Prognoses of new complete dentures from the patient's denture assessment of existing dentures

Incidence and risk factors for non-adaptation of new mandibular complete dentures: a clinical trial

OBJECTIVE

To investigate the incidence and risk factors for non-adaptation of the conventional mandibular complete denture (CMCD).

MATERIALS AND METHODS

A total of 108 edentulous patients were rehabilitated with complete dentures (CDs) and followed up at 3- and 6-month intervals. Adaptation was confirmed based on chewing, phonetics, and comfortable swallowing with the CDs. The risk factors among sociodemographic and patient-centered factors were analyzed. Statistical analyses included the chi-square test and then a multivariate analysis.

RESULTS

After 3 months, 38.0% of patients showed non-adaptation to CMCDs. Non-adaptation was significantly associated with the absence of previous mandibular denture experience (p = 0.042), ulcerations after 15 days of rehabilitation (p < 0.001), and a reduced posterior mandibular ridge (p = 0.035). After 6 months, this incidence decreased to 14.1%. The factors associated with non-adaptation were ulcerative lesions after 15 (p < 0.001) and 30 (p < 0.001) days of the delivery of CDs and the non-regular use of mandibular CDs (p < 0.001).

CONCLUSION

The incidence of non-adaptation was higher after 3 months, with reduction after 6 months. Sociodemographic variables did not influence the adaptation. After 3 months, the absence of previous experience, traumatic ulcers, and reduced mandibular ridges hindered the adaptation of patients to mandibular CDs. After 6 months, only the occurrence of ulcerative lesions and non-regular wear of dentures were risk factors for non-adaptation.

CLINICAL RELEVANCE

A considerable number of patients have difficulties in adapting to the mandibular dentures. Identifying the factors of non-adaptation of the dentures will contribute to increasing the predictability of this critical adaptation period.

Edentulous Patient Satisfaction with Conventional Complete Dentures

Background and Objectives: Edentulism is considered to be an impediment impacting both patients’ quality of life and their nutrition. Conventional complete dentures are still a preferred treatment. However, there is no consensus on the most important factors which could substantially reduce the risk of patient dissatisfaction. This study evaluated the following determinants concerning patient satisfaction with complete maxillary and mandibular dentures: sex, denture-related functional and aesthetic aspects, and the degree of bone resorption. Materials and Methods: This study included 70 patients aged 34–81 years of age. All complete dentures were made by following the same technology. Visual analogue scales were used to assess patients’ overall satisfaction with dentures, comfort, ability to speak and chew, denture aesthetics, stability, and ease of prosthesis cleaning. Satisfaction with upper and lower dentures was rated separately. The degree of bone resorption was classified by using the Kalk and de Baat (1989) method. Results: The mean (SD) age of the study participants was 67.3 (10.4) years; 65.7% (n = 46) were females and 34.3% (n = 24) were males. There were no significant sex-based differences in resorption of the maxilla or mandibula. There were significant differences between maxillary and mandibular dentures, with lower mean satisfaction scores concerning chewing and maxillary complete dentures, and in regard to stability and comfort for mandibular complete dentures. There was a non-significant overall lower satisfaction with increased age. In multivariate analysis for mandibular complete dentures, aesthetics and stability significantly predicted the patient’s comfort levels, and the patient’s comfort significantly predicted overall satisfaction. For maxillary complete dentures, patient comfort and aesthetics significantly predicted overall patient satisfaction. Conclusions: Age, sex, and degree of resorption were not associated with patient satisfaction with complete dentures. Overall, patient satisfaction with both maxillary and mandibular complete dentures was related to their comfort level and denture aesthetics, and patient comfort itself was associated with stability of the mandibular denture.

Patient-reported outcomes with immediate-loaded two-implant-supported mandibular overdentures: Results of a 5-year prospective study

Background/purpose

Few studies have comprehensively assessed long-term patient-reported outcomes for overdentures supported by two immediate implants. The purpose of the study was to evaluate patient-reported outcomes of immediately loaded two-implant-supported overdentures retained by ball attachments over a 5-year evaluation period.

