SECTIONEDITORS

I__!
*.

Liquid-supported
dentures.
preliminary
report
Gert
Care1
ACTA

Boere,

D.D.S.,*

L. Davidson,
University

Hans

de

Koomen,

Part
Ph.D.,**

II: Clinical

study,

and

Ph.D.***
of Amsterdam

and Free

TTniversity.

Amsterdam,

The

Netherlands

A clinical
study
was made
of 11 selected
patients
wearing
liquid-supported
dentures.
The experiences
and opinions
of the patients
were
assembled
and the
results
are discussed.
The most important
conclusions
of this study
are that it is
possible
to make
a liquid-supported
denture
that in general
fits and feels comfortable, has proper
retention,
a slightly
diminished
masticatory
function,
and that can
provide
a solution
to some problematic
prosthodontic
situations.
(J PROSTHET
DENT
1989;62:434-6.)

urmg the past few decades the application

of soft
lining materials has proved to be a useful aid in preserving
or regaining the health of denture-supporting
tissues.y2
However, shortcomings
of these materials have been reported for as long as they have been in use.3 A new alternative is the liquid-supported
denture described in Part I
of this study.4
This study investigated
the clinical performance
of a
liquid-supported
denture. Functional
properties, such as
retention, stability, and tissue response in the supporting
tissues were studied.5 In addition, the patients appreciation of comfort and functioning
of the liquid-support,ed
denture and its durability
were examined.

MATERIAL

AND

METHODS

A group of 11 volunteers with a variety of prosthodontic

situations was selected. They were experienced
denture
wearers in the age range of 35 to 72 years. The group
included (1) six patients with complete dentures, (2) two
patients with a complete maxillary denture and a complete
natural mandibular
dentition, (3) two patients with a complete maxillary
denture and a tooth-supported
partial
mandibular
denture, and (4) one patient with a complete
mandibular
denture and a partial maxillary
denture.
In this group of 11 patients, three had problems with
their dentures, one suffered from chronic pain caused by
loading forces on the mandibular
ridge (support problem),

*Research
Associate,
Department
of Dental Materials
Science and
general practitioner.
**Professor
and Chairman,
Department
of Prosthetic
Dentistry.
***Professor
and Chairman,
Department
of Dental Materials
Science.

10/l/17026
434

one experienced chronic pain at the incisive foramen in a

resorbed alveolar process, and one patient did not wear a
mandibular
denture because of adaptation difficulties. The
other eight patients had no specific prosthodontic
problems and could function well with their dentures. The degree of resorption
and firmness of the residual alveolar
ridge differed among the patients.
To test the applicability,
15 liquid-supported
dentures
were made in the following categories.
A. Maxillary
and mandibular
liquid-supported
dentures were made for four patients (one was the
patient with chronic mandibular
pain).
B. Maxillary
liquid-supported
dentures opposing the
natural dentition or tooth-supported
removable partial dentures were made for four patients. In the patient with the painful palate, a liquid-supported
denture was made opposing an existing conventional
mandibular
denture.
C. For two patients,
only a mandibular
liquid-supported denture was made; one patient had the mandibular denture made opposing a gingivally
supported partial denture and the other patient (with
the adaptation
difficulty), opposing a complete denture.
To , /obtain answers to questions regarding retention, stability, supporting
area, and appreciation,
a questionnaire
solicited the opinions and experiences of these patients.
Some questions were designed to compare the conventional
denture with the liquid-supported
denture. The patients
were seen regularly for oral inspection of the supporting
areas. At the same time, the dentures were checked for
leakage, and the condition
of the foil and fluid was
inspected.

RESULTS
The results of the questionnaires
are summarized in Table I. From the inquiry and our own observations, the following statements can be made.
1. The retention
of the liquid-supported
denture did not
APRIL1990

VOLUME63

NUMBER4

LIQUID-SUPPORTED

Table

DENTURES.

PART

II

I. Opinions and experiences of patients concerning liquid-supported

Patient
No.
category

and

Maxillary

Ret

Sta

SUP

0
-

Mas

Sw

Rep

0
-

++

Corn

denture

1 (A)
2 (A)
3 (A)
4 (A)
5 (B)
6 (B)
7 (B)

+
+
+

Mandibular
1 (A)

0
0

(A)
(A)
(C)
(0

0
0

+
++
+

cause specific difficulties. Seven of the 11 patients noticed

improved retention.
2. All of the patients noticed the mobility of the denture.
In general, patients with a partial natural dentition in the
mandible found this phenomenon somewhat annoying.
3. In two patients, the condition of the supporting
tissues seemed to improve. They found their pain problems
solved. The other patients showed no noticeable differences in the condition of the oral tissues. Pressure spots
were neither indicated by the patients nor observed.
4. Nearly all patients appreciated the smooth feeling of
the liquid-supported denture base. The patient with the
adaptation problem was able to wear this denture 6 hours
per day.
5. Most patients had some problems with mastication
with the liquid-supported
denture, except the patients
with the pain problems. The patients with maxillary and
mandibular dentures (not necessarily both liquid-supported dentures) had fewer problems than the patients
with a denture opposing the partial natural dentition.
6. Few patients had problems with speech. The negative
remarks made by two patients were probably because of the
difference in arrangement of the anterior teeth compared
with the arrangement in the former denture.
7. In seven dentures a leakage developed; in six dentures
the joint between foil and denture coat separated because
of failure of attachment of the foil. In one denture the foil
ruptured, and the cause was unknown. In the dentures
where the joint was damaged, the patients noticed only a
difference in softness of the denture base.

