Mandibular Ridge Research Articles

Comparative Evaluation of Mandibular Ridge Resorption in Post-menopausal Denture and Non-Denture-Wearing Females and Its Relation to Body Mass Index: An In-Vivo Study

Comparative Evaluation of Mandibular Ridge Resorption in Post-menopausal Denture and Non-Denture-Wearing Females and Its Relation to Body Mass Index: An In-Vivo Study

P-36725719-1377 - Evaluation of two computer-assisted personalized tenting membranes for management of mandibular ridge deficiency before implant placement

P-36725719-1377 - Evaluation of two computer-assisted personalized tenting membranes for management of mandibular ridge deficiency before implant placement

Myeloid sarcoma mimicking as recurrent squamous cell carcinoma: What is the etiology?

Abstract Introduction/Objective Myeloid sarcoma is an extramedullary malignancy of primitive myeloid cells and can occur during, preceding, or as a relapse of acute myeloid leukemia that occurs mostly in the soft tissue and skin. Methods/Case Report A 77-year-old white male with a history of oral squamous cell carcinoma status post resection (18 months ago) followed by radiation and chemotherapy (15 months prior), presented to the ear nose and throat clinic with increasing weakness and dizziness. He received two doses of Cisplatin and was currently on Pembrolizumab. On examination, there were two lesions in the oral cavity, one on the right gingivobuccal sulcus and a second on the left posterior mandibular ridge, suspicious for squamous cell carcinoma recurrence. Interestingly, the biopsy did not show evidence of recurrent squamous cell carcinoma but showed sheets of blasts that were positive for MPO, CD117, CD43, and CD68, consistent with myeloid sarcoma. Subsequent peripheral blood and bone marrow examinations showed acute myeloid leukemia. Results (if a Case Study enter NA) NA Conclusion Myeloid neoplasms post-cytotoxic therapy (MN-pCT) occur after radiation, alkylating agents, DNA topoisomerase II inhibitors, antimetabolites, and PARP1 inhibitors for a non-myeloid malignancy. Topoisomerase inhibitors are associated with MN-pCT after a latency period of 1 to 3 years; alkylating agents and radiation are associated with MN-pCT after a latency period of 5 to 7 years. Interestingly, this patient developed myeloid sarcoma in a previously irradiated area within 2 years. Cisplatin was discontinued after 2 doses due to side effect complications and is unlikely to be the culprit. Pembrolizumab is not considered to be a cytotoxic therapy and has not been reported to be associated with MN-pCT, however, the latency period for radiation-induced MN-pCT is unusually short in this patient and this raises the possibility of a Pembrolizumab-induced secondary myeloid neoplasm; additional investigation with other patients on this medication with second subsequent malignancies is required.

Quality of life in edentulous patients: the role of dentures

Preliminary findings from the SB Brazil 2022 indicate a decrease in complete denture usage among individuals aged 65 to 74 years. However, over 50% of the surveyed population still uses complete dentures which can impact the quality of life of full edentulous individuals in unexpected ways. This cross-sectional study evaluated the profile of a sample of edentulous individuals using public services and the impact of edentulism and oral rehabilitation on the quality of life of the participants. The profile was outlined by sociodemographic, clinical, and general health data collected from (n=52) patients' medical records treated between 2015 and 2019, and from edentulous patients undergoing treatment in 2021 at the Ribeirão Preto School of Dentistry (n=29). Interviews regarding the impact of edentulism and oral rehabilitation on quality of life were exclusively conducted with the patient’s undergoing treatment in 2021. The profile (n=81) showed descriptively. The data on the impact of edentulism and oral rehabilitation on quality of life were analyzed using the Spearman correlation test (p<0.05). Women were 70.4%, normal maxillary ridge height was 55.6%, and low or reabsorbed mandibular ridge height was 79%. Sadness was the most reported feeling (41.4%) and 62.1% were not prepared for the consequences of edentulism. Also, a strong positive correlation between “Psychological discomfort and disability” and “Oral/Orofacial pain and discomfort” domains was obtained (ρ=0.837). The results presented are in line with worldwide trends, and it indicates that edentulism and oral rehabilitation significantly influence overall health and quality of life.

