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1.

PURPOSE

The midline fracture of maxillary complete dentures is a frequently encountered complication. The purpose of this study was to assess the effect of frenulum height on midline strains of maxillary complete dentures.

MATERIALS AND METHODS

A removable maxillary complete denture was fabricated and duplicated seven times. Four different labial frenulum heights were tested for stresses occurring on the palatal cameo surface. The strains were measured with strain gauges placed on 5 different locations and the stresses were calculated. To mimic occlusal forces bilaterally 100 N of load was applied from the premolar and molar region.

RESULTS

A statistically significant association between the height of the labial frenulum and the calculated stresses and strains was shown (P<.05) predominantly on the midline and especially on the incisive papilla. The results showed that stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum.

CONCLUSION

Within the limitations of this in vitro study, it can be concluded that the stress on the anterior midline of the maxillary complete denture increases with a higher labial frenulum. Surgical or mechanical precautions should be taken to prevent short-term failure of maxillary complete dentures due to stress concentration and low cycle fatigue tendency at the labial frenulum region.  相似文献   

2.

PURPOSE

To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers.

MATERIALS AND METHODS

Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner''s Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%.

RESULTS

Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124).

CONCLUSION

Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.  相似文献   

3.

PURPOSE

To compare the changes in the occlusal vertical dimension, activity of masseter muscles and biting force after insertion of immediate denture constructed with conventional, tooth-supported and Implant-supported immediate mandibular complete denture.

MATERIALS AND METHODS

Patients were selected and treatment was carried out with all the three different concepts i.e, immediate denture constructed with conventional (Group A), tooth-supported (Group B) and Implant-supported (Group C) immediate mandibular complete dentures. Parameters of evaluation and comparison were occlusal vertical dimension measured by radiograph (at three different time intervals), Masseter muscle electromyographic (EMG) measurement by EMG analysis (at three different positions of jaws) and bite force measured by force transducer (at two different time intervals). The obtained data were statistically analyzed by using ANOVA-F test at 5% level of significance. If the F test was significant, Least Significant Difference test was performed to test further significant differences between variables.

RESULTS

Comparison between mean differences in occlusal vertical dimension for tested groups showed that it was only statistically significant at 1 year after immediate dentures insertion. Comparison between mean differences in wavelet packet coefficients of the electromyographic signals of masseter muscles for tested groups was not significant at rest position, but significant at initial contact position and maximum voluntary clench position. Comparison between mean differences in maximum biting force for tested groups was not statistically significant at 5% level of significance.

CONCLUSION

Immediate complete overdentures whether tooth or implant supported prosthesis is recommended than totally mucosal supported prosthesis.  相似文献   

4.

PURPOSE

Adequate passive-fitting of one-piece cast 3-element implant-supported frameworks is hard to achieve. This short communication aims to present an alternative method for section of one-piece cast frameworks and for casting implant-supported frameworks.

MATERIALS AND METHODS

Three-unit implant-supported nickel-chromium (Ni-Cr) frameworks were tested for vertical misfit (n = 6). The frameworks were cast as one-piece (Group A) and later transversally sectioned through a diagonal axis (Group B) and compared to frameworks that were cast diagonally separated (Group C). All separated frameworks were laser welded. Only one side of the frameworks was screwed.

RESULTS

The results on the tightened side were significantly lower in Group C (6.43 ± 3.24 µm) when compared to Groups A (16.50 ± 7.55 µm) and B (16.27 ± 1.71 µm) (P<.05). On the opposite side, the diagonal section of the one-piece castings for laser welding showed significant improvement in the levels of misfit of the frameworks (Group A, 58.66±14.30 µm; Group B, 39.48±12.03 µm; Group C, 23.13±8.24 µm) (P<.05).

CONCLUSION

Casting diagonally sectioned frameworks lowers the misfit levels. Lower misfit levels for the frameworks can be achieved by diagonally sectioning one-piece frameworks.  相似文献   

5.

