Biomechanical factors related to occlusal load transfer in removable complete dentures

Abstract

Owing to economic conditions, removable dentures remain popular despite the discomfort and reduced chewing efficiency experienced by most denture wearers. However, there is little evidence to confirm that the level of mucosal load exceeds the pressure pain threshold. This discrepancy stimulated us to review the current state of knowledge on the biomechanics of mastication with complete removable dentures. The loading beneath dentures was analyzed in the context of denture foundation characteristics, salivary lubrication, occlusal forces, and the biomechanics of mastication. The analysis revealed that the interpretation of data collected in vivo is hindered due to the simultaneous overlapping effects of many variables. In turn, problems with determining the pressure beneath a denture and analyzing frictional processes constitute principal limitations of in vitro model studies. Predefined conditions of finite element method simulations should include the effects of oblique mastication forces, simultaneous detachment and sliding of the denture on its foundation, and the stabilizing role of balancing contacts. This review establishes that previous investigations may have failed because of their unsubstantiated assumption that, in a well-working balanced occlusion, force is only exerted perpendicular to the occlusal plane, allowing the denture to sit firmly on its foundation. Recent improvements in the simulation of realistic biomechanical denture behavior raise the possibility of assessing the effects of denture design on the pressures and slides beneath the denture.

Full Contoured Tooth-Implant Supported 3-Pointic All-Ceramic Denture During Occlusal Load Transfer in Lateral Region

“…oblique direction of occlusal loads has a significant impact on stresses when comparing to directional bone tissue elasticity. The assumption of vertical occlusal forces is the reason of underestimation of the stresses [15][16][17]. The values of the forces sufficient for fragmentation of foods are within the range of 65 -165 N [15].…”

“…The assumption of vertical occlusal forces is the reason of underestimation of the stresses [15][16][17]. The values of the forces sufficient for fragmentation of foods are within the range of 65 -165 N [15]. In the presented analysis that higher values of mastication load and maximal occlusal force and their oblique acting were assumed to simulate the most unfavorable scenario.…”

“…Each implant system is specific in regards to rigidity [14], as it has stiffness related to the implant abutment and the screw. Finite element analysis whose efficiency in denture biomechanics is widely presented provide detailed data of the load transfer [15]. In twodimensional study [4] the horizontal stiffness of an implant and a bridge is not taken into consideration.…”

Patient satisfaction with occlusal scheme of conventional complete dentures: A randomised clinical trial (part I)

“…[1][2][3][4][5] The occlusal scheme can affect denture retention, stability, occlusal force distribution, aesthetics, masticatory function, patient comfort and general patient satisfaction with dentures. [6][7][8] Review of the literature yielded 5 systematic reviews comparing different occlusal schemes in CCDs, but an account of lacking enough…”

Relevance of Tongue Force on Mandibular Denture Stabilization during Mastication

“…Development in this area seems to be limited to the static concepts of denture stability and bilateral balanced occlusion (BBO). Stability, defined in prosthodontics as resistance to movement on the foundation, including tilting and rotating movements, is weakly correlated with chewing efficiency . BBO can be achieved not only with bilateral pressing at the denture flanges, but also in a more dynamic manner than has been assumed on the basis of clinical investigations .…”