Complete Denture Construction Research Articles

Evaluation of open-face maxillary complete denture for patients with prominent premaxilla: a crossover study.

The establishment of good facial esthetics is one of the main objectives of complete denture construction. Unfortunately, it may be the caused issue for patients having a prominent premaxilla due to excessive lip support by the labial flange of the maxillary denture. Open-face dentures (OFD) may suggest suitable prosthetic management for these patients. However, clinical evidence regarding the efficiency of OFD is scarce. A total of 38 completely edentulous participants having prominent premaxilla and skeletal class I Angle's classification were enrolled in this study. Each participant received a mandibular complete denture and 2 opposing maxillary dentures; conventional (CD) and open-face (OFD). On the day of denture insertion, the participants were divided into 2 groups; CD-OFD and OFD-CD where CD-OFD group was instructed to use the mandibular denture and the maxillary CD for 3 months and then to use the maxillary OFD for another 3 months after a wash-out period of 2 weeks. While group OFD-CD was instructed to use the mandibular denture and the maxillary OFD for 3 months then to use the maxillary CD for another 3 months after a wash-out period of 2 weeks. The dislodging force of the maxillary dentures was evaluated using the universal testing machine and the patient perception of retention, esthetics, and comfort was evaluated using the Visual Analogue Scale (VAS). Evaluation was carried out 1 day, 1 month, and 3 months after denture insertion. The Student t-test was used to compare the 2 maxillary dentures and the intervals for each denture were compared by using the ANOVA test with repeated measures followed by a Post Hoc test (adjusted Bonferroni) for pairwise comparison. The significance of the obtained results was judged at the 5% level (P value). The dislodging force and patient perception of retention did not show significant differences between the 2 dentures, while the perception of esthetics showed significant differences throughout the follow-up period. Perception of comfort showed an insignificant difference only at the 3-month interval. Open-face maxillary dentures can be a suitable alternative for patients with prominent premaxilla to achieve satisfactory retention, aesthetics, and comfort.

Precision Prosthodontic Rehabilitation of Flabby Ridge with a Modified Window Technique: Case Report

Flabby ridge, also known as a soft (mobile), movable, or displaceable ridge, presents a common clinical challenge in dental practice. It primarily affects the alveolar ridges of the upper (maxillary) or lower (mandibular) arches. The anterior region of the maxilla is especially susceptible in edentulous patients. The flabby ridge lacks the firmness and stability required, leading dentures to become loose and unstable. Consequently, this instability can result in discomfort, speech and eating difficulties, and reduced quality of life for denture wearers. The flabby ridge often does not provide the necessary contour and resilience needed to establish an effective seal and maintain suction between the denture base and the underlying tissues. This compromises denture retention, making them susceptible to dislodgement during typical oral functions. Therefore, rehabilitating a completely edentulous patient with flabby tissue presents a formidable challenge for prosthodontists, as it undermines the retention, stability and support of complete dentures. Methods for managing flabby ridges encompass surgical removal, ridge augmentation, specialized impression techniques, balanced distribution of occlusal loads and implant therapy. Various impression techniques have been proposed to address the complexities of such cases. By carefully applying the principles of complete denture construction, a palliative treatment approach can be achieved. Special impressions often employ the window technique to capture a static impression of the flabby area, which introduces its own set of challenges. This innovative case report introduces a modified window technique that incorporates precise record transfer of the flabby ridge using tissue (blotting) paper. Specifically designed for the anterior mandibular flabby ridge, the technique employs a custom tray with a window positioned over the flabby tissues. A mucostatic impression material is utilized to minimize pressure on the flabby tissue, thereby reducing potential tissue distortion during the impression process. The procedure is executed in two steps: first, stable structures are recorded, followed by capturing the mobile tissues using light-body polyvinyl siloxane (PVS) elastomeric impression material within the window area. This method ensures an accurate record of the denture-supporting structures while maintaining the contour and details of the flabby tissues without displacement. Importantly, the technique is crafted for straightforward implementation by general dental practitioners within a primary dental care setting.

