Placement Of Complete Dentures Research Articles

Digital workflow of labial guides for alveolar ridge reduction during implant-supported full-arch rehabilitation.

This article presents a technique for fabricating two-piece labial guides using resin and cobalt-chromium for guided alveoloplasty, implant placement, and immediate full-arch implant-supported fixed complete denture placement. This technique reduces tissue damage and overcomes the negative effect of the anatomical position of the palatal neuropore and mobility of the tissue flap on the positioning and stability of the guide. The use of labial retention metal guides with improved mechanical properties of cobalt-chromium and fixation plugs allows the unilateral placement of the guide. Thus, minimally invasive implant surgery can be performed owing to the absence of large palatal flap elevation and obstruction. Such a design provides better stability of the guides and clear visual access during surgery.

FREQUENCY OF TRAUMATIC ULCERATION IN TISSUES UNDERNEATH NEW CONVENTIONAL COMPLETE DENTURES

Objective:
 To determine the frequency of traumatic ulceration in denture supporting tissues following the provision of new complete dentures.
 Materials and Methods:
 This cross-sectional descriptive study was performed at the Prosthodontics Department of Khyber College of Dentistry, Peshawar over a period of 18 months. With the method of history and clinical examination and using a structured data collection sheet presence of traumatic ulcers in tissues underneath conventional complete dentures was recorded in 184 patients fulfilling the inclusion and exclusion criteria and who had not been previously wearing CD in both jaws. Patients were examined 3 to 4 days following the placement of their complete dentures, on their first recall appointment, for the presence of traumatic ulceration.
 Results:
 Patients (N=184) had mean age of 55.85±2.22 (SD) years with male to female ratio of 1:1.9. Patients returning with one or more traumatic ulcers 3 to 4 days following the placement of their complete dentures were 141 (76.6%) while 43 (23.4%) patients developed no ulcers. Ulcers were more commonly found in older age groups and in females.
 Conclusion:
 Traumatic ulcers were reported in majority of the patients who received conventional complete dentures. Thus the role of a prosthodontist does not end with the placement of the prosthesis. Regular follow up visits and adjustments need to be carried out following placement of complete dentures to ensure patient comfort and acceptance of the prosthesis.

Alveoloplasty: A Case Report of Recontouring The Alveolar Process

Alveoloplasty is one of the common pre-prosthetic surgical procedure carried out in dental surgical practice setups. A. T. Willard in 1853 advocated reduction of the alveolar ridge to bring about the complete proximity of soft tissues over the alveolus. Sir O. T. Dean first proposed “Intra-septal alveoloplasty” in the American Dental Association journal in 1936 so, named as Dean's alveoloplasty. The objective of Pre-prosthetic surgeries provide adequate bony tissue support for the placement of complete dentures. the characteristics of ideal denture base are adequate bony support with proper soft tissue coverage, no undercuts, no sharp ridges. Preprosthetic surgical treatment must begin with a thorough history and physical examination of the patient. The aim of the alveoloplasty procedure is used for recontouring of bony irregularities at the time of extractions or after initial healing. This case report illustrates case of a 71 year old healthy male. On examination who revealed irregular bony spicules on the edentulous ridge. After complete evaluation, alveoloplasty procedure was performed to smoothen the ridge. Proper diagnosis of the condition of edentulous ridges are important for successful fabrication of complete dentures. Every effort should be made to ensure that both the hard and soft tissues are developed in a form that will enhance the patient's ability to wear a denture.

Oral health related quality of life by means of functional changes in Geriatric Oral Health Assessment Index (GOHAI) before and after insertion of new conventional complete dentures in completely edentulous patients.

