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Table of Contents   
ORIGINAL RESEARCH  
Year : 2010  |  Volume : 21  |  Issue : 4  |  Page : 496-499
Comparison of manual and physiologically molded denture bases in complete denture wearers


1 Department of Prosthodontics, K.L.E. Institute of Dental Sciences, Bangalore, Karnataka, India
2 Department of Prosthodontics, Rama Dental College-Hospital & Research Centre, Kanpur - 208 024, Uttar Pradesh, India

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Date of Submission08-Jan-2010
Date of Decision10-Mar-2010
Date of Acceptance02-Sep-2010
Date of Web Publication24-Dec-2010
 

   Abstract 

Background and Objectives: In complete denture wearers, the accumulation of food in the buccal vestibule is one of the factors causing discomfort to the patient. This study was conducted to evaluate the effect of mandibular denture buccal flange on food retention and to correlate between varying angulations of buccal flange of mandibular denture on food retention.
Materials and Methods: Complete dentures were fabricated and the mandibular complete denture was duplicated. The existing (unduplicated) manually molded and physiologically molded dentures were tested for food retention. Twenty test particles having a diameter of 2±0.2 mm were placed on the middle part of the buccal flange and the subjects were instructed to expel the test particles by performing only functional movements of the buccal musculature. The numbers of residual test particles in the buccal vestibule were counted after 30s. The angulations of the denture buccal flange (duplicated) were measured with an optical bevel protractor and trimmed to 50° and the food retention test was performed. Similar tests were performed at 60°, 70° and 80° angulations. The data were evaluated using the Pearson correlation coefficient, One-way ANOVA test and Wilcoxon signed rank test.
Results: The difference between the residual scores of manually molded and physiologically molded denture base was not significant. The difference between the residual scores at different angulations of the buccal flange of the denture was significant.
Conclusion: Only the slope of the flange significantly affects the ability of subjects to expel the test particles.

Keywords: Buccal flange, complete denture, food accumulation

How to cite this article:
Reddy LP, Sangur R. Comparison of manual and physiologically molded denture bases in complete denture wearers. Indian J Dent Res 2010;21:496-9

How to cite this URL:
Reddy LP, Sangur R. Comparison of manual and physiologically molded denture bases in complete denture wearers. Indian J Dent Res [serial online] 2010 [cited 2020 Aug 11];21:496-9. Available from: http://www.ijdr.in/text.asp?2010/21/4/496/74216
In complete denture wearers, the accumulation of food in the buccal vestibule can inhibit mastication and is one of the factors causing discomfort to the patient.

The design of the buccal flange of a denture has an effect on patient comfort. During mastication, food particles should be moved out of the buccal vestibule before swallowing, and the ability to expel these particles has an important effect on food debris accumulation in the buccal vestibule. According to Shogo Minagi, there is a significant relationship between thickness, physiologic moulding and slope of the polished surface of the buccal flange and the ability to expel food particles from the mandibular buccal vestibule. [1]

Although the tissue side of the denture base is created in the impression, contouring the wax develops the polished surfaces. The polished surfaces will be in contact with oral tissues almost as intimately as the tissue side. Therefore, tissue tolerance, comfort, stability and retention of the denture are greatly affected by the polished surface. [2]

The shape or form of the polished surface is usually overlooked. The two end factors in determining inclination of the polished surface are the width of the border and the buccolingual position of the teeth. The middle factor is the fullness given to the wax to obtain convexity or concavity. [3]

According to Chikashiro Okkubo, the weight of the well-fitting mandibular complete denture does not affect jaw movements, denture stability or patient preference. Masticatory movements and denture retention were not significantly affected by increasing the weight of the mandibular denture. [4]

This study was conducted to determine the effect of the mandibular buccal denture base surface on food retention in complete denture wearers.


