Denture Retention Research Articles

Comparison of masticatory performance and oral hygiene status using cream-type denture adhesives and home liners: A cross-sectional study using propensity-score matching.

Differences in the effects of cream-type denture adhesives and home liners remain unclear. This cross-sectional study aimed to clarify the differences in the oral-hygiene status and masticatory performance between participants using cream-type denture adhesives and those using home liners. Masticatory performance with and without cream-type denture adhesives and home liners was evaluated using colour-changeable chewing gum. Oral hygiene was assessed using the tongue coating index (TCI). Propensity-score matching was performed using oral moisture, presence of palatal or mandibular protuberances, type of residual ridge, denture type (complete or partial denture), and denture retention as background factors. Wilcoxon signed-rank test was used to examine the differences in masticatory performance with and without cream-type denture adhesives and home liners and differences in masticatory performance and TCI between the cream-type denture adhesive and home-liner groups. This study included 38 and 40 cream-type adhesive and home-liner users, respectively, and 17 pairs were obtained after propensity-score matching. The Wilcoxon signed-rank tests showed that masticatory performance was significantly different with and without the use of home liners, and higher values were obtained with the use of home-liners. However, the cream-type denture adhesive and home-liner groups showed no significant differences in terms of the change in masticatory performance with the use of them. Furthermore, Wilcoxon signed-rank tests showed that TCI values were significantly high in the cream-type adhesive group. The findings in this study suggest that home liners improve masticatory performance and that participants regularly using cream-type denture adhesives have poorer oral hygiene.

Etiology, Diagnosis And Therapy Of Burning Mouth Syndrome In Denture Wearers - Review

Background: The Burning Month Syndrome (BMS) is an oral mucosa pain - with or without inflammatory signs - without any specific lesion. Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity. The cause of BMS is not known, therefore a complex association of biological, psychological and neurophatic factors has been identified. BMS is classified as an idiopathic (nociplastic) orofacial pain with or without somatosensory changes by International Classification of Orofacial Pain (ICOP 2020). The aim of this study was to understand the etiological factors (local, systemic, and psychosocial) which may be responsible for oral burning associated with BMS, and to offer the prosthodontic practitioners possibilities for treatment generally at all patients, especially at denture wearers in solving this problem. Matherials and methods: Review of literature was used to analyze the etiological factors for BMS, pain characteristics, diagnostic criteria and treatment possibilities for BMS condition at patients with dentures. Results: BMS can be divided into three types depending on the intensity of pain. There are also few possible theories behind the cause of BMS. Local oral factors are: denture acrylic allergies, poorly fitting dentures, para functional activities, salivary gland dysfunction, taste dysfunction, infectious agents, periodontal diseases, peripheral nerve damage. Systemic factors are: nutritional deficiency/anemia, central nervous system disorders, psychological disorders, hormonal changes and diabetes mellitus, xerostomia and Sjogren's syndrome. Discussion: Problems with dentures are important factors in the burning symptoms. Inadequate denture retention and stability can induce abnormal tongue activity and become a habit to retain the denture extensions and in adequate freeway space increase load on the denture bearing areas which results of burning mouth sensation. It is clinically helpful if patients find that removal of the denture reliefs their symptoms. Although the short‐term follow‐up studies may show potential symptomatic improvement with treatment in patients with BMS, the long‐ term outcomes for BMS remain unclear. In perspective, complete understanding of the etiology and pathogenesis is imperative to the development of novel and efficacious therapeutic strategies and will guide overall prognosis of the disease in the future. Conclusion: Although different etiological theories have been proposed to explain primary burning mouth syndrome, none have received universal acceptance to date. BMS is a difficult and challenging problem for the dental practitioner. It is a clinical diagnosis made via the exclusion of all other causes. No universally accepted diagnostic criteria, laboratory tests, imaging studies or other modalities definitively diagnose or exclude BMS. The key to successful management is a good diagnostic work-up and coordination between the prosthodontic practitioners and appropriate physicians and psychologists. All this together will help prosthodontics practitioners to better diagnose and treat the BMS.

