International Journal of Current Research and Review Original Study

DOI: http://dx.doi.org/10.31782/IJCRR.2021.131505

Comparative Evaluation of the Retention of

Maxillary Complete Denture Bases Made by Heat
IJCRR Cure Acrylic Resin Processed on High Expansion
Section: Healthcare
ISI Impact Factor
(2019-20): 1.628
Stone and Type III Dental Stone: An In-Vivo Study
IC Value (2019): 90.81
SJIF (2020) = 7.893
Shruti Keerthi Thota1, Mahalakshmi Gujjalapudi*2, Chandrasekar Anam3,
Copyright@IJCRR
Radha Chiluka4, Praveen Mamidi5, Swaroopkumar M Magar6
1
MDS Prosthodontics, 12445 AlamedaTrace Cir, Apt 118, Austin, Texas, 78727; 2Associate Professor, Department of Prosthodontics, Govern-
ment Dental College, Kadapa, Andhra Pradesh, India; 3Professor and Head, Department of Prosthodontics, SVS Institute of Dental Sciences,
Mahboobnagar, Telangana, India; 4Reader, Department of Prosthodontics, Panineeya Mahavidyalaya Institute of Dental Sciences, road no.5,
Kamala Nagar, Chaithanyapuri, Hyderabad, Telangana-500060, India; 5Professor and Head, Department of Prosthodontics, Panineeya
Mahavidyalaya Institute of Dental Sciences, Raod no 5, Kamala nagar, Chaithanyapuri, Hyderabad,Telangana-500060, India;
6
Reader, Department of Prosthodontics, Saraswati Dhanwantari Dental College and Research Institute, Perbhani, Maharashtra, India.

ABSTRACT
Introduction: Accurate fit of the complete denture is the most important factor in prosthodontic practice. The primary contribu-
tors for the retention are the good base adaptation of a denture to underlying mucosa and the border seal. Despite the success
of acrylic resins as denture base materials, the dimensional changes caused by them must be accepted as one of the disadvan-
tages of acrylic resin dentures.
Objectives: The present study aimed to investigate the retention of maxillary complete denture bases made on type III and type
V dental stones.
Methodology: 15 completely edentulous patients who needed prostheses were included in this study. After primary and second-
ary impressions, two casts were prepared from the mould, one using the type-III dental stone and another with type-V stone.
Thermoplastic resin gaskets of 2 mm in thickness were used to prepare denture bases models on both casts. Heat cure denture
bases were fabricated on the prepared casts and retention was measured using an electronic scale.
Results: It was observed that the mean retentive force increased up to 30% with denture base made on type V dental stone
(mean retentive force 4.46N) than denture base made on type III dental stone (mean retentive force 3.12N).
Conclusion: Based on the study findings, it was concluded that denture bases made on type V stone compensated to a sub-
stantial degree for the shrinkage of acrylic resin and plays an important role in obtaining the optimum retention of the maxillary
complete denture.
Key Words: Maxillary complete denture, Retention, Type III dental stone, Type V dental stone

INTRODUCTION ic pressure, viscosity, base adaption, border seal, muscular

control etc. have all been cited as major or contributory fac-
Denture retention is defined as “resistance of a denture to tors in affecting retention. However, it was observed that not
vertical movement away from the tissues”.1 In simple words, all the factors as they claimed are responsible for affecting
it refers to the force which resists the displacement of a den- complete denture retention and failed to survive scientific
ture in occlusal direction. It is a well- known fact that the ac- scrutiny. 3
curate fit of the denture base to the mucosal tissue and border
seal plays an important role in enhancing the retention and Acrylic polymer resins i.e. polymethyl methacrylate
stability of the complete denture. 2 Various factors such as (PMMA) are the commonly used denture base materials
adhesion, cohesion, interfacial surface tension, atmospher- for the past 60 years. Despite its drawbacks such as shrink-

Corresponding Author:
Dr. Mahalakshmi Gujjalapudi, Associate Professor, Department of Prosthodontics, Government Dental College, Kadapa, Andhra Pradesh,
India; Email: gmahalakshmi@gmail.com
ISSN: 2231-2196 (Print) ISSN: 0975-5241 (Online)
Received: 12.01.2021 Revised: 06.02.2021 Accepted: 29.03.2021 Published: 10.08.2021

