Evaluation of Clinical Periodontal Parameters of Abutment Teeth Supporting Distal-Extension Base Removable Partial Dentures: A Cross-sectional Study.

To assess the clinical periodontal status of abutment teeth in regards of different design components of distal-extension removable partial dentures. Subjects (N=100) with acrylic or cobalt-chromium distal-extension removable partial dentures were enrolled and their periodontal parameters plaque and gingival indices [PI, GI], probing depths [PD], clinical attachment loss [CAL] and a mobility index [MI] evaluated. Denture base type, major connector, occlusal rests position, design of direct retainers, retention, stability and denture wearing habits were further evaluated. Acrylic RPDs were associated with higher mean±SE PI [1.70±0.74], GI [1.76±0.55], PD scores [2.47±1.02 mm] and CAL values [4.46±2.11 mm] compared to CO-CR RPDs [p⟨0.05]. For abutments, the PI [1.6±0.83], GI [1.72±0.57], PD [2.32±1.03] and CAL [4.26±2.08] were higher than their non-abutments counterparts [p⟨0.05]. CAL scores were found to be significantly higher for mandibular abutments compared to maxillary ones [P=0.002]. The highest PI [1.83±1.10] and GI [2.00±0.00] scores were associated with lingual bars and horse-shoe connectors, respectively. Full palatal coverage and lingual plates were associated with the highest PD [2.80±0.48] and CAL [4.70±0.37] scores. Acrylic RPDs, type of major connector, wrought wire clasps and distal occlusal rests may be considered as risk factors for periodontal disease progression in distal-extension removable partial denture wearers.

WAYS OF IMPROVING THE QUALITY OF PROSTHETICS OF MILITARY PERSONNEL.

OBJECTIVE: The aim: Justify the choice of the construction material of dental prostheses, taking into account the clinical picture and concomitant diseases in military personnel and the study of the dynamics of military personnel seeking orthopedic dental care. PATIENTS AND METHODS: Materials and methods: 185 military personnel were examined and fitted with prosthetics in the period from March 2022 to March 2023. Methods: general clinical, content analysis, bibliosemantic, medical and statistical. RESULTS: Results: All patients who came to us for dental care had previously been replaced with fixed metal structures. Of them, 121 people indicated problems related to the use of metal prostheses. From these patients, a risk group of intolerance to prosthesis materials was formed and a search was made for base materials that would be biologically indifferent. For the manufacture of partial removable prostheses, we chose the basic thermoplastic material Acron, manufactured by Roko (Poland), which has high biocompatibility with the tissues of the prosthetic bed. When choosing the structures of partial removable prostheses in patients with various defects of the dentition, we were guided by a small number of clinical visits, which is relevant for military personnel who are on rotation and treated in the hospital. CONCLUSION: Conclusions: Our careful selection of structural material made it possible to prevent complications and produce high-quality removable prostheses in a short period of time. An analysis of the reasons for orthopedic care showed low awareness of the servicemen regarding the need for timely orthopedic treatment.

Assessment of Periodontal Health Among Removable and Fixed Partial Denture Wearers in Aseer Region of Saudi Arabia.

BACKGROUND Prosthetic rehabilitation will have harmful effects on periodontal structure if the patient fails to maintain an oral hygiene protocol. This study aimed to evaluate oral hygiene in fixed and removable partial denture wearers in the Aseer Province of Saudi Arabia. MATERIAL AND METHODS This was a cross-sectional study done on 286 prosthesis wearers aged between 25 and 55 years; 142 were men and 144 women. Clinical examination was done using 3 periodontal parameters: plaque index, gingival index, and calculus surface index. RESULTS It was found that 72% and 25% of patients used fixed and removable partial prostheses, respectively. Most patients were in the 45-55 year age group (38.1%), were medically fit (78%), and used toothbrush and paste (70.6%). Most patients were instructed regarding the use of oral hygiene measures for their prostheses (71.3%). However, around half of the study group (52.8%) had odor from their prostheses. Most fixed prostheses were in the posterior teeth (73.2%) and had 3 units or more (58.7%). Removable partial dentures were mostly tooth-tissue supported (74%). A statistically significant difference was found for plaque index and gingival index between natural teeth and abutments in terms of various prosthetic parameters (P£0.001). The higher prevalence of gingival inflammation, plaque, and calculus accumulation in this study may be correlated to improper oral hygiene methods used by patients. CONCLUSIONS It can be concluded that there is a need to reinforce meticulous oral hygiene practices among patients using prosthodontic appliances.