The oral health-related quality of life determines the quantity to which oral health disrupts the regular life and common functioning of an individual. To evaluate the oral health problems of older adults, Geriatric Oral Health Assessment Index (GOHAI) can be used. GOHAI was developed by Atchinson and Dolan3 before and after complete denture therapy”. Study Design: Cross sectional study. Setting: Department of Prosthodontics, Lahore Medical and Dental College, Lahore. Period: February 18, 2018 to August 17, 2018. Material & Methods: Patients will be selected for the study according to the criteria. Patient history and clinical examination was undertaken. Upper and lower complete dentures was made-up for 30 patients (both male and female) using standardized clinical and laboratory methods. Conventional procedures were applied to complete denture construction. Complete dentures were constructed in the similar dental laboratory within the institution by compression moulding method. Laboratory and clinical remount procedures, beside with occlusal corrections were carried out using a semi-adjustable articulator. The GOHAI questionnaire was completed on two different appointments. First questionnaire was documented before denture insertion and second questionnaire was recorded after complete denture insertion. Results: Before treatment mean GOHAI score was 20.46 ± 2.85 and after treatment mean GOHAI score was improved and was 26.32 ± 2.34. The mean GOHAI score was statistically improved p-value < 0.001. For male patients, before treatment mean GOHAI score was 21.61 ± 2.59 and after treatment mean GOHAI score was improved and was 26.31±2.14. The mean GOHAI score was statistically improved in male patient, p-value < 0.001. For female, before treatment mean GOHAI score was 19.34 ± 2.70 and after treatment mean GOHAI score was improved and was 26.44 ± 2.49. The mean GOHAI score was statistically improved in female patients, p-value < 0.001. Conclusion: According to patient’s information enhancement in functional changes after placement of complete dentures.

Two Cases of Severe Dementia Showing Dramatic Improvement after Denture Placement

Severe dementia, including Alzheimer’s disease, is intractable and progressive. The purpose of this study was to document the improvement observed in two cases of severe dementia after denture placement. The subjects, two women in their 70s with severe dementia, were diagnosed with Alzheimer’s disease by the medical doctors in charge of their cases. In the first case, the subject’s symptoms included severe disorientation, impaired communication, and a tendency to wander. Two weeks after a lower complete denture placement, she was able to greet others. Five weeks later, she was able to communicate and precisely read an analog clock. Her condition continued to improve for at least 3 months. In the second case, the subject’s mouth was always open. She was bedridden in a vegetative state and hardly moved, talked, or laughed; it was impossible to communicate with her. Only a few seconds after an upper complete denture placement, she started to talk, albeit unintelligibly. Two weeks after a lower complete denture placement, she could communicate normally, laugh, and walk without help. Although the underlying mechanism has not yet been clarified, the author hypothesizes that positive signals from the oral area are transferred to the brain as positive stimulation via the trigeminal nerve, the largest cranial nerve.

A clinical study to compare between resting and stimulated whole salivary flow rate and pH before and after complete denture placement in different age groups.

Purpose:This study compared the flow rate and pH of resting (unstimulated) and stimulated whole saliva before and after complete denture placement in different age groups.Materials and Methods:Fifty healthy, non-medicated edentulous individuals of different age groups requiring complete denture prostheses were selected from the outpatient department. The resting (unstimulated) and stimulated whole saliva and pH were measured at three stages i.e., i)Before complete denture placement;ii)Immediately after complete denture placement; andiii)After 2 to 3 months of complete denture placement. Saliva production was stimulated by chewing paraffin wax. pH was determined by using a digital pH meter.Results:Statistically significant differences were seen in resting(unstimulated) and stimulated whole salivary flow rate and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No statistically significant differences were found between the different age groups in resting (unstimulated) as well as stimulated whole salivary flow rate and pH.Conclusion:Stimulated whole salivary flow rates and pH were significantly higher than resting (unstimulated) whole salivary flow rates and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No age related variations in whole salivary flow rate and pH were observed in healthy, non-medicated individuals.Clinical Implications:The assessment of salivary flow rate, pH in different age groups is of prognostic value, which is an important aspect to be considered in the practice of removable prosthodontics.

The efficacy of a topical gel with triester glycerol oxide in denture‐related mucosal injuries

The efficacy of a topical gel with triester glycerol oxide for treating ulcerations related to new complete dentures was studied and compared with a placebo gel. Fifty edentulous patients were enrolled in this double-blind clinical study. All subjects received new maxillary and mandibular complete dentures and were recalled 1, 3 and 7 days after denture placement. Twenty-five subjects received topical gel with triester glycerol oxide (TGO), and 25 subjects received topical gel without TGO. At each visit, pain and discomfort with the new dentures was assessed, and at the last visit, healing of ulcerations was also graded by a clinician. Subjects also graded the gel's taste, smell and ease of use. Specifically, there was no statistically significant difference in ulcer healing (p > 0.05), ratings of smell, taste and ease of use (p > 0.05) or pain and discomfort scores (p > 0.05). However, within-group differences were observed in pain and discomfort scores between follow-up sessions (p = 0.01 for all comparisons). Clinically, TGO gel is not effective in the treatment of mucosal injuries occurring following placement of complete dentures.