Material and methods

Nineteen participants with edentulous mandibles were provided with immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments. The participants completed the Japanese version of the Oral Health Impact Profile (OHIP)-EDENT-19 and the Patient's Denture Assessment (PDA). Additionally, patient satisfaction was measured by a 100-mm visual analog scale (VAS). Measurements were performed at baseline, and at 1 and 5 years following implant surgery.

Results

Seventeen participants and 14 participants were evaluated at the 1-year and 5-year assessment, respectively. Considering the OHIP-EDENT-19, there was a significant decrease in the total (p = 0.046), “functional limitation” (p = 0.021), and “physical disability” (p = 0.034) scores at 1 year and the total (p = 0.045) and “physical disability” (p = 0.024) scores at 5 years following surgery, compared to the baseline scores. Considering the PDA, there was a significant increase in the “function” (p = 0.038) and “lower denture” (p = 0.003) scores at 1 year and the “function” (p = 0.032), “lower denture” (p = 0.008), and “esthetic and speech” (p = 0.043) scores at 5 years following surgery, compared to the baseline scores. Patient satisfaction at 1 year following surgery was significantly greater than that at baseline (p = 0.005).

Conclusion

Immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments improved the oral health-related quality of life and self-assessment of dentures by the patients up to 5 years following implant surgery.

Patient-reported outcomes for the immediate loading of mandibular overdentures supported by two implants soon after implant surgery

Background/purpose

No studies have comprehensively assessed short-term patient-reported outcomes after the provision of overdentures supported by two immediate implants. The purpose of this study was to evaluate short-term patient-reported outcomes for mandibular overdentures retained by ball attachments on two immediately loaded implants.

Materials and methods

Nineteen participants with mandibular edentulism were provided with overdentures retained by ball attachments on two immediately loaded, unsplinted implants. The participants' self-assessment of their dentures and oral health-related quality of life were evaluated with the 22-item Patient's Denture Assessment (PDA), and the 19-item Japanese version of the Oral Health Impact Profile (OHIP-EDENT), respectively. Patient satisfaction was measured on a 100 mm visual analogue scale. Assessments were conducted at baseline, and at 1 and 6 months after implant surgery.

Results

There were significant increases in the PDA “Lower denture” (P = 0.009) at 1 month, as well as “Function” (P = 0.002) and “Lower denture” (P = 0.009) scores at 6 months. Patient satisfaction was also significantly increased at 1 month (P = 0.007) and 6 months (P ≤ 0.000). Significant decreases were observed in the OHIP-EDENT “Physical pain” (P = 0.046) score at 1 month, as well as the summary score (P = 0.033), “Functional limitation” (P = 0.020) and “Psychological discomfort” (P = 0.019) scores at 6 months.

Conclusion

The use of two immediately loaded implants for lower mandibular complete overdentures is associated with improvements in patient's self-assessment of dentures, satisfaction, and oral health-related quality of life, up to 6 months after implant surgery.

Complete denture replacement: a 20-year retrospective study of adults receiving publicly funded dental care

PURPOSE

There is little evidence as to what is the appropriate replacement interval for complete dentures. The aim of this study was to determine the longevity of complete dentures in a population of publicly insured adults across a 20 year observation period.

METHODS

The records of 187,227 Australian adults who accessed complete denture treatment through public clinics between 2000-2019 were assessed. Time to denture replacement was modelled using a Weibull regression and a competing risk regression to adjust for the competing risk of mortality.

RESULTS

Over a 20-year period, 27.7% of dentures were replaced, with a mean longevity of 6.06 (SD: 3.93) years. Pairs of complete dentures had greater mean longevity than single dentures (p<0.001). Approximately 4.6% of dentures provided were replaced within 2 years; 18.4% were replaced between 2 and 10 years and 4.6% of replacements occurred after 10 years.Over 70% of adults who received a complete denture did not replace it during the observation period. Dentures provided by denturists had higher levels of replacement than those made by dentists. Participants over 80 years of age had lower rates of denture replacement. Low socio-economic status and living outside a major city were associated with reduced rates of replacement for dentures under 10 years of age.

CONCLUSION

Complete dentures were commonly replaced after 6 years of service. Pairs of dentures lasted longer than single dentures.

