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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1558-1560  

Assessment of cases of complete denture fracture


1 Department of Prosthodontics and Crown and Bridge, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh, Punjab, India
2 Department of Physiology, Government Medical College, Doda, Jammu and Kashmir, India

Date of Submission30-Mar-2021
Date of Decision05-May-2021
Date of Acceptance09-May-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Ranjna Kumari
Department of Prosthodontics and Crown and Bridge, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh - 147 301, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_284_21

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   Abstract 


Background: There are many causes and reasons associated with fractures of complete dentures. The present study assessed case of complete denture fracture. Materials and Methods: One hundred and fifty complete denture wearers reported to the department of prosthodontics for correction of complete denture fracture were examined carefully. The factors such as retention, stability, and occlusal errors were recorded. Cause of denture fracture was recorded too. Results: Out of 150 patients, males were 80 and females were 70. The site of fracture was incisor area in 25, canine area in 30, midline in 50, molar area in 10, and maxillary tuberosity/retromolar pad area in 35 cases. The etiology of denture fracture was accidental fall in 42, poor fit in 28, poor occlusion in 40, material breakage in 25, and acrylic base defect in 15 cases. The difference was statistically significant (P < 0.05). Conclusion: Most common cause of denture fracture was accidental fall, poor fit, poor occlusion, and material breakage.

Keywords: Denture fracture, material breakage, occlusion


How to cite this article:
Kumari R, Bala S. Assessment of cases of complete denture fracture. J Pharm Bioall Sci 2021;13, Suppl S2:1558-60

How to cite this URL:
Kumari R, Bala S. Assessment of cases of complete denture fracture. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Aug 16];13, Suppl S2:1558-60. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1558/330067




   Introduction Top


Artificial replacement of human teeth had occupied an important role in the history of human civilization.[1] From time immemorial, it has been observed that various types of materials such as wood, bone, ivory, precious and semi-precious metal, and alloys have been used as denture material.[2] Furthermore porcelain and vulcanite rubber were used for artificial teeth and denture base at different times. Acrylic resin, which came into market in 1950s, was widely accepted as denture base material, because of its excellent properties such as good esthetic value, ease of manipulation, ease of repair, and also economic. Since then it is still dominating the field of Prosthetic Dentistry.[3] Subsequently, many other materials such as valplast (Flexi-denture) came in the market but could not compete with acrylic resin so far, because repair, relining, and adjustment of dentures with other materials is a difficult proposition or absolutely impossible.[3] Furthermore, acrylic teeth do not get chemically bonded to flexi-denture materials, and in case of breakage, it is difficult to replace. Polishability of the flexi material is also compromised. Acrylic resin is therefore still the material of choice for artificial denture, but its proneness to fracture deserves special attention to prevent and rectify it.[4]

As literature suggests, there are many causes and reasons associated with fractures of complete dentures. The life of a complete denture wearer is abruptly paralyzed by the sudden fracture of his/her denture which is of utmost necessity for his/her day to day routine life.[5] As part of the dental education faculty, it is always our goal to make the life of denture-wearers easier and happier by investigating and solving the problems related to complete denture patients.[6] The present study assessed case of complete denture fracture.


   Materials and Methods Top


The present study consisted of 150 complete denture wearer reported to the Department of Prosthodontics for correction of complete denture fracture.

Data such as name, age, etc., were recorded. Denture was examined carefully. Factors such as retention, stability, and occlusal errors were recorded. Cause of denture fracture was recorded too. Results thus obtained were subjected to the statistical analysis using Mann–Whitney U test. P <0.05 was considered significant.


   Results Top


[Table 1] shows that out of 150 patients, males were 80 and females were 70.
Table 1: Gender Distribution of patients

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[Table 2] and [Graph 1] shows that site of fracture was incisor area in 25, canine area in 30, midline in 50, molar area in 10, and maxillary tuberosity/retromolar pad area in 35 cases. The difference was statistically significant (P < 0.05).
Table 2: Site of fracture

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[Table 3] and [Graph 2] show that etiology of denture fracture was accidental fall in 42, poor fit in 28, poor occlusion in 40, material breakage in 25, and acrylic base defect in 15 cases. The difference was statistically significant (P < 0.05).
Table 3: Etiology of fracture

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   Discussion Top


The most common causes of denture fracture may be either extra-oral cause like fall from patient's hand to the hard ground surface or inside the mouth during function. One has to depend mostly upon the users' version for the cause of the denture fracture.[7] Inside the mouth, fracture can happen for various reasons like improper occlusion, placement of artificial teeth in the buccal slope of the ridge or against the palate, pressure from opposing natural teeth, poor retention and stability, prolonged use causing wear of artificial teeth and re-sorption of residual ridge, presence of high frenal attachments, prominent mid palatine suture, palatal or lingual torus, hard or soft tissue undercut, etc. Defects in the denture may also be created during laboratory procedure.[8] This may include thin denture base, placing the artificial teeth in the buccal slope of the ridge, incorporation of metal strengtheners, inclusions like plaster or air bubbles within the material, porosity, deep scratches which act as a stress raiser and predispose the denture to fracture.[9] The present study assessed case of complete denture fracture.

