Search Results (238)

Background: The purpose of this systematic review is to understand the epidemiology, risk factors, reporting symptoms, and clinical presentation of denture-induced epulis fissuratum and the various management strategies reported in the literature. Methods: This review was performed in accordance with the PRISMA 2022 guidelines and was registered in the PROSPERO database (CRD42024517759). A systematic electronic search from scientific databases was performed from inception to July 2024. All studies (cross-sectional, observational, and clinical trials), case reports, and case series in the English language addressing the epidemiological and clinical characteristics, as well as the management strategies for prosthetic denture-induced oral epulis fissuratum, were included. The relevant search terms and Boolean operators were employed. Results: A total of 408 articles were obtained from various databases. A total of 41 articles were included for data extraction, of which 20 were case reports and 21 were clinical studies. There were a total of 1472 patients from the included reports. Eighty-two patients had symptomatic epulis fissuratum. A total of 96 patients (6.5%) in the 18 included reports had complete resolution of the lesion following treatment. Conclusions: Diagnosis is primarily based on the pathognomonic clinical presentation of these lesions. Although multiple therapeutic approaches for epulis fissuratum have been described in the literature, a universally accepted or standardized treatment protocol has not yet been established. Full article

Additive manufacturing is now an integral part of digital prosthodontic workflows, and although stereolithography (SLA) is widely used for denture base fabrication, the dimensional accuracy of printed dentures remains highly dependent on manufacturing parameters, particularly build orientation. This study evaluated the influence of build orientation on the trueness and precision of SLA-printed maxillary and mandibular denture bases. Thirty complete denture bases were fabricated using SLA and divided into three groups according to build orientation: 0°, 45°, and 90° (n = 10). The intaglio surfaces of the printed dentures were scanned and compared with their corresponding digital reference models using three-dimensional inspection software. Trueness was quantified using root mean square error (RMSE) and directional deviations, while precision was assessed based on the variability of RMSE values within each group. Statistical analysis was performed using one-way ANOVA and Tukey’s post hoc test (p ≤ 0.05). Build orientation significantly affected the trueness of maxillary denture bases, with dentures printed at 90° demonstrating the lowest RMSE values. No statistically significant differences in trueness were observed among build orientations for mandibular denture bases. Precision was not influenced by build orientation for maxillary dentures, whereas mandibular dentures printed at 90° exhibited significantly greater variability compared with 0° and 45°. Build orientation is a critical factor influencing the dimensional accuracy of SLA-printed denture bases in an arch-dependent manner. Optimizing build orientation may enhance both accuracy and reproducibility, thereby improving the predictability and clinical reliability of additively manufactured denture bases. Full article

Objectives: This study investigated the impact of age on the diagnostic accuracy and patient acceptance of two chewing efficiency tests: the digital Mini Dental Assessment (MDA) using carrots and the CHEW test by Slavicek using fruit gum, applied in both clinical and nursing home settings. Methods: Seventy participants aged 18 to 99 years from dental clinics and nursing homes were included. All participants received a standardized dental examination (reference standard) and performed the MDA and CHEW tests. Sensitivity, specificity, and AUC values were calculated using ROC analysis. Participants rated both tests in terms of taste, consistency, comprehensibility, required time, and subjective chewing sensation. Acceptance was analyzed across age groups and prosthesis types. Results: Both chewing efficiency tests showed good agreement with the clinical reference standard. The AUC was 0.72 for the MDA and 0.78 for the CHEW test (p = 0.192). Sensitivity was higher for the CHEW test (100%) compared to the MDA (83.3%), while the MDA demonstrated slightly higher specificity (59.6% vs. 55.8%). Age significantly influenced both diagnostic outcomes and test acceptance (p < 0.05). Younger participants (<70 years) were more often correctly classified as healthy and tended to prefer the MDA, whereas older participants (≥70 years) preferred the CHEW test, primarily due to taste. Misclassifications occurred most frequently among participants with complete dentures. Conclusions: Both the digital MDA and the CHEW chewing test demonstrated good diagnostic performance in identifying treatment need. Acceptance varied significantly with age, suggesting that test selection may be optimized based on patient characteristics. These simple and rapid assessments may support early detection of dental treatment needs in clinical and nursing home settings. Full article

