The history of complete denture impression procedures has been influenced largely by the development of impression materials from which new techniques and ideas arose. The purpose of this study was to compare the retention of complete dentures made by using different impression techniques like conventional, admixed, all green, and functional techniques. The results showed that there was significant difference in retention between the six techniques where functional technique showed the highest mean value of retention followed by elastomeric, all green, and admixed, while cocktail and green stick compound showed the lowest mean value. However, on clinical examination, the retention produced by the six techniques was satisfactory.
Aim:
The aim of this work was to evaluate stress distribution on implants in All-on-Four situation with varying distal implant angulations (30°,40°,45°) and varying cantilever lengths (4 mm, 8 mm, 12 mm, 16 mm) in atrophic maxilla using finite element analysis.
Setting and Design:
A
in vitro
study, finite element analysis.
Materials and Methodology:
Three-dimensional finite element model of an edentulous maxilla restored with a prosthesis supported by four implants was reconstructed to carry out the analysis. Three different configurations, corresponding to 3 tilt degrees of the distal implants (30°, 40°, and 45°) were subjected to 4 loading simulations.
Statistical Analysis Used:
The results of the simulations obtained were evaluated in terms of Von Mises equivalent stress levels at the bone-implant interface.
Result:
From a stress-level viewpoint, the 45° model was revealed to be the most critical for peri-implant bone. In all the loading simulations, the maximum stress values were always found at the neck of the distal implants. With increasing distal implant tilt, cantilever length reduces depending on the quality of bone. At 30° angulation of distal implant a maximum cantilever length of 16 mm may be given if the quality of bone is D3 but only 8 mm cantilever may be recommended if bone quality is D4. At 40° angulation, 16 mm in D3 bone and 0 mm in D4 bone whereas at 45° angulation, it reduces to 12 mm in D3 bone and no cantilever is recommended with D4 bone.
Conclusion:
The 45° tilt induced higher stress values at the bone-implant interface, especially in the distal aspect, than the other 2 tilts analyzed. Stress values increased with increased cantilever length which was further influenced by the distal implant tilt and the quality of the bone.
Summary. Prosthetic rehabilitation of a completely edentulous patient is no more confined to replacement of missing teeth. Long span of edentulism and ageing leads to loss of support of the facial musculature, which is of great concern in treating completely edentulous patients. Flaccid facial musculature eventually leads to sunken cheeks and unesthetic appearance, causing a negative impact on psychological well-being of the patient. The use of conventional complete dentures can restore the loss to some extent, but in some cases, additional support is required. The present clinical report exemplifies the use of magnet-retained detachable maxillary cheek plumper prosthesis in a completely edentulous patient with sunken cheeks.
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