Indonesian Journal of Prosthodontics

Modified Suction-Effective denture technique for mandibular flat ridge

Clinton ST. Joewana, Lindawati S. Kusdhany — Mon, 30 Jun 2025 00:00:00 +0000

Aging is a universal, progressive physiological process affecting all living organisms, leading to the loss of bone, bone mineral density, and muscle in humans. The rate and extent of musculoskeletal decline vary due to factors such as diet, systemic diseases, medications, and clinical interventions. Prolonged denture use can lead to atrophy of the residual alveolar ridge, particularly in cases of a flat mandibular ridge, where achieving adequate denture retention and stabilization is challenging. Proper impression techniques play a crucial role in addressing this challenge. This report aims to describe the management of complete dentures in cases of mandibular flat ridges using a modified suction-effective method. A 70-year-old female presented for a complete denture following the extraction of her last upper left tooth. She had previously used removable partial denture around 3 years ago but has not used them since. Clinical findings revealed significant bone loss in the mandible, sufficient spongy tissue on the sublingual area, and panoramic examination classified the mandibular cortical index and bone density as C2. A centric tray was used to record the vertical dimension to fabricate the bite rim used for closed-mouth impression. Lingualized occlusion scheme was then used during denture fabrication to achieve a more stable denture. The suction-effective denture is an enhanced method for achieving retention and stability in patients with flat mandibular ridge. Creating a good peripheral seal on all borders is crucial to achieve the suction effect, which can be facilitated through proper planning and impression technique.

Keywords: mandibular flat ridge, suction denture, suction-effective method, closed-mouth impression

Improving obturator retention in hollow palatal defect using silicone soft-reliner

William Yuwono, Endang Wahyuningtyas, Intan Ruspita, Suparyono Saleh — Mon, 30 Jun 2025 00:00:00 +0000

Defect in the intraoral maxilla or palate resulting from surgical hemimaxillectomy can lead to difficulties in chewing, speaking, swallowing, and may also affect psychological function. One effective rehabilitation method for restoring oral function is the obturator prosthesis. This case report discusses the rehabilitation of a palatal defect following hemimaxillectomy, utilizing a hollow bulb obturator with a silicone-based soft liner and incorporating extracted posterior teeth as immediate dental provisions for relining an interim denture. The patient, a 46-year-old male, presented at Universitas Gadjah Mada Dental Hospital with complaints of discomfort, instability, and inadequate palatal coverage from his prosthetic obturator after undergoing tumor removal in the right maxillary area two years earlier. Examination revealed a significant hollow defect under the palate, exposure of the inferior nasal conchae, and mobility in the first and second premolars on the right side. Panoramic radiographs indicated loss of ridge support around these teeth. To enhance retention and comfort, a silicone-based soft liner was applied to the obturator. The use of extracted teeth proved beneficial for improving occlusal force, strength, and aesthetics. Thus, a hollow ground obturator with a soft reliner is recommended for effective rehabilitation post Class II Aramany hemimaxillectomy.

Keywords: Palatum defect, Obturator, Hollow bulb, Soft-reliner

Prosthodontic rehabilitation of partial edentulism: Fixed-Removable approach

Noor A. Zainon, Haswinee Maniam, Rosli Bidin, Noorhaizad Ithnin — Mon, 30 Jun 2025 00:00:00 +0000

