Search Results (221)

Background: The adhesion between artificial teeth and denture bases is crucial for the longevity of complete dentures. This in vitro study evaluated the shear bond strength (SBS) and failure modes between artificial teeth and denture base resins produced with conventional, milled, and 3D-printed techniques. Materials: A total of 105 specimens were fabricated and assigned to 7 groups (n = 15) combining conventional, milled, or printed denture bases with conventional, milled, or printed teeth. SBS was tested using a universal testing machine, and failure modes were classified as adhesive, cohesive, or mixed. Data were analyzed with one-way ANOVA and Tukey’s post hoc test (α = 0.05). Results: SBS significantly varied among groups (p < 0.001). The conventional base–conventional tooth group (CB-CT) showed the highest bond strength (14.9 ± 3.69 MPa), while the printed base–milled tooth group (PB-MT) had the lowest (6.58 ± 3.41 MPa). Milled base groups showed intermediate values (11.7–12.4 MPa). Conclusions: Bond strength between denture teeth and denture bases depends on the fabrication workflow. Conventional heat-cured PMMA bases exhibited the most reliable adhesion, while milled bases demonstrated satisfactory performance with optimized bonding. Printed bases showed reduced and variable adhesion, suggesting the need for improved bonding protocols before their widespread clinical application in definitive prostheses. Full article

Successful health management in older adults requires adequate nutrition, which is often compromised by oral health issues like edentulism. Tooth loss can reduce masticatory function, especially when rehabilitation treatments fail. The present study aims to generate initial information on the potential effects of the placement of mandibular mini-implants in patients with complete maxillary and mandibular dentures on mandibular kinetics, electromyographic activity, and quality of life. Participants with complete dentures, adequate mandibular bone height, and good general health were recruited. All underwent cone beam computed tomography for diagnosis and planning to place two mandibular mini-implants. Mandibular movements were analyzed using electromagnetic articulography and electromyography before treatment and five months after implant placement. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-7sp at baseline and six months post-treatment. Five subjects were included (mean age 69.7 ± 10.8 years). All mini-implants demonstrated a 100% initial success rate. At five months, significant improvements were observed in the vertical range of maximum opening, as well as in the area, trajectory, and range of frontal and sagittal movement envelopes (p < 0.05)—along with increased movement symmetry. OHRQoL also improved, with greater esthetic satisfaction, communication, and social engagement. Mandibular mini-implants improved mandibular movements and prosthetic stability, enhancing patients’ oral health-related quality of life without altering muscle activity. Full article

Background/Objectives: Fixed prosthetic dentures (FPD) represent a reliable treatment option to rehabilitate oral function and aesthetics. The concentration of loads at a certain level of the bridge causes overloading of the bridge components. The objectives of this study were to identify the frequency and severity of complications in FPDs associated with occlusal overload for patients prosthetically treated with metal–ceramic and metal–acrylic FPDs. Methods: This retrospective cross-sectional clinical study included 306 patients of both sexes, aged 30+, with an FPD requiring rehabilitation. The following data were collected: general demographic data of the patients, data on dental bridges, data on occlusal overloads, and complications of FPDs according to severity. Statistical processing was performed in SPSS. Results: Metal–ceramic FPDs had more abutment teeth (p = 0.035), fewer intermediaries (p < 0.0005), and less severe complications (p = 0.001). Maxillary FPDs had a higher number of abutment teeth, compared to mandible FPDs (p < 0.001). As the life duration of the FPDs increased, the number of intermediaries and the severity grade also increased (p < 0.001). Compared to intercalated and pontics, cantilever pontics of FPDs had a longer duration (p < 0.001), a lower number of intermediaries (p < 0.001), and a higher severity grade (p < 0.001). The presence of occlusal interferences was associated only with a lower FPD duration (p = 0.007). The presence of unbalanced occlusion planes was associated with a higher severity grade, while the presence of shortened arches was associated with a longer FPD duration (p < 0.001), a higher number of intermediaries (p = 0.005), and a higher severity grade (p < 0.001). Conclusions: The most severe complications of FPDs were recorded in the case of shortened arches and cantilever bridges. This study draws attention to the need for preprosthetic and postprosthetic occlusal balancing and the need for complete rehabilitation of the dental arches. Full article

