PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Denture, Complete, Lower”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed1997

Radiographic cephalometry of the facial profile.

Radiographic cephalometry is a biomorphological measuring method used in the prosthodontics as well, and for the facial profile analysis of persons with complete dentures. The purpose of this examination was to objectivize the facial esthetics in patients with complete dentures. The measurements were taken from LL X-ray radiographs obtained by the apparatus "Ortoceph 10" (Siemens, Bensheim, Germany). On the sample of 80 subjects a convexity angle of facial bone structures (N-A: A-Pg) and profile angle of soft facial tissue (ft-unt: lnt-ct) have been examined. The subjects were divided into a group with upper and lower complete dentures (20 males and 20 females) and a group with natural teeth of eugnatic characteristics (20 male and 20 female). The measurements were taken by standard protractor at 0.5% precision. The statistical analysis within and among groups has been made by F-test and t-test respectively. The results showed that the bone structure convexity angle span a range between 0 degree and 5.5 degrees (X = 2.5 degrees), and the facial profile angle between 139.5 degrees and 155 degrees (X = 149 degrees) in persons with complete dentures. In persons with natural teeth the values of bone structure convexity angles span a range between -0.5 degree and 4.8 degrees (X = 2 degrees), and the facial profile angle between 136 degrees and 155.5 degrees (X = 151 degrees). The results of tests proved that there were no statistically significant differences in examined variables between persons with natural teeth and those with complete dentures (p > 0.05). The conclusion is that clinical methods of determining the vertical and horizontal intermaxilliary relations used in the designing procedures of complete dentures were reliable enough in reconstruction of examined angles of soft and hard facial profile structures.

Case-Control Studies↗
PubMed2003

A randomized prospective clinical trial on the effectiveness of three treatment modalities for patients with lower denture problems. A 10 year follow-up study on patient satisfaction.

Treatment of lower denture complaints of patients with an edentulous mandible with a height of at least 15 mm can consist of meticulous construction of a new set of dentures (CD), construction of a new set of dentures following preprosthetic surgery to enlarge the denture-bearing area (PPS), or construction of an implant-retained mandibular overdenture (IRO). The aim of this prospective randomized controlled clinical trial was to evaluate the satisfaction of the above mentioned treatment modalities in resolving lower denture related complaints. Ninety edentulous patients (Cawood class IV and V, mean mandibular height 20.7 +/- 2.7 mm) were randomly assigned to one of these treatment modalities. The main outcome parameters were denture satisfaction and chewing ability, which were assessed using validated self-administered questionnaires focusing on denture-related complaints and problems with chewing different types of food. These parameters were measured before treatment, and 1, 5 and 10 years after treatment. Differences among the three groups were tested by applying a one way analysis of variance and a Tukey's test for multiple comparison. At the 1 year evaluation, significantly better scores were observed in the two surgical groups (IRO, PPS) than in the CD group (P<0.05). At 5 year evaluation the 'complaints of the lower denture' showed a significantly better score in the IRO group when compared to the PPS and CD groups (P<0.05). No significant differences were observed between the PPS and CD group. At 10 year evaluation, the intention to treat analysis revealed no significant differences between the three groups, while a per protocol analysis showed that the IRO group was the most satisfied. From this study it is concluded that both on the short and long term denture satisfaction appears most favourable in the IRO group when compared to the PPS and CD groups. Implant-retained overdentures are, therefore, a favourable treatment modality for edentulous patients with lower denture problems.

Adult↗
PubMed1992

Posterior jaw bone resorption in osseointegrated implant-supported overdentures.

