Residual Ridge Resorption Research Articles

To evaluate the crestal bone loss in mandibular implant overdenture via locator and ball socket attachments

Edentulism is a debilitating and irreversible condition and is described as final marker of disease burden for oral health. Rehabilitating edentulous patients with residual ridge resorption has improved tremendously because of Implant dentistry . Aims and Objectives: To evaluate the crestal bone loss in mandibular implant over denture via locator and ballsocket attachments: An In - Vivo study. Material and method: This study was undertaken in the Department of Prosthodontics and Crown &Bridge Methodology • According to the inclusion and exclusion criteria, twenty subjects were selected for this study. OPG radiographs were recorded for each subject. They were divided into two groups: Group A and Group B. • Group A subjects (10) received ball and socket retained mandibular implant overdenture against a maxillary complete denture with ball diameter of 2.25mm and gingival height of 3mm while Group B subjects (10) received locator retained mandibular implant overdenture. Results The result obtained was subject to comparison by ANOVA statistical analysis. It was found that for ball and socket attachment, highest crestal bone was observed on the mesial aspect of the right implant followed by the distal aspect of the same implant.

Biomechanical Evaluation of Bone Atrophy and Implant Length in Four Implants Supporting Mandibular Full-Arch-Fixed Dentures.

Residual alveolar ridge resorption often occurs after tooth extraction, which causes issues requiring further prothesis rehabilitation. A treatment concept referred to as all-on-four, involving fixed dentures supported with four implants, was recently developed. The current study aimed to determine the effect of changing bone atrophy and implant length in all-on-four treatments on stress and strain in the surrounding bone of the implant. A three-dimensional finite element method was used in this research. The stress analysis was conducted with von Mises stress values. Two types of synthetic jawbone models with mild and moderate atrophy were used. Furthermore, two different implant lengths with a similar implant design and diameter were selected, and they were classified into eight models. Then, the bone model was assessed via a computed tomography (CT) scan and was transformed into a virtual model in Geomagic and SolidWorks with implant rebuilding. After modifying bone atrophy, the von Mises stresses in the surrounding bone of the implant were as follows: mild type 2 < mild type 3 < moderate type 3 < moderate type 4. The bone quantity change rate increased more than when bone conditions were limited. Compared with changes in implant lengths, the stresses in the peri-implant surrounding bone were generally higher in the 9 mm implant length group than in the 11.5 mm group. However, the results did not significantly differ. In conclusion, the von Mises stress and strain increased in the models with moderate atrophy and low-density trabecular bone. Hence, bone atrophy and its presurgical diagnosis in long-term implant prognosis are crucial.

Inhibition of RANKL and Sema4D improves residual ridge resorption in mice

Residual ridge resorption (RRR) is a chronic and progressive bone resorption following tooth loss. It causes deterioration of the oral environments and leads to the pathogenesis of various systemic diseases. However, the molecular mechanisms and risk factors for RRR progression are still unclear and controversial. In this study, we developed a tooth extraction model using mice for analyzing long-term morphological and gene expression changes in the alveolar bone. We further applied ovariectomy to this model to elucidate the effects of osteoporosis on RRR progression. As a result, the alveolar bone loss was biphasic and consisted of rapid loss in the early stages and subsequently slow and sustained bone loss over a long period. Histological analysis indicated that ovariectomy prolonged the activation of osteoclasts in the alveolar bone. Furthermore, the expressions of Tnfsf11 and Sema4d kept increasing for a long time in OVX mice. Administration of neutralization antibodies for receptor activator of NF-κB ligand (RANKL) effectively suppressed RRR. Similarly, inhibition of Semaphorin 4D (Sema4D) also improved alveolar bone loss. This study demonstrated that reduced ovarian function may be a risk factor for RRR and that RANKL and Sema4D suppression are potential treatments.

Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) Complete Dentures for Atrophic Alveolar Ridges: Workflow Combining Conventional and Novel Techniques.

