Removable Complete Dentures Research Articles

Clinical Study to Evaluate the Prevalence of TMD Before and After Delivery of Complete Denture

Temporomandibular disorder (TMD) is a broad term that encompasses number of clinical problems including the temporomandibular joints, the masticatory musculature and related structures, or both. The etiology of TMD is ambiguous since the signs and symptoms which exist in patients with natural teeth may also being observed in edentulous patients. Thus, TMD is a multifactorial problem with varying symptoms combinations and rates. Relationship between removable complete dentures and tempromandibular joint disorder in different gender and age groups. A total of 30 patients (15 female and 15 male) who submitted to Prosthodontics Department, College of Dentistry, Al-Mustansiriyah University to make a new complete denture. The age of participants ranges from (40-80) years with the mean age (65.9) years. Two clinical examiners conducted the patient’s examination; the first examiner takes on a questionnaire to identify the TMD symptoms signs and. Clinical examination of the patients was assessed through part I, II of research diagnostic criteria pre and post one and two months of applying the prosthesis. The clinical evaluation of prosthesis done by the second clinical examiner related to (retention, stability, fitness, occlusion and centric relation) was evaluated twice at predetermined intervals of 1 and 2 months after construction and delivery of denture. Evaluation performed by using Dawson's bimanual technique and recorded within clinical case sheet for complete denture records. The present study shows that the highest frequency of TMD obtained in age group of 70-80 years old followed by age group of 60-69 years old at all intervals, internal derangement (ID frequency) significantly higher in females than male patients (p=0.02). There is significant statistical difference regarding the Myofacial pain dysfunction (MPD) frequency according to the time of using the dentures, those patients with Diabetes Mellitus (DM) formed the highest percentage (39.1%) of those whom presented with MPD followed by those with Hypertension (HT) (32%) and those with history of HT and DM represent (17.4%) only The results also illustrated that prosthesis properties (retention, stability, fitness, occlusion and centric relation) show significant relation with TMDs improvement post one and two months. Most patients with complete denture perceived improvement in the sign and symptoms of TMDs.

Severe alveolar ridge resorption and mandibular torus in an edentulous patient undergoing rehabilitation by applying removable complete dentures with a soft denture liner using duplicate dentures: A case report

Severe alveolar ridge resorption and mandibular torus in an edentulous patient undergoing rehabilitation by applying removable complete dentures with a soft denture liner using duplicate dentures: A case report

Oral and pharyngeal phases of swallowing in removable complete denture wearers

Oral and pharyngeal phases of swallowing in removable complete denture wearers

CORRELATION OF VERTICAL DIMENSION OF OCCLUSION AND VARIOUS SOFT TISSUE LANDMARKS USING LATERAL PROFILE PHOTOGRAPHS

Background: Dentistry’s evolving focus on fixed prostheses contrasts with the relative infancy of the jaw-related concepts in removable complete dentures, particularly in determining the vertical dimension of occlusion (VDO). The criticality of VDO in prosthetic rehabilitation underscores the need for stable parameters. However, due to the lack of a stable paradigm, the precise determination of VDO remains a contentious issue. This study proposes the utilization of lateral profile photographs (LPPs) to estimate VDO in edentulous patients. Methods: A cross-sectional study was conducted at the College of Medical Sciences, Bharatpur, Chitwan, Nepal. Using non-probability convenience sampling, 50 participants aged 20-30 years with specific dental parameters were selected. LPPs were obtained, and angular measurements were recorded to establish correlations and regression models. Results: Statistical analysis revealed a significant correlation between measured angles and VDO. Strong and positive relationships were identified between Stn-Stsn-Stgn and Stn-Stsn-Stg angles and between Stp-Stg-Stgn and Stp-Stg-Stsn angles. The study’s regression models successfully predicted Stn-Stsn-Stgn and Stp-Stg-Stgn angles using Stn-Stsn-Stg and Stp-Stg-Stsn as predictor variables. Conclusions: The study underlines the potential of LPPs as a practical tool for estimating VDO, presenting an accessible alternative to conventional techniques. The observed correlations emphasize the intricate interplay of craniofacial parameters, reinforcing the importance of accurate VDO determination for successful dental treatments.

