Retention Of Mandibular Dentures Research Articles

Three-Dimensional evaluation of marginal bone resorption associated with flap and flapless placement of immediately loaded implants retaining mandibular overdentures with resilient stud attachments. One year randomized controlled clinical trial

Purpose: This study was carried out to evaluate Three-Dimensional marginal bone resorption with flap and flapless placement of immediately loaded implants retaining mandibular overdentures with locator attachments. Materials and methods: Ten edentulous patients (6 males and four females, with an average age of 59 years) complaining of lack of retention of mandibular dentures received two implants in the canine positions of the mandible using either flap (group 1) or flapless (group 2) surgical approach. All implants were immediately loaded with locator retained mandibular overdentures. Cone beam CT was used to measure Three-Dimensional bone loss at mesial, distal, buccal and lingual surface of each implant. Measurements were made at baseline, six and 12 months later after delivery. Results: The survival rate was 90% and 100% for flap and flapless groups respectively. For all implant surfaces, flap group showed significant higher bone resorption than flapless group. After 12 months, the highest bone loss occurred at the mesial surface and the lowest bone loss occurred at the buccal surface in the flap group. For flapless group, the highest bone loss occurred at buccal surface and the lowest bone loss located at lingual surface. For all implant surfaces in both groups, marginal bone loss after 12 months was significantly higher than the values after six months. Conclusion: Within the limitations of this study, the flapless surgical approach is recommended for locator retained mandibular overdentures than the flap approach as it was associated with reduced marginal bone loss after 12 months.

Effect of three denture adhesive forms on complete dentures wearers: An in-vivo study

Aim: Flat ridge is a frequent problem with the retention of mandibular complete denture. The present study aimed to evaluate the effect of three forms of denture adhesives on microbial colonization, retention of mandibular denture, and satisfaction for completely edentulous patients with mandibular flat ridge. Materials and Methods: This study was carried out on 21 completely edentulous patients with mandibular flat ridge. They were divided randomly into three equal groups; group I: patients used denture adhesive paste, group II: patients used denture adhesive powder, and group III: patients used denture adhesive cushion. For each patient, a cotton swab was taken from the buccal shelf area, and microbial colonization was evaluated by calculating colony forming unit on blood agar after 48 h of incubation. The retention of the denture was measured using a digital force gage in newton before using denture adhesive and at 1, 3, and 6 months after using it. Patient satisfaction was evaluated at 1, 3, and 6 months after using denture adhesives. The values of microbial colonization, retention, and patient satisfaction were analyzed using analysis of variance and paired Student’s t-test followed by Tukey’s test. Results: No significant difference was found between the three groups in microbial colonization. The retention of mandibular denture was increased in the three groups with no significance difference between them. There was also no significant difference between the three groups with regard to patient satisfaction. Cushion form denture adhesive gave long time of retention, followed by paste form and then powder form denture adhesive. Conclusion: The number of microorganisms was not increased or decreased by using denture adhesives. Retention of mandibular denture was increased by using denture adhesive, whether paste or powder or cushion, with no significant difference between them.

Assessment of Oral Health Related Quality of Life and Patient Satisfaction after Complete Denture Therapy- An Observational Study

Objective : To assess the oral health related quality of life (OHRQoL) and patient satisfaction after complete denture therapy. Methodology : Participants in the study included 60 first time complete denture wearers. OHRQoL was assessed using Oral Health Impact Profile-Edentulous(OHIP-EDENT) questionnaire; denture quality and patient satisfaction was assessed using denture quality evaluation parameters and patient satisfaction questionnaire respectively. Paired t test was used to analyse pre and post change in OHRQoL and Pearson Correlation coefficient was used to assess the co-relation between various parameters. Results: There was a statistically significant change in the mean OHIP score of patients before and after rehabilitation (p<0.001). Across the seven domains used for measuring the denture quality, stability and retention of mandibular denture showed statistically significant reduction after one month. Significant correlations were observed between the patient satisfaction parameters and the denture quality as well as OHRQoL (p= 0.001, p=0.001 and p= 0.01). Conclusion: OHRQoL improved significantly in first time denture wearers.

