Retention Of Complete Dentures Research Articles

About the retromolar pad - its particularities and role in the stability and retention of the classic complete denture

Aim. This paper aims to bring back into focus the area of the retromolar pad as an important element for the support area and for achieving an effective marginal seal in case of completely edentulous mandible. Material and methods. 24 cases of complete mandibular edentation were analyzed and the characteristics of the retromolar pad were followed. Analyzing the appearance of the retromolar pad, an attempt was made to classify them into the classes proposed by J. Lejoyeux. The clinical implications of various aspects of this area were monitored. Results. In patients with the retromolar pad in the last three classes, difficulties were encountered in adapting the individual tray and during the functional impression; in cases with advanced resorption of the alveolar ridge and unfavorable retromolar pad, a poor marginal seal was obtained. Conclusions. From the analyzed cases, it was reconfirmed that in an old complete mandibular edentation, the retromolar pad can take an oblique or vertical position. Such a situation becomes unfavorable for the retention of the complete denture, for the marginal seal. Knowing the particularities of the completely edentulous prosthetic field and the clinical stages is essential for maintaining denture stability.

Retention and Patient Satisfaction of Conventional Over Simplified Non-Balanced Maxillary Removable Complete Dentures.

Insufficient evidence is available in quantifying the retention between simplified and conventional non-balanced dentures. The aim of the study was to quantify and compare the maxillary denture retention and patient satisfaction between conventional and simplified removable non-balanced complete dentures. This randomized clinical trial recruited 44 patients (n=22) with definitive criteria. Simplified and conventional non-balanced complete dentures were fabricated for the intervention groups. The denture retention of maxillary complete dentures was assessed with a dynamometer and patient satisfaction with a visual analogue scale. The mean retention of maxillary denture and satisfaction were recorded at 0-,3-, and 6 - month intervals. The data were statistically analyzed. (α=.05). The mean ±SD of retention for conventional denture at 0, 3, and 6 months by dynamometer ranged from 122 ± 1.64 N to 121 ± 1.57 N and 111 ±1.45N to 110±1.97 N for the simplified denture. The mean ±SD of visual analogue score varied between 9.45±0.35 to 7.19± 0.69 for conventional dentures and 8.00 ±1.39 to 6.81±0.82 for simplified dentures. The repeated ANOVA, t-test and post-hoc Bonferroni revealed statistically significant differences between the two types of denture. (P⟨.05) Conclusion: Numerical retention and satisfaction were higher in conventional non-balanced dentures than simplified dentures.

A Randomised Controlled Trial of Postoperative Sensitivity after Class II Restoration with Bulk-Fill vs Conventional Composites.

Bulk-fill composites may simplify posterior restorations, saving time and reducing technical complexity. Post-operative sensitivity is a risk of posterior composites; bulk-fill composites could mitigate this. This single centre, double-blinded, parallel groups randomised controlled trial compared postoperative sensitivity following restoration of class II carious lesions with bulk-fill or conventional, layered composite. there will be no difference in post-operative sensitivity between the two materials. Participants requiring class II restoration of posterior teeth were randomised to bulk-fill (FU) (Coltene Fill-UpTM) or conventional, layered (BE) (Coltene Brilliant Everglow) composite. Allocation was concealed during cavity preparation. Only the operating dentist knew allocation. The outcome was 24 h post-operative sensitivity. 41 patients were randomised (20/group). Two patients from FU group were excluded from analysis (factors unrelated to intervention). There was no difference in postoperative sensitivity at 24 h nor any time point. Only participant age and baseline sensitivity scores significantly impacted post-operative sensitivity. One restoration debonded in FU group at 10 days, with no other adverse effects. No difference in time taken to place restorations was seen. Within the study's limitations, post-operative sensitivity after class II posterior restorations was no different in bulk-fill restorations compared with conventional, incrementally cured composite.

