Resorption of the posterior alveolar ridge after 7 years of wearing a mandibular overdenture

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.

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.

Lingualized occlusion is applied to patients with alveolar ridge resorption, and it is considered that this occlusion is functionally useful and should be applied to cases with alveolar ridge resorption. However, selection criteria supported by evidence for what conditions of the alveolar ridge lingualized occlusion should be selected do not exist. For that reason, we conducted an investigation on choosing lingualized occlusion. As a result, no differences were noted in subjects with a good alveolar ridge condition while a sufficient lingualized occlusion effect was obtained in subjects with a poor alveolar ridge condition, suggesting that efficient mastication could be attained. The following indexes were examined as the criteria for applying lingualized occlusion: The ratio of the residual alveolar ridge should be less than approximately 0.5, in which the distance between the inferior border of the mental foramen and the superior border of the mandibular bone should be less than half the distance between the inferior border of the mental foramen and the inferior border of the mandibular bone. The supporting area of the denture base should be less than approximately 2,000 mm(2). Though the effect can be expected when applying lingualized occlusion under these criteria, they are one standard, and cannot be applied in all cases. In clinical cases, it is important to grasp the local and the whole-body conditions of the patient in order to choose denture occlusion.

Background: Magnetic attachment can be used as a retentive devices in overdenture technique in prostheses. The magnets are attached with remaining root structure transfer the occlusal load to the bone through the periodontal ligament of retained roots and then prevent resorption of the alveolar ridge. Alvelar ridge plays an important role for the retention and stability of the denture as they will support the denture base. Magnetic assembly consist of magnet and coping with a keeper on the remaining tooth structure since magnetic attachment can provide support, stability and retention. Purpose: The purpose of this case report was to report magnetic attachment retained complete overdenture design and fabrication as a preserve to alveolar bone height to achieve retention and stability of the denture. Case: A 69 years old female patient, a baker and private English teacher with partial edentulous ridge came to Dental Hospital of Airlangga University asked for dentures. Clinical examination shown a complete edentulous in the upper jaw and partial edentulous in the lower jaw. The remaining teeth were 33, 34, 35, 43 and 44. 33 and 35 are chronic gangrene radix, 35 shown a slightly mobility. 34 non vital, 44 and 45 are vital with moderate resorption. Case management : All the left teeth in the lower jaw were consulted for endodontic treatment. Magnetic attachment retained complete overdenture was choosen for the lower jaw and complete denture for the upper jaw. The remaining teeth in the lower jaw kept the alveolar ridge from resorption and the magnet provided extra retention for the complete overdenture. Discussion: Overdentures supported by magnet attachment achieved greater satisfaction, gives better retention and stability for the denture. On the other side, the natural abutment teeth in overdentures preserved better proprioception and psychologically beneficial as the patient had not undergone extraction. As a conclusion, overdenture supported by magnetic attachment can be used to increase support, retention and stability especially in the lower jaw and also prevent further alveolar ridge resorption. Conclusion: Overdenture supported by magnetic attachment can be used to increase retention and the residual root also prevent further alveolar ridge resorption.

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.

summary The relationship between the size of the denture foundation area and the resorption of the alveolar ridge was investigated in 55 edentulous subjects. The denture foundation area was recorded using a modelling compound impression technique with border moulding. Both sides of each edentulous mandible were examined separately, making a total of 110 experimental sides in the study. On a stone cast made from each impression, the size of the superficial denture foundation area and of the projected denture foundation area on the tentative plane of occlusion of each anatomical zone were measured. The vertical height of the alveolar ridge at the lateral incisor and first molar region was also evaluated. The size of the superficial denture foundation area in the antero‐lingual and postero‐lingual zones showed no significant correlation with the degree of alveolar ridge resorption. The size of the projected denture foundation area on the tentative plane of occlusion in the anterior section showed negative significant correlation with the degree of alveolar ridge resorption. The size of the projected denture foundation area on the tentative plane of occlusion in the posterior section showed no significant correlation with the degree of alveolar ridge resorption.