Frequency of Traumatic Ulcerations and Post-insertion Adjustment Recall Visits in Complete Denture Patients in an Iranian Faculty of Dentistry.

Background and aims The first few days following the insertion of complete dentures are critical for the patients since they are struggling to adapt to their new dentures. This study aimed to evaluate the most common locations of traumatic ulcerations, their frequency and also the duration and number of adjustment visits required to achieve patient comfort fol-lowing placement of complete dentures. Materials and methods Sixty patients were selected from edentulous patients referring to a removable prosthodontics department. Complete dentures were fabricated for the patients. After placement of dentures, all the patients were evaluated from the day after placement until patient comfort was achieved. Descriptive analysis was performed and chi-squared test was used to evaluate the associations between lesions, post-insertion visits and gender. Results A total of 85.8% of patients required denture adjustment because of mucosal injuries during their first visit fol-lowing denture placement. Maxillary and mandibular dentures did not require further adjustments after fourth and sixth visits, respectively. No significant differences were detected between males and females in the number of mucosal injuries in the anatomical areas evaluated in the maxilla and mandible using Fisher's exact test (P > 0.05). Furthermore, the number of mandibular dentures requiring adjustments was significantly higher than maxillary dentures in all the post-insertion ap-pointments (P < 0.001). Conclusion Since most mucosal injuries are located in the vestibule, adequate extension of denture flanges, especially during border molding, and use of pressure indicators that reveal over-extended borders, play an important role in decreas-ing mucosal injuries and improving patient comfort following complete denture placement.

Does prosthodontic rehabilitation change the eating patterns among completely edentulous patients?

Nutrition is compromised in completely edentulous individuals. As there is limited literature available on the nutritional health of the elderly in the Indian population, the present study was undertaken to assess these changes before and 1 month after placement of complete dentures in a dental hospital in Indore, Madhya Pradesh, India. The 10-item closed-ended questionnaire was completed by the investigator who interviewed the subjects (n = 35) before placement of complete dentures and 1 month later. A statistically significant difference was found for having an illness or condition that led to a change in the type and/or amount of food eaten (p = 0.013); eating few fruits, vegetables, or milk products (p = 0.005) and having oral problems that made it difficult to eat (p = 0.003). Prosthodontic rehabilitation improved the eating pattern with increased intake of fruits, vegetables and milk products.

Assessment of changes in oral health‐related quality of life among patients with complete denture before and 1 month post‐insertion using Geriatric Oral Health Assessment Index

Geriatric Oral Health Assessment Index (GOHAI) is a 12-item measure of "patient-reported oral functional problems" intended for use in the assessment of the effectiveness of dental treatment. As there is scanty literature available on GOHAI in the Indian population, the present study was undertaken to assess the changes in GOHAI before and 1 month after placement of dentures in completely edentulous patients reporting to a dental hospital at Indore, India. The GOHAI questionnaire was completed by the examiner who interviewed the patients (n = 35) before placement of complete dentures and 1 month later. Mean, median values were calculated and the data were analysed using Wilcoxon signed-rank test. When overall mean was considered, the GOHAI scores increased from 27.48 to 30.19 (p = 0.002; highly significant). Patients reported improvement in functional changes after placement of complete dentures.

Impacto da perda dentária na qualidade de vida

In order to evaluate the impact of tooth loss in patient's quality of life, 50 volunteers were selected among patients who use the Public Health Services in treatment for their complete denture's placement or replacement. The Oral Health Impact Profile (OHIP-14) and a socio-demographic data collection were applied before treatment. The values were founded through the weight of each question in association with Likert's Scale. As higher was the score, higher was the impact in the quality of life. In this survey 82% were female, 52% of patients between 41 and 60 years old (average: 59.1), and 34% married. The higher values of OHIP-14 dimensions in patient's quality of life were: Psychological Discomfort (122), Physical Pain (121), Psychological Disability (113), Physical Disability (109), Functional Limitation (93), Handicap (82) and Social Disability (76). As it could be observed, the lost of teeth or the use of inadequate prosthesis could bring negative impacts in life's quality, especially regarding preoccupation, stress with mouth problems and shame, although people perceive minor impacts in social relationships and development of their daily activities. This information can be relevant to prepare dentists to raise their knowledge about edentulous people and how to work with them.

