UNIVERSIDADE ESTADUAL PAULISTA

“JÚLIO DE MESQUITA FILHO”

Instituto de Ciência e Tecnologia

Campus de São José dos Campos

ORIGINAL ARTICLE DOI: https://doi.org/10.4322/bds.2024.e4353

Braz Dent Sci 2024 July/Sept;27 (3): e4353

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in

any medium, provided the original work is properly cited.

A randomized clinical trial of a simpliﬁed technique for complete

denture fabrication: patient perceptions, masticatory eﬃciency,

temporomandibular disorders and quality of dentures

Ensaio clínico randomizado de uma técnica simpliﬁcada para confecção de próteses totais: percepções do paciente,

eﬁciência mastigatória, disfunções temporomandibulares e qualidade das próteses

Ana Luísa Barros PASCOAL1 , Marcília Ribeiro PAULINO2 , Angelo Giuseppe Roncalli da Costa OLIVEIRA1 ,

Adriana da Fonte Porto CARREIRO1 , Wilson MESTRINER JÚNIOR3 , Patrícia dos Santos CALDERON1 

1 - Universidade Federal do Rio Grande do Norte, Departamento de Odontologia. Natal, RN, Brazil.

2 - Universidade Federal de Pernambuco, Departamento de Odontologia. Recife, PE, Brazil.

3 - Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto. Ribeirão Preto, SP, Brazil.

How to cite: Pascoal ALB, Paulino MR, Oliveira AGRC, Carreiro AFP, Mestriner Júnior W, Calderon PS. A randomized clinical trial of

a simplied technique for complete denture fabrication: patient perceptions, masticatory efciency, temporomandibular disorders and

quality of dentures. Braz Dent Sci. 2024;27(3):e4353. https://doi.org/10.4322/bds.2024.e4353

ABSTRACT

Objective: To evaluate the efcacy of a simplied technique for complete dentures (CD) fabrication focusing

on patient-reported outcome measures (PROMs), masticatory efciency (ME), temporomandibular disorders

(TMD), and CD technical quality. Material and Methods: Fifty edentulous individuals were allocated into two

groups based on the complete denture (CD) fabrication method: traditional (T) or simplied (S). Patients were

evaluated at baseline and at a 3-month follow-up, considering quality of life and satisfaction. The technical quality

of the CDs and masticatory efciency were assessed at the 3-month follow-up using a validated instrument and

a colorimetric test, respectively. Data were analyzed using McNemar and Mann-Whitney tests for intra-group

comparisons and Chi-square, Fisher’s Exact, or Wilcoxon tests for inter-group comparisons. Results: Forty-two

patients completed the study (T = 20, S = 22). At the 3-month follow-up, no signicant differences were observed

between the groups for masticatory efciency (p = 0.131), CD technical quality (p = 0.456), satisfaction (p =

0.146), and quality of life (p = 0.409). Patient-reported outcome measures (PROMs) improved from baseline

to the 3-month follow-up (p < 0.01) for both groups. The presence of temporomandibular disorders (TMD)

signicantly decreased after denture replacement (p < 0.001). Conclusion: CD fabricated by a simplied

technique seems to be time-efcient and as effective as that fabricated by a traditional technique. Insertion of

new dentures positively inuenced PROMs and TMD presence.

KEYWORDS

Complete denture; Mastication; Patient satisfaction; Quality of life; Temporomandibular disorders.

RESUMO

Objetivo: Avaliar a ecácia de uma técnica simplicada para fabricação de próteses totais (PT) nos desfechos

relatados pelo paciente (PROMs), eciência mastigatória (EM), difunções temporomandibulares (DTM) e qualidade

técnica da prótese. Material e Métodos: 50 indivíduos edêntulos foram alocados em dois grupos com base no

método de fabricação da prótese total (PT): tradicional (T) ou simplicado (S). Os pacientes foram avaliados

antes e 3 meses após a instalação das próteses, considerando a qualidade de vida e a satisfação. A qualidade

técnica das PTs e a eciência mastigatória foram avaliadas no seguimento de 3 meses usando um instrumento

validado e um teste colorimétrico, respectivamente. Os dados foram analisados usando os testes de McNemar

e Mann-Whitney para comparações intra-grupo e os testes Qui-quadrado, Exato de Fisher ou Wilcoxon para

comparações entre os grupos. Resultados: Quarenta e dois pacientes completaram o estudo (T = 20, S = 22).

