Complete Denture Fabrication Research Articles

ASSESSMENT OF THE RELATIONSHIP OF INNER-CANTHAL DISTANCE AND INTERALAR WIDTH TO THE INTER-CANINE WIDTH AMONGST THE POPULATION OF Chitwan

Background: There are many techniques and methods for estimating the maxillary anterior teeth in edentulous patient. Inner-canthal and inter- alar width are one of the methods to establish inter-canine width. The objective of our study is to assess the relation of inner-canthal distance and inter-alar width with inter-canine width and canine-to-canine distance. Methods: Based on inclusion and exclusion criteria, 161 participants were selected. Four parameters, Inner-Canthal Distance, Inter-Alar Width, Inter-Canine Width and Canine tip to Canine tip were measured using digital Vernier caliper. Data entry was done in Microsoft Excel and data analysis on SPSS 21. Descriptive statistics and independent t-test were used. The Pearson’s correlation coefficient was used to find association between continuous variables like Inner-Canthal Distance and Inter-Alar Width with Inter-Canine Width and Canine tip to Canine tip width. Results: Strong positive correlation was found between Inner-Canthal Distance and Canine tip to Canine tip (+0.065) among males. the multiplying factor of Inter-Alar Width and Inner-Canthal Distance was 1.002 to obtain Inter-Canine Width. Similarly, the multiplying factor of Inter-Alar Width was 1.006 and Inner-Canthal Distance was 1.003 to obtain Canine tip to Canine tip. Moderate positive correlation was found between inner canthal distance and canine tip to canine tip among Mongolians and weak positive correlation among Aryans. Conclusions: Study showed that Inner-Canthal Distance and Inter-Alar width can be used to determine combined width of maxillary anterior teeth and tip of canine-to-canine distance in absence of pre-extraction records during complete denture fabrication.

Flexural strength of heat polymerized acrylic resin repaired with different reinforcing materials

Purpose: Heat cure methyl methacrylate has been the denture base material of choice for the fabrication of conventional complete dentures and transitional removable partial dentures. One of the factors that cause fracture is considered to be low resistance to impact, flexural or fatigue. However, dentures repaired with auto-polymerizing acrylic resin alone often experience a re-fracture at the repaired site. This study aimed to evaluate flexural strength of heat polymerized acrylic resin repaired with different reinforcing materials.
 Methods: 48 samples were prepared and divided into four groups. 12 samples were considered as controls, and 36 were divided into 3 experimental groups. The samples were sectioned into two halves from the middle, and were then repaired with rapid repair material, and reinforcing material. Each group was divided into 4 subgroups: unreinforced, reinforced with metal wire, metal mesh, and glass fiber. All specimens were subjected to a 3-point bending test, and the flexural strength was calculated. Results: all the reinforcement groups namely Stainless steel wire, metal mesh and glass fiber improves flexural strength of heat cured acrylic resin samples and glass fiber reinforced samples had the greatest flexural strength when compared with all other groups.

Complete denture fabrication using piezography technique for resorbed ridges: A Case Report.

Complete denture fabrication using piezography technique for resorbed ridges: A Case Report.

Accuracy of surface adaptation of complete denture bases fabricated using milling, material jetting, selective laser sintering, digital light processing, and conventional injection molding.

Milling-based, subtractive fabrication of digital complete dentures represents the computer-engineered manufacturing method of choice. However, efficient additive manufacturing technologies might also prove beneficial for the indication. The aim of the present study was to evaluate the accuracy of surface adaptation of complete denture bases fabricated using subtractive, additive, and conventional manufacturing techniques. A standardized edentulous maxillary model was digitally designed and milled. Twelve duplicated plaster casts were scanned and virtual denture bases designed accordingly. Physical complete denture bases (n = 12 per technique) were manufactured applying different digital and conventional fabrication methods: 1) CNC milling (MIL); 2) material jetting (MJ); 3) selective laser sintering (SLS); 4) digital light processing (DLP); and 5) conventional injection molding (INJ). The INJ group served as control. The intaglio surfaces of the denture bases were digitized and superposed with the surface data of the casts using a best-fit algorithm. Accuracy of surface adaptation was assessed by examining deviations. Statistical analysis was conducted using SPSS (P < 0.05). The milling of denture bases led to significantly better surface adaptation compared with all the other technologies (P < 0.001). The other fabrication methods in the study, including conventional manufacturing, revealed no considerable overall differences. As regards the accuracy of surface adaptation, all the investigated technologies adequately produced complete denture bases, with milled denture bases presenting the most superior results.