Objectives

To investigate dental impacts on daily living and satisfaction with removable complete and partial prosthodontic rehabilitations, and to identify their relationship with personality profiles.

Methods

Sixty-eight patients (38 males and 30 females; mean age = 53.2 ± 11.8 years) received removable prostheses (32 complete dentures and 36 removable partial dentures). Clinical success of prostheses was assessed according specific criteria. The Dental Impact on Daily Living (DIDL) questionnaire was utilized to assess satisfaction with prostheses and impacts on daily living. NEO Five Factor Inventory (NEO-FFI) was utilized to assess patients’ personality profiles.

Results

Participants’ total satisfaction and satisfaction with appearance, pain tolerance, oral comfort, and eating improved after treatment (p < .05). Position of prosthesis and age had no significant relationships with satisfaction or personality scores (p > .05). Females were less satisfied with appearance (p < .05). Patients who received partial dentures were more satisfied with eating and scored higher total satisfaction scores than those who had complete dentures (p < .05). Before treatment; Neuroticism and Openness scores were associated with dental satisfaction and impacts (p < .05). After treatment, Conscientiousness and Extraversion scores were associated with dental satisfaction and impacts (p < .05).

Conclusions

Patients satisfaction with oral condition improved following using removable prosthetic rehabilitation with RPD having better impacts than CD. Psychological profiles (e.g. Neuroticism, Extraversion, Openness and Conscientiousness) might play a role and explain prosthetic impacts on daily living and patients’ satisfaction with prostheses.  相似文献   

6.

Objective

The success of removable partial dentures (RPDs) is partly dependent on patients’ acceptance and compliance in using them. The purpose of this study was to describe the usage of removable partial dentures (RPDs) by patients 1 year after insertion and to evaluate the factors that influence their denture usage.

Methods

Forty-seven patients who received 75 new RPDs at the undergraduate clinic of College of Dentistry, King Saud University, were contacted by telephone 1 year later for an interview. The questions covered denture usage, patient’s satisfaction and reasons for non-use.

Results

Results showed that 36% of patients discarded or occasionally used their RPDs. There was no significant association between denture usage and RPD experience, location or Kennedy classification. A significantly more RPD rejection was found when it was opposed by natural teeth or complete denture. The most quoted reason for RPD rejection was pain and discomfort.

Conclusion

Despite the short follow-up period, RPDs were poorly accepted by patients treated by undergraduate students.  相似文献   

7.
Removable partial denture prostheses are still being used for anatomic, medical and economic reasons. However, the impact on chewing parameters is poorly described.

Objectives

The objective of this study was to estimate the impact of removable partial denture prosthesis on masticatory parameters.

Material and Methods

Nineteen removable partial denture prosthesis (RPDP) wearers participated in the study. Among them, 10 subjects were Kennedy Class III partially edentulous and 9 with posterior edentulism (Class I). All presented a complete and full dentate opposing arch. The subjects chewed samples of carrots and peanuts with and without their prosthesis. The granulometry of the expectorated boluses from carrot and peanuts was characterized by median particle size (D50), determined at the natural point of swallowing. Number of chewing cycles (CC), chewing time (CT) and chewing frequency (CF=CC/CT) were video recorded.

Results

With RPDP, the mean D50 values for carrot and peanuts were lower [Repeated Model Procedures (RMP), F=15, p<0.001] regardless of the type of Kennedy Class. For each food, mean CC, CT and CF values recorded decreased (RMP, F=18, F=9, and F=20 respectively, p<0.01). With or without RPD, the boluses'' granulometry values were above the masticatory normative index (MNI) determined as 4,000 µm.

Conclusion

RPDP rehabilitation improves the ability to reduce the bolus particle size, but does not reestablish fully the masticatory function.

Clinical relevance

This study encourages the clinical improvement of oral rehabilitation procedure.  相似文献   

8.

Objective

This study evaluated the efficacy of NitrAdineTM-based disinfecting cleaning tablets for complete denture, in terms of denture biofilm removal and antimicrobial action.