The risk of memory complaints and cognitive decline increases with age, leading to many older adults being referred to memory clinics for cognitive screening including a comprehensive geriatric assessment (CGA). Although CGA covers medical, cognitive and social domains, it commonly omits an assessment of oral health, despite evidence linking poor oral health to cognitive impairment and reduced quality of life. This study assessed the value of incorporating an oral health assessment into the CGA and explored differences in oral health between patients with and without dementia. Patients with memory complaints attending a memory clinic between April 2022 and May 2025 were asked to undergo an oral health assessment and complete an oral health questionnaire alongside the CGA. Patients unable to cooperate or incapacitated to consent were excluded. In total, 144 participants were included. The mean age was 73.7 years; 59.7% were male. Most participants had natural dentition (75%), and most had carious lesions (93.5%) and periodontal pockets (97.3%). Among denture wearers, denture-related problems were common (61.7%). No differences in oral health were observed between patients with and without dementia. All participants had at least one oral health problem, regardless of whether or not they had dementia. Integrating structured oral health assessments into the CGA therefor has value as it offers opportunities for early detection, intervention, and prevention for further decline in overall and oral health. Full article

Objective: This study aims to evaluate the retentive forces and oral health-related quality of life of completely edentulous subjects wearing heat-cured, 3D-printed, and polyamide complete denture (CD) bases at different intervals. Subjects and Methods: For this crossover study, 45 CDs were constructed for 15 completely edentulous male subjects, and subjects were randomly allocated to 3 equal groups (n = 5/group, 3 CDs/subject). Each subject was randomized to receive one manufactured CD—either heat-cured, polyamide, or 3D-printed. After 3 months, subjects crossed over to the other set, with 4 weeks’ rest between each CD. The retentive force (primary outcome) was measured for each maxillary CD base at baseline, after the first and third months; however, the oral health-related quality of life (second outcome) was evaluated for each CD after the first and third months using the oral health impact profile in the completely edentulous patient (OHIP-EDENT) questionnaire. Results: There were significant differences in retention forces between the polyamide CD and the other two CDs (p < 0.05); however, no significant difference was observed between the heat-cured and 3D-printed CDs at different intervals (p > 0.05). After 3 months of follow-up, significant differences in oral health-related quality of life were observed between polyamide and both 3D-printed and heat-cured CDs (p < 0.05). Additionally, the comparison between heat-cured and 3D-printed CDs revealed no significant variation in the overall OHIP-EDENT scores (p > 0.05). Conclusions: The retention of polyamide bases was higher than that of heat-cured and 3D-printed CDs. Additionally, oral health-related quality of life with polyamide dentures was superior to that of 3D-printed and heat-cured CDs across all OHIP-EDENT measures, except for social disability. Both 3D-printed and heat-cured CD bases provide retention and patient satisfaction within acceptable clinical measures. Full article

Background/Objectives: Artificial teeth in complete dentures are classified according to the materials used: porcelain (PO) or composite resin (CR). However, these materials’ effects on function, patient satisfaction, and quality of life (QOL), as well as occlusal wear, remain unclear. We compared PO and CR complete dentures in edentulous patients by assessing masticatory function, patient satisfaction, and oral health-related QOL at 3, 6, and 12 months post-insertion, as well as occlusal surface morphology owing to material differences. Methods: In this open-label, randomized, single-center, parallel-group study, participants were edentulous patients who visited our hospital and underwent treatment with new complete dentures. The outcomes were oral health-related QOL; subjective satisfaction, assessed using a visual analog scale; and masticatory performance, evaluated with gummy jelly and were assessed at baseline and 3, 6, and 12 months post-denture insertion. Occlusal surface impressions were taken twice, digitized as STL models, superimposed, and analyzed for wear. The Wilcoxon rank-sum test was used to compare between groups. Results: All evaluated items showed improvement. However, no significant differences were observed between the PO and CR groups, including between the amount of wear observed in the two groups. However, the PO group showed a tendency toward less wear. Extended observation may be required to clarify the long-term effects of artificial tooth materials. Conclusions: In the short term, the artificial tooth material did not influence masticatory function, oral health-related QOL, or patient satisfaction. Full article