Complete dentures (CD) are prone to biofilm formation, particularly by Candida species, which may lead to denture stomatitis (DS). As edentulism remains highly prevalent among the global ageing population, denture-related infections represent a significant public health concern. The novelty of this study lies in integrating the clinical severity of DS with the prevalence, microbial load, and antifungal susceptibility profile of Candida spp., providing new insights into the pathogenesis and therapeutic management of this condition. Biofilm from the CD and palate was seeded for prevalence and microbial load. The identification of strains was confirmed molecularly, and susceptibility to micafungin, nystatin, fluconazole, and miconazole was assessed by the broth microdilution method. Prevalence was shown in percentage, microbial load was analyzed using a generalized linear model test, and susceptibility was assessed using Pearson’s Chi-square test (p < 0.05). Candida albicans was the most prevalent regardless of DS. However, a higher microbial load of C. albicans was observed with increased severity of DS (p = 0.038). Except for Candida tropicalis, the microbial load of the CD was higher than that of the palate. C. tropicalis showed resistance to fluconazole with increased severity of DS (p = 0.004). All strains were susceptible to nystatin and miconazole, and three were resistant to micafungin. The findings suggest that the prevalence of Candida spp. is not a determining factor in the variation in DS severity. Nevertheless, patients with severe inflammation harbor an increased load of C. albicans on both sites. Nystatin and miconazole appear to be effective treatments for DS. Full article

The dimensional accuracy of the intaglio surface of complete dentures fabricated using liquid crystal display (LCD) three-dimensional (3D) printing might be influenced by the build angle and post-processing storage conditions. This study evaluated the effect of build angle and natural light exposure duration on the intaglio surface trueness of maxillary complete denture bases. Standardized denture base designs (2 mm uniform thickness) were fabricated using an LCD 3D printer (Lilivis Print; Huvitz, Seoul, Republic of Korea) at build angles of 0°, 45°, and 90° (n = 7 per group). All specimens were printed using the same photopolymer resin (Tera Harz Denture; Graphy, Seoul, Republic of Korea) and identical printing parameters, followed by ultrasonic cleaning and ultraviolet post-curing. Specimens were stored under controlled light-emitting diode lighting and exposed to natural light (400–800 lux) for 0, 14, or 30 days. The intaglio surfaces were scanned and superimposed on the original design data, following the International Organization for Standardization 12836. Quantitative assessment included root mean square deviation, mean deviation, and tolerance percentage. Statistical analyses were performed using one-way analysis of variance and paired t-tests (α = 0.05). Build angle and light exposure duration significantly affected surface trueness (p < 0.05). The 90° build angle group exhibited the highest accuracy and dimensional stability, while the 0° group showed the greatest deviations (p < 0.05). These findings underscore the importance of optimizing build orientation and storage conditions in denture 3D printing. Full article

