[Etiopathogenesis of complication caused by removable full dentures]

The goal of the research was to study the complications caused by removable dentures. For these reason 890 patients were investigated. It was found that the pathologic changes in oral cavity are the results of: poor quality of denture, unfavorable condition before and after prosthesis. The factors responsible in the development of complications after orthopedic treatment were identified: living conditions, quality and toxicity of dentures materials. The received results give an ability to determine the common disturbance in the maxillo-facial system and use adequate methods and remedies to avoid complications caused by removable orthopedic construction.

The prevalence of temporomandibular disorders among two different denture-wearing populations

AIM

The aim of this clinicostatistical study was to profile the complete denture wearers of two different populations, to determine any possible relationship between the prevalence of temporomandibular disorders (TMDs) and factors involved in complete denture wearing and to compare this prevalence between the groups.

MATERIALS AND METHODS

Denture wearers who attended the clinics of the Dental School and Hospital, University of Bristol, U.K. (group A) and the Dental School, University of Athens, Greece (group B), were examined. An approximately equal number of patients; 115 for group A and 136 for group B, were selected. The examination included: (a) a history record with reference to sex, age, years of complete denture experience, sets of dentures used, age of the current dentures, time period of every day denture wearing, any difficulties on opening the mouth, and/or pain at the temporomandibular joint (TMJ) region and (b) a craniomandibular clinical examination in relation to midline deviation, pain and sounds from the joints, pain in the related muscles and inspection of the vertical dimension of occlusion. Data collected were analyzed using the chi-square test.

RESULTS

Denture wearers of group A were older, presented with greater experience in complete denture wearing, used more sets of dentures, most wore dentures exhibiting decreased vertical dimension of occlusion and wore their dentures only in the day time. The TMDs prevalence was not statistically significantly different between A and B groups (34.8% and 41.2% respectively). In group B the TMDs prevalence was greater in females. There was a decreasing TMDs prevalence with increasing age. Neither of the groups showed significant TMDs prevalence in relation to the denture experience, the number of dentures used, the age of the present denture nor the vertical dimension of occlusion. Group B showed a decreasing TMDs prevalence in relation to continuous denture wearing.

CONCLUSIONS

This clinicostatistical study showed that two different population groups of complete denture wearers who presented with different profiles have similar prevalence of TMDs.

Correct complete denture rehabilitation, a chance for recovering abused tissues

The prosthodontic treatment must provide for the edentulous patients bio-functional prosthetic restorations, bio-prophylactic for the surrounding tissues. In this aim, an edentulous patient must be submitted to a methodical clinical examination in order to establish the quality of hard and soft tissues, which will indicate the degree of difficulty of the prosthetic treatment. Additional investigation as a microbiologic examination and cephalometric radiographs can be useful in a modern investigation. In our daily practice, we are rarely confronted with a normal morphology of the denture bearing oral structures. The problem of managing abused tissues in a patient with morphologic abnormalities due to faulty prostheses is sometimes difficult to solve. Preventing the deterioration of oral status must be a condition in providing a chance for the success of the following rehabilitations, mainly in the situation when the complete edentulousness succeeds in a young or middle age patient.

[An edentulous case with articulation disorder and severe bone resorption]

PATIENT

A 71-year-old man complained of articulation disorder caused by poor retention of the upper and lower complete dentures. Both maxillary and mandibular residual ridges showed severe resorption. The dentures had short base borders and poor retentions, and were sway with mandibular functional movement. First, I planned to improve the retention and mandibular position of his dentures by repairing his dentures. When I confirmed to make a good retention and an appropriate mandibular position, I started to make new dentures, and then set them.

DISCUSSION

Evaluation before and after treatment showed recovery of articular function. The new denture, which has suitable tongue space, made the tongue movement area during speaking wider. This might result from the patient acclimatizing to a new condition.

CONCLUSION

New dentures showing stable retention and good articular function were not sway during functioning or articulation, and the patients articulation became clear.

Prevalence and risk factors associated with denture-related stomatitis in healthy subjects attending a dental teaching hospital in North Jordan

There is scant information regarding the prevalence of denture-related stomatitis (DRS) in Jordan.

AIMS

The aims of this study were to investigate the prevalence of DRS in a group of healthy Jordanian subjects wearing removable complete dentures, and to investigate for the factors that may be associated with this infection.

