Naz F et al.

Journal of Advanced Medical and Dental Sciences Research

@Society of Scientific Research and Studies NLM ID: 101716117

Journal home page: www.jamdsr.com doi: 10.21276/jamdsr Index Copernicus value = 85.10

(e) ISSN Online: 2321-9599; (p) ISSN Print: 2348-6805

Original Research
Comparative evaluation of effect of denture adhesives on retention of
maxillary complete dentures using a digital force gauge-An in vivo study
Falak Naz1, Sandeep Kaur Bali2
1
Ex post graduate student, Department of Prosthodontics, Govt Dental College and Hospital Srinagar Kashmir,
J&K;
2
Professor & HOD, Department of Prosthodontics, Govt Dental College and Hospital Srinagar Kashmir, J&K

ABSTRACT:
Successful rehabilitation of a completely edentulous patient using removable complete denture prosthesis depends on an
array of factors ; retention being the most important among them. Although most patients having favourable clinical factors
are believed to be rehabilitated successfully but at the same time there are some patients especially the geriatric ones and
those with associated debilitating diseases where adequate retention is not achievable .In such situations ,denture adhesives
are recommended. In the present study a comparative evaluation was done to study the effect of two commonly available
denture adhesives (Fixon powder and Fittydent paste) on the retention of maxillary denture bases. The study was conducted
on 10 completely edentulous subjects . Maxillary denture base was fabricated for each patient employing the conventional
methods of fabrication and a hook was attached to the same for engagement of the measuring device. A DIGITAL FORCE
GAUGE (Lutron ) was used as the measuring apparatus. Force at which denture base dislodged was recorded and was
considered as retentive value. Data obtained were tabulated and subjected to statistical analysed. Intragroup comparison was
done using paired t-test. Intergroup comparison was done using analysis of variance (ANOVA) .p value <0.05 was
considered as statistically significant. Results show that the retention force value of the paste group was the maximum,
followed by powder group, and the least retention force value was observed with control group employing no adhesive at all.
Within the limitations of the study it can be concluded that the paste form of denture adhesive has the best retentive property
compared to the powder.
Keywords: Dental adhesives, digital force gauge, maxillary denture base, retention, complete denture.

Received: 23/07/2020 Modified: 26/09/2020 Accepted: 28/09/2020

Corresponding author: Dr. Falak Naz, Ex post graduate student, Department of Prosthodontics, Govt Dental College
and Hospital Srinagar Kashmir , J&K;, India

This article may be cited as: Naz F, Bali SK. Comparative evaluation of effect of denture adhesives on retention of
maxillary complete dentures using a digital force gauge-An in vivo study. J Adv Med Dent Scie Res 2020;8(10):135-140.

INTRODUCTION dentures may be influenced by a number of variables

Complete denture fabrication has to satisfy certain classified by Hardy and Kapur (1958) as physical,
basic principles about stress distribution and optimum physiological, psychological, mechanical, and surgical
tissue preservation 1. Sears2 clearly stated that these factors6. Patients seeking a prosthetic therapy demand
principles are the important factors for justification of retentive prosthesis irrespective of their oral
what we do and the way we do it. Good retention, conditions, which is sometimes difficult to achieve
stability, and support are the prime requisite for a with conventional complete denture therapy 7.
well-fitting prosthesis3. Among them, adequate However, protocols for treating completely
retention constitutes an elementary tool for satisfying edentulous patients have improved with time.
the patient with the complete dentures4 (Al- Abdulla Overdenture and implant-supported prosthesis are a
& Khamas).The Glossary of Prosthodontic terms part of such improvements, which provides patient
defines denture retention as ‘‘The resistance of a with more retentive and stable prosthesis8,9. But the
denture to dislodgement”5.The retention of complete cost and time requirements for such treatment

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Naz F et al.

