Comparison of immediate complete denture, tooth and implant-supported overdenture on vertical dimension and muscle activity

Knowledge and Practice of Immediate Dentures among the Dentists in Private Clinics in Khartoum State: A Descriptive Cross-sectional Study

AIM OF THE STUDY

To assess the awareness and practice of Immediate Dentures among the dentists who work in the private clinics in Khartoum state, Sudan Materials and methods: A descriptive cross-sectional questionnaire-based study was conducted among the dental medical officers, registrars, specialists, and consultants who are working in private clinics and centers in Khartoum state and registered the private medical institutions in Sudan. The sample population was 664, using the stratified sampling technique and simple randomization within the stratum, 265 dentists were asked to participate in the study voluntarily A self-administered questionnaire consisted of 32 closed questions and 3 sections, section (1) involved the participant's data, section (2) contained the participant's knowledge, and section (3) the participant's practice was distributed. The participant's knowledge and practice scores were calculated as percentages achieved by dividing the number of accurate answers of the participants by the total number of questions and categorized as Good (66.6-100%), Average (33.3-66.6%), and Poor (less than 33.3%) Data was collected and analyzed using a statistical package of Social Science (SPSS) computer software version 22. Chi-square was used for statistical analysis Results: The response rate was 100%, with nearly equal distribution between males (135, 50.9%) and females (130, 49.1%). The age range is 24-39 years, with a mean of 31.65 ± 7.52 years. The majority of the participants (172, 64.9%) were freshly graduated and young practitioners, with the majority of them having experience ranging from 1 to 6 years. The result of the study revealed that 65.7% of the respondents have average knowledge about immediate denture while 8.7% expressed poor knowledge and only 25.7% had excellent knowledge On the other hand, the majority of the participants (200,75.5%) have never constructed an immediate denture, while only 21.1% have a history of constructing 1-5 immediate dentures, 3% constructed more than 5-10 immediate dentures and only 0.4% constructed more than 10 immediate dentures The lack of knowledge and experience was the main barrier preventing the use of immediate dentures, and the mainstream of the participants (118, 44.5%), evaluated their knowledge about the immediate denture as poor Using the Chi-square test, the correlation between the participants' knowledge and their gender, years of experience, and qualification was found not significant (p -values of 0.46, 027, and 0.66, respectively) while a significant correlation was found between the participants' self-evaluation of their knowledge and their knowledge score with a p-value of 0.000* Conclusion: Within the limitations of this study, the dental practitioners have average knowledge about the immediate denture, but the practice of the immediate denture is still very limited and requires enhancement Clinical significance: Immediate dentures have a significant role in maintaining the patient's esthetics, phonetics, masticatory efficiency, self-esteem, and quality of life. Hence, the knowledge and practice of the different dentists about the immediate denture are of great importance to improve the standard of care provided for the patient Keywords: Dentists, Immediate denture, Knowledge, Practice.

Advanced method of rehabilitating edentulous Jaws: A review of telescopic denture

BACKGROUND

Edentulism conducts to a recognized impairment of oral function with both aesthetic and psychological changes. These patients suffer from a multiplicity of problems with their dentures, such as insufficient stability, retention and pain during mastication. The rehabilitation of a part edentulous patient can be established using a wide range of prosthetic treatment options. The overdenture treatment uses a removable total denture that overlies retained teeth, tooth roots, or dental implants. In the literature it was shown that patients with removable overdentures supported and retained either by tooth roots or implants have more predictable prosthodontic outcomes.

OBJECTIVE

The aim of this review is to provide an overview on the overdenture with a focus on the tooth-supported telescopic overdenture.

METHODS

The literature research was performed in the Scopus, Web of Science, and Pubmed electronic databases. Document type was limited to papers written in English, without time restrictions. The Review was recorded in the international PROSPERO (International Prospective Register of Systematic Reviews) database with the following number CRD42022326415.

RESULTS

A total of 256 articles published were found from electronic searches, Two independent reviewers carried out the screening and the selection process for the studies. First, duplicate citations were eliminated. Then, the two Authors independently screened the retrieved articles by title and abstract of each citation to determine its suitability for inclusion. Finally, 13 full-text articles satisfied the inclusion criteria.

CONCLUSION

Prostheses supported by Frictional telescopic crowns offer an effective treatment alternative for patients with Severely reduced dentitions who do not want implant treatment or complete dentures.