Objectives: The objective of this study was to evaluate changes in anatomical point position, cranio-cervical posture, and respiratory dimensions following conventional bimaxillary total prosthetic rehabilitation. Methods: A prospective, longitudinal, observational, analytical study was conducted on 12 patients, aged 55 to 75 years, at the Department of Dental Prosthetics at the University of Medicine and Pharmacy in Cluj-Napoca. All patients had complete bimaxillary edentulism and received removable dentures as treatment. Clinical and cephalometric analyses were performed before and after prosthetic treatment to compare changes. The cephalometric analysis was based on the guidelines of Tweed and Rocabado for evaluation. Quantitative data were described using the mean and standard deviation for normal distribution and represented by bar graphs with error bars. A paired samples t-test was used to determine differences between groups, with a significance threshold of 0.05 for the bilateral p-value. Results: When analyzing changes in cranial base inclination, the corresponding angles exhibited an increase, indicating cephalic extension. A statistically significant difference in the anteroposterior diameter of the oropharyngeal lumen with and without bimaxillary complete dentures was identified (p < 0.05). For hyperdivergent patients, modifications in the position of anatomical features on cephalometry slightly reduced the VDO and had a slight compensatory effect on skeletal typology. In contrast, for hypodivergent patients, modifications to the position of anatomical landmarks also had a compensatory effect on skeletal typology, increasing the VDO. Conclusion: Changes in the position of anatomical features on cephalometry generally have a compensatory effect on skeletal typology after complete denture placement. Complete prosthetic treatment with removable dentures can significantly influence respiratory function by reducing the oropharyngeal lumen and body posture by cephalic extension and attenuation of the lordotic curvature of the cervical spine. Full article

Polymers are essential materials in the fabrication of partial and complete dentures, where their mechanical properties directly impact durability, comfort, and clinical performance. This study examines the influence of different manufacturing temperatures on the surface hardness of polymeric materials used in dental applications. A total of 60 experimental samples with a rectangular shape of Vertex ThermoSens polymer (Vertex Dental, 3D Systems, Soesterberg, The Netherlands) were fabricated through injection molding at 280 °C and 300 °C and analyzed over time to assess changes in their properties. Hardness measurements, conducted using the EQUOTIP Shore D hardness tester (Proceq SA, Schwerzenbach, Canton of Zürich, Switzerland), indicated increased hardness over time, with higher values observed in samples fabricated at 300 °C. A two-way ANOVA was performed to evaluate the statistical significance of temperature and time on hardness, revealing a significant effect (F = 14.73, p = 0.0185). These findings suggest that processing polymers at elevated temperatures improves surface hardness, significant for denture longevity and patient comfort. Increased hardness contributes to greater wear resistance. Optimizing polymer manufacturing conditions can thus lead to improved clinical outcomes, ensuring more durable and biocompatible dental prostheses. Full article

Background: Patient satisfaction is a critical outcome in the rehabilitation of edentulous patients. While conventional fabrication methods are widely used, digital workflows are emerging as viable alternatives. However, direct comparative evidence from the patient’s perspective remains limited. Objective: To compare patient satisfaction between conventional complete dentures (C-CD) and digital complete dentures (D-CD) in maxillary edentulous patients, including changes in perceptions over time and final prosthesis preference. Methods: A prospective, randomized crossover clinical trial was conducted in 2023–2024 involving 40 completely maxillary edentulous patients meeting specific inclusion criteria. Participants were randomly allocated into two sequence groups: Group 1 (n = 20) received C-CD first, and Group 2 (n = 20) received D-CD first, each for 6 months (T1), followed by crossover to the alternate denture for another 6 months (T2). Patient satisfaction was measured using a 10-item questionnaire at 6 and 12 months. Statistical analysis: Wilcoxon signed-rank tests were used for within-subject comparisons of denture types, and Mann–Whitney U tests for between-group comparisons, with significance set at p ≤ 0.05. Results: Using the paired crossover analysis, D-CD showed significantly better comfort than C-CD (p < 0.05). D-CD scored significantly higher than C-CD in most satisfaction domains, including comfort, retention, speech, esthetics, and need for adjustments (p ≤ 0.05). Median scores for retention, speech, esthetics, and other domains were slightly higher with D-CD but did not reach statistical significance (p > 0.05). Additionally, the D-CD required fewer post-insertion adjustment visits than the C-CD (p < 0.05). By the end of the trial, 28 patients (70%) preferred the digital denture as their final prosthesis, whereas 12 patients (30%) preferred the conventional denture. Conclusions: Incorporating digital technology in the fabrication of complete dentures significantly enhances patient satisfaction compared to conventional methods. This study highlights the clinical relevance of modern dental prosthesis technology and supports the wider integration of digital workflows. Within the limitations of this pilot study, digitally fabricated complete dentures provided overall patient satisfaction comparable to conventional dentures, with the D-CD offering a notable improvement in comfort. The majority of patients ultimately favored the digital denture, supporting the clinical viability of CAD/CAM workflows. Full article