protocols are more as compared with conventional the study after fulfilling inclusion and exclusion
complete denture, thus, limiting their use. So, the criteria. Inclusion criteria for the study were -
conventional denture remains the main stay treatment completely edentulous patients, having well-formed
for majority of completely edentulous patients; hence, ridges, without any undercut requiring surgical
the problem of poor retention of dentures is prevalent correction, with no history of craniomandibular
especially in patients where conventional therapy does dysfunction or medical condition , healthy mucosa
not suffice the needs. So, many complete denture- and exclusion criteria included patients with—
wearer patients resort to other means to improve xerostomia, flabby ridges, poor neuromuscular
retention such as using denture adhesives, which are conditions, palatal defects, unco-operative patients).
available freely over the counter, cheap, easy to Permission from the Institutional Ethics Committee,
use10and have the capacity to enhance treatment was obtained.
outcome11. Two denture adhesives (a powder one, and a paste
‘‘Denture adhesive’’ is a commercially available, non one)were used in the study. In this study, a digital
toxic, soluble material of sticky nature that can be force gauge was used for recording the retentive
applied over tissue surface of the denture in order to values of different adhesives which works on the
enhance the quality of denture retention and thereby basic principle stated by Skinner and Chung25, and is
improving quality of denture stability too12.They are easy to use, and portable device. It was planned to
available in different forms such as powder, check retentive force on maxillary denture bases for
paste/cream, foam and strips/wafer 1. They enhance each patient utilising single base for recording the
retention through optimizing interfacial forces by (a) retentive value of both adhesives. Routine materials
increasing adhesive/cohesive properties and viscosity and standard techniques were used for the fabrication
of the medium lying between denture and supporting of denture bases used in this study. Preliminary and
tissues and (b) by eliminating voids occurring in the final impressions were made for the selected subjects
interfacial space13-16.Use of denture adhesives is used in this study and casts were fabricated.
recommended for enhancing the quality of retention in Prefabricated stainless steel hooks(1.5cm in dia)(Fig
conditions such as immediate dentures, single 2) were attached to anterior palatal region of the
complete denture, maxillofacial prosthesis like waxed up bases approximately corresponding to a line
obturators and in patient’s having poor neuromuscular joining the distal surfaces of cuspids. The casts with
control, poor ridge anatomy, dry mouth, and jaw waxed‑up bases were flasked, and processed in a
relations. It may also be indicated in difficult and curing unit. After they had been processed, the
demanding patients with poor denture adaptation, and denture bases were carefully finished and polished.
in socially active people such as public attorneys, The denture bases was stored in water at room
actors and politicians1,17. Many in vivo and in vitro temperature before testing for retention. Before testing
studies, have evaluated specifically the retentive the denture base for retention, the patients were
ability and efficacy of different types of denture trained to tell, when the denture base gets loose.
adhesives both subjectively and objectively, but with Cephalostat was used for the stabilization of Patient’s
varying results1,17-23. Of all, objective methods have head. Following two denture adhesives were used in
been proven to be reliable24 .Though a no of devices the study, Fixon supergrip powder (ICPA, Mumbai);
have been used in past1,11,23,25-28 to measure the Fittydent paste (Dr. Reddy’s Lab. Ltd., Hyde. The
efficacy of adhesives but most of them are complex denture base without any adhesive was the control
and difficult to use. group, same denture base with Fixon powder was
Therefore, this study aims to evaluate and compare group I, & group II was denture base with Fittydent
the retentive ability of two denture adhesives, which paste .Each group was tested in 10 patients by placing
are commercially and easily available to the patients the denture base in the mouth for 3 min, respectively,
using a simplified device called digital force after which the dislodgement of the denture base was
gauge.(Fig 1) It is a spring-loaded device that engages tested . A digital force gauge (graduated up to
onto the hook of the heat polymerized trial denture 5000gm) was used to record the retentive values in
base and is easy to use and portable. The null each group. The hook of the gauge engaged the wire
hypothesis of this study is there is no effect of any of loop & a vertical downward force was applied to
the 2 types of denture adhesives on the retention of dislodge each trial denture base. (Fig 3,4)The value at
maxillary denture bases. which dislodgement of denture base took place was
considered as retentive value. The retention values of
MATERIALS & METHODS the control group and the two test groups of all the
This study was conducted on 10 completely subjects were tabulated and subjected to statistical
edentulous subjects in the age group of 50 -60yrs analysis.
reporting to the outpatient Department of For the powder form, denture base was wetted and
Prosthodontics, crown and bridge, Government dental Fixon powder was sprinkled over the impression
college, Srinagar. The benefits and drawbacks of the surface of the denture base, for the paste form, the
study were explained to the patients and upon signing denture base was dried and bead size of Fittydent
an informed consent the patients were recruited for paste was applied on the incisor, molar and mid-

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Naz F et al.

palatine region .Both the denture adhesives were

tested for retention on the same day.

Fig 1

Fig 4

RESULTS
The recorded data was compiled and entered in a
spreadsheet (Microsoft Excel) and then exported to
data editor of SPSS Version 20.0 (SPSS Inc.,
Chicago, Illinois, USA). Data was presented as
Mean±SD. The data was explored for normality using
Kolmogorov-Smirnov and Shapiro-Wilk tests of
Fig 2 normality. The data showed a normal distribution and
hence analysis of variance (ANOVA) was employed
for comparing various groups. Graphically the data
was presented by bar diagram. A P-value of less than
0.05 was considered statistically significant. Table
1 shows descriptive statistics of all the groups in
which the mean retention force for control group was
19.96N, Group I was 36.31N,& Group II was40.89N.
Table 2 shows the one way ANOVA statistics in
which a highly statistical significance among all the
groups( p < 0.00001) was found. Graph 1 shows the
comparison between all the groups in which Group II
(paste form) shows the highest mean retention force
value and the control group shows the lowest mean
retention force value.

