Removable Prostheses Research Articles

Removable dental prostheses for patients with Sjögren's syndrome

Sjögren's syndrome (SS) is a chronic autoimmune condition primarily affecting the salivary and lacrimal glands, leading to pronounced dry mouth (xerostomia) and dry eyes. These symptoms create unique challenges for SS patients requiring removable dental prostheses, as the lack of saliva significantly impacts the retention, comfort, and overall effectiveness of these devices. Without adequate saliva, prosthetic retention diminishes, and patients frequently experience issues such as mucosal irritation and increased susceptibility to infections. To address these issues, tailored material choices are critical in designing effective prosthetic solutions. Soft liners, moisture-retentive acrylics, and antimicrobial coatings are among the innovations improving both retention and comfort for SS patients. The aesthetic and functional outcomes of prosthetic solutions are also essential considerations. Enhanced retention mechanisms, such as implant-supported overdentures, not only improve masticatory performance but also aid in preserving the patient’s facial profile and lip support. Advanced materials offering translucency and color stability contribute to a more natural appearance, which is critical for patient satisfaction. The maintenance of these prostheses requires specific care routines to mitigate microbial buildup and tissue irritation. Specialized cleaning agents and salivary substitutes help maintain hygiene and reduce discomfort, while regular follow-up visits enable timely adjustments to accommodate tissue changes and extend the prosthesis lifespan. Implementing a comprehensive approach that considers material selection, functional and aesthetic outcomes, and maintenance strategies can greatly enhance the quality of life for SS patients. By understanding and addressing the specific needs associated with xerostomic conditions, dental professionals can provide prosthetic solutions that offer both reliability and comfort in this challenging context. Regular patient education and diligent care routines remain essential to ensure the long-term success and durability of removable dental prostheses for individuals with SS.

State of oral health in the Portuguese population and associated psychological and social aspects

Abstract Background Oral diseases are a global public health challenge and remain among the most prevalent non-communicable diseases. This study aims to characterize the self-assessment of oral health state, degree of edentulism, oral rehabilitation and the quality of life, namely chewing capacity, and the associated psychological and social aspects in the Portuguese Population. Methods Data were collected by telefone survey, on the 2nd half of 2018 and 1st half of 2019, using the Portuguese population representative, ECOS panel. Descriptive statistics, as well as prevalence estimates, were obtained with weighting for age, sex, region and sample design, for 95% confidence intervals. The modified F-statistic, a variant of the 2nd order Rao-Scott chi-square adjustment, was used to test the bivariate analyses. Results For 53% of the population, the health status of the mouth was perceived as Good or Very Good, for 37% Fair and, in 11% of cases as Bad or Very Bad. It is estimated that around 76% of the population has good oral hygiene habits, approximately 26% have all of their teeth and 8% the total absence of teeth. It is estimated that only around half (49%) underwent rehabilitation using, in the vast majority of cases (78,5%), removable prostheses. It is estimated that 32% of its users have difficulty chewing hard foods and, of these, around 20% have great difficulty or are unable to chew at all. Psychological discomfort due to oral health was higher in the Portuguese population when compared to the European population (17% vs 7 %), psychological limitations due to the appearance of teeth or dentures were equally higher (7% vs 4%), as were social limitations (8,8% vs 4%). Conclusions The oral health panorama in Portugal remains bleak, so strengthening the application and deepening of the national oral health promotion program should constitute a priority aspect in the development of public policies in the country Key messages • Integrating oral health into general health promotion strategies and assessing oral health needs to include psychological and social aspects in the Portuguese Population. • Strengthening the strategies that have been developed in the context of health promotion, prevention and early treatment of oral diseases in Portugal.

Oral Health-Related Quality of Life Improvement After Treatment With Fixed and Removable Dental Prostheses.