Braz Dent Sci 2024 July/Sept;27 (3): e4353

Pascoal ALB et al.

A randomized clinical trial of a simplified technique for complete denture fabrication: patient perceptions, masticatory efficiency, temporomandibular disorders and quality of dentures

Pascoal ALB et al. A randomized clinical trial of a simpliﬁed technique for complete

denture fabrication: patient perceptions, masticatory eﬃciency,

temporomandibular disorders and quality of dentures

INTRODUCTION

Edentulism, the condition characterized

by the loss of all natural teeth, has signicant

implications for oral health and overall well-

being. It is a devastating and irreversible condition

and one of the public health burdens for elderly

people and effects clearly the practice of primary

care [1]. Factors contributing to edentulism

include age, socioeconomic status, and access

to dental care [2]. There is a notable decline in

edentulism in recent years, marking a positive

shift in oral health trends worldwide. However,

the edentulism is still prevalent and can continue

to increase until 2040 [3]. This trend reects

the historical focus of public oral health care for

adults on urgent care, which often involves tooth

extractions [3,4].

To reduce clinical and laboratory steps

during denture fabrication, simplied techniques

for complete denture (CD) fabrication have been

developed. These approaches appear to be as

effective as traditional approaches while requiring

less time and resources [5]. There is no evidence

that dentures made using traditional techniques

are preferred by patients over those made using

simplied techniques [6]. The complete dentures

must also provide retention and stability, which

may be affected by the manufacturing process [7].

Masticatory ability can also be influenced by

technical quality [5]. The degree of residual ridge

atrophy and the duration of edentulism may also

have an impact on treatment success and may

introduce bias when comparing CD fabrication

techniques [8-10].

Several variables, including those assessed

by professionals and patient-reported outcome

measures (PROMs) [11], must be investigated

to assess the effectiveness of simplied methods.

Patient satisfaction should be taken into account

during rehabilitation treatment, especially since

it is associated to patients’ adaptation, as well as

comfort, aesthetics, chewing, and phonetics [6].

The assessment of Oral Health-Related Quality

of Life (OHRQoL) has been considered essential

in determining an individual’s quality of

life [12], as oral rehabilitation encompasses

psychological and social aspects in addition to

physical health [12]. A widely used instrument

for assessing OHRQoL in edentulous patients

is the OHIP-EDENT [13]. This inventory has

demonstrated strong psychometric properties,

enabling the evaluation of the impact of oral

rehabilitation on both the functional aspects and

quality of life of edentulous individuals [14].

Epidemiological studies have reported the

presence of Temporomandibular Disorders (TMD)

in complete dentures (CD) patients; however,

there is no consensus regarding the prevalence

of these disorders in these patients [5,15]. Most

CD wearers are elderly and the prevalence of

TMD in this population is controversial. Authors

such as Schmitter et al. [16] claim that elderly

patients may exhibit signs and symptoms of TMD,

but rarely complain of pain. Literature is still

controversial regarding the factors that contribute

to the development of TMD in CD wearers [6].

For instance, Sanjeevan et al. [17] in a meta-

analysis, compare simplied and traditional CD

production techniques and found no differences

in patient satisfaction or technical quality.

The authors also observed that the simplied

technique made less expensive and time efcient

CD. However, while some studies support the

efficacy of simplified techniques, the limited

number of randomized clinical trials using

similar clinical methodologies and differences

in simplied techniques in the literature did not

support the use of such a technique.

Simplied techniques for CD offer signicant

benefits in terms of cost, time efficiency, and

3 meses após a instalação das PTs não foram observadas diferenças signicativas entre os grupos quanto à

eciência mastigatória (p = 0,131), qualidade técnica das PTs (p = 0,456), satisfação (p = 0,146) e qualidade

de vida (p = 0,409). Os desfechos relatados pelos pacientes (PROMs) melhoraram 3 meses após a instalação

das próteses (p < 0,01) para ambos os grupos. A presença de disfunções temporomandibulares (DTM) diminuiu

signicativamente após a substituição das próteses (p < 0,001). Conclusão: As PTs fabricadas pela técnica

simplicada parecem ser tão ecazes quanto aquelas fabricadas pela técnica tradicional. A inserção de novas

PTs inuenciou positivamente os PROMs e a presença de DTM.