The relationship between the size of the denture foundation area and the resorption of the alveolar ridge was investigated in 55 edentulous subjects. The denture foundation area was recorded using a modelling compound impression technique with border moulding. Both sides of each edentulous mandible were examined separately, making a total of 110 experimental sides in the study. On a stone cast made from each impression, the size of of the superficial denture foundation area and of the projected denture foundation area on the tentative plane of occlusion of each anatomical zone were measured. The vertical height of the alveolar ridge at the lateral incisor and first molar region was also evaluated. The size of the superficial denture foundation area in the antero-lingual and postero-lingual zones showed no significant correlation with the degree of alveolar ridge resorption. The size of the projected denture foundation area on the tentative plane of occlusion in the anterior section showed negative significant correlation with the degree of alveolar ridge resorption. The size of the projected denture foundation area on the tentative plane of occlusion in the posterior section showed no significant correlation with the degree of alveolar ridge resorption.

This study aimed to quantify the morphology of the retromolar pad (RMP) and its correlation with alveolar ridge resorption, as well as to evaluate its role in edentulous restorations through multidisciplinary research. This multimethod study comprised three components: (1) a cross-sectional analysis of 200 edentulous mandibular models to quantify retromolar pad (RMP) dimensions-including height, area, and others- to classify RMP shapes (pear, triangular, bar) according to Cawood's classification of ridge resorption; (2) finite element analysis (FEA) simulating occlusal loads on three representative RMP morphologies to evaluate stress distribution and displacement; (3) Clinical trial involving 15 edentulous patients (Cawood classes V-VI), each receiving two dentures-one fabricated using a conventional tray (ATD group) and the other using a modified tray designed for the RMP (MTD group)-to compare patient satisfaction and denture fit, assessed via root mean square (RMS) deviation. Model analysis revealed significant dimensional variations among RMP shapes, with a weak negative correlation between RMP morphology and alveolar ridge resorption (Rs = -0.31, P < .001). FEA identified pear-shaped RMP as exhibiting the lowest stress concentration (305.7 kPa) and minimal displacement (236.3 μm). Clinically, dentures from the MTD group demonstrated significantly better fit, indicated by a lower RMS value, and higher patient satisfaction regarding retention and comfort compared to the ATD group. RMP morphology influence restorative outcomes in edentulous jaws, with pear-shaped RMP providing superior effect. RMP can be utilized to enhance complete denture retention, particularly for patients with severe alveolar ridge resorption.

The placement of different graft materials and/or the use of occlusive membranes to cover the extraction socket entrance are techniques aimed at preserving/reducing alveolar ridge resorption. The use of grafting materials in fresh extraction sockets has, however, been questioned because particles of the grafted material have been found in alveolar sockets 6-9 months following their insertion. The aims of the study were to (i). evaluate whether alveolar ridge resorption following tooth extraction could be prevented or reduced by the application of a bioabsorbable polylactide-polyglycolide sponge used as a space filler, compared to natural healing by clot formation, and (ii). evaluate histologically the amount and quality of bone tissue formed in the sockets, 6 months after the use of the bioabsorbable material. Thirty-six patients, undergoing periodontal therapy, participated in this study. All patients were scheduled for extraction of one or more compromised teeth. Following elevation of full-thickness flaps and extraction of teeth, measurements were taken to evaluate the distance between three landmarks (mesio-buccal, mid-buccal, disto-buccal) on individually prefabricated stents, and the alveolar crest. Twenty-six alveolar sockets (test) were filled with a bioabsorbable polylactide-polyglycolide acid sponge (Fisiograft), while 13 sockets (controls) were allowed to heal without any filling material. The flaps were sutured with no attempt to achieve primary closure of the surgical wound. Re-entry for implant surgery was performed 6 months following the extractions. Thirteen biopsies (10 test and three control sites) were harvested from the sites scheduled for implant placement. The clinical measurements at 6 months revealed, in the mesial-buccal site, a loss of bone height of 0.2 mm (1.4 SD) in the test and 0.6 mm (1.1 SD) in the controls; in the mid-buccal portion a gain of 1.3 mm (1.9 SD) in the test and a loss of 0.8 mm (1.6 SD) in the controls; and in the distal portion a loss of 0.1 mm (1.1 SD) in the test and of 0.8 (1.5 SD) mm in the controls. The biopsies harvested from the test sites revealed that the new bone formed at 6 months was mineralized, mature and well structured. Particles of the grafted material could not be identified in any of the 10 test biopsies. The bone formed in the control sites was also mature and well structured. The results of this study indicate that alveolar bone resorption following tooth extraction may be prevented or reduced by the use of a bioabsorbable synthetic sponge of polylactide-polyglycolide acid. The quality of bone formed seemed to be optimal for dental implant insertion.