BACKGROUND: Effective history-taking and comprehensive clinical investigations play a vital role in systematic treatment planning process for a successful treatment outcome. OBJECTIVE: This case report highlights prosthetic rehabilitation utilizing milled featured fixed-removable prostheses taking into account patient concerns to achieve aesthetically pleasing outcome without surgical intervention. CASE REPORT: A 68-year-old Malay female was unsatisfied with her maxillary partial acrylic denture and requested for a substitute. Several treatment options were discussed to replace the multiple missing teeth on both arches. The implant-retained prosthesis was not considered as an ideal treatment option due to the patient's financial constraint and reluctance for surgical intervention. Combination of fixed-removable prostheses were planned. The maxillary removable partial cobalt-chrome denture was fabricated with milled features of anterior fixed dental prosthesis to enhance the retention, support and stability of the prosthesis. Mandibular partial cobalt-chrome denture with composite build-up on attrited anterior teeth were fabricated as a definitive treatment plan. CONCLUSION: This prosthodontic management was able to provide satisfactory aesthetic and functional outcome thus achieving a mutually protected occlusion scheme. Regular prostheses maintenance and oral hygiene instructions will enable the patient to perform adequate plaque removal. Ultimately, meticulous case selection is essential to achieve favourable longevity of the prostheses.

Keywords: Dental prostheses, fixed-removable prostheses, milled features, partially edentulous, cobalt-chrome denture

Complex aesthetic rehabilitation with lithium disilicate veneers

Wina M. Wijaya, Murti Indrastuti, Intan Ruspita, Titik Ismiyati — Mon, 30 Jun 2025 00:00:00 +0000

Currently, demand on society for dental aesthetics has become increase especially dental veneer. Minimal invasive technique is the most advantageous technique in dental veneer due to pulp tissue remained safe and aesthetic aspect fulfilled. In this case is to give detail of aesthetic procedure to correct irregularities anatomical of the teeth using lithium disilicate veneers. A 20-year-old female patient came with a complaint of multiple diastema on anterior upper teeth. Based on objective examination 12 and 22 having peg-shaped and 53 maintain prolonged retention, agenesis and still sufficient. Multiple diastema between 53, 12, 11, 21, 22 and 23. Crown lengthening was performed on 53 to improve inciso-gingival ratio and tooth preparation for this case were using minimal invasive. Six units of lithium disilicate indirect veneer were placed using resin cement. Indirect veneers are placed with overjet and overbite are 3 mm, there is no changing contact maxillary and mandibular prior and following placement indirect veneers. Minimal invasive preparation involves in making the space needed for the restorative material of choice, outlining requirements for aesthetic needs, and outlining requirements that will make fabrication easier and created satisfactory result. After 2 months follow-up, veneers still retained well and stable, the veneers colour resembles natural teeth, tissue adaptation was also performed good and the patient is satisfied with the treatment results. Lithium disilicate veneers can be used as a treatment option for anterior teeth with deformities and primary tooth which still sufficient was performed.

Keywords : indirect veneer; peg-shaped; primary tooth; lithium disilicate; cosmetic dentistry

Ocular prosthetic of patient with shallow socket: Different impression technique

Nadya K. Putri, Adella S. Maharani, Murti Indrastuti, Sri B. Barunawati — Mon, 30 Jun 2025 00:00:00 +0000

ABSTRACT

The loss of an eyeball can be caused by trauma, surgery, or defects in the ocular area. Missing this part of the body can result in loss of vision and a decrease in self-confidence for the patient. Through our clinical report, a custom-made ocular prosthesis was made using acrylic resin materials which aims to provide rehabilitative care and restore patient self-confidence. A 27-year-old patient came to RSGM Prof. Soedomo for an ocular prosthesis after losing her eyeball due to an infection. Clinical examination revealed that the patient's ocular profile is convex while her eye sockets are shallow. This makes it challenging to create an ocular prosthesis. In this case report, the impression of work model uses two methods to determine the best way to make an impression of shallow eye sockets. Using an individual tray, one impression uses putty and light body, and the other uses light body only. Better results were obtained when the impression was made using the light body only in this case. The patient expressed satisfaction with her new custom-made ocular prosthetic. When compared to manufactured ocular prosthesis, custom-made prostheses offer superior fitting, comfort, and aesthetics, as they closely resemble the contralateral patient's natural eye.

Keywords: Ocular prosthesis, Shallow eye socket, Impression technique.

