An Alternative Method for Incorporating Fiber Meshes in Complete Upper Dentures

The most commonly used material for constructing complete dentures is polymethyl methacrylate (PMMA). However, the strength characteristics of PMMA, such as impact strength and fatigue strength, are poor, and fracturing of PMMA dentures is a common problem in prosthodontic practice. Reinforcing PMMA with various materials, such as carbon fibers, glass fibers (fiberglass), and ultrahigh modulus polyethylene fibers, has been suggested to strengthen the denture-base material. A common problem encountered when packing the resin on these specimens is fiber slippage beyond the denture edges. The present study proposes an alternative method of incorporating fiber meshes into complete dentures, whereby a thin filament of self-polymerizing resin at the perimeter of the fiber mesh is produced, giving a clear and stable shape to the mesh that fits the upper jaw cast. During placement of the shaped mesh on the cast, a positive-negative relationship is created between the mesh and cast, which immobilizes the mesh during the incorporation process.

Biomechanical Analysis of Implant Assisted-Overdentures with Variations in the Attachments Systems

The aim of this study was to assess the stress patterns on the peri-implant zone and residual alveolar ridge in different overdenture attachment system designs by the photoelasticity method. Four attachments systems were tested: O-ring, ERA, Bar-clip, and Bar-clip/O-ring association. The prostheses were loaded with 100 N in five pre-determined points and the photoelastic model was evaluated by a circular polariscope. The anterior load, O-ring, and ERA showed better stress distribution in relation to the bars systems, which presented stress levels surrounding implants. The molar load, Bar-clip/O-ring association, presented the biggest stress concentration on the peri-implant region in relation to the others. When the second molar was loaded, there was a concentration of stress in the alveolar ridge in all situations analyzed. Within the limitation of this “in vitro” study, it could be concluded that there were biomechanical differences among the attachments systems analyzed, principally between isolated and the bars systems. The O-ring showed better stress distribution and the Bar-clip/O-ring showed higher stress concentration.

Clinical performance of removable partial dentures: A retrospective clinical study

Removable partial dentures (RPDs) (conventional and implant-supported) treatment is considered a viable option to replace missing teeth as inexpensively as possible, but it has limitations. Objectives: This study reports the effect of gender and location (maxilla vs. mandible) on the clinical performance of removable partial dentures (RPDs). Materials and Methods: A total of 100 Patients who had RPDs delivered between 1990-1995 were evaluated. A 4-point scoring system was used to assess seventeen criteria. These criteria include acceptance, stability, support, retention, adaptation, occlusion, integrity, and design of the pros-theses, rest and rest seat preparation, occlusal wear, esthetics, phonetics, tissue condition, mobility of abutments, gingival and plaque indices. The data were analyzed using Kruskal-Wallis and Mann-Whitney U non-parametric statistical tests. Results: The results showed that acceptance of RPDs was rated the lowest. Other reasons for failure were poor retention, lack of integrity of the prostheses and inadequate adaptation. Retention and design of major connectors attributed to Mandibular RPD failure. Success rate of 75% was observed in male compared with 67.2% for female. Maxillary RPDs showed a higher success rate (78%) compared with the mandibular (70.1%). No significant statistical difference in Alpha scores between female and male patients and between maxillary and mandibular RPDs (p < 0.05). Conclusions: The clinical performance of RPDs showed a higher success rate in male patients compared to female patients and the maxillary RPDs showed a higher success rate compared to mandibular.

Swallowing threshold parameters of subjects with complete dentures and overdentures