Material and methods

Forty complete denture wearers (14 men and 26 women) with a mean age of 62.3±9.0 years were randomly assigned to two groups and were instructed to clean their dentures according to two methods: brushing (control) - 3 times a day with denture brush and tap water following meals; brushing and immersion (experimental) - brushing the denture 3 times a day with denture brush and tap water following meals and immersion of the denture in NitrAdineTM-based denture tablets (Medical InterporousTM). Each method was used for 21 days. Denture biofilm was disclosed by a 1% neutral red solution and quantified by means of digital photos taken from the internal surface before and after the use of the product. Microbiological assessment was conducted to quantify Candida sp.

Results

An independent t-test revealed a significant lower biofilm percentage for the experimental group (4.7, 95% CI 2.4 to 7.9) in comparison with the control group (mean 37.5, 95% CI 28.2 to 48.1) (t38=7.996, p<0.001). A significant reduction of yeast colony forming units could be found after treatment with Medical InterporousTM denture tablets as compared to the control group (Mann-Whitney test, Z=1.90; p<0.05).

Conclusion

The present findings suggest that NitrAdineTM-based disinfecting cleaning tablets are efficient in removal of denture biofilm. In addition, a clear antimicrobial action was demonstrated. Therefore, they should be recommended as a routine denture maintenance method for the prevention of the development of microbial biofilm-induced denture stomatitis.  相似文献   

9.
10.

PURPOSE

The purpose of this study was to compare the coronal bone level and patient satisfaction in 1-implant and 2-implant assisted mandibular overdentures.

MATERIALS AND METHODS

Twenty patients who had maladaptive mandibular dentures were treated in this study. Patients were randomly divided into two groups. The first group received 1 implant (Simple line II, Implantium, South Korea) in their mandibular midline and the second group received 2 implants in their B and D regions (according to Misch''s category). If the primary stability of each implant was at least 60 ISQ, ball attachment was placed and denture relined with soft liner. After 6 weeks, retentive cap incorporated with hard acrylic resin. In the 6 and 12 months recalls, periapical digital radiograph were made and visual analogue scale questionnaires were used to record patient satisfaction. The Friedman test was done for comparing the presurgical and postsurgical parameters in each group and the U-Mann Whitney test (P<.05) was done for comparison of post-treatment results between the two groups.

RESULTS

All implants achieved sufficient primary stability to be immediately loaded. Patient satisfaction was high, and there were no significant differences between two groups (P>.05). In addition, mean marginal bone loss was 0.6 ± 0.67 mm in the first group and 0.6 ± 0.51 mm in the second group, after 12 month. Mean marginal bone loss showed no significant differences between two groups.

CONCLUSION

This preliminary one-year result indicated that mandibular overdentures anchored to a single implant can be a safe and cost-effective method as a starting step for implant-overdenture treatment.  相似文献   

11.

Purpose:

The purpose was to assess the outcome of improved staff supervision on the efficiency and quality of complete dentures delivered by clinical students.

Materials and Methods:

The audit was performed in two parts. In the first cycle, retrospective analysis for complete dentures delivered by clinical students was undertaken, and patient''s satisfaction was graded using Geriatric/General Oral Health Assessment Index (GOHAI). All the impeding factors encountered in the first cycle were identified, and corrective measures were implemented. Subsequently, a prospective analysis for the dentures delivered under strict staff supervision was undertaken in the second cycle. Patient satisfaction was graded again using GOHAI.

Results:

Improved staff supervision increased the patient satisfaction significantly.

Conclusions:

The quality of care had improved in leaps and bounds compared to the first cycle due to increased level of supervision and strict adherence to the recommendations made at the end of the first cycle.  相似文献   

12.

BACKGROUND

Though implant dentistry is very successful and predictable in treatment of patients with destroyed dentition, there are some cases with limitations to implant therapy. In these cases, alternative treatment modality should be considered.

