Pressure transmission and distribution under denture bases using denture teeth with different materials and cuspal angulations

Effects of mechanical stress on human oral mucosa-derived cells

OBJECTIVES

Placement of a denture results in the application of mechanical stress (MS), such as occlusal force, onto the oral mucosa beneath the denture. To better understand the molecular mechanism underlying MS-induced inflammation in the oral mucosa, we examined the impact of MS on human oral epithelial cells (HO-1-N-1) and human fibroblasts (HGFs) in this study.

MATERIALS AND METHODS

MS was applied on HO-1-N-1 and HGFs using a hydrostatic pressure apparatus. The expression and production of inflammatory cytokines and growth factors were examined by real-time RT-PCR and ELISA. MS-induced intracellular signal transduction via MAP kinase (MAPK) was also examined.

RESULTS

1 MPa MS resulted in a significant increase in inflammatory cytokines, and 3 MPa MS resulted in a significant increase in FGF-2. MS also increased p-38 phosphorylation and the addition of a p-38 inhibitor significantly suppressed the production of inflammatory cytokines.

DISCUSSION

Our study suggested that MS applied through a denture increases the production of inflammatory cytokines from oral mucosal epithelial cells and fibroblasts via the p38 MAPK cascade. These responses to MS likely lead to inflammation of the mucosal tissue beneath dentures. On other hand, up-regulation of growth factors is likely a manifestation of the biological defense mechanism against excessive MS.

Pressure transmission area and maximum pressure transmission of different thermoplastic resin denture base materials under impact load

PURPOSES

The purposes of the present study were to examine the pressure transmission area and maximum pressure transmission of thermoplastic resin denture base materials under an impact load, and to evaluate the modulus of elasticity and nanohardness of thermoplastic resin denture base.

METHODS

Three injection-molded thermoplastic resin denture base materials [polycarbonate (Basis PC), ethylene propylene (Duraflex), and polyamide (Valplast)] and one conventional heat-polymerized acrylic resin (PMMA, SR Triplex Hot) denture base, all with a mandibular first molar acrylic resin denture tooth set in were evaluated (n=6). Pressure transmission area and maximum pressure transmission of the specimens under an impact load were observed by using pressure-sensitive sheets. The modulus of elasticity and nanohardness of each denture base (n=10) were measured on 15×15×15×3mm³ specimen by using an ultramicroindentation system. The pressure transmission area, modulus of elasticity, and nanohardness data were statistically analyzed with 1-way ANOVA, followed by Tamhane or Tukey HSD post hoc test (α=.05). The maximum pressure transmission data were statistically analyzed with Kruskal-Wallis H test, followed by Mann-Whitney U test (α=.05).

RESULTS

Polymethyl methacrylate showed significantly larger pressure transmission area and higher maximum pressure transmission than the other groups (P<.001). Significant differences were found in modulus of elasticity and nanohardness among the four types of denture bases (P<.001).

CONCLUSIONS

Pressure transmission area and maximum pressure transmission varied among the thermoplastic resin denture base materials. Differences in the modulus of elasticity and nanohardness of each type of denture base were demonstrated.

Influence of denture tooth thickness on fracture mode of thin acrylic resin bases: An experimental and finite element analysis

STATEMENT OF PROBLEM

The optimum selection of denture teeth for patients with a reduced interarch distance has not been established.

PURPOSE

The purpose of this in vitro study was to investigate the influence of denture tooth material and thickness on the fracture resistance of thin acrylic resin denture bases.

MATERIAL AND METHODS

Acrylic resin (AC), composite resin (CO), or ceramic (CE) molar denture teeth were embedded in denture base blocks (2.0 mm thick). The distance from the central fossa to the tooth base was 0.5, 1.0, 2.0, or 2.5 mm for AC and CO, and 1.0 mm for CE (n=7), with a total thickness of 2.5 mm for all specimens. Each specimen was placed on a 3-point flexural setup with a shorter (8 mm) or longer (12 mm) support span than the tooth width and vertically loaded. A finite element analysis was performed to assess the stress distributions. The effects of tooth thickness and support span were statistically tested with ANOVA, followed by the Tukey honestly significant difference post hoc test (α= .05).

RESULTS

With the shorter support, the mean fracture load was higher in CO than AC, regardless of the tooth thickness. Under the longer support, the mean fracture load with the CO decreased significantly as the tooth thickness increased, with increased maximum stress. Some CO tooth specimens of 2.0 mm or 2.5 mm thickness failed at the tooth-denture base interface at significantly lower loads than those exhibited by tooth fractures. CE showed minor cracks before bulk fracture.

CONCLUSIONS

Higher fracture resistance was indicated with CO; however, the resistance decreased as the thickness of the CO tooth increased.

Biomechanical factors related to occlusal load transfer in removable complete dentures

Owing to economic conditions, removable dentures remain popular despite the discomfort and reduced chewing efficiency experienced by most denture wearers. However, there is little evidence to confirm that the level of mucosal load exceeds the pressure pain threshold. This discrepancy stimulated us to review the current state of knowledge on the biomechanics of mastication with complete removable dentures. The loading beneath dentures was analyzed in the context of denture foundation characteristics, salivary lubrication, occlusal forces, and the biomechanics of mastication. The analysis revealed that the interpretation of data collected in vivo is hindered due to the simultaneous overlapping effects of many variables. In turn, problems with determining the pressure beneath a denture and analyzing frictional processes constitute principal limitations of in vitro model studies. Predefined conditions of finite element method simulations should include the effects of oblique mastication forces, simultaneous detachment and sliding of the denture on its foundation, and the stabilizing role of balancing contacts. This review establishes that previous investigations may have failed because of their unsubstantiated assumption that, in a well-working balanced occlusion, force is only exerted perpendicular to the occlusal plane, allowing the denture to sit firmly on its foundation. Recent improvements in the simulation of realistic biomechanical denture behavior raise the possibility of assessing the effects of denture design on the pressures and slides beneath the denture.