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Many factors can contribute to the fracture of complete dentures. This article has identified some of these factors and presented some methods that can greatly reduce or eliminate functional complete denture base fractures when used with a thorough diagnosis and treatment plan.
The occlusal force pattern during chewing and biting was studied in eight edentulous patients whose dentitions had been restored with mandibular bilateral posterior two-unit cantilever fixed prostheses supported on osseointegrated titanium fixtures and occluding with complete maxillary dentures. The chewing pattern was comparable to that reported for subjects with complete healthy dentitions or with tooth-supported cross-arch fixed partial dentures. However, during chewing and swallowing the voluntary capacity of the jaw-closing muscles was used to a much greater extent. Contrary to reports for cantilevers in tooth-supported cross-arch unilateral posterior two-unit cantilever fixed partial dentures occluding with natural teeth, the posterior cantilever segments in the present fixture-supported cantilever prostheses occluding with complete dentures regularly exhibited the largest local forces. Despite this, material failures of this type of fixed prostheses are rare, as demonstrated in long-term follow-up studies.
The objective of this research was to compare the ability of the two most popular methods for denture cleaning to remove plaque microorganisms from dentures. Dentu-Creme abrasive denture paste and Efferdent alkaline peroxide denture-cleanser soak were selected for study. Two trials were completed in which these materials were used alone and in combination along with a no-treatment control to determine the level of recoverable plaque bacteria from removable dentures. Plaque was allowed to accumulate for 48 or 72 hours in individuals with healthy oral mucosa during which time they refrained from all denture hygiene procedures. The results of two studies following similar double-blind cross-over designs were consistent in that soaking with the denture cleanser caused a significantly greater reduction of microorganisms than did brushing with the denture paste. Further, combining brushing with the soak did not reduce the level of recoverable microorganisms significantly more than soaking alone. Overall, brushing alone did not consistently remove more microorganisms than were observed in the no-treatment group. The denture-cleanser soak displayed broad antimicrobial activity against gram-negative anaerobic rods (Fusobacterium sp.), gram-positive facultative cocci (streptococci), and gram-negative anaerobic cocci (Veillonella sp.), as well as total recoverable microorganisms, which were all equally reduced by the denture-cleanser treatment. These results support the need for use of a denture cleanser in addition to brushing with a denture paste for proper denture hygiene.
When fixed partial dentures are indicated in an arch opposing a complete denture, it is best to develop the occlusal surfaces of the fixed restorations at the same time that the opposing denture teeth are arranged in wax to permit greater flexibility and reduce the compromise in developing bilateral balanced occlusion. This article describes the development of bilaterally balanced occlusion between casting patterns for fixed partial dentures and a complete denture. The technique emulates the ease of arranging maxillary and mandibular denture teeth and can be used to develop fixed restorations with metal or porcelain occlusal surfaces. Porcelain occlusal surfaces are described because the use of porcelain is more technique sensitive.
The transmandibular implant has been designed to provide the patient with a severely atrophic mandible an implant that will bear the masticatory load. Thirteen edentulous patients treated with maxillary complete dentures and mandibular overdentures retained by the transmandibular implant were examined biannually for 2 years. Prosthodontic complications included the development of parafunctional habits, "combination syndrome," and epulis in association with the mandibular denture. Surgery was necessary to control chronic mucosal irritation related to muscle pull in one patient. Among the soft tissue parameters, plaque index, gingival index, and sulcus depth demonstrated statistically significant correlations (Spearman). All patients reported an absence of discomfort and those with previous functional complaints reported the ability to masticate all foods. Patient response to overdenture reconstruction with the transmandibular implant seems to be similar to that observed with the combination case. Oral hygiene appears to be directly related to the soft tissue response.
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Explore the source record for details and available documents.