MATERIALS AND METHODS

A total of 300 complete denture patients attending a dental teaching centre in North Jordan for replacement dentures were examined thoroughly for the presence of DRS. Demographic data, including denture-wearing habits, duration of denture usage and smoking, were also obtained. Oral mucosal tissues were examined for signs of denture trauma. Dentures were assessed for plaque accumulation.

RESULTS

Of the 300 subjects examined, 175 were male and 125 were female. The overall prevalence of DRS in males and females was 52% (157/300). Increased plaque deposits (plaque indices 2 and 3) were significantly more prevalent in subjects with severe forms of DRS (p<0.01). Dentures that were more than 20 years old were located in the group of subjects with grade 2 and 3 infections. A total of 86% of patients with DRS complained of denture trauma compared to 10% of subjects with healthy mucosa, and 87% of the DRS group wore dentures continuously day and night. A total of 70% of subjects with grade 3 DRS were heavy smokers (more than 15 cigarettes/day).

CONCLUSION

Local factors studied contributed significantly to the development of DRS in healthy subjects and are important factors to be considered in the pathogenesis of this infection.

Assessment of oral status and oro-pharyngeal candidosis in elderly in short-term hospital care

OBJECTIVES

To evaluate prevalence of oral candidosis and predisposing conditions in hospitalized elderly patients.

DESIGN

We examined 104 elder patients recently hospitalized in two geriatric hospitals for shortterm hospital care.

METHODS

Information was collected on patients' sex, age, mental and physical disabilities, smoking habits, medical prescriptions, oral pathologies, denture wearing, oral hygiene habits and oral hygiene level. Quality of existing dentures was evaluated. Oral mucosae were examined for clinical signs suggesting oral candidosis. Semiquantitative cultures of Candida were carried out to confirm the clinical diagnosis.

RESULTS

The diagnosis of oral candidosis was confirmed in 18/54 patients showing clinical signs of oral candidosis. Confirmed oral candidosis was associated with the presence of other infections, proteo-caloric denutrition, ongoing antibiotic therapy, and denture wearing. Dentures in patients with confirmed oral candidosis at poorer technical quality of the acrylic surface in contact with the underlying mucosa.

CONCLUSION

The wearing of removable dentures is a major predisposing factor for oro-pharyngeal candidosis of elderly patients in short-term hospital care. Appropriate oral and denture hygiene measures as well as denture wearing habits should be introduced or maintained to prevent this infection.

Addressing problems in complete dentures

The authors have compiled a set of solutions to the most common issues influencing the success of complete denture cases. A brief review and discussion of occlusal vertical dimension is presented, followed by a troubleshooting guide to problems such as inadequate retention and stability, discomfort, and other problems affecting treatment outcome.

Clinical study on the correlation between psychogenic dental prosthesis incompatibility, oral stereognosis, and the psychologic diagnostic tools SCL-90-R and CES-D

PURPOSE

The objective of this study was to use an oral stereognosis test to evaluate possible intraoral/sensorimotor causes in patients with a psychologic diagnosis of psychogenic prosthesis incompatibility, and to evaluate possible correlations between oral stereognosis and the psychologic diagnostic tools Symptom Checklist-90-R (SCL-90-R) and Center of Epidemiological Studies Depression Scale (CES-D).

MATERIALS AND METHODS

The study cohort comprised 83 patients with complete dentures fabricated according to a standardized protocol. Twelve patients diagnosed with psychogenic prosthesis incompatibility (11 women, 1 man) using the SCL-90-R and CES-D scales in a previous study and a group of 24 randomly selected control subjects (14 women, 10 men) underwent an oral stereognosis test with 10 neutral-tasting plastic test specimens with a maximum edge length of 8 mm in 2 test cycles.

RESULTS

The results revealed no significant differences in oral stereognostic ability between patients with diagnosed psychogenic dental prosthesis incompatibility and the control patients. The patients in the test group expressed clear dissatisfaction with their dentures. No correlation was found between oral stereognostic ability and the SCL-90-R or CES-D values.