For several years, osseointegrated implant-supported overdentures have been used in the rehabilitation of full edentulism with excellent results, at least in the lower jaw. This study involved 3 groups of patients with different prosthetic reconstructions: (1) mandibular overdentures supported by 2 implants connected by a bar (30 patients), (2) mandibular fixed prostheses supported by 4-6 implants (25 patients) and (3) mandibular complete dentures without implant support as controls (85 patients). The primary aim of this study was to examine on orthopantomograms (by means of the area index to minimize distortion and magnification errors), posterior mandibular ridge resorption in the 3 treatment groups. The present data demonstrated a minimal posterior mandibular ridge resorption in patients with fixed implant-supported prostheses. A more considerable posterior ridge resorption was observed in the complete denture group and especially in the overdenture wearers. For the latter, the annual posterior jaw bone resorption after the post-extraction remodeling period of 6 months, was 2- to 3-fold that of full denture wearers. When patients were edentulous for more than 10 years, the difference between the 2 latter groups disappeared. It is suggested that although the overdenture design on 2 implants offers advantages from a financial and failure rate point of view, its indications in younger patients should cautiously be evaluated in a long-term perspective concerning posterior mandibular bone resorption.

Adolescent↗
PubMed1999

Implant-retained mandibular overdentures compared with complete dentures; a 5-years' follow-up study of clinical aspects and patient satisfaction.

The aim of this prospective randomized controlled clinical trial was to evaluate and compare clinical aspects and satisfaction during the first year following treatment and consecutively the change in treatment during the next 4 years of follow-up. Patients were allocated to one of the following treatment modalities: an implant-retained overdenture (IRO-group, 2 endosseous implants, n = 61) or a complete denture (CD-group, n = 60). One year after placement of the denture, unsatisfied patients of the CD-group got the opportunity for a retreatment including an implant-retained overdenture. In the IRO-group 4 implants were lost during the first year and again 4 implants were lost during the next 4 years (survival rate: 93%). All patients could be re-operated successfully. In the CD-group 14 patients (23%) chose an implant-retained overdenture after 1 year. Patients of the IRO-group were significantly more satisfied than patients of the CD-group after 1 year (satisfaction score 8.3 versus 6.6, scale 1-10) and after 5 years (7.4 versus 6.4). From this study it can be concluded that endosseous implants have a high survival rate after 5-years' follow-up. Satisfaction score of the IRO-group is diminishing in time, probably because patients get used to an improved situation. After 5 years, the mean satisfaction score of the CD-group (including patients who got implants) was still lower than of the IRO-group, in spite of the opportunity to a retreatment and have implant-retained overdentures.

Alveolar Bone Loss↗
PubMed2000

Effectiveness of three treatment modalities for the edentulous mandible. A five-year randomized clinical trial.

Currently, 3 treatment options are available for patients with denture complaints and an edentulous mandible with a height of at least 15 mm: meticulous construction of a new set of dentures (CD), construction of a new set of dentures following preprosthetic surgery to enlarge the denture-bearing area (PPS), and construction of an implant-retained mandibular overdenture (IRO). The aim of this study was to evaluate patient satisfaction and subjective chewing ability of edentulous patients treated with one of these treatment modalities. Ninety edentulous patients (Cawood class IV and V, mean mandibular height 20.7 mm) were randomly assigned to receive 1 of these 3 groups. Denture satisfaction and chewing ability were assessed using questionnaires focusing on denture-related complaints and problems chewing different types of food were assessed before treatment, and 1- and 5-years after treatment. At the 1-year evaluation, significantly better scores were observed in the 2 surgical groups (IRO, PPS) than in the CD group. At 5-year evaluation the "complaints of the lower denture" showed a significantly better score in the IRO group when compared to the PPS and CD groups. No significant differences were observed between the PPS and CD group. From this study it is concluded that both in the short and long term denture satisfaction appears most favourable in the IRO group when compared to the PPS and CD groups. Implant-retained overdentures are therefore a satisfactory treatment modality for edentulous patients with problems with their lower denture, even in cases of not severely resorbed mandibles.

Analysis of Variance↗
PubMed2000

Onlay grafts in combination with endosseous implants in severe mandibular atrophy: one year results of a prospective, quantitative radiological study.