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 Thota et al: Retention of maxillary complete denture bases

age and dimensional changes during polymerization, it re- stone(Kalabhai enterprises, India) and another with type-V
mained as the material of choice for denture base fabrication stone (Hardrock, whip mix, USA). Thermoplastic resin gas-
4,5,6
reported that the dimensional changes in the denture oc- kets of 2 mm in thickness were used to prepare denture base
cur irrespective of the processing techniques or the acrylic models on both casts (Figure 1). The clear resin bases were
resin is chosen. The first unavoidable dimensional change invested and the molds thus obtained were packed with heat
is shrinkage, which occurs during processing and finishing cure acrylic resin(Dentsply, UK) to prepare permanent den-
(0.3- 0.5%). The second change is the linear expansion of ture bases. Flasks containing the bases were kept in room
0.1- 0.2%, which occurs due to the storage of the dentures in temperature water, the temperature was gradually raised to
a water bath or due to the absorption of oral fluids while in 740C and maintained for 9 hours in a thermostatically con-
the oral cavity.7,8,9 trolled acrylization unit.
Various studies have been conducted in the past analysing the After polymerization, the flasks were allowed to bench cool
retention of maxillary denture base with and without border for one hour, and the denture bases were removed carefully.
molding, different border molding materials, different border Any remnants of stone or blebs of acrylic resin were removed
molding techniques, different posterior palatal seals etc. 10-13 carefully with the help of acrylic resin bur under magnifica-
However, little research has been done, to study the influ- tion. The denture bases were polished; handles were fabri-
ence of the type of dental stone used to fabricate the cast. It cated on the trays using self- cure acrylic resin (DPI) (Figure
is found that the coefficient of linear expansion in type III 2). The denture bases were then subjected to evaluation of
dental stone and increased expansion of type V stone com- retention.
pensates for the dimensional changes resulting from shrink-
For measuring retention, an electronic scale was used (Fig-
age in denture bases. 14 The present study was conducted to
ure 3). The maximum amount of force required to dislodge
evaluate and compare the retention of maxillary complete
the maxillary denture bases was measured using this scale.
denture bases made on type III and type V dental stones. The
The retention of the maxillary denture bases was tested after
null hypothesis was that there would be no significant dif-
they remained in the patient’s mouth for a minimum of 15 to
ference in the retentive forces applied on the denture base
20 minutes. The patient was then made to seat in a comfort-
fabricated on type III and type V dental stone.
able position and was instructed not to exert any pressure on
the denture base with the tongue. The electronic scale was
then attached to the specially made handle to the denture
MATERIALS AND METHODS base (Figure 4). The amount of load was gradually in the
electronic scale till the maxillary denture base dislodge and
Sample selection the readings were noted down.
Fifteen completely edentulous patients who required pros-
Statistical analysis: Collected data were analysed with t-test
theses were included in this study. The study was carried out
statistics for statistically significant differences at the 95%
in the Prosthodontics Department of Panineeya Institute of
confidence level. Statistical analysis was performed using
Dental sciences. Prior approval was obtained from the ethics
software IBM SPSS version 20.0. A value of P<0.05 was
committee of the institution to conduct the study. Patients
considered statistically significant.
with maxillary edentulous arch, with a minimum of 6 months
of healing period following extraction, with no signs of in-
fection, well-healed, round, smooth, resilient and thick oral
mucosa covering the ridge were included. Ridges without RESULTS
any unilateral or bilateral undercuts were selected. Patients The amount of forces applied to dislodge the denture bases
who had limited mouth opening and with abnormal Salivary were considered as the retentive values. For each patient, five
slow were excluded from the study. readings were taken for the type III and type V denture bases
of each patient and the mean of these values was obtained.
Methodology
Group 1 i.e. type III dental stone showed the minimum val-
The primary impression of the denture bearing area was ob-
ue, in the range of measurement of dislodging force, to be
tained with impression compound (DPI, Pinnacle), special
1.56N and the maximum value to be 5.09N, with an aver-
trays were fabricated using self-cure acrylic resin and were
aging group mean of 3.12N respectively. Group 2 i.e. type
border molded to get an acceptable extension and border
V dental stone showed the minimum value, in the range of
thickness. The master cast was then obtained from the fi-
measurement of dislodging force, to be 3.02N and the maxi-
nal impression, which is then positioned and sealed using
mum value to be 6.32N, with an averaging group mean of
modelling wax in the duplicating flask and duplicated us-
4.46N respectively (Table 1).
ing duplicating silicone (Unisil Flow, Chennai). Two casts
were prepared from the mould, one using the type-III dental The computed value of the “independent t-test” was highly