For several years, implant-supported overdentures have been used with excellent results in rehabilitation of the edentulous mandible. The effect on the antagonistic jaw bone resorption however, has not yet been evaluated. The aim of this study was to examine on orthopantomograms the anterior and posterior maxillary ridge resorption in three groups of patients with different mandibular prosthetic reconstructions: (1) overdentures supported by two implants, (2) fixed prostheses supported by four to six implants, and (3) complete dentures. The results indicated a more pronounced annual bone resorption in complete denture wearers compared to patients with implant-supported overdentures. A limited but continuing bone resorption was observed for the patients with implant-supported overdentures, and a slightly higher annual bone resorption occurred in the implant-supported fixed prosthesis group.
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The purpose of this study was to determine if a relation between diabetes mellitus and denture stomatitis could be supported by observing an increased prevalence of denture stomatitis in subjects with either diagnosed diabetes mellitus or elevated plasma glucose levels. The study involved 301 subjects wearing either complete or partial maxillary dentures. Medical history information, oral examination records, and laboratory data were used for the study. No significant increase in the prevalence of denture stomatitis was found in those subjects with either previously diagnosed diabetes mellitus or elevated plasma glucose levels when compared with subjects with normal glucose metabolism.
OBJECTIVES: The aim of this study was to establish the treatment outcome of full denture treatment with or without implant support, in which the outcome assessment focuses on the patient's subjective evaluation ('denture-satisfaction'). DESIGN: A multicenter randomized clinical trial. SUBJECTS: Thirty-two men and 118 women (mean age 56 +/- 9, range 35-84 years) participated in the study. The mean height of the mandible was 13 +/- 2 mm, measured on a lateral cephalometric radiograph. The patients were randomly assigned to either a group treated with implant-retained mandibular overdentures and a new maxillary denture, or to a control group treated with a new set of complete dentures. MAIN OUTCOME MEASURES: Denture satisfaction was assessed using questionnaires focusing on denture-related complaints and 'a general satisfaction rate'. RESULTS: Based on the baseline data, from the 'denture complaints' questionnaire six interpretable factors could be extracted. One factor did not vary following treatment and was excluded from the outcome analysis. At the 1-year evaluation three out of five factors showed significantly better scores for the group treated with implants than for the control-group. The same was found for the general satisfaction rate. CONCLUSION: For patients with a severely resorbed mandible, overdentures retained by dental implants appear to provide a more satisfactory solution to their denture-related problems.
Fifteen edentulous patients with complaints regarding denture comfort and/or function were treated with the transmandibular implant. All patients were restored with conventional maxillary dentures opposed by implant-supported removable prostheses. Two to 4 years after surgery, these patients were evaluated for vertical and horizontal maxillary bone loss with a radiographic analysis developed by the authors. With this technique, attention was focused on vertical alveolar ridge resorption in the anterior maxilla. Although the sample size was small, the findings from this study indicate that vertical bone loss in the anterior maxilla does occur when a maxillary denture is opposed by an implant-supported overdenture. Comparison of these results with a previous study that evaluated anterior maxillary resorption when a complete maxillary denture opposed natural mandibular anterior teeth and a distal extension removable partial denture demonstrated no statistically significant difference.
Overdentures supported by osseointegrated implants overcome many of the complications observed with overdentures supported by natural teeth. Dental implants are free of biologic consequences associated with natural teeth, such as dental caries and periodontal disease. Bone undercuts adjacent to implants do not mimic those found adjacent to natural tooth roots. Implants are used to provide predictable retention, support, and stability for overdenture prostheses. When lip or facial support is required, the overdenture is the treatment of choice. Likewise the overdenture may improve phonetic deficiencies associated with alveolar bone loss.
The treatment alternative described maximizes the benefit of remaining teeth while allowing simplified alteration of the prosthesis if abutments are lost during the life span of the removable partial denture (RPD). A conversion partial is an RPD whose tooth-frame assembly components are individually fabricated and then joined with an acrylic resin major connector. The conversion RPD optimizes retention and stabilization of a terminal dentition and can be easily converted to an immediate complete denture.
This article describes 2 patients who presented with self-made dentures. Each patient had a different motivation for avoiding professional dental treatment. One patient made her own denture because she could not afford dental care, while the other could afford such care but avoided treatment due to a dental phobia. A discussion of diagnosis and treatment planning is presented for each situation.
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