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*1 Adisman IK. The use of denture adhesives as an aid to denture treatment. J Prosthet Dent 1989; 63;711-5 *2 Yankell SL. Overview of research and literature on denture adhesives. Compend Contin Educ Dent 1984;4(Supplement);518-21 *3 McKevitt FH. The measured vertical dimension and denture adhesive 4/28/12 powders. J Prosthet Dent 1951;1:393-401
Negative Attitude*
q To hold base plates while recording dental relations q In immediate denture construction until well-fitting
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Mechanism of Action
q *Shay: the material swells 50 to 150 percent by
q Filling in spaces between the prosthesis and the q Anions in the adhesive are attracted to the cations of
4/28/12 *Shay K. Denture adhesives: choosing the right powders and pastes, JADA
Physical Force
q Stefan. Physical force q Force required to pull two disks or plates apart is
ses viscosity of the adhesive thereby sing the force required bioadhesive and cohesive forces
q Modern adhesives use materials that provide strong q Bioadhesion via carboxyl groups q Adhesive hydrates carboxyl groups form electrovalent
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-synthetic copolymer- used widely because of its high level of carboxyl groups
q Sodium carboxymethylcellulose (CMC)- natural q CMC is more soluble than PVM-MA q CMC- stong initial hold q 1970s-combination of PVM-MA (calcium salts) amd CMC q Quick upfront hold (CMC) and a hold of longer duration
(PVM-MA)
CMC
q Even greater cohesive strength q *Stronger, longer hold than calcium salts
*Mackay BJ, Jackson JJ, Vanalstine RL, Mas JC. Comparitive efficacy of powder denture adhesive (Abstract). J Dent Res 1993;72(Special Issue):376 *Mackay BJ, Jackson JJ, Vanalstine RL, Rajaiah J. Comparitive efficacy of cream denture adhesive (Abstract). J Dent Res 1993;72(Special Issue):376
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eliminate the need for complete dentures.. The major problem with denture adhesives is not their effect on tissue nor the results of their long-term usage, nor even their effect on vertical dimension; it is that the dental profession knows so little about them.
*1 Stafford GD. Denture adhesives: a review of their uses and compositions. Dent Pract September 1970;21:17-9 *2 Tautin FS. Dental adhesives-a problem.Dent Survey 1978;54(8):24-6
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criticism
powders in prosthodontia prompts the query: has prosthodontia fallen into disrepute?
*McKevitt FH. The measured vertical dimension and denture adhesive powders. J Prosthet Dent 1951;1:393-401 *McKevitt FH. Denture adhesive powders. J Calif Dent Assoc Nevada State Dent Soc 1957;33:469-72
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Kapurs study
q Kapur objective approach q *A method for scoring denture retention and stability (ill,
denture retention, thereby improving denture wearers incisive ability denture adhesives
q Advised dentists to "keep an open mind on the subject of q Patients have an increased sense of security, added comfort
q Adhesives allowed greater occlusal pressure q More for patients with ill-fitting prostheses q Amount of time needed to chew didnt vary
*Stafford GD, Russell C. Efficiency of denture adhesives and their possible 4/28/12 influence on oral microorganisms. J Dent Res 1971;50:832-6
eating standardised portions of food (celery, taffy apple, steak and hard roll sandwich) with and without a denture adhesive
q Patients had or were provided with well-fitting prostheses q Results: significant reduction in dislodgement when an
*Tarbet WJ, Boone M, Schmidt NF. Effect of a denture adhesive on complete denture dislodgement during mastication. J Prosthet Dent 4/28/12
both well-fitting and ill-fitting dentures but exerted their greatest effect with ill-fitting dentures
*Chew CL, Phillips RW, Boone ME, Swartz ML. Denture stabilization with adhesives: A kinesiographic study. Compend Contin Educ Dent 1984;4(Supplement): S32-8
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gnathodynamometry)
q In patients whose tissues were judged to be unlikely for
achieved biting forces similar to patients with more satisfactory support tissues
q Improvement in maxillary retention and stability
Contd
q *Conclusion: "A denture adhesive thus an be of
considerable benefit to many denture wearers, even those with good quality denture support tissues. Subjectively, the adhesive provides confidence; objectively, it allows the development of needed forces in the biting and chewing of foods.