The Influence of Incorporating Zno on The Surface Hardness of Poly Methyl Methacrylate. In Vitro Study

Introduction: Heat cured resins are commonly utilized for construction of complete and partial dentures. Such materials have poor mechanical properties and may be exposed to fracture. The present study, therefore, was conducted to evaluate the impact of incorporating ZnO on acrylic resins’ surface hardness. Materials and Methods: Twenty specimens were constructed in total. The study composed of 2 major sets, and each set had ten specimens. The 1st set had 1% zinc oxide and the second group had no zinc oxide and considered as control. All samples were subjected to the hardness test three times and average reading was recorded for all specimens. Results: a significant decrease in the surface hardness of acrylic re sins following the incorporation of ZnO (control group: 12 7.62+2.53 g/mm2, zinc oxide group: 106.67+ 1.51). Conc lusions: The addition of zinc oxide at 1 % would decrease the surface hardness of acrylic resins.

Evaluation of Intern Students Knowledge of Complete Denture Impression Practice in Benghazi University

Objectives: The aim of treatment with complete denture is to restore function and esthetics and maintain patient health. Making an accurate impression is a very critical factor for success or failure of the complete dentures. The aim of this study is to evaluate the knowledge of intern dental students about procedures followed in impression practice for complete denture construction in the city of Benghazi.
 Materials and method: This descriptive cross-sectional study was done amongst dental intern students in Benghazi city, Libya. A total of 120 students were selected randomly. A survey was conducted through a printed standard questionnaire with 13 multiple-choice questions, only 81 questionnaires returned. Data from the completed questionnaires were collected and analyzed, the statistical analysis was done using SPSS statistical software version 23 (SPSS, IBM, Armonk, NY, USA).
 Results: Low knowledge scores were found regarding the final impression material, the tray fabrication steps (spacer and relieve holes) and the timing of previous denture discontinuation prior to the primary impression step. Also, a low level of knowledge was found regarding the stage of posterior palatal seal establishment. The scores for all the questions were calculated and tabulated; the scores 1,2 and 3 are low knowledge (57%), good knowledge (43%) and excellent knowledge 0% respectively.
 Conclusion: The percentage of low knowledge level was significantly higher than expected, as observed in the overall results indicating that there are procedures and information about complete denture impression practice that remains unknown to the interns, which influence the denture satisfaction of the patient. Changes in the undergraduate education system to focus on these aspects may facilitate the interns to gain more knowledge regarding complete denture impression procedures especially final impression.

Comparison of retention and denture base adaptation between conventional and 3D-printed complete dentures.

Background. In recent years, complete denture construction has been revolutionized using computer-aided designing and computer-aided manufacturing (CAD-CAM) technology. This clinical study compared the retention and denture base adaptation of 3D-printed complete dentures fabricated using dimethacrylate-based resins with a photoinitiator versus conventional complete dentures. Methods. Ten completely edentulous patients were nominated for this study. Each patient received two complete dentures. One complete denture was conventionally fabricated, while the other was digitally fabricated through 3D printing of dimethacrylate-based resins with a photoinitiator. Denture base adaptation for both dentures was evaluated using surface matching software. Denture retention was also evaluated using a digital force meter at the time of complete denture insertion (T0 ), after three months (T3 ) and six months (T6 ) of denture use. Results. Regarding adaptation (mean misfit values), a statistically insignificant difference was detected between the two differently fabricated complete dentures. In addition, comparable satisfactory retention values were observed for both conventionally fabricated and 3D-printed dentures; however, there was an insignificant increase in retention over time. Conclusion. 3D-printed complete dentures fabricated using dimethacrylate-based resins could be a promising alternative to conventionally fabricated complete dentures with satisfactory denture base adaptation and retention.

