Many methods have been tried to improve patient comfort with dentures over the years and marketed to the public, but do suction dentures help? Suction cup dentures, with a suction cup in the middle of th e upper denture have been around for over 100 years with several journal articles reporting cases of pathological effects on the soft tissues. There is a destructive effect of the negative pressure with these suction cups, with excessive growth of tissue under the suction cup and perforations in the palate requiring surgical closure the fistula. This post explains the two newer alternative methods, with somewhat similar names but vastly different methods; the Abe suction – effective denture and the alternative Ultra suction denture and compares both to conventional lower (mandibular) denture techniques. The term “suction denture” as marketed by some clinics could easily refer to either concept. Ultra Suction Dentures use a valve system to create suction against the gums, keeping the dentures in place. Two tiny Ultra Suction valves are inserted into the denture, one each side. A special bar is placed over the tissue model prior to denture processing, and then removed after processing allowing space for the negative pressure to be formed. This spacer (suction chamber) also reduces the supporting ridge in contact with the denture. On firmly biting down, the gingival tissues penetrate the suction chamber. The air is expelled through the valves and the valves prevent its reintroduction. The lower pressure beneath the denture exerts a pull and seals the denture. The valve system as invented by Mony Paz is manufactured by Biomedics in New Zealand and available in Australia. The system can be incorporated into a conventional denture base. There is one Egyptian study demonstrating increased denture retention and satisfaction in the short term. Unfortunately, the negative pressure effect created by the valves of the system drags the gingival tissues towards the suction chamber and overgrowth (hyperplasia) of the tissues covering the ridge is possible. Additionally there are also some reports of food jamming in the valves and difficulty in cleaning the fine holes that lead to the valves, along with loss of the suction. Long term prospective clinical studies are recommended to investigate the biological effect of the system on the supporting tissues before widespread acceptance. An alternative approach was taken by Dr. Jiro Abe from Japan, developing the suction-effective denture technique in 1998. This is marketed by some as the “Suction Denture” but has no mechanical suction device installed. They do not contain as could be imagined some new revolutionary suction device inserted in the denture, but is rather a total philosophy of advanced denture design to enhance stability and retention of complete dentures. Better results are possible as compared with traditional technique, combining a philosophy of several key elements for an improved denture process (BPS system). This involves a precise impression technique of preliminary and final impression procedures, bite registration, tooth position and injection moulding system for accurate and an intimate fit. A healthy healed tissue base is fundamental. The impression for the new denture is made in layers. In the first step, the focus is on the border of the denture and in the second step focus is on the impression of the overall mucosa, frenula, and other anatomical structures. The objective of the technique with border moulding is full extension without overextension. The corners of the back of the lower denture typically are a little longer than a conventional denture, having wings to tuck under the cheek muscles and providing an improved air seal. This combination of improved denture impression can significantly increase the retention of a denture in some, but not all patients. With chewing the denture is seated, air is expressed and it sucks onto the gum with atmospheric pressure. This is the “effective suction” as proposed by Jiro Abe, created without a mechanical suction device. The disadvantage is that they can feel bulky if fully extended. Below are before and after videos of a patient using the suction effective technique of construction as proposed by ABE. References: Vaaka P, Donga SK, Ganapathi AK, Devi PB, Kaluvakolanu S, Mohammad Z. Suction Cup Induced Palatal Fistula: Surgical Closure by Palatal Rotational Flap. Ann Med Health Sci Res. 2016 Mar-Apr;6(2):129-132. Hany, Sal & , Badra & Iman, Aw & Radi, Iman & Aboulela, Alaa. (2018).The effect of Ultra-Suction System on the retention of mandibular complete denture. Egyptian Dental Journal. January Vol. 56, 101-109. Don’t forget to share this via Twitter, Google+, Pinterest and LinkedIn.