Modified Combined Impression Technique for Cawood & Howell Class V/VI Mandibular Ridges: A Case Report

Geriatric prosthodontic rehabilitation with compromised residual ridge has become challenging, the principal concern being rejuvenating and maintaining complex stomatognathic functional harmony with severe residual ridge resorption (RRR). Modification of contemporary treatment techniques should be considered to achieve a patient’s functional and esthetic requirements. Contemporary prosthodontics utilizing combination of Neutral zone technique (NZ) and all green impression (AGI) for the management of Cawood & Howell Class V/VI (severely resorbed) ridges are innovative techniques for the construction of removable prosthesis with a profound effect in denture stability and retention, particularly in mandible. NZ implies the principle of synergistic activity of Oro-muscular function in denture stability by arranging the prosthetic teeth within the neutral zone area, hence preventing their interfere with the oro-muscular function, while AGI aimed at achieving prosthesis retention through functional moulding and the viscosity of impression material helps disseminate the forces transmitted to the denture-bearing area reducing the potential for discomfort arise from the soft tissue folds over atrophic ridge. This case report attempts to present a combination of modified impression techniques utilizing all green impression techniques and neutral zone techniques in a 66-year-old patient for C&H Class V mandibular ridge. The goal of this technique is to provide optimal stability covering the maximum denture bearing area and selectively distributing the pressure and to produce a denture molded by oro-muscular function in harmony with its surrounding structures thereby enhancing stability and retention.

In vitro Evaluation of Implant Impression Techniques and Elastomeric Materials: A Comparative Dimensional Accuracy Study

Abstract Context: Dimensional precision in implant impression. Aims: The purpose of this study was to comparatively evaluate the dimensional accuracy of two implant impression techniques with two different variants of vinyl polysiloxane impression material. Material and Methods: The edentulous mandible reference model was fabricated in clear resin. In the anterior region of the mandibular ridge, three dummy implants were placed in a spread-out configuration. Impressions were made using two elastomeric impression materials and two impression techniques using customised impression trays. Finished casts were then divided into four groups having four samples each. The mean centre-to-centre distances between adjacent analogues (in sample casts) and between adjacent implants (in the control cast) were measured with the help of a profile projector. Statistical Analysis Used: Data were analysed using Student’s t-test. Results: The open-tray technique showed more accurate results with a combination of medium body and light body, whereas in the closed tray technique, mono-phase vinyl polysiloxane appeared to be a better option. Amongst all, mono-phase with closed tray provided statistically significant results. P < 0.05 in Group C and other group’s P ≥ 0.05. Conclusions: Within the limitations of this study, both implant impression techniques appeared to be equally accurate depending on clinical conditions, temperature and time of the procedure. However, mono-phase impression material with closed tray provided statistically significant results.

Four locator attachments of mandibular implant-retained overdentures with two different distributions: A 10-year retrospective preliminary study of residual alveolar ridge changes.

There is little information on the long-term function of the four Locator attachment of the mandibular implant retained overdenture (OD), particularly with different distributions. To compare the effect of different four inter-foraminal implant distributions retaining a mandibular OD after 10 years of function on posterior mandibular ridge resorption (PMandRR), anterior maxillary ridge resorption (AMaxRR), and the amount of marginal bone loss (MBL) around all four implants. Twenty-two participants with total edentulism who had worn mandibular OVDs retained by four inter-foraminal implants for 10 years of functional life were selected for this study. They were divided into two groups based on implant distribution: Group I with a quadrilateral distribution (QD) of implants and Group II with a linear distribution (LD) of implants. PMandRR, AMaxRR, and MBL around implants were measured. After 10 years of function, PMandRR was significantly higher in the LD group than in the QD group (p < 0.001*). There was no significant difference in AMaxRR between the QD and LD groups (p = 0.431). The QD group showed a significantly greater amount of MBL around dental implants when compared with the LD group (p = 0.002*). The LD of implants demonstrates more PMandRR compared with the QD. The QD of implants demonstrates a greater amount of MBL around dental implants compared with the LD. Both implant distributions demonstrate the same effect on the AMaxRR. MBL around implants remained within normal accepted values after 10 years of function.

Complete denture treatment in a resorbed mandibular ridge with suction effective method and neutral zone technique using a semi-adjustable articulator: A case report

Complete denture treatment in a resorbed mandibular ridge with suction effective method and neutral zone technique using a semi-adjustable articulator: A case report

Effectiveness of Using the Magnetic Mallet for Ridge Splitting of the Narrow Posterior Mandibular Ridge with Simultaneous Implant Placement (A Clinical Trial)

Effectiveness of Using the Magnetic Mallet for Ridge Splitting of the Narrow Posterior Mandibular Ridge with Simultaneous Implant Placement (A Clinical Trial)

The influence of uneven placement of mini dental implants on retention form of lower complete over denture: An in vitro study