In taking an overall view of the radiographs made of patients that underwent simultaneous onlay-grafting and implant placement in the anterior mandible, changes are seen in the grafts. The impression arose that a number of stages could be distinguished in this process of remodelling of the graft. The purpose of the present study was to objectivate the existence of those stages in the first year after bone-grafting by densitometric and height measurements of the onlay grafts using standardized extraoral radiographs (OLCR) and densitometric analysis in a group of 8 patients. OLCRs were taken at regular intervals in the first year after surgery. The measurements were performed in three fixed fields, both ventrally and dorsally of each implant. Generally the densitometric measurement fields were located at the (upper) cortex, the upper spongiosa and the lower spongiosa of the onlay graft. The OLCRs were also used for measurements of the height of the complete graft and of the thickness of the cortex of the graft, using a gauged caliper. The results indicate the following remodelling of the structure of the onlay grafts: 1) decrease in the thickness and the radiographic density of the (upper) cortex of the onlay graft predominantly in the first 6-month period; 2) no significant changes in the radiographic density of the upper spongeous part of the graft; 3) a decrease of approximately 25% in the overall height of the graft, particularly during the first 6-month period; 4) an increase in the radiographic density of the lower part of the spongeous bone in the second 6-month period. It is concluded that the remodelling of the graft has a predictable pattern in time: the first half year being dominated by bone resorption, mainly confined to the cortex of the graft, whereas the second half year is characterized by an increase in bone density in the (remaining) cortex as well as the lower spongeous parts of the graft.

Absorptiometry, Photon↗
PubMed1998

The mandibular staple bone plate: a long-term retrospective evaluation.

PURPOSE: Clinical and radiographic parameters and denture satisfaction were evaluated in a long-term retrospective study of patients treated with the mandibular staple bone plate. PATIENTS AND METHODS: Fifty-six edentulous patients were treated with the mandibular staple bone plate to stabilize their lower denture. The mean evaluation period was 103 months (range, 84 to 139 months). Peri-implant mucosa and bone height were scored, together with quality of the prosthesis and prosthodontic maintenance care. Denture satisfaction was assessed by using two questionnaires. RESULTS: Four staple bone plates were removed during the evaluation period, and one appeared to be fractured. The remaining 51 staple bone plates were functional without any signs of major complications (survival rate, 91%). No further alveolar resorption in the interforaminal region of the mandible took place during the evaluation period. Patients were very satisfied with the prosthetic construction. CONCLUSIONS: The mandibular staple bone plate is a good modality to stabilize the lower denture. However, endosseous implant systems are preferred because of comparable success rates with a more simple operative procedure.

Adult↗
PubMed2003

Two-implant mandibular overdentures: simple to fabricate and easy to wear.

Success rates for titanium dental implants in the anterior mandible are very high. Because of these success rates, as well as lower costs, it is common to treat edentulous patients with just 2 implants and ball anchors for retention of the overdenture, instead of 4 implants and a bar. In this paper the fabrication of 2-implant overdentures is described. In a controlled clinical trial (to be reported elsewhere), 30 subjects received a 2-implant overdenture for the mandible and a conventional prosthesis for the maxilla. The 30 control patients received conventional complete dentures for both jaws. The stability of the overdentures was excellent, and the lingual dimensions of the denture could be reduced to the level of the mylohyoid line to provide more space for the tongue. In patients with tense labial musculature or a limited amount of attached gingiva, it was important to elevate the shoulder of the implant and ball abutment above the gingival level to avoid peri-implant problems. Significantly fewer visits for adjustment related to post-placement pressure spots were required for mandibular overdentures than for conventional mandibular prostheses.

Aged↗
PubMed2001

A randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part IV: Comparisons of dietary intake.

