic), attachments (precision locks), or telescopic crowns. Advantages: high strength characteristics, minimal base thickness (rapid adaptation, preservation of diction and taste sensitivity), transmission of up to 70% of masticatory load to abutment teeth (significant slowing of bone atrophy), possibility of repair and relining, long service life. Disadvantages: visibility of metal elements in the smile zone (resolved by using telescopic crowns or precision attachments, which increases the construction cost). According to the Dental Council of Catalonia, clasp-retained dentures remain the «gold standard» for extended bounded and free-end defects of dental arches.
Complete Removable Dentures — Selection Features in Total Edentulism
In the complete absence of teeth, the choice is limited to acrylic, nylon dentures, and Acry Free. Acrylic complete dentures provide fixation through adhesion and the «suction effect» — air rarefaction between the base and the mucous membrane. The degree of fixation is directly proportional to the contact area and saliva fluidity. Nylon complete dentures demonstrate poorer fixation indices, especially on the lower jaw, due to the base elasticity disrupting the peripheral seal. Spanish clinical protocols of 2026 do not recommend nylon dentures for total replacement on the lower jaw. Acry Free provides an optimal balance of aesthetics, comfort, and fixation. A critically important limitation of all types of complete removable dentures is their inability to prevent bone tissue atrophy. The absence of physiological load on the underlying bone triggers the resorption process: during the first year of wear, bone volume decreases by an average of 1–2 mm, in subsequent years — by 0.5–1 mm annually. After 5–7 years, atrophy reaches a degree that complicates subsequent dental implantation without preliminary bone grafting.
Adaptation to Removable Dentures — SEPES 2026 Protocol
The period of neuromuscular adaptation to removable dentures ranges from 2 to 12 weeks, depending on the construction volume and the patient's individual sensitivity. The SEPES 2026 protocol regulates five directions of adaptation therapy. First — eating behavior: it is not recommended to exclude solid food; vegetables and fruits should be chopped but kept in the diet for gradual training of the masticatory muscles. Second — diction: daily reading aloud for 20–30 minutes, articulation exercises on sibilant and fricative sounds («s», «z», «ts», «ch», «sh»). Third — salivation: in the first 2–3 weeks, hypersalivation or xerostomia is possible; frequent small sips of water and sugar-free lozenges are recommended. In the hot Mediterranean summer conditions, maintaining hydration is critically important — dehydration aggravates mucosal dryness and reduces denture adhesion. Fourth — local anti-inflammatory therapy: upon appearance of chafing areas, rinses with chamomile, sage, or oak bark infusions are indicated. Fifth — gum massage: daily digital massage of the denture-bearing area (3 times a day for 3–5 minutes) improves tissue trophism and accelerates adaptation.
Care of Removable Dentures in the Mediterranean Climate
The hygienic regimen for removable dentures is regulated by protocols of the Spanish Society of Periodontology (SEPA, 2026). Daily care: rinsing the denture under running water immediately after each meal; mechanical cleaning with a soft-bristled toothbrush and low-abrasive toothpaste (RDA abrasivity index not exceeding 30) twice daily. Weekly care: soaking the denture in a solution of enzymatic disinfectant tablets (Corega, Protefix, Fittydent, Lacalut) for 15–20 minutes to remove protein pellicle and bacterial biofilm. Periodic care: use of an ultrasonic bath once every 2–3 weeks to remove pigmented calculus and mineralized deposits. Storage specifics: acrylic dentures require storage in a humid environment (water or disinfectant solution) to prevent deformation from drying; nylon and Acry Free dentures can be stored in a dry closed container. For clasp-retained dentures with metal elements, the use of chlorinated tap water is not recommended — darkening and corrosion of alloys are possible. In Barcelona, where tap water is less chlorinated than in Northern European countries, the risk is minimal; however, filtered or boiled water is preferable.