Extreme residual ridge resorption is a challenging clinical situation for the fabrication of complete dental prostheses. Computer-aided design and computer-aided manufacturing (CAD/CAM) complete dentures have been shown to have superior fit and material strength to conventionally fabricated dentures, but no clinical protocols have been described for cases of extreme residual ridge resorption. This report describes a workflow combining conventional and novel techniques for CAD/CAM complete dentures fabrication for atrophic alveolar ridges and demonstrates that a CAD/CAM workflow is an effective tool for solving this complex situation.

Numb Chin Syndrome Associated with Residual Ridge Resorption in Edentulous Mandible: Report of a Case

Numb Chin Syndrome Associated with Residual Ridge Resorption in Edentulous Mandible: Report of a Case

A case report of implant overdenture for an edentulous patient with a high level of residual ridge resorption of the mandible

A case report of implant overdenture for an edentulous patient with a high level of residual ridge resorption of the mandible

An edentulous case with severe mandibular residual ridge resorption treated using an implant overdenture

An edentulous case with severe mandibular residual ridge resorption treated using an implant overdenture

Effect of Posterior Residual Ridge Resorption and Relining for Mandibular Implant Overdentures on Bending Strain Around Implants.

To examine the influence of posterior residual ridge resorption (PRRR) and relining on bending strain around implants under an overdenture. Maxillary and mandibular edentulous models were made and covered with white silicone. Four strain gauges were placed on four sides of each implant. Two tissue-level implants were placed bilaterally in the part between the lateral incisors and canines of the mandible. A maxillary conventional denture and a mandibular overdenture were fabricated to fit the models. Three levels of bone resorption around the implant were created: 0, 0.8, and 1.5 mm. The surface of the residual ridge was uniformly removed from the area near the distal side of the implant to the retromolar section, and three levels of PRRR were created (0, 1, and 1.5 mm). After the measurement, the experimental denture of the PRRR of 1 mm and 1.5 mm were relined. Locator attachments were used. A 98-N occlusal force was applied, and bending strains around the implant were measured. The Kruskal-Wallis test and Bonferroni correction were employed to analyze the data. Without relining, at each bone resorption level around the implant, the bending strain was smallest with PRRR of 0 mm and largest with PRRR of 1.5 mm. The bending strain after relining was smaller than the bending strain with ridge resorption. Bending strains after relining were smaller than bending strains with no ridge resorption, but there was no significant difference in bending strain between these three groups. As PRRR increased, the bending strain increased without relining. As bone resorption around the implant progressed, PRRR enhanced the increase in the peri-implant bending strain. Bending strain was reduced when relining was performed.

Association between gonial angle on orthopantomogram and reline frequency in removable partial denture wearers.

Removable dentures are a reasonable option for prosthetic treatment. However, continuous residual ridge resorption and reline procedures are inevitable owing to the strong pressure exerted on the mucosa or inappropriate pressure distribution. This study aimed to elucidate the association between the gonial angle on orthopantomogram (GAO) with occlusal force and reline frequency in removable partial denture wearers. Participants were patients who had previously received removable partial denture treatment for a free-end defect. Age, sex, number of remaining teeth, remaining opposing teeth, and occlusal support were investigated. GAO was measured using panoramic radiographs. The mean relining interval was calculated as the mean number of days between denture insertion and the first relining or subsequent relining. The association between the mean relining interval and each factor was investigated. Sixty-five subjects (33 females) were analyzed. The median value of the mean relining interval was 533.3 days, and the median GAO was 123°. There was a significant positive correlation between the mean relining interval and GAO (rs = 0.335). The number of remaining opposing teeth and occlusal support exhibited weak negative correlations with mean relining interval (rs = -0.187 and -0.214, respectively). Multivariate analysis using a generalized linear model showed that GAO was a significant explanatory variable for the mean relining interval. Within the limitations of this study, GAO was found GAO was found to contribute to the increased frequency of relining due to ridge resorption in patients with a small GAO.

Prosthodontic management in residual ridge resorption

Bone resorption is a chronic, progressive disease and irreversible process that occurs in all patients and can be classified into six different types. There are some of pathological and etiological factors that may cause resorbed ridge such as anatomical, prosthodontics, metabolic and systemic factors. The present article, were reviewed the literature concerning on possible mechanism, diagnosis, etiological factors and how to manage and prevent of resorbed ridge for edentulous patients.

