Complete
denture prosthodontic treatment is an integral aspect of the dentistry as the
quality of life is compromised due to complete tooth loss. Patient’s desires
are considered as prime element in fabrication of prosthesis for giving a
successful treatment. The patient’s satisfaction or perception has always been
a key objective in any prosthodontic treatment.
The
key in fabricating a good set of complete denture greatly depends on achieving objectives
of preservation, stability, support, retention, aesthetics and comfort. Retention,
thus, plays a very important role in complete denture.
Establishing
proper posterior palatal seal commands a definite clinical procedural protocol
if one is to create an optimally retentive complete maxillary prosthesis. In this
study two methods of establishing the PPS will be followed. One, the
conventional method wherein the PPS will be recorded using low fusing green
stick compound and other wherein a novel device named “compograph†aided
technique shall be used where the the compressibility of tissue is recorded to
define its resiliency. Being an indigenously developed instrument and
technique, there exists a need to use the instrument to establish the PPS seal
and compare both retention and clinical soft tissue changes with the
conventional semi functional method. Hence a need to conduct the study was felt
necessary with following objectives.
1.To
evaluate the retention of maxillary complete dentures fabricated using the
conventional semi
functional technique and Compograph aided Posterior palatal seal using dynamometer
retention test
2.
To evaluate the clinical retention evaluation of maxillary complete dentures
fabricated using the conventional semi functional technique and Compograph
aided Posterior palatal seal using functional tests at baseline and after seven
days.
3.
To evaluate the clinical soft tissue changes seen on Posterior palatal seal
area after denture insertion
at baseline and after observational period of 7 days for both the groups.
4.
To compare the dynamometer retention readings and clinical retention test
evaluations of maxillary
complete dentures fabricated using the conventional semi functional technique and
Compograph aided Posterior palatal seal technique within and between the
groups.
5.
To compare the clinical changes of soft tissues under maxillary complete
dentures fabricated
using the conventional semi functional technique and Compograph aided Posterior
palatal seal technique within and between the groups.
A
sample size of 17 patients was calculated for whom two sets for dentures shall
be fabricated. Patients
who report to Department of Prosthodontics and Crown & bridge, K. M. Shah
Dental College & hospital, Vadodara, and seek replacement of all missing
teeth with complete denture prosthesis will be screened for inclusion and
exclusion criteria of the study. All the patients who fit into the inclusion
and exclusion criteria will be included after they sign a written informed
consent form available in three local
languages (English, Hindi and Guajarati). All the required information about
the study shall be clearly stated to the patients through the patient
information sheet (English, hindi and gujarati).
Two maxillary dentures shall be
fabricated for every patient. However, the denture to be inserted first shall
be decided on the basis of a randomised sequence using a computer generated randomization
technique. Based upon random allocation, the patients
would be given either of the two dentures. Denture insertion procedure shall be
done as per routine and evaluated for stability, phonetics, aesthetics and
occlusion.
The Dynamometer Retention
test, Clinical functional retention tests and clinical evaluation of soft
tissue in the PPS area shall be performed by a blinded evaluator on the day of
denture insertion and 7 days after the denture delivery
On the seventh
day after the first denture insertion, the first denture shall be taken away
from the participant. The participant shall now be placed on a washout period
of no denture wear for seven days. After this, the second denture as per the
allocation sequence shall be inserted and the steps as followed for testing and
follow up evaluations shall be conducted by the same blinded evaluator after
seven days of use of second denture.
The
data of retention tests and clinical soft tissue changes shall be entered in
the Proforma sheet
The ethical
and feasibility issues shall be addressed.
This study will help us to evaluate which of the
two methods of establishing Posterior palatal seal is more beneficial with
respect to retention and post palatal soft tissue health. The same technique
shall be recommended in further clinical practice. |