Relation of Vibrating Line to Location of Fovea Palatinae in Local Population

OBJECTIVE: The objective of this study was to assess the location of foveae palatinae in relation to vibrating line for developing posterior palatal seal to enhance retention of maxillary complete dentures. Retention of a complete denture is the major factor to resist the forces of dislodgement along the path of insertion. In complete denture fabrication, fovea palatinae is the guideline for the posterior extension in the maxilla. Fovea palatinae mucous gland secretion helps in the retention by forming a thin layer within the maxillary complete denture. METHODOLOGY: The study was conducted in Sharif College of Dentistry in Lahore, Pakistan on a sample size of two hundred and fifty dentate, partially dentate and edentate patients with different age groups. Clinical examination of the maxilla was conducted for assessment of the vibrating line, whether it was at, anterior to or posterior to the fovea palatinae. The researcher used an indelible pencil to mark the ah line i.e vibrating line and its distance with fovea palatinae was measured. RESULTS: Results were concluded using SPSS Version 23. The fovea palatinae were mostly found to be located at 1.68 mm±1.11 anterior to the vibrating line. Thus, the dentists should assess this distance for the posterior extension of the maxillary denture. CONCLUSION: Fovea palatinae location in relation to vibrating line is an important landmark for posterior palatal seal in a complete denture. In the majority of cases, fovea palatinae were located 1.68 mm±1.11 anterior to the vibrating line. KEYWORDS: Foveae Palatinae, Vibrating line, Retention, Posterior palatal seal.

Linear Dimensional Change in Acrylic Denture Teeth Positions Factored by Different Processing Techniques and Occlusal Forms: An In Vitro Study

The current literature lacks substantial evidence for the effect of denture base processing techniques and posterior denture tooth forms on denture tooth shifts due to denture base resin polymerization. The aim of this study was to evaluate the combined effect of PMMA-based denture processing techniques (compression packing and injection molding) and posterior tooth forms (semi-anatomic and non-anatomic) on the linear dimensional shift of denture teeth following denture processing in both horizontal and vertical dimensions. Two different complete denture fabrication techniques were used to prepare forty ideal maxillary complete dentures using two different types of posterior tooth forms. The used fabrication techniques were conventional heat polymerized compression packing and injection molding. The posterior tooth forms used in the current study were non-anatomic tooth (0 degrees) and semi-anatomic tooth forms (approximately 20 degrees). Initial linear measurements (vertical and horizontal) were taken from pre-specified points for the central incisor and first molar. Specimens were randomly divided into four groups (n = 10), and denture processing was performed using the two techniques. Final linear measurements were recorded. The linear change in dimension for all six parameters was calculated by deducting the after values from the before values. Since the discrepancies were both positive and negative in magnitude, the absolute value of the difference was taken for further analysis. This value represents the dimensional change. T-tests were used to compare the mean dimensional changes. Furthermore, the mean dimensional changes for all the six parameters were compared using a two-way analysis of variance. The alpha error was set at 5%, and a p-value of less than 0.05 was considered statistically significant. The injection molding technique showed significantly fewer tooth movements in both the vertical and horizontal measurements as compared to the conventional compression packing technique. The non-anatomic tooth showed significantly fewer changes in tooth movement as compared to semi-anatomic teeth in both the compression and injection techniques. This study can guide the selection of a proper processing technique for a particular posterior tooth form, thus minimizing occlusal discrepancies and reducing occlusal corrections during laboratory and clinical remount procedures.

Neutral zone concept for implant placement in mandibular overdentures: a case report

The objectives for complete denture fabrication are to provide comfort, function and aesthetics. The availability of implant-assisted overdentures has benefited complete denture wearers; however, the success of the prostheses can be further enhanced when the neutral zone concept is incorporated as a mean to locate the correct position of the implants, as well as the tooth arrangement for optimal outcome of the prescribed prostheses. CPD/Clinical Relevance: Use of the neutral zone concept to assist implant placement and teeth setting in a severely resorbed edentulous mandible is beneficial.

