Complete Removable Dental Prostheses Research Articles

Oral function in completely edentulous patients rehabilitated with implant-supported dental prostheses: A systematic review and meta-analysis.

This review evaluated the effects of rehabilitation with implant-supported prostheses on the oral function of completely edentulous adults. Systematic literature searches were performed to identify records reporting on oral function in completely edentulous adults rehabilitated with implant-supported prostheses. Meta-analyses were performed on various outcomes including bite force, masticatory performance, muscle activity, mandibular movement/chewing pattern, and salivary flow. 5507 records were identified. Thirty studies qualified for data extraction and analysis. The kappa (𝛋) for the search and identification strategy ranged between 0.50 and 1.00. Meta-analysis was performed grouping the studies by outcomes and split by time points of 6-12 months, 12-36 months, and >36 months after implant therapy. The meta-analyses revealed a significant improvement in oral function of completely edentulous adults after rehabilitation with implant-supported prostheses at 6-12 months (Z = -4.895, p < .001; 95% CI: -0.703, -0.301; τ2 = .609; Q = 114.953, df = 17, p < .001; I2 = 85.2%), at 12-36 months (Z = -4.886, p < .001; 95% CI: -0.580, -0.248; τ2 = .908; Q = 280.611, df = 35, p < .001; I2 = 87.5%) and at more than 36 months (Z = -9.108, p < .001; 95% CI: -1.472, -0.951; τ2 = .019; Q = 7.918, df = 7, p = .340; I2 = 11.6%). The included studies demonstrated a low to moderate risk of bias. This systematic review concluded that the oral function of completely edentate adults significantly improved with implant-supported/retained prostheses, even when only one jaw received implant therapy. Therefore, implant therapy should be promoted for edentulous adults to alleviate the shortcomings of conventional complete removable dental prostheses.

A novel prosthesis presentation test to screen for cognitive and functional decline.

To validate a novel screening test for cognitive and functional decline in older patients rehabilitated with complete removable dental prostheses (CRDPs). Edentate old in-patients rehabilitated with CRDPs were included in this study. Participants were requested to remove their prostheses before their intraoral examinations. The prostheses were then presented in an inverted orientation. Participants had to correct the orientation of the prostheses and insert them in the appropriate jaws. The test was repeated after the intraoral exam. Appropriate statistical models were used (⍺ = .05) to associate the test results with the participants' mini-mental state examination (MMSE) score, functional independence measure (FIM), age and sex. Among the 86 participants (mean-age: 85.4 ± 6.4 years; mean MMSE: 19.8 ± 5.5; mean FIM: 77.9 ± 20.8), 21 (24.4%) failed to correctly insert the prosthesis. The prosthesis presentation test (PPT) was associated with the FIM but not the MMSE. Regression models further confirmed an association with age (P = .043), but not sex. Additional analyses revealed the PPT test is associated with the FIM's cognitive sub-sets of memory, problem solving and social interaction. The PPT is a novel, simple and quick screening tool that can help detect functional difficulties in older people. It can easily be performed during an oral examination. Future studies are needed to determine whether the PPT can be used to detect deficits in executive function, as a complement to the MMSE and also as a first assessment of a patient's ability to manage dentures independently.

CAD-CAM complete denture resins: Effect of relining on the shear bond strength

ObjectivesThe aim of this study was to compare the shear bond strength of relined CAD-CAM complete removable dental prosthesis (CRDP) resins with conventional heat-polymerized polymethylmethacrylate (PMMA) resin. MethodsA total of 96 resin specimens in identical dimensions of 10 mm × 10 mm × 11 mm were fabricated for four study groups [#1- Conventional heat-polymerized group: n=24 (ProBase); #2- Milled#1: n=24 (Ivobase); #3- Milled#2: n=24 (Ivotion); #4- 3D-printed: n=24, (NextDent Denture 3D+)]. Twelve specimens in each group were sectioned in the middle to produce a 3 mm defect and then were relined using a conventional denture relining material. All specimens underwent thermocycling (5-55°C) for 10,000 cycles. The shear bond tests were carried out in a universal testing machine. One-way ANOVA and Tukey's test were used for statistical analysis (p<0.05). The two-parameter Weibull distribution values were calculated. ResultsRelined 3D-printed specimens had a significantly lower shear bond strength when compared with conventional (p=0.0003) and milled groups (Milled#1: p=0.0004; Milled#2: p<0.0001). There were no differences in the shear bond strengths between the milled and conventional groups. Weibull distribution presented the highest shape value for the non-relined Milled#1 (22.83) group and the lowest values for the 3D-printed relined group (4.001). ConclusionThe findings of this study conclude that the shear bond strength of the conventionally-relined 3D-printed resins used for fabricating CRDPs was inferior to the shear bond strength of conventionally-relined resins employed for manufacturing CRDPs using CAD-CAM milling and conventional heat-polymerization techniques. Clinical significanceWhen considering 3D-printing for the fabrication of CRDPs, it is recommended to employ it in clinical situations where a frequent need for denture relining is not expected.

