Conventional Removable Dentures Research Articles

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.

Mandibular Bar-Retained Tooth-Supported Over Denture: Case Report

Alveolar bone loss is an inevitable consequence of tooth loss associated with old age. Increased alveolar bone resorption in mandible will lead to prosthetic concerns such as loss of retention and stability in the mandibular denture. Conventional removable complete dentures have long been the treatment of choice for complete edentulism, but it comparatively provides compromised retention, stability and poor masticatory efficiency, at times failing to meet expectations of the patients. To overcome these drawbacks, while retaining some of the remaining natural teeth which will aid in improved retention, stability and support, the concept of overdenture is seen as a patient-friendly and more successful alternative to conventional complete dentures. This case report discusses about the step by step procedure for the fabrication of a bar retained tooth-supported mandibular over-denture that opposes a conventional complete maxillary denture with an identification mark (Photographic method).

Prosthetic journey of magnets: a review.

Magnets have been widely used in dentistry as a means of retention in various prosthodontic applications. This review summarizes the historical background, types, and modes of action of magnets in dentistry, including their uses in conventional removable prostheses, sectional dentures, overdentures, maxillofacial prostheses, and implant-supported prostheses. A comprehensive electronic literature search was performed through multiple databases, including Medline via Pubmed, Wiley Online Library, Ebscohost, Science Direct, and Google Scholar. We used the following keywords: "magnets", "retention", "overdenture", and "maxillofacial prosthesis", with a focus on articles published between October 1953 and March 2016. We found 20 articles, and 16 were selected for inclusion in this review based on their relevance to the topic at hand. Recent advancements in magnetic technology have resulted in newer magnets that exhibit superior biological compatibility and corrosion resistance. These properties have made magnets an effective retentive aid intra- and extra-orally.

THE TECHNIQUE FOR MAKING AESTHETIC ACRYLIC RESIN REMOVABLE PARTIAL DENTURES IN AN ANTERIOR CROSS BITE CASE

Background: Certain cases such as anterior cross bites require a different aesthetic removable denture technique from the conventional removable denture. Purpose: To provide an overview of a case about the technique of making aesthetic acrylic resin removable partial dentures for anterior tooth replacement in cases of anterior cross bite. Case analysis: The study examined the working model with maxillary and mandibular anterior cross bite cases. Result: The arrangement of artificial teeth was carried out as ideally as possible, so that it became harmonious. In this case, the incisal artificial teeth 11, 12, 21 were brought forward labially, so that an edge-to-edge position was formed with the opposing teeth. The clasp made was a half jackson which was placed on teeth 15 and 25, so that when the patient smiles the clasp is not visible to fulfill the aesthetic requirements. Conclusion: The technique of making aesthetic removable partial dentures in cases of anterior cross bite that has received more attention is the arrangement of the dental elements because it is different from the normal tooth arrangement. The artificial teeth were arranged in edge-to-edge bite position in order to obtain a harmonious occlusion while taking into account of the labial arch of the adjacent tooth as well as occlusion with the opposing tooth.

PROSTHODONTIC MANAGEMENT OF KNIFE-EDGE RIDGE USING CUSTOMIZED PREFABRICATED METAL MESH CUSTOM TRAY IMPRESSION TECHNIQUE

Knife-edge ridge is a form of an alveolar ridge primarily caused by lateral resorption i.e. bone resorption on the buccal as well as lingual areas at a faster pace. It is usually a common clinical finding affecting the mandibular edentulous ridges; in particular, the mandibular anterior region. It can be attributed to a number of reasons i.e. the etiology is similar to the multifactorial etiology of the residual ridge resorption. The treatment options or management of knife- edge ridge generally includes a surgical and a non-surgical approach. The non-surgical approach involves the fabrication of conventional removable dentures using various modified impression materials &amp; techniques. Prosthetic management of the patients with knife-edge ridge is a testing situation for the prosthodontist. The basic principles of retention, support, and stability are important in defining the success of a complete denture; the same can be affected in unconventional situations like knife-edge ridge. The incorporation of the conventional impression techniques may lead to an unstable and an unsatisfactory denture. Therefore, various impression materials &amp; techniques have been proposed in literature to overcome such issues. This case report portrays an innovative and practical yet simple modified impression technique utilizing the incorporation of a customized prefabricated metal mesh into the custom tray i.e. single step impression technique using polyvinyl siloxane as the impression material of choice for managing the knife-edge ridge situation in the mandibular arch and ultimately ensuring a well-fitting prosthesis.

