Patients' expectations and satisfaction of complete denture therapy and correlation with locus of control

P>Considering the importance of patients' satisfaction with complete denture therapy and the influence of psychosocial aspects and expectations regarding satisfaction with their dentures, the present study aimed to test for a correlation between locus of control profiles and expectations before and satisfaction after complete denture therapy. Sixty-four patients rated their expectations for aesthetic and functional results of complete denture therapy on a 10-cm visual analogue scale (VAS), using scores from 0 (worst results) to 10 (best results). A similar questionnaire was used regarding satisfaction after final denture adjustments. Patients also answered a locus of control questionnaire in the initial interview. anova and a chi-squared test were used to test for correlations among ratings, patient gender and locus of control profiles. The significance level adopted was 0 center dot 05. The expectation ratings before treatment were significantly lower than the post-treatment completion ratings, both for aesthetics (P < 0 center dot 001) and function (P = 0 center dot 004). There was no correlation between locus of control profiles and patients' ratings or between gender and VAS scores. No correlation was found between locus of control profiles and scores for expectations before and satisfaction after complete dentures.

Water sorption, solubility, and bond strength of two autopolymerizing acrylic resins and one heat-polymerizing acrylic resin.

STATEMENT OF PROBLEM: Because water sorption of autopolymerizing acrylic reline resins is accompanied by volumetric change, it is a physical property of importance. As residual monomer leaches into the oral fluids and causes tissue irritation, low solubility of these resins is desired. Another requirement is a satisfactory bond between the autopolymerizing acrylic resins and the denture base acrylic resin. PURPOSE: This study compared the water sorption, solubility, and the transverse bond strength of 2 autopolymerizing acrylic resins (Duraliner II and Kooliner) and 1 heat-polymerizing acrylic resin (Lucitone 550). MATERIAL AND METHODS: The water sorption and solubility test was performed as per International Standards Organization Specification No. 1567 for denture base polymers. Bond strengths between the autopolymerizing acrylic resins and the heat-polymerizing acrylic resin were determine with a 3-point loading test made on specimens immersed in distilled water at 37 degrees C for 50 hours and for 30 days. Visual inspection determined whether failures were adhesive or cohesive. RESULTS: Duraliner II acrylic resin showed significantly lower water sorption than Kooliner and Lucitone 550 acrylic resins. No difference was noted in the solubility of all materials. Kooliner acrylic resin demonstrated significantly lower transverse bond strength to denture base acrylic resin and failed adhesively. The failures seen with Duraliner II acrylic resin were primarily cohesive in nature. CONCLUSIONS: Autopolymerizing acrylic reline resins met water sorption and solubility requirements. However, Kooliner acrylic resin demonstrated significantly lower bond strength to denture base acrylic resin.

Effect of Surface Treatments on the Bond Strength between Composite Resin and Acrylic Resin Denture Teeth

Purpose: This investigation studied the effects of 3 surface treatments on the shear bond strength of a light-activated composite resin bonded to acrylic resin denture teeth. Materials and Methods: The occlusal surfaces of 30 acrylic resin denture teeth were ground flat with up to 400-grit silicon carbide paper. Three different surface treatments were evaluated: (1) the flat ground surfaces were primed with methyl methacrylate (MMA) monomer for 180 seconds; (2) light-cured adhesive resin was applied and light polymerized according to the manufacturer's instructions; and (3) treatment 1 followed by treatment 2. The composite resin was packed on the prepared surfaces using a split mold. The interface between tooth and composite was loaded at a cross-head speed of 0.5 mm/min until failure. Results: Analysis of variance indicated significant differences between the surface treatments. Results of mean comparisons using Tukey's test showed that significantly higher shear bond strengths were developed by bonding composite resin to the surfaces that were previously treated with MMA and then with the bonding agent when compared to the other treatments. Conclusion: Combined surface treatment of MMA monomer followed by application of light-cured adhesive resin provided the highest shear bond strength between composite resin and acrylic resin denture teeth.

