|Year : 2020 | Volume
| Issue : 1 | Page : 8-10
Prospective of denture adhesives in prosthodontics: A review
Chandrakala V, Deepmala S
Department of Prosthodontics, KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
|Date of Submission||11-Feb-2020|
|Date of Acceptance||16-Feb-2020|
|Date of Web Publication||20-Mar-2020|
Department of Prosthodontics, KLE Society’s Institute of Dental Sciences, Bengaluru, 560022 Karnataka.
Source of Support: None, Conflict of Interest: None
Denture adhesives have been used for many years by denture wearers, although properly fitted and maintained dentures should not require the use of denture adhesives. A number of studies have been conducted to assess the effectiveness of denture adhesives, but there have been few reports in the dental literature on the number of denture wearers who use them regularly. This could be due to the dismissive attitude of a prosthodontist and mistaken belief of its limitation only to compensate deficiencies in clinical and technical measures during denture fabrication. On the contrary, denture adhesives increase chewing efficiency with more retention, reduce denture instability, and provide more satisfaction; thus increasing the confidence of the patients under proper instructions of a prosthodontist about its cautioned use.
Keywords: Complete denture, denture adhesives, fixatives, retention, saliva
|How to cite this article:|
Chandrakala, Deepmala. Prospective of denture adhesives in prosthodontics: A review. Int J Oral Care Res 2020;8:8-10
| Introduction|| |
The denture adhesives are considered a useful additive treatment for enhancing denture retention and stability. The use of denture adhesives was first mentioned in dental literature in the nineteenth century, though its presence dates back to the late eighteenth century. Adhesives were formulated by mixing vegetable gums, which absorbed moisture from the saliva and swelled to a mucilaginous substrate that adhered to the mucosa of the mouth and the denture. According to Zarb et al., the term “denture adhesive” refers to a commercially available, nontoxic, soluble material that is applied to the tissue surface of the denture to enhance retention, stability, and function. Although their first application was reported in 1913, followed by other patents in the 1920s and 1930s, it was not until 1935 that the American Dental Association Council on Dental Materials, Instruments and Equipment characterized denture adhesives as nonmedical products.,,,
In 1967, Kapur conducted a study on 26 denture wearers and devised a method for scoring denture retention and stability. He concluded that denture adhesives increased denture retention, thereby improving denture wearer’s incisive ability. Stafford and Russell, using radiotelemetry, measured the change in pressure at the denture–base mucosa interface with and without adhesives and found that the denture adhesives allowed total occlusal greater pressure.
Tarbet et al. addressed the role of adhesives in denture retention and stability, and found that the patient perceived improved chewing ability, confidence, and comfort, and reduced wobble and collection of food particles under denture. Chew et al. used a kinesiographic technique to determine the effectiveness of denture adhesives in improving the retention and stability of the complete maxillary denture in vivo. Abdelmelak and Michael suggested that the denture adhesives act as a cushion under complete denture, reducing the transmission of pressure and friction to the underlying mucosa.,
| Constituents of Dental Fixatives|| |
The constituents of dental fixatives are as follows:
- Adhesive components, for example, gelatin, pectin, and sodium carboxymethylcellulose
- Antimicrobial agents, such as sodium borate, sodium tetraborate, and hexachlorophene
- Fillers, for example, magnesium oxide, sodium phosphate, and calcium silicate
- Flavoring agents, for example, peppermint oil
- Wetting agents, such as mineral oil
Denture adhesives can be broadly divided into the following three groups based on the major constituents:
- Group 1: Materials responsible for adhesive properties, such as Karaya gum, tragacanth, acacia, pectin, gelatin, methylcellulose, hydroxymethyl cellulose, sodium carboxymethylcellulose, and synthetic polymers (polyethylene oxide, acrylamides, acetic, and polyvinyl)
- Group 2: Antimicrobial agents such as hexachlorophene, sodium borate, sodium tetraborate, and ethanol
- Group 3: Additives, plasticizers, wetting agents, and flavoring agents such as oil of wintergreen and oil of peppermint
| Mechanism of Action|| |
The composition of denture adhesives continues to change as manufacturers try to improve the efficacy of their products. They have divided recently available denture adhesives into soluble and insoluble groups. The insoluble group includes pads and synthetic wafers. The soluble group includes creams, pastes, and powders. However, one ingredient that is constant in the composition of cream- and powder-type denture adhesives is the inclusion of one or more components that swell and become viscous and sticky as they absorb water, or more appropriately, become hydrated. The two ingredients constant in the insoluble group are a fabric carrier and a component that becomes sticky when hydrated. As the adhesive powders absorb water, they swell to many times their original volume, and the anions, so formed, interact with cations in the proteins in the oral mucous membrane. The viscosity of the adhesive is increased by the thick saliva formed, thereby increasing the denture retention. Newer adhesive materials provide stronger bioadhesive and cohesive forces. Free carboxyl groups formed by the hydration of adhesive, such as methylcellulose, hydroxymethyl cellulose, sodium carboxymethylcellulose, or poly methyl vinyl-ether maleic anhydride, form electrovalent bonds that produce stickiness or bioadhesion. The increased viscosity of the adhesive creams results in their lateral spread.,
Properties of a denture adhesive are as follows:
- Should be available in physical forms such as powder, cream, or a gel
- Should be nontoxic, nonirritant, and biocompatible with the oral mucosa
- Should be odorless and tasteless
- Should be easy to apply and to remove from the tissue surface of the denture
- Should not promote microbial growth
- Should retain its adhesive properties for 12–16 h
- Should provide comfort, retention, and stability to the denture, ensuring the patients’ ability to function with security and effectiveness during speech, mastication, and other functions
Use of denture adhesives in prosthodontics
Many studies on the use of denture adhesives confirm the improvement in denture stability and retention for both new and experienced denture wearers. The increased stability and retention allow denture patients to increase the force they can apply during mastication, which results in fewer chewing strokes to reach the swallowing stage of deglutition. The use of denture adhesives provides a cushioning effect, reduces the amount of food particles collecting under the denture, inhibits the growth of Candida albicans, and assists in the distribution of forces of occlusion over the denture-bearing regions, thereby minimizing local pressure points. In addition, denture adhesives provide a mucosa-protective effect, and in effect, serve as a biobandage and enhance the proprioceptive stimulus of the dentures during function.,,,,,,,
The indications of denture adhesives are as follows:
- Denture adhesives stabilize the trial denture bases, which show inadequate retention and stability due to various reasons, thus increasing try-on accuracy, as recording jaw relations and denture try-on should be carried out using stable and retentive bases.