The effect of neuropeptide ACTH4-10 on the adaptation of patients to dental prostheses according to the data of monitoring the emotional state using a polygraph

BACKGROUND: Monitoring and pharmacological correction of adaptation of patients to full removable dental prostheses is actual and practically important problem in stomatology.&#x0D; AIM: To study the effect of neuropeptide ACTH4-10 on the process of adaptation of patients to complete removable prostheses by monitoring the emotional state using a polygraph.&#x0D; MATERIALS AND METHODS: Examination and primary prosthetics with full removable dentures of patients (6075 years old) were performed of both sexes with total adentia. All patients were divided into three groups: the main group (correction of the adaptation process with ACTH4-10 neuropeptide Semax 0.1% nasal drops), the comparison group (0.9% NaCl solution was administered intranasally) and the control group (without pharmacological correction). Monitoring of the process of adaptation to prostheses was carried out by registering the emotional reaction of patients to the movements of the lower jaw with the help of a polygraph Barrier-14 of the company Antey (Russia).&#x0D; RESULTS: The emotional state of patients in the main observation group who received pharmacological correction with ACTH4-10 neuropeptide reaches the values of adapted patients for most of the studied indicators within 714 days after the application of prostheses, and a month after the application of prostheses - for all studied indicators of the curves of the trajectories of the lower jaw (p 0.05), which cannot be noted in patients of the comparison group (NaCl) and the control group. The results obtained indicate a positive effect of the neuropeptide ACTH4-10 on the process of getting used to patients with complete removable prostheses.&#x0D; CONCLUSIONS: Neuropeptide ACTH4-10 accelerates the process of adaptation of primary prosthetic patients to complete removable dental prostheses according to the monitoring of the emotional background of patients. The method of registering the emotional state of patients using a polygraph allows us to make an objective conclusion about the effect of occlusion and articulation on the psycho-emotional background and judge the patient's adaptation to a dental prosthesis.

CAD-CAM complete removable dental prostheses: A double-blind, randomized, crossover clinical trial evaluating milled and 3D-printed dentures

ObjectiveThis double-blind, randomized, crossover, clinical trial aimed to evaluate and compare the differences between milled and 3D-printed complete removable dental prostheses (CRDPs). MethodsFifteen edentulous patients (men: n = 10, women: n = 5; age: 66.7 ± 8.0 years) rehabilitated with conventional CRDPs were recruited for this trial. Participants were randomized to first receiving either the milled or 3D-printed CAD-CAM manufactured CRDPs and then after 6-weeks cross over to the other set. Both, clinicians and participants were blinded to the group allocation. Outcomes included patient's denture satisfaction (PDS), oral-health related quality of life (OHIP-EDENT), willingness-to-pay analysis, final choice (FC) of CRDPs, clinician's denture quality evaluation (CDQE), chewing efficiency (CE), maximum-voluntary-bite-force (MBF), and prosthodontic maintenance needs. The outcomes were measured at baseline (with old CRDPs), at 1 and 6 weeks after new CRDP insertion; following crossover with the second set of CRDPs, an identical protocol was followed. Generalized linear regression for repeated measures was used for statistical analysis with α=0.05. ResultsAll participants completed the trial. 3D-printed CRDPs required more maintenance visits, adjustment time (p = 0.0003), and adjustment costs (p = 0.021). Patients were willing-to-pay an average of 606.67 Swiss Francs more than the actual cost for the milled CRDPs. There were no differences in the PDS, OHIP, FC, CDQE, CE, and MBF between the two CRDPs groups. ConclusionsThe findings of this double-blind randomized crossover clinical trial confirm that both milled and 3D-printed CRDPs are valid treatment modalities for edentulous patients, with the latter performing inferiorly with regard to the time and costs involved with the prosthodontic aftercare, as well as the patients’ willingness-to-pay. Clinical relevanceThe findings of this trial provide evidence to help the clinician in choosing the appropriate CAD-CAM manufacturing process for fabricating the CRDPs.