Metal frame overdenture retained with metal medium coping and magnet

Tania Santoso, Endang Wahyuningtyas, Murti Indrastuti, Pramudya Aditama — Mon, 30 Jun 2025 00:00:00 +0000

ABSTRACT

Overdenture is a removable denture that replaces partial or complete tooth loss and rests on remaining natural teeth or implants. The overdenture concept of avoiding bone resorption can be used as a continuation of root canal treatment so that the alveolar bone remains well preserved. This case report describes prosthodontic rehabilitation with coping and magnet overdentures to increase retention, stability, and reduce bone resorption that will occur due to tooth extraction. A 65-year-old female patient wanted to have new dentures because the old dentures were loose and unaesthetic. Overdentures with metal medium coping and a magnet were made to increase retention for the new upper denture. A metal medium coping with a length of 3–4 mm on the second upper molar can increase retention by the friction force between the coping and the denture. A fabricated magnet, 3.6 mm in diameter with an attractive force of 700±50 gf, was mounted on the denture base, and the keeper was cemented to the second upper premolar as a supporting tooth. The metal frame overdentures provided excellent retention, stability, functionally, and aesthetics. Metal frame overdentures can be treatment of choice to increase the retention and stabilization of dentures.

Keywords: Metal frame overdenture, Medium coping, Magnet

Tooth-Supported overdenture retained with bareroot, coping and magnetic attachment

Surdin, Endang Wahyuningtyas, Sri Budi Barunawati, Intan Ruspita — Mon, 30 Jun 2025 00:00:00 +0000

Background : Overdenture is removable denture used to replace missing teeth and cover or rest on one or more remaining natural teeth in the mouth. Types of overdentures are non-copping abutment, abutment with copping (long, medium, short) and abutment with Attachment. Abutment with attachment overdenture can provide good retention and stabilization. Objective : The purpose of the case study is the assessment of retention improvement of overdenture dentures with coping and magnetic abutments in complete denture in the upper jaw and bareroot in complete denture in the lower jaw. Case Report : A 59-year-old woman reported having the chief complaint of difficulty in chewing food and speaking due to missing teeth in the upper and lower arch. Intraoral examination revealed the remaining teeth were 17, 23, 24, 43, and had been extruded. Tooth 23 was done to support magnetic overdenture, tooth 24 supported coping overdenture in the full maxillary denture and 43 supported bareroot overdenture in the full mandibular denture. Conclusion : Magnetic and coping retained overdenture enhance the retention in the full maxillary denture and bareroot improves the stability of the mandibular complete denture.

Ocular prosthesis modification with permanent soft liner in anopthalmic socket post evisceration

Andri C. Leo, Syafrinani, Putri WU. Ritonga — Mon, 30 Jun 2025 00:00:00 +0000

Background: Enucleation and eviseration are surgical procedures often used for the removal of the eye. Some post-eviserated patients have complaints of discomfort when using conformer or ocular prosthesis. Ocular prosthesis modified with permanent soft liner (PSL) on the intaglio surface is an alternative to reduce the discomfort. Objective: This case report aims to explain the use of PSL in the manufacture of custom ocular prostheses in post-eviscerated patient. Case report: A 72-year-old male patient came to RSGM USU complaining of difficulty to socialize because he lost his eye and wanted to make a prosthetic. The patient had evisceration 4 months ago and was given a silicone surgical conformer. Tearing was the common complaint, followed by itchiness, soreness and uncomfortable when the conformer is fitted. Custom ocular prosthesis is modified using PSL on the intaglio surface. The use of PSL provides comfort to patients because it acts as a shock absorber and shock distributor that can distribute pressure more evenly so that the tissue in the eye socket receives less impact force. Conclusion: Fabrication of new ocular prosthesis with PSL is a novel way to minimize trauma to underlying supporting tissues so it can reduce the discomfort of the patient.
Keywords: Evisceration, Custom ocular prosthesis, Permanent soft liner

Custom prosthetic rehabilitation of ocular defect in elderly

Vania Erriza, Sri Budi Barunawati, Titik Ismiyati, Intan Ruspita — Mon, 30 Jun 2025 00:00:00 +0000

