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Journal of Prosthodontic Research Jan 2024This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge. (Review)
Review
PURPOSE
This scoping review aimed to systematically map research regarding implant-assisted removable partial dentures (IARPDs), and identify existing gaps in knowledge.
STUDY SELECTION
Two reviewers independently conducted a search of the MEDLINE-PubMed and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for Scoping Review and included articles published in English up to August 31, 2022, including human studies, reviews, and in vitro studies. Expert opinions, animal studies, and clinical studies involving complete overdentures were excluded, and ten aspects for establishing the treatment strategy for IARPDs were examined.
RESULTS
One hundred and twelve articles were chosen. There were two treatment modalities: IARPDs retained by implant- and tooth-supported surveyed single crowns (SCs) or fixed partial dentures (FPDs). In IARPDs retained by tooth-supported surveyed SCs or FPDs, the survival rate of dental implants for IARPDs was relatively higher with a wide range of marginal bone loss and many complications, but with improved functional performance, oral health-related quality of life, and patient satisfaction. There were limited data on survival or success rates and designs of IARPDs, attachment selections, length and diameter, inclination, placement sites, and loading protocols of implants, regardless of prosthetic types. There was limited information on maxillary IARPDs except for survival rates of implants.
CONCLUSIONS
Although IARPDs could become a useful treatment strategy, there is limited scientific consensus with gaps in knowledge about their use. Additional well-designed clinical and in vitro studies are necessary to scientifically establish IARPDs as definitive prostheses in implant dentistry.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Patient Satisfaction; Quality of Life; Tooth
PubMed: 37164658
DOI: 10.2186/jpr.JPR_D_22_00252 -
The Journal of Prosthetic Dentistry Aug 2023Successful outcomes with cast removable partial dentures (RPDs) are dependent on adequate fabrication and adjustments at the delivery appointment. Evaluation of the...
STATEMENT OF PROBLEM
Successful outcomes with cast removable partial dentures (RPDs) are dependent on adequate fabrication and adjustments at the delivery appointment. Evaluation of the number and frequency of postinsertion follow-up appointments helps determine whether the prosthesis continues to fit comfortably and whether function and esthetics continue to be satisfactory. Reports on the number of appointments and frequency and type of adjustments required for RPDs following insertion are sparse.
PURPOSE
The purpose of this university-based population study was to determine the number of appointments and type of adjustments following RPD insertion and their association with patient demographics, type of RPD, and denture survival.
MATERIAL AND METHODS
This retrospective clinical study examined the records of 257 patients at the University of Toronto, Faculty Dentistry, wearing 308 RPDs inserted between 2013 and 2014 with a 5-year follow-up. The outcome measures investigated included postinsertion appointments, type of adjustments, and denture survival.
RESULTS
A total of 48.1% of the dentures (19.5% tissue supported; and 28.6% tooth supported) were maxillary, and 51.9% (34.7% tissue supported; and 17.2% tooth supported) mandibular. Most patients (68.9%) had 1 to 3 postinsertion appointments, with 78.6% having no major adjustments. Twenty-six dentures failed (failure rate 8.4%), with the failure-free time estimated at 4.58 years (95% confidence interval (CI) 4.42-4.73 years, Kaplan-Meier survival analysis). Failed dentures were significantly associated with more minor adjustments (Mean (M)=4.12, SD=3.90, Kruskal-Wallis (K-W) P=.027; OR=1.18; 95% CI 1.05-1.32, P=.006). More minor adjustments were needed for mandibular dentures (multivariable Poisson regression (MPR) P=.003) compared with maxillary dentures. More major adjustments were needed for maxillary dentures (MPR P=.030) compared with mandibular dentures. More minor and major adjustments were needed for dentures that were remade from within 5 years to beyond 10 years compared with first time denture wearers (MPR P<.001). Patients with musculoskeletal disorders required a significantly higher number of minor adjustments (M=3.67, MPR P<.001) and appointments (M=3.87, MPR P<.001) than those without these disorders.
CONCLUSIONS
The 5-year survival of RPDs following insertion was estimated at 91.6%. Most patients required 1 to 3 appointments after insertion. Mandibular RPDs required significantly more minor adjustments, and maxillary RPDs more major adjustments. More minor and major adjustments were needed for dentures that were remade at any time previously compared with first time denture wearers.