Accuracy of anterior denture tooth arrangements of CAD-CAM complete removable dental prostheses made with a tooth mold template

Statement of problemResearch evaluating the accuracy of anterior tooth mold templates to computer-aided design and computer-aided manufacture (CAD-CAM) fabricated complete removable dental prostheses (CRDPs) is limited. PurposeThe purpose of this in vitro study was to investigate the accuracy of the anterior denture tooth arrangement on CAD-CAM complete removable dental prostheses made with the anterior tooth mold template. Material and methodsA maxillary and mandibular edentulous model was mounted on a semiadjustable articulator to simulate a patient’s maxillary arch. Definitive impressions and jaw relation records were made as per the manufacturer’s protocol. A maxillary and mandibular anatomic measuring device was completely seated onto the edentulous models, centered on the edentulous model midline, and horizontally positioned parallel to the mandibular ridge. A medium-size anterior tooth mold template sticker was attached on the anatomic measuring device to identify the maxillary dental midline and incisal edge position and was sent to the manufacturer as the proposed tooth arrangement reference for the definitive complete removable dental prostheses. A total of 10 milled complete removable dental prostheses were generated for 2 groups by using 2 different tooth arrangement techniques. One group (n=5) used the monobloc milling technique without bonding of denture teeth, while the other group (n=5) used the bonding system for denture teeth on the milled denture base. For comparison, a camera mounted on a tripod was used for photographic documentation. Reference markers placed on the edentulous model were used to orient and measure the difference of 4 aspects of the anterior tooth arrangement: average incisal edge position, intercanine distance, midline, and clinical crown length of the left central incisor. The difference values between the tooth mold template and definitive complete removable dental prostheses were statistically analyzed by multivariate ANOVA (α=.05) and 1-sample t tests (adjusted α=.0125). ResultsOverall, statistically significant differences were found between the tooth mold template (control) and definitive complete removable dental prostheses at all measuring aspects except for the midline of the midline of the milled arrangement technique (P<.0125). In terms of the midline value, the value of the milled group did not show a significant difference compared with tooth mold template (-0.19 mm). However, the value of the bonded group indicated a significant difference of midline (0.44 mm toward to the left of the tooth mold template midline). When the complete removable dental prosthesis milled denture tooth and complete removable dental prosthesis bonded denture tooth techniques were compared, there was no difference in the tested variables between the milled and the bonded groups (P>.0125). ConclusionsThe tooth mold template did not represent an accurate position for definitive complete removable dental prostheses for either the milled or bonded techniques. The largest differences were found at the average incisal edge of the anterior teeth and the intercanine distance for both groups. However, there was overall no clinical difference between the 2 groups (milled and bonded) of CAD-CAM complete removable dental prostheses.

Digital Duplication and 3D Printing for Implant Overdenture Fabrication.

This technical report describes a workflow to fabricate an implant overdenture via digital duplication of an interim complete removable dental prosthesis and additive manufacturing (3D printing). An edentulous patient was provided with an interim maxillary denture after implant placement. After 4 months of healing, the existing interim denture was scanned, duplicated via 3D printing, and used to make the final impression, record the maxillomandibular interocclusal relationship, and transfer the esthetic information to the definitive implant overdenture. The framework of the implant overdenture was digitally designed and manufactured using a direct metal printing (DMP) system. This digital duplication workflow facilitated the implant overdenture fabrication with favorable clinical outcomes.