Eye loss may cause deformities on patient's face that furthermore affect their psychosocial state. Ocular prosthesis is found to be effective to rehabilitate patients with eye loss due to trauma, congenital eye defect, tumor, or surgery. Elderly patients have special needs and limitations, such as communication, financial status, and access to healthcare providers. Through this case report, we present a successful fabrication of custom-made ocular prosthesis for elderly patient following right oculi enucleation. A 71-year-old male patient came with chief complaint of losing his old ocular prosthesis and wanted a new one. Initial impression was made with irreversible hydrocolloid. Final impression of patient's eye socket was made using individual custom tray and light body addition silicone impression material. A wax model was made and tried on patient, then processed with white acrylic resin to match patient's contralateral sclera color. Iris and pupil positioning were done, and ocular prosthesis was drawn to match patient's contralateral eye. The patient was satisfied with his new custom-made ocular prosthesis because of better fitting, comfort, and aesthetics compared to his old fabricated ocular prosthesis. Ocular prosthetic rehabilitation in elderly is associated with improvement of psychosocial status which leads to better quality of life.

Keywords: ocular defect, custom prosthetic, ocular prosthesis, elderly

Management of mandibular flat ridge using modified suction-effective method in geriatric patient

Luluk LA. Leonita, Lindawati S. Kusdhany — Mon, 30 Jun 2025 00:00:00 +0000

Background: Geriatric patient has compromised medical conditions, physical disability, and cognitive impairment, thus the treatment plan must consider many factors both local and systemic condition of the patient. The main problem that often arises when treating edentulous patients, especially in elderly patients, is severe mandibular ridge resorption. This makes it difficult to achieve retention and stabilization of the mandibular complete denture. One technique to overcome this problem is using suction effective mandibular complete denture introduced by Dr. Jiro Abe. This method can provide sealing of the entire denture border including the retromolar pad area. Objectives: This report aimed to elaborate the management of flat mandibular ridge using modified suction-effective method in geriatric patient. Case report: A 71-year-old male geriatric patient with fully edentulous teeth came with history of hypertension and high risk of falling. The patient had never used any denture before and wanted to be able to eat properly and seek improvement in appearance. The mandibular showed highly resorbed ridge along with spongious tissue. Modification of this technique carried out by utilizing semi-adjustable articulator and the use of bite rim mounted on custom tray which facilitated closed-mouth impression that is in accordance with patient’s functional movement in occlusion state. Conclusion: Rehabilitation of complete denture in elderly patients must consider efficient and appropriate method according to the patient's systemic and local conditions. Flat ridge management in geriatric patient using semi-adjustable articulator and modified suction-effective method can provide retention and stability in mandibular complete denture.

Accuracy of intraoral scanner on subgingival finish line with gingival retraction

Nabilah F. Damanik, Haslinda Z. Tamin, Putri WU. Ritonga — Mon, 30 Jun 2025 00:00:00 +0000

Background: The development of intraoral scanner (IOS) technology has brought about a significant transformation in dentistry, enabling more efficient and accurate digital workflows. Studies show that IOS provides clinically acceptable accuracy similar to conventional methods, especially for fixed prothesis. However, there are special challenges when impression subgingival finish line accurately. The use of gingival retraction methods is essential for easy access to these margins. Objectives: This literature review aims to describe the accuracy of IOS in impression subgingival finish line with the aid of gingival retraction, and compare the effectiveness of mechanical and chemical retraction methods in digital impression of subgingival finish line. Mechanical methods, such as the use of retraction cord, provide stability to the sulcus but may cause discomfort and potential damage to the periodontium. Meanwhile, chemical methods using aluminum chloride-based pastes show good results in displacing gingival tissue with minimal side effects. Summary: Based on existing studies, the combined method of mechanical and chemical retraction provides the best results for impression accuracy in the subgingival area, taking into account patient comfort and quality of the final result. Thus, choosing the right retraction method can improve clinical outcomes and ensure the long-term success of digital- based prosthodontic restorations.

