CLINICAL EVALUATION OF COMPLETE DENTURES FABRICATED BY AN ADVANCED DIGITAL TECHNIQUE USING HEAT-CURED ACRYLIC RESIN
Keywords:
complete denturesAbstract
The aim of this study was to clinically evaluate the effectiveness of complete dentures fabricated by an advanced digital workflow using heat-cured acrylic resin and a Kravets verticulator, in comparison with dentures produced by a conventional technique based on cold-cured acrylic resin. Patients in the test and control clinical groups received complete dentures fabricated according to a CAD/CAM protocol with virtual design in Exocad, followed by three-dimensional assessment of dimensional accuracy between final dentures and their virtual prototypes. Clinical examinations included evaluation of temporomandibular joint (TMJ) function, masticatory muscles, denture retention and stability, as well as denture hygiene. Oral-health-related quality of life was assessed using the OHIP-14 questionnaire before treatment and during denture use. Throughout the 12-month follow-up, patients in both groups showed normal mouth opening without deviation or deflection and no clinical signs of TMJ disorders. In the test group, the mean occlusal discrepancy between final dentures and prototypes was minimal (approximately 30±4 µm in the maxilla and 29±4 µm in the mandible), whereas in the control group discrepancies exceeded 230 µm, which was associated with a higher frequency of discomfort complaints and the need for relining. Denture hygiene, assessed using the Jeganathan index, revealed a greater accumulation of deposits in the control group. Total OHIP-14 scores significantly decreased after treatment in both groups, but the clinical effect was more pronounced in the test group (∆OHIP-14 = 3.74 versus 2.65). These findings indicate high clinical effectiveness of the advanced digital technique for complete denture fabrication and its advantages in terms of prosthesis accuracy, retention, hygiene, and patient-reported quality of life.
References
1. Goodacre C.J., Garbacea A., Naylor W.P., Daher T., Marchack B.W. Clinical outcomes with digital complete dentures // Journal of Prosthetic Dentistry. – 2016. – Vol. 115(6). – P. 704–711.
2. Infante L., Yilmaz B., McGlumphy E., Finger I. Fabricating complete dentures with CAD/CAM technology // Journal of Prosthetic Dentistry. – 2018. – Vol. 119(6). – P. 826–832.
3. AlHelal A., AlRumaih H., Kattadiyil M. Clinical evaluation of CAD/CAM milled complete dentures // Journal of Dentistry. – 2016. – Vol. 53. – P. 29–36.
4. Kattadiyil M.T., Goodacre C.J. CAD/CAM complete dentures: a review of technique and patient outcomes // Journal of Prosthodontics. – 2019. – Vol. 28(2). – P. 161–167.
5. Kattadiyil M.T., AlHelal A. An update on digital complete dentures // Journal of Prosthodontics. – 2017. – Vol. 26(2). – P. 94–103.
6. Ishida Y., Muroi M., Murakami N. Accuracy and clinical fit of CAD/CAM dentures // Dental Materials Journal. – 2019. – Vol. 38(2). – P. 235–243.
7. Miyazaki T., Hotta Y. CAD/CAM systems available for dentistry // International Journal of Computerized Dentistry. – 2017. – Vol. 20(1). – P. 31–46.
8. Bidra A.S., Taylor T.D., Agar J.R. Computer-aided technology for complete dentures: systematic review // Journal of Prosthetic Dentistry. – 2019. – Vol. 121(4). – P. 637–643.
9. Garrett N.R., Shen C. Clinical performance of monolithic digital complete dentures // Journal of Prosthodontics. – 2020. – Vol. 29(7). – P. 611–617.
10. Taubmann A., Krebber M., Kordass B. Digital vs conventional dentures: randomized controlled trial // Clinical Oral Investigations. – 2022. – Vol. 26(3). – P. 2439–2448.
11. Amin F., Abdelnabi M., Aly N. Effect of polymerization method on denture base accuracy // Journal of Prosthodontics. – 2020. – Vol. 29(1). – P. 71–78.
12. Ayman A., El-Deeb H. Dimensional stability of denture base resins // Journal of Advanced Prosthodontics. – 2019. – Vol. 11(3). – P. 145–152.