The role of progressive oral implant rehabilitation in mastication, cognition and oral health‐related quality of life outcomes—A pilot to define the protocol

The implications of oral rehabilitation after tooth loss require further investigation. To conduct a pilot study to investigate: (a) changes in masticatory performance with progressive oral implant rehabilitation (POR); (b) association between POR and neurocognitive function using functional magnetic resonance imaging (fMRI); and (c) oral health-related quality of life (OHQoL) outcomes. Four completely edentulous patients (mean age: 73±1.4years) participated. Each received new complete removable dental prostheses (RDPs) transitioned to mandibular two implant-retained RDPs (IR-RDP). Assessments were performed at 4 time points for neurocognitive skills, fMRI with functional tasks (jaw clenching, working memory and sustained attention, inhibition), masticatory performance with colour-changing gum and OHQoL. Assessments were performed with new complete RDPs (T0 as baseline data) and IR-RDPs at 1week (T1), 6weeks (T2) and 12months (T3) post-insertion. Data analyses were based on intra-patient and inter-patient results. Masticatory performance and QoL improved with an IR-RDP at each time point. FMRI jaw clenching sensory and motor cortical activity decreased at T1, with motor cortical activity increasing to T0 levels at T2. For cognitive fMRI activation tasks, cortical activity decreased from T0 to T1 across all regions of interests (ROI) and increased at T2 throughout the cognitive brain regions. Neurocognitive skills declined at T1, followed by improvement to or beyond T0 levels at T2. Improvements in masticatory performance and OHQoL occurred from complete RDPs to IR-RDP. Prosthetic adaptation was associated with neurocognitive changes to pre-insertion activity levels or greater after 6weeks. These pilot data suggest both behavioural and neural associations between POR and cognition; however, larger study numbers are required.

Treatment of edentulous mandible with metal-resin fixed complete dentures: A 15- to 20-year retrospective study.

The purpose of this retrospective study was to report the implant and prosthetic complications of mandibular metal-resin fixed complete dentures (MRFCDs) opposing a maxillary complete removable dental prosthesis (CRDP) in a 15- to 20-year post-placement follow-up period. Dental records of 24 edentulous patients treated by a mandibular MRFCD and a maxillary CRDP were reviewed. Complications for the implants, MRFCDs, and CRDPs were recorded in four different recall periods: 0-5years, 5-10years, 10-15years, and more than 15years. The survival and failure times based on Kaplan-Meier statistics were analyzed using Lifetest procedures. Product-limit survival estimates were used for cumulative survival rates (CSRs). The mean service time was 18.5years. The CSR for the implants and MRFCDs was 91.8% at 16.9years (confidence intervals: 85.2% and 95.5%) and 80% at 19.6years (confidence intervals: 44.1% and 94.1%), respectively. The implant failures after 15years occurred because of a tumor resection. Acrylic resin tooth fracture (45.8% of patients) and wear (75% of patients) were the most common complications with the MRFCD. Retaining screw complications [loosening (8.1% of retaining screws) and fracture (11.3% of retaining screws)] were also common. The outcomes seen with MRFCD over the long term were favorable. After placement of prostheses, 1 implant loss was observed potentially due to prosthetic/hygiene/periodontal factors. However, potential maintenance complications such as acrylic resin tooth fracture and/or wear and retaining screw loosening and fracture may occur in the long term when a similar design is used for the mandible.

CAD/CAM milled complete removable dental prostheses: An in vitro evaluation of biocompatibility, mechanical properties, and surface roughness.

This study compared the biocompatibility, mechanical properties, and surface roughness of a pre-polymerized polymethyl methacrylate (PMMA) resin for CAD/CAM complete removable dental prostheses (CRDPs) and a traditional heat-polymerized PMMA resin. Two groups of resin substrates [Control (RC): conventional PMMA; Test (RA): CAD/CAM PMMA] were fabricated. Human primary osteoblasts and mouse embryonic-fibroblasts were cultured for biocompatibility assays. Mechanical properties and surface roughness were compared. ANOVA revealed no difference between the resin groups in the biocompatibility assays. RA demonstrated a higher elastic modulus (p=0.002), young's modulus (p=0.002), plastic energy (p=0.002), ultimate strength (p=0.0004), yield point (p=0.016), strain at yield point (p=0.037), and toughness (p<0.0001); while RC displayed a higher elastic energy (p<0.0001). Laser profilometry concluded a rougher surface profile (p<0.0001) for RA. This study concluded that the tested CAD/CAM resin was equally biocompatible and presented with improved mechanical properties than the traditional heat-polymerized PMMA resin used in the fabrication of CRDPs.