CASE DESCRIPTION

A patient with destroyed dentition was rehabilitated with a lateral rotational path removable partial denture. According to the diagnosis, we determined to raise vertical dimension for esthetic and functional restoration. The final restoration was performed after four months of provisional period.

CLINICAL IMPLICATION

The edentulous patients with compromised esthetics and functions can be successfully treated with a rotational path removable partial denture through adequate treatment planning and precise laboratory procedure.  相似文献   

13.
Information on the longevity of fiber-reinforced composite fixed partial dentures (inlay FPDs) should be considered in the selection of materials, operative techniques and patient instructions related to prognosis and long-term cost-effectiveness.

Objective

This study evaluated the long-term survival of fiber-reinforced, adhesively-bonded composite prostheses placed in posterior teeth.

Material and Methods

Twenty-one patients that received adhesively bonded polyethylene inlay FPDs in posterior teeth were selected from a private practice dental office and invited to evaluation. Of the eligible 21 patients, 13 (mean age 50.3 ±11.5 years) agreed to be enrolled as participants, providing 22 restorations, as several subjects presented more than one inlay FPD. One dentist placed all inlay FPDs using Ribbond as reinforcement and Tetric Ceram/Durafil or Charisma/Renamel composite combinations, according to manufacturer’s instructions. Two independent calibrated operators performed the evaluation, using modified USPHS criteria. Survival functions of restorations were analyzed with Kaplan-Meier and Log Rank test (α = 0.05).

Results

The majority of restorations received A or B scores. Four (18.2%) inlay FPDs fractured among the 22 evaluated. The mean estimate survival rate was 7 years (95% CI: 5.9 to 8.1), and the overall percentage of survival was 81.8%. There were no significant differences (p>0.05) between composite combinations or tooth location considering all clinical aspects evaluated and survival functions.

Conclusion

Posterior fiber-reinforced fixed partial dentures exhibited acceptable clinical performance after a period up to 8 years.  相似文献   

14.

Objective

The purpose of this study was to determine whether there is a correlation between the clinical quality of conventional complete dentures and patient quality of life.

Materials and methods

This study included a random sample of 32 completely edentulous patients (15 males and 17 females) who were treated with conventional complete dentures. Using a validated questionnaire, three investigators evaluated the dentures independently on the basis of seven clinical parameters: esthetics (lip support and lower lip line), retention and stability of the maxillary and the mandibular dentures, and occlusion. Patients completed the validated Oral Health Impact Profile-20 (OHIP-20) questionnaire. Correlations were determined by using the point-biserial correlation coefficient.

Results

Clinicians rated the overall clinical quality of the dentures satisfactory in 80.3% of patients. The mean (±standard deviation) total OHIP-20 score was 56.3 ± 15.9 out of a possible 120 maximum. A statistically significant negative correlation was found between the stability of the maxillary and mandibular dentures and the total OHIP-20 score (p = 0.009 and 0.0023, respectively). A negative correlation between the total OHIP-20 score and the retention of the mandibular denture approached significance (p = 0.092). Esthetics, retention of the maxillary denture, and occlusion were not correlated with patient quality of life (p > 0.169).

Conclusion

Stability of the maxillary and mandibular dentures is the denture quality parameter that can most significantly affect patient quality of life.  相似文献   

15.

Objective

Effective cleaning of dentures is important for the maintenance of good oral hygiene for denture stomatitis patients. The in vivo efficacy of three different brands of alkaline peroxide tablets (Polident, Efferdent, and Fittydent) and two mouthwashes (CloSYS II and Corsodyl) to eliminate Candida albicans on dentures was evaluated in this in vivo study.

Material and methods

Ninety denture wearers with clinical evidence of denture stomatitis were randomly divided into 5 test groups and 1 control group. Each group was further divided into three subgroups in which the dentures were subjected to 15-, 30-, and 60-min disinfection procedures. The dentures of each test group were treated with one of the cleaners, while those of the control group were treated with distilled water. Swab samples from the palatal surfaces (2 cm x 2 cm template delimited area) of the upper dentures were obtained before and after 15, 30, and 60 min periods of cleaner use and examined mycologically.