Aim: To compare the chewing process and swallowing threshold parameters of subjects with complete dentures and overdentures with data obtained from subjects with complete natural dentitions. Metho-dology: The chewing process in terms of swallowing threshold parameters of four groups of subjects with complete dentures (all females) was quantified by sieving particles after chewing of an artificial test ‘food’ and compared with that of subjects with com-plete natural dentitions as a reference group (33 sub-jects). All subjects (except those of the reference group) had a complete denture in the upper jaw. Regarding the lower jaw two groups with complete dentures (with high (24 subjects), respectively low mandible (12 subjects)) and two groups with overdentures (implant-retained (22 subjects), respectively natural root supported (19 subjects)) were composed. Results: The ‘overdenture-implants’ group needed significantly more chewing cycles and time (mean: 45 cycles in 32 seconds) until ‘swallowing’ compared to the group with complete natural dentitions (mean: 26 cycles in 19 seconds until ‘swallowing’). Also the ‘complete denture-low mandible’ group needed sig-nificantly more cycles and time (mean: 52 cycles in 44 seconds) until ‘swallowing’ than the complete dentition group. In the ‘overdenture-natural roots’ group these outcomes (33 cycles in 24 seconds) were not significantly different compared with the complete dentition group. The ‘complete denture-high mandi-ble’ group (32 cycles in 26 seconds) needed not sig-nificantly more cycles until ‘swallowing’, however time until ‘swallowing’ was significantly longer com-pared to the complete dentition group. All denture groups had significantly larger mean particle sizes when ‘swallowing’ (sizes in the order of 3 mm) than the natural dentition group (about 2 mm). Conclusion: Despite efforts to compensate for a reduced chewing efficiency, subjects with complete dentures (including overdentures) had 50% larger median particle sizes when ‘swallowing’ compared to subjects with complete natural dentitions.

Treatment of Elderly Bedridden Patients with Removable Dentures to Promote Their Daily Physical Activities: A Case-Control Study

Bedridden patients remain in bed for various reasons, such as chronic illness, old age, and disability, and they cannot perform self-care activities completely or partially. The provision of care for bedridden patients is a major issue in the aging population. Effective rehabilitation is associated with several factors such as cooperation between the patient and the medical staff, selection of effective facilities, and the financial burden. The objective of this study was to evaluate the effect on the activities of daily living (ADL) of occlusion restoration using removable dentures in bedridden older people. This case-control study comprised 32 bedridden older patients who were divided into two groups as follows: denture (n = 18) and no-denture (n = 14). No rehabilitation was provided to any of the patients. The patients were evaluated 3 months after placing the denture, and the ADLs were compared between the two groups. Of the 18 bedridden patients who received removable dentures, 55.6% demonstrated improvements in the ADLs, and the effects persisted for at least 3 months. No improvement in the ADL was observed in the no-denture group. The results of this study suggested that adequate occlusal support can improve the ADL of the elderly. Thus, it is important to take care of oral health early in life in order to maintain oral health, which could help prevent the decrease in the ADL during the later stages of life.

Effect of Accessory Retention Forms on the Bond Strength of Resin-bonded Fixed Partial Dentures:a 3D Finite Element Study

Interface debonding between prostheses and abutments was the most frequent failure mode of resin-bonded fixed partials dentures(RBFPDs) in clinic. The purpose of this study was to investigate the effect of accessory retention forms on the bond strength of RBFPDs. Three types of 3D finite element models were constructed.The model of posterior metal plate RBFPD with spoon-shaped occlusal rest seats served as the control. The remaining two types of models based on the control added the retention form design of the pin hole and axial groove respectively. The axial or buccolingual load of 150 N was applied on the prosthesis, first premolar and first molar respectively. The maximum principal stresses of the adhesive layer in different models were calculated. Under the load of the same magnitude, the stress due to the buccolingual load was significantly higher than that due to the axial load in the adhesive layer. The proximal shoulder, occlusal rest seats wall and the proximal margin adjacent to the shoulder were the high risk region where the adhesive layer damaged easily. Compared with the control model, the pin and groove models could slightly decrease the stress in the adhesive layer after the axial loading, while the stress in the adhesive layer drastically decreased after horizontal loading and reduced by 22% and 31% respectively. These results indicate that the horizontal occlusal force has a more serious harm to the debonding of RBFPDs. In addition, the accessory retention forms(e.g. pin and axial groove retention forms) can decrease the stress level in the adhesive layer, which are conducive to increase the load-bearing capacity of RBFPDs.