Comparing the functional efficiency of tooth-supported overdentures and implant-supported overdentures in patients requiring oral rehabilitation: A systematic review

The aim of this article is to compare the functional efficiency of tooth-supported overdentures and implant-supported overdentures in patients requiring oral rehabilitation. The comparative quantification of the improvement in functional efficiency is very difficult to assess because of the variations in the study designs like the age of the population studied, the male-to-female ratio, the outcome measures used, the clinical setting in which the implant therapy was provided, oral status of the subjects included and the type of implant therapy provided. In this systematic review, the articles included compared the functional efficiency by assessing the bite force, chewing efficiency, electromyographic (EMG) changes measured by EMG analysis, and patient satisfaction for subjects who have been rehabilitated with either a tooth-supported overdenture or an implant-supported overdenture. This will help the clinicians to better plan the treatment, keeping in mind the long-term prognosis for that particular patient.

Comparison of tensile bond strength of ball attachments made of different materials to root canal dentin after chewing simulation

BACKGROUND

Debonding of ball attachments is one of the complications that annoy teeth supported overdenture wearers. The polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) polymers are widely applied in the dental field. The purpose of the current study was to compare the tensile bond strength of ball attachments made of such materials and the commonly used titanium ones after 5 years of overdenture insertion and removal (5000 cycles) in addition to chewing simulation (1,200,000 cycle).

METHODS

Extracted mandibular canines (N = 60) were randomly allocated into three groups and received ball attachments; titanium (group TI; N = 20), PEEK (group PE; N = 20), PEKK (group PK; N = 20). In each group, the samples were divided into two subgroups whereas tensile bond strength was measured pre aging (T0; n = 10) and post aging (T1; n = 10). Tensile bond strength was measured by the Pull out test using the Universal testing machine. Failure mode analysis was determined by examination of the samples' surfaces under 65X stereomicroscope. The resulting data followed normal distribution and the significance level was set at (α = 0.05).

RESULTS

One Way Anova showed statistically significant difference between the three groups (P < .00001). PostHoc Tukey test showed statistically significant difference between the groups TI and PE, TI and PK and no statistically significant difference between the groups PE and PK. Paired t test showed statistically significant difference in the tensile bond strength pre and post aging in each group.

CONCLUSIONS

PEEK and PEKK ball attachments could be concluded to have a higher tensile bond strength compared to the titanium ones when bonded to root dentin. Tensile bond strength of such attachments may decrease with aging as well. Clinically, the higher tensile bond strength may have a lesser rate of debonding and thus reduced patient apprehension.

Effects of rehabilitation with complete dentures on bite force and electromyography of jaw and neck muscles and the correlation with occlusal vertical dimension

OBJECTIVES

The purpose of this study was to assess the effects of oral rehabilitation with complete dentures on bite force and electromyography of the suprahyoid and sternocleidomastoid muscles, and their correlation with occlusal vertical dimension (OVD). The research questions were "What are the effects of rehabilitation with complete dentures on bite force and electromyography of suprahyoid and sternocleidomastoid muscles, and how are they correlated with OVD?"

MATERIALS AND METHODS

Patients who are wearers of unsatisfactory removable complete dentures were attended in three sessions (T0, T1, and T2). At T0, while the patients still wore the old dentures, they were submitted to bite force and surface electromyographic exams of the suprahyoid and sternocleidomastoid muscles. These exams were repeated, and the OVD was measured while the patients wore their old and new prostheses, 30 days after insertion of the new prosthesis (T1). The exams were repeated 100 days after the insertion of the new prosthesis (T2). The data were submitted to the Shapiro-Wilk normality test, analysis of variance (ANOVA), and Pearson correlation and linear regression, all with 5% significance.

RESULTS

Fifteen patients participated in the study. No statistically significant difference was observed for bite force or electromyography in T0, T1, or T2. However, the correlation and regression tests showed important interactions between the OVD and maximum voluntary occlusal bite force, as well as the OVD and electromyography during deglutition for the suprahyoid muscles.

CONCLUSION

Rehabilitation did not impact bite force nor the activity of the assessed muscles (electromyography). On the other hand, OVD was shown to be an important factor for bite force, and deglutition of water after rehabilitation.

CLINICAL RELEVANCE

This study shows what are the influences of rehabilitation on oral functions and reinforces the importance of corrected reestablishment of OVD because it has been found to be an important factor for bite force and electromyography during deglutition.

