Effect on patient satisfaction of mandibular denture tooth arrangement in the neutral zone

A systematic review of patient-oriented outcomes following complete denture treatment: a comparison between the neutral zone technique and conventional approach

OBJECTIVES

To determine the patient-oriented outcomes after complete denture (CD) treatment using neutral zone (NZ) techniques compared with those of conventional dentures.

MATERIALS AND METHODS

Electronic and hand searches were conducted up to December 2023 based on PICOS criteria. Population (P) was patients with complete edentulism on maxillary and mandibular arches and were either or not wearing CDs. Intervention (I) focused on the fabrication of mandibular and/or maxillary CD using NZ techniques. Comparators (C) included other CD fabrication approaches, such as conventional and simplified techniques, and the use of old or existing CDs. Outcomes (O) were patient-oriented treatment outcomes. Study design (S) included human studies.

RESULTS

Eleven human experimental studies were included. NZ dentures demonstrated better patient-reported outcomes, by providing greater comfort, enhancing denture stability and retention, reducing food traps underneath the denture, as well as improving appearance, chewing efficiency and speech. Objective findings varied, with most studies showing equivalent outcomes for NZ and conventional dentures. However, one study indicated superior, and another demonstrated worse outcomes for NZ dentures.

CONCLUSIONS

NZ dentures generally improve patient-reported outcomes more than conventional dentures. However, their impact on objective outcomes compared with a conventional denture remains uncertain.

Complete denture rehabilitation for a patient with Parkinson's disease using clinical strategies: A case report

OBJECTIVE

To present clinical strategies for prosthetic rehabilitation with complete dentures (CDs) of a Parkinson's disease patient.

CASE REPORT

An 82-year-old patient sought the Department of Dentistry at UFRN, reporting retention dissatisfaction and hamper to the mandibular CD adaptation. Patient-reported a dry mouth sensation, and exhibited disordered mandibular movements, tremors, and resorbed mandibular ridge. Aiming retention and stability, double molding with zinc enolic oxide impression paste, neutral zone technique, and non-anatomic teeth were proposed as clinical strategies. At delivery, identification and relief in the supercompression areas were performed to facilitate the acceptance and use of the new dentures.

CONCLUSION

The strategies promoted patient satisfaction regarding retention, stability, and comfort. This treatment may be considered for the rehabilitation of Parkinson's disease patients, favoring the adaptation process.

Factors Affecting Patient Satisfaction with Complete Dentures

Background

Rehabilitation of the edentulous patients has always been a challenge. The success of conventional complete denture therapy might be affected by several factors such as patients' age, personality, previous denture wearing experience, expectations, aesthetics, residual ridge form and anatomy, denture quality, the method of its construction, dentist experience, and dentist-patient relations.

Objectives

The aim of this study was to compare patient satisfaction with complete dentures provided by fourth and fifth year dental students and prosthodontists with a minimum of 5 years' experience at the University of Jordan Hospital 8 weeks after insertion.

Methods

Questionnaires were distributed to a total of 60 completely edentulous patients who received complete maxillary and mandibular dentures. Besides demographic questions, the questionnaire included questions that probed the patient's satisfaction with his maxillary and mandibular dentures in general using two types of scales.

Results

Results indicated that dentist experience does not affect patients' satisfaction with their complete dentures. Our results also indicated that patients who had previous dentures could adapt more easily and were generally more satisfied with their newly inserted dentures especially with regard to their chewing ability and comfort with their mandibular dentures. Gender also influenced patient satisfaction with complete dentures especially the part related to psychological and social disability.

Conclusions

Results of this study will help in further understanding factors influencing patient satisfaction with their complete dentures.

The Neutral Zone Approach with CAD/CAM Record Bases

Lack of adequate retention, support, and stability in the complete denture can be attributed to a poor fit or incorrect shape of the polished surfaces. This article presents a case using the neutral zone technique effectively with the fabrication of computer-aided design and computer-aided manufacturing (CAD-CAM) record bases in an edentulous patient with severely resorbed alveolar ridges and discusses the overall treatment steps and clinical implications of this technique. A stable neutral zone and an accurate jaw relation were recorded using CAD-CAM record bases and stability of complete denture was optimized by arranging denture teeth and reforming polishing surfaces in the neutral zone. A new complete denture was fabricated for a patient with atrophic alveolar ridges by a technique utilizing the neutral zone with CAD-CAM record bases. This article is protected by copyright. All rights reserved.

Effectiveness of denture space recording method in the prosthetic treatment of edentulous patients

PURPOSE

To present a clinical rationale for the effectiveness of denture space recording methods for the prosthetic treatment of edentulous patients through a review of the literature.

STUDY SELECTION

A total of 3167 studies were extracted from a search of four terms, namely denture space, neutral zone technique, flange technique, and piezography using PubMed and J-STAGE databases. A total of 57 documents that matched the inclusion and exclusion criteria were selected.

RESULTS

From the extracted articles, the clinical application of denture space recording methods was found to be effective in edentulous patients with severe ridge resorption. The relationship between the labiolingual and buccolingual pressure in patients with neuromuscular problems or with mandibular or lingual defects differs from those without it, so a stable prosthesis ca n be easily fabricated by locating the neutral zone using denture space recording methods.

CONCLUSIONS

The literature on denture space recording methods suggests that its application on challenging cases of edentulous patients is useful in providing prostheses with improved retention and stability.