496 Indian J Dent Res, 21(4), 2010

Address for correspondence:

Dr. Lakshmipathy P Reddy
E-mail: drlpreddy@gmail.com
Received : 08-01-10
Review completed : 10-03-10
Accepted : 02-09-10
ORIGINAL RESEARCH
Comparison of manual and physiologically molded denture
bases in complete denture wearers
Lakshmipathy P Reddy, Rajashekar Sangur
1
ABSTRACT
Background and Objectives: In complete denture wearers, the accumulation of food in the
buccal vestibule is one of the factors causing discomfort to the patient. This study was conducted
to evaluate the effect of mandibular denture buccal flange on food retention and to correlate
between varying angulations of buccal flange of mandibular denture on food retention.
Materials and Methods: Complete dentures were fabricated and the mandibular complete
denture was duplicated. The existing (unduplicated) manually molded and physiologically
molded dentures were tested for food retention. Twenty test particles having a diameter of
20.2 mm were placed on the middle part of the buccal flange and the subjects were instructed
to expel the test particles by performing only functional movements of the buccal musculature.
The numbers of residual test particles in the buccal vestibule were counted after 30s. The
angulations of the denture buccal flange (duplicated) were measured with an optical bevel
protractor and trimmed to 50 and the food retention test was performed. Similar tests were
performed at 60, 70 and 80 angulations. The data were evaluated using the Pearson correlation
coefficient, One-way ANOVA test and Wilcoxon signed rank test.
Results: The difference between the residual scores of manually molded and physiologically
molded denture base was not significant. The difference between the residual scores at different
angulations of the buccal flange of the denture was significant.
Conclusion: Only the slope of the flange significantly affects the ability of subjects to expel
the test particles.
Key words: Buccal flange, complete denture, food accumulation
Department of Prosthodontics,
K.L.E. Institute of Dental
Sciences, Bangalore,
Karnataka,
1
Rama Dental
College-Hospital & Research
Centre, Kanpur - 208 024,
Uttar Pradesh, India
relationship between thickness, physiologic moulding and
slope of the polished surface of the buccal fange and the
ability to expel food particles from the mandibular buccal
vestibule.
[1]
Although the tissue side of the denture base is created
in the impression, contouring the wax develops the
polished surfaces. The polished surfaces will be in
contact with oral tissues almost as intimately as the
tissue side. Therefore, tissue tolerance, comfort, stability
and retention of the denture are greatly affected by the
polished surface.
[2]
The shape or form of the polished surface is usually
overlooked. The two end factors in determining inclination
of the polished surface are the width of the border and
the buccolingual position of the teeth. The middle factor
is the fullness given to the wax to obtain convexity or
concavity.
[3]
According to Chikashiro Okkubo, the weight of the
well-ftting mandibular complete denture does not affect
In complete denture wearers, the accumulation of food in
the buccal vestibule can inhibit mastication and is one of
the factors causing discomfort to the patient.
The design of the buccal fange of a denture has an effect
on patient comfort. During mastication, food particles
should be moved out of the buccal vestibule before
swallowing, and the ability to expel these particles has an
important effect on food debris accumulation in the buccal
vestibule. According to Shogo Minagi, there is a signifcant
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DOI:
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Indian J Dent Res, 21(4), 2010 497
Comparison of manual and physiologically molded denture bases Reddy and Sangur
jaw movements, denture stability or patient preference.
Masticatory movements and denture retention were not
significantly affected by increasing the weight of the
mandibular denture.
[4]
This study was conducted to determine the effect of the
mandibular buccal denture base surface on food retention
in complete denture wearers.
MATERIALS AND METHODS
The present in vivo study was carried out on 10 complete
denture patients aged between 35 and 78 years. Among
them were four female and six male patients. Patients who
were selected randomly from the outpatient department
were frst-time denture wearers and residents of Davangere
district, Karnataka state, India. The study was performed
with the informed consent of the patient. Clearance from
the local ethical committee was obtained prior to the study.
The method followed in this study has been discussed under
the following headings:
Duplication of mandibular complete denture.
Test for food retention in manually molded and
physiologically molded denture bases.
Modifcation of buccal fange angulations and food
retention test.
Duplication of lower complete denture
A new set of complete dentures was fabricated for
edentulous patients using the conventional technique.
A complete denture duplication technique was used as
described by Wargner.
[5]
Test for food retention in manually molded and
physiologically molded denture bases
The food retention test was performed in the existing
complete denture (unduplicated) and then it was modifed by
physiologically molding the buccal fange. The physiologic
denture bases were prepared by using a modeling compound.