Minimise Weight, Increase Retention: Hollow Denture - A Case Report

The increased inter-ridge space due to resorption of residual ridge and long upper lip length makes the prosthetic rehabilitation of such patient a great challenge for a prosthodontist. Retention and stability of complete denture in cases of residual ridge resorption is usually reduced because of minimised denture bearing area. The maxillary denture fabricated in such patients are bulky in nature which further compromise its retention. So, in this case report a simplified technique is described for construction of hollow maxillary denture which being light in weight further improves denture retention.

GENETIC ASSOCIATION OF HYPOXIA INDUCIBLE FACTOR (HIF) – 1 ALPHA GENE AND RESIDUAL RIDGE RESORPTION OF JAW BONE

Due to considerable alterations in individual bone structure, the residual ridge is constantly under the stress of bone resorption. In certain circumstances, this can cause disproportionate bone deterioration, making restorative dental management difficult. This inimitable curative procedure in the oral cavity is affected by specific factors in the oral tissue. A variety of HIFs are expressed during the healing of oral wounds in comparison to skin wounds. The target of this review article was to look at a cistron tic connotation among SNP of the HIF-1 α gene that is understood to own great genetic diversity, and also the residual ridge reabsorption (RRR). Hence, this review concentrates on the association and genetic basis of HIF α gene in residual ridge resorption.

Analysis of Residual Ridge Morphology in a Group of Edentulous Patients Seeking NHS Dental Implant Provision-A Retrospective Observational Lateral Cephalometric Study.

A convenience sample of 154 edentulous patients referred for implant provision at a Regional National Health Service Dental Hospital in the North West of England were identified. The cephalometric radiographs that were taken as part of the patient baseline investigation were assessed. Digital tracing was used to measure the anterior maxillary and mandibular bone height and ridge angle with respect to the maxillary and mandibular planes. The mean height of the bone in the maxilla was found to be 14 mm, and the mean ridge angle for the anterior maxillary residual ridge is 104°. The mean height of bone in the mandible was 18 mm, while the mean ridge angle for the anterior mandibular residual ridge was 77°. Using the Cawood and Howell classification demonstrated that class VI mandibles were the most common. The cross-sectional shape of the mandible varied, with the triangular shape most common. Although there was adequate bone stock for implant placement in these cases, the mandibular residual ridge resorption presents a lingual inclination to the residual bone. The limited residual ridge position and inclination would dictate that conventional implant placement could be challenging.

Suction cup induced palatal hyperplasia in maxillary complete denture: A case report

Although various methods have been applied for getting a Complete Denture with perfect retention, but it is difficult to attain. Residual ridge resorption creates an ill-fitting denture, hence causing difficulty while eating and even dislodging during talking, even adding to the patient's embarrassment. Suction cup has been widely used for the retention &amp; stability of dentures, but is known to carry few complications like palatal perforations and oro-antral communications. Here we present a case report of palatal hyperplasia due to the suction cup.

English

The main aim of prosthetic dentistry is restoring the form, function, comfort and appearance of the patient by the placement of a prosthesis replacing the missing teeth and contiguous tissues.1 Various prosthetic options for partially edentulous patients include an interim removable partial denture (RPD) to a cast partial denture, a fixed dental prosthesis (FDP), and a more implant-retained prosthesis. However, FDP and implant-retained prosthesis are not always feasible, particularly in patients with excessive residual ridge resorption and jaw defects due to trauma and / or surgical ablation. In such a situation, a dentist may resort to another option of fixed-RPD prosthesis, to restore the defective hard and soft tissues to achieve natural aesthetics, phonetics, comfort, and better hygiene. This hybrid prosthesis fulfils the objectives of the rehabilitation such as support, stability, and retention characteristics similar to a fixed prosthesis and aesthetics and hygiene maintenance of a removable prosthesis.2,3,4,5 Any prosthesis designed or fabricated should be based on the prosthetic principles of support, stability, retention, and preservation of remaining structures.1 From the patient's perspective, retention is one of the important factors for its acceptability. These retentive options range from simple bar and clip attachments to more sophisticated spark erosion overdentures.6,7 Spark erosion prosthesis is technique sensitive, bulky, and requires expensive equipment.6,7 On the other hand, precision attachments provide better vertical support and stimulation to the underlying tissue through intermittent vertical massage.8 Treatment with a hybrid denture is an affordable choice to fulfil the patient's aesthetic demands along with providing a good prognosis for the prosthesis and preservation of the remaining dentition. This article presents two case reports of prosthodontic rehabilitation of a patient with mandibular defects using an attachment-retained fixed-removable hybrid prosthesis.

