laque, reduced oxygen tension, and reduced salivary flow with thermal and pH changes. The authors conclude that the role of denture hygiene is of considerable importance since plaque on the surface of the denture base may cause a change from orthokeratinization to parakeratinization.
Effects of oral hygiene conditions and plaque accumulation on denture surfaces of the geriatric, was studied by Pietrokovski, Azuelos, Tau, and Mostavoy (1995). The percentages of inflammatory lesions in both denture and nondenture wearers was found to be higher in institutions without attending dental personnel. Drake and Beck (1993) also studied the elderly and found that good oral hygiene is necessary for people wearing removable partial dentures; partial dentures in need of repair or adjustment were related to periodontal status.
Yi, Ericsson, Carlsson, and Wennstrom (1995) studied patients with advanced periodontal destruction wearing cross-arch fixed partial dentures. They found that combined periodontal, prosthodontic, and maintenance treatment resulted in success.
Additional problems may be related to the denture connector to the gingival margin. Some authors report that there needs to be a space underneath the denture base, and others conclude that the appliance needs to be closely applied to the gingival margin. Orr, Linden, and Newman (1992) investigated this relationship with ten subjects and found no significant differences in subgingival plaque samples from any area. They concluded that gingival health deteriorated rapidly with the insertion of a removable appliance; coverage of the gingival margin, regardless of degree of gingival relief, had a detrimental effect. It has been concluded that partial dentures covering the gingiva have a detrimental effect on gingival health (Budtz-Jorgensen, 1994).
McHenry, Johansson, and Christersson (1992) studied the effect of a removable partial denture mandibular major connector d...