Conventional Removable Prostheses Research Articles

Analysis of Satisfaction Levels in Completely Edentulous Patients Treated with Different Configurations of Implant Supported Rosthesis.

The aim of this study is to evaluate and compare patient satisfaction levels in edentulous patients treated with different configurations of implant supported prosthesis. Also, the effect of previous prosthesis experience before implant treatment on patient satisfaction was investigated. A study population of 142 patients was identified. Patients seperated into four treatment types. Group 1 comprised 43 patients treated with implant supported overdenture for mandible and conventional complete denture for maxilla while group 2 comprised 32 patients treated with implant supported overdentures for maxilla and mandible. Group 3 comprised 26 patients treated implant supported overdenture for mandible and fixed prosthesis for maxilla. Group 4 comprised 41 patients treated with implant supported maxillomandibular fixed restorations. A questionnaire consisting of specific issues about masticatory performance, pronunciation, comfort, social ability were used to evaluate treatment outcomes. The patients in group 4 were significantly more satisfied regarding masticatory performance than other treatment modalities. VAS scores of Group 3 and group 4 regarding comfort and social ability were similar while scores of these two groups were significantly higher than that of group 1 and 2. The patients who used conventional removable prosthesis before implant treatment were more satisfied with their implant supported prosthesis regarding social ability.(p=.03) Conclusion: It was found that treatment design of that implant supported fixed prosthesis on maxilla and implant overdenture on mandible provided comparable level of satisfaction with maxillomandibular fixed prosthesis for edentulous patients. Implant supported fixed prosthesis for maxilla and implant supported overdenture for mandible served as a practical alternative to satisfy patients especially in patients with mandibular atrophy who would demand extensive surgeries for maxillomandibular fixed prosthesis. Satisfaction level of implant supported overdenture was not superior to conventional prosthesis for maxilla. Previous removable prosthesis experience may influence social comfort of patients.

Two-Parts Bilateral Dse-Hinge Design Maxillary Denture Stabilizer

Nowadays, the adult patient male or female demand for esthetic as a first choice in relation to other factors. The current case report introduces a technique of treating a young patient with complicated problems of bad condition of remaining teeth with partially edentulous arch. In this study a new precession attachment (Dse-HINGE) design was used to make prosthodontic appliance more comfortable, and esthetically acceptable than traditional design removable partial denture. The results of this procedure showed a successful clinical treatments with fixed bridge and new Dse-Hinge attachment removable prosthesis. Finally, patient remarks a preferable esthetic, stabilization, retention, and more comfortable function results of fixed prosthesis with Dse-Hinge attachment in relation to previous conventional removable prosthesis.

Management of Edentulous Patients with Maxillary Substance Loss: A Case Report

Depending on the location and extent of the loss of substance following maxillary resection surgery, all functions of the masticatory apparatus may be adversely affected. Eating and communication are impaired, which has a negative impact on the patient's psychological state [1]. When reconstructive maxillofacial surgery is not possible, rehabilitation with a maxillofacial prosthesis is essential. It must restore functions (phonation, eating, breathing, etc.) and reintegrate the patient into his psychosocial environment by masking his disability [2]. To achieve these objectives, this prosthesis, like a conventional removable prosthesis, must meet the Housset triad (support - retention - stabilisation), but also the objective of tightness. We therefore speak of a "prosthetic tetrad in PMF" (Housset's triad completed by the objective of tightness) [3]. In the case of a completely edentulous arch with substance loss, the treatment becomes more complex due to the reduced support surface. The maxillofacial prosthodontist must therefore be extremely vigilant to ensure the success of this appliance. A wise choice of technique and impression material, as well as respect for the occlusal parameters (occlusal plane, vertical dimension, centric relation, etc.) will ensure prosthetic stability and integration [4]. In this article, we will focus on the peculiarities of the management and the different stages in the fabrication of a maxillofacial prosthesis for a patient with total edentulism and loss of maxillary substance.

Oral Rehabilitation of Marginal Maxillectomy Patient After Local Flap Reconstruction

The treatment of oral cancer can lead to various oral complications, including oral defects, tissue deformation, and trismus in patients who have undergone oral cancer surgery with resection of any part of the maxillary. Restoring the ability to chew, swallow, and maintain esthetics is essential and a significant challenge. The aim of this study was to report a successful clinical case of preprosthetic surgery and prosthetic rehabilitation of a 65-year-old man who had undergone marginal maxillectomy, resulting in tissue scarring and a significant reduction in maximal mouth opening. The oral rehabilitation was achieved using a conventional removable prosthesis. This case demonstrates that preprosthetic surgery combined with conventional removable prosthesis is an effective strategy for complex rehabilitations providing functional and esthetic improvement in the affected area for patients with marginal maxillectomies resulting from oral cancer.