Metal versus poly ether-ether Ketone secondary copings for rigid telescopic retained implant supported mandibular over dentures. Evaluation of clinical retention forces

Purpose: The aim of this study was to evaluate and compare clinical retention values of metal and poly ether-ether Ketone secondary copings for rigid telescopic retained implant supported mandibular overdentures Material and methods: Eight edentulous patients (4 males and 4 females) who were unsatisfied with the retention of mandibular dentures were randomly assigned equally into 2 groups then received 4 implants in the interforaminal region of the mandible. Group I received telescopic overdentures with metal secondary coping (control group), Group II received telescopic overdentures with Poly ether-ether secondary copings (PEEK) (test group). Measurement of clinical retention forces (in Newton) were performed by digital force meter device attached to a special device that ensure application of vertical dislodging perpendicular to the patient’s occlusal plan. Measurements were performed at time of overdenture insertion, 3 months and 6 months after insertion. Results: For all times of measurements, PEEK secondary copings were associated with significant higher clinical retention values than metal secondary copings. For metal and PEEK groups, retention values at base line were the highest values followed by retention values after 3 months and the least retention forces were noted after 6 months. Conclusion: Within the limitations of this study caused by small patient sample and short evaluation period, PEEK secondary copings for telescopic attachments of mandibular implant overdentures is recommended than cobalt chromium secondary copings as it was associated with increased clinical retention values even after 6 months of clinical use.

Hubungan Laju Alir dan Viskositas Saliva dengan Tingkat Kecekatan Gigi Tiruan Penuh pada Pasien Rumah Sakit Gigi dan Mulut Universitas Andalas

The most common complaint reported by patients in denture wearing is loose denture, caused by lack of retention. In the complete denture wearing, saliva plays an important role in retention. A well-fitting denture base to supporting tissues and the presence of adequate border seals will provide optimal denture retention. This condition can be achieved if it is supported by adequate volume, flow, and consistency of saliva. The purpose of this study is to determine the relationship between flow rate and viscosity of saliva with complete denture retention in Andalas Dental Collage and Hospital. This study used a cross sectional design. Thirty patients of complete denture wearers at the Andalas Dental Collage and Hospital were included in this study. Samples were selected through consecutive sampling method. Data were collected by using medical records, saliva viscosity assesstment, salivary flow rate measurement, and complete denture retention examination. Data were analyzed by Mann Whitney tes with p< 0,05. There was a significant relationship between salivary flow rate and maxillary complete denture retention (p= 0,002) and there was a significant relationship between saliva viscosity and maxillary complete denture retention (p= 0,002). However there was no relationship between salivary flow rate and mandibular complete denture retention (p= 0.101) and there was no relationship between saliva viscosity and mandibular complete denture retention (p= 0,223). The conclusion of this study was that the flow rate and viscosity of saliva was associated with maxillary complete denture retention yet was not associated with mandibular denture retention.

The Effect of Flexible Acrylic Resin Lingual Flanges on The Retention of Mandibular Complete Dentures

. Purpose: To evaluate the effect of flexible lingual flanges on the retention of conventional mandibular complete denture. Material and methods: Ten completely edentulous patients were selected for this study with ages ranged from 50-60 years. All patients had received heat cured acrylic resin denture without modification (Group І) then heat cure lingual flanges were removed and replaced by flexible lingual flanges (Group ІІ). All patients were instructed to use their resin dentures for equal periods of three months when retention of denture base were measured after one month and at the end of three months, period of two week interval was left between each group as a washing period. Results: The results of this study showed that there was a significant difference between them, as the flexible lingual flanges (group ІІ) was better than the heat cured acrylic resin denture base (group І). Conclusion: Within the limitation of this study, it was concluded that retention of the mandibular denture modified with flexible acrylic resin “versacryl” was higher than that of the conventional heat cured acrylic resin denture. Retention was increased by time in each study group. The use of flexible acrylic resin in mandibular complete dentures (as lingual flange) could be considered as an alternative effective treatment

Is the time an impact factor for improvement mandibular denture retention?

Complete denture is still the most common way to treat edentulism Therefore achieving optimum retention and stability is an essential and dynamic issue to improve the quality of life The aim of this study was to evaluate denture retention for one year follow up Material and methods patients from the outpatient clinic of Prosthodontics Department Faculty of Dentistry Minia University Egypt were included in this study They were selected out of sixty examined patients The age ranges were years They have completely edentulous ridges and having Class III broad and rounded ridge with adequate height and width according to Cawood and Howell classification of edentulous mandibles The protocol of the study was approved by the Local Research and Ethics Committee Patients received complete maxillary and mandibular dentures following the conventional steps of complete denture construction A force measurement gauge was used for measuring the retention for mandibular denture The retention was recorded after two weeks from denture insertion three six and twelve months Data was statistically analyzed using t test at a significance level lt Results The retention values for the mandibular dentures showed a statistically insignificant change with time along the follow period p Conclusion The present results showed that the time cannot be considered as an effective factor for improvement of mandibular denture retention

Two-Implant-Supported Mandibular Overdentures: Do Clinical Denture Quality and Inter-Implant Distance Affect Patient Satisfaction?

