Abstract
Aims. The purpose of this systematic review was to evaluate studies that assessed denture–mucosa pressure distribution and pressure–pain threshold and their methodology, used to measure such pressure distributions, mainly in complete and implant overdentures. Materials and methods. An electronic search of the relevant full-text peer-reviewed literature on denture–mucosa pressure distribution was done. Searches were performed independently by two researchers by using the OVID Medline, PubMed and Web of Science databases from 1 January 1946 to 31 December 2021 using the following MeSH terms; (denture OR complete dentures OR implant supported dentures) AND (mucosa OR mucous membrane) AND (pressure OR hydrostatic pressure). Only those publications in the English language were included. Furthermore, a manual search of the citations of the included studies was done to ensure a thorough search was conducted. Results. A full text review resulted in a total of eighteen studies. Of these, seven evaluated various intraoral pressures, two investigated the pressure–pain threshold in edentulous oral mucosa, five measured intraoral pressure through finite element analysis/FEA studies, two demonstrated pressure transducer and pressure measuring systems, and two investigated the comparison between implant-overdentures and complete dentures. Conclusions. To date, there is no study that assesses the pressure distribution on oral mucosa to provide a standardised and validated baseline pressure range which can be used to improve the designs and materials used for fabricating complete dentures. The relationship between pressure on the oral mucosa and the pain threshold of denture-wearing patients still remains poorly understood. There is yet no baseline data which can be universally applied for future studies; to correlate the oral mucosa pressure and pain threshold of edentulous patients encourages further research, especially comparing mucosa pressure under different denture designs for both complete and implant overdentures.
Highlights
Full-text articles were included to ensure thorough review of the respective studies. This was completed to identify any gaps within the current literature to supplement the development of our methodology to measure the denture–mucosa pressure distribution in a typical edentulous patient
Outcome parameters were defined with respect to existing reviews; the main outcome parameters of the included studies according to the denture–mucosa pressure distribution in terms of pressure–pain threshold (PPT), as well as an evaluation of the methodology used to measure pressure, including the standardisation and validity of the results
During the full-text screening, five articles were excluded since they were out of the scope for this systematic review, being clinical studies conducted with dentate patients
Summary
An electronic search using Ovid MEDLINE, PubMed and Web of Science was performed with the following MESH (Medical Subject Headings) terms: (denture OR complete dentures OR implant supported dentures) AND (mucosa OR mucous membrane) AND (pressure OR hydrostatic pressure). The evaluation criteria were defined in accordance with the PICO(S) (Patient or Population, Intervention, Control or Comparison, Outcome and Study types) criteria. The review included all studies involving completely edentulous patients with conventional complete dentures, or implant overdentures. Full-text articles were included to ensure thorough review of the respective studies. This was completed to identify any gaps within the current literature to supplement the development of our methodology to measure the denture–mucosa pressure distribution in a typical edentulous patient. Outcome parameters were defined with respect to existing reviews; the main outcome parameters of the included studies according to the denture–mucosa pressure distribution in terms of PPT, as well as an evaluation of the methodology used to measure pressure, including the standardisation and validity of the results. The lower limit on the publication date was potential studies were assessed independently by two reviewers (AP, JJEC) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines
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