PubMed · 17128220
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R M Dean. 2006-11-25. Do no harm.. https://doi.org/10.1038/sj.bdj.4814276
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Occlusion is a critical component in any aspect of prosthodontic care including that related to the treatment of dentate, partially dentate, or edentulous patients. When complete dentures are fabricated for an edentulous patient, occlusion has a considerable influence on the outcome of treatment. Due to the relative simplicity involved in development of a lingualized occlusal scheme by dental laboratory technicians, this approach has gained favor among practitioners who are able to evaluate and/or correct tooth arrangements for complete dentures. This article will highlight the influences of a lingualized tooth arrangement in complete denture occlusion as it relates to improving edentulous patients' function and quality of life; it will also demonstrate a predictable approach to achieving lingualized occlusion in complete denture prosthodontics.
The single maxillary denture is a complex prosthesis that requires a complete understanding of the basics of denture occlusion. Theilemann's formula must be applied to each individual patient, and appropriate treatment must be taken to assure complete balance in all excursive movements. The basic principles of retention, stability, and support should not to be taken for granted, and steps must be completed so that all components are working in harmony for success of the maxillary denture. Treatment of various patients has been illustrated to allow the reader to comprehend better the modalities that can be employed for preparing the oral environment before denture insertion thereby ensuring better success in treating these classes of patients.
STATEMENT OF PROBLEM: Complete dentures contribute significantly to the facial esthetics of edentulous patients. However, information as to the effect of complete dentures on the natural position of the head is limited. PURPOSE: The purpose of this pilot study was to evaluate the immediate and 30-day effect of wearing complete dentures on the dynamic natural head position measured during walking. MATERIALS AND METHODS: The sample consisted of a volunteer group of 16 patients, 8 women and 8 men, who received new complete dentures. The ages of the subjects ranged from 45 to 64 years (mean=52 years). Dynamic measurement of head posture was carried out by a specially constructed inclinometer device. Each subject in turn was fitted with the inclinometer system and instructed to walk in a relaxed manner for 5 minutes. The data, measured as degrees, were stored in a pocket data logger. This procedure was repeated before insertion of dentures (T1), immediately after insertion of dentures (T2), and 30 days after insertion of dentures (T3). Stored dynamic head posture data were transferred to computer for analysis. The means of the measurements were statistically compared with Friedman and following Wilcoxon tests (alpha =.05). RESULTS: Twelve of 16 (75%) subjects showed an average of 4.6 degrees of cranial extension immediately after insertion of dentures. Six (37.5%) subjects showed an average of 6.4 degrees of cranial flexion, and 8 (50%) subjects showed an average of 5.2 degrees of cranial extension at T3 relative to the T1 measurement. Dynamic head posture measurements of the other 2 subjects remained unchanged. There were significant differences between different measurements of dynamic head posture positions (P<.025). However, only the T1 and T2 measurements were significantly different (P<.015). CONCLUSION: The findings indicate that the statistically significant average extension 4.6 degrees in subjects immediately after insertion of complete dentures was not stable after a 30-day evaluation period and did not produce any statistically significant change. The overall effect of wearing dentures was an irregular flexion or extension pattern on dynamic head posture.