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Aranda-Herrera B, Cruz TRADL, Jurado CA, Garcia-Contreras R. Anterior Hyperfunction Syndrome: Literature Review and Conceptual Model. Clin Pract 2024; 14:1584-1600. [PMID: 39194932 DOI: 10.3390/clinpract14040128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/26/2024] [Accepted: 08/02/2024] [Indexed: 08/29/2024] Open
Abstract
Combined Kelly syndrome, also known as anterior hyperfunction syndrome, is a complex pathological condition of the stomatognathic system, originally established by five characteristics but primarily triggered by edentulism, specifically, the absence of the upper and posterior mandibular teeth. This condition is characterized by a series of clinical features, such as bone loss, tuberosity growth, enamel wear, periodontal damage, muscle fatigue, pain, and temporomandibular joint issues. However, these features are not unique and rather reflect an oral hyperfunction state. There is a lack of consensus on the best way to assess and diagnose this condition, which is proposed to be understood as an "oral hyperfunction state" rather than a syndrome. This study aims to conduct a literature review to analyze the available information on anterior hyperfunction syndrome in dentistry, with the goal of proposing a conceptual model of the etiological risk factors that contribute to early diagnosis and the prevention of complications. This approach has important clinical implications, as it would allow for the early identification and management of risk factors, thus improving the quality of life of patients and preventing malpractice that could compromise their oral health.
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Affiliation(s)
- Benjamin Aranda-Herrera
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Mexico
| | | | - Carlos Alberto Jurado
- Operative Dentistry Division, Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Rene Garcia-Contreras
- Interdisciplinary Research Laboratory, Nanostructures, and Biomaterials Area, National School of Higher Studies (ENES) Leon, National Autonomous University of Mexico (UNAM), Leon 37684, Mexico
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Comparing Masticatory Performance of Maxillary Mini Dental Implant Overdentures, Complete Removable Dentures and Dentate Subjects. J Clin Med 2021; 10:jcm10215006. [PMID: 34768527 PMCID: PMC8584742 DOI: 10.3390/jcm10215006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Mini dental implant (MDI) overdenture rehabilitation for the edentulous maxilla is a valuable, less invasive and affordable treatment alternative for complete removable dentures (CRD). However, comparative quantification of masticatory performance in different oral conditions are scarce. Purpose: This study compares objective masticatory performance of dentate groups, maxillary CRD and MDI overdentures and subjective masticatory performance in maxillary CRD and MDI overdentures. Materials and Methods: Four groups were defined, age 20+ dentate dental students (DS), age 50+ complete dentate subjects (DP), age 50+ maxillary CRD or MDI overdentures/dentate mandible. Objective masticatory performance was evaluated by measuring circular Variance of Hue (VOH) or the mixture degree of two-color chewing gum (Hue-check View Gum® Test). Additionally, subjective masticatory comparison was investigated in the CRD and MDI groups, with a visual analogue scale (VAS) for different food consistencies and the Oral Health Related Quality of Life (OHRQL) OHIP-14 questionnaire. Results: The mean VOH was 0.11 (SD 0.50, range 0.05–0.27) for the dentate dental 20+ students, 0.13 (SD 0.08, range 0.03–0.31) for the 50+ dentate group (p = 0.774), 0.41 (SD 0.41, range 0.14–0.76) for the CRD group and 0.39 (SD 0.18, range 0.07–0.76) for the MDI group (p = 0.725). Based on the VAS scores, no improvement was found between the CRD and the MDI overdenture group (p > 0.050). The mean OHIP-14 total score was 12.10 (SD 15.87, range 0–56) for CRD, while the MDI group (p = 0.039) saw a significant improvement to 2.85 (SD 2.85, range 0–15). Conclusion: Comparable results in objective masticatory performance were registered in dentate 20+ and 50+ subjects with a remarkable inferior outcome for the CRD and MDI group. Compared to CRD, MDI overdentures revealed no substantial improvement in subjective and objective masticatory performance. However, for MDI a significant increase in OHRQL was apparent.