Missing teeth negatively affect oral functions and masticatory efficiency, which in turn can reduce a person's quality of life (QoL). This study is aimed at evaluating the effect of dental prostheses on oral health-related quality of life (OHRQoL) in adults. This is an observational study to measure patients' OHRQoL using a cohort study design before and after treatment with different dental prostheses (fixed and removable). Ninety-seven patients who received dental prostheses responded to a questionnaire before dental prosthetic treatment and then after the completion of the treatment. The conduction was face-to-face or via telephone interviews. The questionnaire is divided into two parts to verify the demographic and the patient's related factors and to measure OHRQoL using the Oral Health Impact Profile-5 (OHIP-5). Descriptive statistics, inferential statistics, and multivariable analysis were conducted using Stata Statistical Software: Release 14.2 (2016; StataCorp LLC, College Station, Texas, United States) and were at a 0.05 significance level. Data were collected from the 97 patients, of which 70% were male with a mean age of 39.5 and 30% were female with a mean age of 43. The educational level showed that only 15% of the patients received a bachelor's degree and that the remaining 85% stopped at a high school general educational level. The received prosthetic treatment consisted of 23% single crowns, 29% fixed partial dentures (FPD), 20% removable partial dentures (RPD), and 28% complete dentures. Self-reported overall health indicated that 64% of the patients had very good health and 36% had good health or a lower quality of health. There was a significant difference in OHIP scores before prosthetic treatment (M=5.4, SD=0.57) and after prosthetic treatment (M=3.2, SD=0.49) with no significant difference in the reduction in OHIP scores between fixed prostheses (M=-2.8, SD=0.64) and removable prostheses (M=-1.5, SD=0.74). The amount of improvement in OHIP answers after wearing a prosthesis was significant (p<0.0001). Linear regression indicated that having a history of discomfort from general oral health improved (decreased OHIP score) by 2.2 after prosthetic dental treatment compared to participants without a history of general oral health discomfort when all other variables are held constant. Within the limitations of this study, it can be concluded that restoration of missing teeth with a dental prosthesis has an immense impact on individuals' QoL, regardless of the type of dental prosthetic restoration.

Stress-strain state of dental immediate prosthesis and associated tissue under the influence of external force

Purpose: to analyze the stress-strain state (SSS) of a removable plate immediate denture with a printed dentition made of polymethyl methacrylate (PMMA) and a polyethylene terephthalate (PET) base under multifactor loading conditions based on the principles of mathematical modeling. Materials and methods: For mathematical modeling of SSS, Comsol Multiphysics 5.6 software (Comsol Inc., USA) was used, which provided numerical data for analytical interpretation. We considered a flat 2D model consisting of a printed monolithic dentition and a PMMA bonding layer, a PET base, the mucous membrane of the prosthetic field and jaw bone tissue. Results: The fields of von Mises stresses (VM) and deformations under the influence of normal, oblique and tangential loads (up to 500 N), the localization of their maximum values and the average value inside the prosthetic structure, mucous membrane and bone tissue were determined. The maximum values of VM in the mucous membrane are compared with the pain threshold based on known literature data on algesiometry of the oral mucosa. An assessment was made of the critical length of microcracks (CLM) according to Griffiths, which lead to the formation of a main crack followed by brittle fracture of the structure base. Using the phase field method, the probability of crack formation in the considered model of an orthopedic structure under the influence of static loads of various magnitudes and directions was calculated. Conclusions: Using the method of mathematical modeling of SSS, it was shown that failures when using immediate dentures with printed teeth made of PMMA and a PET base can be caused by the effect of overloading the areas of the base and caused by the deformation process inside the prosthetic structure. The maximum stress in the prosthetic elements was 79.7 MPa and deformation – 0.47 mm. The pain threshold of the oral mucosa is higher than the highest stress value in the prosthetic bed according to Mises (0.002 MPa) for normal load of 500 N. The SSS heterogeneity coefficient of the removable plate immediate prosthesis model is 8.6. The critical length of a microcrack according to Griffiths is lcrit = 1.9...2.7 µm. Using the Comsol Multiphysics phase field method, it was established that the probability of the formation of a large crack in the base of the prosthesis was 6·10–3 %, 0.36 %,0.73 % for a normal, inclined and shear load of 500 N, which is a sufficient value for the operation of removable laminar dentures with printed teeth from PMMA and a PET base during the warranty period.

THE ROLE OF ALTERED CAST IMPRESSION TECHNIQUE IN ACHIEVING ACCURATE PROSTHETIC FIT: A CASE REPORT

In dental practice, posterior bilateral edentulous spaces are most commonly encountered situations. Removable prosthesis generally is tooth or tissue borne or in combination. But the distal extension cases obtain their support from both the teeth and tissue adjacent to ensure equal distribution of forces on the teeth and the soft tissue. In this case report altered cast technique for fabrication of removable partial dentures has been described in detail. It is best alternative for impression making especially in distal extension cases for its better tissue adaptability, better support, uniform stress distribution, and stability of the prosthesis. Thus, increases patient comfort and function.

