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Journal of Indian Prosthodontic Society 2022Mandibular overdenture is suspected to fracture, especially in the midline and anterior region due to low surface area of coverage and minimum acrylic thickness in...
Mandibular overdenture is suspected to fracture, especially in the midline and anterior region due to low surface area of coverage and minimum acrylic thickness in addition to attachments pickup holes that weakens the denture. Dentures used to be conventionally reinforced with metal meshwork which cannot be done in a digital workflow. This in vitro report introduces a novel approach of digital overdenture reinforcement using computer-aided design, computer-aided manufacturing, and rapid prototyping technologies. This novel approach provided digital reinforced, stable, and well-adapted overdenture with accurate and easy attachment pickup. Digital reinforced denture has fewer clinical steps with fewer laboratory complications. The newly developed overdenture fabrication techniques have the ability to change the conventional clinical and laboratory workflow from analog to digital. Which grantee standardization of the outcome on both research and clinical work.
Topics: Denture Retention; Dental Prosthesis, Implant-Supported; Dental Implants; Denture, Overlay; Mandible
PubMed: 36511033
DOI: 10.4103/jips.jips_514_21 -
Compendium of Continuing Education in... Jan 2019Proper treatment planning is critical to achieving a successful outcome when treating patients with implant overdenture restorations. Key factors related to success...
Proper treatment planning is critical to achieving a successful outcome when treating patients with implant overdenture restorations. Key factors related to success include the number, location, and distribution of implants and choice of abutment. Contemporary design of stud-style abutment systems for overdentures is aimed at accommodating patients who present with challenges such as anatomical limitations or poor dexterity hampering insertion and removal of prostheses. This article describes the effective management of excessive angulation to achieve an enhanced outcome with implant overdenture treatment, even with a less-than-ideal clinical presentation.
Topics: Denture, Overlay; Humans; Patient Care Planning; Prostheses and Implants
PubMed: 30601025
DOI: No ID Found -
Gerodontology Dec 2022To report on the use of a mandibular 3-implant overdenture with a novel implant distribution opposing a maxillary complete denture for the rehabilitation of an older...
OBJECTIVE
To report on the use of a mandibular 3-implant overdenture with a novel implant distribution opposing a maxillary complete denture for the rehabilitation of an older edentulous patient.
BACKGROUND
The use of oral implants with attachment systems of various numbers and designs to support removable partial and complete dentures is well documented with success and predictability.
MATERIALS AND METHODS
An older edentulous patient with a mandibular implant-assisted removable partial denture was presented with failing remaining dentition. Teeth were extracted and a single midsymphyseal implant was placed. A mandibular overdenture on three implants with ball attachments in a tripod distribution was constructed to oppose a new maxillary complete denture made using a modified impression technique.
RESULTS
Over 2 years of follow-up, no significant biological or mechanical complications were reported, and denture retention and stability remained optimum.
CONCLUSION
Mandibular overdentures on three implants with ball attachments in a tripod distribution, opposing a maxillary complete denture, could be an alternative treatment option for the older edentulous patients.
Topics: Humans; Denture, Overlay; Denture Retention; Dental Prosthesis, Implant-Supported; Dental Implants; Mandible; Mouth, Edentulous; Denture, Complete, Lower
PubMed: 36218242
DOI: 10.1111/ger.12615 -
Journal of Prosthodontics : Official... Dec 2022To estimate the effects of the thermal cycling (TC) process on the metal surfaces of Locators, as well as retention loss, and the correlation between them.
PURPOSE
To estimate the effects of the thermal cycling (TC) process on the metal surfaces of Locators, as well as retention loss, and the correlation between them.
MATERIALS AND METHODS
Twenty-five new Locator R-Tx were included in the study. Four areas were marked on each Locators' patrix metal surface and scanned using a confocal scanner (μsurf explorer; NanoFocus). Three surface roughness parameters were measured in the scans: Sa (average distance of peaks from the central plain of the area), Vmp (volume of the peaks in the area), and Spc (mean curvature of the peaks describing the degree of their sharpness). Retention test was performed using Instron® 4500 compression tension tensile tester at a speed of 10 mm/min. The retention tests were done using a working model made of two acrylic blocks in which the Locator system parts were inserted. The surface parameters measurements and the retention tests were performed 2 times, once before and once after TC. The Locators were subjected to 15,000 TC cycles by investing them into 2 tubs with different water temperatures, 55°C and 5°C. During each 60-second cycle, the Locators were submerged in each tub for 20 seconds, with a 10 second transition time between the tubs. The post-TC retention and surface parameters measurements were compared with those prior to TC and the prior to TC measurements served as controls. Changes in parameters before and after TC were analyzed by a two-way ANOVA nested model with random intercept and slope by restricted maximum likelihood method. Correlation between retention and surface parameters was quantified and examined using Kendall's correlation test. The findings were considered statistically significant if p < 0.05.