CONCLUSIONS

This study is the first to use oral stereognosis tests for patients with psychologically diagnosed psychogenic dental prosthesis incompatibility. The diagnosis of psychogenic prosthesis incompatibility by the SCL-90-R and CES-D scales is affirmed by the lack of correlations between the functional/anatomic aspects of oral stereognostic ability, psychologic diagnostic tools, and the clinical picture of psychogenic prosthesis incompatibility. Thus, psychogenic prosthesis incompatibility can be classified more explicitly as a psychosomatic disorder.

The role of candida in inflammatory papillary hyperplasia of the palate

The objective of this study was to investigate the expression by immunohistochemistry of the major basement membrane (BM) components (laminin, collagen type IV, fibronectin) in specimens from the palatal mucosa lesions of patients with complete dentures and diagnosis of inflammatory papillary hyperplasia of the palate (IPHP). Furthermore to evaluate the potential role of candidal infection in patients with IPHP. Biopsies of palatal mucosa were obtained from patients with IPHP, generally healthy/orally healthy patients with dentures, and healthy subjects. Immunohistochemical studies performed with specific antibodies to BM proteins. Scrapings and swaps of oral lesions from all patients and control groups were taken from the palate, and Candida species colonization was assessed with mycology tests. Immunohistochemical expression of BM components revealed thin linear staining in the BM of healthy palatal mucosa. In IPHP discontinuities or disruptions in BM were observed at the interface between epithelium and the underlying connective tissue in the areas of severe inflammatory response. Our findings suggest an interaction between the expression of BM components and Candida involvement in the development of IPHP, a disorder involving inflammatory reaction and modification of soft tissues.

Relationship between Candida and nocturnal denture wear: quantitative study

The purpose of this study was to evaluate the relationship between Candida and denture wear during the night. Twenty-four edentulous volunteers were randomly divided into two groups. Group I (GI, n = 11) was composed of volunteers who wore their complete dentures day and night and Group II (GII, n = 13) was composed of volunteers who wore their complete dentures only during the day. Three examination periods were performed for both groups. In GI, the first examination (A) was carried out after overnight denture wearing. Subsequent examinations were conducted after one (B) and seven nights (C) without denture use during sleep. In GII, the first (A) was done without previous use during sleep, and the following were carried out after one (B) and seven nights (C) of overnight denture wearing. Total unstimulated saliva was collected in a sterile container and cultured in duplicate inside Petri dishes. The values of colony forming units (CFU mL(-1) +/- s.d.) were obtained: GI A - 10.1 x 10(3) +/- 1.2 x 10(4), B - 2.0 x 10(3) +/- 2.6 x 10(3), and C - 2.6 x 10(3) +/- 5.9 x 10(3) and GII: A - 0.4 x 10(3) +/- 0.6 x 10(3), B - 9.4 x 10(3) +/- 17.7 x 10(3) and C - 6.3 x 10(3) +/- 15.3 x 10(3). The mean counts for Candida sp. were expressed as log (CFU + 1) mL(-1) and statistical significance of differences among groups was tested by anova (alpha = 0.05). Multiple comparisons were performed according to Bonferroni test and indicated significant differences between A-B and A-C, but not between B and C for both groups. It was concluded that there is a significant relationship between continuous denture wear and Candida sp.

Frequency and location of traumatic ulcerations following placement of complete dentures

PURPOSE

To determine the location of mucosal injuries that appear following placement of complete dentures, as well as the number of adjustments necessary to achieve patient comfort. The frequency of mucosal injuries in female and male patients and their connection with clinical anatomic features were also investigated.

MATERIALS AND METHODS

Sixty-one completely edentulous healthy patients who wore dentures (47 women and 14 men) took part in the study; 122 newly fabricated complete maxillary and mandibular dentures were investigated. All patients were seen for a 1-week adjustment appointment. Areas where signs of denture-induced mucosal injuries appeared were marked on an anatomic illustration. The follow-up period was in 1-week increments as deemed necessary by the patient. Associations between variables were analyzed with analysis of variance. Results were recorded as mean + SD. Statistical significance was set at P < or = .05.

