Overdenture sequelae: A nine-month report

Abstract

Six patients who were treated with maxillary and/or mandibular overdentures were recalled at specified intervals and observed for a period of 9 months. All these patients received periodontal therapy prior to overdenture fabrication. “Relief” and “no relief” methods of the acrylic resin of the overdenture opposing the abutment roots and supporting tissues were studied. The evaluation of dental and periodontal health was made, and the gingival index, sulcus depth, gingival crevicular fluid flow, width of the attached gingiva, root mobility, and dental caries were recorded. The subgingival microflora was examined at different time intervals to correlate gingival health and microbial ecology with overdenture wear. No statistically significant changes were noted with regard to the sulcus depth and width of the attached gingiva. A statistically significant decrease in the gingival index and the gingival crevicular fluid flow was observed around all the abutment roots, while no mobility of the abutment roots or dental caries were detectable throughout the length of the study. The pretreatment subgingival microflora consisted of a variety of microbial species. Following periodontal therapy and at the time of insertion of the overdentures, only Veillonella, Actinomyces, Bacteroides, and Candida were present. However, at the last recall Bacteroides and Candida were eliminated, while Fusobacterium, Treponema, Selenomonas, and Streptococcus repopulated the gingival crevice. Nevertheless, clinical gingival health was maintained. Additional studies are planned to determine if the total number of organisms rather than the composition of the flora is the important determinant of health or disease of the gingival tissues around the abutment roots supporting overdentures. It can be concluded that irrespective of which abutment management technique is used, the periodontal health of the abutment roots can be successfully maintained by good plaque control by the patient and by frequent professional recall visits. This study is part of a continuing longitudinal study of the effects of overdentures on their supporting tissues.