Construction faults, age, gender, and relative medical health: factors associated with complaints in complete denture patients

Factors triggering the oral mucosal lesions by complete dentures

Oral mucosal lesions may represent acute or chronic reactions to factors related with dentures. The aim of this study was to determine the frequency of the oral lesions related to gender, age, the length of time of denture usage, the balance of denture and cleaning methods and frequency. The 106 patients who have old complete dentures came to the Dental Faculty of Marmara University, Istanbul (Turkey) to have new complete dentures were asked to participate in the investigation. The subjects (51 men and 55 women) were 37-80 years of age with a mean age of 60.28+/-10.52 years. All main factors were estimated in subgroups: cleaning methods and frequency were divided into 3 subgroups respectively as toothbrush and toothpaste/soap, denture cleansing tablets and sodium carbonate, and 3 times a day, everyday, every 3 day and once a week. The data obtained was evaluated by One-way ANOVA, Mann-Whitney U-test, Kruskal-Wallis-test, Student t-test and chi(2)-test. The level of statistical significance was set at p<0.05. The patients displayed statistically significant differences in the topics of the length of time of denture usage and the balance of denture in terms of retention. The complete denture wearers should be educated in the importance of periodic examination due to the changing of supporting tissues for detection early mucosal lesions to maintain their oral and dentures hygiene in optimum level.

The current and future treatment of edentulism

The purpose of this review and summary is to focus the clinician's attention on existing potential limitations regarding the management of edentulism. The current published data and opinions concerning the need for treating edentulism, the quality of dentures, related morbidity, and alternative or related therapeutics (e.g., dental implants) suggest there are opportunities for improvement in the treatment of the edentulous population. This may be achieved by adopting a broader therapeutic strategy focused not solely on technical aspects of an oral prosthesis. Instead, a wider array of clinical features of the edentulous patient should be addressed. A contemporary strategy may include concerns for prevention of tooth loss, evaluation of residual alveolar ridge resorption, and related issues of denture function, continual evaluation of oral mucosal health, compassionate management of maladaptive patients, a rationale for timely replacement of dentures, and continued development of dental implant therapies. The importance of therapeutic technical quality can be underscored, but should not overwhelm the broader concerns for assuring the overall health and well-being of the edentulous population.

Satisfaction of the complete denture wearers related to various factors

All dentists who have worked with complete denture wearers know that patient satisfaction is not based only on the technical quality of the dentures. The aim of this study was at assessing the effect of gender, the number of the dentures used before, the length of time of denture usage, education and age on the satisfaction of the complete denture wearers. The students of the Dental Faculty of Marmara University (Turkey) made new dentures for 342 patients who were asked to participate in the investigation. The subjects (137 men and 205 women) were 39-89 years of age with a mean of 61.62 years. The attitude toward dentures in general was measured by means of 11 items of a questionnaire. The 10 main questions of the questionnaire were answered by the participants, and quantified on a 7-point scale, while the 11th issue (general satisfaction) was evaluated on a scale of 1-10. All main factors were also estimated in subgroups. For example, the education was analyzed in 4 subgroups, the time of denture usage was divided into two subgroups (below and above 3 years) and the number of dentures used before was also taken as up to 3 or more than 3 dentures. The age of the subjects was taken in 3 subgroups: 40-55, 56-65 and >65 years. One-way ANOVA, Tukey and Student t-tests were used to evaluate the answers to the questionnaire. Our patients displayed statistically significant differences only in the topics of their ability of cleaning their dentures, due to education and number of previously used dentures.

Pressure-pain threshold of oral mucosa and its region-specific modulation by pre-loading

Once subjected to denture wearing, oral mucosa has to withstand mechanical loads of various levels and durations. However, how this load affects oral mucosal sensitivity is unknown. This study investigated the pressure-pain threshold (PPT) of oral mucosa with or without pre-loading. An electric pressure algometer was developed specifically for measuring the PPT of oral mucosa. Measurements of 10 dentulous maxillae showed that the baseline PPT (BPPT) of the palatal site was 4.9- and 3.7-fold greater than that of the labial or buccal sites, respectively. The PPT of the labial site decreased significantly compared with its BPPT after 2 s-100% BPPT and 5 s-100% BPPT pre-loading. The PPT of the palatal site increased after 5 s-50% BPPT and 5 s-80% BPPT and 0.2 s-100% BPPT and 2 s-100% BPPT pre-loading. The PPT of the buccal site did not change after all levels and durations of pre-loadings tested. These results indicated the disproportionate modulation of oral mucosal PPT following various loads, suggesting that oral mucosa possesses region-specific psychophysical tolerance to mechanical stimuli.

Mapping, profiling and clustering of pressure pain threshold (PPT) in edentulous oral mucosa

OBJECTIVES

Edentulous oral mucosa involves different tissue types, various innervation and wound healing process. We hypothesized that pressure pain threshold (PPT) of edentulous oral mucosa varies significantly among different regions. The objective of this study is to examine regional differences and correlations of PPT in edentulous oral mucosa.

METHODS

Pain threshold (PPT) was measured at 112 sites in 15 edentulous patients using an electric-controlled pressure algometer. PPT mapping was created by the level of PPT, and PPT clustering was undertaken based on the inter-site correlation of PPT.

RESULTS

PPT increased from the anterior to posterior alveolus in both maxilla and mandible, but decreased from the anterior palate to the posterior palate. PPT decreased from the ridge crest to the buccal vestibule. The inter-site difference was four fold within the maxilla and 2.4 fold within the mandible. Principal component analysis applied on PPT inter-site correlation matrix revealed that the maxilla and mandible could be differentiated statistically. The maxilla and mandible were divided into three and four clusters, respectively.

CONCLUSION

These results demonstrate that different areas of edentulous oral mucosa have different PPT and that the PPT varies proportionally in selected areas, providing useful diagnostic and therapeutic information in removable prosthodontics and a new opportunity for understanding pain underneath the denture.