School of Dentistry, Cardiff University, Cardiff, CF14 4XY, UK.
School of Dentistry, Cardiff University, Cardiff, CF14 4XY, UK.
J Dent. 2017 Jul;62:64-71. doi: 10.1016/j.jdent.2017.05.008. Epub 2017 May 17.
Existing in vitro methods for testing denture adhesives do not fully replicate the complex oral geometries and environment; and in vivo methods are qualitative, prone to bias and not easily reproducible. The purpose of this study was to develop a novel, quantitative and more accurate model to test the effect of adhesives on the retentive force of mandibular free end saddle partial dentures.
An in vitro model was developed based on an anatomically accurate cast of a clinical case. Experimentally, the amount of adhesive was varied (0.2g-1g) and the tensile force required for displacement was measured. Different commercially available adhesives were then tested at the optimum volume using the in vitro model. A 3D finite element model of the denture was used to assess how the forces to induce denture displacement varied according to the position of the force along the saddle length.
The mass of adhesive was found to significantly alter retention forces, with 0.4-0.7g being the optimum range for this particular scenario. Use of adhesives significantly improved mandibular free end saddle partial denture retention with the worst performing adhesive increasing retention nine-fold whilst the best performing adhesive increased retention twenty three-fold. The finite element model revealed that 77% more force was required to displace the denture by positioning forces towards the mesial end of the saddle compared to the distal end.
An in vitro denture adhesive model was developed, which demonstrated that mass of adhesive plays a significant role in enhancing denture retention and supported the design principle of placing as few teeth as clinically necessary on the distal end of the free end saddles.
Limiting the position of teeth on free end saddles to the mesial and mid portion of the saddle will reduce displacements caused by mastication. The movement of mandibular free end saddle partial dentures can be restricted with the use of denture adhesives. Altering the mass of adhesive used can further improve the retention of mandibular free end saddle partial dentures for patients.
现有的测试义齿黏附剂的体外方法不能完全复制复杂的口腔几何形状和环境;而体内方法是定性的,容易产生偏差,且不易重现。本研究旨在开发一种新颖的、定量的和更准确的模型来测试黏附剂对下颌游离端鞍式局部义齿固位力的影响。
根据临床病例的解剖学精确模型开发了一种体外模型。实验中,改变黏附剂的用量(0.2g-1g),并测量位移所需的拉伸力。然后,在体外模型中测试了不同商业可得的黏附剂在最佳体积下的情况。使用三维有限元模型评估了沿鞍长度施加力的位置如何根据产生义齿位移的力而变化。
黏附剂的质量显著改变了固位力,对于这种特定情况,0.4-0.7g 的范围是最佳的。使用黏附剂显著提高了下颌游离端鞍式局部义齿的固位力,表现最差的黏附剂将固位力提高了九倍,而表现最好的黏附剂则将固位力提高了二十三倍。有限元模型显示,将力定位在鞍的近端而不是远端,需要增加 77%的力才能使义齿移位。
开发了一种体外义齿黏附剂模型,该模型表明黏附剂的质量在增强义齿固位力方面起着重要作用,并支持了将尽可能少的牙齿放置在游离端鞍的近端和中部的设计原则。
将游离端鞍上的牙齿位置限制在鞍的近端和中部,可以减少咀嚼引起的位移。使用义齿黏附剂可以限制下颌游离端鞍式局部义齿的运动。改变使用的黏附剂质量可以进一步提高下颌游离端鞍式局部义齿患者的固位力。