Objectives: This in vitro study aimed to evaluate the effect of placing two mini-dental implant (MDI) at different heights on the retention form of the lower over denture (OD). Materials and Methods: Sixteen acrylic mandibular blocks and their corresponding ODs were prepared and divided into four groups (four sets per group) to represent an atrophic mandibular ridge with two MDIs placed parallel to each other at inter-implant heights (IHs) of 0.0, 1.5, 3.0, and 4.5 mm. The OD blocks were mounted on a manual pulling stand and pulled vertically 12 times to measure the peak tension load (N). The data were analyzed using one-way analysis of variance (ANOVA), and the differences between the means were compared (P &lt; 0.05). Results: One-way ANOVA showed a statistically significant effect of IH on the retention force of the OD blocks (P &lt; 0.05). The mean retention force (N) for evenly placed MDIs was as follows: 32.2 ± 0.95, 1.5 mm IH: 30.1 ± 0.56, 3.0 mm IH: 26.1 ± 0.71, and 4.5 mm IH: 27.4 ± 0.90. Conclusion: The retention force of the OD blocks was significantly affected by the vertical inter-implant distance. A significant reduction in the mean retention force was observed for ODs retained by MDIs placed at an IH &gt;1.5 mm.

Assessment of various treatment techniques in restoring articulatory balance in the mastication center of occlusion

In clinical practice, due to various factors, we are facing patients with few teeth left in the lower jaw, often without any perspective. As a result of the reduced load capacity, they are loosened and can be completely lost. On the other hand, prosthodontics has a great potential for a unique implant - prosthetic rehabilitation. The goal is to preserve the alveolar ridge and slow down its resorption. With the advancement of the technology, conventional dentures are being replaced with more sophisticated therapeutic methods, such as modern prosthodontic superstructures. One of the latest solutions for this problem is the application of the Brånemark system (Nobel Biocare). These restorations that are applied represent a multi-unit system of implants and one hybrid prosthesis. This represents a mobile prosthetic suprastructure, which can be fixed with specific attachments on 4 implants. This combination of placement of a hybrid prosthetic structure on 4 implants is known as „all on four“. There are many discussions and writings about this multidisciplinary concept in the professional world. Over these 4 implants, a suprastructure with maximum 12 teeth can be immediately placed. The prosthetic construction circularly covers the entire toothless mandibular ridge. The data obtained from the patients show difference in the development of the bite force in the mastication center. The results have also shown a better quality of life in patients using a hybrid denture compared to the conventional prosthetic rehabilitation

Press-Fit Placement of a Rectangular Block Implant in the Resorbed Alveolar Ridge: Surgical and Biomechanical Considerations.

Rectangular Block Implant (RBIs) were manufactured, using computer-aided-design lathe turning, surface roughened with grit blasting and gamma irradiated. Implants were surgically placed into the resorbed edentulous mandibular ridges of both greyhound dogs (ex vivo and in vivo) and humans; the pooled total was 17 placements. The aim was to achieve mechanical stability and full implant submergence without damage to the mandibular canal and without bone fracture: fulfilment of all of these criteria was deemed to be a successful surgical outcome. Rectangular osteotomy sites were prepared with piezo surgical instrumentation. Sixteen implants were fully submerged and achieved good primary stability without bone fracture and without evidence of impingement of the mandibular canal. One implant placement was deemed a failure due to bone fracture: the event of a random successful outcome was rejected (p < 0.01 confidence, binomial analysis). Technique of placement yielded excellent mechanical retention: key biomechanical factors that emerged in this process included under preparation of the osteotomy site with the use of specifically designed trial-fit gauges, the viscoelastic property of the peri-implant bone, the flat faces and cornered edges of the block surfaces which enhance stress distribution and mechanical retention, respectively. It was concluded that the surgical protocol for the RBI placement in the resorbed alveolus is a predictable clinical procedure tailored to its specific, unique biomechanical profile.

Internally weighted mandibular denture: Addressing severe resorption for enhanced stability and comfort: A case report

The prosthetic rehabilitation resorbed mandibular ridges presents a clinical dilemma when opting not to proceed with endosteal implants. Over time, mandibular complete dentures supplemented with extra weight have demonstrated efficacy in meeting the requirements of patients with significantly resorbed ridges. The weight of such dentures, crafted from cast metal, has conventionally been calculated by taking into account the weight of the wax and the density of the alloy. This clinical report outlines the case of a 68-year-old woman with a significantly resorbed mandibular ridge, emphasizing the application of a weighted mandibular complete denture.