Effect of proximal contact strength on the three-dimensional displacements of implant-supported cantilever fixed partial dentures under axial loading

Objective:This study investigated the effect of proximal contact strength on the three-dimensional displacements of cantilever fixed partial denture(CFPD) under vertically concentrated loading with digital laser speckle(DLS) technique.Methods:Fresh mandible of beagle dog was used to establish the implant-supported CFPD for specimen.DLS technique was employed for measuring the three-dimensional displacement of the prosthesis under vertically concentrated loading ranging from 200 to 3 000 g.The effect of the contact tightness on the displacement of CFPD was investigated by means of changing the contact tightness.Results:When an axial concentrated loading was exerted on the pontic of the implant-supported CFPD,the displacement of the CFPD was the greatest.The displacement of the prosthesis decreased with the increase of contact strength.When the contact strength was 0,0.95,and 3.25 N,the displacement of the buccolingual direction was smaller than that of the mesiodistal direction but greater than that of the occlusogingival direction.When the force on the contact area was 6.50 N,the mesiodistal displacement of the prosthesis was the biggest while the buccolingual displacement was the smallest.Conclusions:The implant supported CFPD is an effective therapy for fully or partially edentulous patients.The restoration of the contact area and the selection of the appropriate contact strength can reduce the displacement of the CFPD,and get a better stress distribution.The most appropriate force value is 3.25 N in this study.

Effects of short-term adaptation to new complete dentures on perception thresholds for interocclusal thickness in experienced and non-experienced denture wearers

Background The ability of patients to discriminate thickness can change with time after the insertion of new complete dentures, and this adaptation may differ according to the experiences of the patients If so, an education program to reinforce the oral functions may be needed This study was to evaluate patients' ability to discriminate thickness by comparing experienced and non-experienced denture wearers after the insertion of new complete dentures Methods Forty edentulous patients with a skeletal Class Ⅰ jaw relationship without any temporomandibular disturbances were in the study After insertion of new complete dentures, all patients were tested for discrimination threshold for interocclusal thickness The thickness perception test was repeated on days 1, 7, and 30 after the insertion of new dentures The discriminatory ability was assessed with steel and aluminium foils placed between the upper and lower central incisor teeth The records included the duration of wearing dentures The data were subjected to statistical analysis of two-way ANOVA, multiple comparison test and Student's t test Results Discrimination of tactile ability significantly increased over 30 days in experienced denture wearers as compared with non-experienced patients ( P <0 001) The difference in thickness perception threshold was statistically significant between the two groups ( P <0 001) Conclusion Adaptation and denture experience can affect thickness discrimination of complete denture wearers

Using a Simple Chair-Side Copy Denture Technique in the AvaDent Digital Denture Process: A Case Report and Review

Introduction: Several techniques have been described by which a pair of dentures may be replicated. Case Report: The method described in this paper used materials readily available in a private practice to generate a pair of duplicate dentures for a 74-year-old Black male, which captured all of the features of the patients’ existing pair. These were modified chair-side and used to capture vital information on fit, occlusion and aesthetics, forming a template which was transferred to the laboratory and used to generate new dentures via the traditional laboratory process. The same template was also used to generate a pair of “AvaDent Digital Dentures” by digital scanning and production of a digital denture template for try and then fabrication of the digital denture. Conclusion: The results of this pilot study show that this simple chair-side method of fabricating duplicate dentures can be incorporated successfully into the AvaDent Digital Denture fabrication process to generate a pair of dentures with comparability if not superior fit and aesthetics to a pair fabricated from the same template via the traditional laboratory process.

Mandibular Anterior Immediate Denture Using Visible Light Cure Acrylic

Management of a 51-year-old female of Afro Trinidadian descent required removal mandibular incisors. This patient’s periodontal condition and her inability to afford pre-prosthetic surgery, bone grafting or even a fixed partial denture for replacement of the proposed units after extraction necessitated alternative treatment options to implants. Her profession required interaction with the public and as such an immediate replacement was essential. Impressions were taken and an immediate partial denture fabricated using a visible light cure acrylic. The mobile teeth were extracted and the denture delivered to the patient with minimal adjustments. The patient was monitored for three months while healing of the extraction site occurred and her periodontal condition was treated. Inability to afford definitive treatment for one year required the denture be maintained for that period. Follow up showed that the aesthetics, function and structural integrity of the denture had not been compromised.