Precision Prosthodontic Rehabilitation of Flabby Ridge with a Modified Window Technique: Case Report

Flabby ridge, also known as a soft (mobile), movable, or displaceable ridge, presents a common clinical challenge in dental practice. It primarily affects the alveolar ridges of the upper (maxillary) or lower (mandibular) arches. The anterior region of the maxilla is especially susceptible in edentulous patients. The flabby ridge lacks the firmness and stability required, leading dentures to become loose and unstable. Consequently, this instability can result in discomfort, speech and eating difficulties, and reduced quality of life for denture wearers. The flabby ridge often does not provide the necessary contour and resilience needed to establish an effective seal and maintain suction between the denture base and the underlying tissues. This compromises denture retention, making them susceptible to dislodgement during typical oral functions. Therefore, rehabilitating a completely edentulous patient with flabby tissue presents a formidable challenge for prosthodontists, as it undermines the retention, stability and support of complete dentures. Methods for managing flabby ridges encompass surgical removal, ridge augmentation, specialized impression techniques, balanced distribution of occlusal loads and implant therapy. Various impression techniques have been proposed to address the complexities of such cases. By carefully applying the principles of complete denture construction, a palliative treatment approach can be achieved. Special impressions often employ the window technique to capture a static impression of the flabby area, which introduces its own set of challenges. This innovative case report introduces a modified window technique that incorporates precise record transfer of the flabby ridge using tissue (blotting) paper. Specifically designed for the anterior mandibular flabby ridge, the technique employs a custom tray with a window positioned over the flabby tissues. A mucostatic impression material is utilized to minimize pressure on the flabby tissue, thereby reducing potential tissue distortion during the impression process. The procedure is executed in two steps: first, stable structures are recorded, followed by capturing the mobile tissues using light-body polyvinyl siloxane (PVS) elastomeric impression material within the window area. This method ensures an accurate record of the denture-supporting structures while maintaining the contour and details of the flabby tissues without displacement. Importantly, the technique is crafted for straightforward implementation by general dental practitioners within a primary dental care setting.

Effect of Using Two Different Techniques of Denture Base Fabrication on Retention of Maxillary Complete Denture: An in Vivo Comparative Study

Effect of Using Two Different Techniques of Denture Base Fabrication on Retention of Maxillary Complete Denture: An in Vivo Comparative Study

Improving the Retention of Maxillary Complete Denture: A Case Report

Complete dentures play an essential role in restoring oral function and improving the quality of life for individuals who have missing all their normal teeth. One of the key factors determining the success of complete dentures is their retention, which refers to the ability of dentures to stay securely in place during normal oral function. Adequate retention is essential for proper speech, mastication and overall comfort of the denture wearer. The study aimed to improve the retention of complete dentures through three different approaches: spacer, posterior palatal seal area, and undercut area. Three dentures were fabricated using the same steps, with variations in certain steps based on the retention technique being employed. The study showed that all three dentures had improved retention compared to standard complete dentures. The dentures that included the posterior palatal seal area and spacer demonstrated higher retention than the denture that employed the undercut technique. It is worth noting that the patient did not find the denture with the undercut technique satisfactorily.

Japanese Wooden Plate Denture as Origin of Suction Retention.

The modern theory of complete denture retention using suction was applied to wooden plate dentures in Japan from the first half of the 16th century, which is an astonishing achievement since it was clinically applied in North America and Europe in the latter half of the 19th century nearly 300 years later. Wooden dentures are unique to Japan resulting from skilled Japanese craftsmanship and are not found in other countries. We comprehensively reviewed reports on wooden plate dentures, analyzed 145 complete and partial dentures, and discussed their history. Japanese wooden plate dentures are mainly made of box wood, and artificial teeth are made of pagodite, ivory, and natural teeth. Small nails were driven into the molar region. Many existing dentures revealed attrition on the occlusal faces, thereby indicating that the wearers were able to masticate sufficiently. Wooden plate dentures have been used for 400 years in the early 20th century. Although Japanese wooden dentures have not been mentioned in the history of dentistry in Western literature, they comprise an important part of the history of denture development.

Frailty and mini dental implants

AbstractPatients who have been diagnosed as frail and have atrochic jaws may have a dramatic increase of quality of life with mini implant treatment for retention of a mandibular complete denture.

