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Statement of Problem: The introduction of digital techniques might improve the quality and cost-effectiveness of treatment with complete removable dental prostheses (CDs)., Purpose: The purpose of this pilot clinical trial was to study and compare the clinical feasibility, complications during fabrication, and quality of 2 types of digitally designed CDs., Material and Methods: Five participants were recruited into this preliminary clinical trial. For each participant, 2 pairs of digital CDs were designed. Prosthesis bases were fabricated by using identical data, either by milling from polymethyl methacrylate blanks or by injection molding. The treatment involved 4 clinical appointments. Polyvinyl siloxane impressions were made with custom trays and were subsequently digitalized. After evaluating esthetics and function with trial dentures, the CD bases were fabricated. To evaluate the workflow and quality of the prostheses, the clinical outcome was measured on 6-point scales ranging from poor (grade 6) to excellent (grade 1). For both prosthesis types, the following aspects were examined: fit, retention, esthetics, phonetics, maxillomandibular relation, and occlusion., Results: Both types of digital CDs could be fabricated without major complications. Only a few minor complications occurred during the fabrication process, predominantly esthetic issues. No pronounced difference was found between the prostheses concerning functional aspects. The definitive esthetic outcome was rated as very good., Conclusions: The CDs fabricated using digital technology met the clinical requirements. However, more research is needed to confirm the results of this investigation., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: When we examined a previously published prospective multi-center clinical trial in which complete denture-wearers were followed over a period of 2 years, we found that about 30% of the variability in the clinical wear data of denture teeth was due to unknown characteristics of the subjects. In the second part of the study, we try to identify which patient- and therapy-related factors may explain some of this variability., Methods: The clinical wear data of denture teeth at different recall times (6, 12, 18, 24 months) in 89 subjects (at baseline) were correlated with the following parameters, which may all have an influence on the wear of denture teeth: age, gender, bruxism as reported by the subjects, number of prostheses used so far, time since last extraction, smoking, fit of dentures as judged by the subject and the clinician, average denture wearing time and wearing of denture during the night. To evaluate the influence of the different patient- and therapy-related variables, both a univariate analysis (one extra factor to the model) and a multivariate analysis were carried out using linear mixed models with the variable Log mean as the outcome., Results: None of the patient- and therapy-related parameters showed a statistically significant effect on the wear of denture teeth. There was, however, a trend for women to show less wear compared to men and a trend of decreasing wear with increasing age., Significance: Further research is required to identify the factors which are responsible for the high variability observed between the subjects regarding clinical wear data., (Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: The purpose of this study was to compare the use of different variables to measure the clinical wear of two denture tooth materials in two analysis centers., Methods: Twelve edentulous patients were provided with full dentures. Two different denture tooth materials (experimental material and control) were placed randomly in accordance with the split-mouth design. For wear measurements, impressions were made after an adjustment phase of 1-2 weeks and after 6, 12, 18, and 24 months. The occlusal wear of the posterior denture teeth of 11 subjects was assessed in two study centers by use of plaster replicas and 3D laser-scanning methods. In both centers sequential scans of the occlusal surfaces were digitized and superimposed. Wear was described by use of four different variables. Statistical analysis was performed after log-transformation of the wear data by use of the Pearson and Lin correlation and by use of a mixed linear model., Results: Mean occlusal vertical wear of the denture teeth after 24 months was between 120μm and 212μm, depending on wear variable and material. For three of the four variables, wear of the experimental material was statistically significantly less than that of the control. Comparison of the two study centers, however, revealed correlation of the wear variables was only moderate whereas strong correlation was observed among the different wear variables evaluated by each center., Significance: Moderate correlation was observed for clinical wear measurements by optical 3D laser scanning in two different study centers. For the two denture tooth materials, wear measurements limited to the attrition zones led to the same qualitative assessment., (Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: The purpose of this study was to compare plaque adhesion, tissue reaction, and technical complications for complete dentures based on visible light-cured resin (VLCR) or on conventional poly(methyl methacrylate) (PMMA)., Materials and Methods: A stratified randomized cohort study was designed with 52 patients treated with a complete denture in the maxilla (n = 28), the mandible (n = 2), or both (n = 22). Seventy-four dentures were manufactured, 38 of PMMA and 36 of VLCR. Investigators and patients were unaware of the nature of the denture base material. Plaque adhesion, tissue reaction, and technical complications were investigated 4 weeks after denture insertion (baseline). Recall investigations were performed after 6, 12, and 24 months., Results: After 6, 12, and 24 months, plaque adhesion was significantly higher for VLCR dentures than for PMMA dentures. Tissue reaction was comparable for both groups, however. After 6, 12, and 24 months, need for repair was significantly greater for VLCR prostheses. The mean number of additional aftercare sessions per patient after 24 months was 50 % higher for VLCR than for PMMA., Conclusions: Good oral hygiene must be established by patients treated with VLCR dentures, to remove biofilm from these dentures. Increased aftercare must also be taken into account when this material is used., Clinical Relevance: VLCR might be a viable alternative to PMMA for patients with allergic reactions to residual monomer or benzoyl peroxide.