Analysing the reasons why patients with complete missing teeth seek re-prosthodontics

Basic construction material of such dental constructions is not without well-known disadvantages. Identification of the main reasons for the replacement of complete removable acrylic plate dentures will make it possible to find the most relevant area for development in the field of improvement of this type of prosthetics.AIMS: To assess the reasons for patients' requests for replacement of complete removable acrylic dentures.METHODS: In the period from 2021 to 2022, a comprehensive dental examination of patients with complete absence of teeth who sought dental prosthetic care to replace previously used full removable plate prostheses was carried out, the reasons for the need for a new dental structure of this type and the frequency of their occurrence in the near and distant future were determined. Statistical differences between the indicators were assessed using the nonparametric method of analysis - the χ2 test. In order to assess the risk of a particular cause of referral, relative risk was calculated at 95% confidence interval.RESULTS: The main reason for the patients with complete absence of teeth to replace the operated full removable plate prosthesis in the period up to 3 years is one or another mechanical breakage. After three years of use of this type of dental structure, risk of mechanical failure and functional deficiencies statistically significantly increases by 1.8 and 1.6 times respectively. When prostheses are used for more than 6 years, referrals due to various functional deficiencies begin to dominate the percentage with 58.3%.CONCLUSIONS: The increasing risk of functional defects in the form of impaired fixation and stabilisation makes it necessary to develop a set of measures to prevent the development of atrophic processes in the alveolar bone tissue of the upper and lower jaw alveolar processes, as well as dystrophic changes in the mucous membrane of the denture bed.

Insertion axis in removable prosthesis: a preliminary report.

Removable partial denture (RPD) is still a widely used prosthesis today to solve non-implant cases, despite its aesthetic contraindications. The aim of the following work is to evaluate how much the communication and explanation to the patient of the insertion axis of the removable partial prosthesis in the periodontium and teeth has an impact on his degree of acceptance of the aesthetic limits of this prosthesis. For this study, 150 patients were examined from 10 dentists, 5 in Lombardy and 5 in Sicily, using inclusion criteria and exclusion criteria. All selected patients required removable partial dentures. The data was obtained by completing 2 questionnaires, at three different times, at prosthesis delivery, at 6 and 12 months. Questionnaires highlighted overlapping data in the two regions and a total absence of communication of the insertion axis by the dental technician laboratories was highlighted with a percentage of 100%. 28% of the patients complained of pain during the insertion of the prosthesis at 12 months and 39.33% of patients had mobility of remaining teeth with clasps at 12 months. All patients experienced no discomfort, and no important data were reported at the first 6-month follow-up. For mobile partial dentures, respecting the insertion axis can improve the predictability of the periodontal tissue and the resistance of the remaining teeth with clasps. The drawing of an arrow in the model shows the insertion axis of the prosthesis. It would be desirable to include information regarding the insertion axis and advice for the management of the removable partial denture in the first days of use in the declaration of conformity given to the doctor and to thepatient, in the indications section. It can be said that correct insertion of the removable partial denture, helped by verbal and written instructions from the doctor, can reduce possible periodontal alterations of the remaining teeth, by eliminating spurious stresses during insertion and removal of the prosthesis.

Hardness Analysis of Foods in a Diet Based on the Mediterranean Diet and Adapted to Chilean Gastronomy.

The human diet is a factor for disease prevention and the extension of life expectancy. Loss of teeth can adversely affect chewing capacity, which can lead patients to modify their diet and subsequently result in a poor dietary intake. This work is conducted within the framework of an ongoing research project in the Dentistry School of Universidad de la Frontera aimed at designing a diet for patients with complete removable dental prostheses (CRDP). This study aimed to evaluate the hardness of foods in a diet designed for patients using CRDP, using texture profile analysis (TPA). TPA was used to measure the hardness of 43 foods, categorized into seven groups, dairy, animal protein, fruits, vegetables, cereals and grains, high-lipid foods, and vegetable protein, to understand their impact on masticatory performance in CRDP wearers. TPA consists of two compression cycles where the food sample is compressed until it reaches a pre-established deformation. The first force peak achieved in the first cycle is used as a measure of sample hardness. Significant differences in hardness were identified within each food group, indicating a wide spectrum of textural properties that could influence chewing behavior. These findings suggest that assessing food hardness can help tailor dietary recommendations to improve masticatory efficiency in patients with dental prostheses.

