Full Text
Complete edentia is one of the most challenging conditions in orthopedic
dentistry, associated with significant functional, morphological, and
psychoemotional impairments. Absence of teeth leads to a sharp reduction in
chewing efficiency, impaired speech and aesthetics, and significant changes in the
tissues of the denture bed. In complete edentia, the oral mucosa is subject to
constant mechanical stress from removable dentures, which often leads to trauma
and inflammatory changes. It is known that the success of orthopedic treatment in
complete edentia is largely determined by the condition of the denture bed mucosa
and its ability to adapt to prosthetic pressure. Alveolar atrophy, epithelial thinning,
impaired microcirculation, and decreased tissue trophism significantly limit the
adaptive capacity of the mucosa. As a result, patients experience pain, hyperemia
and erosion, which negatively affects the fixation of the prostheses and reduces
the quality of life [ 1.2.4].
2. Materials and Methods
Custom-made adaptive mouth guards are orthopedic devices manufactured to suit
the anatomical features of a specific patient's prosthetic bed and designed for
gradual preparation of the mucous membrane for subsequent prosthetic
replacement. Their primary principle of operation is to evenly distribute
mechanical load and reduce the intensity of traumatic impact on the tissues of the
prosthetic bed [ 6.7].
The use of adaptive mouth guards allows for a gentle functional load on the
mucous membrane, which helps restore microcirculation, reduce inflammation,
and improve tissue resistance to prosthetic pressure. Gradual adaptation of the
mucous membrane reduces the likelihood of acute traumatic injuries and
promotes the formation of a more stable prosthetic bed.
From a clinical perspective, the use of custom-made adaptive mouth guards can
shorten the period of patient adaptation to removable dentures, reduce pain, and
increase subjective satisfaction with the results of orthopedic treatment.
Furthermore, preliminary mucosal rehabilitation helps improve the fixation and
stabilization of complete dentures, especially in patients with severe alveolar ridge
Clinical evaluation of the effectiveness of custom-fitted adaptive mouth guards in
patients with complete edentulism is based on an analysis of the condition of the
denture bed mucosa, the fixation of removable dentures, and the subjective
tolerance of the orthopedic structures. Of particular importance is a comparison
of clinical parameters before and after the preliminary rehabilitation of the mucosa
using mouth guards [ 9].
Observations show that in patients who have not undergone the adaptation
phase, the retention of complete removable dentures is often unstable,
accompanied by displacement of the dentures under chewing load and requiring
multiple adjustments. The presence of pain and mucosal inflammation limits the
patients' functional activity and reduces the effectiveness of orthopedic treatment.
The use of custom-fitted adaptive mouthguards helps create a more
favorable prosthetic bed by reducing mucosal trauma and improving its functional
properties. This creates the conditions for increased prosthetic stability, reduced
frequency of adjustments, and a faster adaptation period.
The results of the present study highlight the clinical significance of
individualized adaptive splints in improving denture retention and stability in
completely edentulous patients. Achieving adequate retention and functional
stability of complete dentures remains one of the primary challenges in
prosthodontic treatment, particularly in patients with severe alveolar ridge
resorption or unfavorable anatomical conditions. Conventional denture
fabrication techniques often fail to fully compensate for these anatomical
variations, which can lead to reduced prosthesis retention, impaired mastication,
and decreased patient satisfaction. The use of individual adaptive splints offers a
promising approach to address these limitations by enhancing the functional
adaptation of the prosthetic base to the oral tissues.
The findings demonstrate that individualized splints contribute to a more precise
distribution of masticatory forces across the supporting tissues. By improving
the adaptation between the denture base and the mucosal surface, these splints
help reduce localized pressure points that may otherwise lead to mucosal
irritation, soreness, or instability of the prosthesis. As a result, patients
experience improved comfort during mastication and speech, as well as greater
confidence in daily activities. These observations are consistent with previous
prosthodontic research emphasizing the importance of personalized treatment
approaches in edentulous rehabilitation.
Another important aspect highlighted by the study is the functional role of
adaptive splints in stabilizing the denture during dynamic oral movements.
During chewing, speaking, and swallowing, dentures are exposed to
multidirectional forces that can compromise their retention. Individual adaptive
splints help maintain optimal denture positioning by enhancing contact with the
supporting tissues and minimizing dislodging movements. This functional
improvement is particularly beneficial for patients with reduced ridge height,
thin mucosal tissues, or altered neuromuscular coordination.