Comparative cost-analysis for removable complete dentures fabricated with conventional, partial, and complete digital workflows

Statement of problemComparative cost-analysis related to different manufacturing workflows for removable complete denture fabrication is seldom performed before the adoption of a new technology. PurposeThe purpose of this study was to compare the clinical and laboratory costs of removable complete dentures fabricated with a conventional (workflow C), a partial digital (workflow M), and a complete digital (workflow D) workflow and to calculate the break-even points for the implementation of digital technologies in complete denture fabrication. Material and methodsClinical and laboratory costs for each of the investigated workflows and the manufacturing options related to denture base and denture teeth fabrication were collected from 10 private Italian dental laboratories and clinics. The selected variables included the clinical and laboratory manufacturing time needed to complete each workflow (opportunity cost); costs for materials, labor, packaging, and shipping; and capital and fixed costs for software and hardware, including maintenance fees. The effect of manufacturing workflows and their options on the outcomes of interest was investigated by using generalized estimated equations models (α=.05). Cost minimization and sensitivity analysis were also performed, and break-even points were calculated for the equipment capital costs related to the implementation of workflows M and D. ResultsFrom a laboratory standpoint, workflows M and D and related manufacturing options significantly (P<.001) reduced manufacturing time (5.90 to 6.95 hours and 6.30 to 7.35 hours, respectively), and therefore the opportunity cost of each denture compared with workflow C. Workflow M allowed variable costs savings between 81 and 169 USD, while workflow D allowed for an additional saving of 34 USD. The sensitivity analysis showed that the break-even point related to the capital investment for the equipment needed to implement workflows M and D could be reached, depending on the manufacturing options adopted, between 170 and 933 dentures for workflow M and between 73 and 534 dentures for workflow D. From a clinical standpoint, workflows C and M were almost identical. Conversely, workflow D, which included intraoral scanning, required 1 fewer appointment, saving 0.6 hours of chairside time and about 14 USD for materials compared with M. ConclusionsDigital workflows (partial and complete digital workflows) were more efficient and cost-effective than the conventional method of fabricating removable complete dentures, with workflow D showing the lowest opportunity and variable costs and break-even point. Savings increased when stock denture teeth were replaced with milled denture teeth and still further with the adoption of 3-dimensionally (3D) printed denture teeth. Milling equipment and materials for denture base fabrication were more expensive than those for 3D-printing. Milling monobloc dentures reduced opportunity and labor costs but increased material cost.

Comparison of Dimensional Changes Between CAD-CAM Milled Complete Denture Bases and 3D Printed Complete Denture Bases: An In Vitro Study.

This study compared the dimensional changes between computer-aided design and computer-aided manufacturing (CAD-CAM) milled complete denture bases (CDBs) and three-dimensional (3D) printed CDBs. One maxillary completely edentulous stone model was fabricated with three reference points at the incisive papilla, right molar, and left molar areas marked as X, Y, and Z, respectively. It was scanned to produce a standard tessellation language (STL) file, which was imported to a metal milling machine software to produce the metal model. This metal model was used to fabricate 30 CDBs for analysis. The CDBs were divided into three groups (n = 10 each) according to the fabrication method used as follows: Group 1, CAD-CAM milled CDBs; Group 2, 3D printed CDBs; and Group 3, conventional compression molded CDBs. The CDBs of all groups were scanned after fabrication, and the dimensional changes in each were evaluated by two methods. The first was the two-dimensional evaluation method that involved linear measurement of the distances between the reference points (X-Y, X-Z, and Y-Z) of the scanned reference cast and dentures. The second method was the 3D evaluation method that involved the superimposition of the STL files of the dentures on the STL file of the reference cast. Data were calculated and were statistically analyzed using one-way analysis of variance and Tukey's pairwise post hoc tests. There was a significant difference in the dimensional accuracy between the CAD-CAM milled, 3D printed, and conventional compression molded CDBs (p < 0.05). The dimensional accuracy of the CAD-CAM milling system in complete denture fabrication is superior to that of the compression molding and 3D printing systems.