Advantages of Additive Manufacturing for Complete Removable Dentures

The purpose of this review is to examine the existing body of research regarding complete 3D-printed dentures. This examination will cover new biomaterials, methods of creation, workflow, how well they work in clinical settings, and the contentment of patients using them. The methodology involved implementing a search plan, establishing criteria for inclusion and exclusion, and picking out relevant studies. Four reviewers conducted separate searches on PubMed, Scopus, and Embase databases to collect articles released from 2002 to 2023. From the electronic database, a sum of 116 headings was acquired, and after implementing exclusion criteria, 28 articles were pinpointed relating to technology for creating full dentures through printing. Present advancements and progress in digital dentistry have effectively enabled the production of removable dental prostheses through CAD/CAM technologies.

A Root-Supported Overdenture: An Approach to Preventive Prosthodontics

The use of residual teeth to support an attachment-retained overdenture is an alternative therapy to extractions and complete removable denture, particularly for the mandibular arch. Overdenture offers several advantages, including maintenance of the alveolar ridge and proprioception. Retention and stability are also enhanced by means of attachment systems, which improves schwing efficiency and better psychological integration of the prosthesis. This article describes, through a clinical case, the fabrication and interest of a tooth-supported overdenture using two axial attachments.

Ranking Technologies of Additive Manufacturing of Removable Complete Dentures by the Results of Their Mechanical Testing.

In this study, a methodology was developed for ranking manufacturing technologies of removable complete dentures (RCDs) according to the results of their full-scale mechanical tests. The actuality of the study is motivated by establishing the advantages and drawbacks of 3D-printed RCDs in contrast with ones manufactured via an analog protocol. The RCDs were fabricated via four technological routes that included various combinations of subtractive technologies (hot polymerization/HP and CAD/CAM milling) and additive manufacturing (digital light processing/DLP) ones and the installation of commercially available cosmetic denture teeth (DT). In the mechanical tests, different blocks of teeth (incisors, canines, premolars and molars) were loaded. To solve the ranking problem, it was proposed to interpret the results of the mechanical tests in terms of the reliability, durability and compliance/stiffness criteria. For this purpose, the combined AHP-VIKOR method was applied. In addition, a computer simulation of the mechanical loading conditions and the response of the RCDs was performed based on the finite element method (FEM). As the key conclusion, it was stated that additive manufacturing (AM) methods are competitive and cost-effective techniques for the fabrication of RCDs.

Accuracy and reproducibility of real and virtual occlusal contact points in implant-supported fixed prostheses.

To evaluate the accuracy and reproducibility of real and virtual occlusal contact points in implant-supported, fixed complete dentures. The study included 19 participants using mandibular interim complete-arch fixed prosthesis supported by 3 or 4 implants as opposed to conventional removable complete dentures. At installation, an examiner installed the prostheses and verified the occlusal contact points through 2 methods: recording the real contact points with carbon paper (RC) followed by occlusal photography and intraoral scanning (VC) to record the virtual contact points to obtain a screen print of the software. Then, the two images were randomized to determine the order to be inserted into Microsoft PowerPoint for blind and paired evaluation. The independent variables consisted of the distribution of occlusal contacts points (qualification through pre-defined scores based on the position of the contact points on the surfaces of the teeth) and the reproducibility of the methods by verifying the number of occlusal points. For this, a descriptive analysis was used to evaluate the distribution of occlusal contacts points and the Wilcoxon test for the reproducibility of the occlusal contact points between the methods (p<0.05). The methods had 100% and 73.6% real and virtual occlusal contact points, respectively, which is considered clinically excellent. There was no significant difference regarding the reproducibility of the methods by the number of occlusal contact points (RC: x̅13.32; VC: x̅13.68; p=0.715). The use of the tested intraoral scanner can be an easy and fast tool for studying and mapping the occlusion, and storing data for future treatment, with the conventional method being the preferred method for performing the occlusal adjustment.