Effect of Different Definitive Impression Techniques for Resorbed Mandibular Ridge on Retention of a Lower Complete Denture.

This study aimed to evaluate the effect of different definitive impression techniques for the resorbed mandibular ridge on the retention of lower complete dentures. Ten completely edentulous male patients with severe atrophic mandibular ridge were selected from the Prosthodontic Department's outpatient clinic, Faculty of Dentistry, Sinai University (Kantara branch). Each patient received four dentures. Dentures were divided into four groups according to the type of final impression, Group I: Conventional impression techniques (open mouth technique), Group II: Cocktail impression techniques, Group III: Modified functional impression technique, and Group IV: Wire impression technique. Each denture was used for one month and at the end of the month the retention test was carried out and the results were tabulated and statistically analyzed. There is a statistically significant difference between the groups. The results also showed that the highest mean value was in group IV, whereas the lowest mean value of retention was in group I. Wire impressions produce lower dentures with higher retention, whereas conventional impressions produce lower dentures with the lowest retention, so it is considered to be more advantageous. The wire impression technique is superior in the management of resorbed ridges as compared with other techniques.

Total and partial magnetic retained overdenture. A clinical report.

Abstract An overdenture is a denture supported partly by soft tissues and partly by retained teeth or implants. Magnetic tooth-retained overdentures are used to increase support, retention, and stability but also prevent alveolar ridge resorption. Magnetic attachments increase the retention of partial or complete dentures regardless of the path of the insertion and, in addition, can be used for abutment teeth with periodontal disease. This paper discusses two oral rehabilitation cases with total and partial tooth-retained overdenture.

Clinical Trial to Assess Physiology and Activity of Masticatory Muscles of Complete Denture Wearer Following Vitamin D Intervention.

Background and Objectives: Little information is available on the role of Vitamin D as a micro-nutrient deficiency with masticatory muscle efficiency and its effect on the function of removable prosthesis. The aim of this study was to evaluate the role of vitamin D on masticatory muscle activity among completely edentulous patients and its effect on the retention of removable complete dentures (RCDs). Materials and Methods: A non-randomized clinical control trial was conducted on completely edentulous patients (60.53 ± 7.01 years) in the Indian population between 2017 and 2019. Subjects were evaluated for temporomandibular disorders according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum Vitamin D (S Vit D) levels, Ultrasonography (USG), and surface Electromyography (sEMG) readings of the masseter muscle were recorded at enrolment (Level 0), after 3 months of Vitamin D therapy (Level 3), and after consecutive 3 months of maintenance therapy, i.e., after 6 months from baseline (Level 6). The fabrication of new RCDs was done for all after the enrolment, and the retention of RCDs was assessed by asking a question regarding denture retention and asking respondents to mark their satisfaction on a 5-point Likert scale. Data were analysed using ANOVA, Paired'-test and Pearson correlation coefficients. A p-value less than 0.05 indicated a statistically significant association. Results: Between enrolment and a six-month follow-up, S Vit D levels showed an increase from 16.03 ± 5.68 ng/mL to 31.35 ± 9.28 ng/mL, showing an increase of 15.32 ± 9.38 ng/mL (95.57% rise). Statistically significant values were observed for USG and sEMG. Conclusions: Results showed that S Vit D affects masticatory muscle activity by improving its thickness and boosting its tonicity. Healthy muscles assist in the retention of RCDs, consequently aiding in mastication, speech, and phonetics, hence improving patient satisfaction. Clinical implication: Acknowledging the fact that the prevalence of Vitamin D deficiency is worldwide. We suggest Vitamin D therapy as a nutritional intervention among the elderly completely edentulous population, following dietary counselling, and consider Vitamin D therapy to be an adjunct to nutritional counselling for improving masticatory muscle activity and efficiency, which aids in RCD retention and stability. Consequently, improving oral health-related quality of life for individuals.

