The influence of splinting abutments in acquired maxillary defects on biting force

The purpose of this study was to evaluate the influence of splinting abutments in patients with acquired maxillary defects on biting forces using electronic load sensor device. Materials and methods: Ten patients complaining from hemimaxillectomy were selected . they were divided into two group, the first group received definitive obturator and the second received definitive obturator with splinting the remaining teeth. The biting force were measured using I Load digital sensor Results : The results revealed that the splinting group record increasing in biting force than the unsplinting group. All The patient of the splinting obturator was satisfied with their obturators. Conclusion: Splinting the remaining teeth in hemimaxillectomy patient provide more bite force and more patient satisfaction. (544) Noha Ali Gamal Eldin and Enas Taha Ibrahim Darwish E.D. J. Vol. 64, No. 1 muscles modified by jaw biomechanics and reflex mechanisms (4) Determination of individual bite force level has been widely used in dentistry, mainly to evaluate the therapeutic effects of prosthetic devices and to provide references values for studies on the biomechanics of prosthetic devices . (5) The aim of this study was to evaluate the influence of splinting abutments in an acquired maxillary defect on biting force using electronic load sensor device. MATERIALS AND METHODS Ten patients had undergone tumor removal surgically and were in need for obturator was selected from the outpatient clinic of the prosthodontic department, faculty of oral and dental medicine, Cairo University. The patients were generally in an acceptable health condition and free any systemic diseases that may interfere with obturation procedure. The patients were hemi-maxillectomy with remaining dentulous side with missing upper left first molar (class I modification 1). The patients were subjected to either radio-or chemotherapy and had stopped such treatment at least four years ago without any signs of recurrence. Patients grouping The patients were divided into 2 groups; the first group received definite obturator while the second group received splinted acrylic teeth (porcelain fused to casted metal crowns). Construction of obturator An appropriate stock tray was selected and slight modification was done using pink wax, blocking of undesirable undercuts was done using a small piece of gauze covered with Vaseline. Primary impression was obtained for the upper and lower jaws to have the study cast. For the first group, surveying and mouth preparation were done before taking the secondary impression. (Figure 1) Bite registration using pink wax on the defect side softening of the wax block and allow the patients to close in the correct bite with the intact side completely closed chrome-cobalt alloy with extension base extending into the defect was fabricated. The design included the cingulum rest seat on the upper central incisor, modified T-bar retainer on upper central incisor. , occlusal rest seats on posterior teeth, buccal retainers and palatal bracers on the premolars, palatal retainers and buccal bracers on the molars for stabilization and major connector extending into the defect. (Figure 2) Fig. (1) Secondary impression taken with alginate material Fig. (2) definitive obturator THE INFLUENCE OF SPLINTING ABUTMENTS IN ACQUIRED MAXILLARY (545) For the second group, the teeth were prepared for crown receiving, secondary impression was taking (figure 3) and the wax patterns were prepared to accept the obturator with the design as for the first group. Metal casting was made and crowns were cemented using zinc-phosphate cement. The obturator was made on the bridge with the same design and dimensions by surveying. The biting force was evaluated using load star sensor device at insertion, 3 months and 6 months later. The I-load (digital USB sensor) was connected to PC USB, the force was applied in direction vertical to the top surface of the sensor, a steel ball of 3/8 diameter was placed directly on the center of the dome shape top for comparison only i-load sensor. Patient was seated in an upright position where the sensor was placed horizontally at the embrasure area of second premolar and first molar, an average of ten readings was taken. (figure4) Data were collected, tabulated and statistically analyzed by ANOVA test.