The modeling compound was softened and placed on the
buccal fange of the mandibular denture. The patient was
asked to perform all physiological movements before it get
set or hardens [Figure 1].
The food retention test was carried out as follows. The
complete maxillary and mandibular dentures were placed
in the mouth and, with the help of a spoon, 20 sugar test
particles having a diameter of 20.2mm were kept on the
middle part of the buccal fange of the lower denture. Then,
the subjects were instructed to expel the test particles
by performing only functional movements of the buccal
musculature without using their tongue. After a period of
30s, the number of residual particles in the buccal vestibule
was counted. This test was performed in a similar manner
three times and the residual scores were recorded.
Modification of buccal flange angulations and food
retention test
The angulation of the buccal fange in a duplicated denture
was measured with the help of an optical bevel protractor
[Figure 2]. The buccal fange was molded manually by
adding a self-cure acrylic resin/trimming of fanges to 50,
and the food retention test was carried out as described
above. The buccal fange, which was molded to 50, was
trimmed to 60, 70 and 80 and a similar test for food
retention was performed for each slope and the residual
scores were noted.
RESULTS
Statistical analysis
Continuous data are expressed as mean SD.
The Pearson correlation coeffcient was used in the
statistical analysis of dependency between the residual
score and the buccal slope angle of the fange of the
denture.
One-way ANOVA test was used for multiple group
comparison followed by Wilcoxons signed rank test
for the group-wise comparison.
A P-value <0.05 was considered statistically signifcant.
The difference between the mean residual scores of complete
denture wearers with manually and physiologically molded
denture fange revealed no signifcant effect on residual scores
by the physiologically molded denture bases when compared
with the manually molded denture bases [Figure 3 and
Table 1]. As the P-value in this table is not signifcant (P>0.05),
the difference between the residual scores of manually molded
and physiologically molded denture base is not signifcant.
The difference between the mean residual scores of complete
denture wearers with varying angulations of buccal fange
of the mandibular denture reveals the infuence of the slope
of the buccal fange on the ability to expel the test particles
[Figure 4 and Table 2]. The mean residual scores tended to
change depending on the angle of the buccal slope with
the occlusal plane. As the angulations of the buccal fange
change, the residual score also changes.
DISCUSSION
The evaluation of complete denture prosthesis has proven
difficult because of many problems in the evaluation
methodology. Functional evaluation methods such as
masticatory effciency tests and food retention tests and
morphological evaluation methods such as tests for the
adaptation of the denture to the supporting tissue have
been used.
In case of complete denture wearers, the food lodgment is
the major problem, which leads to discomfort of the patient.
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498 Indian J Dent Res, 21(4), 2010
In the mastication process, food particles should be moved
out of the buccal vestibule before swallowing, and the ability
to expel these particles has an important effect on food debris
accumulation in the buccal vestibule.
[1]
According to various studies, there is a signifcant relationship
between thickness, physiological moulding and slope of the
polished surface of the buccal fange and ability to expel food
particles from the mandibular buccal vestibule.
[1]
Shogo Minagi used partially edentulous patients in his study
to evaluate the effect of different aspects of the polished
surface of the buccal fange on food retention in the buccal
vestibule. He concluded that the thickness of the buccal
Comparison of manual and physiologically molded denture bases Reddy and Sangur
Figure 3: Residual scores in physiologically and manually molded
denture bases
Angle of buccal slope
Figure 4: Effect of angle of buccal slope on the mean residual score
Table 2: Comparative statistics of residual scores at various angles of the buccal slope
Angles of the buccal slope Residual score Group-wise comparisons*
Range Mean SD Groups
compared
Mean
difference
Z-value P-value
50 5.3311.0 7.73 1.96 50-60 -3.11 2.81 <0.01
50-70 -1.66 2.09 <0.05
60 1.666.60 4.62 1.79 50-80 +1.70 1.94 NS
60-70 +1.45 2.19 <0.05
70 4.338.00 6.07 1.39 60-80 +4.81 2.81 <0.01
70-80 +3.36 2.70 <0.01
80 7.0013.66 9.43 1.98
One-way ANOVA, F=13.4, P<0.01, Signifcance; *Wilcoxons signed rank test (-) decreased scores; P<0.05, P<0.01: Signifcant ; (+) increased scores; P>0.05 Not
signifcant
Table 1: Residual scores in manually and physiologically
molded denture bases
Type of denture base Residual scores MD vs. PD
Range Mean SD
MD 3.336.66 5.20 0.91 P=0.37;
NS
PD 4.007.66 5.59 1.01
Wilcoxons signed rank test P>0.05; NS, MD: Manually molded denture base,
PD: Physiologically molded denture base
Figure 1: Physiologically molded denture base by using the modeling
compound
Figure 2: Measuring the angulations of buccal fange by using the
optical bevel protractor
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Indian J Dent Res, 21(4), 2010 499
fange did not have any signifcant effect on the ability
of the subjects to expel test particles. But, the slope of the
fange did signifcantly affect the ability of the subjects to
expel the test particles.