Background/Objectives: Population aging presents new challenges for achieving healthy aging. Edentulism is a condition that diminishes quality of life. Several studies have attempted to analyze the impact of edentulism on masticatory function either by evaluating the final stage of the food bolus or the masticatory process itself. The present study aims to develop a chewing index (Ci) based on chewing time, the number of cycles, and the muscular activity of the masseter and temporal muscles. Methods: Two groups (n = 10 each, 60–80 years old), one with functional dentition (21 or more teeth) (Group F) and one with complete denture wearers (Group D), were used. Participants were asked to chew a total of 36 food samples. The number of chewing cycles (N), chewing time (T), and bilateral activity of the masseter and anterior temporal muscles were recorded and quantified using the root mean square. This activity was normalized with respect to a 5 s maximum voluntary clenching (T_MAV). A chewing index (Ci) was calculated using the equation Ci = N × $\overline{V_{\%}}$ × T/T_MAV, where $\overline{V_{\%}}$ represents the average normalized activity of the four muscles. Results: Ci values ranged from 0 to 62 for Group F and 0 to 262 for Group D. For 15 out of the 36 food samples, Ci was higher in Group D than in Group F. Conclusions: The results of this study are consistent with previous research showing that complete denture wearers must chew for a longer time and perform a greater number of chewing cycles compared with subjects with functional dentition. Full article

Background: Three-dimensional (3D) facial scanning is an objective, non-invasive method for quantifying facial soft-tissue changes following complete denture (CD) rehabilitation. Reliable quantification of these changes in completely edentulous patients can support more predictable aesthetic and functional outcomes. Methods: This prospective before–after observational study included 30 completely edentulous patients (12 men, 18 women; age 48–87 years; mean ± SD: 67.8 ± 9.2 years) who received new maxillary and mandibular CDs. Structured-light 3D facial scans were obtained at baseline (edentulous, without dentures) and post-rehabilitation with dentures in place, in relaxed posture (RP) and maximal intercuspation (MI). Sixty-five validated anthropometric landmarks were analyzed. Primary outcomes were lower facial height (Sn-Gn), nasolabial angle (Cm-Sn-Ls), lower facial convexity (Ls-Li-Pg), mouth width (Ch-Ch), and upper vermilion height (Ls-Sto). Pre–post changes were assessed using paired-sample tests (p < 0.05). Results: Thirty-four of 65 parameters (52.3%) demonstrated significant post-treatment changes (p < 0.05), mainly in the perioral and lower facial regions. The reported parameters were selected due to their clinical relevance in evaluating perioral support and facial profile changes after complete denture treatment. In RP, upper lip thickness increased from 3.69 ± 0.97 mm to 4.96 ± 1.11 mm (Δ = +1.27 mm; p < 0.0001) and lower lip thickness from 6.18 ± 2.69 mm to 7.36 ± 1.52 mm (Δ = +1.18 mm; p = 0.0408). The nasolabial angle decreased from 116.08 ± 9.17° to 108.06 ± 9.56° (Δ = −8.02°; p = 0.0016). In MI, mouth width increased from 55.72 ± 3.43 mm to 57.97 ± 3.13 mm (Δ = +2.25 mm; p = 0.0102). Conclusions: Complete denture rehabilitation produces measurable, clinically relevant improvements in facial soft-tissue morphology in completely edentulous patients, particularly affecting lip support, mouth width, and the nasolabial profile. Structured-light 3D facial scanning provides a reproducible approach to objective outcome assessment and may support individualized denture design. Full article

Background/Objectives: The purpose of this in vitro study is to evaluate the effect varying palatal vault depths have on the accuracy of complete maxillary denture bases fabricated using additive manufacturing technology. Methods: One hundred complete maxillary denture bases were manufactured on two different digital light processing (DLP) dental 3D printers at five different palatal depths. After manufacturing, the denture bases were post-cured, scanned, and then analyzed in metrology software. Statistically significant differences were determined using two-way ANOVA tests for normally distributed data and the Kruskal–Wallis test for non-normally distributed data. Color deviation maps were used to give clinical relevance to the results. Results: Significant differences were found for both printers among some groups for the different palatal depths. In relation to the negative mean deviation, the data revealed that the NextDent printers were the least accurate (0.047 ± 0.004) in the group with the deepest palate. The positive mean deviation revealed the most deviation (0.077 ± 0.009) in the group with the deepest palate, which was also mirrored in the Asiga printer (0.050 ± 0.002). The color deviation maps revealed areas of positive and negative average deviation in all groups. The effect of the printer model (p = 0.007) and palatal depth (p = 0.04) on negative average deviation was significant. The effect of the interaction of printer and palatal depth was also significant (p = 0.001). Conclusion: Deeper palatal vaults are associated with higher deviation in DLP 3D-printed complete maxillary denture bases manufactured through additive manufacturing. Full article

