A case report of a patient with metal-based complete dentures from a long-term follow-up perspective

Background:Following tooth extraction, alveolar ridge resorption, particularly in the mandible, is a chronic, progressive process that can extend beyond the alveolar ridge in severe cases. Research indicates that despite its dense structure, the mandibular ridge is highly susceptible to this type of resorption. This study aimed to evaluate mandibular ridge resorption following complete denture therapy over a six-month to one-year period, assessing changes at the masticatory centre and mental foramen. Differences between patients with complete dentures and those without were examined to determine whether denture fabrication impacts ridge resorption. Materials and Methods:The study was conducted over a five-year period at the Clinic for Removable Prosthodontics, Faculty of Dentistry, in Skopje. Sixty patients (32 men and 28 women), aged 51 to 70, participated and were divided into two groups: the first received complete dentures after an initial period of post-extraction bone healing, while the second did not receive dentures during this time. Results: Results demonstrated significantly lower resorption in denture-wearing patients, with a 4.3% resorption rate at the masticatory centre and 3.1% at the mental foramen, compared to 8.5% and 6.3% in the non-denture group, respectively (p < 0.01). This difference indicates that patients with complete dentures experience notably reduced mandibular ridge resorption compared to those without dentures. Conclusion: Our findings suggest that timely, well-fitting complete denture fabrication shortly after tooth extraction plays an essential role in slowing alveolar ridge resorption and preserving ridge height, with potential implications for improved patient outcomes based on cultural, social, and economic factors.

The effects of clinical wear on the incidence of temporomandibular disorders among patients with complete dentures

Sensory disturbance resulting from denture pressure may be caused by advanced alveolar ridge resorption in a patient with an edentulous jaw. We report our observations of a patient with complete dentures with inferior alveolar sensory nerve disturbance due to alveolar ridge resorption associated with a mandibular canal.The patient was a 65-year-old woman, who had begun using complete lower dentures six years earlier. She had become aware of dysesthesia of an area innervated by the right mental nerve, and also hypoesthesia, and thus consulted the Tokyo Dental College Suidobashi Hospital for oral surgery.Hypoesthesia of the area innervated by the mental nerve, i.e. dysesthesia, and gingival area dysesthesia in response to pressure on the right mandibular molar tooth were noted at the time of the first medical examination. Medical treatments performed included denture adjustment, medications, and rehabilitation guidance to restore sensation. The hypoesthesia disappeared progressively within two months, and the dysesthesia resolved three weeks thereafter. The sensory testing method used for this patient enabled both quantitative assessment of the disorder and evaluation of the recovery process over time. Based on the features of each laboratory procedure, the author considers it to be important to assess perception disorders comprehensively.

Complete edentulous is a condition which a person loses all of his or her natural teeth. The treatment is done by making a complete denture (CD). The parameter of successful treatment is dependent on its use. Patient’s ability to adapt to new CDs is often becomes the problem. If it’s not solved properly, it will impact the oral health and quality of life of the patients, so post-treatment evaluation and control are important. One problem that is widely complained is the retention and stability of lower CD. According to previous studies, the patient's adaptation to CD is related to the condition of dentures, which is a combination of CD’s quality and characteristics of alveolar ridges, so the difference between dentist's evaluation of CD’s quality and patient's subjective assessment could happen due to improper clinical assessment of denture-bearing area, which consists of anatomy of supporting and limiting structures. However, other researches suggest alveolar ridges don’t affect patient acceptance of CDs, so studies in this area are still considered equivocal. The purpose of this study is to determine the influence of anatomy of lower complete denture supporting structures on retention and stability. This study is a descriptive analytic research with clinical examination of lower denture and oral cavity. Total of samples are 30 CD patients those fulfill the inclusion and exclusion criteria. The result of this study based on the Fisher Exact Test showed a significant influence between the anatomy of lower complete denture supporting structures on retention and stability.