Prosthetic Rehabilitation of Parkinson’s Disease Patient with Flabby Ridge Using Modified Window Technique: A Case Report

A flabby alveolar ridge is a mobile soft tissue seen superficially affecting either maxillary or mandibular alveolar ridge. It commonly develops when alveolar bone gets replaced by hyperplastic soft tissue. It is particularly seen in maxillary anterior region of long term denture wearers. Inadequate support stability and retention of complete denture are the problems encountered in these patients. Tremors caused by Parkinsonrsquos disease can make prolonged dental treatment challenging. Various methods are used for managing flabby alveolar ridges which include surgical technique special impression procedures equalized distribution of occlusal forces and implant placement. Special impression technique that involves window technique for flabby ridge has multiple challenges. This case report discusses the use of modified window technique for managing maxillary ridge with flabby area from canine to canine in a Parkinsonrsquos disease patient. This impression technique aids in recording the impressions of the flabby ridges with minimal displacement thus enhancing retention stability and support of the denture.

Evaluation of dynamic impression lining material effects on masticatory function and the oral health-related quality of life of complete denture wearers: A six-month randomized controlled trial.

To determine the effect of a dynamic impression lining material (DIL) on the retention and stability of mandibular complete dentures (LCD), masticatory performance, and the oral health-related quality of life (OHRQoL) of the patients wearing complete denture (CD) compared with those wearing a denture with conventional hard denture liner (HL). Twenty-five patients who wore CD with an ill-fitting LCD were randomly assigned to two groups: LCD relined with DIL (Dynamic impression lining material) or HL (Tokuyama® Rebase II (fast)). Three objective measures (denture retention, stability, and masticatory performance) were measured. The OHRQoL was also measured using the Thai version of oral impacts on daily performance. Outcomes were measured at six time points: baseline, 3 days, 1 week, 1 month, 3 months, and 6 months after relining. Outcome changes were analyzed using a generalized estimating equation, and all models were adjusted for age, mandibular ridge form, and CD age at a 5% significance level. After LCD relining, the frequency and severity of adverse oral impacts significantly decreased. In the DIL group, denture pain occurred on and off over six months, and an ill-fitting denture impacted at one month. In the HL group, denture pain continuously decreased over time. At 3 months, changes in the clinical properties of DIL were observed, including perceived odor. The material also peel-off from the denture base, and plaque accumulation was observed. In contrast, the HL properties remained stable for over 6 months. Although DIL improves denture retention and stability, masticatory performance, and the OHRQoL of the patients who wear CD, oral adverse effects were not eliminated. The clinical properties of DILs changed at 3 months, while the HL remained relatively stable for up to 6 months.(The clinical trial registration number: Thai Clinical Trials Registry (TCTR) number TCTR20210625005.).

Associated short and regular implants for complete denture retention in an atrophic mandible: clinical follow-up

Associated short and regular implants for complete denture retention in an atrophic mandible: clinical follow-up

Prosthodontic way of overcoming the hurdle of flabby tissues: A case series

Flabby ridges displaceable tissues are a common finding in long term denture wearers. Careful management is mandatory, failing which flabby ridges adversely affect the retention, stability and support of complete dentures. Management of flabby ridges can be driven either surgically or prosthodontically. A list of techniques has been noted in the literature for prosthetically managing flabby tissues such as Zafarullah Khan Technique, modified Zafarullah Khan Technique, Shum & Pow Technique, Hobkirk’s Technique, Palatal splinting using two part tray technique, etc. The decision to consider which material & or technique is appropriate depends on the particular clinical situation. Moreover, the advent of newer dental materials has added to this confusion. The proper diagnosis and planning is required for selecting the material and technique according to the displaceability of the tissues. This article describes a series of clinical scenarios, incorporating these impression techniques and materials for managing the condition.

Comparison of retention and denture base adaptation between conventional and 3D-printed complete dentures.

