Tissue Surface Adaptation and Clinical Performance of CAD-CAM Milled versus Conventional Implant-Assisted Mandibular Overdenture.

Purpose: To evaluate the surface adaptation and maximal biting force of CAD-CAM milled mandibular overdenture (CAD-CAM MOD) compared to conventional compression mold mandibular overdenture (CC MOD). Materials and Methods: Ten completely edentulous subjects with persistent complaints of their complete mandibular dentures were received four dental implants in the anterior mandible. Three months after osseointegration, subjects were randomly received either conventional compression mold or CAD-CAM MOD in a crossover design. To assess tissue surface adaptation, the fitting surfaces of each denture base were scanned and placed on the reference master cast. Three and six months after each overdenture was inserted, clinical performance in the form of maximum biting force was evaluated. Results: The results of this study indicated that the tissue surface adaptation of the CAD-CAM MOD bases was significantly better than the conventional (compression mold technique) processed bases where (P=0.0001). Regarding clinical performance (maximum biting force), the CAD-CAM MOD exhibited better clinical performance (P=0.0001). Conclusions: In denture processing methods, the CAD-CAM overdenture delivered more precise adaption and clinical performance than the compression mold technique.

Custom double tray for a special impression technique for flabby maxillary residual ridge: Case report.

The construction of a removable dental prosthesis for patients with compromised residual alveolar ridges is a challenge for prosthodontists. Flabby anterior ridges and hypermobile tissues in completely edentulous arches require special considerations during prosthetic management, especially when natural dentations remain on the opposite side. Previous studies have revealed that the displacement of flabby tissue can be reduced during impressions by controlling the applied forces via changes in factors such as the tray design, scraping of impression trays, impression material, window technique, and seating velocity of the impressions. However, there may still be some forces applied during impression or there is no even space because there are no trays supporting the vinyl polysiloxane (VPS) impression material in the open window area. Using a custom double tray with even gap between these trays and injecting light body impression material may eliminate these forces and provide accuracy due to even space for the impression material. This article is a clinical report of a patient who presented with an anterior flabby maxillary edentulous ridge opposing the remaining anterior natural teeth. A custom double tray was fabricated using the principle of the window technique. The gap between the double trays allows mucostatic impressions of flabby ridge tissue to be made with accuracy. The maxillary single denture, which was made with a custom double tray, satisfied the patient.

Effect of Implant Position on Clinical and Radiographic Outcomes of Locator-Retained Mandibular Overdentures: A 1-Year Prospective Study.

PURPOSE: To evaluate the influence of implant position on clinical and radiographic outcomes of Locator-retained mandibular overdentures MATERIALS AND METHODS: Fifteen edentulous participants with compromised bone at canine regions of the mandible were given 2 implants in the premolar areas (study group, PM). The control group (CA) consisted of 15 participants who received 2 implants in the canine regions, matched to PM and assigned as historical control. For study and control groups, mandibular dentures were constructed and attached to the fixtures with Locator attachments using the delayed loading protocol. Clinical (plaque scores, gingival scores, pocket depth, and implant stability) and radiographic (marginal bone loss) outcomes were assessed after denture delivery (T0), 6 months (T6), and 12 months (T12) later. RESULTS: The survival rate was 100% in both groups. All clinical and radiographic parameters increased significantly with time. No significant difference in plaque scores, gingival scores, or implant stability between groups was observed. PM group recorded significantly higher pocket depth and marginal bone loss than CA group at T6 and T12. CONCLUSIONS: Within the limits of this short-term clinical study, canine position for implants retaining mandibular overdentures with Locator attachments is preferred over the first premolar position, as it was associated with reduced peri-implant pocket depth and marginal bone loss after 1 year.

Effect of telescopic distal extension removable partial dentures on oral health related quality of life and maximum bite force: A preliminary cross over study.

OBJECTIVES: This cross over study aimed to evaluate the effect of telescopic distal extension removable partial dentures on oral health related quality of life and maximum bite force MATERIALS AND METHODS: Twenty patients with complete maxillary edentulism and partially edentulous mandibles with anterior teeth only remaining were selected for this cross over study. All patients received complete maxillary dentures and mandibular partial removable dental prosthesis (PRDP, control). After 3 months of adaptation, PRDP was replaced with conventional telescopic partial dentures (TPD) or telescopic partial dentures with cantilevered extensions (TCPD) in a quasi-random method. Oral health related quality of life (OHRQoL) was measured using OHIP-14 questionnaire and Maximum bite force (MBF) was measured using a bite force transducer. Measurements were performed 3 months after using each of the following prostheses; PRDP, TPD, and TCPD. RESULTS: TCPD showed the OHIP-14 lowest scores (i.e., the highest patient satisfaction with their OHRQoL), followed by TPD, and PRDP showed the highest OHIP-14 scores (i.e., the lowest patient satisfaction with OHRQoL). TCPD showed the highest MBF (70.7 ± 3.71), followed by TPD (57.4 ± 3.43) and the lowest MBF (40.2 ± 2.20) was noted with PRDP. CONCLUSION: WITHIN The Limitations of This Study, Mandibular Telescopic Distal Extension Removable Partial Dentures with Cantilevered Extensions Were Associated with Improved Oral Health Related Quality of Life and Maximum Bite Force Compared to Telescopic or Conventional PRDP. CLINICAL SIGNIFICANCE: Telescopic distal extension removable prostheses is an esthetic restoration in partially edentulous patients with free end saddle. This article describes the addition of cantilevered extensions of this prosthesis. The results showed that telescopic distal extension removable prostheses with cantilevered extensions were associated with improved oral health related quality of life and maximum bite force compared to telescopic or conventional RPDs.