Results

The reduction in the number of colony-forming units (CFU) of C. albicans before, and after 15, 30, and 60 min of use of CloSYS II and Corsodyl was significantly greater than that of the control group (p<0.05). Moreover, there was no statistically significant difference (p>0.05) among Polident, Efferdent and the control group in any of the treatment periods. Dentures treated with Fittydent appeared to have a significantly greater reduction in the number of Candida spp. only after 60 min of treatment.

Conclusions

The results of this study showed that the use of mouthwashes significantly reduced the number of microorganisms on dentures.  相似文献   

16.

Background

Fractures of acrylic resin dentures are a common occurrence in clinical dentistry. The denture may be fractured accidentally when dropped or while in service in the mouth due to flexural fatigue.

Objectives

The aim of this study was to compare the elastic modulus and the flexural strength between two heat-cured acrylic resins used in denture bases: a high-impact resin (Lucitone 199) and a traditional resin (Rodex).

Materials and methods

Rectangular strips of Lucitone 199 and Rodex (10 samples each) were fabricated and stored in artificial saliva at 37 °C for 2 weeks. The specimens were subjected to a three-point flexural test. The data were statistically analysed with Student’s t-test (p ⩽ .05).

Results

The high-impact acrylic resin had a lower elastic modulus (p = .000) and higher flexural strength (p = .001) compared to the traditional acrylic resin.

Conclusion

Within the limitations of this study, it can be concluded that the high-impact acrylic resin is a suitable denture base material for patients with clinical fracture of the acrylic denture.  相似文献   

17.

STATEMENT OF PROBLEM

Over the years, resin-bonded fixed partial dentures (RBFPDs) have gone through substantial development and refinement. Several studies examined the biomechanics of tooth preparation and framework design in relation to the success rate of RBFPDs and considered retention and resistance form essential for increase of clinical retention. However, these criteria required preparations to be more invasive, which violates not only the original intentions of the RBFPD, but may also have an adverse effect on retention due to loss of enamel, an important factor in bonding.

PURPOSE

The object of this in vitro study was to compare the dislodgement resistance of the new types of RBFPDs, the conventional three-unit fixed partial denture, and conventional design of RBFPD (Maryland bridge).

MATERIAL AND METHODS

Fifty resin mandibular left second premolars and second molars were prepared on dentiforms, according to the RBFPD design. After model fabrication (five group, n = 10), prostheses were fabricated and cemented with zinc phosphate cement. After cementation, the specimens were subjected to tensile loading at a cross head speed of 4 mm/min in a universal testing machine. The separation load was recorded and analyzed statistically using one-way analysis of variance followed by Duncan''s multiple range test.

RESULTS

Group V, the pin-retained RBFPDs, had the highest mean dislodgement resistance, whereas specimens of group II, the conventional RBFPDs, exhibited a significantly lower mean dislodgement resistance compared to the other 4 groups (P < .05). There were no significant differences between group I, III, and IV in terms of dislodgement resistance (P > .05). Group V had the highest mean MPa (N/mm2) (P < .05). There was no significant difference between groups I, II, III and IV (P > .05).

CONCLUSION

Within the limits of the design of this in vitro study, it was concluded that: 1. The modified RBFPDs which utilizes the original tooth undercuts and requires no tooth preparation, compared with the conventional design of RBFPDs, has significantly high dislodgement resistance (P < .05). 2. The modified RBFPDs which utilizes the original tooth undercuts and requires minimal tooth preparation, compared with the conventional FPDs, has significantly no difference in retention and dislodgement resistance)(P > .05). 3. The pin-retained FPDs showed a high dislodgement resistance compared to the conventional three-unit FPDs (P < .05).  相似文献   

18.

PURPOSE

The aim of this study was to measure the changes on the marginal and internal adaptation of zirconia based anterior fixed partial dentures after the porcelain firing process.

