Effect of denture fabrication and wear on closest speaking space and interocclusal distance during deglutition

Statement of problem. The accuracy of assessing maxillomandibular relationships for trial bases and dentures using phonetic and swallowing methods has not been compared to that observed with definitive prostheses. Thus, there is no evidence to prove whether measurements obtained through such methods remain the same after adaptation to dentures.Purpose. This study investigated changes in the closest speaking space, interocclusal rest space, and interocclusal distance during deglutition in edentulous patients during and after complete denture treatment.Material and methods. Eighteen edentulous subjects participated in this study and measurements were performed after 7 Intervals of time: (1) with occlusion rims and record bases following creation of the maxillomandibular relationship record, (2) with trial dentures, (3) at Insertion of definitive complete dentures, (4) 1 week, (5) 2 weeks, (6) 1 month, and (7) 3 months after insertion. Recordings of interocclusal distances were made with a mandibular kinesiograph. Closest speaking space was measured during the pronunciation of the word 'seis'. The distance between postural rest position and centric occlusion, or interocclusal rest space, was measured using a kinesiograph. Interocclusal distance during deglutition was tested by recording the closest mandibular position recorded during swallowing of 20 mL of water. Data were analyzed using repeated-measure ANOVA, followed by the Student-Newman-Keuls test (alpha=.05).Results. A significant (P <.01)reduction in the mean closest speaking space was found when it was evaluated using occlusion rims and record bases (4.6 mm) compared with other stages (3.0 to 3.4 mm). No significant differences were found in mean interocclusal rest space and interocclusal distance during deglutition among the time periods evaluated.Conclusions. The presence of occlusion rims can influence mandibular position during pronunciation of the /s/ sound. The arrangement of artificial teeth changes the closest speaking space. However, rest position and deglutition were not affected, either during denture fabrication or short-term use.

Clinical evaluation of abutment teeth of removable partial denture by means of the Periotest method

Prosthodontics should be one of the means of establishing conditions for the maintenance of periodontal health. The forces applied to the abutment teeth and their effects are very important considerations in the design and construction of the removable partial dentures. This 6-month follow-up clinical study evaluated the degree of mobility of abutment teeth of distal extension and tooth supported removable partial dentures by using Periotest. Two types of clasp design were selected for evaluation. In cases with unilateral and bilateral distal-extension, a clasp design including a T clasp of Roach retentive arm, a rigid reciprocal arm and a mesial rest were used. For the abutments of tooth-supported removable partial dentures, a second clasp design with a cast circumferential buccal retentive arm, a rigid reciprocal clasp arm and a rest adjacent to the edentulous ridges was selected. A total of 68 abutment teeth was analysed. Periotest values were made at the time of denture placement (control) and at 1, 3 and 6 months after the denture placement. The statistical analysis was performed using Friedman test. All analysis was performed at a 0.05 level of significance. The results revelled that no significant changes in tooth mobility were observed during the 6-months follow-up (P > 0.05). In conclusion, our findings suggest that adequate oral hygiene instructions, careful prosthetic treatment planning and regular recall appointments play an important role in preventing changes in abutment tooth mobility caused by removable partial denture placement.

Composite occlusal surfaces for acrylic resin denture teeth

Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to a loss of chewing efficiency and a loss of vertical dimension of occlusion. The use of metal occlusal surfaces on the acrylic resin denture teeth will minimize occlusal wear. Several articles have described methods to construct metal occlusal surfaces; however, these methods are time-consuming, costly, and sometimes considered to be unesthetic. These methods also require that the patient be without the prosthesis for the time necessary to perform the laboratory procedures. This article presents a quick, simple, and relatively inexpensive procedure for construction of composite occlusal surfaces on complete and partial dentures.

Inferior alveolar nerve transposition with involvement of the mental foramen for implant placement

Inferior Alveolar Nerve (IAN) transposition is an option for prosthetic rehabilitation in cases of moderate or even severe bone reabsorption for patients that do not tolerate removable dentures. The aim of the present report is to describe an inferior alveolar nerve transposition with involvement of the mental foramen for implant placement. The surgical procedure was performed under local anesthesia, by the inferior alveolar, lingual and buccal nerve blocking technique. Centripetal osteotomy was performed, and bone tissue was removed, leaving the nerve tissue free in the foramen area. After that, transsection of the incisor nerve was performed, and lateral osteotomy was started from the buccal direction, toward the trajectory of the IAN. The procedure was concluded, by making use of a delicate resin spatula to manipulate the vascular-nervous bundle. The drilling sequence for placing the dental implants was performed, and autogenous bone was harvested using a bone collector attached to the surgical suction appliance. After the implants were placed, the bone tissue previously collected during the osteotomies and drilling processes was placed in order to protect the IAN from contact with the implants. The surgical protocol for inferior alveolar nerve transposition, followed by implant placement presented excellent results, with complete recovery of the sensitivity, seven months after the surgical procedure.

Oral health of Alzheimer's patients in Sao Jose dos Campos, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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.

Estudo histológico comparativo da mucosa palatina em pacientes portadores e não portadores de próteses totais antes e após a instalação de novas proteses.

The authors verified histologically in 20 no dentates patients, the influence of complete dentures on the hard palate mucosa. The patients were divided in two groups: I. Patients that never used complete dentures; II. Patients that were using complete dentures when this research was realized. New prosthesis were made for each one of the 20 patients. Immediately before they received the new prosthesis and ninety days after this, biopsies were realized. The circunferencial pieces of the hard palate mucosa were fixed in formol 10% and coloured with Hematoxylin/Eosin and Mallory's Tricomic for histomorphologic analysis and measuring of the stratum corneum of the epithelium. It was made the statistical analysis and the results showed that: 1. In normal conditions, the utilization of the full dentures produces the reduce of the thickness of the stratum corneum. This was more observed in Group I. 2. The range difference of the thickness of the stratum corneum between the first and the second biopsies in the groups I and II (4.86 microns and 2.18 microns) were not statistically significant. 3. With the use of complete dentures the stratum corneum of the epithelium showed tendence to parakeratinization.