Management of atrophic jaws with all-on 4 concept - A review article

A typical condition in older patients is the event of edentulous, which can be the after effect of many factors like poor oral hygiene, dental caries, and periodontal problems. It has negative social and psychological effects on individuals that include adverse impacts on facial and oral esthetics, masticatory function, and speech abilities, that when combined, are translated into significant reductions in patients’ quality of lives. conventional removable complete dentures, implant-supported removable, &amp; fixed prosthesis are all the alternatives prosthetics options for restoring the edentulous jaws. The all-on-four concept is offered as an alternative to conventional implant applications in which four implants are placed in the inter foraminal region in the mandible and in the pre-maxillary region in total edentulism cases. The two anterior implants follow the jaw anatomy and the two distal implants are tilted at 45° angulation posteriorly. This arrangement allows for good implant anchorage, short cantilever length, and large inter implant distance thus favoring fruitful outcome of the treatment. The goal of this review is to determine the underlying principles of this concept and to illustrate the method's benefits and drawbacks.

Patient-reported outcome and cost-effectiveness analysis of milled and conventionally fabricated complete dentures in a university clinic: A retrospective study

Statement of problemThe custom disk is a novel method of complete denture fabrication; however, patient-reported outcomes and fabrication costs are unknown. PurposeThe purpose of this retrospective study was to evaluate general patient satisfaction with complete dentures fabricated through the custom disk method. In addition, a comparative cost-effectiveness analysis was conducted for the custom disk method and conventional removable complete dentures. Material and methodsComplete dentures were fabricated for 44 edentulous participants by using the custom disk method (n=20) or the conventional removable complete denture (n=24). General patient satisfaction was measured by using visual analog scales before and after denture fabrication and compared by using the Wilcoxon signed-rank test (α=.05); the fabrication cost for each method was investigated and compared by using the Mann-Whitney U test (α=.05). Cost-effectiveness was analyzed with the incremental cost-effectiveness ratio as incremental cost per change in general patient satisfaction for the custom disk method with respect to the conventional removable complete denture. ResultsThe median general patient satisfaction with the custom disk method and conventional removable complete denture after the intervention was 84.0 mm and 91.0 mm, respectively. General patient satisfaction with the custom disk method was significantly higher after the intervention (P=.002). The median labor costs for the custom disk method and conventional removable complete denture were 24 516 and 36 583 Japanese yen, respectively, and the difference was statistically significant (P<.001). The median of the total cost of the custom disk method and the conventional removable complete denture was 41 104 and 45 276 Japanese yen, respectively, and the difference was statistically significant (P=.004). The incremental cost-effectiveness ratio was −251.4. ConclusionsThe custom disk method improved general patient satisfaction. The labor and total costs of the custom disk method were significantly lower than those of the conventional removable complete denture. The incremental cost-effectiveness ratio demonstrated that the custom disk method was more cost-effective than the conventional removable complete denture.

English

Treatment of the edentulous dental arches with endosseous implant supported fixed prosthesis has gain popularity in dentistry. It has many advantages compared to a removable denture, including increased patient satisfaction, improved speech, aesthetics, function and confidence. Correct diagnosis and accurate implant planning lead to successful complete arch implant rehabilitation and hence, provide the patient with desirable aesthetic and functional outcomes. Edentulism can lead to complications in aesthetic, functional and psychological aspects of an individual. In earlier days, conventional complete denture prosthesis served as the sole line of treatment option for such cases. Nevertheless, most of the patients using conventional removable denture finds it difficult in adapting to their prosthesis due to psychological issues. Now a days, implant supported prosthesis give them an opportunity to lead a normal healthy life fulfilling their functional and aesthetic requirements.[1] One of the well documented treatment modalities in implant dentistry for patients with edentulous arches is the fixed implant rehabilitation with an implantsupported complete dental prosthesis. Beyond four decades of clinical experience emphasize the effectiveness of this technique.[2]

