International Journal of Current Advanced Research

ISSN: O: 2319-6475, ISSN: P: 2319-6505,

6505, Impact Factor: 6.614
Available Online at www.journalijcar.org
Volume 9; Issue 02 (B); February 2020;
2020 Page No.21217-21222
DOI: http://dx.doi.org/10.24327/ijcar.2020
//dx.doi.org/10.24327/ijcar.2020.21222.4164
Research Article
ADVANCEMENTS IN COMPLETE DENTURE PROSTHESIS-A
PROSTHESIS A REVIEW
Dr. M.A. Eswaran1, Dr. Rathika Rai2, T. Sangeetha3 and S.G.Devika3
1Reader, Department of Prosthodontics, Thai Moogambigai Dental College and Hospital
2HOD and Professor, Department of Prosthodontics, Thai Moogambigai Dental College and Hospital
3Junior resident, Department of Prosthodontics, Thai Moogambigai Dental Colleg
College and Hospital
AR T IC L E I NF O AB ST RA CT
Article History: Complete dentures are prosthetic devices fabricated to replace all missing teeth and are
Received 12th November, 2019 supported by surrounding soft and hard tissues of the oral cavity. According to the
Received in revised form 23rd condition and patient need different types of dentures are made. Complete denture uses to
December, 2019 support facial muscle and decrease the oral bone loss and create self
self-confident among
Accepted 7th January, 2020 patients. This article throws light on technique of making different types of complete
Published online 28th February, 2020 denture prosthesis.

Key words:
Denture marking,Denture labelling,
CAD/CAM, CEREC,Magnets, Bio functional
prosthetic system.

Copyright©2020 Dr.M.A. Eswaran et al. This is an open access article distributed under the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

INTRODUCTION Characterizations of these dentures add as a compliment to the

esthetic factor in false denture. Complete dentures must be as
Complete Dentures Prosthodontics involves the replacement of aesthetic as its use. “Denture characterization is modification
the lost natural dentition to provide favorable support and of the form and shade of the denture base and teeth to produce
stability for the dentures, with the preservation of alveolar ore lifelike appearance” according to the GPT8 4.
a more
bone1.More dental care and new products are being developed
in shorter time periods, as the patients become more active and Review of literature
demand to improve clinical efficiency by combining two or Denture Marking and Labelling
more steps into one2.
Identification
fication is an essential need of any medicolegal
For the patients facing the loss of all the natural teeth, there are investigation because a wrong identity may pose a problem in
three treatment options. One is for the patient to have all delivering justice. The Forensic Odontology in American
remaining teethth extracted and wait six to eight weeks for the Board guidelines show that most dental identi
identifications are
extraction sites to cure. Following healing, leaving the patient based on filling, dental caries,
ries, missing teeth and prosthetic
without teeth not only during the curing phase but also during devices. Prosthodontists play a very important role in forensic
the time required for the manufacturing of complete denture. A dentistry as they are concerned with manufacture of various
second option is to change an existing removable partial prosthesis which can help as a main tool for identi
identification. Bar
denture into an interim complete denture. A third option is to coding technique is also used for denture marking. (FIG 1)
make a conventional immediate complete denture3.
Tray Byte (Dentsply Tray byte) combines the edentulous
custom tray with a prepositioned occlusion rim that allows for
impression-making
making and recording centric and vertical
relationships during the same appointment. This technique can
shorten clinical fabrication steps from five appointments to
three. Other “three visit denture systems” may not use occlusal
rims (the so-called “mush-bite”)
bite”) or they may skip the final wax
try-in2. The dentogenic concept was proposed by John P. Frush
and Roland D. Fisher to bring in a revolution into the esthetics
in artificial dentures in 1955.
*Corresponding author: Dr. M.A. Eswaran Fig 1
Reader, Thai Moogambigai Dental College and Hospital
International Journal of Current Advanced Research Vol 9, Issue 02(B), pp 21217-21222, February 2020
In post mortem during war, crimes, and civil unrest, natural the denture label is placed on internal surface, they become
and mass disasters are recognized with the help of dentures. invisible when relining is done. The most appropriate sites for
Labeling of all dentures is suggested by most international the location of denture marker are5:
dental associations and forensic odontologists. Recently
1. Posterior buccal surface of maxillary denture (FIG
Aadhaar card number as shown in FIG2A and name as shown
3A)
in FIG 2B is also used in labelling the denture.
2. Lingual flange of mandibular denture (FIG 3B)

