White SC, Scarfe WC, Schulze RKW, et al: The Image Gently in

dental radiography should be designed to limit
the exposure to radiation while achieving the
clinical purpose for the examination. Children
today will undergo years of dental radiographs
over their lifetimes and need to be protected
whenever possible.
Dentistry campaign: Promotion of responsible use of maxillofacial
radiology in dentistry for children. Oral Surg Oral Med Oral Pathol
Oral Radiol 118:257-261, 2014
Reprints available from WC Scarfe, Dept of Surgical and Hospital
Dentistry, Univ of Louisville School of Dentistry, Louisville, KY
40292; e-mail: wcscar01@louisville.edu, william.scarfe@louisville.edu

Removable Prosthodontics
Denture adhesives

Background.—Denture wearers worldwide use den-
ture adhesives to improve denture retention and stability,
which allows better function and speech production.
In vivo studies confirm that denture adhesives enhance
the overall performance of complete dentures and in-
crease their resistance to dislodgment forces. However,
denture adhesive materials are not generally included in
dental school curriculum and most dental professionals
express no preference for the various materials. A system-
atic review of the available literature looked at denture ad-
hesive effectiveness with respect to retention, stability,
mastication, and biocompatibility. Patient and dental pro-
fessional attitudes toward denture adhesives were also
noted.
Methods.—The Medline database was searched elec-
tronically and manually, and 32 articles relevant to this
study were identified. Twenty-one evaluated the efficacy
of denture adhesives with respect to retention, stability,
and masticatory performance. Six assessed the biocom-
patibility of denture adhesives. Five presented patients’
and/or dental professionals’ attitudes toward denture
adhesives.
Results.—Studies of denture adhesives’ effectiveness
use multiple techniques to provide objective measures of
performance, so the results are difficult to compare. Most
evidence indicates that retention and stability of removable
dentures are significantly increased with denture adhesive
use. Mastication time is reduced and mastication rate
increased. Greater effectiveness was achieved by applying
denture adhesives to both dentures rather than just the
maxillary prosthesis.
A cushion adhesive was found to be most effective in
achieving clinical improvement for patients with poor to
fair dentures or prosthesis-bearing tissues. The material ad-
justs to both the supporting tissues and the intaglio of the
denture. The cushion adhesive’s effect lasts over 10 hours,
with a range between 3 to 12 hours for denture adhesives of
all types. Retention with paste adhesives lasts between 4
and 10 hours. Paste adhesives also perform longer in maxil-
lary than in mandibular dentures.
Paste-type adhesives are most effective in improving
incisal force, followed by powder and strip adhesives.
Mandibular dentures demonstrate lower retention, stability,
and support than maxillary removable prostheses because
they are smaller and oral and tongue muscles exert more
disruptive force. As a result, mandibular denture adhesives
demonstrate a shorter length of effect.
Scientific evidence does not support the supposition
that denture adhesives, properly used, can cause oral path-
ologic conditions, excessive bone resorption, or altered ver-
tical dimension, occlusion, or taste. The data regarding
potential microbial contamination from denture adhesives
are limited.
Patients who wear removable dentures may add
increasing quantities of adhesives as alveolar bone resorp-
tion makes their dentures less well-fitting rather than
seek the dentist’s help. The risks of continuing to wear den-
tures that are ill-fitting, potential hyperzincemia from exces-
sive ingestion of denture adhesive, and possible
concealment of a tumor should be explained to the patient
when dental adhesive use is begun. Fifty-nine percent of
oral cancer cases have been reported in persons who are
edentulous.
Prosthodontic educators acknowledge that denture ad-
hesives offer patients benefits, including improved denture
fit and comfort. However, they also have concerns about
the possibility of using the adhesive to mask underlying
problems and facilitating patients not seeking dental care
appropriately. They also cited concern over denture

86 Dental Abstracts
adhesives promoting oral diseases or conditions such as
denture stomatitis, candidiasis, unbalanced oral flora situa-
tions, and alveolar bone resorption, although they did not
believe oral cancer or leukoplakia results from denture ad-
hesive use. Educators also supported the integration of
denture adhesive information into both denture wearer ed-
ucation and predoctoral dental curriculums.
Patients are often unaware of the existence or advan-
tages of denture adhesives. Some used them in the past
but have discontinued their use. Often they cite a lack of
effectiveness as the main reason for stopping the use of ad-
hesives. Denture adhesive use ranges from 1 week to 30
years, with most patients reporting use between 1 week
and 3 years.
Discussion.—Denture adhesives can significantly
improve complete denture performance and offer several
benefits to patients. Knowledge about these products
among both educators and the general public is lacking,
and some misconceptions are held that should be ad-
dressed by a review of the evidence.
Replanted Teeth
Implant-supported versus intentionally replanted teeth
Background.—Endodontic treatment is designed to
prevent and/or resolve pulpal and periapical patholog-
ical conditions, thereby reestablishing healthy periradic-
ular tissues. Long-term survival is high with nonsurgical
root canal treatment (NSRCT), but healing does not al-
ways follow this intervention. Successfully treated teeth
can become reinfected through coronal microleakage
as well. Implant-supported single crowns (ISCs) are an
option for these cases that has a high success rate. In
addition, apical microsurgery can be considered,
although anatomic factors or medical conditions may
contraindicate this approach. Intentional replantation
(IR) may be of help in some cases with this complica-
tion. It is often considered an option of last resort
because success rates differ widely and no protocol has
been established for it. Comparisons were made be-
tween the outcomes of ISC treatment to replace missing
teeth and IR through a systematic review and meta-
analysis of the literature.
Methods.—The PubMed, Cochrane Library, Web of Sci-
ence, and Embase databases were searched for publications
from January 1966 to April 2014. Articles were divided into
those on ISC and those on IR.
Clinical Significance.—Clinical studies do not
show that denture adhesives promote any alter-
ation in the oral microbial population and indi-
cate they have no role in oral diseases or
alveolar bone resorption. Denture wearers
who use these products tend to view them posi-
tively overall as long as they fulfill the patient’s
needs. Educators need to include information
about denture adhesives in their courses as
appropriate, and dentists should convey accu-
rate information about the products to their pa-
tients with dentures.
Papadiochou S, Emmanouil I, Papadiochos I: Denture adhesives: A
systematic review. J Prosthet Dent 113:391-397, 2015
Reprints available from S Papadiochou, 20 Napoleontos Zerva, The-
ssaloniki, 54640, Greece; e-mail: sofiapapadiochou@gmail.com
Results.—There were 27 articles on ISC included in the
analysis, representing 838 teeth and 4130 implants. Sample
sizes ranged from 20 to 287 teeth. Follow-up varied from 2
to 6þ years, but most ISC losses occurred in the first 2 years
after the procedure. Significant variance in survival was
noted between the studies.
Eight studies addressed IR, with follow-up ranging from
2 to 22 years. Most IR losses occurred in the first 2 years,
with rates stabilizing thereafter. Only two of the IR studies
were published within the past 12 years. Contemporary IR
practice, analysis, and interpretation could not be evaluated
based on the available data.
The overall mean survival was 88% for IR teeth, with
root resorption occurring as a complication in all studies.
Its overall prevalence was 11%. ISCs had an overall mean
survival of 97%, which was significantly higher than for IR
teeth.
Discussion.—The survival for ISCs was significantly
greater than for IR teeth. IR is not often performed, being
considered an option of last resort by many. When it is
done, the second maxillary and mandibular molars are
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