Comparison of the impact of two types of removable partial dentures on the periodontal health of the remaining teeth: A prospective clinical study.

OBJECTIVE: To evaluate and compare the impact of two removable partial dentures (acrylic removable partial denture [ARPD] and metallic removable partial denture [MRPD]) on periodontal tissues of the remaining teeth in the first 12 months of denture use. MATERIALS AND METHODS: This prospective clinical study included 40 patients, of which 20 received ARPDs, 20 received MRPDs, nine in the maxilla, and 11 in the mandible each. The patients were 45-65 years old; 24 were females, and 16 were males. Patients' demographic details, clinical indicators of periodontal complications, and biochemical measurement of Hs-C-reactive protein (CRP) and alkaline phosphatase (ALP) were considered. One-way analysis of covariance and Friedman were used to measure the differences in clinical periodontal parameters between the two types of dentures. RESULTS: The significant findings were: Plaque index (PLAQ) scores for abutment teeth were higher in MRPD wearers (mean = 12.15) than ARPD wearers (mean = 10.45), whereas ARPD users had significantly higher mean bleeding on probing (BOP) values (mean = 1.5) than MRPD users (mean = 0.00); mobility of abutment teeth showed no significant differences; timeline comparisons showed a significant increase in the percentage of nonabutment teeth mobility in ARPD users (p = .028) compared with MRPD users over the same follow-up period (p = .102). CONCLUSIONS: For a short-term period of 1 year, periodontal and mobility parameters have no significant impact on the abutment and nonabutment teeth of ARPD and MRPD users. Moreover, biochemical markers (CRP and ALP) for periodontal inflammation exhibited no significant difference in both types of dentures.

Double Crown-Retained Removable Prostheses Supported by Implants or Teeth and Implants: A Long-Term Clinical Retrospective Evaluation.

OBJECTIVES: The objective of this retrospective clinical study was to investigate the survival rates and complications of implant (I)-retained or tooth-implant (TI)-retained prostheses and abutments (teeth, implants) over a mean observation period of 11.26 years. The study also aimed to analyze the differences and complication rates between implant-retained double crown removable dental prostheses (I-DC-RDPs) versus tooth-implant-retained double crown removable dental prostheses (TI-DC-RDPs). MATERIAL AND METHODS: We reviewed the clinical data of 110 nonsmokers (mean age = 53.9 years) who received DC-RDPs in maxillary or mandibular arches. 153 teeth and 508 implants were used to restore partially edentulous (PE; TI-DC-RDPs; n = 53) and completely edentulous (CE; TI-DC-RDPs; n = 57) arches. Two designs of the distal extension were used: cantilevers (CANs) and saddles (SADs). Restorations were examined for abutment survival, mechanical, or biological complications. RESULTS: The 10-year survival rates were 99.3% (95% CI: 95.4-99.9%) for teeth and 99.3% (95% CI: 97.5-99.7%) for implants. The cumulative rates of TI- and I-RDPs free of technical complications were 77% and 86%, respectively. The risk of complications was not significantly different between the CAN and SAD subgroups of I-RDPs (p > 0.05). However, for TI-RDPs, technical complication risk was significantly higher in SAD type compared with CAN restorations (p = 0.02). CONCLUSIONS: I- and TI-DC-RDPs seem to be recommendable for restoration of CE or PE arches. The technical and biological complication rates were lower for I-DC-RDPs in the CE arches than for TI-DC-RDPs in the PE arches. Regarding the RDP design, CAN prostheses produced significantly fewer technical complications than did SAD prostheses.

[The effect of astaxanthin on the adaptation of the oral mucosa to a removable denture]. / Vliyanie astaksantina na adaptatsiyu slizistoi obolochki rta k s"emnomu protezu.

THE AIM: Of this study was the evaluation of the effect of the antioxidant gel on the oral mucosa and reduction of the time of adaptation to a removable denture in patients with partial adentia. MATERIAL AND METHODS: The study comprised 105 patients aged 30-65 years divided into three groups: the main group of 45 patients, the comparison group of 35 patients, the control group of 25 patients. The main group was given a prophylactic gel with natural astaxanthin after the delivery of a removable prosthesis. The patients of the control group and the comparison group do not received an antioxidant gel. Patients of all three groups underwent a study of the hygienic state of the oral mucosa and oral fluid to assess the state of oral microbiocenosis. The main group and the comparison group underwent visual examination and photoplanimetric control after the placement of a removable denture. RESULTS: A positive preventive and anti-inflammatory effect of astaxanthin gel was found in patients who received an immediate and a partial removable dentures. The use of the gel for 7 days helps to reduce the values of hygiene indices, concentrations of bacterial plasmalogen and endotoxin in the oral fluid in the short-term perspective. CONCLUSION: Preventive dental gel with astaxanthin decreases the time of adaptation to removable dentures by 1.7-2 times and reduces the risk of prosthetic stomatitis due to its wound-healing, anti-inflammatory and antimicrobial actions.

Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications.

OBJECTIVES: The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial dentures (DERPDs) in terms of patient-reported outcome measures (PROMs: patients' quality of life and satisfaction) and to determine mechanical and biological complications associated with ISRPDs. MATERIAL AND METHODS: An electronic search was performed on four databases to identify studies treating Kennedy class I or II edentulous patients and which compared ISRPDs with DERPDs in terms of PROMS and studies, which evaluated mechanical and biological complications associated ISRPDs. Two authors independently extracted data on quality of life, patient satisfaction, and biomechanical complications from these studies. The risk of bias was assessed for each study, and for PROMs, the authors performed a meta-analysis by using a random-effects model. RESULTS: Thirteen articles were included based on the selection criteria. The difference in mean scores for quality of life (30.5 ± 1.8; 95% confidence interval [CI], 24.9-36.1) and patient satisfaction (-20.8 ± 0.2; 95% CI, -23.7 to -17.8) between treatments with conventional and implant-supported removable dentures was statistically significant (p < .05). Implant-supported removable dentures improved patients' overall quality of life and satisfaction. Some mechanical and biological complications, such as clasp adjustment, abutment or implant loosening, marginal bone resorption, and peri-implant mucositis, were noted in ISRPDs during patient follow-up. Studies assessing PROMs were very heterogeneous (I2 = 65%, p = .85; I2 = 75%, p = .88). CONCLUSIONS: ISRPDs significantly improved quality of life and patient satisfaction. Some mechanical and biological complications have been associated with ISRPDs treatment, requiring regular monitoring of patients to avoid the occurrence of these complications.

Removable Partial Dentures with Polyetheretherketone Framework: The Influence on Residual Ridge Stability.

PURPOSE: To provide, in a clinical case-control study, 1-year data on edentulous residual ridge dimensional changes for patients wearing removable partial dentures (RPD) with Polyetheretherketone (PEEK) framework, fabricated with a digital workflow, and a control group of untreated patients. MATERIALS AND METHODS: Ten patients were treated with PEEK RPD, and six controls were studied. Intraoral scans at baseline (T0) and after a median period of 1 year (T1) were superimposed, trimmed, and reoriented (T0r and T1r), moved to a metrology software, and realigned. A curve (C0) was then traced on T0r, along the residual ridge crest; its projection (C1) on T1r was obtained. The mean distance C0-C1 was the dependent variable of interest and represented the 1-year changes in the height of the edentulous ridge. In addition, mean 3D distance between T0 and T1 at each edentulous area was measured. Differences in these outcomes measured between RPD treated and control groups were statistically assessed. RESULTS: Twenty-six and 14 edentulous areas were investigated in the RPD treated and control groups, respectively. No significant differences were observed for potentially confounding variables, such as median follow-up time (12.5 vs. 13 months, respectively), the alignment accuracy between T0r and T1r (0.01 mm vs. 0 mm, respectively), the median number of remaining teeth (6 vs. 8.5, respectively), and the median length of edentulous areas (25.5 mm vs. 22.8 mm, respectively). For the outcomes of interest, no statistically significant difference was seen in the mean distance between C0 and C1 (i.e., changes in residual ridge height: -0.39 ± 0.52 mm vs. -0.52 ± 0.54 mm, respectively) or in the mean 3D distance at corresponding points of the denture bearing areas (-0.3 ± 0.46 mm vs. -0.4 ± 0.35, respectively). CONCLUSIONS: Although 1 year is a relatively short observation period, this clinical study shows that there are no short-term differences in edentulous residual ridge height and overall dimensions between patients wearing PEEK RPD, fabricated with a digital workflow, and controls without an RPD.