RESULTS

Eighty-seven percent of the dentures required adjustment at week 1, 50% at week 2, and only 7% at week 3. No patients required a further visit. Most frequently injured maxillary areas were the vestibular sulcus (41%), maxillary tuberosity (21%), and hamular notch (12%). In the mandible, the most frequently injured areas were the retromylohyoid area (17%), lingual sulcus (14%), and vestibular sulcus (13%). Denture-induced irritations were detected in a higher ratio in the mandible (P < .001), especially in male denture wearers at the first adjustment (P < .05). Men had a higher ratio of lesions at the region of the maxillary vestibular sulcus between the labial and buccal frenum and at the mandibular vestibular sulcus of the buccal shelf region (P < .001).

CONCLUSIONS

Denture-induced irritations appeared most often in the vestibular sulcus of the maxilla and mandible, indicating that it is necessary to evaluate the area of the facial seal of the prosthesis by applying a medium- or a heavy-pressure indicator paste to the borders, and to make adjustments at the delivery stage and subsequent adjustment appointments. Denture placement must not be the final patient-clinician encounter when treating with complete dentures. Denture adjustments are very important clinical phases of denture fabrication and essential in patient care.

Postprandial whole-body protein metabolism after a meat meal is influenced by chewing efficiency in elderly subjects

BACKGROUND

The rate of protein digestion affects protein utilization in elderly subjects. Although meat is a widely consumed protein source, little is known of its digestion rate and how it can be affected by the chewing capacity of elderly subjects.

OBJECTIVES

We used a [1-(13)C]leucine balance with a single-meal protocol to assess the absorption rate of meat protein and to estimate the utilization of meat protein in elderly subjects with different chewing efficiency.

DESIGN

Twenty elderly volunteers aged 60-75 y were involved in the study. Ten of them had healthy natural dentition, and the other 10 were edentulous and wore complete dentures. Whole-body fluxes of leucine, before and after the meal (120 g beef meat), were measured with the use of a [1-(13)C]leucine intravenous infusion.

RESULTS

A rapid increase in plasma aminoacidemia and plasma leucine entry rate was observed after meat intake in dentate subjects. In complete denture wearers the increase in leucine entry rate was delayed (P<0.05), and the amount of leucine appearing in peripheral blood during the whole postprandial period was lower than in dentate subjects (P<0.01). Postprandial whole-body protein synthesis was lower in denture wearers than in dentate subjects (30% compared with 48% of leucine intake, respectively; P<0.05).

CONCLUSION

Meat proteins could be classified as fast digested proteins. However, this property depends on the chewing capacity of elderly subjects. This study showed that meat protein utilization for protein synthesis can be impaired by a decrease in the chewing efficiency of elderly subjects.

A comparison of oral health related quality of life between complete and partial removable denture-wearing older adults in Korea

The purpose of this study was to compare the oral health related quality of life (OHRQoL) between older Korean adults with complete and partial removable dentures using oral health impact profile (OHIP). A pool of 4250 Korean older adults was identified by random stratification by area from the sample cohort of Korean National Survey of Oral Health in the year of 2000. Out of the potential pool, 445 subjects with removable partial dentures (RPDs) or complete dentures (CDs) agreed to be interviewed by telephone. Each question in the survey was about how frequently each event was experienced during the past 12 months. To analyse the association between OHIP scores and removable denture status, bivariable analysis and multiple linear regression analysis were used. RPD users showed higher scores on eight items than CD users. They were 'breath stale', 'food catching', 'sensitive teeth', 'toothache', 'tense', 'unable to brush teeth', 'less tolerant to family members' and 'irritable with others'. RPD users might be associated with higher scores of functional limitation, physical pain and psychological discomfort than CD users. RPD users had slight tendency to be associated with higher OHIP-49 score than CD users, but it was not statistically significant. The findings of the present study confirm that there is no general OHRQoL difference between RPD and CD users. But in the items and subscales of OHIP, RPD users might experience more impaired OHRQoL than CD users.

Dental care of patients with autoimmune vesiculobullous diseases: case reports and literature review

Dental management of patients with autoimmune vesiculobullous disorders is complicated because of prominent involvement of oral mucosa, increased risk of oral disease, and difficulty in rendering dental care. Although these diseases are relatively uncommon, dental practitioners should be familiar with the oral sequelae of these conditions and their management. Pemphigus vulgaris, cicatricial pemphigoid, and epidermolysis bullosa represent the most common autoimmune oral vesiculobullous diseases. This case-illustrated review summarizes the pathogenesis, diagnostic features, and natural history of oral vesiculobullous disorders, placing an emphasis on the treatment and prevention of associated oral disease aimed at maintaining a healthy, functional dentition.