Background and Objectives: Edentulism is considered to be an impediment impacting both patients’ quality of life and their nutrition. Conventional complete dentures are still a preferred treatment. However, there is no consensus on the most important factors which could substantially reduce the risk of patient dissatisfaction. This study evaluated the following determinants concerning patient satisfaction with complete maxillary and mandibular dentures: sex, denture-related functional and aesthetic aspects, and the degree of bone resorption. Materials and Methods: This study included 70 patients aged 34–81 years of age. All complete dentures were made by following the same technology. Visual analogue scales were used to assess patients’ overall satisfaction with dentures, comfort, ability to speak and chew, denture aesthetics, stability, and ease of prosthesis cleaning. Satisfaction with upper and lower dentures was rated separately. The degree of bone resorption was classified by using the Kalk and de Baat (1989) method. Results: The mean (SD) age of the study participants was 67.3 (10.4) years; 65.7% (n = 46) were females and 34.3% (n = 24) were males. There were no significant sex-based differences in resorption of the maxilla or mandibula. There were significant differences between maxillary and mandibular dentures, with lower mean satisfaction scores concerning chewing and maxillary complete dentures, and in regard to stability and comfort for mandibular complete dentures. There was a non-significant overall lower satisfaction with increased age. In multivariate analysis for mandibular complete dentures, aesthetics and stability significantly predicted the patient’s comfort levels, and the patient’s comfort significantly predicted overall satisfaction. For maxillary complete dentures, patient comfort and aesthetics significantly predicted overall patient satisfaction. Conclusions: Age, sex, and degree of resorption were not associated with patient satisfaction with complete dentures. Overall, patient satisfaction with both maxillary and mandibular complete dentures was related to their comfort level and denture aesthetics, and patient comfort itself was associated with stability of the mandibular denture.

Aim: To compare the type of stress distribution pattern occurring with anatomic and non-anatomic tooth forms beneath a complete denture in both maxillary and mandibular arch. Methodology: A photoelastic model of the edentulous maxillary and mandibular ridge was prepared meticulously to simulate the human mandible and maxilla. Two sets of acrylic teeth with anatomic and non-anatomic occlusal forms were used to fabricate upper and lower dentures. A vertical static load of 100 N was applied through the mandibular model to the maxillary model. After load application on the dentures the photoelastic model as well as the upper and lower complete dentures were sectioned in the midline. The sectioned photoelastic model was viewed through a polariscope to observe the fringe pattern indicating varying amounts of stress distribution. In this study, a two-dimensional photoelastic stress analysis technique was utilized. Results: Force per unit area was observed more in anatomic teeth than the non-anatomic counterpart. Hence anatomic tooth forms may increase the possibility of bone resorption rate over a period of time. However, in non-anatomic lower teeth, a decrease in value was observed from posterior to anterior region. Conclusion: Stress of greater magnitude was observed with cuspal teeth whereas non-anatomic (0°) showed slightly less magnitude of stress. Depending upon the clinical situation the clinician needs to choose the type of occlusal tooth forms for edentulous patients.

Cephalometric evaluation of the changes in patients wearing complete dentures. A ten-year longitudinal study

The purpose of this study was 1) to verify and apply a system to measure the three-dimensional (3-D) movement of the upper and lower complete dentures and the movement of the mandible with six degrees of freedom, and 2) to analyze the relationship between denture movements and the path of closure of the mandible during functions. A 3-D motion capture system with four infrared TV cameras was used for this purpose. The loci of each of three targets on the subject's head, the upper dentures, the lower dentures, and the mandible were measured three-dimensionally. The relationship between the lower dentures and the mandibular movements was analyzed in the change of the inner product of normal vectors of the denture occlusal planes and mandibular planes. The results were as follows: This system could measure the denture mobility within 3.5 x 10(- 1) mm in error. The mobility of the upper dentures had a correlation to the path of closure of the mandible regardless of the working side or nonworking side, and the lower dentures had a tendency to move toward the working side.

Introduction: Lateral throat form plays an important role in the success of lower complete denture as it affects its retention and stability. The length and thickness of lower dentures should be properly established in this region. Aim of this study is to evaluate the difference in the extension of lateral throat form between the patient's mouth and lower dentures. Materials and Methods: The lateral throat form was classified according to Neil's classification into Class I, Class II and Class III. The length of the lateral throat form was measured in the patient's mouth and in lower dentures with the help of UNC periodontal probe, and a comparison was made between them. Results: Among all the patients in this study, Neil's Class I lateral throat form was 53%, Class II was 37% and Class III was 10%. The average variation between the extent of lateral throat form intraorally and in lower denture at the anterior edge of the retromolar pad was 1.7 ± 1.75 mm in the right side and 2.5 ± 2.00 mm in the left side, whereas at the posterior edge of retromolar pad, it was 2.23 ± 1.92 mm in the right side and 3.06 ± 2.25 mm in the left side. Conclusions: The proportion of Neil's Class I was the highest followed by Class II and Class III was the lowest. The difference between the length of lateral throat form in the patient's mouth and in lower denture was statistically significant (P < 0.05).