Narrative Review on Prosthetic Reconstruction of Neurofibromatosis Cases Undergoing Hemi-Mandibu lectom

Neurofibromatosis (NF) is an autosomal-dominant inherited syndrome with teeth retention and complex tooth deficiencies which can affect swallowing, speech, esthetic, and airway patency. That’s where the rehabilitation of structures, functions, esthetics deformities, and life quality with different prosthetic choices should be considered. The present literature review inspected the prosthetic treatment plans to rehabilitate NF type 1 after hemi-mandibulectomy. By an extensive literatures search, some articles were chosen. The prosthetic treatment options for dental reconstruction of the hemi-mandibulectomy can be conventional removable prostheses, implant-supported fixed protheses, and implant-supported removable protheses. Ultimately, choosing among prosthetic treatment plans is made based on clinician opinion, patient preference, and ridge condition in each case.

Mini Dental Implants in the Stabilization of the Complete Mandibular Removable Prosthesis

Mini-implants represent a therapeutic alternative to conventional implants as they were proposed following the Mc Gill consensus. Their installation is faster, relatively simpler, reducing the postoperative course. Clinically, their use improves chewing and comfort. In the long term, the complications are fairly comparable to those encountered with prostheses using additional retention using conventional implants. In conclusion, this therapeutic solution represents an alternative to conventional implants, which can be proposed in response to the difficulties experienced by patients with unstable removable prostheses. The rehabilitation of a totally edentulous, resorbed mandible, with conventional removable prostheses, constitutes a very difficult challenge for the practitioner and often gives poor results in terms of satisfaction, comfort, stability and masticatory efficiency. Following the publication of the Mc Gill consensus of 2002, implant therapies appeared and became indisputable and uncontested. However, in some patients, the placement of so-called standard implants proves to be impossible due to the complexity of the protocols, the surgical consequences, sometimes an insufficient quantity of bone or even for economic reasons. In this context, the existence of mini-implants offers an interesting therapeutic alternative in totally bi-maxillary edentulous patients, wearers of complete maxillary removable prostheses and only in these cases.

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.

Characterization of Dentures for a Natural Esthetic Result: A Case Report

Background: Dental implants offer many viable clinical solutions, but there are patients when they cannot be chosen as the optimal plan. Conventional removable prostheses still come up as a functional option, and several techniques have been developed so that their appearance can be esthetically enhanced and, in certain circumstances, even customized. Case report: This paper presents a clinical case where new conventional dentures were manufactured for both jaws. The patient was complaining about the “artificial” appearance of the pre-existing restorations and was also diagnosed with depression, which was an extra challenge to be dealt with. Attention was also given to individualizing the esthetic performance utilizing materials and techniques for the characterization and customization of the dentures for a natural-like result, in accordance with all the clinical factors that influence the restoration in edentulous patients. Conclusion: As shown in the presented case, complete dentures remain a viable treatment plan. Especially via the process of characterization and customization, higher patient satisfaction and easier acceptance can be achieved.

Sociodemographic Factors and Implant Consideration by Patients Attending Removable Prosthodontics Clinics.

Objective This study is aimed at investigating the treatment options offered to and chosen by patients attending a student prosthodontics clinic and to investigate the effect of the sociodemographic background of participants on implant consideration. Material and Methods. A cross-sectional descriptive study was conducted on 200 participants including their socioeconomic background, treatment options presented, treatment preferences, and implant consideration. Bivariate tests (unpaired t-test, chi-square, and Mann–Whitney test) and Spearman correlation were used for comparison of different socioeconomic groups according to treatment preferences (implant consideration versus conventional removable prosthesis). Results Treatment options presented by dental students include 63.5% complete denture, 32% implants/removable dentures, and partial denture 4.5%. Conventional removable prostheses were mostly chosen due to low income. Implants were only considered by 26% of participants. Age and implant consideration had a significant negative correlation. No significant difference in gender and residency area on implant consideration was found. The chi-square test showed a significant difference between implant consideration and conventional removable prostheses in the various occupation groups. Conclusions Low income is the main factor prohibiting patients from considering dental implants. Age and educational level may play a considerable role in considering dental implants. There should be more emphasis on dental students' treatment planning education to include and explain dental implants as a treatment option for their patients in the prosthodontics clinic.