Correlation between adhesion, enzyme production, and susceptibility to fluconazole in Candida albicans obtained from denture wearers

OBJECTIVE

The aim of this study was to assess the contribution and the correlation between the virulence factors of Candida albicans in denture stomatitis.

STUDY DESIGN

Thirty C. albicans strains obtained from the oral cavity of patients with denture stomatitis and 30 C. albicans obtained from the oral cavity of denture wearers with normal palatal mucosa were compared for adhesion ability to buccal epithelial cells (BEC), reduction in adhesion after exposure to fluconazole, and enzyme production. The correlation between these virulence factors was assessed by Pearson's correlation coefficient.

RESULTS

C. albicans obtained from denture stomatitis patients were more adherent to BEC and higher enzyme producers than those obtained from healthy patients. Our results demonstrated that exposure to fluconazole reduces C. albicans adherence to BEC. This study could also provide evidence of correlation between virulence factors.

CONCLUSION

Our results suggest that adhesion and enzyme production could be factors that, along with predisposing conditions related to the host, determine if an individual will develop disease or remain as a healthy carrier and confirm that fluconazole has an impact on the adherence ability and enzyme production in C. albicans.

[Case of complete denture with improvement of facial aspect through the recovery of the mandibular position]

PATIENT

This is a clinical case report of esthetic and masticatory impairment due to a mandibular protrusion during occlusion. The patient was a complete edentulous subject who complained about esthetic and matiscatory disturbance. First of all, treatment dentures were done, in order to improve the mandible position and recover the facial aspect. Objective evaluations were carried out to compare the improvements achieved after the insertion of the new dentures.

DISCUSSION

The treatment dentures were used to improve patient's mandible position as well as vertical dimension. Once the facial appearance was recovered as a result of an appropriate mandible position, a reduction of the angle formed between the FH plane and the A-B plane from 87 to 83 was recognized after the insertion of the new dentures through the analysis of lateral cephalograms. It indicates that the mandible's position changed to backward position resulting in an improvement of the facial aspect.

CONCLUSION

In the present clinical case report, not only subjective evaluation for appropriate mandible position and vertical dimension, but also including objective evaluation methods allowed us to evaluate and compare objectively the patient's pre and post operative condition.

Prevalence of temporomandibular disorder signs in patients with complete versus partial dentures

OBJECTIVES

To determine the prevalence of signs of a temporomandibular disorder (TMD) in completely edentulous patients wearing upper and lower complete dentures (CD) and to compare this to the prevalence of signs in partially edentulous patients wearing upper and lower clasp-retained acrylic removable partial dentures (RPD).

MATERIALS AND METHODS

A questionnaire and a clinical examination were used to assess 200 patients. One hundred of these were complete denture wearers being treated for the provision of replacement CD. The other 100 patients were partially edentulous patients, who had RPD replacing upper and lower partially missing teeth and their supporting structures.

RESULTS

It was shown that there was a statistically significant difference between the two groups regarding the presence of temporomandibular signs. Partially edentulous patients wearing upper and lower RPD had a significantly higher prevalence of TMD signs than edentulous patients wearing CD (36% compared to 17%). They also exhibited significantly (P<0.04) more signs of joint tenderness (18%) on clinical examination compared to (5%) only in the CD-wearing patients. Tenderness upon palpation in the periauricular region was the most common site reported in both groups.

CONCLUSIONS

The partially edentulous patients (wearing RPD) exhibited more TMD signs when compared with the CD-wearing patients. Significantly, more partially edentulous patients had joint tenderness (P<0.04) than did CD-wearing patients. The masseter muscle most commonly demonstrated muscle tenderness.