Caracterización de la estomatitis subprotésica en portadores de prótesis removible en clínicas de la Universidad San Gregorio de Portoviejo, Ecuador / Characterization of subprosthetic stomatitis in patients with removable prosthesis. San Gregorio de Portoviejo University

RESUMEN Introducción: La estomatitis subprotésica es un proceso inflamatorio de la mucosa bucal que se encuentra cubierta por una prótesis removible, de causa multifactorial y alta prevalencia. Objetivo: Caracterizar la estomatitis subprotésica en pacientes portadores de prótesis removible atendidos en las clínicas odontológicas de la Universidad San Gregorio de Portoviejo en el período marzo-noviembre de 2019. Método: Se realizó un estudio descriptivo transversal, con los criterios de inclusión siguientes: mayores de 18 años, ambos sexos, buen estado de salud general, no practicar hábitos tóxicos, usar prótesis removible, total o parcial, confeccionada de acrílico o metales. Todos los sujetos de la investigación firmaron el consentimiento informado antes de realizarles la historia clínica de odontología del Ministerio de Salud Pública del Ecuador de donde se extrajeron los datos sociodemográficos, signos clínicos y características de la prótesis. Resultados: Fueron evaluados 100 pacientes. El 45 %, presentaba signos clínicos de estomatitis subprotésica; predominó el sexo femenino con el 33 % y el grupo de edad de 40 a 59 años con un 26 %. La mayoría de las prótesis no se ajustan ni adaptan de manera correcta, y tienen un mal estado físico, en el 80, 82,2 y el 91 %, respectivamente. El 84,4 % de los pacientes utilizaba prótesis parcial removible, confeccionadas con acrílico, por un periodo de 1 a 6 años en el 60 % de los casos. Conclusiones: El diagnóstico de estomatitis subprotésica se asocia con el mal estado físico, desajuste e inadecuada adaptación de las prótesis removibles, lo que indica la necesidad de la institución para el establecimiento de estrategias docentes hacia la comunidad para su prevención y diagnóstico temprano.

ABSTRACT Introduction: Subprosthetic stomatitis is an inflammatory process of the mucosa in the oral cavity covered by a removable prosthesis, with a multifactorial cause and high prevalence. Objective: To characterize subprosthetic stomatitis in patients with removable prosthesis treated at the dental clinics of San Gregorio University in Portoviejo in the period March-November 2019. Method: A cross-sectional descriptive study was conducted, with the following inclusion criteria: patients over 18 years old, both sexes, good general health, no toxic habits, use of removable prosthesis, total or partial, made of acrylic or metals. All the patients involved in the research signed their consent, information given to them before taking their dental records taken by the Ministry of Public Health of Ecuador, from which socio-demographic data, clinical signs and characteristics of the prosthesis were extracted. Results: 100 patients were evaluated. Forty-five per cent showed clinical signs of subprosthetic stomatitis; the female sex (33%) predominated and the age group 40-59 years with (26%). Most of the prosthesis did not fit or adapt correctly and were in poor physical condition in 80%, 82.2% and 91% respectively. 84.4% of the patients used removable partial prosthesis, made of acrylic, for a period of 1 to 6 years, (60%) of the cases. Conclusions: The diagnosis of subprosthetic stomatitis is associated with poor physical condition, maladjustment and inadequate adaptation of removable prostheses, which indicates the need for the institution to establish educational strategies towards the community for prevention and early diagnosis.

Oral care of a patient with a SAPHO syndrome and a nickel allergy.

SAPHO is an acronym for Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis. The syndrome is difficult to diagnose because it may present many different manifestations in adults and children. Its origin is still unknown, although some infectious, genetic and immune hypotheses have been put forward. We report the case of a 49-year-old woman with SAPHO syndrome, who developed a serious cutaneous allergy following the insertion of a removable partial denture (RPD). The oral care and treatment of this patient are described.

Influence of Implant Position in Implant-Assisted Removable Partial Denture: A Three-Dimensional Finite Element Analysis.

PURPOSE: To determine the ideal position of a dental implant to assist a posterior extended partial removable dental prosthesis (PRDP), through stress values, displacement values, and deformation of periodontal ligament (PDL). MATERIALS AND METHODS: A finite element analysis of different implant positions was analyzed using a 3D mandible model from a human patient. Test models were created: model A (implant in second molar area), model B (implant in the first molar area), and model C (implant in premolar area). A control model without implant support was also created. Overall displacement values, von Mises stress distribution maps, and nonlinear deformations were evaluated. RESULTS: Some differences could be observed between test models. The introduction of an implant in the edentulous area, unlike a conventional removable partial denture without implant support, decreases stress values in the biological structures such as: mandible, tooth, soft tissue, and PDL. Placing the implant in the first molar area resulted in improved displacement values, and reduced maximum stress values at the peri-implant bone area, metal structure, and implant were observed. CONCLUSIONS: Within the limitations of this study we can conclude that placing the implant in the position of the first molar improves biomechanical behavior of implant-assisted PRDPs.

