Denture–Mucosa Pressure Distribution and Pressure–Pain Threshold in In Vivo, In Vitro and In Silico Studies: A Literature Review

Aims. The purpose of this systematic review was to evaluate studies that assessed denture–mucosa pressure distribution and pressure–pain threshold and their methodology, used to measure such pressure distributions, mainly in complete and implant overdentures. Materials and methods. An electronic search of the relevant full-text peer-reviewed literature on denture–mucosa pressure distribution was done. Searches were performed independently by two researchers by using the OVID Medline, PubMed and Web of Science databases from 1 January 1946 to 31 December 2021 using the following MeSH terms; (denture OR complete dentures OR implant supported dentures) AND (mucosa OR mucous membrane) AND (pressure OR hydrostatic pressure). Only those publications in the English language were included. Furthermore, a manual search of the citations of the included studies was done to ensure a thorough search was conducted. Results. A full text review resulted in a total of eighteen studies. Of these, seven evaluated various intraoral pressures, two investigated the pressure–pain threshold in edentulous oral mucosa, five measured intraoral pressure through finite element analysis/FEA studies, two demonstrated pressure transducer and pressure measuring systems, and two investigated the comparison between implant-overdentures and complete dentures. Conclusions. To date, there is no study that assesses the pressure distribution on oral mucosa to provide a standardised and validated baseline pressure range which can be used to improve the designs and materials used for fabricating complete dentures. The relationship between pressure on the oral mucosa and the pain threshold of denture-wearing patients still remains poorly understood. There is yet no baseline data which can be universally applied for future studies; to correlate the oral mucosa pressure and pain threshold of edentulous patients encourages further research, especially comparing mucosa pressure under different denture designs for both complete and implant overdentures