DOWEL PIN - SNAP FIT TECHNIQUE: A NOVEL SPLIT CAST TECHNIQUE

Complete denture construction comes with a lot challenges both during the clinical and laboratory steps. Lab remounting is one of those steps it is done to mount the master cast back in position after acrylisation of the complete denture to undergo selective grinding. But the conventional methods used for this technique have not been good enough to hold the master cast in place in a stable manner. The novel technique introduced in this article uses dowel pins for remounting, and it provides a more stable, reliable and snug fit technique without making the technique any more complicated.

Antifungal Effect of Silver Nano Particles Coating on Denture Base Specimens Made of Acrylic Resin

OBJECTIVE: The present study was under taken to determine the anti-fungal effect of Silver Nano partial coating in concentrations of 0.1%, 0.2%, 0.5% and 1% on heat cure acrylic denture through diffusion disc method. Poly methyl methacrylate (PMMA) or simply acrylic is most commonly used material for construction of complete dentures. Denture stomatitis is an inflammatory disorder of oral mucosa, frequently observed in denture wearers. The unpolished intaglio surface of PMMA base dentures coupled with adverse conditions such as poor hygiene, dry mouth and compromised immune system leads to denture related stomatitis in 50-70% of complete denture wearers. Antifungal agents such as silver have been added to acrylic denture bases to in part self-disinfect property. METHODOLOGY: The supplied modeling wax sheet was cut in to 25 specimens of dimensions 10x10x 2mm with help of wax knife. The wax sheet was invested in stone plaster with in metal flask using open flasking method for mould formation. Heat cured acrylic resin polymer and monomer (Meadway Royale Heat Cure, MR. Dental, and UK) was mixed according to manufacturer's instructions of 2.5gm powder to 1ml monomer. The mixed acrylic was packed in dough stage followed by pressure packing in hydraulic bench press for 30 minutes under 9.8 MPa. Curing was done by placing the flask in water at room temperature until boiling. It remained in boiling water for 45 minutes and then allowed to cool down in water bath. A total of 25 acrylic plates were recovered from the flask and divided into five groups. Group A have no coating , group B coated with 0.1% sliver nano particles, group C coated with 0.2% silver nano particles, group D coated with 0.5% silver nano particles and group E coated with 1% silver nano particles solution. Each specimen was cut in to 6mm disc by Laser Engraving Machine. These discs were utilized for calculating zone of inhibition through diffusion disc method in agar media. RESULTS: The diameter of zone of inhibition increased with the increasing concentrations of silver nano particles. When the concentration of silver nano particles was 1%, the zone of inhibition size was maximum (20.48mm). When the concentration was 0.1%, the size of zone of inhibition was minimum (10.02mm) .This difference was statistically found to be highly significant (0.005). CONCLUSION: This study results demonstrate that silver nano-particles have good antifungal activity against Candida Albicans when used as surface coating. This antifungal property is directly influenced by the concentration of silver nano particles used. KEY WORDS: Antifungal property, Silver nano particles (AgNPs), Candida Albicans (CA).

Evaluation of the phonetic method for determining the vertical dimension of occlusion in complete denture construction

Evaluation of the phonetic method for determining the vertical dimension of occlusion in complete denture construction

Stability is success: Rehabilitation of an atrophic mandibular ridge employing neutral zone technique - A case report

Mandibular ridge resorption is a biomechanical and a complex disease that brings about chronic, progressive, cumulative and irreversible changes in bone structure resulting in severe impairment in fit and function of prosthesis. Some common hormonal, neurological, metabolic disorders can affect the adaptability of denture which can be diagnosed by a trained prosthodontist with proper history taking and clinical examination. If a denture stays inside or outside of the neutral zone, it will be unstable during functional & physiological activities such as talking, swallowing and mastication. Neutral zone technique is a long being used for the management of severely resorbed mandibular ridge. Various materials can used in recording neutral zone which have their own advantages and disadvantages. This technique serves as an alternative approach for the construction of mandibular complete denture. This technique is most effective for denture where there is a highly atrophic ridge, neuromuscular incoordination and history of denture instability. This clinical report describes in detail the fabrication of a complete denture in a patient with poorly formed mandibular ridge using neutral zone technique with addition of cast metal in mandibular denture for extra stability.