Retrospective Comparison of Postinsertion Maintenances Between Conventional and 3D Printed Complete Dentures Fabricated in a Predoctoral Clinic

PURPOSE

A retrospective study to analyze the clinical performance of 3D printed complete dentures in edentulous patients compared with conventional complete dentures regarding postinsertion visits and patient reported outcomes.

MATERIAL AND METHODS

Electronic charts were reviewed to analyze 420 (maxilla 270, mandible 150) heat-polymerized conventional complete dentures (CCD) inserted between July 1, 2015 and June 30, 2016 and 217 (maxilla 130, mandible 86) 3D printed complete dentures (PCD) inserted between July 1, 2017 and June 30, 2018. Number of remakes, number of postinsertion adjustments, type and number of repairs, and patient reported complications were compared between two types of complete dentures. The frequency of denture repair and patient reported complications were analyzed using chi-square of independence test.

RESULTS

The frequency of pain and visible ulcer lesions in the maxilla was determined to be 46.67% with CCD and 36.15% in PCD (p = 0.047). There was no statistical significance in other items. The majority of esthetic concerns was dissatisfaction with the shape of dentures with CCD (4.67%) and they had statistically significant, less frequent, esthetic problems than PCD (11.63%) (p = 0.047).

CONCLUSIONS

Similar clinical performance was recorded between the two groups, but the overall pain and visible ulcer lesions were less in the printed complete dentures then the conventionally processed dentures. However, the esthetic aspect was better in conventionally processed complete dentures.

Eleven-year follow-up of reconstruction with autogenous iliac bone graft and implant-supported fixed complete denture for severe maxillary atrophy: A case report

RATIONALE

The iliac bone graft procedure is one of the treatment options for individuals with extremely resorbed alveolar bones. An autogenous block bone graft can allow the use of an implant-supported fixed dental prosthesis, rather than conventional removable dentures, by completely edentulous patients. However, the iliac bone graft technique is an invasive procedure and should be carefully selected based on its long-term clinical results. This case report describes 11-year long-term outcomes for implant-supported complete denture on the grafted iliac bone.

PATIENT CONCERNS

A 68-year-old Asian man was referred for oral rehabilitation with fixed dental prostheses. The patient had been unsatisfied with his removable dental prostheses in masticatory performance.

DIAGNOSIS

Radiographical examination revealed severely atrophied maxilla.

INTERVENTIONS

The atrophied maxilla was reconstructed with an iliac block bone graft, after which an implant-supported fixed complete denture was placed.

OUTCOMES

During 11 years of follow-up, several prosthetic and mechanical complications were encountered. Nevertheless, no biological complications were observed. Marginal bone levels around the implants were well-maintained on the radiographs after 11 years of prosthetic use.

LESSONS

Iliac bone graft can be chosen as a predictable treatment option that allows patients with extremely atrophic maxilla to use a fixed dental prosthesis instead of a removable denture.

The effects of adding various ratios of zirconium oxide nanoparticles to poly(methyl methacrylate) on physical and mechanical properties

The aim of the present study is to evaluate the transverse strength, modulus of elasticity, surface roughness, hardness, and water sorption/solubility of nanoparticle zirconium oxide (nano-ZrO₂) added to heat-cured poly(methyl methacrylate) (PMMA) after thermocycling. The specimens were divided into four groups according to the ratio of nano-ZrO₂ addition to heat-cured PMMA; group 1: 5% nano-ZrO₂; group 2: 10% nano-ZrO₂; group 3: 20% nano-ZrO₂, and group 4 (control): PMMA without nano-ZrO₂. A statistically significant decrease in transverse strength was observed by all additional rates of nano-ZrO₂ compared with group 4 (control; P < 0.025). When hardness results were evaluated, groups 1 and 2 showed statistically higher values compared with groups 3 and 4 (P < 0.025). The surface roughness of group 3 was statistically higher than the other groups (P < 0.025), but it was within the clinically acceptable limits. As the nano-ZrO₂ addition rate increased, water sorption/solubility values of the specimens also increased. Although nano-ZrO₂ addition had an adverse effect on some mechanical and physical properties of heat-cured PMMA, it increased hardness values, implying that the addition of nano-ZrO₂ would contribute positively to some mechanical properties of PMMA denture base material when nano-ZrO₂ was homogeneously distributed in PMMA.