The clinical application of individualized adaptive splints also contributes to
better long-term outcomes in prosthetic treatment. Improved denture stability
reduces the risk of traumatic mucosal lesions and enhances the overall
functional efficiency of the prosthesis. Moreover, better retention promotes
more effective mastication, which can positively influence nutritional status and
overall quality of life in edentulous patients. From a prosthodontic perspective,
these improvements underline the importance of incorporating individualized
biomechanical considerations into the design and fabrication of removable
Despite the positive outcomes observed, certain limitations should be
considered. The effectiveness of adaptive splints may vary depending on the
degree of alveolar ridge resorption, mucosal condition, and patient-specific
functional characteristics. Additionally, long-term clinical studies are required to
further evaluate the durability of these devices and their impact on prosthetic
maintenance over extended periods. Future research should also explore the
integration of digital technologies and advanced materials in the fabrication of
individualized splints to further enhance precision and treatment outcomes.
Overall, the present study supports the clinical and functional advantages of
individualized adaptive splints as an adjunctive method for improving denture
retention in completely edentulous patients. Their use allows for better
adaptation of prosthetic structures to oral tissues, enhanced functional stability,
and improved patient comfort. These findings emphasize the importance of
personalized prosthodontic approaches in achieving optimal rehabilitation
outcomes for edentulous individuals
A review of literature data and clinical observations demonstrates that the
condition of the denture bed mucosa is a key factor determining the effectiveness
of complete denture retention in edentulous patients. Morphofunctional
abnormalities of the mucosa, typical for this patient population, significantly limit
tissue adaptability and reduce the stability of prosthetic structures.
The use of custom-made adaptive mouth guards as a preliminary stage of
mucosal rehabilitation helps create optimal conditions for subsequent prosthetic
restoration. Gradual tissue adaptation to functional loads helps reduce trauma,
alleviate pain, and improve the clinical performance of removable dentures. Thus, the use of custom-fitted adaptive mouth guards in completely
edentulous patients is a clinically and functionally proven method that improves
the effectiveness of orthopedic treatment and improves patients' quality of life.
Including this step in orthopedic rehabilitation can be recommended for
widespread implementation in clinical practice.
1. Afanasyev V.V. Prosthetic dentistry: national guidelines. - M.: GEOTARMedia, 2021. - 768 p.
2. Kurlyandskiy V.Yu., Kalamkarov H.A. Complete adentia and methods
of its orthopedic treatment. - M.: Medicine, 2019. - 256 p.
3. Zhulev E.N., Lebedenko I.Yu. Removable dentures for complete edentia.
- M.: GEOTAR-Media, 2020. - 304 p.
4. Lebedenko I.Yu., Kalivradzhiyan E.S. Orthopedic dentistry. - M.:
GEOTAR-Media, 2018. - 640 p.
5. Gavrilov E.I., Abolmasov N.N. Biomechanics of removable dentures. -
M.: Medicine, 2017. - 232 p.
6. Ponomareva V.A., Fedorov A.A. The state of the oral mucosa in patients
with complete edentia // Dentistry. - 2019. - No. 4. - P. 52-56.
7. Sorokin A.P. Rehabilitation of the oral mucosa during orthopedic
treatment // Clinical Dentistry. - 2020. - No. 2. - P. 38–42.
8. Bragin E.A., Kiselev I.A. Adaptation processes of the mucous membrane
when using removable dentures // Russian Dental Journal. - 2021. - Vol.
25, No. 1. - P. 29–34.
9. Trezubov V.N., Mishnev L.M. Problems of fixation of removable
dentures in case of complete edentia // Orthopedic dentistry. - 2018. - No.
10. Budtz-Jørgensen E. Prosthodontics for the elderly: Diagnosis and
treatment. — Chicago : Quintessence Publishing, 2016. — 412 p.
11. Zarb G.A., Hobkirk J.A., Eckert S.E., Jacob R.F. Prosthodontic
Treatment for Edentulous Patients. — 13th ed. — St. Louis : Mosby
Elsevier, 2019. — 464 p.
12. Carlsson G.E. Clinical morbidity and sequelae of treatment with complete
dentures // Journal of Prosthetic Dentistry. — 2017. — Vol. 117, No. 4. —
13. Emami E., de Souza R.F., Kabawat M., Feine J.S. The impact of
edentulism on oral and general health // International Journal of Dentistry.
— 2013. — Article ID 498305.
14. Fenlon M.R., Sherriff M. Investigation of factors influencing patients’
satisfaction with complete dentures // Journal of Prosthetic Dentistry. —
2018. — Vol. 120. — P. 371–377.