In present study, out of 150 patients, males were 80 and females were 70. We found that site of fracture was incisor area in 25, canine area in 30, midline in 50, molar area in 10 and maxillary tuberosity/retromolar pad area in 35 cases. Naik[10] in their study found that the ratio of fracture of upper to lower denture was 1:3. Most fractures were common among males (55%). The most common reason being accidental dropping of the denture in case of the lower and improper fit and stability of the denture, improper arrangement and occlusion of the teeth for the upper one. Midline fracture was the most common site of fracture (60%). After analysis, the causes for the fracture were divided into material factors and clinical/technical factors. It was concluded that the after denture delivery, instructions of denture care were required to reduce mishaps, proper principles of denture construction were required for mechanical advantage of the denture – balanced occlusion, removal of interferences, reduction of stress concentration areas, etc., has to be followed.

We observed that etiology of denture fracture was accidental fall in 42, poor fit in 28, poor occlusion in 40, material breakage in 25, and acrylic base defect in 15 cases. Ray et al.[11] in their study, 81 reported fracture cases out of 646 complete dentures were selected for this study, out of which upper was 33 (40.8%) and lower was 48 (59.2%). It was also noted that, in case of complete denture fracture, 57 cases (70.37%) had midline fracture, 15 cases (18.52%) had fracture elsewhere in denture and in 9 cases (11.11%) teeth were de-bonded from the base. When the presence of porosity and crazing causes fracture of denture, we had seen that in case of complete denture, these were present in 29 cases (35.80%) and absent in 52 cases (64.20%). Twenty-seven cases (33.33%) opposed natural dentition. In 26 cases (32.10%), artificial teeth were set on ridge and in 55 cases (67.90%), teeth are buccal to ridge. When retention and stability were concerned, out of 81 fractured complete dentures, in 66 cases, these were poor. Occlusal prematurity also influences denture fracture. In complete denture fracture cases, out of 81 cases, occlusal prematurity was present in 59 cases.

According to Beyli and von Fraunhofer,[12] it is clear that internal defects in the acrylic denture base such as voids, porosities, notches, scratches, and residual stresses are predominant factors in the fracture of the denture. These areas of stress concentration lead to crack formation and propagation.

The shortcoming of the study is small sample size.


   Conclusion Top


The authors found that most common cause of denture fracture was accidental fall, poor fit, poor occlusion, and material breakage.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Smith DC. The acrylic denture: Mechanical evaluation mid-line fracture. Br Dent J 1961;110:257-67.  Back to cited text no. 1
    
2.
Hargreaves AS. The prevalence of fractured dentures. Br Dent J 1969;126:451-5.  Back to cited text no. 2
    
3.
Jagger DC, Harrison A, Jandt KD. The reinforcement of dentures. J Oral Rehabil 1999;26:185-94.  Back to cited text no. 3
    
4.
Darbar UR, Huggett R, Harrison A. Denture fracture: A survey. Br Dent J 1994;176:342-5.  Back to cited text no. 4
    
5.
Wiskott HW, Nicholls JI, Belser UC. Stress fatigue: Basic principles and prosthodontic implications. Int J Prosthodont 1995;8:105-16.  Back to cited text no. 5
    
6.
Jagger DC, Harrison A. The fractured denture-solving the problem. J Prim Dent Care 1998;5:159-62.  Back to cited text no. 6
    
7.
Kydd WL. Complete base deformation with varied occlusal tooth form. J Prosthet Dent 1956;6:714-8.  Back to cited text no. 7
    
8.
Lambrecht JR, Kydd WL. A functional stress analysis of the maxillary complete denture base. J Prosthet Dent 1962;12:865-72.  Back to cited text no. 8
    
9.
Rees JS, Huggett R, Harrison A. Finite element analysis of the stress concentrating effect of fraenal notches in complete dentures. Int J Prosthodont 1990;3:238-40.  Back to cited text no. 9
    
10.
Naik AV. Complete denture fractures: A clinical study. J Indian Prosthodont Soc 2009;9:148.  Back to cited text no. 10
  [Full text]  
11.
Ray PK, Makhal M, Sen SK. Incidence and causes of fracture of acrylic resin complete denture. J Evol Med Dent Sci 2014;3:14787-94.  Back to cited text no. 11
    
12.
Beyli MS, von Fraunhofer JA. An analysis of causes of fracture acrylic resin dentures. J Prosthet Dent 1981;46:236.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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