Comparative Analysis of Adaptation of Conventional and Printable Complete Denture Bases to the Underlying Casts - An In Vitro Stereomicroscopic Study.

Properly adapted complete denture bases will have adequate retention to the underlying oral mucosa. With technological advancement, there are various techniques of fabrication of complete dentures. There are studies regarding the marginal adaptation of conventional and CAD-CAM denture bases, but there is not enough research comparing the marginal adaptation and polymerisation shrinkage of conventional and 3D printed complete denture bases. In vitro study using stereomicroscopy to determine the marginal discrepancy between the denture base and the cast. Twelve gypsum casts were taken and divided into conventional and 3D-printed groups. Conventional denture bases were fabricated by adapting wax of 2 mm thickness which was subsequently processed whereas 3D printed bases were designed and the standard tessellation language (STL) files were used to print the denture bases. Three points were marked at the mid-palatal line and on both maxillary tuberosities. Digital images were then captured at the marked regions and were used to measure the maximum gap between the cast and denture base at the marked regions. Data were analysed using an independent t-test and one-way ANOVA. Conventional dentures had a significantly lesser marginal discrepancy than 3D printed dentures (P = 0.000). The left maxillary tuberosity showed the highest marginal discrepancy, significantly different from mid-palatal and right tuberosity sites. Conventional dentures perform better than their counterparts in terms of adaptation. This accurate adaptation is vital for the retention of the complete denture.

Alternative fixation mechanisms for complete removable dentures: a literature review and pilot study

Adhesives for removable dentures are specialized alternative products designed to enhance the retention of dentures. They help prevent dentures from shifting, ensuring comfortable and secure wear. Adhesives come in various forms, such as creams, powders, pads, strips, and gels. Creams and gels are applied to the inner surface of the denture, creating a strong bond with the gums, while powders provide a thin layer of fixation. Pads and strips can be conveniently attached to the denture, distributing the fixation evenly. Choosing the right adhesive is important for ensuring comfort and preventing possible allergic reactions. Regular cleaning of dentures and proper use of adhesives contribute to oral health and the longevity of the dentures. This literature review presents contemporary aspects and developments in materials aimed at improving the quality of retention for removable dentures.

Retention of Digital Mandibular Complete Denture in In Flat Resorbed Ridge with Different Impression Techniques, A Randomized Clinical Trial.

Retention of Digital Mandibular Complete Denture in In Flat Resorbed Ridge with Different Impression Techniques, A Randomized Clinical Trial.

Evaluation of effect of low-level laser therapy on alleviation of pain in patients with implant-supported mandibular overdenture: A pilot study

Aim: Rehabilitation of edentulous jaws with implant-supported overdenture has achieved a comprehensive acclamation across the globe due to compromised retention and stability in conventional complete dentures. In dentistry, low-level laser therapy (LLLT) has become a viable treatment option for lowering inflammation, easing pain, and speeding up wound healing. This study aimed to evaluate the effect of LLLT on alleviation of pain in patients with two implant-supported mandibular overdentures. Study Setting and Design: This study was carried out in the Department of Prosthodontics at Index Institute of Dental Sciences, Indore, Madhya Pradesh. Completely edentulous patients willing for implant-supported mandibular overdenture and who gave consent, were enrolled. Materials and Methods: A total of ten implants were placed in five patients with completely edentulous mandibular arch willing for implant-supported mandibular overdenture. Individuals from the outpatient division of Department of Prosthodontics, Crown & Bridge, Index Institute of Dental Sciences, Indore were chosen as patients. Bilateral implants were inserted into the mandible at locations B and D. On the experimental side, low-level laser therapy (wavelength 810 nm) was administered immediately following implant insertion and on the third day. Over the course of 72 hours, pain after surgery was assessed using visual analogue scale (VAS) values, beginning at baseline. Statistical Analysis Used: The Mann-Whitney U test was used for statistical analysis of the intergroup pain alleviation scores. Results: The results showed that on intergroup comparison, the experimental side exhibited significantly reduced VAS pain scores relative to the control side (P<0.05). Conclusion: LLLT can be used as a promising adjuvant therapy to lower the degree and duration of pain after undergoing dental implant surgery.