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 Thota et al: Retention of maxillary complete denture bases

significant (p= 0.002) implying that the means of the two ers. Denture wearers, usually learn to effectively control the
groups i.e. type III and type V dental stone were highly dif- dentures and master patterns of orofacial muscular activity,
ferent from each other. In simple words, the mean force serve to retain, rather than displace, their prosthesis. 18 We
required to dislodge denture bases made on type V stone believe that these retention values are not a true reflection of
(4.46N) was larger than the mean force to dislodge denture retentive force offered by the denture base fabricated on den-
bases made on type III stone (3.12N) at p<0.05 level. tal stone, but is a combination of effective muscular control
of denture wearers and dental stone. To avoid the bias from
The variations among the observations on the force of dis-
muscular retention, we constantly reminded the patients to
lodgement concerning type III and type V dental stones have
relax their cheeks and other muscles, and the average of re-
been depicted diagrammatically (Figure 5).
petitive measurements was considered for statistical analy-
sis. The authors only have measured the dislodging forces
on single occasion. They have not studied the effect on the
DISCUSSION retention of denture bases due to immersion in water for up
Following the results of the present study, the stated null hy- to one week, as evidence suggested that water sorption can
pothesis was rejected, meaning the use of maxillary denture help compensate for processing shrinkage by expanding the
bases made on high expansion type V dental stone exhibited denture.19,20,21 The retentive forces of the denture bases made
higher retention than type III dental stone. on type III and type V dental stones must be verified at dif-
ferent time intervals. Lastly, the authors did not analyse the
Despite many factors cited for the retention of the complete setting expansion of type III and type V dental stones. Fur-
dentures, only a few have survived the scientific scrutiny. ther research is needed to understand how much compensa-
They include surface tension, base adaptation, viscosity, tion is acquired using type III and type V dental concerning
seating force, soft tissue and time. Many believed that good the polymerisation shrinkage of the acrylic denture bases.
base adaptation and border seal as primary contributors for
the retention of the denture base and must be achieved. 15, 16
even though the denture bases fabricated using acrylic resins
CONCLUSION
have desirable characteristics, both shrinkage and expansion
are inevitable. Even though the properties of acrylic resins in Within the limitations of the present in vivo study, it can be
complete dentures were improved, the problem persists. 17 In concluded that the maxillary denture bases fabricated on
1996, Sykora and Sutow, investigated the ability of high ex- type V dental stone had offered better retention than the den-
pansion stone in reducing the processing distortions of acryl- ture bases fabricated on type III dental stone. This recom-
ic resin denture bases. They found that the denture bases pro- mends the use of type V dental stone, which is especially
cessed on high expansion stone had better posterior palatal beneficial in situations where retention is compromised due
seal adaptation (Sykora and Sutow,1996). Again in 1997, the to anatomic factors.
same authors tested the ability of high expansion stone in
Conflict of Interest: None
compensating for some of the dimensional changes occur-
ring in acrylic denture bases. Their results demonstrated that Source of funding: Self
expansion of the stone can help compensate for shrinkage
Authors contribution
that occurs in acrylic resin material.
1. Keerthi Thota S – Data collection
The findings of the present study showed that the use of type
V dental stone improved the fit of the maxillary complete 2. Gujjalapudi M – Study design
dentures compared with type III dental stone. Type V den- 3. Anam C - Investigation
tal stones have exhibited a mean dislodging force of 4.46N 4. Chiluka R – Manuscript writing
(ranging from 3.02N to 6.32 N)which is significantly higher 5. Mamidi P- Editing
than type III stone, which has a mean dislodging force of 6. Magar SM- Review
3.12N (1.56N to 5.09N). It shows that approximately 30%
increase in the retentive force of maxillary denture bases
made on type V dental stone compared to those made on REFERENCES
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A comparative study of retention of complete denture base with

Table 1: Independent t-test comparing the values of mean dislodging force and range among type III and type
V dental stone
Group Statistics
Group N Mean Std. Deviation Minimum Maximum
Force Type- III 15 3.1233 1.04570 1.56 5.09
Type V 15 4.4647 1.11169 3.02 6.32

t-test for Equality of Means

t df Sig. Mean Difference Std. Error Difference 95% Confidence Interval
(2-tailed) of the Difference
Lower Upper
Force -3.41 28 0.002* -1.34133 0.39407 -2.14855 -0.53412

*Statistically significant

Figure 2: Finished and polished heat cure acrylic bases with

Figure 1: Denture Base models prepared with thermoplastic handles processed with self-cure acrylic for checking the re-
resin sheet of 2mm thickness using a vacuum forming machine. tention in the patient.

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 Thota et al: Retention of maxillary complete denture bases

Figure 3: Electronic scale used to measure the load required to dislodge the denture bases.

Figure 4: Retention of maxillary bases fabricated on type-III & Type-V stone casts evaluated in the patient using an electronic
scale.

Figure 5: Pattern of the force of dislodgement in two study groups.

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