Fig 3A

Fig 3B
Fig 2 A Fig 2b
These areas are chosen because: Visible to the reader, adequate
,6 thickness of resin to incorporate without any technical
The American Dental Association 5 has described certain
criteria for denture marking: difficulties, aesthetics of the denture is not affected. Other sites
The identification should be specific. are: Within the palate or buccal to tuberosity regions, in case
The technique should be simple.
The mark should be fire and solvent resistant.
of fixed prosthesis like crowns the initial or identification
The denture should not be weakened. number is marked usually on lingual surface of anterior and
The mark should be cosmetically acceptable. posteriors. Occlusal surface of the posteriors is not preferred
because of chance of loss of details during occlusal
Denture Marking
adjustments.
Surface marking methods5,7 Inclusion methods5,7
Engraving method Lose inclusion method Denture Labelling and its importance in forensic dentistry
Embossing method Youngs method
Invisible ink method Dippenars method In the finding of the following, marking dentures has been well
Fibre tip pen method Reesons method documented as a useful aid: Victims of fatal disasters,
Heaths method Clear acrylic T bar method misplaced dentures in hospitals, nursing homes, and
Stevensons method Olivers method institutions, as well as patients who suffer from
Weckers electro pen method Lenticular card method
Laser etching method Bar coding method unconsciousness or psychiatric problems such as traumatic or
Radio frequency identification senile loss of memory.8More often denture may be found close
Onion skin paper method
tag to the scene where body is found and chances of finding of
Denture bar coding method Lead foil method edentulous person wearing denture are less difficult in
Metallic band according to
Swedish guidelines comparison to those in a dentate patient. Hence denture
Photograph inclusion method labeling is very important.9
MinI Dent method
Data matrix code In the recent Highland Towers Condominium disaster at Ulu
Microlabelling Kelang, Selangor there were five edentulous victims wearing
Cast embossed identification dentures. The investigating forensic odontologist did not find
plate
any of their dentures having any form of identifying markings,
Ceramic crown engraving
method thereby frustrating the dental victim identification team from
Memory card method. making any conclusive identification.10The denture should be
Sites for Location of the Denture Marker labeled and include the country code prefixed before the
Usually polished surface of denture is preferred but if esthetics identity card number is proposed by the author in the study.
is concerned, internal surface or impression surface is used. If The driving license number, social security number or the

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Advancements in Complete Denture Prosthesis-A Review

income tax file number can be used in countries where no Components: All CAD/CAM system consist of three
identity cards are issued to their citizens is the recommended components: Digitalization tool/scanner, Software,a
identifying number to be employed.11 It has been observed in production technology scanner.
numerous incinerated bodies the lower lingual posterior, and
There are two different scanning possibilities: 1) Optical
the upper palatal posterior portions of the dentures are usually
scanners 2) Mechanical scanners
spared. These sites become the option of areas for the
marking.10 Denture marking should also not be restricted to Optical scanners: The basis of this type of scanner is the
acrylic dentures only but also be extended to those made from collection of three-dimensional structures in a ‘triangulation
cobalt-chromium. Cobalt-chromium appliances withstand procedure’. Here, the source of light (E.g. laser) and the
melting even in some cases of incinerated remains. Identifying receptor unit are in a definite angle in their relationship to one
markings can also be incorporated in orthodontic appliances, another. Computer can calculate a three-dimensional data set
maxillo-facial reconstructive prostheses, crowns, and from the image on the receptor unit through this angle.
bridges.11Denture labeling was evaluated in an Indian sample. Examples: LAVA Scan ST (3M ESPE, white light projections)
In European studies the results are different wherein the most and es1 (etkon, laser beam).
of patients agreed to denture marking, indicating patient
Mechanical scanner: The master cast is read mechanically
background (E.g., Education level).12
line-by-line by means of a ruby ball and the three-dimensional
Advantages Disadvantages structure is measured in this scanner variant. This type of
 All the ADA specifications are scanner isdifferentiatedby a high scanning accuracy, whereby
not fulfilled by the denture
marking systems. the diameter of the ruby ball is set to the smallest grinder in the
 If the denture labelling milling system as shown in FIG 5, with the result that all data
 Patient identification in natural systems are placed on the collected by the system can also be milled. Example: Procera
and mass accident. internalsurface, they become Scanner.
 Appliance identification in old invisible when relining is
people institutions. done.
 Retrieval of dental records in  After inclusion of the marker
cases of emergencies like in the dentures changing the
accidents. patients detail becomes a
 Diagnostic and decision tedious job.
support in medico legal issues.  Certain denture marking
 Recording and storage of systems are expensive and
patient’s details on an easily require special equipment’s to
accessible system. read the data.
 Complete and assured  There is fading of certain
documentation of patient’s identification marks like
details since the marked photograph, bar codes micro
dentures are fabricated by labels etc. over a period of
trained professionals. time.
 Surface engraving methods
leads to food lodgment and the
details can be changed without
the consent of the patient and
the dentist. Fig 5