To investigate the following three null hypotheses in patients rehabilitated with a mandibular overdenture supported by two unsplinted implants: (1) patient satisfaction is not related to the clinical quality of the dentures; (2) inter-implant distance (IID) has no effect on the clinical quality of the dentures; and (3) IID does not influence patient satisfaction. Forty edentulous patients who were rehabilitated with a two-implant-supported mandibular overdenture participated in the study. Independent investigators evaluated the dentures on the basis of five clinical criteria using the validated Denture Quality Evaluation Form, and the patients completed the validated Denture Satisfaction Scale. Irreversible hydrocolloid impressions of the mandible were made and poured immediately in die stone. The IID was measured by adapting an orthodontic wire to the mandibular alveolar ridge crest, extending from the center of one implant to the center of the other. Spearman correlation analyses were used to identify possible correlations, with a significance level set at P < .05. The clinicians' overall mean rating of the clinical quality of the dentures was 91.5% (standard deviation 6.27%). The stability of the mandibular overdenture and of the maxillary conventional complete denture was significantly related to satisfaction (r = 0.389 and r = 0.44, respectively). Significant associations were found between the mandibular stability items and satisfaction with both maxillary and mandibular dentures. The stability of the maxillary denture was significantly associated with patient satisfaction with mandibular denture retention, stability, and comfort. None of the 12 denture satisfaction items were significantly associated with IID. Similarly, IID did not have an effect on the quality of either denture in terms of retention, stability, or occlusion. Denture stability was the feature that had the most influence on patient satisfaction with the mandibular overdenture and with the maxillary conventional denture. IID had no effect on the clinical quality of either denture and did not influence patient satisfaction.

Masticatory function parameters in patients with varying degree of mandibular bone resorption

PurposeThis cross-sectional study analyzes how bone resorption affects the masticatory function and investigates the relation between perceived and measured masticatory function. MethodsThirty complete dentures wearers were divided in two groups according to mandible bone atrophy based on the classification criteria from Cawood & Howell. Retention and stability of the mandibular complete denture, masticatory performance (MP) indexes (X_50 and B) and masticatory efficiency (ME, sieves 4 and 2.8) were evaluated. Geriatric Oral Health Assessment Index (GOHAI) and Dental Impact on Daily Living (DIDL) questionnaires were completed by the patients. ResultsA strong correlation between bone atrophy and poor retention was found (P=0.0132). Neither masticatory performance indexes nor GOHAI and DIDL domains showed statistical differences (P>0.05) when patients were compared according to the atrophy criteria. Mandibular length showed a negative correlation with ME4, showing a positive association (R2=0.17, β=−0.67, P=0.029). Mandibular denture retention was significantly correlated with MPB (P=0.01) and ME2.8 (P=0.01). GOHAI showed a positive association between the physical and the functional domains and ME2.8 (R2=0.17; β=1.22; P=0.02). DIDL showed a negative association between ME4 and oral comfort domain (R2=0.16; β=−2.94; P=0.02). ConclusionMandibular bone height does not directly affect the masticatory function and is inversely correlated with the self-perceived masticatory ability.

Hubungan Laju Alir dan Viskositas Saliva dengan Tingkat Kecekatan Gigi Tiruan Penuh pada Pasien Rumah Sakit Gigi dan Mulut Universitas Andalas

The most common complaint reported by patients in denture wearing is loose denture, caused by lack of retention. In the complete denture wearing, saliva plays an important role in retention. A well-fitting denture base to supporting tissues and the presence of adequate border seals will provide optimal denture retention. This condition can be achieved if it is supported by adequate volume, flow, and consistency of saliva. The purpose of this study is to determine the relationship between flow rate and viscosity of saliva with complete denture retention in Andalas Dental Collage and Hospital. This study used a cross sectional design. Thirty patients of complete denture wearers at the Andalas Dental Collage and Hospital were included in this study. Samples were selected through consecutive sampling method. Data were collected by using medical records, saliva viscosity assesstment, salivary flow rate measurement, and complete denture retention examination. Data were analyzed by Mann Whitney tes with p&lt; 0,05. There was a significant relationship between salivary flow rate and maxillary complete denture retention (p= 0,002) and there was a significant relationship between saliva viscosity and maxillary complete denture retention (p= 0,002). However there was no relationship between salivary flow rate and mandibular complete denture retention (p= 0.101) and there was no relationship between saliva viscosity and mandibular complete denture retention (p= 0,223). The conclusion of this study was that the flow rate and viscosity of saliva was associated with maxillary complete denture retention yet was not associated with mandibular denture retention.