Kinesiographic study of complete denture movement related to mucosa displacement in edentulous patients.

The mucosa that covers the residual ridges of edentulous patients may present some distortion or displacement when occlusal loading is applied in complete dentures. This distortion and movement of the denture can result in acceleration of residual ridge resorption and loss of retention and stability. The aim of this study was to analyze the pattern of upper complete denture movement related to underlying mucosa displacement. A sample of 10 complete denture wearers was randomly selected, which had acceptable upper and lower dentures and normal volume and resilience of residual ridges. The kinesiographic instrument K6-I Diagnostic System was used to measure denture movements, according to the method proposed by Maeda et al.7, 1984. Denture movements were measured under the following experimental conditions: (A) 3 maximum voluntary clenching cycles and (B) unilateral chewing for 20 seconds. The results showed that under physiological load, oral mucosa distortion has two distinct phases: a fast initial displacement as load is applied and a slower and incomplete recovery when load is removed. Intermittent loading such as chewing progressively reduces the magnitude of the denture displacement and the recovery of the mucosa is gradually more incomplete.

Cytotoxicity of denture base resins: Effect of water bath and microwave postpolymerization heat treatments

Purpose: This study compared the effect of two postpolymerization heat treatments on the cytotoxicity of three denture base resins on L929 cells using 3H-thymidine incorporation and MTT assays. Materials and Methods: Sample disks of Lucitone 550, QC 20, and Acron MC resins were fabricated under aseptic conditions and stored in distilled water at 37°C for 48 hours. Specimens were then divided into three groups: (1) heat treated in microwave oven for 3 minutes at 500 W; (2) heat treated in water bath at 55°C for 60 minutes; and (3) no heat treatment. Eluates were prepared by placing three disks into a sterile glass vial with 9 mL of Eagle's medium and incubating at 37°C for 24 hours. The cytotoxic effect from the eluates was evaluated using the 3H-thymidine incorporation and MTT assays, which reflect DNA synthesis levels and cell metabolism, respectively. Results: The components leached from the resins were cytotoxic to L929 cells when 3H- thymidine incorporation assay was employed. In contrast, eluates from all resins revealed noncytotoxic effects as measured by MTT assay. For both MTT assay and 3H-thymidine incorporation, the heat treatments did not decrease the cytotoxicity of the materials tested. Conclusion: Resins were graded by 3H-thymidine incorporation assay as slightly cytotoxic and by MTT assay as noncytotoxic. Cytotoxicity of the denture base materials was not influenced by microwave or water bath heat treatment.

Effect of microwave treatments on dimensional accuracy of maxillary acrylic resin denture base

Microwave energy has been used as an alternative method for disinfection and sterilization of dental prostheses. This study evaluated the influence of microwave treatment on dimensional accuracy along the posterior palatal border of maxillary acrylic resin denture bases processed by water-bath curing. Thirty maxillary acrylic bases (3-mm-thick) were made on cast models with Clássico acrylic resin using routine technique. After polymerization and cooling, the sets were deflasked and the bases were stored in water for 30 days. Thereafter, the specimens were assigned to 3 groups (n=10), as follows: group I (control) was not submitted to any disinfection cycle; group II was submitted to microwave disinfection for 3 min at 500 W; and in group III microwaving was done for 10 min at 604 W. The acrylic bases were fixed on their respective casts with instant adhesive (Super Bonder®) and the base/cast sets were sectioned transversally in the posterior palatal zone. The existence of gaps between the casts and acrylic bases was assessed using a profile projector at 5 points. No statistically significant differences were observed between the control group and group II. However, group III differed statistically from the others (p<0.05). Treatment in microwave oven at 604 W for 10 min produced the greatest discrepancies in the adaptation of maxillary acrylic resin denture bases to the stone casts.