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Van Doorne L, Fonteyne E, Matthys C, Bronkhorst E, Meijer G, De Bruyn H. "Longitudinal Oral Health-Related Quality of Life in maxillary mini dental implant overdentures after 3 years in function". Clin Oral Implants Res 2020; 32:23-36. [PMID: 33043547 DOI: 10.1111/clr.13677] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/17/2020] [Accepted: 09/28/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Longitudinal evaluation of Oral Health-Related Quality of Life (OHRQoL) during treatment of flaplessly placed, one-piece mini-dental-implants (MDIs) for maxillary overdentures is rarely investigated, nor is the impact of MDI failures. MATERIAL AND METHODS This multicenter prospective cohort study evaluated the 3-year outcome of 5-6 MDIs in the edentulous maxilla in patients above 50 years with dentate mandible. Provisional dentures were provided before final prosthetic connection was established at 6 months. Postoperative discomfort was assessed using a visual analogue score (VAS). OHRQoL was investigated using the Oral Health Impact Profile (OHIP)-14 at baseline (preoperatively), postoperatively, post-prosthetic connection and after 3 years in function. RESULTS 164 (78.4%) of the 204 placed MDIs were still in situ after 3 years, in 29/31 patients. Two patients lost 5/6 MDIs resulting in two prosthetic failures (6.45%). With regard to pain, a score of 4.1/10 (SD 2.8) was recorded on day 1, and 1.1/10 (SD 1.7) on day 7. A decrease in total OHIP-14 scores was observed postoperatively (15.6; SD 12.8) as compared to baseline (21.3; SD 13.1), with improvement of OHRQoL. Furthermore, this was statistically significant at connection of the final prosthesis (7.3; SD 6.7) (p = .006). The OHIP-14 improved less (p = .011) when experiencing one or more implant losses (9.5; SD: 9.85), in comparison with no implant loss (20.7; SD: 13.97). A failure of one MDI did not affect OHIP-14 score (p = .658); however, multiple failures did (p = .007). CONCLUSION Maxillary MDI overdenture treatment yields significant OHRQoL improvement when at least 5 MDIs survive, preserving functional comfort.
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Affiliation(s)
- Luc Van Doorne
- Cosmipolis Clinic, Brugge, Belgium.,Ghent University Hospital, Gent, Belgium
| | | | | | - Ewald Bronkhorst
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Gert Meijer
- Department of Dentistry-Implantology and Periodontology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Hugo De Bruyn
- Department of Dentistry-Implantology and Periodontology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
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Khuder T, Yunus N, Sulaiman E, Ibrahim N, Khalid T, Masood M. Association between occlusal force distribution in implant overdenture prostheses and residual ridge resorption. J Oral Rehabil 2017; 44:398-404. [PMID: 28295492 DOI: 10.1111/joor.12504] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2017] [Indexed: 11/29/2022]
Abstract
This study aimed to investigate residual ridge resorption (RRR) of anterior and posterior maxillary and mandibular edentulous ridges, in patients treated with mandibular implant overdentures (IOD) and compare with conventional complete denture (CD) wearers, and to determine at each location, the association of RRR with the occlusal forces distribution and other patients' variables. The anterior and posterior RRR of IOD (six males, 17 females) and CD (12 males, 11 females) groups were determined using baseline and follow-up dental panaromic radiographs (DPT) (mean intervals 4 ± 1·8 years). The bone ratios were calculated using proportional area: anatomic to fixed reference areas and mean difference of ratios between the intervals determined RRR. The ridge locations included anterior and posterior maxillary and posterior mandibular arches. The T-Scan III digital occlusal system was used to record anterior and posterior percentage occlusal force (%OF) distributions. There were significant differences in anterior and posterior %OF between treatment groups. Two-way anova showed RRR was significant for arch locations (P = 0·005), treatment group (IOD versus CD) (P = 0·001), however, no significant interaction (P = 0·799). Multivariate regression analyses showed significant association between RRR and %OF at anterior maxilla (P = 0·000) and posterior mandible (P = 0·023) and for treatment groups at posterior maxilla (P = 0·033) and mandibular areas (P = 0·021). Resorption was observed in IOD compared to CD groups, with 8·5% chance of less resorption in former and 7·8% in the latter location. Depending on arch location, ridge resorption at various locations was associated with occlusal force distribution and/or treatment groups (implant prostheses or conventional complete dentures).