Background. In recent years, complete denture construction has been revolutionized using computer-aided designing and computer-aided manufacturing (CAD-CAM) technology. This clinical study compared the retention and denture base adaptation of 3D-printed complete dentures fabricated using dimethacrylate-based resins with a photoinitiator versus conventional complete dentures. Methods. Ten completely edentulous patients were nominated for this study. Each patient received two complete dentures. One complete denture was conventionally fabricated, while the other was digitally fabricated through 3D printing of dimethacrylate-based resins with a photoinitiator. Denture base adaptation for both dentures was evaluated using surface matching software. Denture retention was also evaluated using a digital force meter at the time of complete denture insertion (T0 ), after three months (T3 ) and six months (T6 ) of denture use. Results. Regarding adaptation (mean misfit values), a statistically insignificant difference was detected between the two differently fabricated complete dentures. In addition, comparable satisfactory retention values were observed for both conventionally fabricated and 3D-printed dentures; however, there was an insignificant increase in retention over time. Conclusion. 3D-printed complete dentures fabricated using dimethacrylate-based resins could be a promising alternative to conventionally fabricated complete dentures with satisfactory denture base adaptation and retention.

Determination of the Frequency of Various Anatomical Forms of the Hard Palate for Complete Denture Fabrication

OBJECTIVE: To determine the frequency of patients with various anatomical forms of the hard palate for complete denture fabrication and to compare the mean distortion in heat cure denture base polymer in millimetres in different hard palate forms. METHODOLOGY: Informed consent was taken from total of seventy six patients and divided into low and medium hard palate forms. Dental casts were prepared from alginate impression and poured in type III stone and reference point R was marked on the deepest part of the posterior palatal seal area at the junction of hard and soft palate on each cast. After curing, the cast along with the cured denture base was retrieved from the flask. After 48h of curing cycle the distortion was measured in millimetres from R to R' via traveling microscope. RESULTS: Among seventy six participants the frequency of low palate forms was 45 (59.2%) and medium palate forms was 31 (40.8%). For each sample three readings were taken R1, R2 and R3. The mean distortion measured in low hard palate form was 0.52mm with a standard deviation of 0.18, the mean distortion measured in medium hard palate form was 0.76mm with a standard deviation of 0.27, which were clinically significant with a p-value of 0.0001. CONCLUSION: The hard palate forms has direct influence on retention of maxillary complete denture in posterior palatal area. KEY WORDS: Heat Cure denture base, distortion in hard palate forms, dimensional changes in heat cure, hard palate anatomy and denture bases

Post-dam

The success of an upper complete denture is dependent on various factors, including retention and stability during function, comfort and aesthetics. Physical retention of the denture depends upon adequate extension and fit, along with a good border seal. The border seal of an upper denture relies upon extension of the flanges to the functional depth and width of the sulci, and the post-dam. The post-dam of an upper complete denture is a raised ‘lip’ along the posterior border that becomes embedded into the palatal mucosa. This ‘embedding’ of the border within the mucosa helps to create the seal. This technique tip highlights the location and shape of the post-dam, as well as the clinical stages involved in its construction. CPD/Clinical Relevance: Successful location and application of a post dam will help in retention of an upper complete denture.

Evaluation of Denture Adhesive versus Single Implant on Complete Denture Retention and Patient Satisfaction

Evaluation of Denture Adhesive versus Single Implant on Complete Denture Retention and Patient Satisfaction

Management of a complete denture in the flat mandibular ridge using a semi-adjustable articulator along with an effective suction method

Background: Complete dentures can improve the quality of life of edentulous patients. The selection of a suitable articulator and an impression technique is important to construct a stable and retentive complete denture with good occlusion. The use of a semiadjustable articulator ensures that the dentures can be constructed such that their movement closely resembles the patient’s physiological movements. The effective suction method can ensure the development of the border seal according to the patient’s anatomical condition. The use of a semi-adjustable articulator along with an effective suction method is expected to provide good results in the construction of a complete denture. Purpose: This report aimed to describe the management of individual complete dentures in the flat mandibular ridge using a semi-adjustable articulator along with an effective suction method. Case: A 69-year-old female patient came with a chief complaint of her old dentures being unusable and wanted new dentures made. The patient’s general condition was good, and the last extraction was done three months prior to the patient’s arrival. The mandibular posterior alveolar ridge showed dextral tapering and sinistral flatness. Case Management: A complete denture with an acrylic base was fabricated using a semi-adjustable articulator along with an effective suction method. Conclusion: Flat ridge case management using a semi-adjustable articulator with an effective suction method can improve complete denture retention and stability.