[A comparative study of immediate versus complete dentures: evaluation by the patient].
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Success in complete-denture treatment is often directly related to the health and condition of the hard and soft tissues that make up the denture-bearing areas. Surgical alteration of the denture-bearing area is frequently necessary to ensure a morphologically correct form capable of providing adequate support for the prosthesis. A number of these anatomic hard and soft tissue obstacles are discussed, and methods for managing these hindrances to complete-denture treatment are suggested.
The most frequent failures in complete denture construction are examined. All possible failures have been taken into con- been divided into 3 groups: failures in denture retention, in interocclusal relations and factors which are reducing denture stabilization. Failures in the lower complete denture retention with poor extension have been most frequently found (90% cases). Less frequent was poor extension of the upper complete denture. Disbalance such as excentric occlusion and articulation blocking have been frequently found. A sizable vertical occlusal dimension was also significant.
Thirty-six complete dentures were remounted both with check-bite as well as central-bearing-point (CBP) registration. The mandibular or denture position was registered in the condylar area three times with each method. Two independent operators carried out the registrations. One half of patients had their occlusion equilibrated according to the check-bite registration, the other half in the central-bearing-point position. After individual determination of the hinge axis the upper dentures were mounted by a face-bow transfer into a Dentatus articulator. A total of six registrations was performed and repeatedly compared in the condylar area in three dimensions using a computer supported measuring device. The reproducibility of the check-bite registration was 0.37 +/- 0.33 mm, with a maximum of 1.77 mm. For the central-bearing-point method this was 0.29 +/- 0.26 mm with a maximum of 1.56 mm. The mean difference in condylar position between both methods was 0.66 +/- 0.55 mm with a maximum of 4.02 mm. A third independent operator re-examined 30 of the patients 2-3 weeks after the remounting and evaluated the adaptation to the new dentures. Those patients whose dentures were equilibrated with the central-bearing-point method tended to cope better with their dentures and suffered on average from fewer pressure spots.
When the complete denture population was examined for depression with the BDI, the greatest prevalence of depressive symptoms was found to coincide with the age groups that included the greatest proportion of denture wearers. An awareness by the dentist of high-risk groups for depression within the patient pool may help explain difficulties in achieving patient satisfaction with dentures, facilitate recognition of a problem, and make possible appropriate referral for diagnosis and treatment.
PURPOSE: For a complete denture to function effectively, the denture must be stabilized during mastication. The alveolar ridge has various forms, and we must choose the artificial tooth arrangement that is most suitable to the form of the alveolar ridge. The purpose of this study was twofold: (i) to examine the relationship between the alveolar ridge form and the stress distribution on the mucosa, and (ii) to model the contact condition between the denture base surface and mucosa. MATERIALS AND METHODS: In this study, the three-dimensional finite element method was used for the analysis. Four types of alveolar ridge were prepared. As a loading condition, three load places were prepared: the mesial position, the central position and the distal position. We utilized the 'contact option (MARC)' to simulate the true behaviour of the denture. RESULTS: We were able to model the contact condition by using the 'contact option'. Maximum stresses were distributed on the alveolar ridge in which the absorption is severe. And, the distal load produced large compressive stresses on the inclined plane of posterior alveolar ridge in which alveolar form.
Setting teeth for complete dentures is traditionally done away from the clinic in the dental laboratory. This has unwittingly given the impression that arranging tooth position is a mechanical process in which the clinician has little say. Many technicians are given few instructions, but a detailed prescription is crucial to the success of the denture. This article describes those considerations the dentist should address in communicating with the laboratory technician. A 'denture space' impression technique is described to assist the dentist in the correct prescription for posterior teeth placement.
One hundred complete denture wearers were evaluated for mandibular dysfunction by collating information gathered with a questionnaire and physical examination. The most frequent symptoms centered on poorly fitting and functioning dentures, headaches, and pain in the neck and temporomandibular joints. Ninety-four percent of the patients demonstrated clinical signs of mandibular dysfunction. Two-thirds of the patients had decreased facial height, marked dental attrition, and significant occlusal discrepancies in the dentures. Periodic recall is suggested for the evaluation of mandibular dysfunction in all denture patients.
Success in wearing complete denture depends, in order of importance, on motivation, neuromuscular control and technical considerations. To address the two aspects of motivation and neuromuscular control, fourth year students at Sydney University are taught a protocol which encompasses duplication of the patient's existing denture and modification of this duplicate to satisfy the patient's needs and wants. This modified duplicate denture acts as a diagnostic prototype which is used as a guide during construction of the new denture.
PURPOSE: Suction is achieved when complete dentures are first fitted, but it fades during the months following insertion, when it is increasingly complemented by muscular denture control. The aim of this study was therefore to investigate the extent to which patterns of mastication are altered by experimental failure of physical retention. MATERIALS AND METHODS: Seven edentulous volunteers had maxillary replica dentures made, with fine tubes incorporated so that alternating positive and negative air pressure could be generated under the fitting surface. Mandibular movements, EMG, and pressure under the denture base were recorded during unilateral chewing. RESULTS: The change of physical retention passed undetected by all subjects; they continued chewing apparently undisturbed. However, during air injection, the mandibular excursions were slightly slower (nonsignificant) and demonstrated a reduced variance (P < or = .05). The muscle activity showed significantly longer bursts (P < or = .05), and peak activity occurred later in the cycle (nonsignificant). CONCLUSION: Sudden failure of denture retention seems to initiate an immediate and effective modulation of centrally generated muscular activity patterns.