Antimicrobial activity of monocaprin: a monoglyceride with potential use as a denture disinfectant

Monocaprin is a 1-monoglyceride of capric acid that has antimicrobial activity against enveloped viruses, certain bacteria, and the yeast Candida albicans. Solutions containing monocaprin were formulated and tested in vitro against a number of micro-organisms, including species found in the oral cavity and common pathogenic species. The antimicrobial activity of monocaprin was tested with strains growing on a surface as well as in the planktonic phase. Micro-organisms tested were: Streptococcus mutans, Candida albicans, Lactobacillus sp., Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Two sets of dilutions were prepared for each test strain; one to be inoculated with the micro-organism growing in the planktonic phase and the other with the same strain growing on a filter paper disk. Control solutions were also prepared to find out if any of the excipients were affecting the microbicidal effect of monocaprin. Test strains growing on the filter paper surface were less sensitive to monocaprin than the same strain growing in its planktonic phase. C. albicans was the micro-organism that was most sensitive to monocaprin, but S. mutans also showed appreciable sensitivity. The indication that monocaprin may have potential as a topical agent against Candida was tested in an open study of denture disinfection in 32 patients attending a geriatric daycare centre. A significant, but short-term, reduction in counts of Candida on the fitting surface of full dentures was observed.

Construction faults associated with complete denture wearers' complaints

Edentulism is considered a poor health outcome and may compromise the quality of life. Although the number of adults losing their natural teeth is diminishing, there are still large numbers of edentulous adults in the population. A retrospective study was conducted with information derived from literature (from 1984 till 2004) about the patients who experienced ongoing difficulties with new complete dentures, to determine possible underlying causes. Relationships were observed when denture construction or design faults were compared with patient complaints and the advised solution of the problem. CONCLUSION. This study suggests that in most instances, complete denture patients present with complaints only when there is real design fault. Clinician must carefully evaluate the denture for faults in denture base extension and horizontal and vertical jaw relationships.

Cephalometric evaluation of maxillomandibular relationships in patients wearing complete dentures: a pilot study

The purpose of this study was to evaluate the changes in vertical and sagittal maxillomandibular relationship of the patients who had been wearing dentures for an extensive period. Fifteen edentulous patients (seven men and eight women; mean age 63.5 years) who had worn dentures for six to 16 years (mean 10 years) were selected for this study. New prostheses were fabricated by conventional methods, and the patients were evaluated cephalometrically before and after the new prosthesis. The results were compared by Wilcoxon signed rank test (P < .05). Results indicated that a prognathic mandible and a pseudo Class III relationship with a reduced occlusal vertical dimension became a normal Class I maxillomandibular relation when the new prosthesis was inserted. A better facial profile was achieved.

A 2-year study of Candida-associated denture stomatitis treatment in aged care subjects

OBJECTIVE

To test the efficacy of two methods of treatment for denture stomatitis in aged care institutions.

BACKGROUND DATA

Candida-associated denture stomatitis has been associated with a lack of denture hygiene.

MATERIALS AND METHODS

Sixty subjects with denture stomatitis were randomly divided into three groups: sodium hypochlorite denture soak, microwaving and control. Both methods of treatment were carried out on a nightly basis for 1 week, excepting the control group. Standardised photographs of the palate and microbial samples of palate, upper and lower dentures were taken before and after treatment.

RESULTS

Both hypochlorite and microwave irradiation significantly reduced the numbers of Candida and aerobic bacteria on both dentures and both methods significantly reduced Candida on the palate. However, palatal aerobic bacteria were not significantly reduced by either method and the controls showed insignificant changes at all three sites for both Candida and aerobes.

CONCLUSION

While both methods of denture disinfection were successful, except for the counts of palatal aerobic bacteria, three independent observers of the clinical photographs had difficulty in identifying the controls but were more successful with the treatments. The raters also showed that there was no difference between both methods of disinfection and this agreed with the microbiological analysis.

Fluconazole and/or hexetidine for management of oral candidiasis associated with denture-induced stomatitis

OBJECTIVE

The aim of the present study was to compare the influence of fluconazole capsules and/or hexetidine mouthrinses for the management of oral candidiasis associated with denture stomatitis. DESIGN RELEVANT: Sixty-one patients (ages 43-76 years, mean: 61) admitted to the Department of Oral Surgery and Medicine and diagnosed as suffering from oral candidiasis associated with denture stomatitis by microbiological examination were involved.