One-time definitive attachment connection versus healing abutment placement for an implant-retained mandibular overdenture: Peri-implant metabolic activity

Statement of problemUnscrewing the healing abutment can affect the soft tissue integration and apical migration of the biological width, which may compromise the integrity of peri-implant soft tissue. PurposeThe purpose of this clinical study was to determine the level of glycosaminoglycan (GAG) detected in the peri-implant crevicular fluid (PICF) between the test group (1-time abutment) and control group (healing abutment) for implant-retained mandibular overdentures. Material and methodsTwo dental implants were installed in the canine regions of the mandibular ridge of 18 healthy completely edentulous participants using 2-stage surgery and a delayed loading protocol. At the second stage surgery, the implant on the right side was exposed, and a healing abutment was screwed onto the implant (control group), while on the left side the definitive ball abutment was screwed onto the implant (test group). After 10 days, the healing abutment in the control group was unscrewed and replaced with the definitive ball abutment. For both groups, the ball attachment was directly picked up to incorporate the attachment house to the mandibular denture. PICF samples were collected from the participants at 7 days, 3 months, and 6 months after overdenture use. Statistical analysis was done with an independent samples t test (α=.05). ResultsA significant difference was found in the volume of PICF and the level of GAG between the test and control groups at the 7-day evaluation period (P=.008, P=.002, respectively), while the volumes of PICF and the levels of GAG were not significantly different (P>.05) at the other evaluation periods. ConclusionsThe 1-time abutment protocol offers biochemical and economic advantages compared with the conventional method of using the healing abutment before placement of the definitive attachment for an implant-retained overdenture with single attachments.

Occlusal equilibration and muscle activity in fixed versus removable mandibular implant supported overdenture

ObjectivesSingle denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular prosthetics. Therefore, this study assessed patients’ occlusal equilibration, muscle activity, and oral health-related quality of life (OHRQoL) receiving milled removable or fixed mandibular implant retained prostheses.Materials and methodsTwenty-two edentulous mandibular ridges patients were randomly distributed into two groups based on the definitive prosthesis received. Group I: Removable mandibular implant-supported overdenture, Group II: Implant retained fixed prosthesis. Occlusal equilibration was evaluated utilizing Occlusense, muscle activity via Electromyograph (EMG) at delivery, after one, and three months. The OHRQoL was evaluated by Oral Health Impact Profile questionnaire (OHIP-19) before delivery and after follow-ups. Data were collected, tabulated, and analyzed, utilizing independent t-test and One-way ANOVA followed Tukey`s post-hoc test. Significance level set at P ≤ 0.05.ResultsGroups I &II showed significant improvement in occlusal equilibration, muscle activity and OHRQoL. Group II demonstrated significantly higher improvement than group I in occlusal equilibration associated with muscle activity after 1 month, and in functional limitations domain in OHRQoL questionnaire after 3 months.ConclusionImplant retained mandibular prosthesis showed improvement in occlusal equilibration, muscle activity, and OHRQoL regardless of prosthesis type employed. Fixed implant-supported prosthesis revealed better outcomes than removable mandibular implant-supported overdenture concerning occlusal equilibration, muscle activity, and OHRQoL regarding functional limitations.Clinical relevanceImplant retained mandibular prosthesis is one of best treatment options for single mandibular completely edentulous patients, as dental implants improved occlusal equilibration, muscle activity, and OHRQoL.

Internally weighted denture for management of severely resorbed mandibular ridges : A case report.

Internally weighted denture for management of severely resorbed mandibular ridges : A case report.

Evaluation of the Success of Autogenous Block Grafting in Atrophic Maxillary and Mandibular Ridges Prior to and After Implant Placement.

Dental implantology's success relies on adequate bone volume and quality, necessitating bone augmentation for implant placement. Primary lateral bone augmentation, utilizing autogenous block grafts, addresses horizontal bone loss. This study aims to evaluate the efficacy of autogenous block grafting, specifically ramus and fibula blocks, in addressing severe atrophic ridges before and after implant placement. Twenty-one patients underwent block grafting, predominantly using the ramus technique (80/20 ratio). CBCT measurements assessed horizontal grafting outcomes. Implant success and bone volume changes were analyzed. Post-grafting, bone width increased from 1.8-3.1 mm to 4.5-6 mm, exceeding critical thresholds. Implant success reached 95%, indicating the grafting techniques' effectiveness. Autogenous block grafting, especially with ramus and fibula blocks, transforms severe atrophic ridges, enabling successful implant integration. Long-term follow-up is essential for a comprehensive evaluation. This study provides crucial insights into autogenous block grafting's transformative impact on challenging cases, guiding future applications in reconstructive dentistry.