Hollow denture-a solution to post covid total maxillectomy patients: A case report

Retention, stability and support are the basic principles on which the success of a complete denture. The ability lies in applying these principles professionally in cases with total maxillectomy that are narrow and constricted with increased interarch space. This will provide decreased support, retention and stability and also increased weight of the processed denture will compromise them further and try to dislodge denture. This article highlights a technique for the fabrication of a hollow maxillary complete denture in situation where there is no ridge tissue due to total maxillectomy followed by post covid mucormycosis. Weight of a denture may be a contributing factor to the successful resolution of a patient’s problem; the hollow denture can be considered as one of the treatment modalities. The advantage of a hollow maxillary or mandibular denture is the reduction of excessive weight of acrylic resin, which normally replaces lost alveolar ridge in the interridge space of the denture wearer. This clinical report describes a case report of Total maxillectomy patient with resorbed ridges where a simplified technique of fabricating a light weight hollow maxillary complete denture was used for prosthodontics rehabilitation.

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.

Single implant overdenture – a more sustainable treatment option for resorbed mandible

Rehabilitation of edentulous patient is done by dentist with the fabrication of complete denture. It is commonly observed that mandibular dentures are not satisfactory when compared to maxillary denture due to centrifugal resorption of mandible. Thus rehabilitation of atrophied edentulous mandible by using implant to support and retain the prosthesis is an acceptable treatment option. It adds to the denture stability, increase masticatory efficiency and comfort of the patient. The present case report discuss about a patient with prosthodontics rehabilitation consisting of single implant supported overdenture.

Flangeless denture for prominent pre-maxilla: An excellent approach for restoring facial aesthetics: A case report

Complete denture fabrication is always challenging when intraoral conditions are not favourable and ideal. Ridge contour varies with patients and excessive bulky maxillary ridges often have a compromised facial aesthetics as well as retention. Restoring labial fullness in a completely edentulous patient is a sensitive procedure. The thickness of the labial flange further compromises the labial fullness and results in an unaesthetic maxillary denture. Surgical intervention is required for such clinical conditions. However, sometimes patients are unwilling to undergo any surgical procedure and hence, to confront such perplexity, an unconventional approach is required in which a prosthetic modification is done in the complete denture. In this article, a nonsurgical treatment approach with flangeless denture was considered in patient with severely proclined premaxilla with severe maxillary labial undercuts in completely edentulous patient to achieve comprehensive rehabilitation with greatest regard to aesthetics.

Fabrication of complete denture using digital technology in patient with mandibular deviation: a case report

Fabrication of complete denture using digital technology in patient with mandibular deviation: a case report

Closed mouth impression method for immediate complete denture fabrication on maxillary and mandibular flat ridges in medically compromised patient: A case report

Immediate complete denture is a full arch prosthetic, inserted immediately following the extraction of all remaining teeth to replace the missing dentition and associated structures. Female patient, 74 years old, came to make a new set of denture but didn’t want the remaining mobile teeth get extracted before the new denture ready because it was still needed for her old partial denture retention. Upon clinical examination, she has flat maxillary and mandibular ridge which will make the immediate denture fabrication more elaborate. She has also been taking antiplatelet drugs regularly after a heart valve surgery 10 years ago. The treatment of choice was immediate complete denture which will be fabricated using closed mouth impression method, and conscientiously planned to prevent post-extraction hemorrhage complication. It is considered that immediate complete denture will also help controlling post-extraction hemorrhage and promote healing on the extraction socket, as it aids as a surgical splint. This paper was aimed to report an immediate complete denture fabrication using closed mouth impression method on a flat maxillary and mandibular ridge in a medically compromised patient.

Closed mouth impression method for immediate complete denture fabrication on maxillary and mandibular flat ridges in medically compromised patient: A case report

Closed mouth impression method for immediate complete denture fabrication on maxillary and mandibular flat ridges in medically compromised patient: A case report

Comparative Masticatory Performance of Bilateral Balanced Occlusion and Lingualized Occlusion in Complete Denture Patients