RESULTS
There was a significant decrease in retention of 16.6N at the second retention test (p < 0.001). A significant statistical decrease in surface parameters were measured after TC process, Sa and Vmp (18 ×10 μm, p = 0.041 and 0.94 ×10 1/μm, p = 0.001, respectively). A significant statistical increase in Spc of 6.4 ×10 μm /μm (p = 0.023) was noticed. The correlation between retention decreases and surface changes was not statistically significant.
CONCLUSION
The TC process causes a substantial reduction in retention to the Locator system over time. In addition, TC causes significant but minor changes to the Locator surface area. Most of the changes are in the horizontal dimension.
Topics: Denture Retention; Denture, Overlay; Dental Stress Analysis; Time Factors; Water; Surface Properties; Materials Testing
PubMed: 35061925
DOI: 10.1111/jopr.13481 -
The Journal of Prosthetic Dentistry Apr 2022This report describes a digital workflow for the fabrication of a complete maxillary denture opposing an implant-retained overdenture. This procedure provides a...
This report describes a digital workflow for the fabrication of a complete maxillary denture opposing an implant-retained overdenture. This procedure provides a predictable and accurate 3-visit technique to digitally scan and articulate edentulous ridges, avoiding the discomfort associated with analog impression making. Wax rims were applied to intraorally relined plastic edentulous stock trays. The occlusal relationship was registered at the appropriate vertical dimension of occlusion by using these tray and rim assemblies. The digital laboratory scanning of the relined tray and rim assemblies resulted in accurate virtual articulation of the digital edentulous intraoral scans. The removable restorations were digitally designed, milled, and delivered, and the clinical and laboratory steps are described.
Topics: Computer-Aided Design; Denture, Complete; Denture, Overlay; Humans; Mouth, Edentulous; Workflow
PubMed: 33549339
DOI: 10.1016/j.prosdent.2020.12.024 -
Nutrients Mar 2023Tooth loss may affect food ingestion and, consequently, nutrition intake. The neuroimaging literature using functional magnetic resonance imaging (fMRI) was reviewed to... (Review)
Review
Tooth loss may affect food ingestion and, consequently, nutrition intake. The neuroimaging literature using functional magnetic resonance imaging (fMRI) was reviewed to summarize the changes in brain functions in response to denture rehabilitation in patients with partial or complete edentulous dentition. Overall, this review covered nine fMRI studies on denture rehabilitation. Eight recruited complete edentulous patients, whereas one recruited partially edentulous patients. The risk-of-bias assessment revealed concerns regarding all nine studies. Due to the heterogeneity of the studies and the lack of brain coordinates reported, a meta-analysis could not be conducted, and this review could only summarize the findings without statistical validation. The evidence from jaw-clenching studies suggested that implant-supported fixed dentures could be the best option, as compared to implant-supported overdentures and complete dentures, as it was associated with higher brain activity levels in various brain regions, including those corresponding to the primary sensory (postcentral gyrus) and motor cortices (precentral gyrus). Gum-chewing studies indicated that perhaps the medial and middle frontal gyri were associated with food comminuting and food mixing, which could be improved by the full replacement of the dental arch, instead of only partial replacement. All the fMRI studies described the functional neuroplasticity of the patients undergoing denture rehabilitation and suggested that certain rehabilitation options were more beneficial in restoring masticatory functions, as well as their associated brain activity levels.
Topics: Humans; Adult; Magnetic Resonance Imaging; Denture, Complete; Mouth, Edentulous; Denture, Overlay; Neuronal Plasticity; Mastication
PubMed: 37049418
DOI: 10.3390/nu15071577 -
Journal of Dentistry Mar 2019The aim of this prospective pilot study was to evaluate the concept of one single implant placed in the edentulous mandible to retain a complete denture with regard to...
OBJECTIVES
The aim of this prospective pilot study was to evaluate the concept of one single implant placed in the edentulous mandible to retain a complete denture with regard to implant survival and prosthodontic maintenance over an observation period of 10 years.
MATERIALS AND METHODS
Eleven edentulous patients were included and received one implant in the midline of the mandible. Five implants healed submerge and were uncovered 2 months later. The other six healed un-submerged and were provided with a healing abutment 4 mm in height thus moderately loaded. All denture bases were temporarily relined during the healing period and two months later provided with a ball attachment for implant retention. Implant related parameters and prosthodontic maintenance interventions were assessed four weeks after implant loading and then annually.