Prosthetic management of flabby ridge using customized prefabricated metal mesh custom tray impression technique: A case report

Flabby ridge is defined as an excessive mobile soft or fibrous tissue on the superficial aspect of the residual alveolar ridge. It is usually a common clinical finding affecting the maxillary and mandibular edentulous ridges; in particular, the maxillary anterior region. It can be attributed to a number of reasons i.e. long-term denture wearers, natural teeth opposing an edentulous ridge etc. The treatment options or management of flabby ridges generally include a surgical and a non-surgical approach. The non-surgical approach involves the implant-retained prostheses and fabrication of conventional removable dentures using various modified impression techniques. Prosthetic management of the patients with flabby ridge is a testing situation for the prosthodontist. Although, retention, support, and stability are the important principles defining the success of the complete denture, the same can be affected in unconventional situations like flabby ridge. The incorporation of the conventional impression techniques may lead to an unstable and an unsatisfactory denture. Henceforth, various impression techniques have been proposed in literature to overcome such issues and recording the entire denture bearing area in function along with flabby tissue in an undisplaced form. This case report portrays an innovative and practical yet simple modified impression technique using the incorporation of a customized prefabricated metal mesh into the custom tray i.e. single step impression technique along with the polyvinyl siloxane impression material for managing and minimizing the displacement of a flabby ridge in the maxillary arch and ultimately ensuring a well-fitting prosthesis.

Digital Telescopic Denture- A Viable Treatment Modality of Preventive Prosthodontics: Clinical Report

A telescopic denture is considered a good alternative to the conventional removable dentures as they provide better retention, stability, support, stable occlusion, decrease in the forward sliding of the prosthesis, and better control of the mandibular movements because of the proprioception feedback which increases the chewing efficiency. Well, fabricated prosthesis with good clinical and laboratory expertise and maintained with excellent care can be a successful one. The fabrication technique

Clinical effectiveness of implant support for distal extension removable partial dentures: functional evaluation using occlusal force measurement and masticatory efficiency

BackgroundImplant-supported removable partial dentures (ISRPD) are supported at the free-end region with implant retainers. As implant retainers prevent denture settlement and facilitate denture retention, this is intended to improve masticatory performance in comparison with that of conventional removable dentures. In the present study, we evaluated the effect of implant retainers at the free-end region of removable dentures on occlusal force and masticatory efficiency using a pressure-sensitive sheet, and measured glucose concentration in saliva after mastication with gummy candy.MethodsIn the present study, the occlusal force and masticatory efficiency of 13 subjects were measured in the following three conditions: without dentures (Condition 1), wearing dentures but not supported by implants (Condition 2), and wearing dentures supported by implants (ISRPD) (Condition 3). All data were statistically compared.ResultsRegarding the occlusal force, Condition 3 showed significantly higher scores than the other conditions; however, there were no significant differences between Conditions 1 and 2. Regarding the masticatory efficiency, Condition 3 showed significantly higher scores than Condition 2.ConclusionsWith ISRPD, the occlusal force and masticatory efficiency were increased in comparison with those with conventional removable dentures.

Mortality in Edentulous Patients: A Registry-Based Cohort Study in Sweden Comparing 8463 Patients Treated with Removable Dentures or Implant-Supported Dental Prostheses.