Change in the Dominant Side of Chewing as a Serious Factor for Adjusting the Prophylaxis Strategy for Implant-Supported Fixed Dental Prosthesis of Bounded Lateral Defects

OBJECTIVE

 The main purpose of this article is to study the effect of a change in the dominant side of chewing after prosthetics with fixed structures on implants on the main indicators of osseointegration, adaptation to dentures, and the clinical dental status of patients.

MATERIALS AND METHODS

 In a clinical trial, an analysis was made of the adaptation of 64 patients to intraosseous implant-supported fixed dentures and 56 apparently healthy volunteers. The examination complex included determination of the functionally dominant side of chewing, gnathodynamometry and electromyography indicators of masticatory muscles, and radiological osseointegration criteria. The overall treatment outcomes were evaluated using a visual analogue scale and an objective medical questionnaire, "Prognosis of Adaptation to Orthopedic Structures."

RESULTS

 Patients were divided into two subgroups: with a change in the dominant side of chewing after completion of orthopaedic treatment (40 cases) and without a change in the dominant side of chewing (24 cases). In the second subgroup of patients, in contrast to the first subgroup, relatively better indicators of gnathodynamometer and electromyography were observed. So, in the first group, gnathodynamometry indicators on the dominant side were 255.7 N and in the second group 225 N after 9 to 12 months. Electromyography indices amounted to (198.5 μV s) to (166.3 μV s) after 9 to 12 months. Bone density remained at the required level, and overall treatment outcomes were higher. Namely, the compact plate of the alveolar ridge was preserved, and the condition of the bone tissue around the implants testified to stable osseointegration. The participation of surface masticatory muscles in adaptation of patients to intraosseous implant-supported fixed orthopaedic structures and the necessity and importance of changing the dominant chewing side for the general outcomes of orthopaedic treatment have been discussed.

CONCLUSIONS

 It has been established that a change in the functionally dominant chewing side is accompanied by relatively unstable indicators of chewing function, which is combined with increased loads on the installed prostheses during 3 to 6 months of adaptation. This must be taken into account when planning an individual patient adaptation complex for dental orthopaedic structures.

Premaxilla Stress Distribution and Bone Resorption Induced by Implant Overdenture and Conventional Denture

PURPOSE

To relate the principal stress, strain, and total deformation in the premaxilla region beneath a complete denture to the pattern of premaxilla bone resorption when opposed by a conventional complete denture (CD) or by a two-implant-retained overdenture (IOD) using finite element analysis (FEA).

MATERIALS AND METHODS

Three-dimensional solid models of the maxilla, mucosa, and denture of a selected edentulous patient were created using Mimics and CATIA software. The FEA model was created and duplicated in ANSYS 16.0 to perform two simulations for the IOD and the CD models. The values of maximum stress and strain and total deformation were obtained and compared to the outcomes of premaxilla resorption from a parallel clinical study.

RESULTS

The maximum principal stress in the premaxilla in the IOD model ranged from 0.019 to 0.336 MPa, while it ranged from 0.011 to 0.193 MPa in the CD model. The maximum principal strain in the IOD model was 1.75 times greater than that in the CD model. Total deformation was 1.8 times higher in the IOD model. Greater bone resorption was observed in regions of higher stress, which were on the occlusal and buccal sides of the premaxilla residual ridge.

CONCLUSION

Stress, strain, and total deformation values present in the premaxilla area beneath a CD were approximately two times greater in a comparison between an opposing mandibular two-IOD and an opposing mandibular CD. The results were consistent with a parallel clinical study in which the rate of premaxilla bone resorption was almost three times greater in the IOD group.

Effect of mucostatic and selective pressure impression techniques on residual ridge resorption in individuals with different bone mineral densities: A prospective clinical pilot study

STATEMENT OF PROBLEM

Although different impression techniques have been advocated for complete denture prosthodontics, objective studies that predict their effect on alveolar bone resorption are lacking.

PURPOSE

The purpose of this prospective clinical pilot study was to objectively evaluate the effect of complete dentures fabricated by different impression techniques on mandibular residual ridge resorption in individuals with different bone mineral density.

MATERIAL AND METHODS

Ninety-six participants with edentulism, selected according to inclusion criteria, underwent bone mineral density assessment and were divided into normal, osteopenic, and osteoporotic groups. Half of the participants in each group were provided with dentures fabricated by selective pressure impression technique (subgroup SIT), and the other half were provided with dentures fabricated by mucostatic impression technique (subgroup MIT). Computed tomographic scans of the mandible were made at denture delivery and 1 year after prosthesis use to assess alveolar bone height and width difference at marked locations at and after denture delivery. The data obtained were analyzed with the Student t test (α=.05).