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Affiliation(s)
- T Khuder
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur
| | - N Yunus
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur
| | - E Sulaiman
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur
| | - N Ibrahim
- Department of Oro-Maxillofacial and Medical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - T Khalid
- Department of Restorative Dentistry, School of Dentistry, Cardiff University, Cardiff, UK
| | - M Masood
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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Finite element analysis of implant-assisted removable partial dentures: Framework design considerations. J Prosthet Dent 2017; 118:177-186. [PMID: 28089330 DOI: 10.1016/j.prosdent.2016.10.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/31/2016] [Accepted: 10/31/2016] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Connecting an acrylic resin base to both a metal framework and a rigidly fixed implant may affect the rotational displacement of the prosthesis during loading. PURPOSE The purpose of this finite element analysis study was to analyze the effect of connecting a denture base metal framework to an implant with the aim of decreasing the rotational movement of an implant-assisted removable partial denture. MATERIAL AND METHODS A mesial occlusal rest direct retainer and a distal occlusal rest direct retainer were modeled and adapted to incorporate a modified denture base metal framework in the connection area for each model. The stress and deformation patterns of the prosthesis structure were determined using finite element analysis and compared for both situations. RESULTS A maximum von Mises stress of 923 MPa was observed on the metal framework of the prosthesis with a mesial occlusal rest, and the maximum value was 1478 MPa for the distal occlusal rest. A maximum von Mises stress of 17 MPa occurred on the acrylic resin denture base for the mesial occlusal rest, and a maximum von Mises stress of 29 MPa occurred for the distal occlusal rest. CONCLUSIONS The distal occlusal rest direct retainer is stiffer than the mesial design and undergoes approximately 66% less deformation. The modified denture base framework with an I-bar and distal occlusal rest design provides more effective support to the acrylic resin structure.
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Arafa KA. Effects of different complete dentures base materials and tooth types on short-term phonetics. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2015.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Comut A, Andrawis M. Maxillary definitive impression of excessively movable tissue with a single material. J Prosthet Dent 2015; 114:616-8. [PMID: 26139042 DOI: 10.1016/j.prosdent.2015.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 04/28/2015] [Accepted: 04/28/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Alper Comut
- Clinical Assistant Professor, Department of Prosthodontics, New York University College of Dentistry, New York, NY.
| | - Mark Andrawis
- Resident, New York University College of Dentistry, New York, NY
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Resende CMBMD, Ribeiro JAM, Dias KDC, Carreiro ADFP, Rego MPPD, Queiroz JWND, Barbosa GAS, Oliveira ÂGRDC. Signs of Combination Syndrome and removable partial denture wearing. REVISTA DE ODONTOLOGIA DA UNESP 2014. [DOI: 10.1590/1807-2577.1041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Combination Syndrome (CS) is a pathological condition observed in maxillary complete denture (CD) and mandibular removable partial denture (RPD) wearers. Purpose: The aim of this study was to observe and measure the prevalence of CS signs in treatment-seeking wearers of maxillary CD associated or not with RPD (mandibular Kennedy Class I). The association between RPD wearing and the number of CS clinical signs was also evaluated. Material and method: The sample included 62 patients seen at the Department of Dentistry, Federal University of Rio Grande do Norte (UFRN). A clinical oral examination was conducted to assess the presence of specific clinical signs of CS as described by Kelly (1972): bone resorption in the maxillary anterior region, tuberosity overgrowth, palatal papillary hyperplasia, extrusion of mandibular anterior teeth and bone resorption in the mandibular posterior region. The chi-square test at the 95% level of significance was used to test the association between dependent and independent variables. Result: Mandibular resorption was the most frequent complication (93.5%). There was a statistically significant difference between RPD wearers and non-wearers with regard to extrusion of mandibular anterior teeth (p = 0.045). Conclusion: Within the limitations of the present study, a high prevalence of CS clinical signs was observed, but no association between RPD wearing and syndrome characteristics was found.
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Guerrero CA, Marin D, Galvis AI. Evolución de la patología oclusal. Una revisión de la literatura. JOURNAL OF ORAL RESEARCH 2013. [DOI: 10.17126/joralres.2013.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sakar O, Sulun T, Bilhan H, Ispirgil E. Does the presence of anterior mandibular teeth increase the incidence of denture stomatitis? J Prosthodont 2012; 22:174-8. [PMID: 22984815 DOI: 10.1111/j.1532-849x.2012.00924.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To compare the frequency of denture stomatitis (DS) under maxillary complete dentures (CDs) in patients with opposing mandibular distal extension removable partial dentures (RPDs) and CDs. MATERIALS AND METHODS Participants included 365 maxillary CD wearers (241 women, mean age 70.5 ± 13.2 years; 124 men, mean age 71.5 ± 10.4 years) from 7 rest homes in Istanbul. A total of 268 had mandibular CDs; 97 had mandibular distal extension RPDs. Two independent, calibrated examiners performed oral examinations. Presence of maxillary denture-related stomatitis and the effect of risk factors on DS were evaluated and recorded. RESULTS The frequency of palatal DS (Newton I-III) was 45.1% (n = 121) in the mandibular CD group and 49.5% (n = 48) in the mandibular distal extension RPD group, a statistically insignificant difference (p= 0.4). Factors significantly associated with palatal DS were maxillary denture age (p= 0.02), reduced occlusal vertical dimension (p= 0.04), and nocturnal denture wear (p= 0.03). CONCLUSION In this study, DS beneath maxillary CDs did not differ between mandibular distal extension RPD and CD wearers. The presence of mandibular anterior teeth did not influence the occurrence of palatal DS.