Objectives The purpose of this study was to investigate if edentulism is associated with all-cause mortality. The aims were to analyze the association between age, socioeconomic factors, and mortality in edentulous patients treated with either removable dentures or implant-supported prostheses. Methods All patients who became edentulous according to the Swedish Social Insurance Agency (SSIA) between 2009 and 2013 (N = 8463) were analyzed regarding prosthetic treatment, age, gender, and socioeconomic status. The patients were divided into two groups, depending on whether they were treated with dental implants (implant group; IG) or with conventional removable dentures (denture group; DG). Data on mortality for all included individuals were obtained from the Swedish National Cause of Death Register and compared to a reference population. Cumulative survival rates were calculated, and a multivariable regression analysis for the included variables was performed. Results Between 2009 and 2018, 2192 of the patients (25.9%) were treated with implant-supported dental prostheses (IG) and 6271 patients (74.1%) were treated with removable dentures without support of dental implants (DG). Altogether 2526 patients (30%) died until December 31, 2019, and the overall mortality was significantly higher for the DG compared to the IG during follow-up (p < 0.001). Younger edentulous patients (≤59 years) presented a higher mortality than the reference population, while implant patients over 79 years of age demonstrated a lower mortality. The final results from the multivariable logistic analysis showed that lower equalized disposable income (EDI) and the choice of conventional removable dentures are the most important factors for increased patient mortality (p < 0.001). Conclusions Edentulous patients have an overall higher mortality compared to a reference population. Low socioeconomic status increases all-cause mortality. Individuals treated with dental implants show statistically significant lower 10-year mortality compared to patients treated with conventional removable dentures, regardless of socioeconomic status.

Effect of peri-implant disease on oral health-related quality of life in geriatric patients.

This study aimed to evaluate the effect of peri-implant disease on the quality of life in geriatric patients using implant-supported overdentures. Peri-implant disease and bone loss are two main complications of dental implant treatment that can impact the quality of life in the geriatric population. This cross-sectional study included 109 geriatric individuals treated in the prosthodontics and periodontology departments. On clinical examination, periodontal pocket depth, gingival index (GI) and plaque index (PIn) were measured to determine peri-implant status. Marginal bone loss was measured by radiological examination, using ImageJ software. Moreover, the Oral Healthy Impact Profile-14 (OHIP-14) questionnaire was used to evaluate participants' perceived oral health-related quality of life. Peri-implantitis (PI) and peri-implant mucositis (PM) prevalence were 30% and 24%, respectively. Only 44% of patients had healthy implants. Although total OHIP-14 scores were higher in the PI group than in the healthy and PM groups, this difference was not statistically significant (P=.148). Total OHIP-14 score was significantly correlated with PIn and GI. Within the limitations of this study, it can be said that on quality of life in patients using implant-supported overdenture related to clinical parameters such as PIn and GI. Results also indicated that geriatric patients should take action to improve their oral health. Further longitudinal studies are needed to support our results and should include control groups that use conventional removable dentures.

An Innovative Cost-Effective Approach for Characterization of Removable Prosthesis - Case Series

Esthetics plays a crucial role in rehabilitation of removable dentures to achieve a pleasant smile. Denture esthetics is the effect produced, which improves the beauty and attractiveness of a person. With the advances of implants and ceramics, the conventional removable denture needs to be updated. denture characterization is a must in avoiding denture look and giving natural look. Giving the prosthesis as close as possible to the natural apparatus before the tooth loss is the key to a successful prosthetic, esthetic and functional rehabilitation. As a prosthodontist dealing in fulfilling the aesthetic challenges an economical alternative to high-end costly procedures is a must considering the Indian scenario, keeping in mind the biocompatibility and longevity of the treatment. As per literature light cure, gum staining is one of the techniques for masking denture base color and imparting natural color to mucosa but considering the cost involved many patients requiring aesthetic enhancement of prosthesis avoid going for such treatment thereby compromising their aesthetic. the present case series describe an innovative cost-effective alternative to the previously describe technique for masking the denture base color by using composite mixed with stains to replicate the natural apparatus.