Effect of post-polymerization heat treatments on the cytotoxicity of two denture base acrylic resins

Introduction: Most denture base acrylic resins have polymethylmethacrylate in their composition. Several authors have discussed the polymerization process involved in converting monomer into polymer because adequate polymerization is a crucial factor in optimizing the physical properties and biocompatibility of denture base acrylic resins. To ensure the safety of these materials, in vitro cytotoxicity assays have been developed as preliminary screening tests to evaluate material biocompatibility. 3H-thymidine incorporation test, which measures the number of cells synthesizing DNA, is one of the biological assays suggested for cytotoxicity testing. Aim: The purpose of this study was to investigate, using 3H-thymidine incorporation test, the effect of microwave and water-bath post-polymerization heat treatments on the cytotoxicity of two denture base acrylic resins. Materials and Methods: Nine disc-shaped specimens (10 x 1 mm) of each denture base resin (Lucitone 550 and QC 20) were prepared according to the manufacturers' recommendations and stored in distilled water at 37°C for 48 h. The specimens were assigned to 3 groups: 1) post-polymerization in a microwave oven for 3 min at 500 W; 2) post-polymerization in water-bath at 55°C for 60 min; and 3) without post-polymerization. For preparation of eluates, 3 discs were placed into a sterile glass vial with 9 mL of Eagle's medium and incubated at 37°C for 24 h. The cytotoxic effect of the eluates was evaluated by 3H-thymidine incorporation. Results: The results showed that the components leached from the resins were cytotoxic to L929 cells, except for the specimens heat treated in water bath (p<0.05). Compared to the group with no heat treatment, water-bath decreased the cytotoxicity of the denture base acrylic resins. Conclusion: The in vitro cytotoxicity of the tested denture base materials was not influenced by microwave post-polymerization heat treatment.

Prosthetic rehabilitation of a bone defect with a teeth-implant supported, removable partial denture

The use of teeth-implant, mucosa-supported removable dentures for rehabilitation of partially edentulous patients involves highly complex biomechanical aspects. This type of prosthesis associates 3 kinds of support that react differently to the functional and parafunctional forces developed in the oral cavity. Although the construction of removable partial dentures may seem paradoxical when osseointegrated implants are placed, in some cases, this option is an excellent alternative to solve difficulties related to the anatomic, biologic, psychomotor, and financial conditions of the patient. This article reports on a case in which a teeth-implant, mucosa-supported removable partial denture was the option of choice for a patient with financial and anatomic limitations, having a large structural loss of the residual alveolar ridge caused by trauma by a gunshot injury at the mandible. The 5-year follow-up did not reveal any type of biomechanical or functional problem. Copyright © 2006 by Lippincott Williams and Wilkins.

Nasal width as a guide for the selection of maxillary complete denture anterior teeth in four racial groups

Purpose: Selecting artificial teeth for edentulous patients is difficult when pre-extraction records are not available. Various guidelines have been suggested for determining the width of the maxillary anterior denture teeth. This study was undertaken to evaluate the use of the nasal width as a guide for the selection of proper width maxillary anterior denture teeth in four racial groups of the Brazilian population. Materials and Methods: One hundred and sixty subjects (40 Whites, 40 Mulattos, 40 Blacks, and 40 Asians) were selected. Using a sliding caliper, the nasal width and the intercanine distance were measured. The Pearson product-moment correlation coefficient was used to determine the relationship between the above measurements. A prediction was made of the percentage of subjects of the White, Mulatto, Black, and Asian populations in which the selection error due to the clinical application of the method of the nasal width would be within 0 to 2 mm, within 2 to 4 mm, and greater than 4 mm. Results: The four racial groups showed a weak correlation between the intercanine distance and the nasal width. In 39.7% of the White, 55.7% of the Mulatto, 81.9% of the Black, and 48.2% of the Asian populations, errors greater than 4 mm would be present with the use of the nasal width. Conclusions: The correlation found between the intercanine distance and the nasal width was not high enough to be used as a predictive factor. The relationship between natural tooth width and artificial tooth width as predicted by the nasal width showed that the nasal width method is not accurate for all the studied groups. Copyright © 2006 by The American College of Prosthodontists.

