Maxillary reservoir denture to overcome radiation-induced xerostomia - Light at the end of the tunnel.

Xerostomia is a subjective symptom of dry mouth. It can occur as a part of the systemic disease, drug-induced side effect, or following therapeutic radiation therapy to the head-and-neck region. The primary complication faced by these xerostomic patients is the difficulty in retention of removable dentures. It is important to recognize that the prosthodontic management of these patients requires special attention and care. In an attempt to overcome the presence of xerostomia, several techniques of introducing reservoirs into the dentures containing salivary substitutes have been proposed. This case report presents a simplified approach for the construction of a reservoir in the maxillary denture, specifically in patients where other treatment modalities have failed. This technique provided excellent lubrication to oral tissues, hygienic for the patient, and utilized routine denture base material.

Comparison of the linear dimensional accuracy of the maxillary denture teeth by three flask closure methods. An in vitro study.

PURPOSE: This laboratory study conducted to evaluate and compare the influence of different flask closure methods on linear dimensional changes of standardized simulated maxillary complete dentures. MATERIALS AND METHODS: Thirty casts were made from a silicone mold representing an edentulous maxillary arch. Thirty identical maxillary dentures were made and randomly assigned to 3 test groups (A, B, C). In Group A, flasks were placed directly in pressure clamp after trial closure. Group B: The final closure was done in a hydraulic press then transferred to pressure clamp. Group C: After trial closure flask was positioned between the two iron plates of the Restriction System flask closure (RSFC) method. Then linear distances were measured three times before and after polymerization: right incisor to left incisor (RI-LI), right premolar to left premolar (RPM-LPM), right molar to left molar (RM-LM) and left incisor- to- left molar (LI-LM) and right incisor- to- right molar (RI-RM) with the help of digital caliper with an accuracy of 0.01mm. ANOVA and Tuckey's test were used to compare the groups (p < 0.05). RESULTS: Inter molar (LM-RM) width showed the greatest dimensional change after processing and Linear dimensions were not significantly influenced by the packing procedure. CONCLUSION: Within the limitations of this study, Restriction System flask closure (RSFC) method demonstrated a similar performance in reducing the tooth movement when compared with other flask closure methods. The posterior region of the denture may present changes in the tooth position after processing, which need to be clinically adjusted.

Dentures for Randomised Controlled Trials.

Making complete dentures for dental research is difficult. The difficulty is not in the construction of dentures, but making sure the clinician is blind to the randomizations, and avoiding confounding variables. For research purposes it is essential that two sets of dentures are similar in every way, apart from the area to be investigated. A previous article showed how to duplicate a lower denture when it was articulated against a single upper denture. This paper describes the additional duplication of upper dentures. These additional problems presented the clinical and technical teams at the Leeds Dental Institute some challenges.

Implant overdentures: dental students' performance in fabrication, denture quality, and patient satisfaction.

The purpose of this study was to evaluate dental students' performance when fabricating a mandibular two-implant overdenture (OD) as compared to conventional dentures (CD) and to determine if these prostheses were successful. Twenty students and twenty patients were divided into two groups: complete denture group (CDG) and maxillary denture and two-implant OD group (ODG). Students' progress was evaluated at each appointment as they were given a clinical assessment score (CAS), which varied from 1 (unacceptable, needs to repeat procedure) to 4 (acceptable, no errors). The success of the prosthesis was evaluated by the patients using a visual analog scale (VAS) and an expert (a prosthodontist) using a denture quality assessment (DQA) form. Performance for both groups was not statistically different across all eight appointments (CDG 3.16 versus ODG 3.25; p=0.46). Patients with ODs reported greater stability with their dentures (p=0.048) and greater ability to chew than patients with CDs (p=0.03). There were no differences between the groups in terms of expert appraisal (ODG 71.1 versus CDG 67.5; p=0.59). The performance of dental students when fabricating a two-implant OD is thus not different from that of a CD. Students can successfully fabricate a two-implant OD as perceived by both patients and prosthodontists.

Dimensional accuracy of upper complete denture bases: the effect of metallic flask closure methods.

OBJECTIVES: To verify the dimensional accuracy of upper complete denture bases under the effect of different methods of metallic flask closure. MATERIALS AND METHODS: Wax record bases were assigned to six groups: 1-2: traditional clamp; 3-4: RS system; and 5-6: flask with screws. Flasks were immediately polymerised or bench stored for 6 h prior to polymerisation. Resin base-cast sets were sectioned at regions corresponding to the canines, first molars and posterior palatal zone. Gap discrepancies were measured at five points: right and left ridge crests, palatal midline, and right and left marginal limits of the flanges. An optical micrometer was used for measurement purposes. RESULTS: Data were submitted to anova, and the means compared by Tukey's test (alpha = 0.05). Results revealed significant differences in the flask closure technique, polymerisation time, section, and their interactions. Discrepancy values for the RS system and flask with screws were significantly lower than those related to the traditional clamp, regardless of whether resin polymerisation was immediate or delayed for 6 h. CONCLUSIONS: Flask closure methods should be considered when the denture base stability and comfort of the patient are being assessed during clinical use of the dentures.