The Use of a Gothic Arch Tracing to Record Centric Relation in the Construction of Complete Dentures

The establishment of a fixed and reproducible reference point (centric relation) is critical when reorganizing the occlusion in a dentate patient or constructing complete dentures in an edentulous patient. There are many techniques for guiding the patient's mandible into centric relation and recording the relationship between the maxilla and mandible in this position. Some patients are resistant to being manipulated into this position and have an unreproducible habitual path of closure. A gothic arch tracing is considered to be the most reliable and predictable method of determining centric relation. The present article describes the gothic arch tracing technique and illustrates its use in an edentulous patient during the construction of complete dentures. CPD/Clinical Relevance: The gothic arch technique can be used to predictably locate centric relation in both dentate and edentulous patients.

A study comparing patient satisfaction and retention of CAD/CAM milled complete dentures and 3D printed CAD/CAM complete dentures versus conventional complete dentures: a randomized clinical trial

Objective: To compare the three different methods of complete denture fabrication assessing patient satisfactionand retention after insertion for six months’ follow-up period. Material and Methods: The study was conductedin the Prosthodontic Department where a total of forty-eight patients were recruited from the outpatient clinicsfulfilling the inclusion criteria. This study was designed as a randomized controlled clinical trial. All patientsfollowed the steps of complete denture construction till jaw relation record. Then, all eligible patients wererandomized to intervention and control groups. For intervention groups digital scanning, designing, manufacturingof complete dentures was done; 3D printing for first and milling for second intervention. For the comparatorgroup, complete dentures were manufactured the conventional way. After 2 weeks of delivery of the dentures,patients received a patient satisfaction questionnaire, retention was measured by retention force gauge. Bothreadings were also recorded after 3 months and at 6 months. The mean and standard deviation values werecalculated for each group in each test. The significance level was set at P < 0.05. Results: No statistical differencewas found in terms of patient satisfaction and retention between the three groups at different time intervals.Conclusion: The manufacturing technique seemed to have no influence on patient satisfaction and retentionwith milled showing the least results.KEYWORDSComputer-aided design; Denture, Complete; Denture retention; Patient satisfaction; Printing, Three-dimensional

The Relationship of Facial Measurements with the Mesiodistal Width of the Maxillary Anterior TeethWidth of the Maxillary Anterior Teeth

The relationship between facial measurements and the size of the maxillary anterior teeth in the Malaysian population is still a point of contention. Objective: The purpose of this study was to establish a relationship between facial measurements and the mesiodistal width of the maxillary anterior teeth (MDW), which could be used to guide the selection of anterior teeth for complete denture construction. Methods: The facial and dental measurements were obtained directly from 170 Malay adults aged between 19 to 35 who had morphologically normal permanent maxillary anterior teeth from canine to canine. The facial dimensions measured were interpupillary distance (IPD), intercanthal distance (ICD) and interalar distance (IAD). The facial dimensions were measured using a digital vernier calliper while the mesiodistal width of the maxillary anterior teeth was measured with a flexible ruler. The three facial dimensions were correlated with MDW for both genders. Results: The IPD and IAD were significantly (p>0.001) larger in males (IPD: 68.30±4.24mm; IAD: 39.60±2.54mm) than in females (IPD: 65.93±3.91mm; IAD: 36.96±2.29). There was no significant correlation between any of the facial dimensions and MDW in males or females. Conclusion: For the studied population, the interpupillary, intercanthal, and interalar distances may not be used as reliable guides when determining the size of maxillary anterior teeth in complete denture construction

Phonetic contouring of polished surface of denture base for speech enhancement

The three main factors in complete denture construction are mechanics, esthetics, and phonetics. Out of which phonetics is generally given least importance as the tongue tends to adapt and patients tend to return to normal speech after a post insertion practice period of several weeks to several months. This may not be acceptable to certain group of people in accordance with their needs to speak socially or vocationally. An accurate approximation of palatal contours of a maxillary complete denture to patient’s tongue can improve intelligibility and decrease the post- insertion practice period. This article outlines a technique to replicate the patient’s palatal anatomy onto the polished palatal surface of a complete denture.