3-Year Bone Remodeling in Mandibular Overdenture Wearers: Results from an RCT Comparing Immediate vs Conventional Loading Using Cone Beam Computed Tomography.

To evaluate the circumferential bone level and the morphological changes in posterior mandibular ridge of mandibular overdenture wearers submitted to conventional and immediate loading through cone beam computed tomography (CBCT) at 1 and 3 years. Twenty participants who received 2 NDI (Facility - 2.9x10 mm) were randomly allocated to the conventional loading (CL: n=10) or immediate loading (IL: n=10) groups. CBCT scans were performed in each group to analyze the vertical (VBL) and horizontal (HBL) bone level around the implants, analyzed together with the posterior bone remodeling of the mandible measured at distances of 5, 10, 15, and 20 mm from the mental foramen (L1-L4). Differences between groups were verified using the student t test at a significance level of 5%. The IL group showed a significantly higher HBL in the first year (P=.028) and a significantly higher VBL in the third year (P=.032), with HBL of -0.22 mm and VBL of -0.59 mm, respectively. After the third year, measurements of the percentage of cortical and medullar height indicated that the IL group presented a significantly higher percentage of cortical bone height (40.1 ± 9.3) compared to the CL group (31.8 ± 5.8) at position L1 (P=.05). No difference was found for posterior ridge remodeling (P>.05). IL group showed slightly higher values of HBL and VBL, and locally displayed more replacement of medullary by cortical bone. However, circumferential bone level values in the IL group are still clinically acceptable and the posterior resorption rate remained stable after 3 years of function, irrespective of the loading type.

Orthodontic wires: newer approach for impression making and neutral zone in severely resorbed mandibular ridge: A case report

The management of the resorbed mandibular ridge is a difficult task. Rehabilitating a patient who is completely edentulous is a common dental procedure, but it can sometimes be challenging and difficult. Making an impression with the available stock trays, even after modification, is difficult in extremely resorbed ridges.Many materials have been used to record and transfer the neutral zone in complete dentures. So here we present a new technique of making an impression with properly adapted wire for recording the impression along with recording the neutral zone with a heavy body addition silicone impression material that rests on the wire loops projecting upward on the denture base to achieve maximum retention and stability and also for the preservation of residual alveolar ridge.

Efectividad de los adhesivos disponibles comercialmente sobre la retención de prótesis removibles completas mandibulares en el reborde mandibular reabsorbido: un estudio in vitro

Background: Denture adhesives are alternatives used to improve retention, stability, comfort and satisfaction in patients with complete dentures. Evidence on the effectiveness of denture adhesives on resorbed mandibular ridges is scarce. Among the many commercially available denture adhesives, the ideal material for the severely resorbed mandibular ridge remains in dispute. Objective: The aim of this study was to evaluate the effectiveness of different quantities of four commercially available denture adhesives on the retention of mandibular complete dentures in severely resorbed ridges. Materials and Methods: A resorbed edentulous mandibular ridge model was manufactured in acrylic resin. A denture base was made and three loops were attached to it. Four commercially available denture adhesives (Fixodent, Perlie White, Fiftydent and Polident) were tested in amounts of 0.2 g, 0.4 g, 0.6 g, 0.8 g and 1.0 g. The acrylic resin model was evenly moistened with 1 ml of water and a weighted amount of adhesive material was applied to the denture base. The universal testing machine engaged the loops fixed on the denture base and applied the vertical displacement force. The maximum vertical displacement force values were recorded for each denture adhesive material at different amounts. Statistical calculation was performed using Kruskal Wallis with Bonferroni post hoc correction. Results: Statistically significant differences were observed in the mean values of the vertical displacement force for adhesive amounts of 0.2 g, 0.4 g, 0.6 g and 1.0 g (p&lt;0.05) between the four adhesive materials tested. Statistically significant differences were observed when four denture adhesives were compared to each other in different amounts (p&lt;0.05). Statistically significant differences were observed between different amounts for each of four denture adhesives (p&lt;0.05). Conclusions: Among the four materials tested, Polident showed greater effectiveness at 0.6 g and 0.8 g, Fittydent at 0.6 g, 0.8 g and 1 g, Fixodent at 0.4 g and 0.6 g and Perlie White at 1 g and 0.8g quantity to resist vertical displacement. forces on the severely resorbed mandibular crest. Using an appropriate amount of denture adhesive allows for proper retention of the denture; Replacement of this adhesive is necessary once a day.