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.

Dutch consensus on guidelines for superstructures on endosseous implants in the edentulous mandible.

This consensus report has been reached under the authority of the Dutch Society for Oral Implantology and the Dutch Society for Prosthetic Dentistry by a panel of Dutch dentists and prosthodontists (listed above) who are involved in the treatment of patients with oral implants, either via practice or via research. They were commissioned with a task to "formulate guidelines for the prosthetic treatment of edentulous patients receiving oral implants in the mandible".

["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.

[Implant-retained overdentures compared with complete dentures with or without preprosthetic surgery. Satisfaction and subjective chewing capabilities]. / Overkappingsprothese op implantaten versus volledige prothese zonder en met mondbodemvestibulumplastiek. Tevredenheid en subjectief kauwvermogen.

The aim of this prospective randomized clinical trial was to evaluate and compare a set of clinical items and satisfaction of a group of edentulous patients during a 5-year follow-up. They were treated according to one of the following modalities: 61 patients with a mandibular overdenture on two implants (IMP-group), 60 patients with a conventional complete denture (VP-group) and 28 patients with a complete denture after preprosthetic surgery (MVP-group). It can be concluded that endosseous implants, serving as retention for a mandibular overdenture, have a high survival rate after 5 years of follow-up (93%). The mean satisfaction score of the VP-group was lower than of the IMP-group. The mean satisfaction score of the MVP-group is lower than of the IMP-group.

[Overdenture prostheses on implants versus complete dentures]. / Overkappingsprothese op implantaten versus volledige prothese.

OBJECTIVE: To establish the treatment outcome of implant retained overdentures (IRD) versus complete dentures (CD) in which the outcome assessment focuses on the patient's subjective evaluation ('denture-satisfaction and chewing ability'). DESIGN: A multicenter randomized clinical trial (prospective). SETTING: The department of Oral Function and Prosthetic Dentistry of the University of Nijmegen, the department of Oral and Maxillofacial Surgery of the University Hospital Nijmegen and the department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics of the University Hospital Groningen. METHODS: In this study 151 patients with severely resorbed mandibles participated, treatment had been assigned according to a balanced allocation method. Denture satisfaction and chewing ability were assessed using questionnaires before and 1 year after treatment. RESULTS: Before treatment all patients were dissatisfied with their mandibular denture and they could hardly chew tough or had food. One year after treatment the IRD-group was satisfied with their mandibular denture, whereas only one third of the CD-group was satisfied. With respect to the chewing ability the IRO-group scored significantly better than the CD-group (p < or = 0.0001). CONCLUSION: For patients with a severely resorbed mandible, overdentures retained by dental implants appear to provide a more satisfactory solution to their denture-related problems.

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.

Quando a satisfação autorrelatada do paciente com a prótese implantossuportada mandibular influencia na colocação de uma prótese total fixa na maxila: os benefícios do planejamento e colocação 3D baseados na TCFC e nos guias estereolitográficos – acompanhamento de dois anos e 11 meses / When the self-reported patient satisfaction with implant-supported mandibular denture influences on the use of implant-supported maxillary prostheses: the benefi ts of a 3-D implant planning and placement based on CBCT and stereolithographic guides – two year and 11-month follow-up

Este relato mostra um paciente de 72 anos de idade onde sua prótese total inferior sobre implantes motivou-a para usar uma prótese total fixa na maxila. Após os procedimentos de TCFC e protéticos no plano de tratamento, guias estereolitográficos foram construídos para uma colocação de implantes dentários sem levantamento de retalho. Cinco implantes foram colocados nas regiões 14, 13, 11, 22, e 24 com torque de inserção de 32 Ncm. A prótese total fixa definitiva foi entregue em até 48 horas. Após dois anos e 11 meses, não foram registradas complicações. Quando adequadamente indicada, a cirurgia virtual guiada tem se tornado uma realidade efetiva para pacientes idosos.

This case reports on a 72 years-old patient whose complete mandibular implant-supported prosthesis motivated her to use a fi xed appliance in the maxilla. After CBCT and prosthodontic procedures for treatment planning, stereolithographic guides were constructed for a flapless dental implant placement. Five implants were placed in the regions of 14, 13, 11, 22 and 24 with a 32 Ncm insertion torque. The final maxillary implant-supported prosthesis was delivered until 48 hours. After two years and 11 months, no complications were reported. When properly indicated, virtual guided surgery has become an effective possibility for elderly patients.

[Studies on the retention of total lower dentures in relation to the time of wearing]. / Untersuchungen über die Haftung totaler Unterkiefer- Prothesen in Abhängigkeit von der Tragezeit

Clinical experience in the prosthetical care of edentulous patients shows that primarily patients wearing dentures for the first time express the desire, after a few months, to have original denture adhesion restored. Especially for complete lower dentures diminishing adhesion is unfavorable. Measurements regarding the adhesive strength of complete lower dentures of 34 patients showed that adhesive strength is decreasing. This was measured and statistically evaluated in this investigation. 33 percent of the original adhesive strength is lost within 6 months. With originally strong adhesion (2, 000 p) this reduction is more drastic than with originally small adhesion (200 p). It was not possible to establish that adhesive strength is declining preferably as a result of a specific anatomic situation.

[Effect of the shape of the edentulous alveolar process on stability and motility of the total lower prosthesis]. / Der Einfluss der Form des zahnlosen Alveolarfortsatzes auf die Stabilität und Verschieblichkeit von totalen Unterkieferprothesen.

The stability and the mobility of full lower dentures (as determined in 185 edentulous subjects by mea-s of the tests according to Herbst) were brought in relation to the form of the endentulous alveolar process. There was a statistically significant relationship which may be used for prognostic purposes.

[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.