Management of Long Span Kennedy’s Class IV Situation with a Fixed Removable Entity

The treatment modality for treating a patient within the Kennedys class IV with long edentulous span situation demands biomechanical level of balance followed by good aesthetics. The long edentulous span complicates the matter due to the unavailability of sufficient number of abutments to support the synthetic oral prosthesis. Conventional removable prosthesis is not advised for an equivalent reason. This case report describes a way for the fabrication of a custom attachment to retain prosthesis. A cast partial removable denture is retained by a custom attachment. The patrix a part of the custom attachment is fabricated using castable semi precision attachment Rhien 83. The matrix a part of the attachment is fabricated using castable precision attachment 83 which is constituted by embedding inside the tissue-fitting surface of the prosthesis. This manuscript describes custom attachment for rehabilitating the long-span Kennedy class IV situation.

Digitalization of Conventional Removable Prosthesis: Cad-cam Dentures

During the last few decades significant advancements in the field of technology have been integrated in our day to day life. In the medical field and more specifically dentistry, one of the novel applications of robotic technology is the use of Artificial Intelligence in prosthodontics. Newer technologies have been consistently developed based on the principles that try to simulate the human brain functioning to develop solutions that do not just follow preprogrammed instructions, but also have some traits of the human’s such as the reasoning ability and experienced learning from practice without being programmed manually. Integrating CAD/CAM technology into removable denture designing and fabrication has helped in improvement of the quality of the dentures and simplification of the laboratory work. Manual laboratory procedures are either reduced or eliminated, thus enabling the dental technician and the dentist to ensure reproducibility and accuracy of prostheses. This reduces overall time requires in patient rehabilitation. This article presents a critical review on the application of CAD- CAM technology in removable prosthodontics and possible research directions in this field in the future.

Do implant-supported prostheses affect bioavailability of nutrients of complete and partially edentulous patients? A systematic review with meta-analysis

Summary Background & aims Debate still exists about the impact of dental implant-supported prostheses on nutritional status of partially and complete edentulous patients. This review aims to answer the focused question: “Do complete and partial edentulous patients, using implant-supported prostheses, present better nutritional and masticatory functions when compared to those using conventional rehabilitations?”. A possible cause–effect relationship between masticatory improvements and nutritional gain was also evaluated. Methods Literature search included 6 databases (PubMed/Medline, Embase, LILACS, Scopus, Web of Science, and The Cochrane Library - CENTRAL), grey literature (Google Scholar, Proquest Dissertations and Thesis and Open Grey databases) and manual search (last update June 2020), without language, publication time and follow-up restrictions. We included only studies evaluating both masticatory and nutritional outcomes. The PICO question comprised complete and partial edentulous patients (Population), submitted to implant-supported prostheses (Intervention), in comparison to conventional dental prosthetic rehabilitation, evaluating masticatory function and nutrition parameters (outcomes). Risk of bias was assessed by using Cochrane Collaboration's tool (randomized clinical trials), Joanna Briggs Institute critical appraisal checklist (paired clinical trials), and Meta-Analysis of Statistics Assessment and Review Instrument” (JBI - MAStARI) critical appraisal tools (cohort studies). All meta-analyses were conducted at 5% level of significance. This report followed the PRISMA guidelines. (Review registration PROSPERO - CRD42019135744). Results We identified 1199 articles while searching databases. Fourteen articles met eligibility criteria, including 817 prostheses installed in 660 patients (mean age = 66.8 years-old). Patients wearing implant overdentures (IOD) presented better masticatory function in comparison to conventional complete denture (CD) wearers (p Conclusion Current evidence indicates significant masticatory improvements for dental fixed implant-supported prostheses in comparison to conventional removable prostheses. However, bioavailability remained stable for most of the nutrients, especially for complete edentulous patients. These results indicate the importance of a multidisciplinary approach during oral rehabilitation (nutrient specialist), in order to enhance food choices and promote health benefits to the patients.

Use and need of removable dental prostheses in an institutionalized Brazilian elderly population: a cross-sectional study.