Clinical outcomes and costs of conventional and digital complete dentures in a university clinic: A retrospective study

Statement of problemScientific data analyzing the clinical outcomes and costs of complete dentures fabricated by using conventional and computer-aided design and computer-aided manufacturing (CAD-CAM) processes are lacking. PurposeThe purpose of this retrospective study was to compare the treatment duration, financial costs, and postdelivery adjustments of CAD-CAM and conventional removable complete dentures. Material and methodsThirty-two edentulous participants (16 women, 16 men; age 35-85 years) who had received either CAD-CAM (n=16) or conventional (n=16) maxillary and mandibular removable complete dentures provided by prosthodontists with a minimum of 2 years of experience were evaluated. The CAD-CAM denture systems were either DDS-AV (AvaDent Digital Dental Solutions) (n=11) or DD-IV (Wieland Digital Denture) (n=5). The total treatment period (days) was recorded at 3 different time points (T0: preliminary alginate impression; T1: denture delivery; T2: last scheduled postdelivery adjustment). Adjustments during the follow-up (after T2) were noted and included the removal of areas of excessive pressure, relining, or repairs. The costs of the dental treatment and the laboratory fees were calculated. The Wilcoxon rank sum tests were used for statistical analysis (α=.05). ResultsNo statistically significant difference regarding the treatment duration between digitally and conventionally fabricated removable complete dentures was found: T0-T1 (P=.889); T1-T2 (P=.675); T2- T3 (P=.978). No significant difference was found in the number adjustments for areas of excessive pressure, relines, or repairs (P=.757, P=1.000, P=1.000) during the period. Laboratory costs of CAD-CAM removable complete dentures were significantly lower than those of conventional removable complete dentures (P<.001), but clinical fees were similar between groups (P=.596), resulting in a reduction in the overall total costs for the CAD-CAM removable complete dentures (P=.011). Regarding the number of clinical visits, neither the group (conventional/CAD-CAM (P=.945)/DDS-AV/DD-IV [P=.848]) nor the interaction group (conventional/CAD-CAM and DDS-AV/DD-IV)/period (P=.084/P=.171) showed any significant differences. ConclusionsCAD-CAM removable complete dentures can be considered a viable alternative to conventional removable complete dentures regarding treatment duration, clinical and follow-up visits, adjustments, and maintenance requirements.

Taxonomic Composition and Population Level of the Prosthetic Bed Mucosa Microbiota in Case of Dentition Defects in Patients Wearing Partial Dentures

The article considers the taxonomic composition and the population level of the oral cavity microbiota and changes in their characteristics after prosthetic rehabilitation with partial removable dentures. In the patients with partial loss of teeth wearing conventional removable dentures, the taxonomic composition of the gingiva microbiota changes due to the biotope contamination with opportunistic S. aureus and yeast-like fungi of the Candida genus, S. haemolyticus, K. pneumoniae, enterobacteria (E.coli, K.pneumoniae, E.cloacae), B.catarralis, M.lacunata and partial elimination of S. sialivarius, S.sanguis, S. mutans, S. mitis from the biota.&#x0D; The objective of the research was to study changes in the gingiva in the examined patients.&#x0D; Materials and Methods. Microbiological (bacteriological and mycotic) examination of gum mucus secretion in the patients with partial loss of teeth was performed. The control group consisted of 50 (23 men and 27 women) patients without any infectious and noncommunicable diseases, who had no problems adapting to removable denture during the last 6 months.&#x0D; Results and Discussion. In 78.72% of the patients, microorganisms isolated and identified from the surface of the prosthetic bed, were in associations that consisted of 2 (31.70%), 3 (8.51%) and 4 (8.51 %) taxons. The most numerous associations consisting of 2 taxons were: S. aureus and M. lacunata; S. aureus and N. flavescens; S. haemolyticus and B.catarrhalis as well as C. albicans and S. epidermidis. In the biotope (the surface of the gum mucosa of the prosthetic bed) of the patients wearing partial removable laminar dentures, the population level reduced in S. salivarius, S. sanguis, S. mutans, S. mitis and significantly increased in opportunistic staphylococci (S. aureus, S. haemolyties, S. epidermidis), S. pyogenes, enterobacteria (E. coli, K. pneumoniae, E. clocacae), B.catarrhalis. Microorganisms S. aureus and C. albicans reached a high population level; it increased in S. haemoliticus, S. epidermidis, S. pyogenes, E. coli, E. cloacae, K. pneumoniae as well.&#x0D; Conclusions. In the patients with partial loss of teeth wearing conventional removable dentures, the taxonomic composition of the gingiva microbiota changed due to the contamination of the habitat with opportunistic S. aureus and yeast-like fungi of the Candida genus, S. haemolyticus, K. pneumoniae, enterobacteria (E .coli, K. pneumoniae, E. cloacae), B. catarralis, M. lacunata and partial elimination of S. sialivarius, S.sanguis, S. mutans, S. mitis from the biota.