Aim Extraction of the posterior maxillary teeth is the main cause behind maxillary sinus expansion. The aim of the present study was to examine the relationship between extraction of maxillary posterior teeth and sinus expansion in periodontitis patients. Materials and methods A preliminary cross-sectional study was conducted. Two hundred participants underwent clinical and radiographic examination using panoramic radiograph. Results Based on the data analysis of the examined sample, no statistical correlation was reported between the maxillary sinus dimensions and age, gender, periodontal condition, alveolar ridge resorption as well as the number of missing teeth. Conclusions It was concluded that extraction of maxillary posterior teeth, periodontal condition and alveolar ridge resorption could not be considered as risk factors for maxillary sinus pneumutization.

The number of fractured anterior teeth following trauma has been increasing while not every patient is able to afford a dental implant instead of maintaining the injured tooth. Thus, a tooth conservation solution is required to place an aesthetic and functional restoration without biologic width violation. The aim of this study was to evaluate the effectiveness of minimally traumatic controlled surgical extrusion in fractured anterior teeth crown lengthening by assessing the periodontal status through clinical examination and radiographs. This longitudinal observational study investigated a group of 18 patients (six males and 12 females) at the Department of Periodontology, National Hospital of Odonto-stomatology, Ho Chi Minh City, Vietnam. Following pre-surgery procedures and examination, minimally traumatic controlled surgical extrusion was carried out using a periotome. Patients were examined at four follow-up appointments after 1week, 1, 3 and 6months to record the following experimental variables: periodontal parameters including the gingival index (GI), pocket depth (PD), bleeding on probing (BOP), mobility, marginal gingiva position, alveolar ridge resorption, periapical osteogenesis, tooth resorption and ankylosis. All periodontal parameters were significantly decreased at 3 and 6months post-procedure (P<0.001). Tooth mobility decreased gradually following surgery, and at 6months, all teeth became normal at level 0. Periapical osteogenesis changes were significantly increased at 1, 3 and 6months in comparison with pre-surgery (P<0.001). Marginal gingiva position and alveolar ridge resorption were not significantly different between pre-surgery and 1, 3 and 6months post-surgery. No cases of root resorption or ankylosis were observed at 6months post-surgery. A minimally traumatic controlled surgical extrusion technique for clinical crown lengthening yielded highly successful results in both aesthetic and functional aspects, and no cases had unfavourable outcomes during the 6-month follow-up period.

Alveolar bone undergoes volumetric changes after extraction due to physiologic bone remodeling. The amount of alveolar bone available during prosthodontic treatment can affect the esthetic outcome of the treatment and make implant placement challenging. Socket preservation techniques are advocated postextraction to maintain the bone's vertical and horizontal alveolar bone dimensions and prevent its atrophy. This review is oriented toward a clinician, describing the different materials and techniques in practice today for socket preservation. A variety of methods have been studied as a means to stop alveolar ridge resorption. While immediate implant placement was recommended as a socket preservation technique, clinical trials have not demonstrated favorable results. The main techniques favored by clinicians today involve bone grafts, bone substitutes, barrier membranes, and combinations thereof. As with periodontal defects, these materials show favorable outcomes in alveolar bone regeneration and ridge preservation. Tooth bone grafts, both autogenous and allogenous, have been recommended recently for ridge preservation as they are chemically similar to bone and can induce osteogenesis. The use of autologous platelet concentrates has yielded contradictory results in studies. Cutting-edge approaches entail using growth factors and tissue engineering concepts. While these strategies are still in the development stages, it has peerless potential in preserving and regenerating alveolar bone. Alveolar ridge resorption is an unavoidable physiological process after extraction and leads to severe bone deficiencies, affecting esthetics. These changes in alveolar ridge dimensions make implant placement difficult and affect the longevity of the implant. Clinical intervention can prevent alveolar bone resorption and preserve the ridge. Bone grafts and substitutes including concentrates remain the best choices in ride preservation. The use of growth factors and tissue engineering concepts requires further clinical trials before widespread use in clinical practice.