Introduction: Incomplete polymerization of in vivo composite resins (CR) poses a significant problem, with monomer-to-polymer conversion rates ranging from around 60 to 75%. Furthermore, oxygen exposure hampers polymerization in the surface layers. This research aims to evaluate the autophagy-inducing potential of three types of CRS and to explore the role of the Akt/mTOR–autophagy–apoptosis crosstalk in composite resin-induced autophagy. The study uses human gingival fibroblasts and three composite materials (M1 and M2, which are 3D printed, and M3, which is milled). Materials and Methods: SEM analysis was performed on the dental materials, and cells kept in contact for 24 h were subjected to tests including the following: MTT, LDH, NO, immunological detection of proteins involved in autophagy and apoptosis, as well as immunofluorescence tests (Annexin V and nucleus; mitochondria and caspase 3/7; detection of autophagosomes). Results: The results showed statistically significant decreases in cell viability with M1 and M2, linked to increases in cytotoxicity and oxidative stress (LDH and NO). Using multiplex techniques, significant increases in glycogen synthase kinase 3 beta (GSK3b) protein were observed in both M1 and M2; a decrease in mTOR (mechanistic target of rapamycin) expression was noted in M1 and M3. Immunofluorescence tests revealed an increase in Annexin V across all materials studied, and an increase in autophagosomes in M1 and M2, whereas a decrease was observed in M3. Conclusions: The relationship between apoptosis and autophagy is highly complex, indicating they may occur sequentially, coexist, or be mutually exclusive. Understanding this complex interplay can help in designing new 3D-printing protocols and monomer compositions to prevent autophagy imbalance. Full article

Background/Objectives: Complete denture rehabilitation in edentulous patients presents functional and biomechanical challenges. Mini-implant-supported overdentures improve retention, stability, function, and comfort, particularly in complex class II or class III mandibulo-maxillary relationships. However, mechanical complications such as ball abutment wear may compromise long-term success. This case report aims to describe the clinical context, methods employed to manage ball abutment wear, and related complications in a patient with a mandibular mini-implant overdenture. Methods: This retrospective case report presents two approaches to managing abutment wear and enhancing overdenture retention: silicone matrices (Retention.Sil, Bredent Medical GmbH & Co.KG, Senden, Germany) and abutment reconstruction using prefabricated cemented spheres (Concave Reconstructive Sphere, Rhein83, Bologna, Italy). Results: A significant mechanical complication associated with mini-implant overdentures is the wear of ball abutments, which may develop over time as a result of continuous interaction between the O-ring system and the abutment surfaces. Both techniques effectively preserved mini-implants while enhancing denture retention, function, and comfort. Conclusions: Mechanical complications, such as ball abutment wear, may compromise the retention and functional performance of mandibular overdentures. Alternatives like silicone matrices and reconstructive spheres address abutment wear in mandibular overdentures, ensuring long-term retention and sustainable, patient-centered care for the elderly. Full article

Background/Objectives: Pathological tooth loss resulting from poor oral hygiene or systemic diseases can lead to partial edentulism, affecting patients both psychologically and physically. These consequences include facial height reduction, temporomandibular dysfunction, and impaired phonetics and mastication. Immediate complete dentures are often an effective provisional solution during the transition to full edentulism; however, establishing the occlusal plane can be challenging when remaining teeth prevent a conventional wax try-in. This clinical case aims to present a qualitative clinical case study of a single patient, illustrating the use of the Broadrick Occlusal Plane Analyzer (BOPA) for the establishment of an occlusal plane in harmony with the anterior and condylar guidance. Methods: A 51-year-old male patient presented to the Department of Prosthodontics at the School of Dentistry, Autonomous University of Guadalajara, with partial edentulism, periodontal disease, and generalized Grade III tooth mobility. Immediate maxillary and mandibular complete dentures were selected as the treatment of choice. Due to the presence of remaining teeth that hindered clinical determination of the occlusal plane, the BOPA was used during the denture design process. Results: Anatomical landmarks were combined with BOPA tracing to establish an occlusal plane harmonious with anterior and condylar guidance. The center of the curve was modified to accommodate anatomic variability in anteroposterior reference points. Conclusions: The use of the Broadrick Occlusal Plane Analyzer facilitated the accurate determination of the occlusal plane for the fabrication of immediate complete dentures in a patient where clinical assessment was limited. This modification allowed the establishment of a bilateral balanced occlusal scheme, contributing to functional and acceptable provisional oral rehabilitation during postoperative alveolar healing. Full article