STATEMENT OF PROBLEM: It is unclear whether the replacement of conventional mandibular dentures with implant-supported overdentures alters the diet and thus improves the nutritional intake of edentulous persons. PURPOSE: The purpose of this study was to compare the pretreatment and posttreatment diets of edentulous diabetic patients who received new dentures with either a conventional complete mandibular denture (CD) or a mandibular implant-supported overdenture (IOD). MATERIAL AND METHODS: New dentures were made for 89 edentulous diabetic patients with acceptable metabolic control without insulin (NIT) or with insulin (IT). A randomized approach was used to assign 37 patients a mandibular CD and 52 patients a mandibular IOD supported by 2 cylindrical implants. Of the 89 patients, 58 submitted a dietary log for 7 consecutive days before treatment (PT) and 6 months after treatment completion (PTC). An average daily intake of 28 essential nutrients was determined for each patient at each time interval. Separate 2 x 2 x 2 repeated analysis of variance (ANOVA) tests were performed for each nutrient to compare the means of the 2 denture groups (CD and IOD), 2 diabetic groups (NIT and IT), and 2 time intervals (PT and PTC). The intakes were also compared with the recommended daily allowance (RDA). RESULTS: ANOVAs for all 28 nutritional variables showed no main effect for either denture type or diabetic treatment. Time effects were seen for magnesium, potassium, copper, and monounsaturated fats. The PTC mean intake of the total sample (N = 58) decreased for all 3 minerals and increased for monounsaturated fats with study dentures. Post hoc tests showed the differences between PT and PTC means to be statistically significant for only magnesium (P=.043) and potassium (P=.015). The percentage of patients with PT intake 25% or more below the RDA ranged from 33% to 85% in the CD group and from 24% to 100% in the IOD group for the same 11 nutrients. PTC fiber intake deficiency was noted in almost all participants. Carbohydrate consumption was markedly lower than that recommended by the American Diabetic Association. CONCLUSION: As is often the case with elderly groups, this group of edentulous diabetic patients showed highly comprised nutritional intakes of fiber, vitamins, and minerals. The replacement of old dentures with new dentures that included either a mandibular CD or IOD did not alter patient diets such that the patients improved their nutritional intakes of essential micronutrients and macronutrients.

Aged↗
PubMed1999

A 5-year prospective randomized clinical trial on the influence of splinted and unsplinted oral implants retaining a mandibular overdenture: prosthetic aspects and patient satisfaction.

Prosthetic outcome and patient satisfaction were evaluated in order to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. This study included 36 fully edentulous patients randomly divided into three groups according to the attachment system they received: magnets, ball attachments or straight bars (reference group). None of the implants failed during the whole observation period in any of the groups. After 5 years of observation, the Bar group presented the highest retention capacity and the least prosthetic complications but revealed more mucositis and gingival hyperplasia. Patient satisfaction rated similar for all groups although the Magnet group showed lower retention forces. All patients would repeat the same treatment even though the majority of the Magnet group would prefer a more retentive solution because of limited denture stability.

Adult↗
PubMed2006

Masticatory function with mandibular implant-supported overdentures fitted with different attachment types.

Oral Rehabilitation by means of implant-retained mandibular overdentures is known to improve the oral function. The improvement may depend on the degree of retention and stability of the denture and thus on the type of attachment. In this within-patient cross-over clinical trial, we examined the hypothesis that more retention and stability of the overdenture improves the masticatory function. Eighteen patients received two permucosal implants, a new overdenture, and, successively, three different suprastructure modalities: a magnet, a ball, and a bar-clip attachment. We quantified aspects of the oral function by measuring the electromyographic activity of the jaw muscles and the jaw movement during chewing. The muscle activity was significantly lower for the unsupported new mandibular denture compared with values for the supported new denture. No significant differences in muscle activity were observed among the three attachment types. Furthermore, we did not observe significant differences in jaw muscle activity between the old unsupported denture and the new supported denture, despite significant differences in masticatory performance. Measuring muscle activity during chewing will thus not provide adequate information about masticatory function. Thus, subjects chewed more efficiently after implant treatment. No changes in cycle duration or in jaw movement parameters were observed among the various measurement moments.

Adult↗
PubMed1976

Dolder bar joint mandibular overdenture: a technique for nonparallel abutment teeth.

A mandibular overdenture technique has been presented that utilizes the Dolder bar joint attachment. Endodontically treated lower canines were retained as abutments. Two techniques for attaching the bar to teeth with divergent root canals were discussed: (1) the Schubiger screw system for those teeth with extremely divergent canals and (2) the Stutz pivots system for teeth with only slightly divergent root canals. The use of the Dolder bar joint offers periodontally involved teeth an improved crown/root ratio and splinting of the teeth. Because the bar is close to the alveolar bone, forces of mastication exert much less leverage to the teeth. Finally, the bar joint offers slight vertical and rotational movement of the denture as well as a stressbreaker action.