* Tarbet WJ, Silverman G, Schmidt NF. Maximum incisal biting force in denture wearers as influenced by adequacy denture bearing tissues and the use of an adhesive. J Dent Res 1981;60(2):115-9
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q Increase of upto 20N (35N baseline to 54N at eight hours) q *2 Functional bite forces of 40 to 50N are required to incise
foods such as hard pretzels, apples and carrots crosses the required threshold
*1 Grasso JE, Rendell J, Gay T. Effect of denture adhesive on the retention and stability of maxillary dentures. J Prosthet Dent 1994;72:399-405.22. *2 Gay T. Rendell J, Majourau A, Maloney F. 4/28/12 quantitative Use of
Review
q Lack of objective measurement tools q Objective methods can provide a authoritative
broader base
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q* Definite pattern
Boone
q *He commented that, "much of this information is
fact, but more of it is fallacy, especially as it relates to the causes of alveolar bone change. and function have been lumped together bone changes.
q Over-the-counter products for altering prostheses fit q "accused of destroying bone, or at least of causing q Products should be divided into insoluble (causatives)
Denture pads agents Soluble agents Dissipate Insoluble Softened toilet paper Flow under pressure Insoluble plastic denture Spread
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Contd
q *1 Boone remarked, "If the use of adhesives were to cause
bone resorption, the stresses involved would have to be transmitted through the oral mucosa, even with ill-fitting dentures. If these stresses were of sufficient magnitude or duration to cause bone changes, it would be reasonable to expect that soft tissue lesions would occur. hygiene
*1 Boone M. Analysis of soluble and insoluble denture adhesives and their relationship to tissue irritation and bone resorption. Compend Cont Educ Dent 1984;4(Supplement): S22-5 *2 Abdelmelak RG, Michael CG. The effect of denture adhesives on the 4/28/12 palatal mucosa under complete dentures: a clinical and histological
*1 Bartels HA. Bacterial activity and tissue tolerance: their role in prosthodontia. J Dent Educ October 1944;9:57-72 *1 Bartels HA. Bacteriological appraisals of adhesive denture powders. J Dent Res 1945;24(1):15-6 *2 Kelly J, Kutscher AH, Tuoti F. Bacteriological studies with a new adhesive preparation for oral use. J Conn State Dent Assoc 1959;33(3):9-14 4/28/12
flora
q Imbalance in the flora by selective inhibition and
support
q Denture trauma initiates and perpetuates stomatitis q Adhesives reduce potential trauma
4/28/12 *Stafford GD, Russell C. Efficiency of denture adhesives and
*Tarbet WJ, Grossman E. Observation of denture supporting tissue during six months of denture adhesive wearing. JADA 1980;101:789-91 4/28/12
Clinical Implications
q Denture patients can benefit in a variety of clinical dimensions by using denture adhesives
q Denture adhesives have a place in the professional care
ofpatients; they can significantly enhance denture performance and patient confidence but should not be used to compensate for denture deficiencies
q *Continuous use of a denture adhesive in an ill-fitting
denture can mask an underlying stomatitis that can lead to further involvement
Contd
q *1 Adisman suggested that, patient instructions
regarding the use or non-use of denture adhesives should be an integral part of denture aftercare instructions.
q *2 Shay said that some patients may benefit from
denture adhesives and that, the "keys to their proper use lie in the special needs of each patient, the properties of the adhesives themselves and in the dentist's knowledge and willingness to help.
*1 Adisman IK. The use of denture adhesives as an aid to denture treatment. J Prosthet Dent 1989; 63;711-5
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Conclusions
q Contraindicated in ill-fitting dentures q Improved function q Greater retention and stability q Increased incisal bite force q Sense of comfort (physical and psychological) for the
patient
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