PALAVRAS-CHAVE

Prótese total; Mastigação; Satisfação do paciente; Qualidade de vida; Disfunções temporomandibulares.

Braz Dent Sci 2024 July/Sept;27 (3): e4353

Pascoal ALB et al.

A randomized clinical trial of a simplified technique for complete denture fabrication: patient perceptions, masticatory efficiency, temporomandibular disorders and quality of dentures

Pascoal ALB et al. A randomized clinical trial of a simpliﬁed technique for complete

denture fabrication: patient perceptions, masticatory eﬃciency,

temporomandibular disorders and quality of dentures

accessibility. However, they also present trade-offs,

particularly concerning customization for patients

with anatomical limitations, overall quality, and

improvements in PROMs. The propose of this

research is evaluate the efficacy of a simplified

CD fabrication technique in terms of PROMs,

masticatory efficiency, TMD, and CD technical

quality. Given that this is an equivalence trial, our

expectation was that the simplied technique would

demonstrate efficacy comparable to traditional

methods while being more cost-effective and time-

efcient. The null hypothesis was that there is no

difference between the S and T techniques with

respect to the parameters analyzed.

MATERIAL AND METHODS

This randomized clinical trial was entered

into the clinicaltrials database (identifier:

NCT02652403). Each patient provided written

informed consent in accordance with the

regulations of the local Research Ethics Committee

(protocol number: 37098714.5.0000.5292).

The sample size calculation was according to

prior study Regis et al. [6]. The power test was

calculated using Sealed Envelop Ltd software

(https://www.sealedenvelope.com/power/

continuous-equivalence/) at 80% and the 95%

condence interval and considering a standard

deviation of 2.99 from General Ohip-Edent [6]

with a minimum sample of 18 patients per group,

anticipating possible sample loss, 25 patients’

group were adopted.

The sole inclusion criterion was the use

of previous dentures (in both jaws) for at least

one year, while the exclusion criterion was the

presence of pathological changes in the alveolar

ridges (such as CD-induced brous hyperplasia).

A standardized preliminary alginate impression

using edentulous metal tray was made for all

patients. Subsequently, patients were randomly

assigned, using a sealed envelope, to one of two

groups: traditional technique, considered the

control group (T), or simplied technique (S).

Patients were blinded to their assigned study

group.

The treatment was carried out by four

experienced prosthodontists in accordance with

a standardized clinical protocol. The clinical

protocol for the traditional technique was

similar to previous studies [5,6,12] and the

simplied technique consisted of four chair-side

and three laboratory steps (as detailed in the

Table I). The initial alginate impression was

standardized and consistent across groups, and

it was made with metal-perforated edentulous

impression trays that were wax-lined on the

border using soft utility wax (to minimize border

over extension). The work casts based on the

alginate impression and the arbitrary mount on

SAA (using a 15 degrees plan) in the S group

were the differences between the traditional and

simplied methods [6].

The post dam was created arbitrarily, by

marking the work cast, for the S group and during

Table I - Chair-side and laboratory steps of the two methods

Step Traditional Simpliﬁed

1 Chair-side Preliminary alginate impression

(edentulous metal trays) Final alginate impression (edentulous metal trays)

2 Laboratory Primary casts and custom trays fabrication

(auto polymerizing acrylic) Work casts and occlusal rims fabrication

3 Chair-side Secondary impression (impression compounds and

Zinc oxide–eugenol paste)

Jaw registration (vertical dimension and centric

relation), teeth shade selection and casts arbitrarily

mount on SAA (using a 15 degrees plan)

4 Laboratory Work casts and occlusal rims fabrication Teeth set-up (33-degree teeth and mutually protected

occlusion)

5 Chair-side

Jaw registration (vertical dimension and centric

relation), teeth shade selection and casts mount on

SAA using face-bow

Teeth try-in

6 Laboratory Teeth set-up (33-degree teeth and mutually protected

occlusion) Laboratorial ﬁnishing process

7 Chair-side Teeth try-in Denture insertion

8 Laboratory Laboratorial ﬁnishing process

9 Chair-side Denture insertion

SAA: semi adjustable articulator.