Topics: Humans; Denture Design; Denture, Partial, Removable; Retrospective Studies; Esthetics, Dental; Tooth
PubMed: 37419711
DOI: 10.1016/j.prosdent.2023.05.003 -
The International Journal of... Feb 2024To explore the applications of 3D printing for the fabrication of complete dentures, a literature search was conducted using PubMed to identify articles related to the... (Review)
Review
To explore the applications of 3D printing for the fabrication of complete dentures, a literature search was conducted using PubMed to identify articles related to the topic of 3D-printed complete dentures. A search was conducted that included the following keywords: digital complete denture workflow, printed complete denture, additive manufacturing complete denture, digital complete denture, CAD/CAM complete denture. Articles published before 2016 were excluded to increase the relevancy of reporting results. Determining how 3D-printed dentures compare to conventional and milled dentures is important to better understand how they can be used clinically. Material strength, color stability, and denture base adaptation are discussed. Currently, the area of greatest innovation is with printing resins and improving physical and esthetic properties. As with every innovation, multiple generations of materials are created before the gold standard is achieved. While the ideal printed denture material does not currently exist, based on the published research, printed dentures have material strength that meets ISO standards, with denture base adaptation similar to conventionally processed dentures. Clinically, it is likely that printed dentures will have more challenges with fractures, color stability, and staining. However, printed dentures offer many benefits, and the current limitations will be addressed as new materials are developed. We are currently at the beginning of what is an exciting future for printed dentures.
Topics: Printing, Three-Dimensional; Denture, Complete; Humans; Denture Design; Computer-Aided Design
PubMed: 38787580
DOI: 10.11607/ijp.8832 -
Journal of Prosthodontic Research Oct 2023Removable partial dentures have a wide range of applications as missing tooth prostheses, and the denture design can be quite diverse. However, the factors affecting...
PURPOSE
Removable partial dentures have a wide range of applications as missing tooth prostheses, and the denture design can be quite diverse. However, the factors affecting masticatory function remain unclear. We investigated the effect of denture design, especially the use of indirect retainers and major connectors, on masticatory function in patients with mandibular bilateral distal extension dentures.
METHODS
Fifty-three patients with mandibular Kennedy Class I and Eichner classification B occlusal support were included in this study. Masticatory performance (MP) was assessed using gummy jelly. For the dentures, the type of major connector (bar or apron), presence or absence of indirect retainers, number of rests, and number of artificial teeth were evaluated. The number of functional teeth and occlusal support, Eichner classification, maxillary denture usage, mandibular residual ridge height, and duration of denture use were also evaluated. The factors influencing on the MP were evaluated using the Mann-Whitney U test, Spearman's correlation coefficient, and logistic regression analysis.
RESULTS
MP was significantly higher when the major connector was bar-type or when there was an indirect retainer than with an apron-type or no indirect retainer. MP was positively correlated with the number of functional teeth, occlusal support, and number of rests. Logistic regression analysis revealed that the number of functional teeth and the presence or absence of an indirect retainer were factors that significantly influenced the MP.
CONCLUSIONS
An indirect retainer setting is useful for achieving good masticatory performance in mandibular bilateral distal extension dentures.
Topics: Humans; Denture Design; Tooth; Denture, Partial, Removable; Mandible; Mastication
PubMed: 36740265
DOI: 10.2186/jpr.JPR_D_22_00135 -
The Journal of Prosthetic Dentistry Sep 2023The popularity of computer-aided design and computer-aided manufacturing (CAD-CAM) dentures has led to the introduction of new denture materials and resins. However,...
STATEMENT OF PROBLEM
The popularity of computer-aided design and computer-aided manufacturing (CAD-CAM) dentures has led to the introduction of new denture materials and resins. However, studies on the surface characteristics of these materials and how they compare to dentures fabricated by more traditional methods are lacking.
PURPOSE
The purpose of this cross-sectional study was to determine whether the surface roughness (Ra) of denture base materials differed based on manufacturing technique.
MATERIAL AND METHODS
Disks of Ø10×2-mm (n=10) were fabricated using 6 different manufacturing techniques, including compression molding (Lucitone 199), injection molding (Ivocap High Impact), Computer Numerical Control (CNC) milling (Ivotion Base), and additive manufacturing on the Carbon M2 (Lucitone Digital Print), the SprintRay Pro55 S (Dentca Denture Base II), and the Envision One (Flexcera Base) systems. An automatic, noncontact laser confocal microscope (VK-X1000 Series; KEYENCE) was used to analyze the Ra surface roughness of each specimen at ×5 magnification. The images were imported into a multifile analyzer, horizontal and vertical roughness profiles were inserted into each scan, and Ra values were calculated and averaged by following the International Organization for Standardization (ISO) 4287 standard. A 1-way analysis of variance (ANOVA) was performed to compare the effect of manufacturing technique on surface roughness, followed by the Tukey multiple comparisons test (α=.05).