Based on literature data it is obvious that there is a connection between smoking and periodontal diseases. Alveolar bone loss increases with smoking. Tobacco smoking affects the proportion of subgingival bacterial flora by influencing oxidoreduction potential of dental plaque and thus making conditions for development of anaerobic bacteria. According to some researchers, smoking affects the mineral component of bone tissue. Orthopantomograms show higher level of alveolar bone loss in smokers than in nonsmokers with the same level of oral hygiene. The aim of this study was to establish if smoking affects alveolar bone loss in complete denture wearers. Our clinical investigation included 60 patients of both sexes (30 smokers and 30 nonsmokers) all complete dentures wearers. All patients met study criteria: jaw relation and smokers who smoke over 20 cigarettes per day. All subjects were interviewed, and after that orthopantomograms were made. They were used to calculate the degree of alveolar bone loss. The examined subjects were approximately of the same age. Mean age of smokers was 59.9 and nonsmokers 61.8. It was established that differences regarding resorption in men were not significant. The degree of resorption in women smokers and women non-smokers was different, but differences were not significant. It has been proven that the number of cigarettes smoked per day is very important. It is considered that the risk of oral epithelial dysplasia increases when smoking more than 20 cigarettes per day. Considering our results regarding resorption of edentulous alveolar ridge in smokers and nonsmokers, we concluded that there were no significant differences. There are opinions in literature that smoking is not an etiological factor in resorption, but there are some opinions that smoking is connected with the degree of resorption in periodontium. The analyses of resorptive changes in edentuolous smokers were done only around implants and it was estimated that smoking has more influence than other clinical risk factors. On the bases of our research we may conclude that smoking does not directly affect the degree of resorption of edentulous alveolar ridge with complete denture wearers.

Tooth position in relation to the denture base foundation

Background: In dental prosthetics many advances have been achieved, but the great problem is still having with us: that is the resorption of the residual alveolar ridge and managing or preventing the secondary soft tissue changes brought on by bone loss. Objective: To evaluate the rate of resorption of alveolar ridge height of maxillary anterior arch in patients treated with immediate partial denture. Materials and Methods: This observational comparative study was conducted in the Department of Prosthodontics, Bangabandhu Sheikh Mujib Medical University for the duration of one year. On the basis of inclusion criteria patients were initially included in the study. A written informed consent was obtained from every patient. Study sample divided equally into two groups, Group A and Group B. Each group consists of 15 patients. Group A patients were treated with extraction of teeth followed by immediate denture prosthesis and group B patients were treated with extraction of teeth, but not provided by any prosthesis. Data were collected on the basis of alveolar bone resorption in the period of 1 month, 3 months and 6 months of extraction on a predesigned data collection sheet. Results: Mean vertical height at one month follow up was 25.48 (±2.41) mm in group A and 23.43 (±2.85) mm in group B which was statistically significant. Mean vertical height at three month follow up was 23 (±1.33) mm in group A and 22 (±2.99) mm in group B which was statistically significant. Mean vertical height of alveolar bone at six month follow up was 22.5 (±2.71) mm in group A and 21.5 (±3.18) mm in group B which was also statistically significant. Conclusion: Patient treated with immediate partial denture following extraction of teeth shows less alveolar bone resorption than patients treated without immediate partial denture.