Analysis of Marginal Bone Loss and Residual Ridge Resorption in Conventionally Loaded Single and Two Implant Supported Overdentures

Purpose: The aim of this study was to analyze the marginal bone loss and residual ridge resorption in patients wearing single and two implant-supported overdentures. Materials and methods: This study was conducted on 20 edentulous patients between 50-75 years of age who have been completely edentulous for a period of at least one year or more. Patients were divided into two groups: Group-A in which two implants of size 3.75x13mm were placed in B and D position and ball abutments were attached to make an overdenture; in Group-B patients, a single implant at position C was placed and overdenture was made with ball abutments. Crestal bone loss was recorded around the margins in both the groups and residual ridge resorption was calculated in the mandibular posterior region using Wical And Swoope method. The data collected were compared for analysis using the Man-Whitney U test. Results: For 2-IOD overall mean crestal bone loss for one year was 0.15± 0.03cmand for S-IOD it was 0.14 ± 0.03cm. The significance value was calculated to be 0.518 and U=41.5 which was found to be non-significant. Difference in residual ridge resorption was also found to be non-significant in both the groups with the significance value of 0.284 and U=36. Conclusion: The scope of the single implant-retained overdentures can be a promising alternative for patients with an atrophic mandible, systemically compromised patients with financial difficulties.

Prevalence of Residual Ridge Resorption (RRR) Pattern in Edentulous Mandible and its Association with Complete Denture - A Retrospective Study

Prevalence of Residual Ridge Resorption (RRR) Pattern in Edentulous Mandible and its Association with Complete Denture - A Retrospective Study

Association of Residual Ridge Resorption with Age, Gender and Underlying Medical Conditions in Completely Edentulos Patients - A Retrospective Study

Association of Residual Ridge Resorption with Age, Gender and Underlying Medical Conditions in Completely Edentulos Patients - A Retrospective Study

Management of cawood class V mandibular ridge using “Dynamic impression technique”: A case report

Residual ridge resorption is a chronic, progressive, irreversible and cumulative disease. Stability is defined as resistance to horizontal displacement of prosthesis. Providing a stable lower denture has been challenging for dentists. This article outlines the management of the mandibular ridge resorption with dynamic impression technique. Stability of complete lower dentures has challenged dentists and patients alike. Dynamic impression technique is clinically significant for management of resorbed mandibular ridge, as the range of action of the muscles and other structures that relate to the denture space is recorded by an impression so that the denture can be shaped accordingly.

English

Removable prosthesis is probably one of the oldest types of dental therapy used to rehabilitate patients with complete or partial edentulousness. The main function of the edentulous alveolar ridge is to provide a major area of support for the dentures.1 Ill-fitting prosthesis leads to a condition where there is no longer adequate support of bone due to RRR. Hence, rehabilitation of such cases pose a clinical challenge, as there is a decreased denture foundation area for support, retention and stability.2 Residual ridge resorption (RRR) is the severe atrophy of alveolar bone underlying the mucoperiosteum. RRR affects the alveolar bone morphology, resulting in a decreased denture foundation area and increased inter-alveolar ridge space. The increase in inter-ridge distance provides a huge restorative space which results in a heavier complete denture due to greater volume of denture base material. This increase in restorative space amalgamates with the long lip length of the patient which gives rise to huge challenge to the success of the complete denture. Also, decreased denture foundation area increases the heaviness of the prosthesis and negatively affects the retention of the denture due to gravity.3 Various weight-reduction techniques have been used in the past using a rigid three-dimensional spacer, such as dental stone (Ackerman, 1955), cellophanewrapped asbestos, silicone putty during laboratory preparation to keep denture base content out of the intended hollow cavity of the prosthesis. The following case report describes a distinct lab technique for construction of hollow maxillary complete denture for a patient with severe RRR.