Complete Denture Fabrication Research Articles

A modified impression technique for flabby and severely atrophic mandibular ridge: A case report

Complete denture fabrication in clinically compromised situations such as flabby ridge and/ or atrophic ridge is a challenging task for the prosthodontist for years. Flabby ridge and highly resorbed residual mandibular ridge is commonly observed in older patients. Accurate impressioning of these tissues plays a major role in ensuring a well-fitting and stable prosthesis. This article describes a technique for making a definitive impression for highly displaceable and resorbed residual ridges. The technique is especially applicable for mandibular edentulous ridges. The choice of the impression materials, as well as the design of the impression tray, focuses on preventing distortion of the displaceable residual ridges during impression making.

A literature review on esthetics in complete denture

Denture esthetics in the field of prosthodontics has become a prime most demand of the edentulous patients in the recent time. The different processes that are required in the fabrication of complete denture in terms of esthetics constitutes from impression making, selection of teeth, occlusion, proper vertical dimension, accurate recording of the occlusal plane and a good smile line.

Window denture: An unconventional approach for the bulky edentulous ridges

Prosthetic rehabilitation in patients having prominent labial ridge with conventional complete denture is an uphill task. Severe labial ridge undercuts are commonly seen incompletely edentulous maxilla than in mandible. This may be attributed to the fact related to the proclined maxillary anteriors, indicated for extraction. Treatment approaches generally involve either a surgical or a non-surgical option. The non-surgical or the prosthetic option generally involves the fabrication of conventional complete denture, which may further compromise the esthetics due to excessive thickness of the labial flange. To challenge such situations, an unconventional approach is needed for fabricating a complete denture. This case report delineates a simple, economical, conservative and non-surgical treatment approach for fabrication of denture in a patient with excessive bulky maxillary ridge, to pronounce the final facial aesthetics of the patient.

Current Status of Digital Complete Dentures Technology

Fabrication of complete dentures (CDs) utilizing computer-aided design and computer-aided manufacturing (CAD/CAM) methods has attracted a lot of attention. The purpose of this paper was to summarize current knowledge about digital CDs and the relevant technology, and to present the application of the new technology in a dental geriatrics case. Initially, some of the challenges regarding digitization of the oral mucosa as a supporting surface of the CDs’ intaglio surface are listed. Next, a brief introduction of the CAD software capabilities regarding CDs is presented. The latest CAM additive and subtractive techniques for CDs are following. Subsequently, the consecutive steps for the construction of a digital CD as part of the prosthodontic treatment of a 90-year-old ambulative female patient are presented. Finally, some considerations about the digital workflow in CD manufacturing are discussed. In conclusion, the new digital technology has clear advantages; however, implementation requires careful planning. The digital workflow is applicable and versatile.

English

This article describes the fabrication of a hollow maxillary complete denture using silicone putty and a double flask technique. A successful complete denture directly depends on retention, stability and support accompanied by good aesthetics. However, in case of atrophic edentulous ridges the challenge lies in the fact that there is a significantly lesser denture bearing area that can lead to a number of problems. The most important of these is an increased interarch space resulting from excessive resorption of upper or lower arch. This can lead to a resulting heavy complete denture that further deteriorates the bone condition due to excessive and continuous load, accelerating bone resorption. Moreover, there is no effective support to deal with any kind of harmful lateral forces and this can lead to dislodgment of the denture. The operator’s efficiency lies in applying the basic principles of fabricating a denture and innovating various steps to counter critical situations. Various methods such as asbestos, silicone putty, modelling clay, thermocol, salt, wax have been used for creating a hollow space inside the denture. Out of the various methods that have been used for fabrication of a hollow space inside a complete denture, silicone putty method is one of the more convenient and accurate method for achieving the objective, thereby rendering a lighter prosthesis. A hollow maxillary denture is highly advantageous as it reduces the weight of acrylic resin, thereby preserving the residual alveolar ridge. It also helps in stability of the denture by indirectly reducing the lateral forces.

