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Clinical evaluation of retention and patient satisfaction of monolithic complete denture: A crossover controlled
Eman A Ibrahim1, Ahmed M Abdelhamid2, Eman Alrafah2
1Assistant Lecturer, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Statement Of Problem:
Studies that clinically evaluated retention and patient satisfaction of monolithic complete dentures (CDs) are sparse.
Purpose:
The purpose of this crossover controlled clinical trial was to clinically evaluate retention and patient satisfaction of monolithic CDs.
Material And Methods:
Twenty-two completely edentulous patients received conventional heat-activated polymerized acrylic resin CDs (Vertex-Dental Three-Dimensional (3D) system). The conventional CDs were scanned with desktop scanner (Medit T710; MEDIT Corp), and standard tessellation language (STL) files were used as a guide to design 22 monolithic disks (Ivotion Denture System; Ivoclar AG). Retention was evaluated using a digital force gauge (Digital Push Pull Force Gauge S-500N; Soonkoda). A vertical pull was applied using the hooked end, which was connected to a metal ring fixed at the center of the denture base. For every denture, 3 measurements were made. The highest number was considered the peak retention force. A patient satisfaction questionnaire was delivered at 1-week and 6-month intervals. The responses completely satisfied, partially satisfied, and dissatisfied were coded as 2, 1, and 0 as listed. Normality was confirmed using the Shapiro Wilk test and Q-Q plots. Retention was compared between conventional and monolithic groups using the paired t test. Repeated measures ANOVA was conducted with Bonferroni corrected post hoc testing (α=.05).
Results:
The mean difference in retention was 17.4 N for maxillary conventional CDs and 20.0 N for maxillary monolithic CDs. The mean difference in retention was 14.1 N for mandibular conventional CDs and 16.1 N for mandibular monolithic CDs. Retention differed significantly between conventional and monolithic CDs in both the maxillary and mandibular arches (P=.003 and.030). A significant difference was observed between the maxillary and mandibular CDs in both groups. Patient satisfaction with monolithic CDs was greater than conventional CDs, with mean differences of 2.17 after 1 week and 3.00 points after 6 months (P=.014 and.003). Repeated measures ANOVA confirmed a statistically significant and large effect of denture type on satisfaction P=.001, partial eta squared=0.628.
Conclusions:
Compared with conventional heat-polymerized CDs, the retention and patient satisfaction provided by monolithic CDs were noticeably higher. A significant difference in mean retention forces was found between maxillary and mandibular CDs, with mandibular monolithic dentures exhibiting improved retention force values. Using monolithic disks represents a successful treatment option for digitally fabricated dentures, although appropriate patient selection is mandatory.