Fabrication of an interim complete removable dental prosthesis with an in-office digital light processing three-dimensional printer: A proof-of-concept technique

This report describes a proof of concept for fabricating an interim complete removable dental prosthesis with a digital light processing 3-dimensional (3D) printer. Although an in-office 3D printer can reduce the overall production cost for an interim complete removable dental prosthesis, the process has not been validated with clinical studies. This report provided a preliminary proof of concept in developing a digital workflow for the in-office additively manufactured interim complete removable dental prosthesis.

Accuracy and reproducibility of virtual edentulous casts created by laboratory impression scan protocols

Statement of ProblemAlthough computer-aided design and computer-aided manufacturing (CAD-CAM) complete removable dental prostheses (CRDPs) have gained popularity, conventional impressions are still common for CAD-CAM CRDP treatment. These need to be digitized and converted into virtual edentulous casts with a laboratory impression scan protocol during prosthesis fabrication. How this can best be accomplished is unclear. PurposeThe purpose of this in vitro study was to compare the accuracy and reproducibility of virtual edentulous casts created by a dental laboratory laser scanner and a cone beam computed tomography (CBCT) scanner with a digitized master cast. Material and methodsA master cast was digitized as the virtual reference cast. Ten polyvinyl siloxane impressions were made on the master cast and scanned with the dental laboratory laser scanner and CBCT scanner. The impressions were sprayed with antiglare spray and rescanned. Four groups of virtual study casts (N=40) were created from the impression scans. All virtual study casts and the reference cast were registered with surface-matching software, and the root mean square (RMS) values (representation of overall accuracy) and percentage of measurement data points within 1 standard deviation (SD) of mean RMS values (%, representation of overall reproducibility) among the 4 study groups were measured. Additionally, 95 numeric distance differences (representation of accuracy at each region) were measured in 5 distinct regions: the apex of the denture border, 6 mm from denture border, crest of the ridge, palate, and posterior palatal seal. The repeated-measures ANOVA and post hoc test (t grouping) were used to determine statistical differences (α=.05). ResultsThe laboratory scanner group had a significantly larger RMS value (4.0 ±0.3 μm, P<.001) and smaller percentage of measurement data points within 1 SD of mean RMS value (77.5 ±1.0%, P<.001). The RMS values between the CBCT scanner (1.2 ±0.3 μm) and CBCT scanner–spray (1.1 ±0.2 μm) groups were not significantly different (P=.968), and the percentage of measurement data points within 1 SD of mean RMS values (90.1 ±1.1% versus 89.5 ±0.8%) were also not significantly different (P=.662). The numeric distance differences across 5 regions were affected by the scanning protocols (P<.001). The laboratory scanner and laboratory scanner–spray groups had significantly higher numeric distance differences at the apex of the denture border and crest of the ridge regions (P<.001). ConclusionsThe CBCT scanner created more accurate and reproducible virtual edentulous casts, and the antiglare spray only significantly improved the accuracy and reproducibility of virtual edentulous casts created by the dental laboratory laser scanner. The accuracy of the virtual edentulous casts was different across 5 regions and was affected by the scanning protocols.

Polyetherketoneketone (PEKK), a framework material for complete fixed and removable dental prostheses: A clinical report

This clinical report demonstrates the use of polyetherketoneketone (PEKK) as a framework material with individually luted heat-pressed lithium disilicate glass-ceramic crowns for an implant-supported complete fixed dental prosthesis (ICFDP) and a conventional complete removable dental prosthesis (CRDP). This prosthesis design provides a non–computer-aided design and computer-aided manufacturing (CAD-CAM) option for the fabrication of ICFDPs and CRDPs with individualized ceramic crowns for optimal esthetics. The performance of PEKK as a framework material needs to be assessed in clinical trials.

Masticatory Performance and Maximum Bite and Lip Force Depend on the Type of Prosthesis.