The aim of this study was to assess the use and need of conventional removable prostheses (total and partial) and their associated factors among institutionalized elders. A cross-sectional study was conducted with 1003 elderly people living in non-profit private long-term care institutions in Belo Horizonte, Brazil. Inclusion criteria required a minimum Mini Mental State of Examination (MMSE) score of 21. After the test, 191 individuals were included. Oral examination and interviews were conducted to identify participants' use (throughout the day/every day) and need (do not have/have but do not use) of removable dental prostheses. Socioeconomic health indicators and behaviours were collected from institutional records and via interviews. Bivariate analysis was performed using chi-square test (p<0.05). Poisson regression with robust variance was used in multivariate analysis. Most elders were female (76.4%) and independent in their daily activities (56.5%). Elderly men (PR 1.26) and those whose dental visit was more than one year ago (PR 1.38) showed higher need of dental prostheses. Elderly women (PR 1.68) and individuals with morbidities (PR 1.33) had higher prostheses use. This study demonstrates how socio-demographic characteristics, health indicators, and oral health services impact the use and need of dental prostheses among elders and how these can contribute to public oral health policy development.

Attachment-retained removable prostheses: Patient satisfaction and quality of life assessment

Statement of problemStudies on the impact of incorporating attachments in removable prostheses on patient-based outcomes are scarce. PurposeThe purpose of this clinical study was to investigate oral health–related quality of life (OHRQoL) and patient satisfaction in partially edentulous participants before and after rehabilitation with mandibular attachment-retained removable prostheses as compared with conventional removable prostheses. Material and methodsThis crossover study included 74 participants (aged 36 to 57). Initially, 56 received conventional clasp-retained removable dental prostheses (RDPs), and 18 received conventional overdentures (ODs) based on their mandibular partially edentulous state. Two months later, of the 56 RDP participants, 24 had received extracoronal attachment-retained RDPs, 17 received telescope-retained RDPs, and 15 received bar-attachment retained RDPs. The 18 OD participants received ball attachment–retained ODs. Assessments included Oral Health Impact Profile-short version-14 for OHRQoL and a visual analog scale (VAS) for patient satisfaction. Assessments were done before treatment and 2 months after wearing each prosthesis with a 1-month washout period. Statistical analysis included the Friedman then the Wilcoxon signed rank test for Oral Health Impact Profile-short version-14 scores and repeated measures ANOVA then the Bonferroni or paired t test for VAS scores (α=.05). ResultsThere were no dropouts. Rehabilitation, irrespective of prosthesis type, significantly improved OHRQoL in all domains and significantly increased overall patient satisfaction (P<.05). When compared with the conventional prostheses, attachment-retained prostheses significantly improved functional limitation, psychological discomfort, and physical limitation domains in all groups (P<.05), as well as the physical pain domain in the OD group (P=.041). General satisfaction, stability, comfort, ability to speak, and ability to masticate significantly increased (P<.05) with attachment-retained prostheses. Conventional prostheses were significantly easier to clean (P<.05) in all groups, except for the telescope-attachment group. ConclusionsBoth conventional and attachment-retained prostheses significantly increased patient satisfaction and improved OHRQoL in all domains as compared with before treatment. However, incorporation of attachments further improved functional limitation, psychological discomfort, and physical limitation domains in all groups, as well as the physical pain domain in the OD group. Participants were more satisfied with their attachment-retained prostheses in most aspects.

Britain's youngest implant patients? – A Case Series of implant treatment in children with ectodermal dysplasia

AbstractEctodermal dysplasia is a hereditary disorder that is characterised by abnormalities in the development of embryologically derived ectodermal tissues and structures. Many patients with this condition can present with oligodontia or anodontia. Subsequently, this can lead to aesthetic and functional problems that can have negative effects on self‐esteem, self‐image and overall quality of life. Therefore, for this group of patients, there is a demand for prosthetic treatment in early childhood that is effective in managing their specific issues. This case series presents a method of prosthetic rehabilitation that uses dental implant‐retained overdentures for two paediatric patients with ectodermal dysplasia. We discuss the treatment options and limitations of conventional removable prostheses for these patients, and the rationale for implant placement. Furthermore, we discuss the significance of the psychological well‐being of the child and the positive effects that this treatment can have during their crucial early years of development and school years. Currently, there is limited evidence available for the use of dental implants in children. Thus, a multi‐disciplinary team approach with appropriate planning and parental involvement is essential for successful outcomes.

