Finn Fløystrand

A novel miniature bite force recorder and its clinical application

Solid state components were used to construct a miniature bite force recorder suitable for registrations in large study groups. A semiconductor was chosen as the sensory unit. The complete recording system included a power supply, the bite force recorder, a chart recorder and a millivoltmeter. Laboratory calibration tests were performed to screen the limitations of the recorder. Series of loads were applied in the range from 10 to 1000 N. Eight females and eight males, 20 to 25 years old, were asked to produce a succession of maximum bites at three second intervals for as long as possible. The bite force recorder was positioned between the first molars on the left side. The laboratory tests showed that loads in the range from 10 to 1000 N were recorded with an error less than four percent. In the clinical tests, the mean maximal bite force was 500 N ranging from 330 to 680 N. The number of maximum bites varied from 5 to 27. No statistically significant differences were observed between the sexes as regards the maximal bite force and the number of bites.

Assessment of an additive index for plaque accumulation on complete maxillary dentures

There appears to be a relation between accumulation of plaque on complete maxillary dentures and denture stomatitis. The present index was introduced to assess the location and amount of plaque in some areas of the fitting surfaces of complete maxillary dentures. Scores were recorded in five defined areas on the denture base. Four ranked scores were used: 0 - no visible plaque, 1-plaque visible only by scraping on the denture base with a blunt instrument, 2-moderate accumulation of visible plaque, and 3-abundance of plaque. By summing up the scores from the five areas, the plaque was recorded on a scale from 0 to 15 points. The inter- and intra-reliability were tested for two examiners using the index on 50 complete maxillary dentures. Expressed in terms of Scotts Pi, inter-examiners agreement was 0.83, and intra-examiner 0.83 and 0.82 for examiners A and B, respectively. A simplification of the index was also presented. In this index the scores 0 and 1 were combined to score 0, -no visible plaque, and score 2 and 3 were combined to score 1, -visible plaque. Using this index, Scotts Pi was calculated to 0.91 for inter-examiner reliability. For the intra-examiners reliability Scotts Pi was calculated to 0.91 for examiner A and 0.89 for examiner B.

Dimensional stability of elastomeric impression materials in custom-made and stock trays

Elastomeric impression materials for fixed prosthodontics are considered most stable when they have an even thickness of 2 to 4 mm. To obtain this, a custom-made impression tray is recommended. The purpose of the present study was to compare the stability of impressions made in custom trays and trays made of chromium-plated brass. The impression materials chosen were polyether and silicone. Two master models of the upper jaw were made of metal. The canines and first molars represented abutment teeth with flat occlusal surfaces. An engraved cross on each surface made it possible to measure in a microscope the distances between the abutment teeth on the models and in the impressions. The accuracy of the method was within +/- 8 micron. Twelve standardized impressions were made with each impression material in the two types of trays. The distances between the abutment teeth were measured immediately on removal of the impression, and after 1 and 24 hours. Although ample amount of impression material (2 to 9 mm) was allowed, the linear dimensional stability of the impressions made in stock trays was not inferior to the stability of impressions made in custom-made trays.

Experiments on in vivo biofilm formation and in vitro adhesion of Candida species on polysiloxane liners.

OBJECTIVES Microorganisms may colonise polysiloxane soft liners leading to bio-deterioration. The aim of this study was to investigate in vitro adhesion and in vivo biofilm formation of Candida species on polysiloxane surfaces. METHODS The materials used in this study were Molloplast B, GC Reline soft, Mollosil Plus, Silagum Comfort and Palapress Vario. The in vitro retention of clinical isolates of Candida albicans to the relining and denture-base materials by microscopic (scanning electron microscopy, SEM), conventional culturing methods and antimicrobial properties of these materials were studied. Candida found on materials and mucosa following long-term use were identified and quantified, and biofilms covering the surfaces were investigated by SEM. RESULTS There was a significant decrease in the number of cells attached in vitro to saliva-coated surfaces compared with non-treated surfaces. An oral Candida carriage of 78% was found. Candida albicans, C. glabrata, C. intermedia and C. tropicalis were identified. In vivo biofilm formation on the liners appeared as massive colonisation by microorganisms. CONCLUSIONS The results of the in vitro experiments suggest that salivary film influences early colonisation of different C. albicans strains. The film layer also minimises the differences among different strains. The Candida carriage of these patients was similar to denture-wearing patients without soft liners.

