In the next part of this series on tooth wear management, we discuss the indications and clinical stages for the provision of removable prostheses for the treatment of severely worn and depleted dentitions. The general design features of a complex prosthesis are described for reorganised occlusal schemes and maintenance guidelines are explained. In addition, the clinical stages for three different situations are described: removable-only approaches, and combined fixed and removable in the same arch and separate arches. The value of providing removable prostheses in worn dentitions allows the immediate rehabilitation of severely worn teeth taking a non-invasive and retrievable approach when the remaining dentition is of poor quality or structure and/or there are missing teeth.
Key points: Removable prostheses in severely worn dentitions are of value when fixed approaches are not indicated or have low prognosis for success, where there are missing teeth, or as part of a combined fixed-removable treatment plan.The general design features of a removable prosthesis include: metal backings on teeth of guarded long-term prognosis; metal or acrylic onlays on posterior teeth where the occlusion allows or vertical dimension is increased; anterior bite platforms where required to gain functional tooth contacts; and minimal apron flanges over teeth used as overdenture abutments.Patients who are provided with removable prostheses to manage their tooth wear need to be carefully monitored, with reduced recall intervals of 3-4 months. Close attention should be paid to preventative regimes and identification of new disease.