DISCUSSION
The evaluation by the patients was used to determine
some of the properties and possibilities of the liquid-supOF

PROSTHETIC

DENTISTRY

0
0

Ret, retention; sta, stability; sup, supporting

area; corn, comfort without any loading
forces; mas, mastication;
distinction
compared
with the former conventional
denture;
0, no difference;
-, negative
distinction
compared

JOURNAL

--

denture

2 (Al

THE

++

8 (B)
9 (B)

3
4
10
11

dentures

0
spe, speech; rep, number
with former conventional

of repairs;
denture.

+, positive

ported denture. The conclusion of several studie& 7 was

that the relation between satisfaction of patients with their
dentures and the quality of the dentures is often ambiguous and as such has questionable worth, even more so because the former denture, with which the liquid-supported
denture was compared, had been accepted. However, the
retention was comparable to a conventional denture.
The stability of the liquid-supported denture, despite its
degree of freedom, was acceptable to patients with resorbed
ridges or flabby ridges, probably because the conventional
denture also showed mobility in functioning. The comfort
of the liquid-supported
denture was one of the main
advantages and was appreciated as such. The pain problems that had been solved returned when a leakage
occurred.
In some patients, mastication caused problems. When
the bolus of food was at one side, the denture tended to be
dislodged. This problem was more pronounced in the maxillary denture than in the mandibular denture. The problems decreased gradually or disappeared as the patient
grew accustomed to the movement. The patients with firm
ridges and the patients with a liquid-supported
denture
opposite the partial natural dentition needed a longer time
to adapt.
To improve the stability, the influence of other liquids
and the outline of the liquid space, especially in the maxillary denture, are being studied. The liquid-supported
denture is more voluminous and more ponderous than a
conventional denture, but this factor did not influence
speech or comfort.
Of the seven dentures with leakage, six showed partial
rupture at the joint, indicating that the quality of the joint
must be improved. Several adhesives have been tried and
one or two are promising.
435

BOERE, mKOOMEN,ANDDAVIDSON

When the joint between the foil and denture coat was
damaged, the patients noticed only a difference in softness
of the base material. They neither tasted nor noticed the
silicone fluid. Some contamination and discoloration of the
foil was observed. Scanning electron microscopic inspection showed no corrosion.

CONCLUSIONS

6. The life span of the liquid-supported denture depends

on the atts~hment of the foil. There were six leakages at the
joint ar - Jne rupture of the foil. The techniques and materials are still subject to improvements.
7. The liquid-supported denture is comfortable for the
patient and can improve some prosthodontic problems.
We

After a period of 1 year in which patients have worn or

are still wearing one or two liquid-supported dentures some
conclusions can be drawn.
1. It is possible to make a denture with a liquid as a supporting medium.
2. The retention of this denture is comparable to the retention of a conventional denture.
3. The stability of the denture is different compared
with a conventional denture because of the fluid system.
Patients with a maxillary liquid-supported denture and a
natural rn~dib~~
dentition found this floating freedom
unpleasant. Patients with resorbed or flabby ridges did not
mind.
4. The foil base does not cause observable irritation of
the supporting tissues. Problems of patients with chronic
pain were solved.
5. Time is needed to become used to the changes in
mastication. Patients with firm alveolar ridges or (partial)
natural dentition wearing a liquid-supported denture experienced a diminished masticatory function.

Bound

volumes

available

thank Professor G. E. Flogel for

his advice

in

this study.

REFERENCES
1. Boucher CO, Hickey JC, Zarb GA. Prosthodontic
treatment
for edentulous patients. 7th ed. St Louis: CV Moaby Co, 1975;3.
2. Gonzales JB. Use of tissue conditioners and reailient liners. Dent Clin
North Am 197~2~249-59.
3. Ping Chaing BK. Polymers in the service of prosthetic dentistry. 3 Dent
1984$2:203-14.
4. Davidson CL, Boere G. Liquid-supported
dentures. Part I: theoretical
and technical considerations. J PROSTHZT DENT 1989;63:303-6.
5. Heartwell CM, Rahn AO. Syllabus of complete dentures. 4th ed. Philadelphia: Lea & Febiger, 1986507-44.
6. Waas MAJ van. Ben k~stgebit,
een kwestie van doorbijten (artificial
teeth, a question of grinning
and bearing)
[Thesis]. Utrecht: State
University
of Utrecht, 1985.
7. Kalk W. Dentures, happy ventures. Netherlands Dent J 1980;87(Suppl
18):45-54.
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DR. CAREL L. DAVUXON

SCHOOL OF DENTISTRY,
Undo
OF A~~~~

ACTA

LcuwFawRG 1
1066 EA AMSTERDAM
THE NETHERLAWS

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436

APRIL

1990

VOLUME68

NUMBER4