CAD/CAM Drawbacks:the complicated mechanics,the apparatus is very

expensive,long processing times compared to optical systems
“CAD-CAM acronym for COMPUTER AIDED DESIGN-
COMPUTER AIDED MANUFACTURING (or Computer Different CAD-CAM systems
Assisted Machining): the Computer Numerical Control (CNC) Cercon: It does not have a CAD component. In this system, a
subtractive fabrication of a 3D object; in dentistry, it is a CAD- wax pattern (coping and pontic) with a minimum thickness of
CAM technology used to produce different type of prostheses, 0.4 mm is made. The system scans the wax pattern and mills a
including crowns, veneers, inlay, onlay, fixed prostheses, zirconia bridge coping from pre-sintered zirconia blanks. The
removable dental prostheses, dental implant prostheses and coping is then sintered in the Cercon heat furnace (1,350C) for
orthodontic and other devices; comp, 6 to 8 hours.13
STEREOLITHOGRAPHY” GPT84 Everest: The Everest system consists of scan, engine, and
therm components. A reflection free gypsum cast is fixed to
the turntable and scanned by a CCD camera in a 1:1 ratio with
an accuracy of measurement of 20 µm in the scanning unit. Its
machining unit has 5-axis movement that is capable of
developing detailed morphology and precise margins from a
variety of materials. Examples: leucite reinforced glass
ceramics, partially and fully sintered zirconia, and titanium.14
Lava: This system uses yttria stabilized tetragonal zirconia
polycrystals (Y-TZP) which have greater fracture resistance
than conventional ceramics. Lava system uses a laser optical
system to digitalize the information. The Lava CAD software
Fig 4
automatically finds the margin and suggests a pontic. The