Braz Dent Sci 2024 July/Sept;27 (3): e4353

Pascoal ALB et al.

A randomized clinical trial of a simplified technique for complete denture fabrication: patient perceptions, masticatory efficiency, temporomandibular disorders and quality of dentures

Pascoal ALB et al. A randomized clinical trial of a simpliﬁed technique for complete

denture fabrication: patient perceptions, masticatory eﬃciency,

temporomandibular disorders and quality of dentures

the custom tray adjustment, before the secondary

impression, for the T group. The denture insertion

appointment was conducted similarly for both

groups. Before insertion, professionals checked

the surface polish and border design of the

dentures. After inserting the CDs, they assessed

border extension and fit, retention, stability,

and occlusal contacts. If the patient reported

any discomfort or if any occlusal disharmony

was observed, the professional performed the

necessary adjustments followed by a polishing

procedure.

Patients completed a general information

inventory at the baseline (gender, age, and years

of use of the previous CD). A calibrated examiner

performed a clinical evaluation of mandibular

residual ridge height, which was classified

according to prognosis: high and medium (better

prognosis), or low residual ridge height (worst

prognosis). The follow-up appointments were

scheduled for 24 hours, 7, 14, and 30 days,

and 3 months after the CD insertion. However,

additional follow-up appointments could be

scheduled if necessary, for instance, if the patient

had any complaints.

PROMs and TMD presence were assessed

at baseline, while patients wore their previous

CD. PROMs were evaluated by a satisfaction

inventory [6] and using the Portuguese version

of OHIP-Edent [13]. Ohip-Edent questions were

grouped into subclasses [6,18]. All subclasses

were comprised of 5 questions, with scores

ranging from 0 to 10 points, except for the

psychological discomfort and disability subclasses,

with 4 four questions and scores ranging from

0 to 8 points. The presence of TMD was assessed

by the Portuguese version of RDC/TMD [19]

and all TMD patients were classied based on

TMD origin (myogenous or arthrogenous or

myogenous and arthrogenous).

Masticatory efciency was assessed using

mastication capsules in combination with a

colorimetric method, as described previously

by Santos et al. [20]. All patients were properly

seated in chairs and instructed to chew the capsule

for 20 seconds. A spectrophotometer (Ultrospec

2100 pro UV / Visible Spectrophotometer, GE

Healthcare, New York, USA) was used to measure

the concentration of the staining intensity of

the fuchsin solution, which was expressed as

absorbance (abs).

The CD quality was assessed using the

Sato et al. [7] instrument, which evaluates:

anterior teeth arrangement, interocclusal

distance, stability of mandibular denture,

occlusion, articulation, retention of mandibular

denture, and border extension of mandibular

denture. Each item was assigned a conversion

number (0-18) based on the scores assigned

(1-3). The general quality of the prosthesis score

ranges from 0 to 100, and 100 indicate better

quality and 0, poor quality.

Examiners calibrated and blinded for

patients group collected data. The same examiner

assessed PROMs and the presence of TMD at

baseline and three months later. Masticatory

efciency and CD quality were only assessed after

a three-month follow-up, to assess patients after

the adaptation period.

Statistical analysis

SPSS software (Statistical Package for Social

Sciences) for Windows, version 20.0, was used to

analyze the data. Baseline data were compared

using the Mann-Whitney, Pearson’s chi-square

or Fisher’s exact tests. The TMD diagnosis was

compared before and after the CD insertion

using the Pearson Chi-square test. The TMD

origin was evaluated using the Mann-Whitney,

Pearson’s Chi-square, and Fisher’s Exact tests.

The satisfaction analysis used the Chi-square test,

Fisher’s Exact test (for inter-group comparison),

and the McNemar test (for intra-group ratings).

For OHIP analysis, the Mann-Whitney test (for

inter-group comparison) and the Wilcoxon

test (for intra-group evaluations) were used.