Dental Abutments↗
PubMedDate not supplied

Stress analysis in edentulous mandibular bone supporting implant-retained 1-piece or multiple superstructures.

PURPOSE: The aim of this study was to investigate the stress distribution in mandibular bone supporting a single or separate multiple implant-retained superstructures. MATERIALS AND METHODS: Three-dimensional finite element models consisting of the mandibular bone, 8 implants, and 1 or more superstructures were created. Vertical and oblique loads were directed onto the occlusal areas of the superstructures to simulate the maximum intercuspal contacts and working contacts, such as the canine-protected and group function occlusion. RESULTS: The unseparated 1-piece superstructure generated the lowest maximum equivalent stresses in the peri-implant bone, followed by the 2-piece superstructure separated at the midline. For the 3-piece superstructure, which was separated between the canine and the premolar, the maximum stress was lower when the canine on the working side was loaded than when the posterior teeth were loaded. DISCUSSION: Separating the 1-piece superstructure into 2- to 4-piece superstructures increased the mechanical stress around supporting implants. Canine load on the working side is distributed well in 1-piece and 3-piece superstructures. CONCLUSION: Based on the results of this finite element model study, canine protected occlusion is recommended for 1-piece and 3-piece superstructures. The unseparated superstructure was more effective in relieving stress concentration in the edentulous mandibular bone than the separated superstructures.

Bite Force↗
PubMed2006

[Patient satisfaction with different types of implant-retained overdentures in the edentate mandible].

The purpose of this study was to determine patient satisfaction with implant supported mandibular overdentures using magnet, bar-clip and ball-socket attachments, and to assess the relation between maximum bite force and patient satisfaction. In a crossover clinical trial, 18 edentulous patients with lower denture complaints received 2 mandibular implants and new lower and upper dentures. The lower denture initially came without any kind of attachment system, but was fitted with one of the attachment types after 3 months. The attachments were changed 3 months thereafter, in random order. A questionnaire concerning denture complaints was given at baseline (with the old denture), after 3 months of functioning with the new denture without attachments and after 3 months of functioning with each of the attachments (within-subject comparison). In addition, at the end of the experiment patients were asked to express their overall satisfaction with their dentures on a visual analogue scale (VAS). Data regarding maximum bite force were obtained from a previous study with the same population. Mandibular implant supported overdenture treatment reduced various denture complaints. The VAS score reflected patients' preference more accurately than scale-scores. Patients strongly preferred bar-clip (10 subjects) and ball-socket attachments (7 subjects) over magnet attachments (1 subject). Patients' preference could not be predicted on the basis of baseline observations. Maximum bite force was not correlated to scale- or VAS scores.

Adult↗
PubMed1989

[Use of a retainer bar in lower full dentures].

In subtotal mandibular edentations, the roots of remaining anterior teeth might be used to enhance the retention of a full denture in building a contramucosal retention bar. Based on a case-report, the authors present the fabrication in five clinical and laboratory sequences, of a maxillary full denture combined with a lower full denture and a retainer bar joining two cuspids. First sequence: Clinical. It mainly concerns: 1) Preparation and impression of the two cuspids for receiving the two posts on which the retention bar will be fixed. 2) The primary plaster impression of the soft tissues. In the laboratory, the coping are directly cast with gold without a core, topped with resin. The individual mandibular impression tray (IIT) presents two windows opposite the two preparations through which the tops of the two copings are showing. Second sequence: Clinical. If the maxillary impression is a classical one, the mandibular impression is peculiar and original. Overall, this provides a reliable working model on which the dental technician will be able to build, the entire prosthesis, not only the retainer bar but also the full denture. This is done in two stages: 1) Secondary impression of the soft tissues with copings in place. 2) Indexing of the copings to the impression tray with acrylic resin, pressing firmly on the rims of the IIT and simultaneously, on the tops of the copings to take into account the different depression of the tissues. In the laboratory, both impressions are boxed and cast, with in place.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Abutments↗
PubMed2001

Nonsubmerged implants in the treatment of the edentulous lower jaw: a 5-year prospective longitudinal study of ITI hollow screws.