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International Journal of Current Advanced Research Vol 9, Issue 02(B), pp 21217-21222, February 2020
framework is designed to be 20% larger to compensate for technician then verifies the fit of the milled coping or
sintering shrinkage.13,14 framework.14
Procera: This system has combined pantographic reproduction
with electrical discharge machining. It uses an innovative
concept for generating its alumina and zirconia copings. A
scanning stylus require 3D images of the master dies that are
sent to the processing center via modem. The processing center
then generates enlarged dies designed to compensate for the
shrinkage of the ceramic material. Copings are developed by
dry pressing high-purity alumina powder (> 99.9%) against the
enlarged dies. These densely packed copings are then milled to
the desired thickness. The Procera restorations have excellent
clinical longevity and strength.14
DCS Precident: It is comprised of a Preciscan laser scanner Fig 6a CEREC 1
and Precimill CAM multitool milling center. It can scan 14
dies at the same time and mill up to 30 framework units in 1
fully automated operation.10 Materials used: Porcelain, Glass
Ceramic, In- Ceram, Dense Zirconia, metals, and Fiber-
Reinforced Composites. This system is one of the few
CAD/CAM systems that can mill titanium and fully dense
sintered zirconia.14
CICERO System: The computer desegregated crown
reconstruction was developed by CICERO Dental System B.V.
(Hoorn, The Netherlands). The system makes use of optical
scanning, near net-shaped metal, ceramic sintering and
computer-aided fabrication techniques.15
Fig 6b CEREC 2
CEREC System: The computer- aided design/computer-aided
manufacture (CAD/CAM) CEREC (computer-assisted ceramic
reconstruction) system is used for electronically designing and
milling restorations.
Cerec 1: In this, the ceramic block could be turned on the
block carrier with a spindle and feed against the grinding
wheel, which grinds the ceramic block to a new contour with a
different distance from the axis at each feed step. (FIG 6A)
Cerec 2: The introduction of an additional cylinder diamond
enables the grinding of partial and full crowns. It introduced
the design of the occlusion in three modes: extrapolation,
correlation and function. However, the design still was Fig 6c CEREC 3
displayed two-dimensionally.16 (FIG 6B)
E4D Dentist System: Presently it is the only system besides
With CEREC 1 and CEREC 2, by using couple charged device CEREC that permits same day in-office restorations. This
camera an optical scan of the prepared tooth is made, and a 3- system includes a laser scanner (Intraoral digitizer), a design
dimensional digital image is generated on the monitor. The center and a milling unit. The scanner is placed near the target
restoration is then designed and milled.14 tooth, and has 2 rubber feet that hold it to specific distance
from the area being scanned. The software gradually creates a
Cerec 3: This system skipped the wheel and introduced the
3D image as each picture is taken. The design system
two bur-system. The “step bur”, reduced the diameter of the
automatically detects the finish lines and marks them on the
top onethird of the cylindrical bur to a small- diameter tip
screen. As soon as the restoration is accepted, the data are
enabling high precision form grinding with reasonable bur
transmitted to either the in-house milling machine or a dental
life.16 The most important factor for three-dimensional
laboratory. The office milling machine will then manufacture
scanning with the Cerec 3 intraoral camera is that tooth
the restoration from the chosen blocks of ceramic or
preparations for crowns and inlays have a unique
composite.18
characteristic: all points of interest can be seen from a single
viewing line, representing the preparation and insertion axes, Restorative materials for CAD-CAM processing: According
respectively.17 (FIG 6C) to the fabrication method: Pre-sintered, densely sintered, Glass
infiltrated
CEREC in Lab: Is a laboratory system in which working dies
are laser-scanned and a digital image of the virtual model is Stages in fabrication of prosthesis with CAD/CAM
displayed on a screen. After designing the framework, the technology: Computer surface digitization, Computer-aided
laboratory technician inserts the suitable VITA In-Ceram designing, Computer assisted manufacturing, Computer-aided
block into the CEREC in Lab machine for milling. The esthetics, Computer-aided finishing.

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Advancements in Complete Denture Prosthesis-A Review

 Reduces lateral forces on the abutment record

Advantages 19,20 Disadvantages 19,20 tooth.
 Applications of new materials  Greater learning curve  Teeth in poor condition such as residual
–The new material for FPDs required. root with caries and cyst, impacted teeth,
frame work are high strength  Capital costs of these systems loose teeth can be used as abutment due
ceramics that are expected is quite high and rapid large- to minimal lateral pressure on the teeth.
have been difficult to process scale production of good
using conventional dental quality restoration is necessary Failures
laboratory technologies. to achieve financial viability.
 Time effectiveness.  Some CAD/CAM system The main problem in the use of magnets as retentive devices is
 Reduced labor. relies on margin capture for corrosion. Both SmCo5 and Nd-Fe-B magnets are extremely
 Quality control. digitization, thus making
 A digital impression also subgingival margin capture susceptible to corrosion, especially in chloride containing
means that patients do not have challenging. environments. Before use in dental applications the magnetic
to have impression material  CAD/CAM is ever advancing materials must be securely separated from the oral fluids.
and trays used, saving them technology. Upgrades and Although some current magnet assemblies are encapsulated in
discomfort. updates are often required.
 Recent innovation in  Matching the patient’s tooth stainless steel or titanium, some are failing approximately 18
CAD/CAM system provide shade to the blocks of months in clinical use because of corrosion and loss of the
occlusion to be viewed and materials used to fabricate the retention provided by the attachment.
developed in dynamic state. restorations can be a challenge
to the dentist initially Biofunctional Prosthetic System (BPS)
Magnets in Complete Dentures It is also called as bio functional or biogenic because of the
ability to construct dentures which are really similar to the
Magnets have been used for retaining complete denture in the
natural elements they substitute, fulfilling this way esthetics,
mouth because they are small and are easy to incorporate into
functional and phonetics demands of the patient. BPS denture
a denture.21The first attempt of using magnets to retain
meets the esthetic demand of patients with its unique Ivoclar
dentures involved implanting them within the jaw as shown in
teeth, which replicate anatomy of the natural tooth Ivoclar
FIG 7, problems ensued because of the large size of the
teeth are made up of 3 layers of cross-linked acrylic resins that
magnets and the inadequate forces that they provided.22
contribute to a life-like appearance and resistance to wearing.
Improvements in magnetic materials have allowed smaller and
BPS system uses a controlled heat/pressure polymerization
more powerful magnetic attachments. Implantation of magnets
procedure during which time the exact amount of material
Two types: a) Magnet Repulsion and b) Magnet Attraction.
flows into the flask to compensate for shrinkage, which
ensures a perfect fit. This pressure also optimizes the physical
properties of the denture. BPS also available in Partial
dentures, Combination dentures, Hybrid dentures, Removable
implant dentures, Complete dentures. (FIG 8)