Fabrication of Metal-Reinforced Complete Dentures Using the CAD-CAM Technique

The digital manufacture of complete dentures would greatly simplify the workflow; however, the metal-reinforced complete dentures production method has not been well established. This article describes a technique of fabricating metal-reinforced complete dentures in a milling machine using the geometry guide, a negative impression of the occlusal surface of the metal-reinforced complete denture designed using the computer-aided design software. The geometry guide supports and stabilizes the artificial teeth and metal framework in the correct position in the surrounding resin. Fabrication of metal-reinforced dental prosthesis using the digital technique is possible with this method.

Trends In The Development Of The Techologies For Fabrication Of Complete Dentures For Patients With Total Tooth Loss

Total tooth loss leads to significant changes in the maxillofacial region, which affects the masticatory function, speech, esthetic outlook, reflexes and the human psyche. The facial frame obtains the so-called “ageing look”. The extraoral changes, especially after a quick complete tooth loss, are shocking both for the patients and for those around them. The treatment plan for these patients requires the fabrication of complete dentures. The technologies for the production of this type of construction have undergone their own evolution. From the classic cuvette technique with acrylic plastic to the digital fabrication with the help of CAD-CAM milling and 3D printing. The aim of the current article is to trace the development of the technologies for fabrication of complete dentures in patients after total tooth loss highlighting the main trends. Today, 50 million dentures are produced globally every year, but only 1% are fabricated with the help of digital instruments. The traditional denture fabrication is a time- and labor-consuming process. The production process for the construction of a digital denture is different from the traditional one. The digital denture production is the future of dental technology. It has the potential to provide a lower price and higher quality care for the patients. Digital technologies do not deprive complete dentures of the possibility of customization. Digital denture designs can be used multiple times but, when needed, can be altered. The endurance and mechanical properties and bio-compatibility of the constructions are much better compared to those fabricated using conventional technologies. Digitization and 3D printing are a means to a reliable, predictable and highly esthetic treatment.

The Validity of Retromolar Pad as an Intraoral Landmark in the Fabrication of Complete Dentures - A Short Review

The Validity of Retromolar Pad as an Intraoral Landmark in the Fabrication of Complete Dentures - A Short Review

Unconventional denture fabrication technique for patient with increased vertical dimension: An innovative alternative

The success of complete denture depends upon the principles of retention, stability, and support. Increased interridge space due to Progressive resorption of alveolar ridge mainly because of disuse atrophy often lead to fabrication of complete denture with exceptional heavy-weighted which has inherent ability for action of leverage forces, hence affecting the retention, stability, and support. This article describes the case of a completely edentulous patient with increased interridge space, which was successfully rehabilitated with a hollow denture fabricated using corrective compound impression technique and Alternative Technique to Remove the Silicone Putty.

A Prosthetic management of flabby ridge in complete denture fabrication – A Case Report

The fabrication of Complete dentures with good retention and stability on flabby ridges poses an arduous task to the clinician. Accurate impressions are first step towards a well-fitting prosthesis. Methods applied for flabby ridge management includes surgical removal, special impression techniques and implant therapy. Special impressions often involve window technique for static impression of flabby area, which present multiple challenges. In this article, a newer technique of impression making of the flabby tissues using a combination of readily available newer and older materials is done to ensure an accurate and easy impression of these tissues.

Digital Workflow to Fabricate Complete Dentures for Edentulous Patients Using a Reversing and Superimposing Technique

This technical procedure demonstrates a 4-step completely digital workflow for the fabrication of complete dentures in edentulous patients. The digital scan data of the edentulous arches were obtained using an intraoral scanner, followed by the fabrication of modeless trial denture bases using additive manufacturing. Using the trial denture base and a wax rim assembly, the interarch relationship was recorded. This record was digitized using an intraoral scanner and reversed for each maxillary and mandibular section individually. The digital scan data directly obtained using the intraoral scanner were superimposed over the reversed data, establishing a proper interarch relationship. The artificial teeth were arranged virtually and try-in dentures were additively manufactured. Subsequently, the gingival and tooth sections were additively manufactured individually and characterized. Thus, fabrication of digital complete dentures can be accomplished using digital data characteristics. The workflow includes data acquisition using an intraoral scanner, data processing using reverse engineering and computer-aided design software programs, and additive manufacturing.