RESULTS

Significantly less reduction in mandibular ridge height and width was found in the MIT versus the SIT subgroups in both osteopenic and osteoporotic participants (P<.05). No significant subgroup difference was found for normal bone mineral density group, although resorption increased in height and width for the SIT subgroup.

CONCLUSIONS

Mandibular residual ridge resorption was reduced for dentures fabricated using the mucostatic impression technique compared with the selective pressure impression technique in individuals with diminished bone density.

Electromyography evaluation of masseter and temporalis, bite force, and quality of life in elderly patients during the adaptation of mandibular implant-supported overdentures

OBJECTIVES

The aim of this study was to investigate the outcomes of the installation of two implant-supported overdentures until such treatment is complete. Although this treatment is well established in the literature, there are no studies comparing what happens to muscles and the quality of life (QoL) of patients during the treatment.

METHODS

We selected 13 completely edentulous patients, according to inclusion and exclusion criteria, to rehabilitate with mandibular overdentures retained by two dental implants and a complete denture as antagonists. We evaluated the efficacy of the treatment and its evolution in five steps: (i) initially, with the old complete dentures, (ii) after the implants' placement with the mandibular prosthesis relined, (iii) after the placement of the healing abutments, (iv) after the installation and adaptation of new prostheses, and (v) after a 3-month follow-up period. At each stage, we evaluated patients via temporal and masseter electromyography (EMG), molar and incisive bite force, and QoL.

RESULTS

The results for EMG found a decrease in muscle activity during rest, the mastication of raisins, and lateral movements when the overdentures were installed. For the bite force and QoL, there was a gradual improvement from the placement of the healing abutments period (P ˂ 0.05), which was sustained until the follow-up.

CONCLUSIONS

Comfort and stability improved during the treatment, demonstrated by the QoL and bite force results. These results are positive for elderly patients who might refuse an implant-supported overdenture due to treatment length.

Comparative evaluation of vertical dimension at rest before extraction, after extraction and after rehabilitation with complete denture - A Cephalometric study

INTRODUCTION

The determination of physiologic rest position of the mandible to the maxillae is of paramount importance in almost all fields of dentistry. The stability of vertical dimension at rest has been controversial if the rest position of mandible remains constant throughout life or not. Despite of several studies on the rest position of the mandible and facial vertical dimension, certain fundamental disagreements remain unresolved. The present study aims to compare the vertical dimension at rest, before and after extraction and after rehabilitation with complete denture.

MATERIAL & METHODS

This study was conducted in a total of ten randomly selected patients, who had some natural teeth present with one or more opposing posterior teeth with vertical occlusal stops but were advised for extraction because of poor prognosis. Digital lateral cephalograms were done and measurements recorded at three stages: prior to extraction of remaining natural teeth, post extraction and after complete denture rehabilitation.

RESULTS

Vertical dimension at rest was found to be greatest in post rehabilitation followed by pre-extraction than post extraction state. The differences in changes were found to be statistically significant.

CONCLUSION

Vertical dimension at rest shows a decrease following extraction of natural teeth, the occlusal stops, and an increase on rehabilitation. It can be stated that vertical dimension at rest is not stable position and varies following extraction of natural teeth and rehabilitation.

Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year

Development of patient-based questionnaire about aesthetic and functional differences between overdentures implant-supported and overdentures tooth-supported. Study of 43 patients with a follow up of 1 year.

OBJECTIVE

The aim of this study is to compare functional efficiency and patients satisfaction between tooth-supported and implant-supported overdenture through a questionnaire that accurately reflects the real concerns of patients with dental prosthesis.

METHODS

Forty-three patients were selected from the out patient clinic, Department of Dentistry "Fra G.B. Orsenigo Ospedale San Pietro F.B.F.", Rome, Italy. Their age were ranging from 61 to 83 years. Eighteen patients were rehabilitated with overdentures supported by natural teeth and twenty-five with overdentures implant-supported. DISCUSSION AND RESULT: The questionnaire proposed one year after the insertion of the prosthetis has showed that there isn't difference statistically significant in terms of function, phonetics and aesthetics between overdenture implant-supported and tooth-supported.

CONCLUSIONS

The results of the questionnaire showed that the patients generally had a high level of satisfaction concern to the masticatory function, esthetics and phonetics. In addition, on average, they haven't difficulty in removal and insertion of the denture and in oral hygiene. They haven't in both groups problems related to fractures.