In making a complete denture, the selection of the artificial posterior teeth is one of the important factors to obtain denture stability and to avoid high pressure applied to the supporting structure under a denture. The purpose of this study was to investigate the influence of the occlusal surface of the artificial posterior teeth on the pressure distribution under a complete denture.The results were as follows:1. In centric occlusion, the occlusal surface of different artificial teeth did not affect the pressure distribution under the complete denture.2. In one-side occlusion, the pressure values were changed remarkably in the buccal area on the working side and palate area as compared with the pressure distribution under the complete denture with two different artificial teeth.3. In one-side occlusion at an eccentric position, the occlusal surfaces of the artificial teeth affect the pressure distribution under the complete denture. The pressure values under the lower denture with Bio-Ace artificial posterior teeth increased on the nonworking side.

Objective: The purpose of this study was to detect the impact of mandibular implant retained overdenture on electromyographic activity of submental muscles during swallowing in edentulous subjects. Materials and methods: Fifteen completely edentulous subjects with problematic lower complete dentures were participated in this study. All subjects received a newly carefully constructed complete dentures and then the lower dentures were changed into mandibular implant retained overdentures by placing two implants on the mandibular canine regions and using ball attachments to retain the overdentures. All the subjects were submitted to surface electromyographic evaluation for the submental muscles without dentures, with complete dentures and with mandibular implant overdenture during swallowing of 10ml of water. Results: There was a statistically significant increase in swallowing duration and electromyographic amplitude of submental muscles after complete dentures insertion and also after insertion of mandibular implant overdenture. Moreover, there was a statistically significant reduction in both swallowing duration and electromyographic amplitude of submental muscles for mandibular implant overdenture when compared to complete dentures. Percentage Overlapping Coefficient showed a non-significant differences between different oral conditions. Conclusion: Rehabilitation of completely edentulous patient with mandibular implant retained overdenture revealed a reduction in swallowing duration and reduction in electromyographic amplitude of the submental muscles during swallowing.

INTRODUCTION: The aim of the study was to observe the relationship between alveolar ridge resorption in mandible and masticatory performance based on gender in complete denture wearers. MATERIALS AND METHODS: The subjects included were those wearing complete denture between the ages of 45-69 years-old, treated at the Dental and Oral Hospital of University Sumatera Utara. Alveolar ridge resorption in mandible was analysed using the panoramic radiograph and masticatory performance was evaluated clinically using the colour-changeable chewing gum. RESULT: 40 patients were included in this study. 50% were women in which 15 women (37.5%) had mild alveolar ridge resorption whilst 5 (12.5%) had severe alveolar ridge resorption. For masticatory performance, 14 women (35%) had good masticatory performance and 6 (15%) had poor masticatory performance. For the men; 17 (42.5%) had mild alveolar ridge resorption whilst 3 (7.5%) had severe alveolar ridge resorption. For masticatory performance, 16 men (40%) had a good masticatory performance and 4 (10%) had a poor masticatory performance. There was a significant correlation between alveolar ridge resorption in mandible and masticatory performance amongst women (p=0.014). However, there was no significant correlation found between gender and alveolar ridge resorption in mandible (p=0.695), between gender and masticatory performance (p=0.716), and between alveolar ridge resorption in mandible and masticatory performance amongst men (p=0.088). CONCLUSION: The alveolar ridge resorption in mandible is associated with masticatory performance amongst women.