[1]
In the present study, the comparison between manually
and physiologically molded denture bases and varying
angulations of buccal fange of the mandibular denture on
the effect of food retention in complete denture wearers
was performed. The various angulations used in this study
were 50, 60, 70 and 80. The results of this study show
the food retention at different angles, which were tested
with sugar particles.
One of the aims behind the selection of conventional sugar
particles as the test food in this study was to establish an easy
clinical procedure by which to evaluate the shape of wax
dentures in daily clinics in the future. The mean diameter
of the particle after 30s of expelling function was 1.80.2
mm, indicating minimal dissolution during the evaluation
period. Possibly, a very slight stickiness might be another
desirable property of this test food. The test food was not
so soluble as to cause suffcient stickiness to inhibit the
expulsion function even after 30s.
There has not been enough investigation on the food
retention of denture wearers at present and it is diffcult
to define which properties are suitable for test food,
although other test foods might give different results. It is
not necessary that the test material be an actual food. The
unique properties of the sugar used here were that it was
easy to count at chair side and that it was safe and edible.
The results of this in vivo study showed that there is no
signifcant difference in residual scores of physiologically
molded denture base and manually molded denture base.
There were differences in residual scores at different
angulations. According to the results of this study, the food
retention at 60 angles is very less when compared to the
50, 70 and 80 angles. There is comparatively less food
retention at 70 than at 50 and 80. The food retention is
higher at 50 and 80.
It shows that 60 is the ideal angulations of the buccal fange
of lower denture for comfort of the patient and causes less
food retention in the buccal vestibule. These results could
be used as a guide for the fabrication of complete dentures.
Further investigations with denture wearers to evaluate the
phenomenon of food debris accumulation are still needed
to correlate these results clinically.
CONCLUSION
The following conclusions can be made from this study:
There is no effect of mandibular denture buccal fange
on the food retention, which is molded physiologically
and manually. The thickness of the buccal fange does
not have a signifcant effect on the ability of the subjects
to expel test particles. Physiologic moulding of the
buccal fange did not show a signifcant affect on the
ability of the subjects to expel a test particle.
The slope of the fange signifcantly affects the ability
of subjects to expel a test particle. There appears to be
a critical angle for this slope.
REFERENCES
1. Minagi S, Suenaga K, Sato T, Nishigawa G, Hara T. The effect of the
mandibular buccal denture base surface on food retention. Int J
Prosthodont 1992;5:457-62.
2. Heartwell CM Jr, Rahn A O. Laboratory procedures. In, Heartwell CM
(ed). Syllabus of complete denture. 4
th
edition. Philidelphia, Lea and
Febiger, 1986;375-89.
3. Hickey JC, Zarb GA, Bolender CL. Appearance and functional harmony of
denture bases. In, Darlene Warfer. Bouchers Prosthodontic treatment
for edentulous patients, 9
th
edition. St. Louis, The CV Mosby company,
1985; 558-73.
4. Appearance and functional harmony of denture bases. In: Hickey JC,
Zarb GA, Bolender CL, editors. Bouchers Prosthodontic Treatment
for Edentulous Patients. 9
th
ed. ST. Louis: The C.V. Mosby Company;
1985. p.458-73.
5. Ohkubo C, Hosoi T. Effect of weight change of mandibular complete
dentures on chewing and stability: A pilot study. J Prosthet Dent
1999;82:636-42.
6. Wagner AG. A temporary replacement for an existing complete denture.
J Prosthet Dent 1987;58:522-5.
How to cite this article: Reddy LP, Sangur R. Comparison of manual and
physiologically molded denture bases in complete denture wearers. Indian J
Dent Res 2010;21:496-9.
Source of Support: Nil, Confict of Interest: None declared.
Comparison of manual and physiologically molded denture bases Reddy and Sangur
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