The aim of this cross-sectional study was to assess maximum restraining lip force (MLF), maximum voluntary bite force (MBF), and patient-related parameters to evaluate their influence on masticatory function in four groups of participants with different dental states. Participants were recruited and assigned to one of four different groups depending on dental status: complete removable dental prostheses (CRDP group); edentulous with two-implant overdentures (IOD group); Kennedy Class I partial removable dental prostheses (PRDP group); or fully dentate (control group). A dental examination was performed and history taken. MLF was measured as the maximum withstood pulling force with three sizes of oral screens, MBF was evaluated using a digital force gauge, and masticatory performance was assessed using a two-color mixing ability test. Linear regression was used to determine the predictive effects of covariates on masticatory performance. Global and pairwise comparisons were also carried out. A total of 68 participants with an average age of 69.3 ± 7.7 years were recruited. MLF depended on the screen size (P = .0004; Kruskal-Wallis) and increased with CRDP use, especially in challenging tasks, such as restraining the smallest screen. The highest MBF was found in dentate participants (P < .0001; Mann-Whitney). Analysis of variance (ANOVA) showed a global significant difference in masticatory performance between groups, with PRDP patients chewing better than CRDP patients. Dental state, time lapse since last tooth loss, and MBF predicted masticatory function. Tooth loss significantly affects MBF and masticatory performance. Free-end saddles with a rotational axis in two-implant IODs and Kennedy Class I PRDPs may limit MBF and consequently masticatory performance. CRDP design should facilitate perioral muscular function.

An important risk factor for esophageal foreign bodies in adults: removable dental prostheses

This study investigated the relationship between removable dental prostheses usage and esophageal foreign bodies in adults. We conducted a retrospective single-center study of 93 patients over 16 years old who were diagnosed with esophageal foreign objects following food ingestion between January 2002 and June 2016. The mean age was 57.1 ± 14.2. The foreign body was bone in 65 cases (69.9%) and it was meat in 28 cases (30.1%). In 77 patients (82.8%), foreign body was in the first narrowing of the esophagus, in 9 cases it was in the middle of esophagus (9.7%) and in 7 cases it was observed in distal esophagus (7.5%). In 53 patients (56.9%), there were removable dental prostheses (31 cases have complete removable dental prostheses). Bone swallowing in 51 of the 65 cases (78.5%) occurred while eating meat without knowing that bone existed. In other cases, meat stuck in esophagus because of inadequate shredding. Sometimes patients with removable dental prostheses cannot chew and cut of red meat effectively, and they cannot notice bones easily while eating meat. Patients using denture should be informed about dietary habits. They should be advised about controlling meat when eating and to swallowing small pieces.

Panoramic radiographs made before complete removable dental prostheses fabrication: A retrospective study of clinical significance

Statement of problemThe value of digital panoramic radiographs to screen for problems before fabricating conventional complete dentures is unclear. PurposeThe purpose of this retrospective study was to examine the influence of pretreatment digital panoramic radiographs on the clinical management of patients receiving complete removable dental prostheses. Material and methodsThe clinical records, including panoramic radiographs, of 169 patients seeking new complete removable dental prostheses over a 6-year period were interpreted independently by both a prosthodontist and an oral and maxillofacial radiologist to identify radiographic findings that influenced clinical patient management. A 95% confidence interval and an observed proportion of agreement were used to interpret the results. ResultsSixty percent of the 169 radiographs examined had 1 or more abnormal or positive radiographic findings; however, only 6 (<4%) of 165 abnormalities detected influenced patient management, and 3 of them were identified during the clinical examination. ConclusionsPretreatment digital panoramic radiographs revealed very few abnormalities that influenced the treatment of patients requiring complete removable dental prostheses. Furthermore, the digital images in this study revealed positive findings at a rate similar to those found in studies assessing analog radiographs, reinforcing current guidelines that recommend against radiographic screening of patients who seek new complete removable dental prostheses.

Muscular activity may improve in edentulous patients after implant treatment.