Fig 3

TABLE 1: Descriptive Statistics

GROUPS N Mean(Newtons) SD Min Max
CONTROL Group(denture 10
19.96 2.514 16.6 25.6
base without adhesive)
Group I(denture base with 10
36.31 2.534 32.5 39
fixon powder)
Group II(denture base with 10
40.89 1.614 37.5 42.5
fittydent paste)

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Naz F et al.

45

40

35

30
CONTROL
25 GROUPI
20 GROUPII
15

10

0
GRAPH 1

TABLE 2: Summary statistics of one way ANOVA

Source of Sum of squares df Mean square F value P value

variation
Between groups 2421.2127 2 1210.6063 236.5458 <0.00001

Within group 138.182 27 5.1179

Total 2559.3947 29

DISCUSSION absorbs water and the carboxymethyl cellulose comes

Successful rehabilitation of edentulous patient in contact with the saliva, the hydrate material (free
depends upon a well-fitting prosthesis, which not only carboxyl groups) is formed and swells greater than
provides function and esthetics, but also instils their original volume, thereby excluding air between
psychological confidence to the patient28. These goals denture bases and bearing tissue. The hydrate material
can be achieved by thorough understanding of the sticks to the fitting surface of the denture and oral
patient, through clinical examination, meticulous mucosa and increases the viscosity of the saliva.
planning with preparation of patient and executing These actions increase the retention of complete
perfect craftsmanship1.Situations like severely dentures29. With so many choices of denture
resorbed alveolar ridge covered by abused tissues adhesives available, selection of adhesive is based on
pose a serious threat of inadequate retention, and thus certain attributes like it should have longer duration of
demands the use of an alternative mechanism to action and should be non-toxic, odor free, tasteless,
encounter such adverse situations. Search in literature easy to use, economic, biocompatible, and easily
has revealed the use of mechanical devices viz. Wires, available8,9,30.
Springs, Suction discs, Suction chambers, use of Two denture adhesives were investigated in
Magnets and Undercuts for providing required present study out of which one were in powder form
retention to prosthesis. These devices increases the (Fixon Supergrip ), and one were in paste form
retention but further complicate the situation by Fittydent). The reason of choice was easy availability,
causing damage to the tissues of the foundation 23. cost effectiveness, biocompatibility, and ease of use.
Denture adhesives also known as fixatives or Numerous studies have been done to evaluate
adherents are commercially available products, which retention objectively, subjectively or by combination
have been used as an aid for the improvement of of both, but advantage of objective study is that it is
retention and stability of complete dentures28 and free from influence of patient’s perception. Also, in
serve as acceptable solution to meet the challenges of vivo study has an advantage over in vitro study for
retention in such patients1. The main components of being clinically more relevant28. Hence, present in
denture adhesives are either vegetable gum or vivo study was designed to evaluate the retention
synthetic polymer as carboxymethyl cellulose and objectively in the form of force required to dislodge
polyvinyl methyl ether maleate. As the adhesive the denture using testing apparatus based on the

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principle given by Skinner and Chung25. Digital force Variation in the results of present study from other
gauge (Lutron FG 5000 A) with 3 types of display studies may be due to difference in testing apparatus,
units: gram, Newton and ounce was used in this study. study design, difference in brands of denture
It had a measure capacity of 5000 g/176.40 oz. /49.03 adhesives used. Thus, from the present study, it is
Newton and overload capacity of 7000 g, high suggested that denture adhesives can be prescribed to
resolution, & high accuracy. the patients to enhance denture retention irrespective
In the present study, the retention of well- of their form. However the patients must be warned
fitting maxillary denture bases was evaluated . Kumar about the ‘use and misuse’, and ‘do’s and don’ts’
& Thombare1 and Pachore et al23 also used only the related with the applications of denture adhesives to
denture bases for evaluation of retentive ability of the enjoy best possible results without threatening the
denture adhesives. However Kapur and Salman 31 health of oral tissues.
used complete dentures. Uniformity of the thickness
of the denture bases was achieved by using one sheet CONCLUSION
thickness of baseplate wax and the monomer: polymer The value of retention obtained with adhesives was
ratio was taken as per manufacturer’s instructions, more than double as compared to dentures used
overnight bench curing was done, processed using without adhesives. The paste form have established its
long curing cycle, overnight bench cooling was done superiority over powder form of denture adhesives .
before retrieval of the denture bases. Denture bases The reason for the paste form being more retentive
for all the patients were constructed using heat-cure can be due to its viscosity.
acrylic resin hence, material of the denture bases were
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