Keywords: Subgingival finish line; gingival retraction; trueness; precision; intraoral scanner.

Hybrid ceramic as an alternative material for crown restoration treatment

Alexander Justin, Syafrinani, Putri WU. Ritonga — Mon, 30 Jun 2025 00:00:00 +0000

Background: All ceramic materials are often used in crown restorations for anterior and/or posterior teeth due to their aesthetic value and high strength. However, some all-ceramic materials such as monolithic zirconia have the disadvantage that they can cause wear problems on antagonistic teeth due to their high hardness. As an alternative to overcome this problem, hybrid ceramic materials are being developed. Objectives: This literature review aims to look at using hybrid ceramic materials as an alternative material for making crowns. A hybrid ceramic material blends the characteristics of ceramic and composite materials, resulting in a material with excellent mechanical strength and aesthetic qualities. It has a similar elastic modulus value to dentin thus reducing the occurrence of wear on antagonistic teeth. Hybrid ceramic materials is fabricated by CAD/CAM system with subtractive (milling) and additive (3D printing) processes. The subtractive fabrication method (milling) produces restorations with high strength properties but has a longer and more complicated manufacturing process. The additive (3D printing) method, on the other hand, is faster and requires less material than subtractive (milling). Summary: Therefore, hybrid ceramic materials should be considered as an alternative material for crown restorations.

Keywords: Hybrid ceramic; CAD/CAM; additive (3D printing); subtractive (milling)

Printing parameters of layer thickness in 3D printing digital light processing on absolute marginal discrepancy and marginal gap in hybrid ceramic-resin crown

Donny Tannu, Syafrinani, Ariyani — Mon, 30 Jun 2025 00:00:00 +0000

ABSTRACT

Marginal adaptation in the form of absolute marginal discrepancy and marginal gap is one of the parameters for long-term clinical success in single crown restorations. The use of 3D printing digital light processing (DLP) additive manufacturing technology can produce accurate and efficient restorations. However, one of the printing parameter, layer thickness, can affect the accuracy of marginal adaptation. This review aims to evaluate the effect of layer thickness variation on absolute marginal discrepancy and marginal gap in definitive hybrid ceramic-resin crown manufactured using 3D DLP printing technology. Results show that a layer thickness parameter of 50 µm is preferred for good fitting accuracy and small cumulative deviation. Smaller layer thickness will increase the number of layers, and manufacturing time but on the other hand will reduce accuracy. Optimalization of the layer thickness is required to obtain the best marginal adaptation of a single crown.

Keywords: Absolute marginal discrepancy; Marginal gap; layer thickness; 3D printing DLP; Hybrid ceramic-resin

Optimization of complete denture treatment for flat ridges with various occlusal schemes in distributing stress and masticatory force

Dina HN. Lubis, Ismet D. Nasution, Putri WU. Ritonga — Mon, 30 Jun 2025 00:00:00 +0000

Edentulism impacts an individual's ability to chew and digest food effectively, leading to a decline in quality of life. This issue worsens with flat ridge conditions, which increase mucosal stress distribution under masticatory load. Excessive stress beyond the pressure-pain threshold results in poor masticatory performance, emphasizing the importance of selecting an ideal occlusal scheme for such ridge conditions. The basic concept of occlusal schemes aims to preserve residual ridge integrity and prevent further damage over time. Lingualized and monoplane occlusions are schemes that can be used in flat ridge complete dentures to evenly distribute stress and reduce masticatory load. The stress distribution between dentures and the underlying dental mucosa is critical for understanding the relationship with the patient's pressure-pain threshold. Therefore, in vitro measurements can simulate stress distribution and masticatory force assessments. This literature review discusses the measurement of stress distribution and masticatory force on flat ridge complete dentures with different occlusal schemes.