Background: Both natural and artificial dentition has an occlusal scheme defined by the shape and positioning of the occlusal contacts. Complete denture fabrication has used a variety of occlusal designs that might have impact on stability of denture and masticatory function. Objective: To determine comparative masticatory performance of bilateral balanced occlusion and lingualized occlusion in complete denture patients Methodology: This study design was randomized trial carried out at the department of Prosthodontics, Altamash Institute of Dental Medicine for duration of six months. A total of 80 subjects were enrolled in the current study and were divided into two groups. Forty subjects were included in each group. In group LO subjects, complete dentures were provided with Lingualized occlusion whereas in group BBO participants, complete dentures were provided with bilateral balanced occlusion. All the required information’s including demographic features were documented in a predesigned Performa. SPSS version 19 was used to enter and analyze all of the data. Results: The mean weight of masticated peanuts in group LO was 5.30gm with standard deviation of 0.89 while in group BBO, the mean weight of masticated peanuts was 9.45gm with standard deviation of 2.10. The difference was significant statistically between two occlusions schemes (p=0.021). Conclusion: Our study concludes that masticatory efficiency was higher in complete dentures patients with lingualized occlusal than bilateral balanced occlusal scheme.. Keywords: Masticatory performance; Bilateral balanced occlusion; Lingualized occlusion

Topography of the location of mental foramen in dried edentulous human mandible and its clinical implication

The mental foramen is an oval or round opening on external surface of mandible and transmits mental nerve and vessels. Mostly located at apex of second mandibular premolar or between the apices of premolars. The study was commenced on 60 dried edentulous mandibles with the aim to determine location of mental foramen(MF) with reference to surrounding anatomical landmarks. By measuring its distance from midline (symphysis menti), posterior border of ramus of mandible, lower border of mandible. Length of lower border (Base) of mandible was also measured. In present study most common shape of mental foramen was round (70%). The mean distances of MF from midline are 24.36mm on right side and 24.15mm left side. From posterior border of ramus are 64.45mm on right side and 64.15mm on left side. From base of mandible are 12.29mm on right side and 12.48mm on left side. Length of base mandible (midline to angle of mandible) is 83.27mm right side and 83.12mm left side. Ratio of distance from symphysis menti to MF and length of base of mandible are same on both sides that are 0.29. There is statistically significant positive correlation between distance from symphysis menti to MF and length of base of mandible.The MF plays a very important role in treatment planning and its location needs to be considered prior to placement of dental-implants, regional anesthesia, osteotomy-surgeries and during complete denture-fabrication in order to avoid MN injury and related complications.

Faster, convenient &amp; effective: the single appointment complete denture: A new dental technique

Conventional complete denture fabrication is a traditionally multi appointment procedure which involves 5-6 steps. This creates a hassle for the geriatric clientele for the time, expense &amp; the travelling required for the completion of the treatment. On the other hand, the specialized techniques like BPS system or Digital dentures reduce the appointment schedule and the time taken to fabricate the dentures but these systems are highly technology specific and requires special armamentarium and has a learning curve attached to it. Hence a new technique comprising of 14 clinical and laboratory steps was developed in our department to provide complete dentures to the patients who has uncomplicated intraoral conditions and has time &amp; travel constraints in a single appointment without use of any specialized equipment.

Additive Manufacturing for Complete Denture Fabrication: A Narrative Review.

To evaluate and compare the benefits and limitations of additive manufacturing for complete denture fabrication. A PubMed and Google Scholar search for topics pertaining to additive manufacturing for complete dentures was performed. The resulting articles were then divided into topics to allow a narrative review. Determining how printing compares with conventional and milled dentures is critical for the widespread adoption of this fabrication technique. Physical properties, denture tooth bond strength, denture base adaptation and soft-liner bond strength are discussed to establish how printing compares. Printing offers many advantages over milled and conventionally processed dentures; however, many questions need to be answered by research. The advantages include reduced cost of most printers compared to milling machines, less material waste, ability to print multiple dentures simultaneously, and complex designs can be fabricated that otherwise could not be milled. Current research has shown flexural strength, fracture toughness, color stability, and denture base adaptation are reduced for printed dentures when compared with milled dentures. Print orientation has been shown to influence accuracy, strength, surface roughness and C. albicans adherence which is not seen with conventional or milled denture materials. These factors do not represent a criticism of printing but rather indicate the need for more research with this new and promising denture fabrication technique. Since printing offers numerous benefits to complete denture fabrication it is likely to have a more significant role in complete denture fabrication in years to come as knowledge increases and materials/techniques continue to advance.