RESULTS
The additively manufactured Dentca Denture Base II (AM-DB) exhibited a statistically significantly higher Ra when compared with the other test groups (P<.001). The additively manufactured Flexcera Base (AM-FB) showed a higher Ra mean value when compared with injection molding (IM) (P=.036). No statistically significant difference in surface roughness was found among the other tested materials representing the different processing methods (P>.05).
CONCLUSIONS
The manufacturing method influences the Ra of denture base materials with varying results. The injection molding method resulted in the smoothest surface compared with additively manufactured and CNC-milled denture base materials.
PubMed: 37723002
DOI: 10.1016/j.prosdent.2023.08.028 -
PloS One 2023This study evaluated surface properties and adhesion/biofilm formation by Candida albicans on 3D printed denture base resins used in 3D printing. Disc-shaped specimens...
This study evaluated surface properties and adhesion/biofilm formation by Candida albicans on 3D printed denture base resins used in 3D printing. Disc-shaped specimens (15 mm x 3 mm) of two 3D-printed resins (NextDent Denture 3D+, NE, n = 64; and Cosmos Denture, CO, n = 64) and a heat-polymerized resin (Lucitone 550, LU, control, n = 64) were analyzed for surface roughness (Ra μm) and surface free energy (erg cm-2). Microbiologic assays (90-min adhesion and 48-h biofilm formation by C. albicans) were performed five times in triplicate, with the evaluation of the specimens' surface for: (i) colony forming units count (CFU/mL), (ii) cellular metabolism (XTT assay), and (iii) fluorescence and thickness of biofilm layers (confocal laser scanning microscopy). Data were analyzed using parametric and nonparametric tests (α = 0.05). LU presented higher surface roughness Ra (0.329±0.076 μm) than NE (0.295±0.056 μm) (p = 0.024), but both were similar to CO (0.315±0.058 μm) (p = 1.000 and p = 0.129, respectively). LU showed lower surface free energy (47.47±2.01 erg cm-2) than CO (49.61±1.88 erg cm-2) and NE (49.23±2.16 erg cm-2) (p<0.001 for both). The CO and NE resins showed greater cellular metabolism (p<0.001) and CO only, showed greater colonization (p = 0.015) by C. albicans than LU in the 90-min and 48-hour periods. It can be concluded that both 3D-printed denture base resins are more prone to colonization by C. albicans, and that their surface free energy may be more likely associated with that colonization than their surface roughness.
Topics: Candida albicans; Denture Bases; Biofilms; Surface Properties; Printing, Three-Dimensional; Materials Testing; Polymethyl Methacrylate
PubMed: 37792886
DOI: 10.1371/journal.pone.0292430 -
The Journal of Prosthetic Dentistry Nov 2023Limited information is available on the shear bond strength (SBS) between denture teeth and denture base resins fabricated using a stereolithography (SLA) 3-dimensional...
STATEMENT OF PROBLEM
Limited information is available on the shear bond strength (SBS) between denture teeth and denture base resins fabricated using a stereolithography (SLA) 3-dimensional (3D) printer.
PURPOSE
The purpose of this in vitro study was to evaluate the SBS between denture teeth and the denture base resins produced with the conventional method and with a 3D printer.
MATERIAL AND METHODS
Conventional or 3D printed denture teeth were included in the study. The denture base resins were manufactured either conventionally or with a 3D printer. Four subgroups were tested: conventional teeth-conventional base resin (CT-CB), conventional teeth-printed base resin (CT-PB), printed teeth-conventional base resin (PT-CB), and printed teeth-printed base resin (PT-PB). The maxillary molars were combined with Ø5×2.5-mm-cylindrical denture base resin. Shear bond testing was performed by applying a parallel force to the denture teeth-denture base resin interface by using a blade-edge chisel with a crosshead speed of 1 mm/min until failure occurred. SBS and elastic modulus (EM) were recorded. One-way ANOVA followed by the Dunnett T3 post hoc test was used for the statistical analysis (α=.05). The failure modes of the specimens were also analyzed.
RESULTS
A statistically significant difference (P<.05) was found between the evaluated groups for the SBS and EM values. PT-PB showed the highest SBS value (15.4 ±2.7 MPa), and CT-PB showed the lowest (0.9 ±0.7 MPa). The PT-CB group showed the highest EM value (62.74 ±20.80 GPa), and the CT-PB group showed the lowest (29.46 ±28.40 GPa). The CT-CB and CT-PB specimens showed mostly adhesive failure; none of the PT-PB specimens showed adhesive failure.