Clinical Efficacy of Mixing Natural Teeth and Implant Supported Denture Sleeve

Objective:To analyze the clinical efficacy of Mixing natural teeth and implant supported denture sleeve,and provide reference for clinical treatment.Methods:46 patients with Molarless in hospital from December 2010-December 2014 were selected,patients were randomly divided into observer group and control group,two groups of patients were designed and planted natural teeth fixed bridge and natural teeth and implants mixed support sleeve denture,regular follow patients and the surrounding alveolar bone height changes,5-year cumulative retention rate,clinical efficiency and other indicators.Results:During clinical observation,patients with no obvious symptoms,the use of feel good,no loose superstructure situation.Two groups of patients were 2 cases of patients with implant loosening occurs,the amount of bone resorption annual observation group(0.22±0.10)mm less than the control group(0.24±0.08)mm,but no significant difference(P>0.05),clinical observation group efficiency(100%)was significantly higher(72.3%)(P<0.05),the observation group study implants 5-year cumulative retention rate was 94.4%.Conclusion:Mixing natural teeth and implant-supported telescopic denture success rate of 100%was observed during the clinical results were satisfactory,with use value.

Accuracy evaluation of a new three-dimensional reproduction method of edentulous dental casts, and wax occlusion rims with jaw relation

The article introduces a new method for three-dimensional reproduction of edentulous dental casts,and wax occlusion rims with jaw relation by using a commercial high-speed line laser scanner and reverse engineering software and evaluates the method’s accuracy in vitro.The method comprises three main steps：（i）acquisition of the three-dimensional stereolithography data of maxillary and mandibular edentulous dental casts and wax occlusion rims;（ii）acquisition of the three-dimensional stereolithography data of jaw relations;and（iii）registration of these data with the reverse engineering software and completing reconstruction.To evaluate the accuracy of this method,dental casts and wax occlusion rims of 10 edentulous patients were used.The lengths of eight lines between common anatomic landmarks were measured directly on the casts and occlusion rims by using a vernier caliper and on the three-dimensional computerized images by using the software measurement tool.The direct data were considered as the true values.The paired-samples t-test was used for statistical analysis.The mean differences between the direct and the computerized measurements were mostly less than 0.04 mm and were not significant（P.0.05）.Statistical significance among 10 patients was assessed using one-way analysis of variance（P,0.05）.The result showed that the 10 patients were considered statistically no significant.Therefore,accurate three-dimensional reproduction of the edentulous dental casts,wax occlusion rims,and jaw relations was achieved.The proposed method enables the visualization of occlusion from different views and would help to meet the demand for the computer-aided design of removable complete dentures.

Effect of Phyllanthus emblica Linn.on Candida adhesion to oral epithelium and denture acrylic

Objective:To investigate the effect of Phyllanthus emblica(P.emblica) Linn,ethanolic extract on the adhesion of Candida albicans(C.albicans) to human buccal epithelial cells(BECs) and denture acrylic surfaces.Methods:Human BECs and transparent acrylic strips were pretreated with ethanolic extract solution of P.emblica fruits at concentration ranged from 18.7 to 300 mg/mL.After washing BECs and the strips were inoculated with three strains of C.albicans (ATCC 10281 and two clinical isolates)(10~7 cells/mL).Normal saline solution(NSS) and 0.2% chlorhexidine gluconate were used as negative and positive controls,respectively.BECs were harvested on 12μm-polycarbonate filters(Millipore,USA).The membrane filters and the strips were stained with Gram stain.Adherent yeast cells on 100 randomly selected epithelial cells and 20 randomly selected fields on each strip were counted under microscope.The statistical significance was calculated by Kruskal-Wallis and Tukey tests at a significant level of P【0.05. Results:Significant lower numbers of all strains of yeasts adhering to BECs and acrylic strips were observed after exposure to 75-300 mg/mL of plant extract compared with NSS.Conclusions: The present study demonstrates that P.emblica ethanolic extract interferes with the adhesion of C. albicans to BECs and denture acrylic surfaces in vitro.