The Mann-Whitney test was used to evaluate

masticatory efciency and denture quality. A 5%

signicance level was used.

RESULTS

Fifty patients were selected and randomly

assigned to one of two groups: T (N=25) or

S (N=25). There were 44 females (88%) and

6 males (12%). The participants’ ages ranged

from 50 to 92 years, and their previous CD

use ranged from 1 to 30 years. At the baseline,

there were no statistical differences between

the groups (Table II). At the 3-month follow-up,

8 participants dropped out of the study for various

reasons (Figure 1). As a result, the nal sample

included 42 patients (38 females and 4 males)

with an average age of 65.96 ± 9.35 years.

Braz Dent Sci 2024 July/Sept;27 (3): e4353

Pascoal ALB et al.

A randomized clinical trial of a simplified technique for complete denture fabrication: patient perceptions, masticatory efficiency, temporomandibular disorders and quality of dentures

Pascoal ALB et al. A randomized clinical trial of a simpliﬁed technique for complete

denture fabrication: patient perceptions, masticatory eﬃciency,

temporomandibular disorders and quality of dentures

The level of adjustment required for the CD

at the insertion appointment was similar for both

groups. On average, patients in the S group needed

2.4 additional follow-up appointments, while

patients in the T group needed 2.9 (p = 0.568).

PROMs evaluation revealed no statistically

signicant differences between groups at baseline

(p=0.662) and 3-month follow-up for or general

OHIP-Endent (p=0.409). Same result was

observed in for general satisfaction baseline

(p=0.381) and 3-month follow-up (p=0.146).

The intragroup (from baseline to 3-month follow

up) analysis revealed significant differences

in OHIP-Edent, p<0.01 for both groups and

in satisfaction for the majority of the assessed

aspects (p<0.05), but not for “pain-maxillary

arch,” (p= 0.500) “adaptation-maxillary arch,”

(p=0.500) and “retention maxillary arch”

(p=0.125) for the S group.

Table II - Baseline characteristics of the sample

Group

Overall

T S

Age (years) 64 (57.5-72) 65 (61.5-75) 65 (58.75-72) 0.225

Gender

-Female 22 (88%) 22 (88%) 44 (88%)

Male 3 (12%) 3 (12%) 6 (12%)

Use of previous CD (years)

Maxillary 6 (3-13.5) 9 (4.5-10) 8 (4-12) 0.430

Mandibular 7 (3-15) 8 (4-10) 8 (4-12) 0.992

Height of the mandibular residual ridge

High / medium 7 (28%) 6 (24%) 13 (26%) 0.500*

Low 18 (72%) 19 (76%) 37 (74%)

T: Traditional, S: Simpliﬁed. Median (interquartile range) for age, and previous use of last complete denture (CD). Other variables in absolute

values (%). Mann- Whitney test, Chi Square test*. (-) Tests not applicable. Signiﬁcant diﬀerence, p<0.05.

Figure 1 - Study ﬂow diagram.

Braz Dent Sci 2024 July/Sept;27 (3): e4353

Pascoal ALB et al.

A randomized clinical trial of a simplified technique for complete denture fabrication: patient perceptions, masticatory efficiency, temporomandibular disorders and quality of dentures

Pascoal ALB et al. A randomized clinical trial of a simpliﬁed technique for complete

denture fabrication: patient perceptions, masticatory eﬃciency,

temporomandibular disorders and quality of dentures

At baseline, the RDC/TMD identified

28 (56%) TMD patients (myogenous = 1,

arthrogenous = 19, and myogenous and

arthrogenous = 8). At the 3-month follow-up,

23 TMD patients were evaluated, 11 (45.8%)

showed improvements (5 patients classied as

non-TMD and 6 improving from myogenous and

arthrogenous to myogenous or arthrogenous)

and 12 (54.2%) remaining stable. No patient

worsened, and all patients who did not have TMD

at baseline remained so at the 3-month follow-up.

At 3 months of follow-up, the inter-group analysis

of TMD diagnosis revealed no difference between

groups (p=0.530). For the entire sample, there

was a signicant difference (p=0.001) in the

presence of TMD before and after CD insertion.

