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Physical-chemical aspects of denture retention and stability: a review of the literature.

The physical-chemical mechanism of retention of dentures is a highly complex one. A review of the literature suggests in addition that retention also is a personal phenomenon under the control of numerous factors. Chief among the factors involved in the retention of a well-adapted denture are the forces related to the wetting of the denture and of the mucosal surfaces and the cohesive or intermolecular characteristics of the saliva. The ill-fitting denture most often results from an increase of variation in the denture-mucosa interspace, probably due to bone resorption rather than to any major changes in the physical-chemical factors.

Atmospheric Pressure

Physical Factors in Denture Retention.

AAThis investigation was carried out to analyze the physical factors of saliva affecting denture retention. A model of examining denture retention is given by two parallel disks separated by a liquid layer. Metal, polyisobutylene (PIB) and poly (methyl methacrylate)(PMMA) were used instead of a denture and mucous membrane; and glycerol, olive oil and castor oil instead of saliva. The experiments were performed with three disk conditions: (1) Both upper and lower disks of metal, (2) both upper and lower disks of PMMA, (3) upper disk with PIB lining and lower of PMMA soley. A strain gauge was used in the experimental apparatus in order to obtain a measurement of high accuracy. In the experiments, the retentive forces developed in layers of 50 mu tickness were measured and compared with the values calculated from theoretical equations. The results are summarized as follows: (1)Retentive force must be resolved into static adhesive and separating forces, (2) surface tension of liquid may not highly influence the retention, and (3) viscosity of liquid plays an important role when two disks are separated.

Adhesiveness

The role of saliva in retention of maxillary complete dentures.

In this study maxillary denture retention was influenced by the salivary volume between the denture base and the mucous membrane. An optimum intervening salivary volume, at which the greatest retention was developed, was also observed. It was observed from determination of electric resistance of palatal mucous membrane that inward and outward flow of intervening saliva was greater in the denture with poor retention than in the one with good retention. Moreover, when the salivary volume between the denture base and mucous membrane was optimum the salivary flow under the denture was minimum.

Adult

Preprosthetic vestibular sulcus extension by the operation of Edlan and Mejchar. A 2-year follow-up study-I.

Nineteen patients suffering from denture retention problems and/or pain on function due to atrophy of the mandibular alveolar ridge were operated on by the method of EDLAN & MEJCHAR. All patients felt an improvement of denture retention. Three out of seven still had pain on function after the operation. An average of 80% of the surgically created sulcus extension remained after 2 years.

Adolescent

A silicone rubber attachment for primary retention of partial dentures.

A technique for primary retention of removable partial dentures has been described. A soft-tissue-borne restoration provides an increase in primary retention without an increase in forces to the abutment teeth, and the restoration requires a minimal outlay of time and money.

Denture Design

[Extension implantations as an aid in defect-restoring prosthodontics].

Because of a lack of denture retention, great difficulties are often encountered in edentulous patients who require prosthetic treatment of defects in the maxillo-facial region. The use of enossal implants may enable temporary rehabilitation with regard to mastication and speech. The possible range of indication is considerably limited in cases of extensive defects of the alveolar process, advanced atrophy and by radiological therapy of malignant tumors. The duration of therapeutic success is contingent upon most accurate implantation techniques and prosthetic treatment as well as the patient's oral hygiene.

Aged

[Studies on the retention of total lower dentures in relation to the time of wearing].

Clinical experience in the prosthetical care of edentulous patients shows that primarily patients wearing dentures for the first time express the desire, after a few months, to have original denture adhesion restored. Especially for complete lower dentures diminishing adhesion is unfavorable. Measurements regarding the adhesive strength of complete lower dentures of 34 patients showed that adhesive strength is decreasing. This was measured and statistically evaluated in this investigation. 33 percent of the original adhesive strength is lost within 6 months. With originally strong adhesion (2, 000 p) this reduction is more drastic than with originally small adhesion (200 p). It was not possible to establish that adhesive strength is declining preferably as a result of a specific anatomic situation.

Denture Retention