BACKGROUND: Although most implant systems have been designed for a two-stage surgical technique, a one-stage surgical technique has always been advocated for the ITI Dental Implant System (Straumann AG, Waldenburg, Switzerland). A new generation of ITI implants was presented in 1988 and included a hollow cylinder, a hollow screw, and a solid screw. PURPOSE: The goal of this study was to evaluate the one-stage surgical technique in connection with the ITI hollow screw in a longitudinal study over 5 years. MATERIALS AND METHODS: Forty-six patients with edentulous lower jaws were supplied with ITI hollow-screw implants. Patients who requested an overdenture (n = 18) had four implants inserted; those who requested a fixed bridge (n = 28) had five to six implants. The patients have been followed annually for 5 years. There was a dropout of three patients (6.5%); one patient did not want to cooperate, one moved from the area, and one was deceased. The clinical examinations included bridge removal for evaluation of the individual implant stability in connection with the 1-, 3-, and 5-year examinations. Radiographic examinations were performed with intraoral radiographs and the long-cone technique. RESULTS: The survival rate after 5 years was 95.7%. The success rate (in which implants undergoing treatment of peri-implantitis were not counted as successes) was 91.4%. The mean marginal bone loss between the baseline and the 1-year examination was 0.1 mm and between the 1- and 5-year examinations was 0.1 mm. These changes in marginal bone level were not significant. CONCLUSIONS: The success rate of ITI hollow-screw implants in the edentulous mandible was 91.4% after a 5-year observation period. There was no significant change in mean bone level between the loading of the implants and the 5-year examination. Peri-implantitis was diagnosed in three patients with poor oral hygiene, and it affected six implants. Five of these failed in spite of treatment.

Adult↗
PubMed2005

Microbiological and clinical outcomes and patient satisfaction for two treatment options in the edentulous lower jaw after 10 years of function.

BACKGROUND: Long-term data on microbiological and clinical outcome as well as on patient satisfaction after implant therapy in the edentulous mandible are limited. Especially comparisons between fixed full prostheses (FFPs) and overdentures (ODs), or between anchoring systems for the latter are scarce. AIM: This study aimed to evaluate both of these parameters at the 10-year follow-up in a group of fully edentulous patients rehabilitated via an OD or a FFP (the latter to allow inter-group comparison). MATERIAL AND METHODS: A total of 37 fully edentulous patients (25 ODs, 12 FFPs, age at implant installation ranged from 36 to 85 years) participated in this study. All subjects received their implants (Branemark System, Nobel Biocare AB, Gothenburg, Sweden) 10 years previously. For the ODs different attachment systems (bar, magnets, ball) had been applied that allowed a further intra-group comparison. At the follow-up visit, 10 years after the abutment insertion, a series of periodontal parameters were recorded, long-cone radiographs were taken and subgingival plaque samples were collected for analysis using checkerboard DNA-DNA hybridization. The clinical and radiographic data were recorded at abutment connection and after 1 and 10 years. RESULTS: After 10 years of loading, mean plaque and bleeding indices and changes in attachment or marginal bone level were not significantly different, neither between the OD and FFP group, nor within the OD group. The marginal bone loss between abutment connection and year 10 was 0.86 and 0.73 mm for OD and FFP groups, respectively. The subgingival microbiota at implant sites from all (sub)-groups was comparable, with low numbers of DNA counts (+/-10 x 10(5)) but high detection frequencies of Actinobacillus actinomycetemcomitans (>90%), Porphyromonas gingivalis (>85%) and Tannerella forsythensis (30%). The composition of the subgingival microbiota was influenced by probing depth and bleeding tendency. Patient satisfaction was very high for both types of prosthetic rehabilitation. The FFP group scored only slightly better for chewing comfort and general satisfaction. CONCLUSION: These data indicate that from the clinical and microbiological standpoint, as well as patient satisfaction, both an OD and a FFP offer a favourable long-term outcome.

Adult↗