Influence of silver coated zeolite fillers on the chemical and mechanical properties of 3D-printed polyphenylene sulfone restorations

ObjectivesTo investigate the chemical and mechanical properties of polyphenylene sulfone (PPSU) depending on its composition and manufacturing. MethodsUnfilled–PPSU1 and with antimicrobial silver coated zeolites filled–PPSU2 specimens were made of granulate–GR, filament–FI, or printed–3D. Scanning microscopy and X-ray spectroscopy were performed. Martens hardness–HM, elastic indentation modulus–EIT and flexural strength–FS were determined initially and after aging. Shear bond strength–SBS to veneering and luting composite after conditioning with 7 adhesive systems were examined after aging. Silver leaching was tested after 1-, 3-, 7-, 14-, 21-, 28- and 42 days. Analyses of variance, Kolmogorov–Smirnov, Kruskal–Wallis, Mann–Whitney U, unpaired t-tests and Weibull modulus were computed (p < 0.05). ResultsZeolites were homogeneously distributed. PPSU1-GR and PPSU1-FI showed the highest HM/EIT, followed by PPSU2-GR, PPSU1-3D and PPSU2-3D. PPSU2-FI presented the lowest HM/EIT, displaying micro pits. Aging showed reduced HM/EIT in PPSU1 and no impact on PPSU2, while FS increased (PPSU1) or decreased (PPSU2). PPSU2-3D presented lower FS than PPSU1-3D. High SBS to the luting (7.0–16.2 MPa) and veneering composite (11.8–22.2 MPa), except for adhesive system PR, were observed. PPSU2-3D showed the highest silver release (9.6%), with all compositions dispensing silver over 42 days. ConclusionsFor the examined period of 6 weeks, antimicrobial silver ions were released from filled PPSU. The high SBS between PPSU and veneering/luting composite confirmed the feasibility of esthetically veneering and luting filled PPSU. To achieve mechanical properties like unfilled PPSU, the processing parameters of filled PPSU require refinement. Clinical significanceThis investigation provides proof of principle that PPSU can be successfully doped with silver-coated zeolites. The combination of 3D-printing with an antimicrobial thermoplastic constitutes a great opportunity in the field of prosthetic dentistry. Potential applications include clasps for removable dental prostheses, provisional or permanent fixed dental prostheses and implant abutments.

Reinforcement of 3D-printed resins for denture base by adding aramid fibers: Effect on mechanical, surface, and optical properties.

The present study evaluated the mechanical, surface, and optical properties of 3D-printed resins for removable prostheses reinforced by the addition of aramid fibers. According to ISO 20795-1:2013 standards, specimens were printed using a digital light processing 3D printer and divided into two groups (n=06/group): 3D-printed resin for denture base as the control group, and a group with the same 3D-printed resin in addition of 5% aramid fibers as the experimental group. Red aramid fibers were chosen for aesthetic characterization. The specimens were evaluated for their mechanical properties, such as elastic modulus (GPa), flexural strength (MPa), and superficial properties by their surface microhardness (KHN), surface roughness (μm), and surface free energy (mJ/m2). Optical properties were evaluated by the color difference (∆E00) between groups. The statistical test chosen after the exploratory analysis of the data was One-way ANOVA followed by Tukey's HSD (α=0.05). The results showed statistical differences in elastic modulus (p<0.0001), flexural strength (p<0.0001), surface free energy polar variable (p=0.0322), total surface free energy (p=0.0344), with higher values for the experimental. Surface hardness and surface roughness showed no statistical difference (p≥0.05). The color difference (∆E00) obtained through the CIEDE2000 calculus was below the perceptibility threshold (≤1.1). Adding aramid fibers to 3D-printed resin for denture bases resulted in better mechanical properties, without major alterations in surface properties. In addition, it is an easy-to-apply choice for mechanical reinforcement and aesthetic characterization, with the expression of small blood vessels in the 3D-printed resin for removable denture bases.

