Method of fixing full removable prostheses on the toothless upper jaw using series-closed valve zones

There has been an increase in the ratio of elderly and senile people to the general population who need prosthetics. At the same time, complete teeth loss leads to various anatomical-topographical changes in the denture bed in the elder age group. Meanwhile, there are insufficient researches aimed at improving the fixation and stabilization of complete removable dentures, which determined the direction of our study. The aim of this research was to increase the degree of retention of complete removable dentures by creating additional valve zones, taking into account the individual anatomical-topographical variability of the denture bed structure of the maxilla.

Material and Methods. Prosthetics of 115 people aged from 60 to 93 years old with complete teeth loss on the upper jaw was carried out. Prosthetics were performed by the method of determining the locations of individual valve zones in the area of the pliable mucous membrane of the denture bed on the edentulous upper jaw, including the use of a digital model of the denture bed obtained by cone-beam computed tomography (CBCT) with the use of a contrast agent and subsequent analysis in 3D graphics editors.

Results. Additional retention elements were determined with the individual anatomical-topographical variability of the location of the malleability zones, places of exit of the neurovascular bundles and places with dense mucosa on the upper jaw to improve the retention of the prosthetic structure. At the same time, the obtained results characterize the increase in the efficiency of functional retention of complete removable prostheses due to the creation of consecutive concentrically closed valve zones, which create negative pressure zones medial to the borders of the prosthetic bed.

Discussion. The developed method provides conditions for increasing the efficiency of retention and functionality of complete removable plate prostheses on the upper jaw due to accurate determination of individual anatomical-topographical features of the prosthetic bed, thickness of the mucous membrane, places of exit of neurovascular bundles, torus and exostoses. The probability of vascular compression with microcirculation disturbance and traumatization of soft tissues adjacent to the prosthetic structure was significantly reduced. The method minimizes alternating loads in the area of torus and exostoses in the area of maxillary tubercles, which significantly reduces the probability of fracture of the base of a full removable plate prosthesis.

Conclusion. Our method in case of depressurization of external valve zones increases the degree of retention and stabilization of complete removable orthopedic constructions on the upper jaw during the operation. At the same time, retention is provided by additional internal valve zones located in places where there is sufficient pliability and there are no neurovascular bundles and exostoses.

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