A double blind randomized clinical trial comparing lingualized and fully bilateral balanced posterior occlusion for conventional complete dentures

PurposeA lingualized occlusion (LO) for complete dentures reduces lateral inferences and occlusal force contacts and direction; thus, LO is theorized to be more suitable for patients with compromised ridges than fully bilateral balanced articulation (FBBA). However, no studies have yet provided evidence to support LO in edentate patients with compromised alveolar ridges. The purpose of this study was to compare LO and FBBA in edentulous individuals with compromised ridges. MethodsSixty edentulous individuals were randomly allocated into groups and received dentures with either LO or FBBA. Following delivery, several denture-related satisfaction variables were measured using 100mm visual analogue scales; oral health-related quality of life (OHRQoL) was also assessed using the Oral Health Impact Profile (OHIP). Sub-group analyses of the effect of moderate and severe mandibular bone loss were also carried out. ResultsNo significant differences were detected between LO and FBBA with the primary outcome. At 6 months, participants with severely atrophied mandibles and FBBA rated their satisfaction with retention of mandibular dentures significantly lower than those with LO (median LO: 86, FBBA: 58.5, p=0.03). They also had significantly lower OHRQoL for the domain of Pain (median LO: 4, FBBA: 5, p=0.02). General satisfaction and total OHIP scores significantly improved between baseline and 6 months only for the LO subjects with severely atrophied mandibles (satisfaction: p=0.003, OHIP total score: p=0.0007). ConclusionsThe results indicate that the LO occlusal scheme with hard resin artificial teeth is more efficient for patients with severely resorbed mandibular ridges.

Effect of the lingual ledge of neutral zone impression on the retention and stability of mandibular complete denture in elders with atrophied alveolar ridge

objectiveThis study examined the effect of lingual ledge on complete denture retention and stability for atrophied mandibular ridge. MethodsTen elders complaining from the retention of mandibular denture were included in this study. Two sets of complete dentures were fabricated for each elder, one with lingual ledge and the other without lingual ledge. For standardization, these complete dentures were fabricated according to neutral zone technique but the difference between the 2 sets of dentures was denture base contours and the presence or absence of lingual ledge. Dentures retention and stability was recorded using force gauge at insertion and after 6 weeks. Data were analyzed to determine statistical equivalent of the retention and stability between these 2 different complete dentures using the SPSS.ver.17 and paired t-test (α = 0.05). ResultForce gauge prosthesis retention and stability measurements showed that the 2 different complete dentures were not statistically equivalent, with the complete denture include lingual ledge demonstrating the greater retention and stability. ConclusionWithin this study, lingual ledge developed during physiologic recording the denture space enhances the mandibular denture retention and stability. Also, with the time there is improvement in the denture retention and stability.

Do flexible acrylic resin lingual flanges improve retention of mandibular complete dentures?

Objectives:The aim of this study was to compare the retention of conventional mandibular complete dentures with that of mandibular complete dentures having lingual flanges constructed with flexible acrylic resin “Versacryl.”Materials and Methods:The study sample comprised 10 completely edentulous patients. Each patient received one maxillary complete denture and two mandibular complete dentures. One mandibular denture was made of conventional heat-cured acrylic resin and the other had its lingual flanges made of flexible acrylic resin Versacryl. Digital force-meter was used to measure retention of mandibular dentures at delivery and at 2 weeks and 45 days following denture insertion.Results:The statistical analysis showed that at baseline and follow-up appointments, retention of mandibular complete dentures with flexible lingual flanges was significantly greater than retention of conventional mandibular dentures (P < 0.05). In both types of mandibular dentures, retention of dentures increased significantly over the follow-up period (P < 0.05).Conclusions:The use of flexible acrylic resin lingual flanges in the construction of mandibular complete dentures improved denture retention.

Rehabilitation of an Edentulous Patient with Implant Supported Overdenture

ABSTRACTThe conventional mandibular complete dentures are often associated with advanced ridge resorption and loss of retention. Dental implants in the anterior mandible were documented as being highly successful treatment option for overdenture. It has been use to improve the retention of mandibular dentures and also to improve patient's satisfaction. Because of high success rates, as well as lower costs, it is common to treat edentulous patients with just two implants and ball attachments for retention of the overdenture, instead of four implants and a bar. In this article a simple process of converting existing conventional denture into an implant supported overdenture by housing the retentive elements directly into the impression surface of the denture through a simple chairside technique is described.How to cite this articleMhatre S, Ram SM, Mahadevan J, Karthik M. Rehabilitation of an Edentulous Patient with Implant Supported Overdenture. J Contemp Dent 2013;3(1):52-56.