The mean masticatory efficiency of the

patients was 0.055 ± 0.029 abs and the average

score for the CD quality for both groups was

83.19 ± 11.07, with no statistical differences

between groups (p>0.05). The entire sample

was then evaluated according to the fabrication

technique (T or S) and height of the mandibular

residual ridge (High / medium or low) with

regard to masticatory efciency and CD quality.

No difference was observed for masticatory

efficiency (p=0 >0.05) in both assessments.

For CD quality, regarding the fabrication

technique, there was no difference (p= 0.456),

however there was a significant statistical

difference in view of the height of the mandibular

residual ridge (p = 0.009), and the CD quality

was greater for high/medium edentulous ridges

(Table III).

DISCUSSION

The present randomized clinical trial evaluated

a simplied technique for complete denture (CD)

fabrication, focusing on patient-reported outcome

measures (PROMs), masticatory efciency (ME),

temporomandibular disorders (TMD), and CD

technical quality. The results indicated no signicant

differences between the fabrication techniques

concerning the analyzed variables, leading to the

acceptance of the null hypothesis. Additionally,

the study demonstrated that PROMs may improve

after suitable CD replacement, irrespective of

the fabrication technique. These findings are

consistent with previous studies by Kawai et al. [21],

Regis et al. [6], Komagamine et al. [12] and

Tôrres et al. [22].

Although the CD quality was not assessed

at the baseline, the authors believe that the

improvement in PROMs is attributed to the new

CD’s aesthetic and functional reestablishment.

The previous CD was used, by the majority of the

sample, for more than 5 years. This prolonged

use may result in poor adaptation, CD wear, and

changes in the vertical dimension, all of which are

known to have a negative impact on CD retention,

chewing, and phonetics, resulting in higher levels

of dissatisfaction [23] and reduced OHRQoL.

Despite the fact that the majority of the

patients were diagnosed with TMD at the

baseline, none of them had TMD as their primary

complaint. The presence of TMD was similar

in both groups at the 3-month follow-up, but

some individuals showed an improvement after

CD replacement. Abdelnabi et al. [24] and

Goiato et al. [25] found similar results. These

results may be related to the restoration of

vertical dimension and centric relation, yielding

mandibular and muscles stability and driving to

the decrease of TMD signs and symptoms [24,25].

Since the fabrication technique seems not

to inuence the masticatory efciency, variables

such as age, gender, duration of edentulism,

residual ridge, and previous experiences can

affect it [8]. Koshino et al. [8] found a signicant

correlation between the basal area of the

mandibular residual ridge with masticatory

ability. However, no statistical correlation was

Table III - Patients’ masticatory eﬃciency, in abs and complete denture quality

n Masticatory eﬃciency

CD quality

Technique

0.456Traditional 20 0.046 (0.031-0.056) 0.131 83 (77-96)

Simpliﬁed 22 0.056 (0.038-0.078) 84 (73.75-89.75)

Height of the mandibular residual ridge

0.009*High / medium 12 0.055 (0.032-0.079) 0.449 88.5 (81.5-95)

Low 30 0.049 (0.033-0.062) 80.5 (72.5-86)

Median (interquartile range). Sample size (n) in absolute values. Mann- Whitney test. Signiﬁcant diﬀerence, p<0.05.

Braz Dent Sci 2024 July/Sept;27 (3): e4353

Pascoal ALB et al.

A randomized clinical trial of a simplified technique for complete denture fabrication: patient perceptions, masticatory efficiency, temporomandibular disorders and quality of dentures

Pascoal ALB et al. A randomized clinical trial of a simpliﬁed technique for complete

denture fabrication: patient perceptions, masticatory eﬃciency,

temporomandibular disorders and quality of dentures

found between masticatory efciency and other

variables in our study. This could be explaining

by factors such as harmful previous experience

or patients’ expectations [9].

Border molding procedures are thought to

be necessary for adequate CD retention, stability,

and support [26] however, in our study, the

omission of this step did not impact the overall

quality of the CD or the retention and stability of

the mandibular CD. These ndings are supported

by the literature [6,21,27,28].

