Effect of Anatomical Variations of Retromolar Pad on Edentulous Restoration.

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.

Loss of alveolar bone from the edentulous jaws is a serious and common clinical problem, especially among the elderly. The retention and stability of dentures are reduced, but little is known about the pathogenesis of this bone loss. The existing data suggest that either local factors, for instance occlusal trauma, or systemic factors such as postmenopausal osteoporosis, contribute to edentulous alveolar bone resorption. This paper reviews the evidence for the aetiology of residual ridge resorption following tooth extraction.

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.

Alveolar ridge resorption following tooth extraction

Background: Denture treatment is crucial for edentulous patients to maintain a long and healthy life, as well as restore their chewing function. After complete dentures are fitted, it is not uncommon for them to become ill-fitting due to ridge resorption over time, requiring adjustments or relining procedures. Residual ridge resorption results from the combined influence of various local and systemic factors. There have been no reported cases of patients who have worn complete dentures for an extended period without experiencing significant alveolar ridge resorption. I report a case of a patient who had not visited a dentist or had any adjustments for 28 years after being fitted with complete dentures. Case presentation: The patient, a 56-year-old woman, visited the general dentistry of the Nippon Dental University Hospital in Tokyo in March 1994. The diagnosis was masticatory dysfunction caused by ill-fitting upper and lower complete dentures. The treatment plan aimed to improve oral hygiene, restore the health of the alveolar ridge, and achieve proper occlusal contact with a final prosthetic device. The upper and lower dentures were fitted in May 1994. In November 2022, her artificial tooth broke, and she visited the clinic requesting denture repair for the first time in 28 years. A medical interview revealed that the patient had never visited another dental clinic since having dentures fitted 28 years ago. Although wear of the artificial teeth was observed, when the fitting condition of the upper and lower dentures was checked using fitting test materials, it was confirmed that there were no problems with the fitting condition and that there was almost no alveolar ridge resorption. Conclusion: I report on a patient who has worn the same dentures for 28 years. Although wear of the artificial teeth was observed due to bilateral balanced occlusion, the occlusal balance was appropriately maintained. It has been found that metal-based dentures, when fabricated using proper methods, do not promote alveolar ridge resorption.

The effectiveness of structured interdisciplinary collaboration for adult home hospice patients on patient satisfaction and hospital admissions and re-admission: a systematic review protocol

Comparison of ridge resorption and patient satisfaction in single implant-supported mandibular overdentures with conventional complete dentures: A randomised pilot study

Objectives: The present study was conducted to investigate the retention and the patient satisfaction of the Thermoplastic Acetal resin distal extension partial denture prosthesis with different denture base extension length either extended to covered the retro molar pad or extended just at the anterior border of the retro molar pad in unmodified Kennedy class II mandibular cases. Thermoplastic Acetal resin partial denture is more comfortable and can replace any number of teeth in a dental arch.Methods: Total number of ten healthy patients with unmodified Kennedy class II mandibular cases were selected and received extra coronal attachment on the experimental side , and received unilateral partial denture with thermoplastic Acetal resin framework. The patients were grouped into two groups. Group I received mandibular unilateral distal(without denture base extension) just end at the anterior border of the retro molar padand group II received mandibular unilateral distal(with denture base extension ) covered the retromolar pad. Then the retention evaluation and patient satisfaction was done at insertion of dentures , six months and after 12 month from the insertion.Results: For both groups regarding the retention evaluation, there was insignificant difference between both groups as P-value > 0.05. Regarding the patient satisfaction Group I (without denture base extension) showed statistically significantly higher mean satisfaction score than Group II.Conclusions: The patients were received mandibular unilateral distal(without denture base extension) more satisfied by the prosthesis. and regarding the retention there was non significant difference between both groups so theunilateral partial denture with thermoplastic Acetal resin framework without denture base extension more preferable .

To investigate patient and surgical characteristics associated with higher patient, surgeon, or anesthesia provider satisfaction with oral sedation in ophthalmic procedures. This was a secondary analysis of a prospective, randomized, double-masked, non-inferiority clinical trial measuring patient satisfaction comparing oral versus intravenous (IV) sedation for ophthalmic surgeries. Data was collected from a validated 6-point satisfaction survey from patients, surgeons, and anesthesia providers. We focused on the oral sedation arm and used multivariate regression analysis to investigate the relationship between satisfaction scores and patients' characteristics, surgery duration, and need for additional anesthesia during the ophthalmic procedure. In total, 142 patients receiving initial oral triazolam with IV placebo were included in this study. Non-White (p = 0.02) and non-English speaker patients (p = 0.003) had higher satisfaction scores with oral sedation. Shorter surgery duration was associated with higher satisfaction scores for both patients (p = 0.01) and surgeons (p = 0.03) but not for anesthesia providers (p = 0.21). The need for supplemental IV sedation intraoperatively was significantly associated with lower satisfaction scores among patients (p < 0.001), surgeons (p < 0.001), and anesthesia providers (p < 0.001). Shorter length of surgery was positively associated with higher patient and surgeon satisfaction with oral sedation. Other factors including non-White race and non-English primary language were associated with higher patient satisfaction. Additional IV sedation needed during surgery was associated with worse patient, surgeon, and anesthesia provider satisfaction. Tailoring oral sedation to procedures that are shorter in duration may help maximize the success of oral sedation as an alternative to intravenous sedation.