Objectives: This in vitro study assessed the accuracy (trueness and precision) of different 3D-printed resin denture bases with 0°, 45°, and 90° printing orientations. Methods: Denture base was designed and fabricated using three 3D-printed denture base resins (DentaBASE, Denture 3D+, and FormLabs). Each resin was printed with its own printer and fabricated with different printing orientations, resulting in a total of 72 specimens (n = 8). Trueness and precision were evaluated before and after thermal aging using the superimposition method with best-fit alignment. The data were collected and analyzed using two-way ANOVA followed by post hoc Tukey’s test (α = 0.05). Results: The printing orientation significantly affected the trueness of 3D-printed resins (p < 0.001). The highest trueness was observed for NextDent at 0° printing orientation, while the lowest value was observed for ASIGA at 0° and 45° printing orientations. The precision of the denture base was significantly affected by different printing orientations for ASIGA (p = 0.006) and NextDent (p < 0.001) before thermal cycling, while the precision of FormLabs was significantly affected (p = 0.017) after thermal cycling. The highest precision was recorded for FormLabs at 45° printing orientation, while the lowest precision was observed for NextDent at 45° and 90° printing orientations. Moreover, the effect of thermal cycling on trueness was only significant for ASIGA at 0° printing orientation; however, the effect of thermal cycling on precision was significant for NextDent at 0° and 90° printing orientations. A 45° printing orientation provided the most accurate clinical fit. Conclusions: ASIGA showed the lowest trueness, while FormLabs exhibited the lowest precision, revealing performance differences between printers. Full article

Natural compound-based strategies have gained attention as alternatives to conventional antifungal therapies, particularly in the management of Candida infections affecting the oral cavity, such as denture stomatitis. Our aim was to investigate the antifungal activity of the polyphenol pterostilbene (PTE) on clinical Candida isolates and microcosm biofilms from denture stomatitis, as well as to evaluate its toxicity and therapeutic efficacy in Galleria mellonella. PTE exhibited fungicidal effects against Candida albicans and Candida dubliniensis at 32 µg/mL. Time-kill assays demonstrated complete inhibition of viability for both strains within 8 h of exposure. In addition, PTE exhibited broad-spectrum antimicrobial activity, significantly reducing the counts of streptococci, mutans streptococci, staphylococci, and yeasts within microcosm biofilms. In vivo, PTE showed no signs of toxicity in G. mellonella at concentrations up to 20× MIC. Prophylactic treatment with PTE enhanced larval survival in experimental candidiasis caused by both C. albicans and C. dubliniensis. Moreover, prophylactic treatment decreased the fungal burden of C. albicans in the G. mellonella hemolymph, while the recruitment of hemocytes involved in host defense mechanisms remained unaltered. In summary, PTE demonstrated antimicrobial activity against Candida planktonic cells and complex biofilms associated with denture stomatitis, exhibiting favorable biocompatibility and in vivo antifungal efficacy in G. mellonella model. Full article

Background/Objective. The objective of this study is to test the hypothesis that there is no significant difference between intraoral scanners and in-lab scanners. An additional objective is to test the hypothesis that there is no significant difference between the accuracy of two types of polyvinyl siloxane PVS impression materials and between PVS impression materials and intraoral scanners. Material and Methods. Fourteen subjects received a set of maxillary and mandibular removable complete dentures [RCD]. Impressions of each RCD were obtained using two PVS impression materials (heavy [H] or medium [M] body with light [L] body). Each RCD was then scanned utilizing two intraoral scanners, Trios [TR] and Omnicam [OM]. The PVS impressions were sent to the lab to be further scanned by an in-lab scanner. STL files of the intraoral and in-lab scans were obtained and trimmed using the GeoMagic X Software. The files were merged [TR vs. OM] and [TR vs. in Lab], [HL vs. ML], [HL vs. TR] and [ML vs. TR] and the gap was measured in sixty points for each merged file. Results. There was no significant difference between [TR vs. OM] with a mean of 44 ± 10 μm. There was a statistically significant difference between [TR vs. In lab] with a mean of 62 ± 21 μm and [ML vs. TR] and [HL vs. ML] with means of 66 ± 24 μm and 50 ± 21 μm, respectively. There was no significant difference between [HL vs. TR] with a mean of 37 ± 10 μm. Conclusions. Intraoral scanners provide a similar quality of scans. The lab scanner depends on the impression materials used. The first null hypothesis was rejected. Using a heavy and light body PVS impression material provides more accurate and dimensionally stable impressions, particularly in full-arch applications, and is comparable to intraoral scanners. The second null hypothesis was rejected, there were significant differences between the PVS groups. These findings guide clinicians in selecting impression methods for complete dentures. Full article