Improved denture retention in patients with retracted tongues

Patients who wear mandibular dentures and hold their tongues in retracted positions alter the dimensions of the sublingual space and disrupt the peripheral seal that is needed for optimal denture retention. The authors studied whether retention could be improved if patients moved their tongues from a retracted resting position to an ideal resting position. The authors observed and classified the mandibular residual ridge morphologies of 85 participants who wore complete dentures. The authors recorded and compared the retention of the mandibular denture before and after repositioning the tongue to the ideal resting position. When the participants' tongues were in a retracted resting position, the average retention of the mandibular denture was 75.38 gram weight (+/- 81.83 standard deviation [SD]). After participants repositioned their tongues to the ideal resting position, the average retention of the mandibular denture was 118.89 gw (+/- 93.00 SD), an increase of 57.73 percent. In all morphological classes, when participants held their tongues in the ideal resting position, the average mandibular denture retention increased by 57.73 percent, a statistically significant improvement compared with when participants held their tongues in a retracted resting position. Clinicians are encouraged to evaluate carefully the tongue resting position in all patients who wear dentures, help create reasonable therapeutic expectations by informing patients about the significant effect that tongue position will have on future denture retention and provide helpful neuromuscular training for patients with retracted-tongue habits.

Phonetics and tongue position to improve mandibular denture retention: A clinical report

The fabrication, use, and wear instructions for complete dentures are often the factors determining success. The dentist must help guide the mental attitude of the skeptical patient to foster acceptance and success of complete dentures. A "feeling of looseness" may be a condition experienced while patients learn to wear a new mandibular complete denture. Some patients may not understand the reasons given by dentists for the lack of retention of a new mandibular denture. This type of patient requires more explanation, more advice, and more instruction. A phonetic training technique, to demonstrate to the patient how to retain and stabilize the mandibular denture, may be needed for some denture patients. This article reports the clinical use of phonetics and its effect on tongue position to improve the retention and stability of a mandibular complete denture.

Repair of a fractured implant-supported mesiostructure bar

Osseointegrated implants are often used for mandibular denture retention. Although clinical success rates are high, complications can occur. A specific clinically relevant example of a fractured bar is presented along with a procedure for its repair. This procedure allows the repair to be done in a timely and cost-efficient manner. (J Prosthet Dent 1997;77:216-8.)

Clinical evaluation of complete denture therapy: Examiner consistency

Criteria were developed to clinically evaluate denture base stability and retention. Six completely edentulous subjects participated in the study. Each patient was treated with two sets of complete dentures. Six prosthodontists who were not involved in the patients' treatment evaluated the stability and retention of each denture at the delivery appointment and weekly for the following 2 weeks by means of criteria in a standardized form. Evaluation of stability and retention for maxillary and mandibular complete dentures worn during weeks 1 and 2 were compared with the evaluations made at the delivery appointment for each denture. In tabulation of the data, the criteria considered reliable were mandibular denture retention, maxillary denture retention evaluated unilaterally, and maxillary denture stability. In each category most examiners rated the judgments the same or better when compared with the delivery appointment data for each patient.

Initial retention of complete mandibular dentures

Initial retention of the mandibular denture was clinically observed and measured as both static and dynamic retention. There was strong evidence that retention of a mandibular denture might continue although the actual period of time could not be determined. Initial retention of the mandibular denture was considered the result of securing the firm relation of the denture to its supporting structures mainly by use of patient control of muscular activity as “proretentive” and stabilizing factors. Static and dynamic retention did show a clear interdependence. While static retention reached maximum values quickly, dynamic retention increased progressively in a period of 4 weeks and reached an optimum of approximately 60 per cent of the value of static retention for the corresponding period. In general, static retention was always higher than dynamic retention. The adjustment by the patients to new mandibular dentures as expressed by their own assessment was easily achieved during the 4 week period of this study.

A clinical evaluation of denture adhesives

Five hundred and seventy-six masticatory performance tests, and four hundred and eighty taste tests were conducted on twenty-four subjects in order to determine and compare the effect of the use of three denture adhesives on denture retention, on the masticatory ability of denture wearers, and on their taste thresholds. All three types of denture adhesives significantly improved the retention of both the maxillary and mandibular dentures. Differences between denture retention obtained with the three adhesives were insignificant. Improved denture retention resulting from the use of adhesives failed to show a significant increase in the masticatory performance of denture wearers, nor were the taste thresholds altered. The mandibular denture retention which resulted with the use of the denture adhesive underwent a significant loss after the subjects had used their dentures for chewing test foods or for sipping taste solutions. This was true for each of the three adhesives tested.