Tooth extraction triggers alveolar ridge resorption, and when this resorption is extensive, it can complicate subsequent reconstructive procedures that use dental implants. Clinical data demonstrate that the most significant dimensional changes in the ridge occur soon after tooth extraction. Here, we sought to understand whether a correlation existed between the rate at which an extraction socket heals and the extent of alveolar ridge resorption. Maxillary molars were extracted from young and osteoporotic rodents, and quantitative micro–computed tomographic imaging, histology, and immunohistochemistry were used to simultaneously follow socket repair and alveolar ridge resorption. Extraction sockets rapidly filled with new bone via the proliferation and differentiation of Wnt-responsive osteoprogenitor cells and their progeny. At the same time that new bone was being deposited in the socket, tartrate-resistant acid phosphatase–expressing osteoclasts were resorbing the ridge. Significantly faster socket repair in young animals was associated with significantly more Wnt-responsive osteoprogenitor cells and their progeny as compared with osteoporotic animals. Delivery of WNT3A to the extraction sockets of osteoporotic animals restored the number of Wnt-responsive cells and their progeny back to levels seen in young healthy animals and accelerated socket repair in osteoporotic animals back to rates seen in the young. In cases where the extraction socket was treated with WNT3A, alveolar ridge resorption was significantly reduced. These data demonstrate a causal link between enhancing socket repair via WNT3A and preserving alveolar ridge dimensions following tooth extraction.

Alveolar bone resorption is a continuous process with mul- tifactorial etiology, and often a serious problem for elderly people, especially in cases with edentulous mandible. Nu- merous studies describe a correlation between multiple systemic and local factors and alveolar ridge resorption. This review aims to analyse the available evidence of factors that may affect the residual ridge resorption and the effect of different denture treatments used to reduce the residu- al ridge resorption. Each patient has unique treatment re- quirements considering that the residual ridge resorption has multifactorial etiology. Management of alveolar bone resorption is considered a challenge in prosthodontic treat- ment. Therefore, research should continue to find methods and materials which will reduce the alveolar bone resorp- tion.

A case control study to investigate the effects of denture wear on residual alveolar ridge resorption in edentulous patients

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

Extraction of teeth is followed by resorption of the residual alveolar ridge that continues throughout life resulting in loss of alveolar height and width. Of the numerous techniques that have been used to arrest post extraction alveoloar ridge resorption, the placement of a graft material inside the socket immediately after extraction has been mostly followed. Type 1 collagen is one of the commonly used graft material that prevent resorption by providing dimensional stability to the socket. Bisphosphonates are an anti-osteoclastic drug that prevent resorption by disrupting the membrane ruffling of the osteoclasts. Alendronate a bisphosphonate, is primarily used in diseases with bone loss. It has been used to reduce active bone resorption significantly without interfering with bone mineralization and quality. The need for the study is to examine the inhibitory effect of alendronate on residual ridge resorption when applied locally in combination with type I collagen on alveolar bone immediately following tooth extraction. Twenty patients with age between 30 and 65years were selected from the out patient department of The Oxford Dental College and Hospital. The patients were divided into two groups. In the first group after extraction of teeth from premolar to midline the sockets were irrigated with saline and sutured. On the left side type I collagen sponge was placed and sutured. In the other group the right side was treated the same way after extraction as in first group where as in the left side sockets type I collagen soaked in 20mg/ml of alendronate was placed and sutured. Patients were evaluated clinically for any local irritation as well as radiologically with orthopantomograph X-rays were taken immediately after the extraction, 1month after extraction and 4months after extraction to determine the amount of bone loss prevented. The statistically significant bone loss prevented by the collagen alone was 22.8% and in collagen with alendronate group was 44.38% at the end of 4months. Type I collagen soaked with alendronate when placed in the socket immediately after extraction of teeth prevents post-extraction alveolar ridge resorption.

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.