Seven Years Follow-up of a Patient with Sjögren's Syndrome Treated with Implant-supported Fixed Prostheses

Sjögren's syndrome (SS) is a complex autoimmune disease that predominantly affects the exocrine glands, notably the salivary and lacrimal glands, resulting in dryness of the mucosa recognized as xerostomia. Chief oral complications reported by patients consist of high caries rate, burning sensation of the mucosa, early tooth loss, intensified tooth wear and repetitive failure of dental restorations. In particular, due to the decreased salivary flow, conventional removable prostheses might irritate the mucosa and lead to painful ulcerations at the borders of the denture. Implant-supported prostheses offer a unique solution to the difficulties experienced by edentulous patients with Sjögren’s syndrome. This research showed no signs of peri-implantitis or peri-implant mucositis during 7-years following the placement of implants. The present study indicates that successful long-term maintenance of dental implants can be also achieved in SS patients.

Dental implants in Sjögren syndrome

Sjögren's syndrome (SS) is a complex autoimmune disease that predominantly affects the exocrine glands, notably the salivary and lacrimal glands, resulting in dryness of the mucosa recognized as xerostomia. Chief oral complications reported by patients consist of high caries rate, burning sensation of the mucosa, early tooth loss, intensified tooth wear and repetitive failure of dental restorations. In particular, due to the decreased salivary flow, conventional removable prostheses might irritate the mucosa and lead to painful ulcerations at the borders of the denture. Implant-supported prostheses offer a unique solution to the difficulties experienced by edentulous patients with Sjögren’s syndrome. This research showed no signs of peri-implantitis or peri-implant mucositis during 7-years following the placement of implants. The present study indicates that successful long-term maintenance of dental implants can be also achieved in SS patients.

Unique, Cost-effective and Retentive Removable Prosthesis to Rehabilitate Long Span Kennedy&amp;#39;s Class I Edentulism with Custom Attachment System: A Case Report

This case report describes about a distinctive custom-made attachment on the abutment teeth to improve the retention and stability of the removable partial denture (RPD). It also throws light on the cost-effective method for altering the abutment teeth with the aid of the crowns and custom-made attachments. Achieving retention in Kennedy's class I bilateral edentulism usually affects the abutment teeth's periodontal health and eventually the retention is compromised. Distal extension edentulism also affects patient's masticatory efficiency. The rehabilitation of a patient with the long span Kennedy's class I condition complicates the problem because of the unavailability of enough abutments to support the prosthesis. Conventional removable prosthesis with clasps and cantilever fixed partial prosthesis are not advisable in this situation for the same reason. A case with Kennedy's class I modification 1 partially edentulous arch with 1st and 2nd molars missing along with central incisors was rehabilitated with an inexpensive custom attachment using die pin and sleeve for giving a fixed prosthesis on abutment teeth and removable prosthesis with missing teeth. This technique has advantages of retention better than conventional RPDs, protection of abutment health by restoring it with crown, easy to place and remove and very cost-effective. The entire technique demands less skill compared to semi precision and precision attachments.

Mastication and oral health–related quality of life in removable denture wearers with Alzheimer disease

Statement of problemAlzheimer disease (AD) can affect masticatory function, affecting oral health–related quality of life (OHRQoL). Whether oral rehabilitation with conventional removable prostheses can restore masticatory function and improve OHRQoL in these individuals is unknown. PurposeThe purpose of this clinical study was to evaluate the influence of oral rehabilitation with removable prostheses on masticatory efficiency and OHRQoL in elders with and without AD. Material and methodsThirty-two elders with mild AD (n=16, mean age=76.7 ±6.3 years) or without AD (n=16, mean age=75.2 ±4.4 years) were recruited. All participants first underwent masticatory efficiency and OHRQoL evaluations, and 2 months after insertion of new removable prostheses, the variables were reassessed. Masticatory efficiency was determined using the sieving method, and OHRQoL was measured by applying the Geriatric Oral Health Assessment Index (GOHAI). The data from the baseline and after insertion of the new removable prostheses were compared by paired t test. Group differences at each time point were assessed by t test (α=.05). ResultsAfter insertion of the new removable prostheses, masticatory efficiency and OHRQoL improved in both the elders with AD and the control. At baseline, elders with AD had lower masticatory efficiency and higher OHRQoL than controls (P<.05). After removable prosthesis insertion, elders with AD continued to show lower masticatory efficiency values than controls, but their OHRQoL was similar. ConclusionsOral rehabilitation with new removable prostheses improved the masticatory efficiency and OHRQoL of elders with and without AD, although masticatory efficiency did not reach control levels in elders with AD.

Impact of fixed implant supported prostheses in edentulous patients: protocol for a systematic review

IntroductionEdentulism is a debilitating and irreversible condition described as the ‘final marker of disease burden for oral health’. Therapy with dental implants is being used on a large scale to...