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Affiliation(s)
- Olcay Sakar
- Department of Prosthodontics, Istanbul University Faculty of Dentistry, Istanbul, Turkey
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Management of compromised ridges: a case report. J Indian Prosthodont Soc 2012; 11:125-9. [PMID: 22654354 DOI: 10.1007/s13191-011-0068-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 05/07/2011] [Indexed: 10/18/2022] Open
Abstract
Complete denture therapy is an age old form of dental treatment. Ridge atrophy poses a clinical challenge towards the fabrication of a successful prosthesis. Extreme resorption of the maxillary and mandibular denture bearing areas results in sunken appearance of cheeks, unstable and non retentive dentures with associated pain and discomfort. This article describes the step by step rehabilitation procedure of a patient with atrophic ridges using a hollow maxillary complete denture with cheek plumpers attached to it and the recording of neutral zone to ensure a stable mandibular denture.
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Alveolar ridge augmentation for implant fixation: status review. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:S179-89. [PMID: 23063396 DOI: 10.1016/j.oooo.2011.09.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 08/08/2011] [Accepted: 09/22/2011] [Indexed: 11/20/2022]
Abstract
This literature review was performed to illustrate and compare different alveolar ridge augmentation procedures before dental implant placement. The review was based on clinical and research studies listed in Pubmed. There is not enough evidence to support any single method as gold standard for any given condition, and choice seemed to be based on personal preferences. There is a lack of long-term survival data or success rates of grafting materials regarding donor and recipient sites. Although ridge splitting and distraction osteogenesis techniques eliminate donor site morbidity, circumvent the use of grafting materials, and reduce the operation time, some disadvantages and limitations should be considered. More studies are needed to compare the fate and characteristics of new bone obtained by these different procedures, as well as subsequent implant survival rates.
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H. Jorge J, C. C. Quishida C, E. Vergani C, L. Machado A, C. Pavarina A, T. Giampaolo E. Clinical evaluation of failures in removable partial dentures. J Oral Sci 2012; 54:337-42. [DOI: 10.2334/josnusd.54.337] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Keni NN, Aras MA, Chitre V. Management of flabby ridges using liquid supported denture: a case report. J Adv Prosthodont 2011; 3:43-6. [PMID: 21503193 PMCID: PMC3076573 DOI: 10.4047/jap.2011.3.1.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 02/21/2011] [Accepted: 03/07/2011] [Indexed: 11/30/2022] Open
Abstract
Flabby ridges commonly occur in edentulous patients. Inadequate retention and stability of a complete denture are the often encountered problems in these patients. A liquid supported denture due to its flexible tissue surface allows better distribution of stress and hence provides an alternate treatment modality in such cases. This case report presents the use of a liquid supported denture in a patient with completely edentulous maxillary arch with flabby tissue in anterior region opposing a partially edentulous mandibular arch.
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Affiliation(s)
- Nandita Nitin Keni
- Department of Prosthodontics, Goa Dental College & Hospital, Bambolim-Goa-India, Panaji, India
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Canger EM, Celenk P, Kayipmaz S. Denture-related hyperplasia: a clinical study of a turkish population group. Braz Dent J 2009; 20:243-8. [DOI: 10.1590/s0103-64402009000300013] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Inflammatory fibrous hyperplasia (epulis fissuratum) (IFH) and inflammatory papillary hyperplasia (IPH) are oral mucosal diseases caused by ill-fitting denture wearing. A study was carried out on a group of Turkish people consisted of 131 female and 39 male complete denture wearers (n= 170) distributed in two age groups (30-60 and 60-80 years old). The analysis of data collected from patients showed that while the incidence of IFH was higher in women than in men, the incidence of IPH was similar. Most lesions were found in the 30-60 year-old group. The incidence of lesions increased as the denture wearing period increased. Soft tissue growth was the main complaint of the patients with IFH and IPH. In the maxilla, the incidence of IFH was higher than IPH. There was also a significant difference between the distribution of the lesion types in the jaws. There were a larger number of lesions in the maxilla compared to the mandible and most IFH lesions were located in the anterior region of the jaws.
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