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Complete denture soft liners improve bite force, mastication, and life quality: A systematic review and meta-analysis
Yasir Nabeel Al-Mohammad1, Caroline Kelly1,2, Eszter Ágnes Szalai1,2
1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Purpose:
To understand the use of soft liners/reliners in complete dentures to improve mastication, bite force, and patient's quality of life, and to reduce pain.
Methods:
A systematic search was performed in MEDLINE (PubMed), EMBASE, and CENTRAL until May 2025 to find clinical studies comparing removable prostheses with and without soft liners or relining with soft and/or hard reliners. Case reports, case series, and in vitro studies were excluded. The Risk of Bias Tool 2, ROBINS-I, and the GRADE approach were used for quality and certainty assessment.
Results:
Thirty-two articles encompassing 710 patients were included (up to 6 months follow-up). Bite force, quality of life, and masticatory performance were significantly better in the soft liners group [MD: 34.99, CI: 19.98; 50.00], [MD: -2.03, CI: -3.30; -0.76], and [MD: 2.48, CI: 0.13; 4.84], respectively. Pain was compared in two ways, using the visual analog scale (VAS) and a questionnaire. For both methods, studies showed a general trend of less pain in the soft liners group, with a statistical significance in the VAS method [MD: -14.18, CI: -18.92; -9.44] and [MD: -2.15, CI: -5.97; 1.68], respectively. Comparisons of electromyography (EMG) amplitude and duration showed no statistically significant differences between groups [MD: -17.23, CI: -149.76; 115.30] and [MD: -0.39, CI: -2.95; 2.17], respectively.
Conclusion:
Using soft liners, regardless of type, for lining or relining complete dentures, improves bite force, mastication, and quality of life and is associated with less pain. No effect was observed on the masticatory muscle EMG (amplitude and duration).