Complete-Denture Aesthetics Revisited in the Digital Age

Background: The objective of this review is to elucidate the principles of complete denture aesthetics and establish a rationale for a digital workflow for chairside arrangement of artificial teeth.Types of studies reviewed: Articles were culled on the topic of complete denture aesthetics and the digital fabrication of complete dentures. These included systematic and literature review articles as well as clinical, descriptive and in vitro studies that range from 1958 to 2020 using PubMed and Web of Science databases.Results: Biometric measurements have been illuminated over the last 60 years, serving as a basis for analogue and digital denture aesthetics. However, a number of studies have shown that individual arrangement of the anterior teeth is essential to capture asymmetry and balance in the setup. This review highlights that customization of the smile is optimally done chairside with patient feedback. A proof of concept was identified from the literature to incorporate a wax try-in in the digital workflow.Practical implications: Given the heightened value placed on aesthetics in dentistry, a review of complete denture aesthetics will enhance the clinician’s skillset, and incorporating a chairside try-in in the digital workflow will lead to more authentic prostheses.

Effect of Food Colorants on Color of Denture Base Acrylic Resins.

Background:Acrylic resin has been successfully used for complete denture fabrication for many years. Color stability is very crucial clinical properties for dental materials, and color change may be an indicator of aging or damaging of materials.Aim and Objectives:This study has been designed to determine the color stability of heat cure denture base acrylic resins in commonly consumed solutions causing stains.Methodology:Four hundred disc samples of four commercially used heat cure denture base resins (Trevalon®, DPI®, Veracril®, and Pyrax®) were fabricated (100 in each group). These were checked for any change in optical density by immersing them in four different staining solutions (tea, coffee, turmeric, and betel leaf, i.e., paan) and synthetic saliva for 1-month synthetic saliva was taken as control. The denture cleansers were also evaluated for their efficacy determined by their ability to remove the stains caused by the staining solutions.Results:It was observed that Trevalon® showed least change in optical density and coffee illustrated the maximum potential for staining the denture base resins and is the most difficult to be removed using a denture cleanser.Conclusion:It can be concluded that Trevalon® demonstrated maximum color stability. Among the staining solutions, coffee caused maximum stains.

A technique for selecting complete denture teeth by attaching printed tooth mold images

Tooth selection for complete denture patients has been assisted by different anthropometric studies of individuals from various ethnicities.1-4 However, it may be difficult for the patient to evaluate the esthetic outcome until the tooth arrangement is completed. Although digital dentistry has enabled visualizing the outcome with a digital trial restoration, the expensive software program and complex workflow may make these procedures inaccessible for many practices, and it may be many years before it becomes routine for complete denture fabrication.

Digitally Fabricated Removable Complete Denture Clinical Workflows using Additive Manufacturing Techniques.

The use of computer aided design and computer aided manufacturing in the fabrication of complete removable dentures has demonstrated that the prostheses produced are superior in many ways to removable dentures produced using analog techniques. A variety of clinical workflows that take advantage of digital technology have been shown to shorten the number of appointments required to produce high quality prostheses. This paper presents an overview of additive manufacturing in contemporary removable complete denture workflows and describes effective three appointment clinical techniques using additive manufacturing to produce a clinical trial denture and definitive prosthesis.

Incorporating Digital Dentures into Clinical Practice: Flexible Workflows and Improved Clinical Outcomes.

Replacement of missing teeth with complete denture prostheses have been successfully accomplished for decades. However, limitations of denture materials and the number of appointments required to fabricate new or replacement complete dentures preclude practicality. New innovations involving a partially or completely digital workflow facilitate the fabrication of complete dentures in fewer, shorter appointments, and by incorporating materials that exhibit improved physical properties. The purpose of this manuscript is to describe the variety of workflows that can be implemented to incorporate digital denture fabrication into clinical practice.

