[Full denture (complete denture base) and physiology].
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In a cross-sectional study involving 185 full denture wearers, the stability of upper and lower dentures was determined by means of active test movements according to Herbst. The percentages of instable dentures and their confidence intervals were calculated. It was found that all sections of upper full dentures can be regarded as equal with regard to stability, whereas the sections of lower full dentures showed considerable differences. Finally, practice-relevant conclusions are drawn from the results of the present study.
The occlusion for complete dentures discussed in this article is based on basic principles and concepts that have been studied, tested, refined, and applied successfully by dentists for years. This should simplify rather than complicate the selection of the proper posterior tooth form for each patient's edentulous condition, the the modification of the teeth, and the use of the many occlusal schemes. The problem of occlusion is the dentist's responsibility and cannot be shared or relegated to nonprofessionals. The motivation for this article has been the hope that it will help the dentist recognize, analyze, and apply sound procedures in managing the problem. Only after this has been skillfully accomplished has the dentist assumed his full professional responsibility to the patient.
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In four full maxillary dentures, the physical mechanisms of retention were examined and quantitatively determined by inductive pressure and motion recorders, in tests performed on a model and on the patients. In addition to capillary or viscous forces, the pressure difference existing in the space between denture and palate on the one hand and the oral environment on the other and resulting during pull-off, provides the greatest retaining effect.
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The frequency and distribution of complete dentures were studied in a population of 358 persons aged 20--69 living in a community in Northern Norway. Among the 83% who attended the investigation, 49% had a maxillary and 26% a mandibular denture. The occurrence of dentures increased with increasing age and with decreasing income and/or social class, while dentures were almost equally common in both sexes, when differences of age and income were taken into account. Of the participants between 50--69 years 39% had received their first maxillary denture at the age 17--24 years. In the age group 30--49 years the corresponding percentage was 20. Forty-four percent of the participants had maxillary dentures and 33% mandibular dentures which were older than 10 years. According to an index on the clinical evaluation of complete dentures as well as to the denture wearers' own opinion, the insufficiency of the dentures tended to increase with increasing age of the dentures. Sex, age, income and social class, however, were found to have only a minor effect on the age and the condition of the dentures as well as on the denture wearers' degree of satisfaction with their dentures. Persons who had natural mandibular teeth, tended to be less satisfied with their maxillary dentures than persons with complete dentures in both jaws.
Oral function was evaluated in complete denture wearers by using a questionnaire, clinical examination and bite force measurements. Ten patients with satisifactory and ten with unsatisfactory dentures were studied and six of the latter patients were reexamined 1 year after the insertion of new dentures. The bite force values were compared with those obtained in ten dentate controls. No significant differences in bite force were found between the satisfactory and unsatisfactory denture groups. Individual values varied much in both groups. The six patients re-examined were satisfied with their new dentures and thought they had improved chewing but no significant increase of bite force was found. The maximal bite force was 5-6 times greater in the dentate subjects than in the denture wearers. Edentulous persons are very handicapped in masticatory function and even clinically satisfactory complete dentures are poor substitutes for natural teeth.
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