Reabsorbed ridges can have a detrimental

effect on the impression process [8] In our study,

the mandibular residual ridge’s reduced height

led to a signicant decrease in the quality of the

CD. Ribeiro et al. [10] found similar results to

ours when they investigated whether the shape of

the jaw was related to CD retention and stability.

Evaluating only patients with severely resorbed

mandible Albuquerque et al. [29,30] compare one-

vs two-step impression procedures for complete

denture fabrication and did not observe differences

between techniques in relation to PROMs, quality

of the prostheses and chewing. As such, careful

execution of preliminary impressions, taking into

account the anatomy of the residual ridge, seems

to produce CD with comparable technical quality

to the traditional technique.

A recent meta-analysis has observed that

complete dentures produced using the simplied

method exhibit significantly lower costs and

reduced manufacturing time compared to those

produced through traditional methods [17].

Consequently, the ndings from this clinical trial

are promising and hold particular signicance for

public health dental systems. The 2010 Brazilian

oral health survey (SBBrasil 2010) highlighted a

considerable demand for prosthetic rehabilitation,

particularly among the elderly population.

Despite this, the number of dentures fabricated

remains insufcient in meeting the treatment

needs of the population.

Studies using simplied complete denture

(CD) techniques involving digital dentures [31,32]

have demonstrated that CDs fabricated through

these methods are as effective as those produced

using traditional methods in terms of patient-

reported outcome measures (PROMs). Moreover,

digital dentures reduce production time and cost,

and provide a more efcient means of storing

and retrieving patient records. However, there

are disadvantages to this technology, including

the signicant investment required for equipment

and training, and potentially limited levels of

customization compared to traditional methods.

Reducing the number of visits to CD

fabrication results in a positive response of

patent’s satisfaction [33]. Employ a simplied

technique for fabricating complete dentures in

in specialized dental centers could enable the

rehabilitation of a greater number of patients

with more efficient utilization of financial

resources [34,35]. Moreover, streamlining

clinical sessions has the potential to enhance

patient adherence to treatment, particularly

among individuals with limited mobility [35,36].

The short follow-up period of our study should

be considered as a limitation. Future research

should focus on longer-term follow-up to conrm

our findings and also explore the integration

of advanced digital technologies in simplied

CD fabrication techniques to enhance clinical

outcomes and PROMs.

CONCLUSION

Within the limitations of this current study, it

was concluded that complete dentures fabricated

by a simplied technique seems to be time-efcient

and as effective as that fabricated by a traditional

technique. The insertion of new dentures positively

inuenced PROMs and TMD presence.

Author’s Contributions

ALBP: Investigation, Formal Analysis,

Writing – Original Draft Preparation. MRP:

Investigation, Formal Analysis, Writing –

Original Draft Preparation. AGRCO: Supervision,

Formal Analysis. AFPC: Supervision, Funding

Acquisition. WMJ: Funding Acquisition. PSC:

Conceptualization, Writing – Review & Editing,

Project Administration, Supervision, Funding

Acquisition.

Conict of Interest

No conicts of interest declared concerning

the publication of this article.

Funding

This study was financed in part by the

Coordenação de Aperfeiçoamento de Pessoal de

Nível Superior - Brasil (CAPES) - Finance Code 001.

Braz Dent Sci 2024 July/Sept;27 (3): e4353

Pascoal ALB et al.

A randomized clinical trial of a simplified technique for complete denture fabrication: patient perceptions, masticatory efficiency, temporomandibular disorders and quality of dentures

Pascoal ALB et al. A randomized clinical trial of a simpliﬁed technique for complete

denture fabrication: patient perceptions, masticatory eﬃciency,

temporomandibular disorders and quality of dentures

Regulatory Statement

This study was conducted in accordance with

all the provisions of the local human subjects

oversight committee guidelines and policies

of: Federal University of Rio Grande do Norte

Research Ethical Comitee.

The approval code for this study is:

7098714.5.0000.5292.

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Patrícia dos Santos Calderon

(Corresponding address)

Universidade Federal do Rio Grande do Norte, Departamento de Odontologia,

Natal, RN, Brazil.

Email: patriciascalderon@yahoo.com.br

Date submitted: 2024 Apr 25

Accept submission: 2024 Aug 06