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Published on: December 20, 2024
Experimental approaches for evaluating the fracture resistance of removable complete dentures: A systematic review of
Xiaoxia Wang1, Andrew B Cameron2, John M Aarts3
1PhD student, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
Statement Of Problem:
Fracture is a common complication with removable complete dentures, yet a standardized, clinically relevant, in vitro method for evaluating fracture resistance is lacking.
Purpose:
The purpose of this systematic review was to synthesize in vitro studies evaluating the fracture resistance of removable complete dentures using denture specimens (incorporating base and tooth components) or denture-base specimens (base only), to appraise methodologies, and to identify clinically relevant testing protocols.
Material And Methods:
An electronic search was conducted in the Ovid MEDLINE ALL, Embase, Scopus, and Web of Science databases up to January 2026, supplemented by manual searching. In vitro studies evaluating the fracture resistance of dentures or denture bases were included. Study selection, data extraction, and risk of bias assessment were performed independently by 2 reviewers.
Results:
Thirty-seven studies were included: 31 investigated maxillary specimens, 2 focused on mandibular specimens, and 4 assessed both arches. Eight testing configurations, categorized by loading location, support conditions, and specimen type, were identified. The most prevalent configurations were Type A (denture specimens) and Type E (denture-base specimens), both using midline loading with rigid support (n=13 each). Type B, involving bilateral posterior loading and the support of simulated mucosa, demonstrated greater clinical relevance. Maximum fracture loads ranged from 126.2 N to 45 575.4 N. Risk of bias assessment classified 8 studies as low risk, 28 as medium risk, and 1 as high risk.
Conclusions:
Significant heterogeneity exists in experimental approaches for complete denture fracture resistance testing. Clinically relevant methodologies should incorporate physiological loading, mucosal simulation, and standardized reporting. The development of consensus-driven testing protocols is required to improve cross-study comparability and enhance the translation of in vitro findings to clinical practice.