Background and Objectives: Complete dentures remain a primary solution for oral rehabilitation in aging and medically compromised populations. The integration of digital workflows, regenerative materials, and smart technologies is propelling prosthodontics towards a new era, transcending the limitations of traditional static prostheses. Materials and Methods: This narrative review synthesizes historical developments, current practices, and future innovations in complete denture therapy. A comprehensive review of literature from PubMed, Scopus, and Web of Science (2000–2025) was conducted, with a focus on materials science, digital design, patient-centered care, artificial intelligence (AI), and sustainable fabrication. Results: Innovations in the field include high-performance polymers, CAD–CAM systems, digital impressions, smart sensors, and bioactive liners. Recent trends in the field include the development of self-monitoring prostheses, artificial intelligence (AI)-driven design platforms, and bioprinted regenerative bases. These advances have been shown to enhance customization, durability, hygiene, and patient satisfaction. However, challenges persist in terms of accessibility, clinician training, regulatory validation, and ethical integration of digital data. Conclusions: The field of complete denture therapy is undergoing a transition toward a new paradigm of prosthetics that are personalized, intelligent, and sustainable. To ensure the integration of these technologies into standard care, ongoing interdisciplinary research, clinical validation, and equitable implementation are imperative. Full article

Background: The potential impact of the number of implants (four vs. six) on the implant survival of implant-supported fixed complete dentures (IFCDs) remains inconclusive and subject to ongoing debate. This study compared the implant survival of immediately loaded four vs. six IFCDs, delivered using a patient-centered systematic treatment plan, in a large patient cohort assessed with consistent diagnostic methodology and comprehensive longitudinal follow-up. Methods: This retrospective study included records of 943 patients receiving 5989 implants with an average follow-up of 5.0 ± 3.2 (range 0–17) years delivered using a systematic clinical decision support system (CDSS) based on a defined alveolar atrophy classification (CC). Implant survival was analyzed considering predictor variables comprising treatment and anatomic and systemic health-related factors at the overall, maxillary, and mandibular levels using Kaplan–Meier analysis, log-rank tests, and single-predictor and multilevel Cox proportional hazard analysis derived from causal direct acyclic graph methodologies. Results: The 2- and 5-year cumulative survival rates (CSRs) of four and six IFCDs were comparable (2-year: 98.6% vs. 98.4%, p = 0.362; 5-year: 98.8%, 98.7% p = 0.346). The differences between four and six IFCDs were more pronounced at the maxillary levels, specifically after 2 years (97.7% vs. 98.6% p = 0.084), and at the mandibular level after 5 years (98.6% vs. 99.4%, p = 0.136.). Multilevel Cox proportional hazard models at overall and jaw levels adjusted for confounding factors indicated that implant loss was correlated to jaw type and age at overall and age alone at the mandibular level. Alveolar atrophy (CC) defined within the adopted CDSS was not robustly associated with implant loss. Conclusions: Under the guidance of a systematically applied patient-centered CDSS, four and six IFCDs demonstrated high and comparable mid-to-long-term implant survival rates irrespective of the level of analysis or statistical model used to adjust for confounding factors. Prosthetic and technical complications were not evaluated and were, therefore, beyond the scope of this study. Full article