The literature on digital technologies for removable dental prostheses: A two-decade bibliometric analysis

Background/PurposeThe advent of digital technologies has significantly transformed the current dentistry, particularly in the fabrication of removable dental prostheses. A bibliometric analysis of literature may provide a direction of research hotspots and future trends in this field. Materials and methodsData were retrieved from Web of Science database for the analysis of literature on digital technologies for removable dental prostheses. Microsoft Excel was used for the descriptive statistics. VOSviewer was deployed for the analysis of published articles. ResultsA total of 457 published documents were identified from 2004 to 2023. The most frequently published article type was original article (n = 262, 57.33%). The number of annual publications and citations significantly increased from 2004 to 2023, respectively (P for trend <0.001). In addition, the significant increased number of publications and citations pre year affected by COVID-19 pandemic were noted (P < 0.002). Most articles were published in Journal of Prosthetic Dentistry (n = 141, 30.85%). The computer-aided design (CAD)/computer-aided manufacturing (CAM) and 3D printing technique were the frequent emphasized keywords in digital technologies for removable dental prostheses. ConclusionThis bibliometric analysis revealed a growing research interest and technological progress in digital technologies for removable dental prostheses during past two decades. The enhancement of accuracy by CAD/CAM and 3D printing suggests a promising future for the application of these technologies in dental practice.

Quality of Communication between Dental Technicians and Dentists during the Fabrication of Removable Partial Dentures in Casablanca, Morocco

Introduction: Communication between the dentist and the dental laboratory technician plays an essential role in the success of prosthetic treatment. The purpose of this study was to describe the quality of communication between dentist and dental technicians, and to highlight the different constraints encountered by the laboratory technician when making removable partial prostheses. Materials and Methods: This is a cross-sectional study conducted among 94 dental technician working in the private sector in Casablanca. To collect data an auto administrated questionnaire was distributed to the dental technicians. This tool included five sections : Identification, communication methods, prosthetic design, communication difficulties and the added value of digitizing the prosthetic chain. Data were statistically processed using SPSS 20 software. Results: A total of 94 dental technicians working in Casablanca were interviewed. All these laboratory technicians (100%) used the laboratory form as their main means of communication. Additional means of communication were used to complete missing information (phone, photo sharing, e-mail). 72.3% of dental technicians designed the metal framework for cast partial dentures themselves and 67% of prosthetists said that digitizing the prosthetic chain could improve dentist - dental laboratory technician communication. Conclusion: Effective communication between dentist and dental technician is essential for successful prosthetic treatment and patient satisfaction

Mechanical Assessment of Denture Polymers Processing Technologies.

Removable prostheses have seen a fundamental change recently because of advances in polymer materials, allowing improved durability and performance. Despite these advancements, notable differences still occur amongst various polymer materials and processing technologies, requiring a thorough grasp of their mechanical, physical, and therapeutic implications. The compressive strength of dentures manufactured using various technologies will be investigated. Traditional, injection molding, and additive and subtractive CAD/CAM processing techniques, all utilizing Polymethyl methacrylate (PMMA) as the main material, were used to construct complete dentures. The specimens underwent a compressive mechanical test, which reveals the differences in compressive strength. All the specimens broke under the influence of a certain force, rather than yielding through flow, as is characteristic for plastic materials. For each specimen, the maximum force (N) was recorded, as well as the breaking energy. The mean force required to break the dentures for each processing technology is as follows: 4.54 kN for traditional packing-press technique, 17.92 kN for the injection molding technique, 1.51 kN for the additive CAD/CAM dentures, and 5.9 kN for the subtractive CAD/CAM dentures. The best results were obtained in the case of the thermoplastic injection system and the worst results were recorded in the case of 3D printed samples. Another important aspect depicted is the standard deviation for each group, which reveal a relatively unstable property for the thermoplastic injected dentures. Good results here in terms of absolute property and stability of the property can be conferred to CAD/CAM milled group.

Dental prosthesis plaque index of Augsburger and Elahi: Expansion and standardisation in community-dwelling frail older people.