Comparative characteristics of materials for relining complete removable dentures as part of import substitution

Relevance. Partial and complete loss of teeth are among the most common dental diseases. According to WHO, up to 75% of the world’s population suffers from them. Complete and partial secondary adentia are complex diseases that have a negative impact on the digestive, endocrine and nervous systems, as well as disrupting many other areas of the patient’s life, including social.Objective. Study of the practical features of using different materials for clinical (direct) relining of removable denture bases, identifying their inherent positive qualities and disadvantages.Materials and methods. During the clinical study, a comparative analysis of materials for direct (clinical) relining of removable dentures was carried out in 3 groups of patients. A total of 45 people took part in the study. The following materials were used: Rebaron (GC, Japan), Rebase II (Tokuyama, Japan), Nolatek (Vladmiva, Russia).Results. It was established that the group of patients with prosthetic relining with Nolatek material showed the best clinical result.Conclusion. The data we obtained allows us to conclude that the modern domestic light-curing polymer composite material Nolatek for clinical relining has a number of operational and clinical-technological advantages over cold polymerization materials.

Influence of tension and deformation indicators on the quality of removable constructions acrylic basis

Background. The question of distribution of masticatory pressure is one of the main branches in quali­tive manufacturing of removable constructions. With the development of software, as well as with the increase in the power of computer technology has also spread to the problems of biomechanics, in particular the biomechanics of the human oral cavity. The aim of our study was to analyze the results of using the method of finite element techniques with the purpose to improve the quality of prosthetic treatment by correct modeling constructional denture elements. Materials and Methods. The study involved 45 patients aged 44–73 years (mean age 59.2±4.3) treated with complete laminar prosthetic constructions for the upper jaw and lower jaw. A powerful method was developed to solve the problems of the theory of elasticity – the finite element method. The main idea is that the body under the study is divided into a finite number of subdomains or elements on which the desired continuous function is approximated by a polynomial (consists of piecewise continuous functions). A two-dimensional quadrangular element with four nodes was chosen as the partition element. Dividing it into elements and further solving the problem was in the ANSYS Mechanical APDL package (USA). Results. Regarding the calibration of the ultimate displacements of nodal points and as a result of the distribution of masticatory pressure under the basis of a complete removable dentures on the tissues of the prosthetic area, the average values of each plane were as follows: for section PM1 – the plane with high pressure was ([675298.14±5.21] m2K). Taking the PM2 region, the values were slightly higher ([369743.3±3.9] m2K) and ([735356.34±4.52] m2K), respectively. Conclusions. Our findings suggest direct relationship between the using of mathematical calculation of material volume, volume deformation, potential data and elasticity theory as auxiliary element in the manufacture of removable dentures and, as a result, direct influence on level of quality of following constructions. Keywords: orthopedic treatment, finite element method, complete removable dentures, tension theory, deformation.

Clinical and epidemiological characteristics of the frequency and structure of edentulism in elderly and senile people of the Republic of Sakha (Yakutia)

Aim. Based on the results of the study of the frequency and structure of complete loss of teeth in the upper and lower jaws, to determine the need of elderly and senile people in prosthetics with complete removable orthopedic structures. Materials and methods. A dental examination was carried out in 5,791 people aged 60 to 93 years. At the same time, on the recommendation of WHO, a key age group of 65-74 years was formed. The study took into account the topography of the absence of teeth, gender, age, the presence and evaluation of previously manufactured complete removable dentures and the need for prosthetics. Results. A high prevalence of complete loss of teeth on the upper and lower jaws was found in the examined age groups of elderly and senile age. The largest proportion of complete loss of teeth of the upper and lower jaws was revealed in the age group of 75-84 years. At the same time, in elderly people, complete adentia is detected mainly in women, since men occupy a quarter of the gender ratio. Meanwhile, taking into account the indications for reprosthetics and the absence of prostheses with complete loss of teeth, the need for the manufacture of orthopedic structures in the form of complete removable prostheses in the surveyed population is determined. Conclusions. The obtained results dictate the need to improve orthopedic rehabilitation of patients with complete loss of teeth in the upper and lower jaws, taking into account the data obtained on the structure and frequency of complete loss of teeth in elderly and senile people.