Fixation of Removable Dentures — Modern Adhesive Systems
To improve the fixation of removable dentures, especially complete ones, adhesive agents are used — creams, gels, powders, and cushions based on synthetic polymers (polyvinyl acetate, carboxymethyl cellulose, copolymers of methyl vinyl ether and maleic anhydride). Mechanism of action: upon contact with saliva, the polymers hydrate, forming a viscoelastic gel that fills the micro-space between the base and the mucosa, creating adhesive and cohesive bonding. Clinical studies conducted at the University of Barcelona (2025) confirm a 300–500% increase in complete denture retention when using adhesives. Application protocol: the denture is dried, the adhesive is applied in dots or thin strips on the internal surface, avoiding the edges (to prevent extrusion); the denture is inserted into the oral cavity and pressed against the jaw with force for 5–10 seconds. The duration of effective fixation is 12 to 18 hours. Importantly: adhesives do not damage the denture material or abutment teeth, but require thorough removal of residues during daily cleaning. Persistence of adhesive residues is a risk factor for the development of denture stomatitis and candidal infection. For patients actively using swimming pools and beaches in Barcelona, water-resistant formulas (Fittydent) are recommended, maintaining adhesion in contact with chlorinated or salt water.
Repair, Relining, and Adjustment of Removable Dentures
All types of removable dentures require periodic professional maintenance. Adjustment: grinding of base areas causing pain and mucosal trauma. Performed in the first 2–7 days after denture placement, included in the warranty obligations of the dental clinic. Repeated adjustment may be required after 6–12 months due to physiological bone tissue atrophy. Relining: restoration of the fit precision of the denture's internal surface to the altered denture-bearing area. Performed laboratorially (replacement of a resin layer) or clinically (application of self-curing resin directly in the oral cavity). Indicated every 2–3 years of wear. Repair of acrylic dentures and Acry Free is possible in case of base cracks, fractures of artificial teeth, or broken clasps. Nylon dentures and Quattro Ti are non-repairable — complete construction replacement is required. Self-repair of dentures using household adhesives is strictly prohibited: material toxicity, disruption of occlusal relationships, and base geometry lead to irreversible damage and impossibility of subsequent professional repair.
Removable Dentures and Implantation — Choosing a Treatment Strategy
The main objective disadvantage of all types of removable dentures is their inability to prevent bone tissue atrophy. According to data from the Spanish Society of Implantology (SEI, 2026), removable dentures restore masticatory efficiency to only 30–40% of the natural dentition. Patients are forced to limit their diet, excluding hard, sticky, and fibrous foods. An alternative strategy is dental implantation followed by fixed or implant-supported removable prosthetics. All-on-4 and All-on-6 protocols (complete jaw rehabilitation on 4 or 6 implants) allow restoration of masticatory function to 85–95% and complete cessation of bone atrophy. Implant-supported removable dentures (bar fixation, locators, spherical attachments) provide reliable fixation while maintaining the patient's ability to remove the appliance independently. In Barcelona, these technologies are widely available. For patients with limited budgets, a two-stage strategy is acceptable: temporary removable prosthetics with planned replacement with implant-supported constructions in 3–5 years. In this case, the choice of primary denture material should consider the need to preserve bone tissue for future implantation.
Conclusion — Algorithm for Choosing a Removable Denture
The choice of a removable denture is determined by the clinical situation, dental status, and the patient's long-term plans. For partial dental arch defects with preserved abutment teeth, clasp-retained dentures are preferable, providing physiological load distribution and slowing bone atrophy. In case of acrylate allergy and impossibility of using a clasp-retained construction, alternatives are Acry Free or Quattro Ti (for small defects). Nylon dentures should be considered as reserve therapy. In total edentulism, the optimal material is Acry Free; acrylic dentures remain an accessible basic solution. For patients planning future implantation, it is recommended to choose dentures providing maximum comfort in the short term, with an understanding of the inevitability of atrophic processes. At the Corona Dental clinic in Barcelona, an individualized orthopedic diagnostic protocol has been developed, including 3D planning and digital smile modeling, allowing the selection of the optimal prosthetic type considering all clinical factors and patient preferences.