   Materials and Methods Top


The present in vivo study was carried out on 10 complete denture patients aged between 35 and 78 years. Among them were four female and six male patients. Patients who were selected randomly from the outpatient department were first-time denture wearers and residents of Davangere district, Karnataka state, India. The study was performed with the informed consent of the patient. Clearance from the local ethical committee was obtained prior to the study.The method followed in this study has been discussed under the following headings:

  • Duplication of mandibular complete denture.
  • Test for food retention in manually molded and physiologically molded denture bases.
  • Modification of buccal flange angulations and food retention test.


Duplication of lower complete denture

A new set of complete dentures was fabricated for edentulous patients using the conventional technique. A complete denture duplication technique was used as described by Wargner. [5],[6]

Test for food retention in manually molded and physiologically molded denture bases

The food retention test was performed in the existing complete denture (unduplicated) and then it was modified by physiologically molding the buccal flange. The physiologic denture bases were prepared by using a modeling compound. The modeling compound was softened and placed on the buccal flange of the mandibular denture. The patient was asked to perform all physiological movements before it get set or hardens [Figure 1].
Figure 1: Physiologically molded denture base by using the modeling compound

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The food retention test was carried out as follows. The complete maxillary and mandibular dentures were placed in the mouth and, with the help of a spoon, 20 sugar test particles having a diameter of 2±0.2mm were kept on the middle part of the buccal flange of the lower denture. Then, the subjects were instructed to expel the test particles by performing only functional movements of the buccal musculature without using their tongue. After a period of 30s, the number of residual particles in the buccal vestibule was counted. This test was performed in a similar manner three times and the residual scores were recorded.

Modification of buccal flange angulations and food retention test

The angulation of the buccal flange in a duplicated denture was measured with the help of an optical bevel protractor [Figure 2]. The buccal flange was molded manually by adding a self-cure acrylic resin/trimming of flanges to 50°, and the food retention test was carried out as described above. The buccal flange, which was molded to 50°, was trimmed to 60°, 70° and 80° and a similar test for food retention was performed for each slope and the residual scores were noted.
Figure 2: Measuring the angulations of buccal flange by using the optical bevel protractor

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   Results Top


Statistical analysis

  • Continuous data are expressed as mean ± SD.
  • The Pearson correlation coefficient was used in the statistical analysis of dependency between the residual score and the buccal slope angle of the flange of the denture.
  • One-way ANOVA test was used for multiple group comparison followed by Wilcoxon's signed rank test for the group-wise comparison.
  • A P-value <0.05 was considered statistically significant.


The difference between the mean residual scores of complete denture wearers with manually and physiologically molded denture flange revealed no significant effect on residual scores by the physiologically molded denture bases when compared with the manually molded denture bases [Figure 3] and [Table 1]. As the P-value in this table is not significant (P>0.05), the difference between the residual scores of manually molded and physiologically molded denture base is not significant.
Table 1: Residual scores in manually and physiologically molded denture bases

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Figure 3: Residual scores in physiologically and manually molded denture bases

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The difference between the mean residual scores of complete denture wearers with varying angulations of buccal flange of the mandibular denture reveals the influence of the slope of the buccal flange on the ability to expel the test particles [Figure 4] and [Table 2]. The mean residual scores tended to change depending on the angle of the buccal slope with the occlusal plane. As the angulations of the buccal flange change, the residual score also changes.
Table 2: Comparative statistics of residual scores at various angles of the buccal slope

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Figure 4: Effect of angle of buccal slope on the mean residual score

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   Discussion Top


The evaluation of complete denture prosthesis has proven difficult because of many problems in the evaluation methodology. Functional evaluation methods such as masticatory efficiency tests and food retention tests and morphological evaluation methods such as tests for the adaptation of the denture to the supporting tissue have been used.

