Retention of complete maxillary dentures related to soft tissue function

Abstract

The influence of free tongue, lip, and cheek function on the retention of complete maxillary dentures was investigated for five experienced denture wearers. Test dentures were designed with full palatal coverage and functionally determined filling in of the vestibular sulcus. The front teeth were arranged primarily to meet cosmetic demands--that is, anterior to the top of the residual alveolar ridge. Retention was measured as resistance to dislodgement-provoking loads applied vertically to the incisive edge of the central incisors, using a miniature bite force recorder. All the participants were able to load their front teeth with 35 N or more without loss of retention. None of them experienced denture dislodgement provided the tongue, lips, and cheeks wee allowed to act freely. If the peripheral soft tissues were separated from the vestibular denture flange, no obvious effect on denture retention could be detected. Physically preventing the tongue from pressing against the posterior part of the denture reduced the retention significantly. Measurements of anterior loads tolerated after stepwise reductions of the denture extension indicated that the tongue acted primarily by pressure against the tuber regions. Tongue pressure against the central parts of the palate and lip or cheek pressure against the vestibular flange seemed to be of less importance.

Resting tongue position and its relation to the state of the dentition: a pilot study

“…The development of reflexes, as the tongue is functioning, helps complete denture wearers to stabilize their dentures. A good example is the stabilizing role that the tongue plays during swallowing, as it presses the posterior part of the upper denture in place ( Orstavik & Floystrand, 1984; Rahn & Heartwell, 1993). Where the denture is ill‐fitting, badly constructed, or occluding with natural anteriors ( Zarb et al ., 1990 ), the tongue is called to compensate the lack of stability; this may result in modified function, development of habits, or alteration of reflexes ( Kessler, 1955; Renner, 1981).…”

Impact of palatal coverage for maxillary implant assisted overdenture on respiratory performance. Spirometric evaluation.

“…To obtain a good result with a conventional maxillary implant assisted overdenture, it is better to be extended to cover the palatal area together with good adaptation and good peripheral seal at the borders (13) . It was found that retention of the denture was affected by covering the maxillary tuberosity more than covering the palatal area (14) . Reduction of the palatal part of maxillary implant assisted overdenture might not affect the retention or stability of the overdenture but provide several benefits for the patient as, decrease gaging reflex, improve taste sensation, better phonetic, and positive effect on rate of salivary flow (15) .…”

Within‐Subject Comparison of Maxillary Implant‐Supported Overdentures with and without Palatal Coverage

“…In order to achieve a satisfying result with a conventional maxillary overdenture, the overdenture design relies on good support and anatomy of the hard palate, together with good adaptation and vestibular seal at the borders . It has been demonstrated that the tuberosity coverage by the denture is more important for retention than the coverage of the palate . Reduction of the palatal coverage offers several benefits for the patients, including an enhanced taste sensation, better control of the gag reflex, a positive effect on salivary flow rate, and even phonetic benefits .…”

“…[12][13][14] It has been demonstrated that the tuberosity coverage by the denture is more important for retention than the coverage of the palate. 15 Reduction of the palatal coverage offers several benefits for the patients, including an enhanced taste sensation, better control of the gag reflex, a positive effect on salivary flow rate, and even phonetic benefits. 14,[16][17][18][19] However, reduction of the palatal coverage might negatively influence the overdenture retention.…”