Fully digital versus conventional workflow: Are removable complete overdentures equally good? A randomized crossover trial.

Implant-supported removable complete overdentures (IODs) are a common treatment in case of edentulism and malfunctioning of the conventional denture. Manufacturing IODs in a conventional way (C-IODs) is time-consuming, but in a digital workflow, this can be done in three sessions. Digitally produced IODs (3D-IODs) are also more advantageous than C-IODs because lost or broken 3D-IODs can be swiftly reproduced as the digital design is always available. To prove in a non-inferiority study, with a margin of 0.3 point per Oral Health Impact Profile-20 (OHIP-20) question, that IODs made according to a fully digital workflow (3D-IODs), function as good as C-IODs with respect to patient-reported outcome measures (PROMs). This randomized crossover study included 36 fully edentulous patients who showed extreme resorption of the maxillary alveolar process, making denture retention difficult. After a maxillary bone augmentation and the installation of 4-6 implants, each patient wore both types of IOD for 1 year each, with the order reversed in two subsets of patients. The 3D-IODs and C-IODs were fabricated in advance for both jaws (at least two mandibular implants were already present). The OHIP-20 survey was performed at baseline, after 1 year (before the IOD switch), and after 2 years to determine patient satisfaction scores using a visual analog scale (VAS). The general health status was assessed using the Short Form (SF-36) questionnaire. Regarding the PROMs, patients preferred the 3D-IOD: the improvement on the overall OHIP scale (0-4), expressed as a mean, was 0.26 points greater than for the C-IOD (p < 0.001). This applied also to the VAS scale (1-100) with an increase of 7.37 points (p < 0.001). Regarding the SF-36 scale, only for the item "emotional well-being," the 3D-IOD scored significantly better (p = 0.033). Compared with conventionally fabricated C-IODs, fully digitally produced 3D-IODs resulted in significantly higher OHIP-20 and satisfaction scores.

Assessment of Residual Ridge Morphology among Edentulous Patients at A Tertiary Care Center of Nepal

Background The morphology of the residual ridge is one of the predominant factors influencing denture retention, stability, support and the masticatory function in edentulous patients thereby affecting both the planning and treatment prognosis. This study was aimed to assess the different types of maxillary and mandibular residual ridge in the group of edentulous population in Chitwan, Nepal. MethodsA descriptive cross-sectional study was conducted in total of 107 completely edentulous patients within the age of 55-85 years’ in Prosthodontic department of Chitwan Medical College. The type of maxillary and mandibular residual alveolar ridge in both male and female patients were noted in a predesigned proforma according to American College of Prosthodontists (ACP) classification system. The collected data was entered into Microsoft Excel and later transferred into SPSS version 26 and analyzed for descriptive statistics.ResultsIn this study, 107 completely edentulous patients both male 63 (58.9%) and female 44 (41.1%) participated in the study. In the maxillary arch, Type B was most prevalent residual ridge type 55 (51.4%) whereas Type C in mandibular arch around 35 (32.7%). In male patients, Type B was most common 36 (57.1%) whereas Type A in female 20 (45.5%). Conclusions From this study it can be concluded that there is variation in the residual ridge. In maxillary arch, type B residual ridge was most prevalent followed by type A while in the mandibular arch type C was prevalent followed by type B.

Research and development of intraoral scanning in edentulous soft tissue

During the complete denture restoration process, accurate impression making is a crucial step for achieving good denture retention. With the increasing popularity of intraoral scanning technology in fixed restoration, the use of intraoral scanning technology in complete denture restoration for edentulous Jaw has also been developed. This article systematically reviews the research progress and application of intraoral scanning of edentulous soft tissue, focusing on difficulties in intraoral scanning of edentulous jaws, scanning accuracy, clinical application effects, as well as precautions involved. The aim is to provide references for clinical application.

3D-Printed Complete Dentures: A Review of Clinical and Patient-Based Outcomes.