Complete dentures are exposed to complex masticatory forces that may lead to material fatigue and eventual structural failure. Occlusal relationships, such as eugnathic and progenic, influence the distribution of these forces significantly. Understanding their biomechanical impact is essential for improving denture design and longevity. The aim of this study was to evaluate the mechanical behaviour of complete dentures under bite loads in eugnathic and progenic occlusal relationships, using both experimental testing and numerical simulations. The focus was placed on identifying the conditions that lead to initial damage and the patterns of stress distribution. The material properties of the denture base and artificial teeth were determined through experimental tensile and compressive testing on cylindrical PMMA specimens. The denture geometry was acquired via 3D tomography based on impressions of an edentulous patient. Experimental testing of the denture bite was conducted to determine the force thresholds at which the initial cracks occur. Numerical simulations were carried out using finite element analysis at bite loads of 100 N and 200 N in both occlusal types, incorporating the obtained material parameters. The experimental results showed that the first signs of denture damage occurred at 6400 N in eugnathic occlusion and 7010 N in progenic occlusion. The numerical simulations confirmed that, during occlusion, the pressure is redistributed across multiple contact points, with a broader distribution reducing the localised stress. This redistribution was more efficient in eugnathic occlusion, which reduced the risk of longitudinal cracking in acrylic teeth. In contrast, progenic occlusion showed higher susceptibility to fractures within the acrylic denture base, particularly between adjacent teeth. Both the experimental and numerical approaches demonstrated that occlusal relationships affect the mechanical resilience of complete dentures directly. The findings highlight that eugnathic occlusion offers biomechanical advantages in stress distribution, potentially reducing the risk of fracture. Incorporating occlusal analysis into denture design protocols can enhance clinical outcomes and improve prosthetic longevity. Full article

Interdisciplinary decision-making significantly influences both the therapeutic potential and clinical outcomes, shaping clinical attitudes and management strategies. As the integration between endodontic and restorative-prosthetic considerations becomes increasingly prevalent, it is essential to understand how different dental specialists, particularly general dental practitioners, prosthodontists and endodontists, approach clinical decision-making and collaborate to optimize patient care. Objectives: This study aims to identify practice disparities in post-endodontic crown placement to inform national policy reforms, including standardised timing protocols and interdisciplinary referral criteria. Methods: A structured questionnaire was distributed to dentists practicing in Romania, yielding 238 collected responses. Results: Substantial variability was found in clinical approaches: diagnostic imaging preferences indicated frequent use of periapical radiography (83.49%) and CBCT (53.67%). Over 70% expressed high confidence in CBCT’s diagnostic precision, significantly higher than periapical radiography (Wilcoxon Signed-Rank test, p < 0.00001). A statistically significant majority (69.3%, binomial test, p < 0.001) preferred delaying definitive crown placement until radiographic healing of periapical lesions. Logistic regression analysis showed endodontists were significantly less likely to choose invasive treatments compared to other specialists (p = 0.027). Although clinicians widely recognize the significance of prosthetic planning, its early integration into the overall treatment strategy has been inconsistent. Conclusions: This study points out the necessity for standardised guidelines that clearly integrate prosthetic planning into endodontic decision-making, enhancing predictability and tooth preservation. Full article