The Neutral Zone technique is not a new but a very valuable technique, it is an alternative approaches in constructing stable complete denture in case of a highly atrophic mandible. The main aim of the Neutral zone technique is to construct denture in muscle harmony, so that it does not get displaced during the actions of the muscles surrounding as the actions of swallowing, mastication, speech and so on. Key words—Neutral zone, Atrophic mandible. Introduction: The goal of dentistry is for patients to keep all their teeth throughout their lives in health and comfort. If the teeth are lost despite all efforts to save them, a restoration should be made in such a manner as to function efficiently and comfortably in harmony with the muscles of the stomatognathic system and the temporomandibular joints. With the increase in the life expectancy of the population, the numbers of complex complete denture cases also have been increasing. The treatment for these complex complete denture cases should be different from those of traditional complete dentures. In case of Atrophic mandible, Dental implants may provide stabilization of mandibular complete dentures, but in cases when it is not possible to provide implants on the grounds of medical risks, economic limitations or patients attitudes, an alternative technique should be thought. The Neutral Zone Technique is an alternative approach for these cases. The Neutral zone technique is not new, but is one that is valuable yet not practiced. The Neutral zone has been defined as the area in the mouth where during function, the forces of the tongue pressing outwards are neutralized by the forces of the cheek and lips pressing inwards. The aim of the Neutral zone is to construct a denture in muscle balance. If the denture is out of harmony with the neutral zone, it will result in instability, interference with function or some degree of discomfort. Thus neutral zone must be evaluated as an important factor before aligning the teeth in complete denture or partial denture. This is the zone where the natural dentition exists. As the mandible atrophies at a greater rate than the maxilla and has less residual ridge for retention and support, the lower denture commonly presents the most difficulties with pain and looseness being the most common complaints. The Neutral zone technique is most effective for patients who have had numerous unstable and nonretentive lower complete dentures. These patients usually have a highly atrophic mandible and there has been difficulty in positioning the teeth to produce a stable denture. The Neutral zone approach has been used for patients who have had a partial glossectomy, mandibular resections or motor nerve damage to the tongue– which have led to either atypical movement or an unfavorable denture bearing area. Background: Sir Wilfred Fish in 1931 first described the influence of the polished surface on retention and stability. He also described how dentures should be constructed in the ‘dead space’, which later became as the

Purpose: The study aims to identify the bacteria present in acrylic complete dentures after long-term use and after the 1st week of placing a new denture. Subjects and Methods: A total of seven subjects presented to the Department of Removable Prosthodontics Clinic, Al Azhar University, Gaza, Palestine, who had old and new complete dentures took part in this study. The inner and outer surfaces of the complete denture bases of both upper and lower dentures were sampled, the samples were cultured, and the bacterial type was determined by microbiological methods. Results: Of the seven subjects studied, five subjects have shown Staphylococcus (STAPH) spp. in the inner and outer surfaces of both upper and lower dentures for the old and the new as well, while one subject has shown the STAPH spp. also on the lower surfaces of both old and new denture, but the upper surfaces showed no bacterial growth. The last subject had grown bacteria on both upper and lower old dentures, but in the new denture, the bacteria grew only in the upper surface. Conclusion: STAPH spp. showed a great prevalence in both old and 1 week of dentures in use as it predominated in the inner tissue surfaces as well as the outer polished surfaces.

Background: Complete denture in the lower jaw often has problems. The entire loss of the mandibular teeth often has a large resorption, so it is difficult to obtain retention and stability. Purpose: To report mandibular magnet retained complete overdenture is can increase retention and stability in the lower jaw. Case: A 60-year-old man came to the Prosthodontics Clinic of RSGM Airlangga University with complaints of the old complete denture that made by previous dentist, is often unstable while talking and chewing, so the patient feel uncomfortable. The denture has been used for approximately four years. Therefore the patient wants to make a new complete denture. Case Management: PFM crown removed and 31,32,33,41,43 are treated with root canal treatment. Magnet keepers are fabricated on teeth 33,43, and metal copings are fabricated on teeth 31,32,41. The complete lower denture is attached to the magnet. Acrylic material denture are chosen. Discussion: Overdenture is a complete or partial denture that is placed above the tooth structure or the root of the original tooth which is the support of the denture. Overdenture treatment can maintain ridge height, reduced load of supporting elements, and avoid mucosal irritation. It’s necessary to add retention in the form of magnets to the teeth 33 and 43 to get good retention and stability. Conclusion: Mandibular magnet retained complete overdenture is can increase retention and stability in the lower jaw so that the patient feels satisfied and comfortable because the dentures are more retentive and stable.