Data sourcesMedline via Pubmed and the Cochrane Library were searched from January 1980 to September 2013. This was complemented by a manual search of the magazines Deutsche Zahnaerztliche Zeitung, Quintessenz, Zeitschrift für Zahnärztliche Implantologie, Schweizerische Monatszeitschrift and Implantologie. Additionally, the list of reference s of all selected full-text articles and related reviews were further scrutinised for potential included studies in English or German.Study selectionThree review authors independently searched for clinical trials that assessed the muscular activity in the intervention groups: edentulous patients treated with implant-overdentures (IODs) and implant-supported fixed dental prostheses (ISFDPs) and the comparison groups: dentates and edentulous patients treated with mucosa-borne complete removable dental prostheses (CRDPs).Data extraction and synthesisThe primary outcome was the muscular activity (measured by electromyography [EMG]) in masseter or temporalis muscle of the participants during clenching and chewing. The data extraction of each included study consisted of author, year, age range, treatment, number of participants, number of implants inserted, arch treated, opposite jaw, kind and side of the muscles that were measured. EMG gain or loss (unit measured: volt) was considered by using the effect size. For the meta-analyses only the studies that included masseter muscle measured separately from temporalis were considered. Concerning the side of measurement (right and left side measured together or right and left side measured separately), only the dominant type in each category was included.ResultsSixteen articles, out of the initial 646 retrieved abstracts, were analysed. The muscular activity of edentulous subjects increased after implant support therapy during clenching (effect size [ES]: 2.18 [95% confidence interval [CI]: 1.14, 3.23]) and during chewing (ES: 1.45 [95 % CI: 1.21, 1.69]). In addition, the pooled EMG data of IODs and ISFDPs were lower than that of dentate subjects during clenching (ES: -1.01 [95% CI: -1.37, -0.65]). However, the ISFDPs showed higher values than dentates during chewing. Among the edentulous patients the IODs and ISFDPs displayed higher pooled values during clenching (ES: 1.12 [95% CI: 0.7, 1.55]) and chewing (ES: 1.33 [95% CI: -0.57, 2.10]). Furthermore, the muscular activity during chewing correlated with the hardness of the food.ConclusionsEdentulous patients with CRDPs can achieve a greater degree of muscular activity after rehabilitation with implant-supported/retained prostheses during clenching and chewing. During clenching, patients with ISFDPs achieved higher EMG-values than those with dentates. The harder the food, the more muscular activity involved.

Complications after use of elastomeric pressure-indicating media at 24-hour follow-up visit for immediate maxillary complete removable dental prosthesis: A clinical report

Various pressure-indicating media are available to assess the adaptation of the intaglio surface of a removable dental prosthesis at the insertion and follow-up appointments. This clinical report describes the use of an elastomer that entered the maxillary sinus through an undetected oroantral communication at the 24-hour follow-up for an immediate maxillary complete removable dental prosthesis. A Caldwell-Luc sinusotomy procedure was required to remove the material, and the patient required over 1 year of healing time before his reported symptoms resolved.

A comparison of two digital techniques for the fabrication of complete removable dental prostheses: A pilot clinical study

Statement of problemThe introduction of digital techniques might improve the quality and cost-effectiveness of treatment with complete removable dental prostheses (CDs). PurposeThe purpose of this pilot clinical trial was to study and compare the clinical feasibility, complications during fabrication, and quality of 2 types of digitally designed CDs. Material and methodsFive participants were recruited into this preliminary clinical trial. For each participant, 2 pairs of digital CDs were designed. Prosthesis bases were fabricated by using identical data, either by milling from polymethyl methacrylate blanks or by injection molding. The treatment involved 4 clinical appointments. Polyvinyl siloxane impressions were made with custom trays and were subsequently digitalized. After evaluating esthetics and function with trial dentures, the CD bases were fabricated. To evaluate the workflow and quality of the prostheses, the clinical outcome was measured on 6-point scales ranging from poor (grade 6) to excellent (grade 1). For both prosthesis types, the following aspects were examined: fit, retention, esthetics, phonetics, maxillomandibular relation, and occlusion. ResultsBoth types of digital CDs could be fabricated without major complications. Only a few minor complications occurred during the fabrication process, predominantly esthetic issues. No pronounced difference was found between the prostheses concerning functional aspects. The definitive esthetic outcome was rated as very good. ConclusionsThe CDs fabricated using digital technology met the clinical requirements. However, more research is needed to confirm the results of this investigation.

Cone beam computed tomography imaging as a primary diagnostic tool for computer-guided surgery and CAD-CAM interim removable and fixed dental prostheses

This article describes a digital workflow using cone beam computed tomography imaging as the primary diagnostic tool in the virtual planning of the computer-guided surgery and fabrication of a maxillary interim complete removable dental prosthesis and mandibular interim implant-supported complete fixed dental prosthesis with computer-aided design and computer-aided manufacturing technology. Diagnostic impressions (conventional or digital) and casts are unnecessary in this proposed digital workflow, providing clinicians with an alternative treatment in the indicated clinical scenario.