Emprego da imunofluorescência direta no estudo das alterações de mucosa de palato, compatíveis com candidíase atrófica crônica, em indivíduos portadores de próteses dentárias totais muco-suportadas.

Histopathology by hematoxilin-eosin (HE) and periodic acid Schiff (PAS), concomitant direct immunofluorescence (DI) against total human immunoglobulins and against Candida albicans, was effectuated in 25 persons dentures wearers. In 5 persons without chronic athrofic candidiasis (CAC) clinical signals in the palate the HE showed wise inflammatory elements in the connective tissue and the PAS marked the continuous basal layer, the intra-cellular grains of granular layer and the uniform parakeratin on epithelial surface. In 20 others, with palatal signals of CAC, in the HE was frequent the features encountered in Candida infected and PAS revealed, beside descontinuous lamina basal and epithelial surface covered by tide and discontinuous parakeratin, the presence of round bodies few largers that presents in the granular layer, casually isolated in the medial portion of ret pegs and connective papillae. In the first 5 persons the DI against total human immunoglobulins not showed signals of the humoral immunologic phenomena, the same was valid to others 20 patients with CAC clinical aspects. However the DI with conjugate against C. albicans in the 20 cases with CAC signals revealed suitable aspects of the structures assumed by Candida in tissues. Cultures of samples obtained of the persons with CAC signals was positive in 100% to Candida, 70% presumptively albicans, against 80% of positiviness to generus Candida, 67% presumptively albicans, in the persons without CAC signals.

Avaliacao das condicoes de saude bucal dos idosos em um municipio brasileiro

This study assessed the oral health of individuals 60 years or older in the city of Araraquara, Sao Paulo, Brazil, in 1998. Of the 194 people who participated in the study, 91 of them were institutionalized and had an average age of 73.6 years, and 103 were not institutionalized and had an average age of 69.3 years. The study participants were examined by a previously trained oral surgeon who determined the prevalence of the most common oral health problems. The results revealed a large number of edentulous individuals (72% of those institutionalized and 60% of the noninstitutionalized participants) and many persons with extracted teeth (93% and 90%, respectively), as well as a high frequency of periodontal pockets (57% and 75%, respectively) and of inadequate dentures (80% and 61%, respectively). Our results show reduced quality of life for a large proportion of these older individuals, and also indicate that public health services should pay greater attention to this population group.

Antifungal activity of propolis on different species of Candida

Propolis is a resinous material collected by bees from the buds or other parts of plants. It is known for its biological properties, having antibacterial, antifungal and healing properties. The antifungal activity of propolis was studied in sensitivity tests on 80 strains of Candida yeasts: 20 strains of Candida albicans, 20 strains of Candida tropicalis, 20 strains of Candida krusei and 15 strains of Candida guilliermondii. The yeasts showed a clear antifungal activity with the following order of sensitivity: C. albicans > C. tropicalis > C. krusei > C. guilliermondii. Patients with full dentures who used a hydroalcoholic propolis extract showed a decrease in the number of Candida.

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.

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.

Sobredentadura inmediata y con carga tardía: Revisión de la literatura

The oral rehabilitation of the patients toothless totals presents large difficulties, because diverse factors act limiting the treatment with complete dentures conventional, as severe reabsorption of the alveolar process, generating for the phonetic patient difficulties and of mastication, annoyance, retention lack and stability of the prosthesis. With the emergence of you implant them osseointegratin idealized by Prof o Branemark, these aspects were improved by means of the possibility of new treatment options, as the overdentures tissue-implant-supported. However, the protocol of Branemark demanded a period of scaring from three to six months, owing the patients to await this time for the placement of the final prosthesis. This way, the surgical technique of immediate load was proposed to abbreviate this period, improving the transition phase, at the same time that it reduces the problems psychological associates. This way, the objective of the present study is to carry out a literature revision about the works that used overdentures comparing immediate and late load, the best alternative and factors wrapped in the success of the procedure discussing. © 2008 1995, Editorial Ciencias médicas.

Candida albicans inactivation and cell membrane integrity damage by microwave irradiation

In indicating the microwave irradiation for disinfecting dentures it is necessary to see how this procedure influences Candida albicans integrity and viability. The aim of this study was to evaluate the ability of microwaves to inactivate C. albicans and damage cell membrane integrity. Two 200-ml C. albicans (ATCC 10231) suspensions were obtained. A sterile denture was placed in a beaker containing the Experimental (ES) or the Control suspension (CS). ES was microwaved at 650 W for 6 min. Suspensions were optically counted using methylene blue dye uptake as indicative of membrane-damaged cells; spread on Agar Sabouraud dextrose (ASD) for viability assay; or spectrophotometrically measured at 550 nm. Cell-free solutions were submitted to content analyses of protein (Bradford and Pyrogallol red methods); Ca++ (Cresolftaleine complexone method); DNA (spectrophotometer measurements at 260 nm) and K + (selective electrode technique). Data were analysed by Student's t- or Wilcoxon z-tests (α = 0.05). All ES cells demonstrated cell membrane damage. Viable cells were non-existent in the ES ASD plates. No significant difference in optical density between ES and CS was observed (P = 0.272). ES cells released significantly high protein (P < 0.001, Bradford; P = 0.005, Pyrogallol red), K+ (P < 0.001), Ca++ (P = 0.012) and DNA (P = 0.046) contents. Microwaves inactivated C. albicans and damaged cell membrane integrity. © 2007 The Authors.

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.