Keywords: complete denture; flat ridge; stress distribution; masticatory force; direct measurement

Accuracy of digital impression scanning strategies for free-end edentulous

Annisa Athirah, Haslinda Z. Tamin, Ricca Chairunnisa — Mon, 30 Jun 2025 00:00:00 +0000

Background: Scanning using intraoral scanners (IOS) offers better accuracy and time efficiency compared to conventional impression methods, especially in overcoming the challenges of free end edentulous cases. The quality of IOS scans is measured by accuracy, which is influenced by scan strategy. Scan strategies include scanning paths, sequences, and combinations. Study conducted that the right scan strategy can affect accuracy as assessed by trueness and precision. However, there is no manufacturer's standard and only a few study on scan strategies in edentulous free end cases. Objectives: This literature review aims to describe scan strategy in improving digital impression accuracy in free end edentulous case. Summary: A zig zag scanning path will help the IOS to capture the tooth morphology better and a linear scanning path will result in smaller deviations. Scanning sequences from the teeth to ridge will reduce the jigsaw effect at the fulcrum point, resulting in a more stable framework during removable denture fabrication.

Keywords: Scan strategy; IOS; free end; trueness; precision

Epidemiological aspects of bruxism at the Abidjan Odonto-Stomatological Consultation and Treatment Center.

Kamon Jean-Claude N’cho, Kouassi Ange Patrick Kouassi, Giles Thierry Maroua — Mon, 30 Jun 2025 00:00:00 +0000

Introduction

Bruxism is a factor that both promotes and aggravates certain oral diseases.

The importance of the repercussions of bruxism shows the interest of our work which is to know the frequency and the prevalence of bruxism.

The general objective of our work is therefore to contribute to the epidemiological study of bruxism in Côte d'Ivoire.

Method

This was a descriptive cross-sectional study of three hundred (300) patients attending the Centre de Consultation et de Traitements Odonto-Stomatologiques d'Abidjan, who underwent a questionnaire and an odonto-stomatological examination.

The criterion used to diagnose bruxism was that of Dr Gilles Lavigne et al.

Results

Our study population consisted of 300 individuals ranging in age from 4 to 82 years, the majority of whom were women [18-40 years], with a bruxism frequency of 22.33%.

Our population of bruxers was predominantly female, accounting for 59.70%. Also, the prevalence of bruxism increased with age.

Conclusion

In our study population, our survey reveals that the prevalence of bruxism is still significant. Practitioners must therefore be provided with the appropriate equipment for better diagnosis and patient management.

Radiographic evaluation of treatment by orthopedic procedures of mandibular fractures in Abidjan Odonto-stomatological consultation and treatment center

Kamon Jean-Claude N’cho, Kouassi Ange Patrick Kouassi, Giles Thierry Maroua — Mon, 30 Jun 2025 00:00:00 +0000

Introduction

In Abidjan, mandibular fractures are generally treated surgically in the stomatology and maxillofacial surgery department of the Hospital and University Centers (HUC) of Cocody and Treichville. They are also treated with orthopedic devices at the Dental Surgery Consultation and Treatment Center in Abidjan, within the Maxillofacial Prosthesis (PMF) section of the Clinical Prosthesis and Occlusodontics department.

Are these orthopedic devices effective in the management of mandibular fractures?

Do these methods achieve satisfactory results in the management of mandibular fractures?

Material and methods

This is a retrospective descriptive analytical study based on the evaluation of usable clinical and radiographic files of patients admitted to the maxillofacial prosthesis section of Odonto-Stomatological Consultation and Treatment Center (CCTOS) who presented fractures to the mandible. The data was processed using epi data software and the search for correlations was carried out using the khi-deux test.

Results

Maxillo-mandibular restraint is the most used with a rate of 85%.

83% of patients have good bone density on radiography after healing.

Conclusion

Orthopedic treatment of mandibular fracture could be indicated in cases of non-displaced fracture with excellent alignment or approximation of bone fragments and some easily reducible fractures.

Keywords: radiographic evaluation, orthopedic procedures, mandibular fractures