Background: Candida albicans adhesion to denture base materials is a primary contributor to denture stomatitis. To address this issue, numerous studies have explored the incorporation of various additives into denture base resins to enhance their antifungal properties. Titanium tetrafluoride (TiF₄) is an inorganic fluoride compound that has proven antimicrobial properties but has not yet been tested with denture materials. This study aimed to evaluate the effect of TiF₄ addition into different denture base materials on antifungal activity, surface roughness, hardness, and color properties. Methodology: A total of 200 disc-shaped specimens were prepared—100 heat-polymerized acrylic resins and 100 3D-printed NextDent resins. Four different concentrations of TiF₄ were incorporated: 1 wt%, 2 wt%, 3 wt%, and 4 wt% for both resins, while one group of each resin remained unmodified as a control. All specimens were subjected to thermal cycling for 5000 cycles, and four tests were conducted: Candida albicans adherence, surface roughness, hardness, and color change. A scanning electron microscope (SEM) was used to prove Candida albicans colonies’ adhesion on the specimens’ surfaces, and Fourier-transformed infrared (FTIR) analysis was performed to show the presence of TiF₄ in the resin material; data were analyzed using one-way ANOVA followed by a post hoc test (α = 0.05). Results: TiF₄ significantly reduced the Candida albicans adhesion to heat-polymerized specimens (p < 0.001). Compared to the control group, the incorporation of TiF₄ resulted in a substantial reduction in C. albicans colony counts, with reductions of approximately 97.6% in 1HP, 97.2% in 2HP, 97.4% in 3HP, and complete inhibition (100%) in 4HP. However, there was no significant difference between the 3D-printed ones (p = 0.913). Surface roughness, hardness, and color change of heat-polymerized groups were not significantly affected by TiF₄ (p > 0.05) except the color of the group treated with 4% (p < 0.05). For the 3D-printed groups, no significant differences were detected between the groups regarding candida count, hardness was significantly increased at 2% TiF₄ compared to the control (p = 0.002), and roughness was least with 4% TiF₄, while the color varied significantly between the groups (p < 0.001). Conclusions: TiF₄ addition decreased Candida albicans adhesion to heat-polymerized denture base materials but showed no antifungal effect on the 3D-printed resin. While roughness remained low in 3D-printed groups at higher concentrations. Hardness was not significantly altered in the heat-polymerized resin, whereas it increased significantly in the modified 3D-printed resin. Color stability was compromised at higher TiF₄ concentrations, particularly in the 3D-printed groups. The type of denture base material and TiF₄ concentration both influenced antifungal activity and denture surface properties. Full article

Background: Mandibular movement is inherently complex, involving both lateral and vertical components. In older adults, this complexity is compounded by diminished neuromuscular coordination and reduced proprioceptive feedback, often impairing effective mastication. Objectives: This study aimed to review dental literature on the influence of masticatory parameters in the formation of wear facets on acrylic resin denture teeth. Methods: A targeted literature review was conducted, analyzing peer-reviewed studies from 1991 to 2024 through PubMed and Scopus. The review focused on masticatory parameters, age-related neuromuscular adaptations, chewing patterns, and preferred-side denture tooth wear, affecting older adults using complete removable dentures. Results: Mandibular movement characteristics—particularly velocity, duration, and cycle frequency—were found to significantly influence denture tooth wear, often resulting in reduced bite force and masticatory efficiency. Contemporary denture materials demonstrated improved wear resistance, aiding in the regulation of chewing frequency and velocity. These factors are increasingly important as age-related changes impact the stomatognathic system. Notably, wear facets were most prominent on the maxillary first molars, regardless of the occlusal scheme. Conclusions: This review provided a comprehensive overview of existing research, analyzed current evidence, and offered insights into the role of masticatory function and wear characteristics in older complete denture wearers. Full article

Objectives: This study aimed to establish reference values for bite force in individuals with various prosthetic restorations and to examine the relationship between prosthetic treatment groups (PTGs) and bite force as an indicator of masticatory muscle function. Materials and Methods: In a cross-sectional study from November 2021 to March 2023, 198 participants aged 18 to 95 years were recruited from multiple dental and geriatric centers. The participants were assigned to seven PTGs based on their dental and prosthetic statuses. Bite force was measured using the Occlusal Force Meter GM10, with three recordings on each side of the jaw, and analyzed using ANOVA. Results: The bite force decreased with fewer teeth and the transition from fixed to removable dentures. Fully dentate participants exhibited the highest bite forces, differing significantly from the other groups (p < 0.001). For the fully dentate individuals (547 ± 240 N), the bite force decreased progressively with the extent of prosthetic restoration, reaching 55 ± 45 N in edentulous individuals with complete dentures in both jaws. However, edentulous participants with two interforaminal implants demonstrated higher bite forces than those with partial dentures. Conclusions: Bite force is significantly impacted by prosthetic restoration type. Fully dentate individuals have the highest bite forces, while edentulous patients with implant-supported dentures also show considerable bite forces, similar to those with partial dentures. Full article