Influence of acrylamide monomer addition to the acrylic denture-base resins on mechanical and physical properties

The aim of the study was to evaluate the effect of adding acrylamide monomer （AAm） on the characterization, flexural strength, flexural modulus and thermal degradation temperature of poly（methyl methacrylate） （PMMA） denture-base resins. Specimens （n= 10） were fabricated from a conventional heat-activated QC-20 （Qc-） and a microwave heat-activated Acron MC （Ac-） PMMA resins. Powder/ liquid ratio followed the manufacturer＇s instructions for the control groups （Qc-c and Ac-c） and for the copolymer groups, the resins were prepared with 5% （-5）, 10% （- 10）, 15% （- 15） and 20% （-20） acrylamide contents, according to the molecular weight ratio, respectively. The flexural strength and flexural modulus were measured by a three-point bending test. The data obtained were statistically analyzed by Kruskal-Wallis test （a=O.05） to determine significant differences between the groups, The chemical structures of the resins were characterized by the nuclear magnetic resonance spectroscopy. Thermal stabilities were determined by thermogravimetric analysis （TGA） with a heating rate of 10 ~C.min-1 from 35 ~C to 600 ~C. Control groups from both acrylic resins showed the lowest flexural strength values. Qc-15 showed significant increase in the flexural strength when compared to Qc-c （P〈O.01）. Ac-10 and Ac-15 showed significance when compared to Ac-c （P〈O.01）. Acrylamide incorporation increased the elastic modulus in Qc-10, Qc-15 and Qc-20 when compared to Qc-c （P〈0.01）. Also significant increase was observed in Ac-10, Ac-15 and Ac-20 copolymer groups when compared to Ac-c （P〈0.01）. According to the 1H-nuclear magnetic resonance （NMR） results, acrylamide copolymerization was confirmed in the experimental groups. TGA results showed that the thermal stability of PMMA is increased by the insertion of AAm.

Two Cases of Severe Dementia Showing Dramatic Improvement after Denture Placement

Severe dementia, including Alzheimer’s disease, is intractable and progressive. The purpose of this study was to document the improvement observed in two cases of severe dementia after denture placement. The subjects, two women in their 70s with severe dementia, were diagnosed with Alzheimer’s disease by the medical doctors in charge of their cases. In the first case, the subject’s symptoms included severe disorientation, impaired communication, and a tendency to wander. Two weeks after a lower complete denture placement, she was able to greet others. Five weeks later, she was able to communicate and precisely read an analog clock. Her condition continued to improve for at least 3 months. In the second case, the subject’s mouth was always open. She was bedridden in a vegetative state and hardly moved, talked, or laughed;it was impossible to communicate with her. Only a few seconds after an upper complete denture placement, she started to talk, albeit unintelligibly. Two weeks after a lower complete denture placement, she could communicate normally, laugh, and walk without help. Although the underlying mechanism has not yet been clarified, the author hypothesizes that positive signals from the oral area are transferred to the brain as positive stimulation via the trigeminal nerve, the largest cranial nerve.

Inhibition of candida adhesion to denture acrylic by Boesenbergia pandurata

Objective:To investigate effect of Boesenbergia pandurata(B.pandurata) rhizome extract on adhesion of Candida albicans(C.albicans) to acrylic surface.Methods:Transparent acrylic strips were prepared and divided into three groups with pretreatment by extract solution of B. pandurata rhizome at concentration of 25,50 and 100 mg/mL,respectively.After washing, the strips were then inoculated with two strains of C.albicans(ATCC13803 and the clinical isolate)(10~7 cells/mL).Normal saline solution and 0.2%chlorhexidine gluconate were used as negative and positive controls,respectively.Stained the strips with modified Cram stain without counterstain.Adherent yeast cells were direct counted under microscope(OlympusCX31, Japan) in 20 randomly selected fields on each strip.The statistical significance was calculated by Kruskal-Wallis and Mann-Whitney non-parametric tests at a significance level of P 【 0.05.Results:Pretreatment with B.pandurata extract significantly reduced the adhesion of both strains of C.albicans to acrylic surfaces in a dose dependent manner.Conclusions: This observation indicates that B.pandurata extract has an inhibitory effect on the ability of C. albicans to adhere to denture acrylic and could be employed as an antifungal agent for preventing denture stomatitis.