Brief on posterior palatal seal area

Accurate recording and duplicating of posterior palatal seal is the vital procedure which contributes to the success in denture retention and subsequent treatment of edentulous patient. The responsibility of recording posterior palatal seal lies on the clinician and not the lab technician. Locating and designing of posterior palatal seal after thorough understanding of the anatomic and physiological boundaries of the region. The diagnostic evaluation and placement of posterior seal are often given only minor attention in complete denture construction. The aim of this article is to supply adequate information on posterior palatal seal, problems encountered while recording posterior palatal seal for longevity of complete denture treatment.

English

Removable prosthesis is probably one of the oldest types of dental therapy used to rehabilitate patients with complete or partial edentulousness. The main function of the edentulous alveolar ridge is to provide a major area of support for the dentures.1 Ill-fitting prosthesis leads to a condition where there is no longer adequate support of bone due to RRR. Hence, rehabilitation of such cases pose a clinical challenge, as there is a decreased denture foundation area for support, retention and stability.2 Residual ridge resorption (RRR) is the severe atrophy of alveolar bone underlying the mucoperiosteum. RRR affects the alveolar bone morphology, resulting in a decreased denture foundation area and increased inter-alveolar ridge space. The increase in inter-ridge distance provides a huge restorative space which results in a heavier complete denture due to greater volume of denture base material. This increase in restorative space amalgamates with the long lip length of the patient which gives rise to huge challenge to the success of the complete denture. Also, decreased denture foundation area increases the heaviness of the prosthesis and negatively affects the retention of the denture due to gravity.3 Various weight-reduction techniques have been used in the past using a rigid three-dimensional spacer, such as dental stone (Ackerman, 1955), cellophanewrapped asbestos, silicone putty during laboratory preparation to keep denture base content out of the intended hollow cavity of the prosthesis. The following case report describes a distinct lab technique for construction of hollow maxillary complete denture for a patient with severe RRR.

A study on changes in phonetics in completely edentulous patients before and after rehabilitation with conventional and customized complete dentures

<p><strong>Background</strong>: A realistic approach to the phonetic aspect in complete denture construction is most often subdued by various factors. The palatal rugae, an important landmark in speech orderliness, are frequently affected due to lack of proper texture on a complete denture. Establishing a correlation between customized palatal surfaces of complete dentures and speech improvement will help to ameliorate post insertion appointments of articulation deficiencies.</p><p><strong>Methods: </strong>Ten completely edentulous subjects of either sex with a mean age range of 50-70 years, fulfilling the inclusion criteria were included in this study. All the participants received three sets of dentures, followed by assessment of speech using photo articulation test, speech intelligibility and acoustic analysis in edentulous state and subsequently after insertion of conventional denture, denture with customized rugae, and denture with customized metallic base.</p><p><strong>Results:</strong> The data collected was subjected to statistical analysis using SPSS 24.0 version and GraphPad Prism version 5. The statistical analysis was carried using ANOVA and student t-test. On evaluating the error patterns, distortion was maximum followed by substitutions. These errors were maximum in edentulous state and decreased subsequently, with the least errors in customized rugae dentures. A statistically significant positive correlation (p<0.0001) was found.</p><p><strong>Conclusions: </strong>Apart from retention, stability and support, equal amount of emphasis has to be laid down on phonetical aspects to improve the overall psychological well-being and social upliftment for patients. The improvement in verbal proficiency for completely edentulous patients can be minimized considerably by customizing the palatal portions.</p>