Access-post: An Answer to Compromised Retention in Fenestrated Denture around Single Standing Molar

Edentulism is a combination of physiological and pathological process and complete loss of teeth at any age may cause imbalance in stomatognathic system leading to impaired function and esthetic disfigurement. Therefore, modern dentistry is mainly focused on preventive prosthodontics which is an alternative philosophy to the conventional removable dentures and is based on preservation of what is remaining in healthy state. Overdentures and fenestrated dentures are two best examples based on this principle. Fenestrated dentures are most of the times fabricated on the request of the patient because keeping a single or few natural teeth will cause compromised retention and difficulty in setting occlusion, so never a suggestion from the clinician. What if retention factor can be eliminated? This article is presenting a case series of prosthetic rehabilitation of few remaining teeth where periodontally compromised teeth were used for retention by aiding them with access-post and sound molars were retained with fenestration in denture.

Preprosthetic correction procedures in patients with combination syndrome

The long-term use of complete maxillary dentures in the presence of natural residual anterior teeth may cause degenerative changes in the masticatory organ that are classified as signs of Kelly’s syndrome and pose a considerable reconstructive challenge. Failure to provide the patient with proper restorations aggravates destruction in the oral cavity, which is manifested as functional disorders and visible in the patient’s facial appearance. The aim of this paper is to present corrective procedures to be conducted before final prosthetic rehabilitation. The authors discuss the steps that need to be taken in the case of particular pathological symptoms linked with Kelly’s syndrome. The possibilities of prosthetic management with the use of conventional removable dentures and/or the application of intraosseous implants to optimize prosthetic treatment and prevent the destruction of the prosthetic base are also presented.

Rehabilitation With Implant Supported Fixed Prosthesis- A Case Report

Treatment of the edentulous patient with fixed reconstructions using multiple implants in both dental arches has many benefits compared to a conventional removable denture, including increased patient satisfaction, improved speech, aesthetics, function and self esteem. With a continuing increase in the use of implants, a significant percentage of edentulous population is benefitting from the advantages of fixed implant restorations. The choice of a suitable prosthesis for a specific case is determined to a great extent by the underlying residual bone volume as well as the teeth being replaced. The aim of the present case report is to describe the oral rehabilitation of a patient with a fixed implantsupported prosthesis.

Biomechanical effects of implant number and diameter on stress distributions in maxillary implant-supported overdentures

Statement of problemImplant-supported overdentures (ISOs) are considered a good alternative to conventional removable dentures. However, varying rates of failure have been reported in some clinical studies. Excessive stress on surrounding tissues is one of the possible causes of implant failure. As stress is transmitted to the bone through the implant, careful planning, correct number of implants, and implant positioning are keys to ensuring appropriate stress distribution. However, research of the optimal number of implants necessary to support a maxillary ISO is insufficient. PurposeThe purpose of this in vitro finite element study was to determine the optimal implant location, number, and diameter to support a maxillary ISO. Material and methodsThree-dimensional models of an atrophic maxilla, dental implants, and ball attachments were modeled, and different loading conditions were applied to simulate realistic conditions. Six models with different numbers and diameters of implants, including mini-dental implants and differently located implants, were formed, and stress values were compared by implementing a finite element analysis. ResultsThe study showed that, as the implant number increased, decreased stress values were observed in peri-implant bone and implants in the maxillary ISO prosthesis. However, changes in implant diameter had no significant effect on stresses. ConclusionsIncreasing the implant diameter was not advantageous; the use of mini-dental implants may be a viable alternative method. However, using 4 implants for maxillary ISOs is indicated.