Análisis de las alteraciones de la posición de los dientes artificiales de prótesis totales maxilares en función del tamaño del arco / Analysis of position alterations in artificial teeth of maxillary complete dentures in function of the arch size

El propósito de este trabajo fue analizar en prótesis totales maxilares la influencia del tamaño de los arcos en el movimiento de dientes artificiales cuando los mismos se someten a las inclusiones con barrera de yeso tipo IV (especial), polimerizado en microondas y medidas gráficamente por computadora. Veinte y una réplicas de prótesis que se habían construido previamente, fueran divididos en tres grupos: grupo 1, constituido de 7 prótesis maxilares del tamaño pequeño; grupo 2, constituido de 7 prótesis de tamaño medio y, grupo 3, de gran tamaño. Las prótesis habían sido medidas en puntos demarcados previamente en los dientes, con un programa de computación gráfica, después del encerado y después de la polimerización y demuflado. La diferencia entre la medida, en las dos etapas, demostró la ocurrencia de pequeñas alteraciones. Fue concluido, del punto de vista estadístico, que no ha tenido diferencias significativas en las alteraciones de la posición de dientes, en los tres tamaños de modelos estudiados.

The purpose of this study was to evaluate the influence of maxillary arch size on the artificial teeth movement in complete dentures. The maxillary dentures were processed with a barrier-type IV gypsum molding technique, and polymerized by microwave energy. Twenty one dentures were fabricated and equally divided into 3 groups, according to maxillary residual ridge size: G1) small; G2) medium and G3) large size. Reference points were made on the incisal edges of the central incisors and the supporting cusps of the premolar and second molar teeth. Linear distances among reference points, in a horizontal plane, were measured with a computer program (Auto cad 2000) before and after processing denture. Although there were differences between measurements, indicating some movement degree among artificial teeth, the results showed no statistical significantly differences among three groups studied. It was concluded that the maxillary arch size has not influence on the artificial teeth position.

Dimensional stability of distances between posterior teeth in maxillary complete dentures.

The aim of this study was to assess the displacement of posterior teeth in maxillary complete dentures stored in water at 37 degrees C. Twenty acrylic resin-based maxillary complete dentures were constructed with the anterior teeth arranged in normal overlap and the posterior teeth in Angle class I. Metallic pins were placed on the labial cusp of the first premolars (PM), and on the mesiolabial cusp of the second molars (M). The final acrylic resin pressing was made in a metallic flask with aid of the RS tension system, and polymerized in a moist-hot cycle at 74 degrees C for 9 hours. The dentures were deflasked after cooling in their own polymerizing water or after cooling in polymerizing water plus bench storage for 3 hours, and stored in water at 37 degrees C for periods of 7, 30, and 90 days. Following deflasking and after each storage period tested, the PM-PM (premolar to premolar), M-M (molar to molar), LPM-LM (left premolar to left molar), and RPM-RM (right premolar to right molar) distances were measured with an STM Olympus microscope, with an accuracy of 0.0005 mm. Collected data were submitted to ANOVA and Tukey's test (5%). There was no statistically significant difference for the PM-PM, M-M, and LPM-LM distances after all storage periods when the flask cooling methods were considered. With exception of the RPM-RM distance after the 30-days water plus bench storage period, the other distances remained statistically stable.

Dimensional stability of distances between posterior teeth in maxillary complete dentures / Estabilidade dimensional de distâncias entre dentes posteriores em prótese total superior

The aim of this study was to assess the displacement of posterior teeth in maxillary complete dentures stored in water at 37°C. Twenty acrylic resin-based maxillary complete dentures were constructed with the anterior teeth arranged in normal overlap and the posterior teeth in Angle class I. Metallic pins were placed on the labial cusp of the first premolars (PM), and on the mesiolabial cusp of the second molars (M). The final acrylic resin pressing was made in a metallic flask with aid of the RS tension system, and polymerized in a moist-hot cycle at 74°C for 9 hours. The dentures were deflasked after cooling in their own polymerizing water or after cooling in polymerizing water plus bench storage for 3 hours, and stored in water at 37°C for periods of 7, 30, and 90 days. Following deflasking and after each storage period tested, the PM-PM (premolar to premolar), M-M (molar to molar), LPM-LM (left premolar to left molar), and RPM-RM (right premolar to right molar) distances were measured with an STM Olympus microscope, with an accuracy of 0.0005 mm. Collected data were submitted to ANOVA and Tukey's test (5 percent). There was no statistically significant difference for the PM-PM, M-M, and LPM-LM distances after all storage periods when the flask cooling methods were considered. With exception of the RPM-RM distance after the 30-days water plus bench storage period, the other distances remained statistically stable.