MANAGEMENT OF HYPER-MOBILE TISSUE WITH A MODIFIED COMBINE TECHNIQUE OF ZAFRULLA AND HOBKRIK

When in partially edentulous patient hyperplastic tissue replaces the alveolar bone, a flabby ridge develops which is often seen in long-term denture wearers. Flabby ridge provide poor retention for the denture fabrication if not recoded properly. A careful consideration and application of Zafrulla and Hobkrik technique of complete denture construction helps practitioner to over cone such conditions easily. This article describes procedure performed for flabby ridge patient and demonstrates Zafrulla and Hobkrik combination impression technique.

A Pressure Cup Denture Pre-eminent to Oronasal Communication: A Case Report

: In this case report, we present a surgical closure of 62 years old women diagnosed with oronasal communication using posteriorly based palatal rotational flap. For obtaining the satisfactory outcomes for construction of complete denture with adequate retention in maxilla use of the suction cups is one of the technique. Palatal suction cups induce negative pressure on mucosal surface and provides the high retention excruciating to palatal perforation. An oronasal fistula is a pathologic epithelium-lined communication between the nasal and oral cavities. An obturator is placed to prevent from further infection. There are various methods of surgical closure depending on the size and destruction of tissues around the fistula. Palatal obturators are frequently used in the initial treatment of postoperative palatal fistulae to address the associated problems experienced with speech and swallowing.

Retention of Rapid Prototyped Complete Dentures Using Two Retention of Rapid Prototyped Complete Dentures Using Two different types Liquid Resin

Objectives: Comparing the retention of upper complete denture manufactured using two different denture base materials, both of them were manufactured using rapid prototyping method. Methods: Nineteen patients were selected. For both groups, the dentures were manufactured using Rapid prototyping method following the next steps, a preliminary impression was made & trial denture bases were constructed on the primary casts for the upper & lower arches for a jaw relation record. A facebow record was used to mount the upper cast, while the lower cast was mounted using a centric relation record. Setting of artificial teeth was performed, then the denture was tried in patient`s mouth. Functional impression was taken during the try in stage. CBCT scanning of the try in with the functional impression was done to obtain STL file then denture manufacturing was done by 3D printing. Results: results showed that there is no significant difference between the two groups. Conclusion: Complete denture retention is not significantly affected by the material used for denture construction. Clinical significance: This in-vivo cross over study introduces a novel approach for digital construction of upper complete denture using recent materials and gives an idea about their retentive value

The Effect of Nano-hybrid Composite Resin Denture Teeth on Mandibular Residual Ridge

Introduction:Progressive ridge resorption is one of the main causes of loss of stability and retention of mandibular complete dentures with subsequent loss of masticatory efficiency and patient discomfort. Aim: This study was conducted to evaluate radiographically the effect of nano-hybrid composite resin teeth on mandibular residual ridge using cone beam computerized tomography (CBCT). A comparative study. Materials and Methods: Twelve completely edentulous male patients were randomly divided into two groups according to the artificial tooth material used in complete denture construction. One group received complete dentures with nano-hybrid composite resin teeth and the other group received complete dentures with cross-linked acrylic resin teeth. CBCT was taken at the delivery, 6 months and 12 months follow -up appointments. The evaluation was done for height and width changes of the mandibular residual alveolar ridge at different anatomical sites either in the anterior or posterior part of the mandible. Results: Analysis was done by using two-tailed t-test revealed that increase in amount of bone loss in both groups which is in favor to patients wearing dentures with nano-hybrid composite resin teeth, with no statistically significant difference between the two groups. Conclusion: Despite of introduction of new denture tooth material as nano-hybrid composite resin teeth, the cross-linked acrylic resin teeth still considered the gold standard denture teeth regarding the degree of occlusal force transmission and preservation of residual alveolar ridge.