Use of finite element analysis for the assessment of biomechanical factors related to pain sensation beneath complete dentures during mastication.

STATEMENT OF PROBLEM: The pain commonly suffered by denture wearers during mastication is not documented in the objective biomechanical criteria for the pressure pain threshold. PURPOSE: The purpose of this finite element analysis study was to determine whether the pressures developed beneath a removable mandibular complete denture during mastication would exceed the average pressure pain threshold in patients for whom the denture foundation had an acceptable load-bearing capacity. MATERIAL AND METHODS: A patient with an acceptable load-bearing denture foundation was modeled with finite element analysis. The denture/mucosa interface was modeled as a sliding or detaching interface. A convex mandibular residual ridge, resilient mucosa, and denture were modeled in computer-aided design (CAD) software using curves and cross sections. A unilateral vertical occlusal load of 100 N was assumed only for model verification, and an oblique mastication load of 141 N was assumed for simulated mastication with balanced articulation. The nonworking-side occlusal contact was simulated in 2 situations: prompt nonworking-side occlusal contact and delayed nonworking-side occlusal contact by setting an initial distance of 0.1 mm or 1 mm between the denture and a flat solid above the nonworking side. RESULTS: The denture was held to the mucosa under vertical force and a maximum pressure of 203 kPa. The denture was tilted under an oblique mastication load and achieved stability through nonworking-side occlusal contact. This means that the denture was supported not only by the denture foundation but also by the nonworking-side occlusal contact and had a downwardly directed stabilizing reaction force. The denture was weakly supported on the delayed nonworking-side occlusal contact compared with the prompt nonworking-side occlusal contact and weakly supported on the denture foundation. In delayed nonworking-side occlusal contact, the pressure beneath the denture was 783 kPa (>pressure pain threshold) compared with 484 kPa (