RESULTS
Over a mean observation period of 108.9 months (35-136 months), no implant was lost. The most frequent prosthetic maintenance intervention was activation of the matrix due to loss of retention, followed by exchange of the female part. Fracture of the denture base in the attachment area was a frequent complication and occurred in 8 cases. Two denture bases fractured twice.
CONCLUSION
Within the limitations of this prospective pilot study, the concept of a single midline implant to retain a mandibular complete denture is promising over ten years for edentulous patients. Regular recall visits should be scheduled due to frequent maintenance interventions. Further research on this topic with a larger study cohort is needed.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture Retention; Denture, Overlay; Humans; Jaw, Edentulous; Mandible; Pilot Projects; Prospective Studies; Treatment Outcome
PubMed: 30690111
DOI: 10.1016/j.jdent.2019.01.006 -
The International Journal of... 2017To investigate the following three null hypotheses in patients rehabilitated with a mandibular overdenture supported by two unsplinted implants: (1) patient satisfaction...
PURPOSE
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.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSION
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.
Topics: Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Denture, Overlay; Female; Humans; Male; Mandible; Middle Aged; Mouth, Edentulous; Patient Satisfaction; Self Report
PubMed: 29084295
DOI: 10.11607/ijp.5295 -
The International Journal of Oral &... 2022To examine the influence of posterior residual ridge resorption (PRRR) and relining on bending strain around implants under an overdenture.
PURPOSE
To examine the influence of posterior residual ridge resorption (PRRR) and relining on bending strain around implants under an overdenture.
MATERIALS AND METHODS
Maxillary and mandibular edentulous models were made and covered with white silicone. Four strain gauges were placed on four sides of each implant. Two tissue-level implants were placed bilaterally in the part between the lateral incisors and canines of the mandible. A maxillary conventional denture and a mandibular overdenture were fabricated to fit the models. Three levels of bone resorption around the implant were created: 0, 0.8, and 1.5 mm. The surface of the residual ridge was uniformly removed from the area near the distal side of the implant to the retromolar section, and three levels of PRRR were created (0, 1, and 1.5 mm). After the measurement, the experimental denture of the PRRR of 1 mm and 1.5 mm were relined. Locator attachments were used. A 98-N occlusal force was applied, and bending strains around the implant were measured. The Kruskal-Wallis test and Bonferroni correction were employed to analyze the data.
RESULTS
Without relining, at each bone resorption level around the implant, the bending strain was smallest with PRRR of 0 mm and largest with PRRR of 1.5 mm. The bending strain after relining was smaller than the bending strain with ridge resorption. Bending strains after relining were smaller than bending strains with no ridge resorption, but there was no significant difference in bending strain between these three groups.
CONCLUSION
As PRRR increased, the bending strain increased without relining. As bone resorption around the implant progressed, PRRR enhanced the increase in the peri-implant bending strain. Bending strain was reduced when relining was performed.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Mandible; Maxilla; Mouth, Edentulous
PubMed: 35235620
DOI: 10.11607/jomi.9193 -
Clinical Implant Dentistry and Related... Feb 2021There is lack of reliable predictors for success of conventional complete denture (CCD) therapy, which in turn might affect the effectiveness of subsequent...
BACKGROUND
There is lack of reliable predictors for success of conventional complete denture (CCD) therapy, which in turn might affect the effectiveness of subsequent implant-retained overdenture (IOD) therapy.
PURPOSE
To investigate relationships between digitally obtained geometrical mandibular residual ridge measures and perceived CCD-stability.
MATERIALS AND METHODS
30 CCD wearing patients (67.9 ± 7.0 years) for whom a new set of CCDs was advised, were treated with new CCDs. Digitalized mandibular gypsum models were measured using the Geomagic Studio 2013 software. Data were obtained for (1) height, width, and cross-section surface area of the residual ridge at different locations (midline, premolar, and anterior edge of retromolar pad) and (2) denture base surface area. Scatter plots and multivariate regression analyses were used to investigate associations between the geometric data and denture base surface area, and correlated with denture stability scores (Spearman rank test).
RESULTS
Scatter plots showed that best model fit for denture base surface area was mean ridge height (R = 0.906). Multivariate regression showed that height at premolar location (p = 0.001) had largest effect on denture base surface area (R = 0.796). Ridge morphology variables, except width at midline location, were significantly correlated with CCD-stability (p-values <0.05). CCD-stability was significantly correlated with denture base surface area (p ≤ 0.001).
CONCLUSION
Residual ridge height at premolar location was most predictive for denture base surface area and perceived CCD-stability.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Complete; Denture, Complete, Lower; Denture, Overlay; Humans; Mandible
PubMed: 33592676
DOI: 10.1111/cid.12976