Presença de Candida spp. em usuários de próteses dentárias removíveis / Presencia de Candida spp. en usuarios de prótesis dentales removible / Presence of Candida spp. in patients who wear dentures

Introdução: O uso contínuo das próteses removíveis e a higiene inadequada das mesmas podem levar ao desenvolvimento da estomatite protética. Doença frequente em usuários de próteses e muito associada à Candida spp. Objetivo: determinar características sociais e os cuidados dos indivíduos com a higienização das próteses dentárias removíveis, assim como a presença de espécies de Candida em usuários de próteses numa comunidade do município de Cabedelo, Paraíba, Brasil. Métodos: Tratou-se de um estudo piloto, transversal, observacional e laboratorial com a avaliação de 14 voluntários. Foram utilizados formulários de investigação e realizada a coleta, o isolamento e identificação do material biológico. Resultados: Os participantes da pesquisa apresentaram renda e escolaridade baixas. A higiene diária das próteses, a escovação com dentifrício, a não remoção das próteses para dormir e a utilização das mesmas por mais de seis anos foram verificadas na maior parte da amostra. Conclusão: Demonstrou-se uma alta presença de Candida spp. nos usuários de próteses dentárias removíveis e Candida albicans foi a espécie mais prevalente(AU)

Introducción: El uso continuo de las prótesis removibles y la higiene inadecuada de estas pueden conducir al desarrollo de la estomatitis protésica, enfermedad frecuente en usuarios de prótesis y muy asociada a la Candida spp. Objetivo: determinar las características sociales y los cuidados de los individuos con la higienización de las prótesis dentales removibles, así como la presencia de especies de Candida en usuarios de prótesis en una comunidad del municipio de Cabedelo, Paraíba, Brasil. Métodos: Se trata de un estudio piloto, transversal, observacional y de laboratorio con la evaluación de 14 voluntarios. Se utilizaron formularios de investigación y se realizó la recolección, el aislamiento e identificación del material biológico. Resultados: Los participantes de la encuesta presentaron ingresos y escolaridad bajos. La higiene diaria de las prótesis, el cepillado con dentífrico, la no remoción de las prótesis para dormir y la utilización de estas durante más de seis años se verificaron en la mayor parte de la muestra. Conclusión: Se demostró una alta presencia de Candida spp. en los usuarios de prótesis dentales removibles y Candida albicans fue la especie que más predominó(AU)

Introduction : The continued use of dentures and inadequate hygiene may lead to the development of denture stomatitis, a frequent disease in patients who wear dentures and very much associated with Candida spp. Objective : To determine the social characteristics and the care of the individuals with the hygiene of their dentures, as well as the presence of Candida species in patients who wear dentures from a community of Cabedelo Municipality, Paraíba, Brazil. Methods : This is a pilot, cross-sectional, observational and laboratory study with the evaluation of 14 volunteers. Research forms were used and the collection, isolation and identification of the biological material were carried out. Results : The participants had low income and schooling. The daily hygiene of the prostheses, brushing with dentifrice, the non-removal of the prosthesis for sleeping and their use for more than six years were verified in most of the sample. Conclusions : A high presence of Candida spp. in the patients who wear dentures was shown, while C. albicans was the most prevalent species(AU)

Presença de Candida spp. em usuários de próteses dentárias removíveis / Presencia de Candida spp. en usuarios de prótesis dentales removible / Presence of Candida spp. in patients who wear dentures

Introdução: O uso contínuo das próteses removíveis e a higiene inadequada das mesmas podem levar ao desenvolvimento da estomatite protética. Doença frequente em usuários de próteses e muito associada à Candida spp. Objetivo: determinar características sociais e os cuidados dos indivíduos com a higienização das próteses dentárias removíveis, assim como a presença de espécies de Candida em usuários de próteses numa comunidade do município de Cabedelo, Paraíba, Brasil. Métodos: Tratou-se de um estudo piloto, transversal, observacional e laboratorial com a avaliação de 14 voluntários. Foram utilizados formulários de investigação e realizada a coleta, o isolamento e identificação do material biológico. Resultados: Os participantes da pesquisa apresentaram renda e escolaridade baixas. A higiene diária das próteses, a escovação com dentifrício, a não remoção das próteses para dormir e a utilização das mesmas por mais de seis anos foram verificadas na maior parte da amostra. Conclusão: Demonstrou-se uma alta presença de Candida spp. nos usuários de próteses dentárias removíveis e Candida albicans foi a espécie mais prevalente(AU)