O propósito deste trabalho foi verificar a movimentação de dentes posteriores em prótese total superior armazenada em água a 37°C. Vinte próteses totais superiores foram confeccionadas com resina acrílica, com os dentes anteriores em transpasse normal e os posteriores em Classe I de Angle. Pinos metálicos foram colocados na cúspide vestibular dos primeiros pré-molares (PM) e cúspide mésio-vestibular dos segundos molares (M). A prensagem final da resina acrílica foi feita em mufla metálica com auxílio do dispositivo RS de contensão e a polimerização em ciclo de água a 74°C durante 9 horas. As próteses foram demufladas após esfriamento em água de polimerização ou em água de polimerização mais armazenagem em bancada por 3 horas e armazenadas em água a 37°C pelos períodos de 7, 30 e 90 dias. Após demuflagem e após cada período de armazenagem em água, as distâncias PM-PM (pré-molar a pré-molar), M-M (molar a molar), PMD-MD (pré-molar direito a molar direito) e PME-ME (pré-molar esquerdo a molar esquerdo) foram medidas com microscópio Olympus STM, com precisão de 0,0005 mm. Os dados coletados foram submetidos à análise de variância e ao teste de Tukey com significância de 5 por cento. Em todos os períodos de armazenagem, as distâncias PM-PM, M-M e PME-ME não apresentaram diferenças estatisticamente significativas quando as muflas foram esfriadas pelos dois métodos. Com exceção da distância PMD-MD no período de 30 dias de armazenagem em água mais bancada, as demais distâncias permaneceram sem diferença estatística significativa.

[Study on retention and stability of linear occlusal complete dentures].

OBJECTIVE: To learn retention and stability of linear occlusal complete dentures by investigating the subjective feelings of patient and the value of retention force. METHODS: Static retention forces of maxillary and mandibular dentures were measured for 25 patients wearing linear occlusal dentures by using Hz-1 retention dynamometer. The subjective feelings of patients in functional state were gained simultaneously through questionnaire. RESULTS: Linear occlusal dentures demonstrate good retention in static and dynamic state. Among patients with severe resorption of residual ridge (RRR), mandibular linear occlusal dentures (shown good retentive subjective feelings) demonstrate significantly smaller retention force than those with slight or medium degree of RRR. There is no correlation between the subjective feelings and the values of retention forces of mandibular dentures. The subjective feelings of patients wearing new linear occlusal dentures are much better than that of old anatomic occlusal dentures. CONCLUSION: Linear occlusal dentures improve the performances of dentures by enhancing their stability during mastication movement.

["Prosthetic condition" and satisfaction with dentures]. / 'Prothetische conditie' en tevredenheid met gebitsprothesen.

This study introduces the concept of 'prosthetic condition', combining the professionally assessed complete denture quality and quality of the residual alveolar ridge. In a group of 397 complete maxillary and mandibular denture wearers the prosthetic condition was assessed and the denture satisfaction recorded. The total prosthetic condition (maxillary and mandibular combined) was good in 225 (57%), moderate in 81 (20%), and poor in 91 (23%) subjects; the mandibular prosthetic condition was good in 155 (39%), moderate in 148 (38%), and poor in 94 (23%) subjects; 297 (75%) subjects were satisfied with their dentures. None of the criteria used for the prosthetic condition could explain the denture satisfaction. Furthermore, there was no significant correlation between prosthetic condition and denture satisfaction.

[Posterior palatal sealing in Hungarian dental practice]. / A pharyngealis lezárás kialakítása a hazai gyakorlatban.

The purpose of the survey was to receive data about the methods, materials and instruments used in the development of the border seal at pharyngeal region. The problem concerned how the theoretical principles are realised in the everyday practice. A questionnaire consisting of 10 questions was given out to 35 dental laboratories in 31 towns of the country. 33 completed forms were returned. On the basis of the survey's results the authors conclude that in everyday practice practically nothing realizes from the recommendations of dental literature. The shape of the upper complete dentures' palatal seal is made by dental technicians, regretfully without the cooperation of dentists and what is more disappointing without their instructions. Dental technicians are left to their own resources to form the pharyngeal seal by mechanical engraving of the casts.

[Studies on the thinning of the upper acrylic resin complete denture with the reinforced palate. (Part 2) Influence of the different palate forms on the thin plate dentures (author's transl)].

In this paper, succeeding the study of the part 1 on the thinning of the upper acrylic resin complete denture with the reinforced palate, it was investigated to keep the same stiffness and strength as the normal resin dentures, and to make the patient comfortable. Besides, many different palate forms exist in the patient's mouth in clinical cases, and so, influence of these forms on the thin plate dentures comes into question. Therefore, 3 types of the palate forms (the standard shape, the extremely large torus and the generally shallow shape) were established, and then the flexural stiffness and strength, and the deformation of the denture bases were scrutinized in this paper. The results obtained in this investigation are as follows: 1) The maxillary torus with sheer bulk had little influence on the flexural stiffness and strength. But, about the generally shallow-shaped denture bases, the mechanical properties dropped a little as compared the normal resin denture bases. The reinforced thin denture bases of which thickness was 60% of the normal one, showed the excellent mechanical properties in spite of the difference of the palate forms. 2) In the upper complete denture base, in spite of the palate forms, anteriority and posteriority of the one were deformed against the load direction around the frontal section through the bilateral canines, and the bilateral ridges of the one were deformed to the load direction around the midline of the denture base. The deformation was extremely decreased by not only the palate but also the whole of the denture base as the reinforced one.