European International Journal of Multidisciplinary Research
and Management Studies
97
https://eipublication.com/index.php/eijmrms
TYPE
Original Research
PAGE NO.
97-101
DOI
OPEN ACCESS
SUBMITED
20 February 2025
ACCEPTED
19 March 2025
PUBLISHED
21 April 2025
VOLUME
Vol.05 Issue04 2025
COPYRIGHT
© 2025 Original content from this work may be used under the terms
of the creative commons attributes 4.0 License.
Optimisation Of The
Manufacturing Method
For Overlaid Prosthesis
Structured By Teeth And
Dental Implants
Turaev Alimjan Bahriddinovich
Samarkand State Medical University, Uzbekistan
Abstract:
Dental defects are a prevalent disease of the
dentoalveolar system. The demand for the production
of detachable prostheses within the spectrum of
prosthetic care is significantly large, ranging from 33%
to 68% [4-6]. Following tooth loss, atrophy occurs in the
alveolar process of the maxilla and the alveolar
segment of the mandible.
Keywords:
Partial edentulism, removable dentures,
attachments, overlapping dentures, hygiene of
removable prosthetic dentures.
Introduction:
Dental defects are a prevalent disease of
the dentoalveolar system. The demand for the
production of detachable prostheses within the
spectrum of prosthetic care is significantly large,
ranging from 33% to 68% [4-6]. Following tooth loss,
atrophy occurs in the alveolar process of the maxilla
and the alveolar segment of the mandible. The atrophy
process beneath a removable denture is permanent,
since the bone fails to accommodate the masticatory
stress [13-17]. Alongside bone atrophy, the position of
the transitional fold alters. On the vestibular aspect, the
arch of the fold flattens and aligns with the denture
base, while the attachment sites of the muscles and
frenulum shift nearer to the centre of the alveolar
ridge. This significantly diminishes the expanse of the
denture field, adversely impacting denture retention
[2, 18, 19]. It is crucial to avert the complete loss of all
teeth in the patient due to these procedures.
Prosthetics in the whole absence of teeth do not
consistently yield the intended outcome [1, 3]. The
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and Management Studies
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European International Journal of Multidisciplinary Research and Management Studies
natural teeth in the oral cavity maintain the volume of
the jawbone, and even with a limited number of teeth,
the retention of a removable prosthesis is significantly
more successful than in the full absence of teeth,
particularly evident when fabricating a prosthesis for
the mandible [20]. Inadequate assessment of periapical
tissues results in the extraction of roots that might
stabilise a detachable prosthesis, hence enhancing its
retention dramatically [21]. Numerous approaches
exist for repairing the crown portion of a tooth through
various stump post configurations; however, their
efficacy in detachable prostheses is not always reliable.
Consequently, overlapping prostheses including locking
mechanisms and dental implants are gaining popularity
in the field of prosthetic dentistry. This type of
prosthetic construction can mitigate the atrophy of the
alveolar process and enhance the stability of removable
prostheses [22]. Lock fasteners alleviate pressure on
the mucosa and enhance functional efficiency by
redistributing pressure to the supporting teeth, hence
positively influencing the stabilisation and retention of
prosthetic devices [24]. The diminution of the base
border expedites patients' adaption to prostheses,
while the inconspicuous attachment parts facilitate the
attainment of an optimal aesthetic outcome.
The objective of the study is to enhance the quality of
prosthetic therapy for partially edentulous patients by
the utilisation of overlapping prostheses anchored by
spherical attachments, dental implants, and collapsable
dental implants.
METHODS
A total of 27 patients (12 males and 15 females), aged
between 59 and 74 years, received treatment at the
Department of Orthopaedic Dentistry of Samarkand
State Medical University. The disease of dental arches
was characterised by isolated teeth with compromised
crowns. The objective examination encompassed an
external assessment of the face, oral cavity, and
mucous membrane of the denture bed, with particular
emphasis on evaluating the periodontal status of the
remaining tooth roots. Three-dimensional dental
computed tomography was conducted to assess the
condition of the supporting teeth's bone tissue, as well
as in patients with dental implants. The research was
conducted using a digital dental computed tomography
system
equipped
with
panoramic
diagnostic
capabilities, specifically the "Kodak 9000 3D". The
patients were categorised into three groups for the
study. The initial control group comprised 10 patients
who received partial removable plate prostheses (6 for
the maxilla and 4 for the mandible) fabricated using
standard methodologies, while the second group
consisted of 9 patients who were fitted with
overlapping
prostheses
featuring
spherical
attachments (5 for the maxilla and 4 for the mandible)
based on our proposed technique. A metal framework
was utilised in two overlapping prostheses, integrated
with lock fittings and entirely covering the denture
base. Two to three dental implants were placed per
jaw, together with five overlapping prostheses (two for
the maxilla and three for the mandible). A metallic
framework was employed in three interlacing
prosthesis. The hygienic quality of removable dentures
was evaluated using a method that allows for the
assessment of plaque accumulation on the prosthesis.
The ASKD-DPI denture plaque index (2015) was utilised
for assessing the plaque index of removable dentures.
Digital data was analysed on a personal computer
employing the variation statistics method with the
Statistica software program. Outcomes and discourse
Following an objective assessment, all patients were
diagnosed with "partial edentulism of class I per
Kennedy classification, and a complete loss of
masticatory efficiency as per Agapov." Following clinical
and radiographic evaluations, the dental roots were
retained, and custom-fitted stump pin inserts were
fabricated. Spherical locking fasteners served as
securing components. A dental implantation procedure
was
conducted
including
the
placement
of
commercially available, collapsable dental implants.