Introducción: El uso continuo de las prótesis removibles y la higiene inadecuada de estas pueden conducir al desarrollo de la estomatitis protésica, enfermedad frecuente en usuarios de prótesis y muy asociada a la Candida spp. Objetivo: determinar las características sociales y los cuidados de los individuos con la higienización de las prótesis dentales removibles, así como la presencia de especies de Candida en usuarios de prótesis en una comunidad del municipio de Cabedelo, Paraíba, Brasil. Métodos: Se trata de un estudio piloto, transversal, observacional y de laboratorio con la evaluación de 14 voluntarios. Se utilizaron formularios de investigación y se realizó la recolección, el aislamiento e identificación del material biológico. Resultados: Los participantes de la encuesta presentaron ingresos y escolaridad bajos. La higiene diaria de las prótesis, el cepillado con dentífrico, la no remoción de las prótesis para dormir y la utilización de estas durante más de seis años se verificaron en la mayor parte de la muestra. Conclusión: Se demostró una alta presencia de Candida spp. en los usuarios de prótesis dentales removibles y Candida albicans fue la especie que más predominó(AU)

Introduction : The continued use of dentures and inadequate hygiene may lead to the development of denture stomatitis, a frequent disease in patients who wear dentures and very much associated with Candida spp. Objective : To determine the social characteristics and the care of the individuals with the hygiene of their dentures, as well as the presence of Candida species in patients who wear dentures from a community of Cabedelo Municipality, Paraíba, Brazil. Methods : This is a pilot, cross-sectional, observational and laboratory study with the evaluation of 14 volunteers. Research forms were used and the collection, isolation and identification of the biological material were carried out. Results : The participants had low income and schooling. The daily hygiene of the prostheses, brushing with dentifrice, the non-removal of the prosthesis for sleeping and their use for more than six years were verified in most of the sample. Conclusions : A high presence of Candida spp. in the patients who wear dentures was shown, while C. albicans was the most prevalent species(AU)

Implant-supported Prostheses in Patient with Sjögren's Syndrome: Clinical Report with 3-year Follow-up.

Sjögren's syndrome (SS), an autoimmune disorder, affects the exocrine glands, including the lacrimal and salivary glands. It is characterized by symptoms of dry eye and dry mouth. As secretion of saliva decreases, patients with SS experience rampant caries, pain in the oral mucosa, inflammation and hardening of the salivary glands, abnormal taste, dysphagia, and loss of teeth earlier than healthy individuals. A removable partial denture is often used as a prosthesis after tooth loss. Compromised salivary lubrication, however, can produce traumatic ulceration of the mucosa, making use of a removable prosthesis in SS patients painful. In such cases, a dental implant is likely to be requested as an alternative. This report describes dental implant treatment in an SS patient, a 50-year-old woman who presented with the chief complaint of masticatory dysfunction and pain due to a removable partial denture. Eight implants were placed in the maxillary and mandibular first molar tooth and second molar tooth regions. Following a 4-month non-loading period, second-stage surgery and provisional restoration with a screwretained implant temporary crown were performed. Screw-retained superstructures were fitted by means of a customized titanium abutment and zirconia crown as the final restoration. No complications, including inflammation of peri-implant soft tissue or resorption of peri-implant bone, were observed at 3 years following placement of the superstructures.

Influence of Oral Morphology on Speech Production in Subjects Wearing Maxillary Removable Partial Dentures with Major Connectors.

BACKGROUND/AIMS: Speech impairment during the initial phase of removable partial denture (RPD) treatment can prevent patient adaptation to RPDs. This study was undertaken to investigate the influence of oral morphology on speech production in subjects wearing RPDs with major connectors. METHODS: Two types of connectors were fabricated for 17 subjects with normal dentitions: covering the middle palate (M-bar) and the anterior/posterior palate (AP-bar). Four target sounds ([∫i], [t∫i], [çi], and [ki]) were evaluated under 3 recording conditions: no connector, M-bar, and AP-bar. The mean appearance ratios of correct labels (MARCs) were calculated as parameters representing speech production accuracy with the speech evaluation system. Subgroup analysis was conducted based on palate height, dental arch width, and front space volume of the oral cavity. RESULTS: Based on the multiple linear regression test, a significant association was found between the MARCs of [∫i] with M-bar and front space (p = 0.036). In the subgroup analysis, the AP-bar had a significant effect on the MARCs of [∫i] among subjects with high palate (p = 0.026), narrow arch (p = 0.004), and small front space (p = 0.014). CONCLUSION: RPDs with major connectors could disturb speech production among patients with high palates, narrow arches, and small front spaces.