There has recently been an increasing trend to shift the fabrication of complete dentures from conventional to digital workflows to shorten the treatment time and increase patient comfort and satisfaction. Digital fabrication of complete dentures can be achieved either by a subtractive process (milling)or by an additive technique (3D printing). The milling process offers numerous advantages; however, they require large-size production machines and are associated with low production efficiency, increased cost, limited block size, and a considerable waste of material. On the other hand, 3D printing technology can potentially offer the benefits of lower manufacturing and equipment costs, good surface details, and lower material waste.Hence, 3D printing is being considered lately by some researchers as a valid choice for manufacturing digital dentures. Therefore, the aim of the current review was to identify and highlight studies on 3D-printed dentures, mainly those investigating clinical and patient-centered outcomes. A search was conducted using thedatabasesPubMed/MEDLINE, Cochrane Library, Embase, and Google Scholar. After applying the inclusion and exclusion criteria, a total of 16 studies that investigated clinical outcomes (masticatory efficiency, biting force, retention and stability, computerized occlusal analysis, and post-insertion maintenance) as well as patient-based outcomes (patient satisfaction, oral health-related quality of life (OHRQoL), patient-related complications, patient preference, and willingness to pay) were included. After a thorough review and discussion of these articles, it could be concluded that 3D printing of complete dentures offers many advantages from both a clinical and patient-based perspective. Retention and comfort with 3D-printed dentures were found to be comparable or even superior to conventional dentures. Moreover, retention of 3D-printed dentures constructed from conventional impressions and digitized casts demonstrated improved retention when compared to a protocol adopting intraoral scanning (digital impressions). Masticatory efficiency, biting force, OHRQoL, and patient satisfaction with 3D-printed dentures varied and were inconsistent among the included studies. Most of the studies reported positive results in the different domains and assessed aspects, while others reported some concerns (especially in terms of aesthetics and phonetics). With regard to post-insertion maintenance, printed dentures showed comparable results to conventional dentures in the short term. The technique seems promising with numerous benefits; however, further clinical research with larger sample sizes and longer follow-up periods is still needed to confirm these conclusions and address the potential concerns.

Replacing Maxillary Posterior Teeth by Cast Partial Denture and Mandibular Arch by Tooth Supported Overdenture: A Case Report

In situations where a fixed prosthesis is not recommended, a conventional removable partial denture is a therapy alternative. In contrast to conventional removable partial denture , cast partial denture has several designs with RPI and Clasp assembly. On the other part, the overdenture is advisable to those older individuals who have few teeth left and want to retain teeth due to it’s firmness. The dentures are more stable when roots are maintained beneath the denture base. Moreover, denture retention is improved by using metal copings on the remaining teeth. This clinical report details the technique that fabricates cast partial denture holding the posterior molars of maxillary arch with a tooth supported overdenture with post preparation with 33 and 43.

Evaluation of different baseplate materials on casts with various palatal vault depths

The choice of baseplate material for a trial complete maxillary denture is a critical decision in prosthodontic practice. One significant factor to consider is the depth of the palatal vault, which can influence the suitability of the baseplate material. Close adaptation of the denture base is essential in preventing lateral denture movement and enhancing denture retention and support.

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.

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.

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.

Prosthodontic Management Of Post Covid Mucormycosis

Background: Post covid mucormycosis although very uncommon, came to the limelight after the covid pandemic owing to the decrease in immunity of affected individuals. Post treatment, most of the patients were subjected to physical and mental trauma owing to the aggressive resection of the affected tissues. Patients faced difficulty in swallowing, speech and it affected the esthetics which had a negative impact on the quality of life of patients. Prosthetic management of such patients involves fabrication of maxillofacial prosthesis which replaces the resected tissue thereby restoring normal oral functions. Aim: To manage patients affected by post covid mucormycosis prosthetically thereby improving the oral health of the individual. Case description: In this article three cases are described which were prosthetically managed with help of obturator, cast partial denture, and hollow denture. Conclusion: Prosthetic rehabilitation of patients affected by mucormycosis is quiet complex considering the fact that surgery cannot be planned as per prosthetic requirements. Most of the time prosthodontists are left with minimal structure which would aid in retention, stability and support of denture. Rehabilitation of such patients with implants is a question of debate as more research is required to have clarity regarding the success of implants in mucormycosis affected patients. Conventional treatment with obturator, partial and complete denture is proven to be successful.