CAD/CAM Complete Denture Systems and Physical Properties: A Review of the Literature

CAD/CAM complete dentures have increased in popularity and a wide variety of systems are currently available. These prostheses present many advantages for clinicians, technicians and patients. Subtractive manufacturing is used by most of the available systems while a few manufacturers use an additive manufacturing technique. This article describes the currently available systems and materials available for the fabrication of CAD/CAM complete dentures and reviews the literature relative to their physical properties. A comprehensive review of the literature was completed to enumerate the currently available techniques to fabricate CAD/CAM complete dentures and discuss their physical properties. A search of English language peer-reviewed literature was undertaken using MEDLINE and PubMed on research articles published between 2000 and 2019. A hand search of relevant dental journals was also completed. The literature indicates the physical properties of CAD/CAM milled poly(methylmethacrylate) or PMMA as it is commonly described is superior to conventionally processed PMMA for the fabrication of complete dentures. The incorporation of CAD/CAM technology into complete denture design and fabrication streamlines the clinical and laboratory processes and provides improved physical properties that enhance denture quality.

Neutral Zone Technique for Complete Denture Fabrication in Severely Resorbed Maxillary and Mandibular Ridge: Case Report

Neutral Zone Technique for Complete Denture Fabrication in Severely Resorbed Maxillary and Mandibular Ridge: Case Report

Gum fit denture: Dentures befitting labial undercut to improve esthetics in anterior maxilla

In our day to day practice we come across patients who present with different forms of residual ridges i.e well formed ridges, severely resorbed or bulbous ridges. An excessively bulky maxillary ridge accompanied by a labial undercut and an inclined pre maxilla can compromise the facial esthetics. The thickness of the labial flange can further compromise the labial fullness and result in an unesthetic maxillary denture. So, in such clinical situations an unconventional approach may be considered for the fabrication of complete denture. This case report thus, describes a simple, economical, conservative and non-surgical treatment modality for fabrication of denture in a patient with a bulky maxillary ridge with a prominent labial undercut to enhance the facial esthetics of the patient.

Computerized occlusal forces analysis in complete dentures fabricated by additive and subtractive techniques.

Fabrication of complete dentures by computer-aided designing and computer-aided manufacturing (CAD-CAM) techniques are now common. Subtractive and Additive are the two principal CAD-CAM techniques used for this purpose. However, studies that evaluated the occlusal forces by CDs manufactured by these techniques are lacking. To compare the occlusal forces in complete dentures fabricated by additive, subtractive and conventional techniques with different occlusal schemes, using computerized occlusal force analysis system [Tech-Scan III (T-Scan III)]. Three groups (Gr) were made on the basis of techniques of fabrication of CDs: Conventional CDs (CCD), Subtractive CDs (SCD), and Additive CDs (ACD). Each group CDs were further divided into three sub groups based on occlusion schemes: bilateral balanced occlusion (BBO), lingualized occlusion (LO) and mono plane occlusion (MO). A total of 45 CDs were made: 15 in each group with 5 CDs of each occlusal scheme. For all samples, occlusal force analysis (percentage of occlusal force applied on the right and left sides of the arch, centralization of forces and percentage of maximum occlusal force) was done using computerized occlusal analysis system: T-Scan III. Univariate regression analysis and logistic regression analysis were used to find the effects of the technique of fabrication and occlusion scheme over the occlusal forces (p< 0.05). The intergroup comparison revealed statistically significant differences (p< 0.01) in right-left side force difference, maximum bite force in CDs fabricated by various techniques and with different occlusion schemes. Though the effect of occlusion scheme was more than the technique of fabrication (according to effect size estimation). The maximum force difference between right-left side was observed in combination of CCD technique and MO scheme (36.88 ± 2.82 N). Furthermore, the maximum bite force was observed for SCD technique (89.14 ± 6.08 N) and LO scheme (92.17 ± 3.22 N). In comparison to ACD, the chances of centre of force out of ellipse was 2.53 time more in CCS and 0.75 times less in SCD techniques and in comparison to MO, the chances of out of ellipse was 0.298 times less in BBO and 0.396 times less in LO schemes, though these chances were not statistically significant (p> 0.05). The digital CDs fabricated by subtractive technique were proved to be superior to additive technique in terms of occlusal force analysis on tested parameters. However, further research is needed on patients to determine the exact superiority of one technique over the other.