Inadequate daily oral hygiene care of dental prostheses could worsen general health of frail older people. The index of Augsburger and Elahi is often recommended to assess maxillary dental prosthesis plaque (DPP). To assess the reliability of an expanded and standardised DPP index of Augsburger and Elahi in trained and untrained examiners, and to determine the applicability of the index in community-dwelling frail older people. Ten community-dwelling frail older persons with complete and partial removable dental prostheses (RDPs) (mean ± SD age = 87.9 ± 8.4 years) participated. Seven persons were revisited after 3 months. The index was expanded with mandibular RDPs. Standardisation was achieved with a specially designed reference sheet. The RDPs were photographed after plaque colouring. Two trained examiners scored the photographs; thereafter, two untrained examiners. One trained examiner scored the photographs again after 3 weeks. Changes in DPP over the 3-month period were assessed with Wilcoxon signed-rank test. Inter- and intra-examiner reliability was assessed with intraclass correlation coefficients (ICCs). The DPP scores did not change significantly over time (Z = -0.594, p = 0.553). Inter-examiner reliability was excellent in the trained examiners (ICC = 0.859-0.947), and fair-to-good in the untrained examiners (ICC = 0.671-0.703). Intra-examiner reliability was excellent (ICC = 0.941-0.962). The proposed expansion and standardisation of the DPP index has an excellent inter- and intra-examiner reliability when performed by trained examiners, and a fair-to-good inter-examiner reliability by untrained examiners. Therefore, the index could be recommended for application in dental prostheses-wearing older persons and could be useful for awareness and education of professional and informal caregivers and the older persons themselves. The Netherlands Trail Register NTR6159.

Challenges in Managing an Edentulous Down Syndrome Patient: A Case Report

Patients with Down Syndrome (DS) are caring, affectionate, and quite social. However, the prosthetic management of edentulous patients with DS depends on the level of their disability, developmental delay and neurobehavioral problems. Muscle hypotonia can affect patient gestures and handling of their prostheses. In addition, intraoral manifestations need to be taken into consideration when designing removable complete dentures, such as macroglossia and maxillo-mandibular sagittal and transverse skeletal misalignment. Dentist is asked to be consistent and to establish a gradual and an atraumatic approach based on the cooperation of the patient and his or her parents, and on the importance of follow ups in the integration of removable prostheses to improve the quality of life and the oral health of these individuals. This article presents the prosthetic treatment of an edentulous 29-year-old female patient with DS and a moderate intellectual disability.

Modified Combined Impression Technique for Cawood &amp; 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 &amp; 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&amp;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.

Long-term complications and management of dental trauma in the adult patient - Part 2: discoloured, displaced and missing teeth.

The second paper in this two-part review series aims to outline the long-term complications of dental trauma in the adult patient in relation to discoloured, displaced or missing teeth. A brief overview of the cause of discolouration is outlined, followed by assessment and management options. These can include bleaching, veneers, or crown restorations to mask the discolouration. Displacement of teeth from the socket can occur due to luxation injuries. Management can include simple digital manipulation, surgical repositioning, or orthodontic extrusion based on the severity of extrusion and the time from injury. Teeth can be lost early or in the long-term following dental trauma and associated hard and soft tissues deficiencies may also ensue. Replacement options can include a removable partial prosthesis, resin-retained bridge or dental implants. Often, hard and soft tissue augmentation procedures may be required to address any defects and rebuild lost anatomical contours. A thorough assessment followed by the development of a sound management plan which takes patients' general and local factors into account can ensure a predictable and successful treatment outcome. This would end in an aesthetically pleasing and a functionally stable result for the patient.

Long-term follow-up of a patient with Parkinson’s disease under nursing care after replacement of fixed implant-supported prostheses with an implant overdenture: a case report

BackgroundIn older patients with progressive neurodegeneration, replacing fixed implant-supported prostheses (FIP) with implant overdentures (IOD) has been proposed to prevent future mucosal injury and create an oral environment that is easier for caregivers to clean. However, there have been no reports on the progress after replacing FIP with IOD. In this report, we present the progress of an older patient with Parkinson’s disease in whom FIP was replaced with IOD.Case presentationAn 81-year-old male patient with Parkinson’s disease presented to our outpatient clinic with bruxism and crossbites. FIPs, with five Brånemark system implants, were placed in the bilateral lower molars. The FIP was replaced with an IOD with two locator attachments to create an oral environment that was easier for caregivers to clean and allow easy recovery of masticatory function if residual teeth were fractured in the care environment. As his systemic condition deteriorated, treatment was changed from outpatient to in-home visits. During dental care visits, professional oral cleaning and denture repair were continued, and good nutritional status was maintained. However, the patient developed cholecystitis and was hospitalized. During hospitalization, gastrostomy was performed because he developed aspiration pneumonia. After discharge from the hospital, the patient remained in bed all day and could not wear an IOD, resulting in buccal mucosa ulceration due to abrasion of the locator abutment. We decided to replace the abutment with cover screws; however, not all the implants could sleep submucosally. Although regular oral cleaning was resumed, new ulcers developed even when cover screws were installed. Additionally, swelling and drainage were observed at the peri-implant mucosal site where peri-implantitis had once occurred during an outpatient visit. The patient was readmitted to the hospital for a urinary tract infection, and subsequent visits were abandoned.ConclusionsBy replacing FIP with IOD in an older patient with Parkinson’s disease, we addressed a barrier to caregiver-provided oral management. The removable prosthesis facilitated smooth oral care by caregivers and functional recovery in the event of trouble with residual teeth. However, it could not completely avoid the recurrence of buccal mucosal ulcers or peri-implantitis.