CONCLUSIONS
Three-dimensional printing led to a better bond between the denture teeth and the denture base resin compared with the conventional method. Although these findings need to be supported by clinical studies, the use of 3D printers is appropriate in the production of denture teeth and denture bases.
Topics: Acrylic Resins; Denture Bases; Dental Bonding; Dental Cements; Resins, Synthetic; Materials Testing; Shear Strength; Surface Properties
PubMed: 37743140
DOI: 10.1016/j.prosdent.2023.08.035 -
The Journal of Prosthetic Dentistry Nov 2023Studies on the impact of denture cleansers on the physical and mechanical properties of denture bases designed and constructed by using computer software programs are...
STATEMENT OF PROBLEM
Studies on the impact of denture cleansers on the physical and mechanical properties of denture bases designed and constructed by using computer software programs are lacking.
PURPOSE
The purpose of this in vitro study was to test the effect of a peroxide denture cleanser on the hardness, fracture toughness, water sorption, and solubility of denture base materials manufactured by 3D printing and computer-aided design and computer-aided manufacturing (CAD-CAM) milling.
MATERIAL AND METHODS
The hardness, fracture toughness, water solubility, and sorption of CAD-CAM milled and 3D printed groups (n=40) were evaluated before and after exposure to a denture cleanser. Hardness (n=10) was analyzed with a Vickers hardness testing machine, and fracture toughness (n=20) with the 3-point bend test. After the fracture of specimens, a scanning electron microscope at ×300 was used for fractographic analysis. Water sorption and solubility (n=10) were evaluated before and after immersion in denture cleanser for 6 days to simulate 180 days of immersion. Two-way repeated ANOVA and 2-way ANOVA were used to test normally distributed data, whereas the Mann Whitney U test and Wilcoxon signed ranks test were used for data that were not normally distributed (α<.05).
RESULTS
The Vickers hardness and fracture toughness of both materials decreased after immersion in denture cleansers, with a higher decrease in values for the 3D printed group (P<.001). The denture cleanser had no effect on the water sorption and solubility of either group.
CONCLUSIONS
Milled specimens had higher hardness values and fracture toughness before and after immersion in the denture cleanser. Denture cleansers resulted in the reduced hardness and fracture toughness of both groups, but the percentage change in the milled group was lower. Denture cleansers had no effect on water sorption or solubility.
Topics: Denture Cleansers; Denture Bases; Materials Testing; Computer-Aided Design; Printing, Three-Dimensional; Water; Surface Properties
PubMed: 37716896
DOI: 10.1016/j.prosdent.2023.08.009 -
Journal of Oral Rehabilitation Dec 2023Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing... (Review)
Review
BACKGROUND
Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food.
OBJECTIVE
To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses.
METHODS
This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches.
RESULTS
Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND.
CONCLUSIONS
Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.
Topics: Humans; Dental Prosthesis, Implant-Supported; Mouth, Edentulous; Denture, Complete; Mastication; Muscles; Dental Implants; Denture, Overlay
PubMed: 37605296
DOI: 10.1111/joor.13564 -
Cureus Sep 2023Background The aim of this study was to compare the responses of 30 denture wearers' opinions concerning the efficiency of two types of adhesives and estimate their...
Background The aim of this study was to compare the responses of 30 denture wearers' opinions concerning the efficiency of two types of adhesives and estimate their satisfaction level using denture adhesive (DA). Materials and methods 30 completely edentulous patients were divided randomly into two groups. Each group received one type of DAs (SECURE, COREGA) and was instructed to follow the same sequence of application. Each type of adhesive was used for seven days, as recommended by the manufacturer. The patients were requested to fill out a questionnaire considering their opinion and satisfaction regarding denture retention, chewing ability and duration of adhesives. Results The majority of patients stated that the prosthetic DAs enhanced their retention, chewing, stability, and efficiency of dentures. There was a significant difference in patient satisfaction regarding denture retention in the mandible and the duration of the adhesive in the mouth. Concerning ability of the patient to remove the adhesive from their mouth, the taste, or the retention of the maxillary denture, there were no statistically significant differences between the two DAs. Conclusions The results of the present study showed that overall satisfaction of complete denture wearers was high significantly different when a herbal DA was applied. This includes improvements in their duration of retention effectiveness, greater stability, and retention of the lower mandibular dentures. To use DA effectively, patients should be oriented by their dentists. Patient education is essential to provide them with a better understanding of both the appropriate technique for applying DA and the possible outcome they may experience.
PubMed: 37900483
DOI: 10.7759/cureus.46001