Fig 7

The first recorded use of magnets in prosthetic dentistry

involved using the repulsion of like poles of magnets to
maintain and improve the seating of complete dentures.22 The
magnetic material used was Alnico type that has been stopped
to use because of large bulk necessary for magnet strength.
The use of attractive force retention was reported in the early
1960s.21 This first attempt was made with Al-Ni-Co V which
was surgically implanted in the mandible of edentulous
patients. Because of the distance between the two magnets,
they provided inadequate force to aid in retention. After that
the smaller and stronger Co-Pt magnets were implanted.21
Several disadvantages were associated with Co-Pt magnets, Fig 8
including their high cost, limited availability, difficult Advantages
fabrication. The implanted magnet migrated through the bone
and tissues until it became exposed in the oral cavity.23 As Reduced irritation to the gum, extremely dense material
material technology improved, smaller magnets were made reduces the chance of breakage, non-porous surface greatly
that could be incorporated into the retained roots. lessor odor causing plaque and bacteria, non-irritating and
comfortable to wear, eat virtually any food, naturally looking
Advantages Disadvantages
 Small size within over denture.  Low corrosion
so you can smile, laugh, speak with comfortable, will not
 Increases the stability. resistance distort stains and taste.
 Easily constructed without special  Cytotoxic effects
technique. of the leachants
 Insertion and removal of overdenture is  High cost
easy.  Short track

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International Journal of Current Advanced Research Vol 9, Issue 02(B), pp 21217-21222, February 2020
CONCLUSION 10. Alhabshi SF, Nambiar P. The contribution of forensic
odontology in the Highland Towers condominium
The review of the literature demonstrate that advancement of disaster. Ann Dent Univ Malaya. 1995; 2:25–8.
complete denture prosthesis is necessary. This study makes the 11. Ling BC, Nambiar P. Denture marking for the
knowledge of denture marking, denture labelling, CAD/CAM, Malaysian population. Ann Dent Univ Malaya. 1996;
magnets in complete denture, bio functional prosthesis system. 3:43–5.
Proper method for fabrication should be done to avoid any 12. Acharya AB, Anehosur GV, Kanchi PP, Naik MG,
complications and to make tooth appear more natural. Every Nadiger RK. Perceptions and preferences on denture
treatment should be done according to the particular patient’s marking in an Indian sample. Gerodontology. 2012;
condition and work should be done in such a way that most 29:117–24.
portion of natural tooth is protected from damage. Hope this 13. Mantri S and Bhasin A. “CAD/CAM in dental
review will be helpful in providing some useful information restorations: an overview”. Annals and Essences of
related to complete denture prosthesis to dental students. Dentistry 2.3 (2010): 123-128.
14. Perng-Ru Liu. “A panorama of dental CAD/CAM
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How to cite this article:
Dr. M.A. Eswaran, Dr. Rathika Rai, T. Sangeetha and S.G.Devika (2020) 'Advancements in Complete Denture Prosthesis-A
Review', International Journal of Current Advanced Research, 09(02), pp. 21217-21222.
DOI: http://dx.doi.org/10.24327/ijcar.2020. 21222.4164

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