Objective: (1) To quantify wear of two different denture tooth materials in vivo with two study designs, (2) to relate tooth variables to vertical loss., Methods: Two different denture tooth materials had been used (experimental material=test; DCL=control). In study 1 (split-mouth, 6 test centers) 60 subjects received complete dentures, in study 2 (two-arm, 1 test center) 29 subjects. In study 1 the mandibular dentures were supported by implants in 33% of the subjects, in study 2 only in 3% of the subjects. Impressions of the dentures were taken and poured with improved stone at baseline and after 6, 12, 18 and 24 months. Each operator evaluated the wear subjectively. Wear analysis was carried out with a laser scanning device. Maximal vertical loss of the attrition zones was calculated for each tooth cusp and tooth. A mixed linear model was used to statistically analyse the logarithmically transformed wear data., Results: Due to drop-outs and unmatchable casts, only 47 subjects of study 1 and 14 of study 2 completed the 2-year recall. Overall, 75% of all teeth present could be analysed. There was no statistically difference in the overall wear between the test and control material for either study 1 or study 2. The relative increase in wear over time was similar in both study designs. However, a strong subject effect and center effect were observed. The fixed factors included in the model (time, tooth, center, etc.) accounted for 43% of the variability, whereas the random subject effect accounted for another 30% of the variability, leaving about 28% of unexplained variability. More wear was consistently recorded in the maxillary teeth compared to the mandibular teeth and in the first molar teeth compared to the premolar teeth and the second molars. Likewise, the supporting cusps showed more wear than the non-supporting cusps. The amount of wear did not depend on whether or not the lower dentures were supported by implants. The subjective wear was correct in about 67% of the cases if it is postulated that a wear difference of 100μm should be subjectively detectable., Significance: The clinical wear of denture teeth is highly variable with a strong patient effect. More wear can be expected in maxillary denture teeth compared to mandibular teeth, first molars compared to premolars and supported cusps compared to non-supported cusps. Laboratory data on the wear of denture tooth materials may not be confirmed in well-structured clinical trials probably due to the large inter-individual variability., (Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

The objectives of this study were to measure the occlusal wear of composite resin denture teeth in patients wearing a complete denture and to evaluate factors affecting wear. Fifty participants provided with complete dentures in at least one jaw were included. Gypsum casts were made from preliminary vinyl polysiloxane impressions 4 weeks after insertion, then after 6 (t(1)), 12 (t(2)), and 24 months (t(3)). Three-hundred and three posterior denture teeth were evaluated after 24 months. Wear was measured indirectly, from the casts, by means of a three-dimensional laser scanner device. Sequential images of the occlusal surfaces were digitized and superimposed (occlusal matching). Statistical analysis was performed by the use of mixed regression models, with the patient being a random effect. Mean wear (median, interquartile range; micrometer) of the entire occlusal surface was 8 (19) at t(1), 18 (34) at t(2), and 40 (61) at t(3). Maximum vertical loss (median, interquartile range; micrometer) was 92 (112) at t(1), 146 (148) at t(2), and 226 (184) at t(3). The dental status of the opposing jaw and the nature of the opposing material significantly affected the wear of denture teeth at t (3). Gender, daily wearing time, jaw, and type of tooth had no significant effects on the extent of wear. Clinically relevant vertical loss of composite resin denture teeth occurs after 24 months. Considering the limitations of this study, wear of denture teeth was affected by dental status and opposing material. The results suggest that wear of composite resin denture teeth exceeds that of enamel.

The objective was to evaluate the development of oral health-related quality of life (OHRQoL) in patients with complete dentures and the association between OHRQoL and patient satisfaction. Fifty-two patients (mean age, 66.3, 48.1% male) received dentures in at least one jaw. The analysis was conducted on participants with dentures in both jaws (CD-Both; n = 22) or in the upper jaw only (CD-Max; n = 28). Data were collected 4 weeks, 6 months, and 1 and 2 years after insertion. OHRQoL was measured by use of the OHIP-EDENT. Self-rated patient satisfaction was assessed on a scale of 0-10. To prove the hypothesis that patient satisfaction would be a meaningful predictor of OHRQoL, and not vice versa, multilevel analysis and cross-lagged correlation analysis were performed for both groups separately. OHRQoL improved from 22.9 (SD, 20.7) to 12.1 (SD, 14.5) for CD-Both and from 20.3 (SD, 17.2) to 14.7 (SD, 15.1) for CD-Max. Multilevel analysis revealed that patient satisfaction and OHRQoL were significantly associated (p < 0.0001) for both groups. Differences between the groups were found with regard to the effect of time after insertion and the interaction between time and satisfaction with OHRQoL which were significant only for the group CD-Both; however, no evidence was found for the causality of this association in the cross-lagged analysis for both groups (ZPF test, p > 0.016). Patient satisfaction and OHRQoL were associated for wearers of complete dentures. Within the limitations of the study, however, the causality that patient satisfaction predicts OHRQoL, and not vice versa, could not be proven.