- Use of adhesives will increase confidence of patients with compromised denture bearing by the ability to adapt to the new prosthesis.
- Comfort and function during the interim period are aided by the use of a denture adhesive in cases of immediate dentures, which get loosened soon due to tissue healing and resorption, requiring relining, rebasing, or a new denture fabrication.
- Clinical findings of ulcers, tissue irritation, inflammation, and compression of the oral mucosa of denture wearers are reduced with concomitant use of adhesives.
- Drug- or radiotherapy-induced xerostomia in denture wearers can be alleviated with the use of denture adhesives.
- Stabilization of dentures can be achieved with denture adhesives in patients with hormonal changes and neuromuscular disorders such as myasthenia gravis, Parkinson’s, and Alzheimer’s disease.
- Gross maxillofacial defects with prosthetic rehabilitation require denture adhesives for retention.
- Denture adhesives act as valuable adjuncts to the retention of radiation carriers or radiation protection prostheses.
- High-profile patients, such as attorneys, executives, and speakers, with psychological security in social situations, need usage of minimal amounts of adhesives.
- Allergies to denture adhesives or any of its components
- Gross inadequacies in retention and function
- Excessive bone resorption and soft tissue shrinkage leading to loss of vertical dimension
- Adhesives should not be used to retain fractured dentures or dentures with lost flanges
| Conclusion|| |
There are occasional situations in which it is not possible to obtain the desirable optimal retention such as improper denture base extensions, compromised denture supporting hard and soft tissues, which include excessive ridge resorption, and developmental abnormalities. In these instances, different mechanical aids to retention, such as springs, suction chambers, suction rubber discs, and magnets, are used. As these mechanical aids to measure retention cause adverse or ill effects to supporting tissues, many patients frequently resort to the use of denture adhesives to increase the retention and stability of the complete denture, which in turn will improve the chewing and masticatory ability and also the psychological well-being of the patient. So, it becomes a necessary protocol for a dentist to know about denture adhesives in detail for its cautioned advice for the patients.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Adisman IK. The use of denture adhesives as an aid to denture treatment. J Prosthet Dent 1989;62:711-5.
Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH, Mericske-Stern R. Prosthodontic treatment for edentulous patients: Complete dentures and implant-supported prostheses. St Louis, MO: Mosby; 2004. p. 442.
Yankell SL. Overview of research and literature on denture adhesives. Compend Contin Educ Dent 1984;4:518-21.
Grasso JE. Denture adhesives. Dent Clin North Am 2004;48:721-3.
Kapur KK. A clinical evaluation of denture adhesives. J Prosthet Dent 1967;18:550-8.
Stafford GD, Russell C. Efficiency of denture adhesives and their possible influence on oral microorganisms. J Dent Res 1971;50:832-6.
Tarbet WJ, Boone M. Schmidt NF. Effect of denture adhesive on complete denture dislodgement during mastication. J Prosthet Dent 1980;44:1-8.
Chew CL, Phillips RW, Boone ME, Swartz ML. “Denture stabilization with adhesives”: A kinesiographic study. Compend Contin Educ Dent 1984;4:532-8.
Abdelmelak RG, Michael CG. The effect of denture adhesives on the palatal mucosa under complete denture—A clinical and histological investigation. Egypt Dent J 1978;24:419-30.
Jagger DC, Harrison A. Denture fixatives—An update for general dental practice. BDJ 1996;180:311-13.
Polytois GL. An update on denture fixatives. Dent Update1983;579-83.
Kumar PR, Shajahan PA, Mathew J, Koruthu A, Aravind P, Ahammed MF. Denture adhesives in prosthodontics: An overview. J Int Oral Health 2015;7:93-5.
Kenneth AI. The use of denture adhesives as an aid to denture treatment. J Prosth Dent 1989;62:711-5.
Boone M. Analysis of soluble and insoluble denture adhesives and their relationship to tissue irritation and bone resorption. Compend Contin Educ Dent 1984;4:S22-5.
Weidner-Strahl SK. Multicenter clinical study of indications for use of denture adhesives. Quintessence 1984;35:1547-51.
Tarbet WJ, Silverman G, Schmidt NF. Maximum incisal biting force in denture wearers as influenced by adequacy of denture-bearing tissues and the use of an adhesive. J Dent Res 1981;60:115-9.
Swartz ML, Norman RD, Phillips RW. A method for measuring retention of denture adherents: An in vivo
study. J Prosthet Dent 1967;17:456-63.
Neill DJ, Roberts BJ. The effect of denture fixatives on masticatory performance in complete denture patients. J Dent 1973;1:219-22.