Comparative Evaluation of the Digital Workflow and Conventional Method in Manufacturing Complete Removal Prostheses.

The aging population in developed countries has increased the number of edentulous patients and, therefore, the need for prosthetic rehabilitation to improve their quality of life. Complete dentures are the main treatment option in these cases. The use of CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) in dentistry has improved clinical protocols and outcomes, achieving a reduction in work time and economic costs for the patients. The main objective of this review was to compare the characteristics of conventional and digital dentures, attempting to determine whether the use of new technologies represents an improvement in the properties of removable complete dentures. A bibliographic review was carried out in the PubMed/MEDLINE, Cochrane Library, Scielo, and Embase databases. With the initial search, 157 articles were obtained. After applying the inclusion and exclusion criteria, 64 publications were selected for this bibliographic review. The different conclusions of the studies consulted were compared regarding fit and retention, fracture resistance, surface roughness, biocompatibility, and aesthetics, taking into account the different methods of prostheses fabrication. In general, digital prostheses have shown better mechanical properties and, consequently, better biocompatibility and aesthetics than conventional prostheses. However, the obtained results were very heterogeneous, preventing a supported conclusion.

Accuracy of Intraoral Scanner for Recording Completely Edentulous Arches-A Systematic Review.

Scanning edentulous arches during complete denture fabrication is a crucial step; however, the quality of the resulting digital scan is still questionable. The purpose of this study is to systematically review studies (both clinical and in vitro) and determine whether intraoral scanners have clinically acceptable accuracy when recording completely edentulous arches for the fabrication of removable complete dentures. An electronic search in medical databases like PubMed, Scopus, and Web of Science (WOS), using a combination of relevant keywords, retrieved 334 articles. After full-text evaluation, twelve articles fulfilled the inclusion criteria for this review (eight clinical studies and four in vitro studies). A quality analysis of the included studies was carried out using the QUADAS-2 tool. The accuracy values varied between different intraoral scanners. Different regions of the edentulous arches showed differences in trueness and precision values in both in vitro and clinical studies. Peripheral borders, the inner seal, and poorly traceable structures like the soft palate showed maximum discrepancies. The accuracy of intraoral scanners in recording clear anatomic landmarks like hard tissues with attached mucosa was comparable to conventional edentulous arch impressions. However, higher discrepancies were recorded when digitizing mobile and poorly traceable structures. Intraoral scanners can be used to digitize denture-bearing areas, but the interpretation of the peripheral border and the soft palate should be carefully carried out.

Patient-Reported Outcomes and Clinical Performance of CAD/CAM Removable Dentures: A Scoping Review.

To review the literature on CAD/CAM removable complete and partial dentures regarding patient- and clinician-reported outcomes. We performed an electronic search of the Cochrane Central Register of controlled trials (CENTRAL), MEDLINE (Ovid), EMBASE, Scopus, and Web of Science databases (last update: March 2023). All clinical trials or observational studies investigating CAD/ CAM removable dentures (conventional or implant-retained) were included. The search yielded 4,035 records and led to 58 included studies. Results suggest that CAD/CAM complete and partial dentures, when compared to the conventional ones, can save time and resources while being rated either noninferior or superior by patients and clinicians in most studies. However, consensus on which workflow offers fewer adjustments and postoperative sessions is still pending. The literature suggests that CAD/CAM complete and partial dentures can combine substantial time and cost savings, with patient and clinician experiences at least comparable to conventional prostheses. Given the low evidence level of existing studies, future well-designed randomized trials with large sample sizes are required to confirm those advantages.