Retention of complete maxillary dentures related to soft tissue function.

The influence of free tongue, lip, and cheek function on the retention of complete maxillary dentures was investigated for five experienced denture wearers. Test dentures were designed with full palatal coverage and functionally determined filling in of the vestibular sulcus. The front teeth were arranged primarily to meet cosmetic demands--that is, anterior to the top of the residual alveolar ridge. Retention was measured as resistance to dislodgement-provoking loads applied vertically to the incisive edge of the central incisors, using a miniature bite force recorder. All the participants were able to load their front teeth with 35 N or more without loss of retention. None of them experienced denture dislodgement provided the tongue, lips, and cheeks wee allowed to act freely. If the peripheral soft tissues were separated from the vestibular denture flange, no obvious effect on denture retention could be detected. Physically preventing the tongue from pressing against the posterior part of the denture reduced the retention significantly. Measurements of anterior loads tolerated after stepwise reductions of the denture extension indicated that the tongue acted primarily by pressure against the tuber regions. Tongue pressure against the central parts of the palate and lip or cheek pressure against the vestibular flange seemed to be of less importance.

Retention of complete maxillary dentures as a result of changes in design

The influence of complete maxillary denture design on retention was studied under clinical conditions simulating chewing. Five persons with an edentulous maxilla and a natural dentition of at least 10 teeth in the mandible participated. Retention was measured with a miniature bite force sensor. The occlusal load required to provoke denture dislodgement was recorded. The general principles of denture design were as follows: the bicuspids and molars were set on top of the residual ridge; the thickness of the denture borders was determined functionally; and the palate was covered to the vibration line, without attempts at border compressions. The details that were changed to evaluate their influence on denture retention were as follows: the point of attack of the dislodgement-provoking load alternated between three distinct pits, situated 2 mm apart in the buccopalatal direction on the occlusal surface of the first right bicuspid; the vestibular denture border on the left side was reduced stepwise to 75%, 50%, and 25% of its original thickness; and the distal extension of the palatal denture border was shortened stepwise (2 + 2 mm, as measured in the midline). Measurements pertaining to one specific problem were carried out within a period of 2 h. The results confirmed the concepts that lingualized occlusal contact, functionally determined filling in of the vestibular sulcus, and full palatal coverage to the vibration line all have a positive influence on the retention of complete maxillary dentures.

Retention of complete maxillary dentures measured as resistance against unilateral occlusal loading

Complete maxillary dentures were tested for their ability to remain in place when subjected to unilateral occlusal loads. The test material comprised five persons, each supplied with three identical dentures. The denture design was based on the principles of 1) functionally determined filling-in of the vestibular sulcus, 2) palatal coverage to the vibration line without post dam, 3) aesthetically governed positioning of the front teeth, and 4) positioning of the lateral teeth in the plane connecting the top of the residual ridge with the central part of the occlusal surface of the antagonizing natural teeth. Resistance to unilateral occlusal loads was measured by means of a miniature bite force sensor. In the pooled material, an average load of 70 N was tolerated before the dentures were dislodged. For a given participant/denture combination, the resistance against dislodgment varied considerably when tested on different days. Marked differences were also found among three identical dentures in one person. The tolerance against unilateral occlusal loads could feasibly be quantified. However, the influence of specific clinical and/or technological factors on denture retention during function should be studied only if strict definitions as to the test conditions are given. These conditions must include the time, person, and denture tested.