MATERIALS AND METHODS

A total of 34 anterior fixed partial dentures using LAVA CAD/CAM system (3M ESPE, Germany) were applied. Two silicone replicas were obtained: one is obtained before porcelain firing process (initial) and the other is obtained after porcelain firing process (final), followed by the examination under a binocular stereomicroscope. Kruskal Wallis and Wilcoxon Signed Ranks tests were used for the statistical analysis (P<.05).

RESULTS

No statistically significant difference was found between initial and final marginal gap values (P>.05). At the internal gap measurements, final marginal area values (59.54 µm) were significantly lower than the initial marginal area values (68.68 µm)(P<.05). The highest and the lowest internal gap values were observed at the incisal/occlusal area and at the marginal area, respectively. In addition, lower internal gap values were obtained for canines than for central incisors, lateral incisors and premolars at the incisal area (P<.05).

CONCLUSION

The firing cycles did not affect the marginal gap of Lava CAD/CAM system, but it is controversial for the internal gap.  相似文献   

19.

STATEMENT OF PROBLEM

The poor chemical bonding of a denture base resin to cast titanium framework often introduces adhesive failure and increases microleakage.

PURPOSE

This study evaluated the shear bond strengths of a heat cure denture base resin to commercially pure titanium, Ti-6Al-4V alloy and a cobalt-chromium alloy using two adhesive primers.

MATERIAL AND METHODS

Disks of commercially pure titanium, Ti-6Al-4V alloy and a cobalt-chromium alloy were cast. Specimens without the primer were also prepared and used as the controls. The shear bond strengths were measured on a screw-driven universal testing machine.

RESULTS

The primers significantly (P < .05) improved the shear bond strengths of the heat cure resin to all metals. However, the specimens primed with the Alloy primer® (MDP monomer) showed higher bond strength than those primed with the MR bond® (MAC-10 monomer) on titanium. Only adhesive failure was observed at the metal-resin interface in the non-primed specimens, while the primed specimens showed mixed failure of adhesive and cohesive failure.

CONCLUSIONS

The use of appropriate adhesive metal primers makes it possible not only to eliminate the need for surface preparation of the metal framework before applying the heat cure resins, but also reduce the need for retentive devices on the metal substructure. In particular, the Alloy primer®, which contains the phosphoric acid monomer, MDP, might be clinically more acceptable for bonding a heat cure resin to titanium than a MR bond®, which contains the carboxylic acid monomer, MAC-10.  相似文献   

20.

Problem statement

Tooth movement has been shown to occur during and after the processing of complete dentures. An understanding of this phenomenon may permit one to construct functional complete dentures that require less occlusal adjustment in the articulator and in the patient’s mouth.

Purpose

The purpose of this study was to examine the effects of three different investing methods on tooth movement occurring during the processing of simulated maxillary complete dentures.

Material and methods

Forty-five similar maxillary dentures were made using heat-polymerized acrylic resin, and assigned randomly to three experimental groups (= 15 each) according to investing method: plaster–plaster–plaster (P–P–P), plaster–stone–stone (P-S-S), and plaster–mix (P–M). Specimens in all experimental groups were compression molded with denture base resin. Transverse interincisor (I–I) and intermolar (M–M) distances, and anteroposterior incisor–molar (LI–LM and RI–RM) distances, were measured with digital calipers at the wax denture stage (pre-polymerization) and after denture decasting (post-polymerization). Analysis of variance and Tukey’s test were used to compare the results.

Results

M–M, LI–LM, and RI–RM movement was significantly greater in the P–P–P group than in the P–S–S and P–M groups; no significant difference in I–I movement was observed among groups. Transverse movement along M–M and I–I was significantly greater than anteroposterior movement in the P–P–P group; no significant difference among measurements was observed in the other two groups.

Conclusion

The study results indicate that the use of dental stone or a 50:50 mixture of plaster and stone for investing of dentures is an important factor in efforts to control the magnitude of tooth movement.  相似文献   

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