Biological complications of removable dental prostheses in the moderately reduced dentition: a systematic literature review.

OBJECTIVES: The aim of the present study was a systematic review and subsequent meta-analysis on biological complications of removable prostheses in the moderately reduced dentition. MATERIALS AND METHODS: A systematic literature search in established medical databases (MEDLINE, EMBASE, BIOSIS, SciSearch, Cochrane, FIZ Technik Web) and a hand search of relevant dental journals was conducted. The search terms were relevant MeSH terms, free search terms, and combinations of the two. The search included randomized controlled trials, prospective and retrospective studies with data on biological complications of removable dental prostheses in the moderately reduced dentition with at least 15 participants, an observation period of at least 2 years, and a drop-out rate of less than 25%. The selection of relevant publications was carried out at the title, abstract, and full-text level by at least two of the authors involved. The publications included were tabulated and analyzed. RESULTS: Of the original 12,994 matches, 1923 were analyzed by title, 650 by abstract, and 111 according to the full text. A total of 42 publications were ultimately included. The following parameters were evaluated. TOOTH LOSS: Results varied, depending on the observation period, between 0 and 18.1% for clasp-retained removable dental prostheses (RDPs), between 5.5 and 29% for attachment-retained RDPs, and between 5.5 and 51.7% for double crown-retained RDPs. CARIES: Results varied, depending on the observation period, between 0 and 32.7% for clasp-retained RDPs, between 1.8 and 29% for attachment-retained RDPs, and between 1.8 and 16.4% for double crown-retained RDPs. ENDODONTIC TREATMENT: Results varied, depending on the observation period, between 3.5 and 19.2% for clasp-retained RDPs, between 6.9 and 16.4% for attachment-retained RDPs, and between 0.6 and 13.9% for double crown-retained RDPs. TOOTH FRACTURE: Results varied, depending on the observation period, between 1.7 and 5.3% for clasp-retained RDPs, between 12.7 and 40% for attachment-retained RDPs, and between 0.4 and 4.4% for double crown-retained RDPs. TOOTH MOBILITY: There were no changes or improvements for clasp-retained RDPs. The better the pre-treatment and supportive care is, the smaller the differences are. For double crown-retained RDPs, a slight increase was found in one study. The results for the parameters probing depth and radiological bone loss were inconclusive. GINGIVAL RECESSION: Gingival recession seemed to be favored by a mandibular sublingual bar. Compared to fixed restorations, removable restorations seemed to be associated with a more pronounced need for dental treatment. Stringent pre-treatment and supportive care reduced the complication rates. CONCLUSIONS: Heterogeneous study designs and data analyses rendered a meta-analysis impossible, so that an evaluation at the highest level of evidence could not be performed. CLINICAL RELEVANCE: Within the limitations of this study, it would be correct to state that removable dental prostheses require intensive maintenance. Suitable pre-treatment and supportive care can lower the complication rates, in the absence of which they constitute trigger factors for (additional) biological complications.

A Five-Year Retrospective Assay of Implant Treatments and Complications in Private Practice: Restorative Treatment Profiles of Long-Span, Implant-Supported Fixed and Removable Dental Prostheses.