Treating severe periodontitis with staged load applied implant restoration: A case report

BACKGROUND Because immediate implant surgery is not recommended for patients who have been diagnosed with periodontitis,researchers have treated these patients with a variety of methods,including combining orthodontic and periodontal surgeries as well as implantation.However,these treatments cost time and money for the patient.Although it has been reported that temporary implants released a severe gag reflex in 1 case,only a few studies have documented using temporary implants to treat patients diagnosed with severe periodontitis.CASE SUMMARY The patient was a 49-year-old female who was missing the majority of her teeth and had gingival atrophy and severe alveolar bone atrophy.After being diagnosed with severe periodontitis,the patient underwent staged load applied implant restoration therapy.The first load-bearing stage was carried out immediately by inserting temporary Osstem mini implants.Maxillary teeth were extracted by using the guided bone regeneration technique,and lateral maxillary sinus lifting was conducted on both sides.During the second load-bearing stage,temporary implants were removed,and permanent implants were placed.The resin bridge was segmented during the third load-bearing stage.During the fourth load-bearing stage,the permanent prosthesis was positioned in the patient’s mouth.CONCLUSION By conducting the load-bearing treatment in stages,the patient’s mouth contained restorations throughout the procedure,thus guaranteeing basic function and appearance.

Effects of plasma treatment time on modification of acrylic denture material

Objective：To study the relationship between plasma treatment time acrylic resin denture material in the size of 2 mm × 10 mm × 10 mm. and efficacy. Methods：Test specimens were prepared from an Plasma treatment was carried out on the surface of Polymethyl methacrylate（PMMA） at different time. XPS studies, IR spectra studies and measurement of wetting angle were performed. Results： XPS showed the peak corresponding to C-O getting higher as the treatment proceeded, however at 120 seconds, the peak did not increase any longer and partly crossed with the peak at the duration of 60 seconds. IR spectra showed the wave corresponding to C-H was reduced as O2-plasma treatment proceeded, and then changed little, Wetting angle initially decreased dramatically, however, as the reaction proceeded, wetting angle increased slightly. Conclusion：Equilibrium was reached for introducing oxygen-containing groups and changing of C-H. As the treatment proceeded, wetting angle increased slightly.

Analysis of the Stress Distribution Pattern of Anatomic and Non-Anatomic Tooth Forms on Maxillary and Mandibular Edentulous Ridges—A Photoelastic Study

Aim: To compare the type of stress distribution pattern occurring with anatomic and non-anatomic tooth forms beneath a complete denture in both maxillary and mandibular arch. Methodology: A photoelastic model of the edentulous maxillary and mandibular ridge was prepared meticulously to simulate the human mandible and maxilla. Two sets of acrylic teeth with anatomic and non-anatomic occlusal forms were used to fabricate upper and lower dentures. A vertical static load of 100 N was applied through the mandibular model to the maxillary model. After load application on the dentures the photoelastic model as well as the upper and lower complete dentures were sectioned in the midline. The sectioned photoelastic model was viewed through a polariscope to observe the fringe pattern indicating varying amounts of stress distribution. In this study, a two-dimensional photoelastic stress analysis technique was utilized. Results: Force per unit area was observed more in anatomic teeth than the non-anatomic counterpart. Hence anatomic tooth forms may increase the possibility of bone resorption rate over a period of time. However, in non-anatomic lower teeth, a decrease in value was observed from posterior to anterior region. Conclusion: Stress of greater magnitude was observed with cuspal teeth whereas non-anatomic (0°) showed slightly less magnitude of stress. Depending upon the clinical situation the clinician needs to choose the type of occlusal tooth forms for edentulous patients.

Color Changes of Polyamid and Polymetyhl Methacrylate Denture Base Materials

Aim: Both conventional and flexible resins may show color alteration due to intrinsic and extrinsic factors. The aim of this study was to evaluate the color changes of the polyamid and heat polymerized acrylic denture base materials in storage of different staining solutions. Methods: Two denture base materials were used in this study. The speciemens were stored in two staining solutions (tea, coffee), distilled water and denture cleaner. For each group, 14 speciemens (25 × 15 × 2.5 mm) were prepared. The color of speciemens was measured using a colorimeter according to the CIE L*a*b* color scale. The color changes of speciemens were evaluated before and after 7 and 30 days. All data recorded were taken by the same investigator to minimize inconstancy of technique. The data were analyzed statistically by repeated measures analysis of variance and Tukey honestly significant difference multiple comparison tests. It was found no statistically significant difference between solutions (P > 0.05). Results: Polyamid denture base resin displayed the greatest colour change when compared to polymetyhl methacrylate denture base resin (P < 0.001). Polyamid material indicated the highest value (ΔE: 7.28) in coffee solution for 7 days. Significance: The colour stability of polymetyhl methacrylate denture base resin is greater than polyamid denture base resin.