In case of complete denture wearers, the food lodgment is the major problem, which leads to discomfort of the patient. In the mastication process, food particles should be moved out of the buccal vestibule before swallowing, and the ability to expel these particles has an important effect on food debris accumulation in the buccal vestibule. [1]

According to various studies, there is a significant relationship between thickness, physiological moulding and slope of the polished surface of the buccal flange and ability to expel food particles from the mandibular buccal vestibule. [1]

Shogo Minagi used partially edentulous patients in his study to evaluate the effect of different aspects of the polished surface of the buccal flange on food retention in the buccal vestibule. He concluded that the thickness of the buccal flange did not have any significant effect on the ability of the subjects to expel test particles. But, the slope of the flange did significantly affect the ability of the subjects to expel the test particles. [1]

In the present study, the comparison between manually and physiologically molded denture bases and varying angulations of buccal flange of the mandibular denture on the effect of food retention in complete denture wearers was performed. The various angulations used in this study were 50°, 60°, 70° and 80°. The results of this study show the food retention at different angles, which were tested with sugar particles.

One of the aims behind the selection of conventional sugar particles as the test food in this study was to establish an easy clinical procedure by which to evaluate the shape of wax dentures in daily clinics in the future. The mean diameter of the particle after 30s of expelling function was 1.8±0.2 mm, indicating minimal dissolution during the evaluation period. Possibly, a very slight stickiness might be another desirable property of this test food. The test food was not so soluble as to cause sufficient stickiness to inhibit the expulsion function even after 30s.

There has not been enough investigation on the food retention of denture wearers at present and it is difficult to define which properties are suitable for test food, although other test foods might give different results. It is not necessary that the test material be an actual food. The unique properties of the sugar used here were that it was easy to count at chair side and that it was safe and edible.

The results of this in vivo study showed that there is no significant difference in residual scores of physiologically molded denture base and manually molded denture base. There were differences in residual scores at different angulations. According to the results of this study, the food retention at 60° angles is very less when compared to the 50°, 70° and 80° angles. There is comparatively less food retention at 70° than at 50° and 80°. The food retention is higher at 50° and 80°.

It shows that 60° is the ideal angulations of the buccal flange of lower denture for comfort of the patient and causes less food retention in the buccal vestibule. These results could be used as a guide for the fabrication of complete dentures. Further investigations with denture wearers to evaluate the phenomenon of food debris accumulation are still needed to correlate these results clinically.


   Conclusion Top


The following conclusions can be made from this study:

  • There is no effect of mandibular denture buccal flange on the food retention, which is molded physiologically and manually. The thickness of the buccal flange does not have a significant effect on the ability of the subjects to expel test particles. Physiologic moulding of the buccal flange did not show a significant affect on the ability of the subjects to expel a test particle.
  • The slope of the flange significantly affects the ability of subjects to expel a test particle. There appears to be a critical angle for this slope.


 
   References Top

1.Minagi S, Suenaga K, Sato T, Nishigawa G, Hara T. The effect of the mandibular buccal denture base surface on food retention. Int J Prosthodont 1992;5:457-62.  Back to cited text no. 1
    
2.Heartwell CM Jr, Rahn A O. Laboratory procedures. In, Heartwell CM (ed). Syllabus of complete denture. 4 th edition. Philidelphia, Lea and Febiger, 1986;375-89.  Back to cited text no. 2
    
3.Hickey JC, Zarb GA, Bolender CL. Appearance and functional harmony of denture bases. In, Darlene Warfer. Boucher's Prosthodontic treatment for edentulous patients, 9 th edition. St. Louis, The CV Mosby company, 1985; 558-73.  Back to cited text no. 3
    
4.Appearance and functional harmony of denture bases. In: Hickey JC, Zarb GA, Bolender CL, editors. Boucher's Prosthodontic Treatment for Edentulous Patients. 9 th ed. ST. Louis: The C.V. Mosby Company; 1985. p.458-73.  Back to cited text no. 4
    
5.Ohkubo C, Hosoi T. Effect of weight change of mandibular complete dentures on chewing and stability: A pilot study. J Prosthet Dent 1999;82:636-42.  Back to cited text no. 5
    
6.Wagner AG. A temporary replacement for an existing complete denture. J Prosthet Dent 1987;58:522-5.  Back to cited text no. 6
    

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Correspondence Address:
Lakshmipathy P Reddy
Department of Prosthodontics, K.L.E. Institute of Dental Sciences, Bangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.74216

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

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