Forming the maxillary palatal relief on the outer palatal surface of the complete removable dentures

Prosthodontic treatment of secondary complete adentia in the upper jaw with completely removable plate prothesis consists in reflecting the palatal relief on the outer surface of the upper jaw prosthesis basis. Preparation of CRPP for SCA is an arrangement of known clinical and laboratory stages.&#x0D; During the prosthodontic treatment of SCA with maxillary CRPP, the following sequence was performed at the clinical and laboratory stages for the purpose of reflection of the palatal relief on the outer side of the maxillary prosthetic bases, the 2nd and 4th laboratory stages have been improved. So that:&#x0D; Replacing the wax with plastic in the composition of complete removable dentures. 4,5,6,7,8 figures of our work refer to this stage. At this stage: Figure 8-reflection of the relief of a part of the hard palate in the base plate wax added to the trial denture of a maxillary complete removable platen prosthesis. Figure 9-reflection of the relief of a part of the hard palate in the denture wax added to the trial denture of a maxillary complete removable platen prosthesis.&#x0D; The present study shows that the complete removable upper plate prosthesis (CRPP) is more functional in the prosthetic treatment of secondary complete adentia (SCA). By using CRPP on the upper jaw, unnatural disturbances in the relief of the palatine region are eliminated. It will be useful for improving other clinical and laboratory stages of preparation of maxillary CRPP.

ANALYSIS OF INTERCONNECTION PROBLEMS DATA INDICATORS OF THE PATIENT'S QUALITY OF LIFE WITH MANUFACTURING PRINCIPLES OF REMOVABLE DENTURES

Assessing the quality of patient's life can become a crucial criterion when evaluating the effectiveness of disease treatment, as well as when comparing the efficiency of various programs: conservative and surgical treatment, various types of drug therapy, rehabilitation regimens, etc. In recent years, increasing attention has been paid to health, particularly dental, associated with the study of the life quality indicators.&#x0D; The purpose of our study was to analyze the relationship between patient's quality of life indicators and the organization of the patient's dental rehabilitation with removable denture structures and the treatment of partial and complete adentia.&#x0D; The study included 56 patients who sought dental care for partial or complete adentia. One of the conditions for forming the selective statistical population was its homogeneity in terms of age and gender composition, as well as general somatic status. When analyzing the data on the life quality of patients with partial and complete adentia, we used the SF-36 questionnaire (The Short Form-36) as a basis, comparing the data both before and after prosthetic treatment to evaluate its effectiveness. Moreover, we took into account both objective and subjective factors that could affect the life quality of patients during prosthetic treatment.&#x0D; The results of quality of life indicators in patients with partial adentia (PA-1 group) and complete adentia (CA-2 group) considering gender and age before and after treatment with partial removable and complete removable dentures, were determined applying the SF-36 questionnaire in compared groups.&#x0D; Thus, analyzing the overall picture, it is possible to note a statistically significant (Р&lt;0.05) decrease in quality of life indicators on all scales in patients with complete adentia (CA) compared to the group of patients with partial adentia (PA).&#x0D; The evaluation of quality of life indicators has an extremely important clinical and prognostic value when making diagnosis, selecting prosthetic treatment method, and evaluating the long-term prosthetic outcomes.&#x0D; These data should be taken into account in the practical activities of prosthetic dentists, to prevent common conflicts arising due to the inconsistency of patients' expectations with the predicted results of treatment and the results of rehabilitation measures.

Complete Removable Prosthesis Stabilized on Implants: Interest and Use of the Locator® Attachment

The complete removable denture retained by implants is a widely used therapeutic option, recognized for its functional and psychological esthetic rendering. Currently, the practitioner has an arsenal of retention systems at his disposal (axial attachments, anchor bars...) and since 2000, the Locator® attachment has been added to the large number of axial attachments. Thus, this article proposes to describe it and to expose, through two clinical cases, the process of its placement.