The production of overlapping prostheses with cast
stump pin tabs and dental implants with spherical lock
fasteners involved obtaining an impression from the
jaw, from which the prosthesis was later fabricated,
employing either a two-layer, two-stage or a one-stage
process with silicone material. During the project,
several silicone impression materials were utilised,
including C-silicones such as Speedex, Stomaflex, and
Zetaplus; And-silicones such as 3M Express, Elite HD,
and Ultrasil; in addition to the polyester impression
substance 3M Impregnum. The impression was filled
with a modelling plastic devoid of ash and exhibiting
minimal shrinkage. Design Resin exhibiting a supporting
tooth with a moulded steel pin insert and a
suprastructure configured as a spherical lock
attachment or an implant featuring a spherical
abutment. Retention features, comprising longitudinal
and transverse grooves, were created on the
counterpart of the pin stump insert in the section
intended for fixation within the gypsum model to
provide optimal mechanical adherence of ash-free
plastic to gypsum. Upon the completion of
polymerisation of the plastic, a functional model was
fabricated using GC FujiRock super gypsum. Upon the
crystallisation of the gypsum, the impression was
excised to prevent distortion of the structural
components and detached from the model. The
insertion path of the prosthesis was established on the
milling parallelometric device's table using an analytical
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and Management Studies
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European International Journal of Multidisciplinary Research and Management Studies
rod. Bushings for lock fasteners were affixed to the lock
component constructed from ash-free plastic, and the
contours of the prosthesis base were delineated.
Occlusal rollers were fabricated from base wax and
used in the clinic to ascertain and document the height
of the lower third of the face, as well as the dimensions,
morphology, and hue of artificial teeth. Artificial teeth
were positioned in the laboratory, and wax was
substituted with plastic. The locking sleeve was
positioned at the base of the overlapping prosthesis,
and a metal framework was incorporated to fabricate
the frame prosthesis. The completed prosthesis was
secured and positioned in the patient's oral cavity at
the clinic. Following the application of the fabricated
orthopaedic devices, the patients reported minimal
discomfort. The self-fixation of dentures in the oral
cavity and their removal by patients presented no
challenges. The patients were arranged for follow-up
appointments at 6, 12, and 24 months. After six
months, four patients in the control group exhibited a
decline in the stability of the partial detachable plate
prosthesis. After 12 months, a decline in fixation was
observed in 9 patients from the control group and in 2
patients from the main group, who received
replacement prostheses utilising cast stump pin tabs
with spherical locking fasteners. After 24 months,
patients in the control group observed a decline in the
fixation of partial removable plate prostheses, while 3
patients in the main group, who received replacement
prostheses utilising cast stump pin tabs with spherical
locking fasteners, 1 patient with a frame prosthesis
employing cast stump pin tabs with spherical locking
fasteners, and 1 patient with an overlapping prosthesis
based on cast pin stump inserts with spherical lock
fasteners and dental implants featuring spherical
abutments, also reported similar issues. Patients were
advised to utilise hygiene products for the effective
cleaning of removable orthopaedic structures. Korega
cleansing tablets, produced by GlaxoSmithKline
Healthcare, represent the most easy and cost-effective
method for cleaning removable dentures. Korega
cleansing tablets comprise a unique formulation of
TAED (tetraacetylethylene diamine), which amplifies
antimicrobial efficacy against bacteria and fungi
responsible for halitosis, sodium carbonate and
potassium monopersulfate for stain removal, and the
surfactant sodium lauryl sulphate for efficient
prosthesis cleansing. The tablets are designed for the
everyday maintenance of detachable orthopaedic
devices. To achieve optimal results, adhere to the
guidelines specified on the packaging: Submerge the
prosthesis in Koreg solution for 3-5 minutes. For
optimal results, cleanse the denture with Koreg
solution with a soft brush, then rinse the prosthesis well
under running water. After 12 months, the dental
hygiene index scores in the control group were
distributed as follows: Three patients exhibited 0-30%;
four patients exhibited 31-70%; three patients
exhibited 71-100%. Main hospital: nine patients
exhibited 0-30%; six patients exhibited 31-70%; two
patients exhibited 71-100%. Hygiene was deemed
satisfactory in 82% of patients.
CONCLUSIONS
An examination of the orthopaedic management of 27
patients with solitary teeth and dental roots, who were
provided with partial removable plates and overlapping
prostheses utilising cast stump pin tabs and dental
implants with spherical locking mechanisms, indicates
that the efficacy of prosthetics is contingent upon the
judicious selection of orthopaedic design and the
clinical context, alongside an accurate evaluation of the
periodontal status of the supporting teeth and the
identification of contraindications for the fabrication of
cast stump pin inserts with spherical locking fasteners.
The suggested technique for producing overlapping
prostheses utilising spherical attachments enables the
fabrication of prostheses without the need for clinical
relocation to install fixation elements in the prosthesis
base. Analogous plastic locking fasteners facilitate the
immediate simulation of an overlapping prosthesis with
fixation elements directly on the model. The precision
of the orthopaedic structure generated by this 160
approach is enhanced. This positively influences the
quality of fixation and stabilisation of the prosthesis.
Consistent washing of dentures is essential for optimal
oral hygiene maintenance; Korega cleansing tablets
facilitate the achievement of an adequate hygiene
standard.
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