[Viscosity of saliva in relation to denture retention. Part 2. Viscosity of mediating fluid in relation to retention of denture].
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Possibilities given by our technics concerning immediate denture and contra-mucosal retention bar mandibular complete denture, allow, at present time, in five clinical steps, an esthetical improvement and a functional rehabilitation, realizing dental prosthesis with all the standard characteristics of classical removal dentures. Any transitional treatment may be suppressed, temporary prosthesis giving often rise to para-functions and resorptions. Finally, these technics give to the patient perfect conditions for a functional integration of prosthesis, as well on psychological as on physiological point of view.
Theories of denture retention have suffered from confusion of model, algebraic errors, and misapprehension of the physics of capillarity, adhesion and cohesion, as well as the role of atmospheric pressure. The rheology of some simple models is set out in context, and the dynamic nature of the problem is emphasized. The importance of a well-fitting denture base is confirmed. A number of points for further investigation are identified.
The objective of this study was to characterize in vitro selected acrylic resin denture base materials by water-contact angle measurements. The sessile drop method and the underwater-bubble method were used. The results obtained from these measurements are discussed in terms of contact angle and polymer-water work of adhesion hysteresis. On polished heat-polymerized samples this hysteresis results from the reorientation of superficial polymer chains. The combined effect of increased sample roughness and of the entrapment of water droplets in the pores of material gives rise to the highest contact-angle hysteresis observed on sand-abraded samples. On the basis of physical analysis of the mechanism involved in complete denture retention, developed in Part I of this work, it is believed that the sand-abraded material is the most convenient for the retention of the complete denture.
The physical-chemical mechanism of retention of dentures is a highly complex one. A review of the literature suggests in addition that retention also is a personal phenomenon under the control of numerous factors. Chief among the factors involved in the retention of a well-adapted denture are the forces related to the wetting of the denture and of the mucosal surfaces and the cohesive or intermolecular characteristics of the saliva. The ill-fitting denture most often results from an increase of variation in the denture-mucosa interspace, probably due to bone resorption rather than to any major changes in the physical-chemical factors.
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Diuretics were suspected of affecting denture retention. A device was constructed to measure changes in retention. Data were obtained from patients both while they were receiving and not receiving diuretics. Significant changes were noted, and the results indicated that patients taking diuretics are likely to have problems with denture retention.
Correlations between the retention of complete dentures and flow rates of the palatal and parotid glands were studied in 86 patients. The determination of secretion rates and forces of the forward leverage leading to a dislocation of the dentures showed a narrow correlation between the secretion of palatal glands and the retention of maxillary dentures. The retention of mandibular complete dentures is adversely influenced by the secretion rate of minor salivary glands. However, there is no correlation between the flow rate of parotid saliva and the retention of either denture. In addition, the medicinal stimulation of salivation showed that an increase of mucus secretion induced an improved retention of maxillary complete dentures.
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AAThis investigation was carried out to analyze the physical factors of saliva affecting denture retention. A model of examining denture retention is given by two parallel disks separated by a liquid layer. Metal, polyisobutylene (PIB) and poly (methyl methacrylate)(PMMA) were used instead of a denture and mucous membrane; and glycerol, olive oil and castor oil instead of saliva. The experiments were performed with three disk conditions: (1) Both upper and lower disks of metal, (2) both upper and lower disks of PMMA, (3) upper disk with PIB lining and lower of PMMA soley. A strain gauge was used in the experimental apparatus in order to obtain a measurement of high accuracy. In the experiments, the retentive forces developed in layers of 50 mu tickness were measured and compared with the values calculated from theoretical equations. The results are summarized as follows: (1)Retentive force must be resolved into static adhesive and separating forces, (2) surface tension of liquid may not highly influence the retention, and (3) viscosity of liquid plays an important role when two disks are separated.
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Three kinds of three dimension finite element models of edentulous mandibile and the complete denture were established to investigate the influence of artificial teeth positions to denture retention and the supporting tissue. Ten myodynamic and traditional complete dentures were constructed to compare the difference of artificial teeth positions to alveolar ridge. The results indicated: 1. The stress was not obvious different in mandible when teeth were placed over the crest of the ridge or moved lingually or buccally to the ridge in 3 mm; 2. Under occlusion force, it was beneficial for the lower supporting tissue with artificial molars being placed over the slope of mandible and beneficial for denture retention with molars teeth being placed on the crest of ridge buccally; 3. With the effects of oral muscles, the teeth on the crest of ridge buccally or lingually in 3 mm in molar and premolar regions were respectively available; 4. There were obvious difference in arch width of artificial teeth arrangement between traditional and myodynamic complete dentures, the arch was wider in myodynamic complete denture than that of traditional complete denture at molar region.
The purpose of this article is to assist the practitioner to understand which factors are relevant to complete denture retention in the light of the current understanding of physics and materials science and thus to guide design. Atmospheric pressure, vacuum, adhesion, cohesion, surface tension, viscosity, base adaption, border seal, seating force and muscular control have all been cited at one time or another as major or contributory factors, but usually as an opinion without proper reference to fundamental principles. Although there has been a detailed analysis published, it seems appropriate that a restatement of the points in a collated form be made. In fact, denture retention is a dynamic issue dependent on the control of the flow of interposed fluid and thus its viscosity and film thickness, while the timescale of displacement loading affects the assessment. Surface tension forces at the periphery contribute to retention, but the most important concerns are good base adaptation and border seal. These must be achieved if full advantage is to be taken of the saliva flow-related effects.
Dynamics of atmospheric pressure under the maxillary complete denture, and their relations with the denture retention influenced by the factors such as the denture seating force, the saliva viscosity and the postdamming, were investigated on the simulation models. The following results were obtained. 1. The atmospheric pressure under the denture became higher than the external one by the denture insertion, and increased during the denture seating, and decreased by the removing force of denture and furthermore became lower than external one by continuous application of its force, and at all became equal to the external one when the denture separated from the basal seat. 2. Greater seating force brought about greater positive pressure and less negative pressure. 3. Higher viscosity of saliva and the postdamming brought about greater positive and negative pressures. 4. Both of greater seating force and higher viscosity of saliva brought about greater retentive force. 5. The postdamming was useful for the maxillary posterior border seal. 6. The atmospheric pressure under the denture base seems not to relate directly to the maxillary denture retention in the static condition but to reveal the status of peripheral seal.
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Analysis of physical forces involved in the mechanism of denture retention clearly shows that the hysteresis of the liquid-solid contact angle governs the viscoelastic response of the system dislodgment. This result is in contradiction to the most commonly admitted view according to which perfect wettability is necessary to obtain good retention and implies the existence of the high advancing contact angle of saliva on a prosthetic material.