13. Liu Y., Liang X., Xu L. Thermal deformation of PMMA denture bases // Dental Materials. – 2021. – Vol. 37(5). – P. 855–863.
14. Abdulrazzaq A., Bencharit S. Fit accuracy of heat-polymerized vs autopolymerized PMMA bases // Journal of Dental Materials. – 2017. – Vol. 33(3). – P. 302–309.
15. Shams A., Abdelnabi M. Comparison of CAD/CAM PMMA and conventional PMMA bases // Clinical and Experimental Dental Research. – 2022. – Vol. 8(1). – P. 112–119.
16. Negreiros W.A., Consani R.L. Dimensional stability of acrylic resins after processing // Journal of Applied Oral Science. – 2020. – Vol. 28. – Article e20190407.
17. Al-Dwairi Z.N., Tahboub K.Y. Polymerization method and denture base fit // Journal of Prosthodontic Research. – 2021. – Vol. 65(3). – P. 314–321.
18. Jeganathan S., Lin C. Denture plaque and hygiene index: review and update // Gerodontology. – 2019. – Vol. 36(2). – P. 89–98.
19. Coco B., Bagg J., Cross J. Microbial biofilm formation on denture acrylic surfaces // Journal of Dentistry. – 2020. – Vol. 96. – Article 103329.
20. Cruz P.C., Andrade I., de Souza R. Biofilm formation on acrylic dentures: clinical evaluation // Journal of Prosthetic Dentistry. – 2018. – Vol. 120(1). – P. 55–63.
21. Kang S.H., Kim H.E., Lee K.S. Factors associated with denture plaque levels in elderly // Gerodontology. – 2019. – Vol. 36(3). – P. 242–250.
22. Pinto L.R., Machado A.L., Vergani C.E. Surface roughness and biofilm adhesion // Journal of Materials Science: Materials in Medicine. – 2021. – Vol. 32(5). – P. 1–9.
23. Gendreau L., Loewy Z. Microbial colonization and denture stomatitis // Journal of Prosthodontics. – 2017. – Vol. 26(2). – P. 113–120.
24. Dhir S., Kumar M. Denture hygiene practices among edentulous patients // Gerodontology. – 2020. – Vol. 37(4). – P. 345–352.
25. Slade G.D. Oral Health Impact Profile: update on validation and use // Community Dentistry and Oral Epidemiology. – 2018. – Vol. 46(1). – P. 90–98.
26. Montero J., Castillo J.L., Albaladejo A. OHIP-14 in edentulous patients: assessment of prosthetic rehabilitation // Journal of Dentistry. – 2016. – Vol. 54. – P. 48–55.
27. Rocha E.P., Henriques C., Barros V. OHIP-14 outcome after denture treatment // Gerodontology. – 2020. – Vol. 37(1). – P. 30–38.
28. Suryakumari G., Reddy P. Impact of conventional vs digital dentures on quality of life // Journal of Prosthodontics. – 2019. – Vol. 28(6). – P. 712–719.
29. Durga K., Kumar V. Quality of life after complete denture therapy // Clinical Epidemiology and Global Health. – 2021. – Vol. 9. – P. 198–203.
30. Sampaio M., Oliveira R., Leles C. Quality-of-life outcomes in prosthetic rehabilitation // International Journal of Prosthodontics. – 2020. – Vol. 33(5). – P. 527–534.
31. Okeson J.P. Management of Temporomandibular Disorders. – St. Louis: Elsevier, 2019. – 528 p.
32. Manfredini D., Guarda-Nardini L., Winocur E. Epidemiology of TMDs // Journal of Oral Rehabilitation. – 2018. – Vol. 45(4). – P. 333–339.
33. Ergun G., Tuncer S. TMJ function in complete denture wearers // Journal of Prosthodontics. – 2021. – Vol. 30(5). – P. 395–402.
34. Herpich C.M., Vieira A.R., Custodio W. Mandibular movement patterns in denture patients // Journal of Prosthetic Dentistry. – 2018. – Vol. 119(5). – P. 676–684.
35. Lemos C.A.A., de Souza Batista V.E. TMJ evaluation in edentulous patients // Clinical Oral Investigations. – 2020. – Vol. 24(6). – P. 2123–2131.