PURPOSE: To describe the restorative treatment profiles of long-span (> three units), implant-supported dental prostheses (LIDPs) prescribed in 27 private practices in the state of Victoria, Australia, during the period from January 1, 2005, to December 31, 2009. The restorative treatment profiles of these prostheses refer to the framework/veneering materials, number of prosthetic units/supporting implants, location in the oral cavity, retention methods, and cantilever designs. LIDPs refer to implant-supported prostheses of fixed or removable design; namely, fixed partial dentures (IFPDs), fixed complete dentures (IFCDs), removable partial dentures (IRPDs), and complete overdentures (IODs). MATERIALS AND METHODS: Private dental practitioners providing implant treatment in Victoria, Australia, were invited to enroll in this study, which was conducted through a dental practice-based research network (the eviDent Foundation). The enrolled practitioners' clinical records of the implant treatments provided during the specified period were accessed for data collection. Descriptive statistics, cross-tabulations, and linear mixed models were conducted for data analyses. RESULTS: During the study period, 627 LIDPs were prescribed to 556 patients by 18 general dentists and 5 prosthodontists. LIDPs were more common in the maxilla than in the mandible except in the case of IODs. Of the fixed prostheses, 60% replaced missing teeth in more than one sextant, 33% in the anterior sextant, and 7% in the posterior sextant. The average number of prosthetic units per implant was higher in mandibular compared to maxillary IFPDs/IFCDs (2.5 vs 1.9, respectively, P < .001). Cantilever pontic(s) were present in 68% of IFCDs (more often in the mandible than in the maxilla) compared to 28% of IFPDs (use of cantilever pontics was about the same in the maxilla and mandible). Screw retention was the most commonly reported retention method in IFPDs/IFCDs (95%). Locator attachment was used for the majority of IRPDs/IODs (83%). CONCLUSION: The clinicians enrolled in this study preferred fixed over removable LIDPs for partially dentate and maxillary edentulous cases. For mandibular edentulous patients, IODs were prescribed more often than IFCDs. A retrievable retention design was favored for IFPDs/IFCDs. IFPDs were predominantly metal-ceramic, and metal-acrylic designs were more popular for IFCDs.

Impending total airway collapse involving a maxillary removable partial denture: A clinical report.

This article presents a rare incident of a bilateral maxillary removable partial denture as an airway foreign body. The removable partial denture and the surrounding soft tissue irritation caused partial obstruction of the airway. Impending airway collapse was avoided after successful removal of the foreign body. Removing a removable dental prostheses at night, not only to prevent soft tissue pathology but also to avoid ingestion or aspiration of the prosthesis, must be emphasized.

Evaluation of the Periodontal Status of Abutment Teeth in Removable Partial Dentures.

The purpose of this study was to evaluate whether the use of removable partial dentures affects the periodontal status of abutment teeth. An observational cross-sectional study was done on a sample of patients rehabilitated with removable partial dentures (2010 to 2013). At a recall appointment, a clinical examination was done to collect data related to the rehabilitation and periodontal status of the abutment teeth. Of 145 invited patients, 54 attended the requested follow-up appointment (37.2%). Mean patient age was 59.1 years, and the study population was 42.6% male and 57.4% female. The mean follow-up time for the prosthesis was 26 months. Abutment teeth had higher values in all periodontal variables (P < .001). Occlusal clasps had the worst results in relation to clasps with a gingival approach (P < .005). Significant differences were also found in mandibular abutment teeth of Kennedy Class I and II compared to Class III (P < .048). The periodontal status of the abutment teeth of removable partial dentures is affected by these rehabilitations. A recall program for these patients involving removable prosthodontics and periodontology appointments is mandatory.

Surface Microstructural Changes and Release of Ions from Dental Metal Alloy Removable Prostheses in Patients Suffering from Acid Reflux.

PURPOSE: To investigate the surface microstructural changes and the release of ions from metal alloys used in removable dental prostheses and the potential effects of acidic reflux found in patients suffering from gastroesophageal reflux disease (GERD). MATERIALS AND METHODS: Thirty-seven (37) patients were recruited. Data were gathered through a questionnaire and clinical examination. Samples of metal alloy from the dentures and patient's saliva were collected. GERD was confirmed using the GerdQ questionnaire. Denture samples were characterized using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS), while salivary samples were tested for trace metal ions using inductively coupled plasma (ICP). RESULTS: Characterization of denture samples revealed the presence of nickel, cobalt, and chromium. Nickel-chromium exhibited an etched surface appearance, while cobalt-chromium exhibited no noticeable surface microstructural changes. Higher mean salivary levels of chromium and cobalt in patients wearing any metal alloy-based denture and of chromium and nickel in patients wearing Ni-Cr prostheses were found to be significant. No differences were found in salivary metal ion levels of patients suffering from GERD. CONCLUSIONS: Nickel-chromium alloy is prone to acid etching in the oral cavity, while cobalt-chromium alloy appears to be more resistant. Cobalt, chromium, and nickel are leached in saliva of patients using cast removable prostheses. The impact of gastric acid on metal ion release from dental metal alloys deserves further investigations. CLINICAL SIGNIFICANCE: This preliminary study suggests that metal-based removable prostheses leach trace metal ions in saliva. Nickel-chromium-based dentures exhibit an etched appearance unrelated to GERD.