A comparative evaluation of retention capacity of different dental implant supported overdenture attachment systems- An in vitro study

The most common way to treat full edentulism is with a complete denture. In the mandible as opposed to the maxilla, there is greater worry over the durability and retention of a traditional complete denture. The mandibular arch's decreased surface area for support and retention is the main cause of this. For a fully edentulous mandible, implant-supported overdentures are a reliable course of treatment.This in-vitro study aimed at comparing the retentive capacity of Ball, Locator and OT Equator Implant supported overdenture attachment system when subjected to 14600 cycles of insertion and de-insertion.Fifteen mandibular dentures were fabricated with heat polymerized polymethyl methacrylate resin to test the retentive capacity of Ball, Locator and OT Equator attachment system. Metal housing with retentive nylon caps were picked up in all the sample using cold cure acrylic resin. The samples were subjected to fatigue testing and only monodirectional force was applied. Ball, Locator and OT Equator attachment system sample were subjected to 14,600 insertion/ de insertion cycle on Universal Testing Machine and data was recorded and statistical analysis was done. All the three groups showed significant differences. The retentive capacity of the Ball attachments lasts longer than that of the Locator and Equator attachments. After ten years of use, All three systems continue to have clinically acceptable retention.

Prosthetic Management of Malpositioned Implant in RPD Case Report

Removable dentures in classe I KENNEDY APPLEGATE remain an essential prosthetic challenge as support is required from the teeth, the mucosa, and the underlying residual ridges. Dental implants can improve denture retention, stability, and support in distal extension removable partial denture. However, a malpositioned implant can complicate tooth/implant-supported condition. This case report describe a 66-year-old female patient treated with maxillary implant -supported removable partial denture (RPD). Both the implants were placed in first premolar site. However, the implant on the left side presented severe facial inclination. We suggest that the discharge of the prosthetic edge with using a laboratory non retentive nylon Patrice’s on the Intaglio of metal housing locator attachment can solve the problem of denture insertion.

Case Report: Impression Making for Flabby Ridge: An Innovative Approach

A flabby ridge is an area of mobile soft tissue found superficially, which affects both maxillary and mandibular alveolar ridges. It is a common finding in long term denture wearers, where the rate of bone resorption is very fast leading to development of hyperplastic soft tissue over the alveolar bone. Fabricating a denture over the flabby ridge poses a problem to the dentist because masticatory forces can displace this mobile denture-bearing tissue, leading to altered denture positioning and loss of peripheral seal. Forces exerted during the act of impression making can result in distortion of the mobile tissue leading to ill-fitting dentures. All these factors compromise the retention, stability, and support of the complete denture. This paper presents a case report for a patient with Kelly’s Combination Syndrome, wherein, an innovative impression technique was used to record the flabby ridges during the process of denture construction. The resultant denture was more comfortable for the patient and did not exert undue pressure over the hypermobile tissues.

Dry Mouth Dilemma: A Comprehensive Review of Xerostomia in Complete Denture Wearers.

Xerostomia, commonly known as dry mouth, presents a significant challenge for individuals wearing complete dentures, affecting their oral health and quality of life. This review explores the relationship between saliva and complete dentures, highlighting the varied management strategies for xerostomia. Saliva plays a critical role in denture retention, lubrication, and oral environment buffering. Complete denture wearers often experience reduced salivary flow, aggravating symptoms of xerostomia.Various management approaches are discussed, including general measures such as hydration and salivary stimulation techniques which aim to boost saliva production naturally. The use of salivary substitutes provides artificial lubrication and moisture to alleviate dry mouth discomfort. Oral lubricating devices, such as sprays, gels, and lozenges, offer relief by mimicking saliva's lubricating properties, thereby improving denture stability and comfort.This review addresses the etiology of xerostomia in complete denture wearers and explores preventive measures to reduce its impact. A comprehensive approach has been discussed for the management of xerostomia which will help to improve the oral health and well-being of complete denture wearers experiencing dry mouth.