MATERIALS AND METHODS

Patients in group 1 (n = 21) were given only fluconazole capsules (Zolax 50 mg once a day), those in group 2 (n = 18) were given only hexetidine mouthrinses (Heksoral 0.1%, twice daily), whereas those in group 3 (n = 22) were given both fluconazole capsules and hexetidine mouthrinses for 14 days. The yeast colonies of the saliva samples were counted and calculated as the number of colony forming units per milliliter. The presence of yeasts in the lesion and denture samples were evaluated as present/absent according to their growth on cultures. Candida albicans was identified by means of germ tube analysis.

RESULTS

Patients in groups 1, 2 and 3 had a statistically significant decrease in the amount of C. albicans in saliva, lesions and dentures after treatment, when compared with pretreatment results (P < 0.05). Candida albicans counts in saliva, lesion and denture after treatment detected no statistically significant difference when the three groups were compared.

CONCLUSION

Of the three study groups, group 2, where hexetidine was the only medication prescribed, was found to be superior on account of fewer potential complications. We conclude that dentists should employ a more conservative intervention with oral mouthrinses rather than risk adverse effects and complications of systemic drugs for the management of oral candidiasis.

The impact of cigarette/tobacco smoking on oral candidosis: an overview

Smoking is associated with a variety of changes in the oral cavity. Cigarette smoke has effects on saliva, oral commensal bacteria and fungi, mainly Candida, which causes oral candidosis, the most common opportunistic fungal infection in man. How cigarette smoke affects oral Candida is still controversial. This brief overview is an attempt to address the clinical findings on the relationship between smoking and oral candidosis and possible mechanisms of pathogenicity.

Period between Completion of Radiation Therapy and Prosthetic Rehabilitation in Edentulous Patients: A Retrospective Study

PURPOSE

The primary purposes of this study were: (1) to describe the number and types of complications patients had before and after insertion of a removable prosthesis (i.e., denture) following radiation therapy to the head and neck and (2) to investigate whether the time between radiation therapy and denture insertion might contribute to those complications.

MATERIALS AND METHODS

This research evaluated edentulous patients and those who were rendered edentulous as a result of their cancer treatment. After obtaining institutional approval following HIPAA regulations, a total of 349 charts were identified: 152 patients from Houston Veterans Administration Medical Center (HVAMC) and 197 patients from M. D. Anderson Cancer Center (MDACC). A total of 190 patients met the inclusion criteria with data available for review.

RESULTS

No significant differences were found in any of the comparisons made, except when comparing complications that occurred after the dentures were inserted and the amount of time it took for prosthetic rehabilitation. The majority of patients had no complications. The patients who received their dentures in 180 days or less had the same number of complications when compared with those patients who received their dentures in 181 to 365 days and those who had to wait longer than a year for prosthetic rehabilitation. Patients with more pre-insertion complications tended to have delayed prosthetic rehabilitation. Those patients who had complications both before and after denture insertion tended to have bilateral dosing of their radiation treatment. Patients who had received radiation therapy were 1.7 times more likely to have post-prosthesis insertion complications. The majority of patients who experienced complications before and after denture insertion had greater than 5000 cGy.

CONCLUSIONS

The numbers of complications reviewed in this retrospective analysis were considerably fewer than the number expected. There appears to be no difference in the number of pre- and post-insertion complications as a function of the time delay from oral surgical procedure to start of radiation treatment (10 to 21 days vs. 22 days or more).

Impact of dry mouth on oral symptoms and function in removable denture wearers in Japan

OBJECTIVE

The purpose of this study was to determine the association of dry mouth with oral symptoms and function, such as denture instability, discomfort, soreness in denture-bearing tissue, and dissatisfaction with chewing, tasting, or speaking in removable denture wearers.

STUDY DESIGN

The subjects were 493 removable denture wearers with a mean age of 67.3 years. Perception of oral dryness was measured by a questionnaire. A multiple logistic regression analysis was used to determine the effect of the dry mouth on oral symptoms and function after controlling for age and gender.

RESULTS

Oral dryness during eating was related to dissatisfaction with chewing (odds ratio, 10.5; P < .001) and speaking (odds ratio, 3.5; P < .05) and overall dissatisfaction (odds ratio, 6.3; P < .01) in complete denture wearers. Feeling of dry mouth was likely to be associated with soreness in denture-bearing tissues in both complete and removable partial denture wearers.

CONCLUSIONS

There was a significant association of the perception of dry mouth among a group of denture wearers with oral symptoms and function.