Impact of Printing Orientation on the Accuracy of Additively Fabricated Denture Base Materials: A Systematic Review.

Printing orientation is one of the printing parameters that affect the properties of three-dimensional (3D)-printed resins. Different printing orientations and directions have been suggested; however, no clear and specific orientations are recommended in the literature in terms of the printing orientation effect on the accuracy and fit of 3D-printed removable dental prostheses. This review aimed to evaluate the effect of printing orientation on the fit and accuracy of 3D-printed removable dental prostheses. The PubMed, Scopus, and Web of Science databases were searched for published articles that investigated the effect of printing orientations on the accuracy and fit of the 3D-printed denture base. Full-length English published articles were searched between January 2010 and December 2023, which examined topics related to printing orientations, building angles, 3D printing, printing technology, accuracy, dimensional changes, internal fit, marginal integrity, marginal discrepancies, trueness, precision, and adaptation. Of the ten included studies, one investigated maxillary and mandibular denture bases, seven assessed maxillary denture bases, and two evaluated mandibular bases. Different printing orientations, ranging from 0° to 315°, were explored, with a higher prevalence of 0°, 45°, and 90°. The included studies utilized stereolithography and digital light processing printing technologies. High accuracy was observed at 45°, followed by 90. Additional struts and bars on the cameo surface increased the accuracy of the 3D-printed denture base. These results shows that printing orientation has a significant effect on the accuracy of 3D-printed resin, with 45° exhibiting the highest accuracy. In addition to the support structure, the density and position can impact the accuracy.

EPIDEMIOLOGY OF PROSTHETIC DENTISTRY IN THE ORTHOPEDIC DENTISTRY CLINIC

Introduction. The urgent task of orthopedic dentistry is the timely and optimal restoration of masticatory efficiency. Removable prosthetics remains one of the most popular methods of dental prosthetics. At the same time, removable prosthetics is associated with a number of clinical complications. An analysis of modern available domestic and foreign sources of literature on the epidemiology of prosthetic stomatitis, as well as the potential role of removable prostheses in the development of this disease, was carried out. Aim. To present the collected updated information from the current available systematic literature on the epidemiology of denture stomatitis, as well as the potential role of removable dentures in the development of the disease and make it accessible to orthopedic dentists. Materials and methods. A literature search was conducted using the electronic database PubMed to find studies related to the epidemiology and etiology of prosthetic stomatitis. The search period covered the period from January 2012 to December 2022, and 53 sources of literature were analysed. Results. A selection of 19 scientific articles was formed as a result of the conducted search and selection of scientific works that most closely corresponded to the set goal of the research. It was established that the prevalence of prosthetic stomatitis varies depending on a certain number of factors. According to the results of research by various authors, this disease affects from 20% to 80% of patients who use removable dentures. Variability of the prevalence of prosthetic stomatitis depends significantly on the age of the patient, gender, type of prosthesis, general health and oral hygiene of people using these structures. Analysis of data from an epidemiological study shows that the prevalence of prosthetic stomatitis among users of removable dentures varies from 20% to 80%. It is possible that the spread of stomatitis prevalence rates was influenced by conducting the study among various samples of the population. In general, the incidence of prosthetic stomatitis was higher among women and the elderly in the studies reviewed. Conclusions. The analysis of available sources of literature on the issue of epidemiology of prosthetic stomatitis allows to systematize the available modern developments, conduct their detailed analysis and make the obtained data available to practicing orthopedic dentists. The perspective of research consists in the detailed study of etiological factors contributing to the development of prosthetic stomatitis in patients with removable prostheses.