The analysis of innovative manufacturing method of complete removable dentures

BACKGROUND: The optimization of the digital protocol in the manufacture of complete removable dentures to obtain milled dentures with design close to those modeled using computer-aided design and computer-aided manufacturing software is an urgent problem in dental prosthetics.&#x0D; AIM: To analyze the manufacturing of complete removable dentures and demonstrate the results of in vitro studies of prostheses obtained according to the developed protocol using the Kravets verticulator and prostheses in which the bases are bonded to the teeth with resins of cold and hot polymerization.&#x0D; MATERIALS AND METHODS: With digital technologies, using the proposed modernized Wieland Digital Denture (Ivoclar Vivadent) protocol, 10 bases and 10 corresponding dentitions were obtained by milling, according to pre-made templates obtained using 3D printing. Then, five samples were bonded with cold cure resin using the verticulator, and five samples were made with hot cure resin and verticulator.&#x0D; RESULTS: On most of the tooth treated with hot cure resin, the interlayer between the structures of the base and dentition was not observed, or interlayers had a thickness of 804 microns. The thickness of the interlayer of the cold curing specimens was 27325 microns. Pores are not observed for plastic bonded specimens, both cold and hot cured.&#x0D; CONCLUSION: The proposed method allows the use of digital technologies to obtain a monolithic plastic prosthesis, which eliminates inaccuracies in tooth positioning, during placement in the base of the prosthesis, and bind the base of the prosthesis and teeth using hot-curing acrylic plastic.

Removable complete denture with a metal base: Integration of digital design and conventional fabrication techniques.

Digitally-designed removable complete dentures are typically composed of a resin denture base without a metal framework. However, metal denture bases are preferable as resin bases are more susceptible to fracture. Therefore, this article introduces a unique technique that integrates computer-aided design (CAD) and conventional resin processing for the fabrication of removable complete dentures with a metal framework. A maxillary complete denture with a metal base and a mandibular implant-retained overdenture reinforced with a metal framework were fabricated. The dentures were designed using CAD software and a tooth library. The denture bases were milled from wax disks, and artificial teeth were placed to complete the wax dentures. The metal frameworks were also designed using CAD software and produced via casting of printed resin patterns. Finally, conventional denture processing techniques were applied to obtain dentures with metal frameworks. A digitally designed, removable complete denture with a metal base can be successfully fabricated using the described technique, which merges digital design and conventional methods. This article demonstrates the feasibility and potential advantages of this innovative approach in denture fabrication. The presented technique provides the following advantages: digital design features, precise space above implant overdenture attachments for a metal framework, convenience of esthetic evaluation with printed trial dentures, long-term data storage and duplication, reliable bond between the artificial teeth and denture base, and enhanced strength of the removable complete denture due to the metal reinforcement.

Odontogenic Keratocyst in an Edentulous Patient: Report of an Unusual Case

The purpose of this study was to report a rare case of an odontogenic keratocyst occurring in the edentulous jaw area. A 64-year-old man presented with a painful swelling of the right posterior mandibular vestibule that prevented him from wearing a complete lower denture. Upon intraoral clinical examination, the patient was totally edentulous and had two removable complete dentures. He had a fistula in the vestibular mucosa of edentulous site 48 that was painful upon palpation. Radiological examination revealed an unilocular radiolucent lesion with a continuous peripheral sclerotic border, centered on both the mandibular angle and right branch. Differential diagnosis mainly included a residual cyst and an odontogenic cystic tumor. The biopsy and the excisional material allowed a diagnosis of an odontogenic keratocyst to be made, the cyst being lined by a uniform parakeratinized squamous epithelium, corrugated in places, showing intercellular edema in places, with a well differentiated basal cell layer ranging from cuboidal to columnar in shape, a relatively thin, inflammation-free fibrous wall, and a cyst lumen that contained varying amounts of desquamated keratin. In this case, the surgical risk was represented by paresthesia of both the inferior alveolar and the lingual nerves. The lesion was enucleated without any complications, and the follow-up after 1 year did not reveal any nerve functional damage. Our case underlines the importance for the clinicians to consider a keratocyst in the differential diagnosis of cyst-like lesions presenting in an edentulous area.