Effect of disinfection treatments on the hardness of soft denture liner materials

Purpose: To evaluate the effects of disinfection treatments with chemical solutions (2% glutaraldehyde, 5% sodium hypochlorite, and 5% chlorhexidine) and microwave energy on the hardness of four long-term soft denture liners. Materials and Methods: Forty rectangular specimens of four soft lining materials (Molloplast-B, Ufi Gel P, Eversoft, and Mucopren soft) were made for each material. Ten samples of each material were immersed in different disinfectant solutions for 10 minutes or placed in a microwave oven for 3 minutes at 500 W. The hardness values were obtained with a Shore A durometer, before the first disinfection cycle (control), and also after two cycles of disinfection. Data were submitted to analysis of variance and Tukey's test (p < 0.01). Results: The highest value of hardness was obtained for Molloplast-B, independent of the disinfection technique. Mucopren soft demonstrated intermediate values and Ufi Gel P and Eversoft the lowest values of Shore A hardness. For Molloplast-B, the disinfection using glutaraldehyde demonstrated the highest value of hardness. The number of disinfections had no effect on the hardness values for all the materials studied and disinfection techniques. Conclusions: The application of two disinfection cycles did not change the Shore A hardness values for all the materials. The glutaraldehyde solution demonstrated the highest values of Shore A hardness for the Molloplast-B, Mucopren soft, and Ufi Gel P materials, while Eversoft did not present any differences in hardness when submitted to different disinfection treatments. Copyright © 2007 by The American College of Prosthodontists.

Bond strength of acrylic teeth to denture base resin after various surface conditioning methods before and after thermocycling

This study aimed to evaluate the durability of adhesion between acrylic teeth and denture base acrylic resin. The base surfaces of 24 acrylic teeth were flatted and submitted to 4 surface treatment methods: SM1 (control): No SM; SM2: application of a methyl methacrylate-based bonding agent (Vitacol); SM3: air abrasion with 30-μm silicone oxide plus silane; SM4: SM3 plus SM2. A heat-polymerized acrylic resin was applied to the teeth. Thereafter, bar specimens were produced for the microtensile test at dry and thermocyled conditions (60 days water storage followed by 12,000 cycles). The results showed that bond strength was significantly affected by the SM (P < .0001) (SM4 = SM2 > SM3 > SM1) and storage regimens (P < .0001) (dry > thermocycled). The methyl methacrylate-based adhesive showed the highest bond strength.

Factors affecting the strength of denture repairs: Topics of interest

Fracture of dentures is a common clinical finding in daily prosthodontic practice, resulting in great inconvenience to both patient and dentist. A satisfactory repair should be cost-effective, simple to perform, and quick; it should also match the original color and not cause distortion to the existing denture. Different repair materials, surface designs, and mechanical and chemical surface treatments have been recommended in order to obtain stronger repairs. This article reviews some of the available literature with regard to the most important factors that may influence the strength of denture repairs. © 2007 by The American College of Prosthodontists.

Complete denture masticatory efficiency: a literature review

The restoration of masticatory function and esthetics is an important aim in dentistry mainly when patients present with extensive tooth loss. The aim of mastication is to reduce food size to produce a homogeneous bolus appropriate to be swallowed. For edentulous patients, chewing efficiency is reduced because dental arches are replaced by artificial teeth. The aim of this study is to present factors related to chewing efficiency for the edentulous patient.

Dual path: A concept to improve the esthetic replacement of missing anterior teeth with a removable partial denture

The dual path of insertion concept for removable partial denture (RPD) design may be used in esthetically demanding situations. When compared to conventional RPDs, the main advantage of this design is the minimal use of clasps. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a dual path RPD. The diagnostic cast was surveyed to ensure the adequacy of the undercuts on the mesial surfaces of the anterior abutments, where rigid minor connectors were placed. Inverted V-shaped canine cingulum rest seats were prepared to provide resistance to tooth movement during function. The dual path RPD concept allows excellent esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation in a Kennedy class IV partially edentulous arch. © 2008 by The American College of Prosthodontists.