Novel software for quantitative evaluation and graphical representation of masticatory efficiency

Immediate versus delayed loading of strategic mini dental implants for the stabilization of partial removable dental prostheses: a patient cluster randomized, parallel-group 3-year trial

Background

Acceptable short-term survival rates (>90 %) of mini-implants (diameter < 3.0 mm) are only documented for mandibular overdentures. Sound data for mini-implants as strategic abutments for a better retention of partial removable dental prosthesis (PRDP) are not available.

Methods/design

The purpose of this study is to test the hypothesis that immediately loaded mini-implants show more bone loss and less success than strategic mini-implants with delayed loading. In this four-center (one university hospital, three dental practices in Germany), parallel-group, controlled clinical trial, which is cluster randomized on patient level, a total of 80 partially edentulous patients with unfavourable number and distribution of remaining abutment teeth in at least one jaw will receive supplementary min-implants to stabilize their PRDP. The mini-implant are either immediately loaded after implant placement (test group) or delayed after four months (control group). Follow-up of the patients will be performed for 36 months. The primary outcome is the radiographic bone level changes at implants. The secondary outcome is the implant success as a composite variable. Tertiary outcomes include clinical, subjective (quality of life, satisfaction, chewing ability) and dental or technical complications.

Discussion

Strategic implants under an existing PRDP are only documented for standard-diameter implants. Mini-implants could be a minimal invasive and low cost solution for this treatment modality.

Trial registration

The trial is registered at Deutsches Register Klinischer Studien (German register of clinical trials) under DRKS-ID: DRKS00007589 (www.germanctr.de) on January 13^th, 2015.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-016-0259-z) contains supplementary material, which is available to authorized users.

Assessment of masticatory performance by means of a color-changeable chewing gum

PURPOSE

Previous research determined the relevance of masticatory performance with regard to nutritional status, cognitive functions, or stress management. In addition, the measurement of masticatory efficiency contributes to the evaluation of therapeutic successes within the stomatognathic system. However, the question remains unanswered as to what extent modern techniques are able to reproduce the subtle differences in masticatory efficiency within various patient groups. The purpose of this review is to provide an extensive summary of the evaluation of masticatory performance by means of a color-changeable chewing gum with regard to its clinical relevance and applicability.

STUDY SELECTION

A general overview describing the various methods available for this task has already been published. This review focuses in depth on the research findings available on the technique of measuring masticatory performance by means of color-changeable chewing gum. Described are the mechanism and the differentiability of the color change and methods to evaluate the color changes. Subsequently, research on masticatory performance is conducted with regard to patient age groups, the impact of general diseases and the effect of prosthetic and surgical treatment.

RESULTS

The studies indicate that color-changeable chewing gum is a valid and reliable method for the evaluation of masticatory function.

CONCLUSION

Apart from other methods, in clinical practice this technique can enhance dental diagnostics as well as the assessment of therapy outcomes.

Choosing the best image processing method for masticatory performance assessment when using two-coloured specimens

Objective masticatory performance assessment using two-coloured specimens relies on image processing techniques; however, just a few approaches have been tested and no comparative studies are reported. The aim of this study was to present a selection procedure of the optimal image analysis method for masticatory performance assessment with a given two-coloured chewing gum. Dentate participants (n = 250; 25 ± 6·3 years) chewed red-white chewing gums for 3, 6, 9, 12, 15, 18, 21 and 25 cycles (2000 samples). Digitalised images of retrieved specimens were analysed using 122 image processing methods (IPMs) based on feature extraction algorithms (pixel values and histogram analysis). All IPMs were tested following the criteria of: normality of measurements (Kolmogorov-Smirnov), ability to detect differences among mixing states (anova corrected with post hoc Bonferroni) and moderate-to-high correlation with the number of cycles (Spearman's Rho). The optimal IPM was chosen using multiple criteria decision analysis (MCDA). Measurements provided by all IPMs proved to be normally distributed (P < 0·05), 116 proved sensible to mixing states (P < 0·05), and 35 showed moderate-to-high correlation with the number of cycles (|ρ| > 0·5; P < 0·05). The variance of the histogram of the Hue showed the highest correlation with the number of cycles (ρ = 0·792; P < 0·0001) and the highest MCDA score (optimal). The proposed procedure proved to be reliable and able to select the optimal approach among multiple IPMs. This experiment may be reproduced to identify the optimal approach for each case of locally available test foods.

Implant-supported mandibular overdentures in very old adults: a randomized controlled trial

The purpose of this study was (1) to investigate denture satisfaction following the conversion of existing mandibular complete dentures to implant overdentures (IOD) in very old edentulous patients who depend on help for activities of daily living and (2) to evaluate secondary end points, such as functional, structural, nutritional, and patient-centered aspects. For this randomized clinical trial, 2 interforaminal short implants were placed in the intervention group (n = 16, 85.0 ± 6.19 yrs) to retain mandibular IODs; the control group (n = 18, 84.1 ± 5.55 yrs) received conventional relines. During the first year, no implant was lost; however, 2 patients died. IODs proved more stable, and participants in the intervention group demonstrated significantly higher denture satisfaction as well as an increased oral health-related quality of life compared to the control group. Maximum voluntary bite force improved significantly with IODs, yet the chewing efficiency was not different between groups. Masseter muscle thickness increased with IODs, mainly on the preferred chewing side. Body mass index decreased in both groups, but the decline tended to be smaller in the intervention group; blood markers and the Mini Nutritional Assessment did not confirm this tendency. These results indicate that edentulous patients who depend on help for activities of daily living may benefit from IODs even late in life.