Frequency and location of traumatic ulcerations following placement of complete dentures

To determine the location of mucosal injuries that appear following placement of complete dentures, as well as the number of adjustments necessary to achieve patient comfort. The frequency of mucosal injuries in female and male patients and their connection with clinical anatomic features were also investigated.Sixty-one completely edentulous healthy patients who wore dentures (47 women and 14 men) took part in the study; 122 newly fabricated complete maxillary and mandibular dentures were investigated. All patients were seen for a 1-week adjustment appointment. Areas where signs of denture-induced mucosal injuries appeared were marked on an anatomic illustration. The follow-up period was in 1-week increments as deemed necessary by the patient. Associations between variables were analyzed with analysis of variance. Results were recorded as mean + SD. Statistical significance was set at P < or = .05.Eighty-seven percent of the dentures required adjustment at week 1, 50% at week 2, and only 7% at week 3. No patients required a further visit. Most frequently injured maxillary areas were the vestibular sulcus (41%), maxillary tuberosity (21%), and hamular notch (12%). In the mandible, the most frequently injured areas were the retromylohyoid area (17%), lingual sulcus (14%), and vestibular sulcus (13%). Denture-induced irritations were detected in a higher ratio in the mandible (P < .001), especially in male denture wearers at the first adjustment (P < .05). Men had a higher ratio of lesions at the region of the maxillary vestibular sulcus between the labial and buccal frenum and at the mandibular vestibular sulcus of the buccal shelf region (P < .001).Denture-induced irritations appeared most often in the vestibular sulcus of the maxilla and mandible, indicating that it is necessary to evaluate the area of the facial seal of the prosthesis by applying a medium- or a heavy-pressure indicator paste to the borders, and to make adjustments at the delivery stage and subsequent adjustment appointments. Denture placement must not be the final patient-clinician encounter when treating with complete dentures. Denture adjustments are very important clinical phases of denture fabrication and essential in patient care.

Impact of new prostheses on the oral health related quality of life of edentulous patients

A study was conducted to evaluate the impact of the placement of complete dentures by using the Global Oral Health Assessment Index (GOHAI). Oral health quality of life indicators can be used to evaluate the effects of dental treatments. The 26 participants were treated in a French University Clinic during 2002. They were randomly divided into two groups. Each group received new prostheses, but evaluation of the quality of life was made at different periods [baseline, denture placement (group 1), 6 and 12 weeks (group 2) after placement]. A questionnaire was used to collect information on patient's satisfaction with the previous and new prostheses. Nonparametric tests were used to test the relationships between patients' satisfaction or baseline data and GOHAI variations with time as well as to compare mean values of GOHAI within each group. At baseline, the impact of oral health problems was apparent; the mean GOHAI-Add score was 45.8 (10.2). Six weeks after placement of the new denture, there was no difference in GOHAI scores compared with the initial assessment. An improvement in GOHAI score was observed 12 weeks after the participants received their new dentures (p < 0.05). Change in GOHAI-Add scores was negatively correlated with the initial GOHAI-Add score. Patients who preferred the new prosthesis enjoyed a positive change in GOHAI scores (p < 0.001). There was a relationship between participants' satisfaction with the new dentures and change in GOHAI scores (p < 0.05). The GOHAI can be used to evaluate needs for and effect of the making of new complete dentures.

Nontraumatic immediate complete denture placement: A clinical report

This clinical report presents a treatment procedure that makes immediate denture placement a more predictable and less stressful procedure. It provides greater control over the prosthodontic aspects of denture delivery by the restorative dentist, and the convenience of performing the placement procedures in a clean, blood-free environment. The delivery of the prosthesis is less traumatic because extractions and/or surgery are deferred. In addition, by the time the remaining roots are extracted, all denture adjustments will have been made and the patient will have accommodated to the prosthesis.

Occlusal perception after placement of complete dentures

Occlusal perception after placement of complete dentures

The effect of protein versus placebo supplementation upon denture tolerance

Within the limits of this study, the evidence suggests that patients premedicated for 1 month with 25 grams of protein daily, beginning 1 week prior to initial placement of complete dentures, require less appointments, less adjustments, and less time during the first 3 weeks after denture placement than a comparable group treated for the same period of time with a placebo. There is suggestive evidence that even after discontinuance of the protein supplement there is continued effect for possibly a month. The importance of protein supplementation is heightened by the fact that protein deficiency is believed to be a relatively common problem in the American public.