The impact of complete dentures on the oral health-related quality of life among the elderly

Digital denture scanning and 3D printing for residents in care homes: A feasibility study for pre-empting denture loss

OBJECTIVE

The aim of this study was to assess the feasibility of digitally scanning dentures and 3D printing replica dentures for care home residents. The study also investigated whether the process and replacement denture was acceptable to the resident.

BACKGROUND

Denture loss is a significant issue for people living in care homes and impacts on nutrition, quality of life and dignity. Denture loss is underreported, and care home residents have barriers to accessing dental care. The conventional process for remaking a denture can often take approximately 2 months with multiple clinical stages, often not feasible in adults with frailty and cognitive impairment. Scanning and 3D (3 dimensional) printing are increasingly used in dentistry, this rapidly evolving technology may provide an innovative solution to denture loss.

MATERIALS AND METHODS

A digital workflow was established using a handheld scanner and 3D printing technology. Care home residents wearing functional acrylic dentures were recruited. Dentures were scanned within the care home, and the scan was sent to a dental laboratory for 3D printing. The dentures were fitted at a subsequent visit, and semi-structured interviews were undertaken with the resident. Using thematic analysis, the feasibility of this pathway was assessed, and the use of digital scanning technology was explored.

RESULTS

Eight residents successfully had dentures scanned and replicated to a satisfactory standard. It took, on average, 10 minutes to scan a denture and 20 minutes to print the denture. All replica dentures were satisfactory to the resident. Qualitative data from semi-structured interviews showed that study participants were satisfied with denture replacements and the process. The 3 main themes that emerged were: the significance of dentures to the individual, satisfaction with the scanning process and general low self-esteem and fatigue.

CONCLUSIONS

This study has established a workflow for digitally storing dentures and replicating them satisfactorily. In the context of a care home setting, a scan of a denture can be used to provide a replacement denture if lost or broken. A large-scale study could follow now that the feasibility of this pathway has been demonstrated.

Comparison of Implant-Retained Overdenture and Conventional Complete Denture: A Survey Study to Measure Patients' Satisfaction and Quality of Life in Dental School Clinics

Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CDs) or implant-retained mandibular overdentures (IODs), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CDs and IODs are the 2 leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least 1 year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IODs had lower physical pain, limitations, and disability scores than males with CD. However, females with IODs reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IODs and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.

Comparative effectiveness of types of denture adhesives in enhancing retention and function of complete dentures: a systematic review with network meta-analysis

OBJECTIVES

The purpose of this systematic review with network meta-analysis was to assess the comparative efficacy of various types of denture adhesives in complete denture patients.

MATERIAL AND METHODS

A search was conducted for trials published in Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until July 2023 (PROSPERO: CRD42023451045). A network meta-analysis was performed to assess the comparative efficacy of different denture adhesive types and ranked using the Surface Under the Cumulative Ranking (SUCRA) system. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the level of certainty of evidence.

RESULTS

Seventeen articles were included in the quantitative analysis. Cream denture adhesives significantly increased bite force in both incisal region (RR = 7.63[95%CI: 3.34, 11.91]) (P < .05) as well as premolar and molar regions (RR = 33.66[95%CI: 15.15, 52.16]). Cream adhesives significantly improved retention of dentures as assessed by the reduced number of denture dislodgments (RR = -5.35[95%CI: -9.93, -0.77]) (P = 0.022), Kapur's index of retention (maxillary denture) (RR = 0.80[95%CI: 0.18, 1.42]) (P = 0.012) and Kapur's index of retention (mandibular denture) (RR = 1.27[95%CI: 0.67, 1.87]) (P < .05). Powder adhesives significantly increased premolar and molar bite force (RR = 36.00[95%CI: 16.20, 55.79]) (P < .05) and Kapur's index of retention (mandibular denture) (RR = 1.54[95%CI: 0.58, 2.49]) (P = 0.002). None of the adhesives were statistically significant for remaining outcomes.

CONCLUSIONS

Cream and powder denture adhesives are effective in enhancing the retention of mandibular dentures (Kapur's index) and bite force in the premolar/molar region in complete denture wearers (moderate level of certainty of evidence).

CLINICAL RELEVANCE

Cream and powder denture adhesives are effective in improving the retention and function of complete dentures.

Gender-wise comparison of oral health quality of life and its relationship with oral health parameters among elderly from Wroclaw, south-west Poland

BACKGROUND

In recent years, there has been an increase of aging population with longer life expectancy in females. This study aims to compare some oral health parameters and quality of life in the elderly.

METHODS

The survey involved 500 urban residents (Wroclaw, Poland) aged 65 and older, of both gender. Socio-demografic data were assessed by self-reported questionnaire. Clinical examination included oral health assessment by the World Health Organization criteria with extension and oral dryness (Chalacombe scale). Quality of Life (QoL) was evaluated using Euro-Quality of Life, Oral Health Impact Profile-14 and Patient Health Questionnaire-9, which were validated for the Polish population. The relationship strength between psychometric scale scores and sociodemographic and clinical factors was determined by calculating Spearman's linear correlation coefficient values and regression coefficient values.

RESULTS

There was no gender-wise differences in oral health parameters, except for a higher number of decayed teeth in males (DT 1.9±3.2 vs 1.2±2.4; p = 0.34). Oral dryness was diagnosed significantly more frequently in females then males (36.9% vs. 25.5%; p = 0.076). The males were significantly more likely to have high treatment needs (36.1% vs. 26.9%; p = 0.032) and they required urgent dental treatment (7.2% vs. 2.8%; p = 0.022). There were no significant differences in terms of QoL evaluated by EQ-5D, EQ-5D VAS or OHIP-14 questionnaires between males and females (0.832±0.194 vs 0.855±0.197, 67.9±10.9 vs 66.1±18.6, 7.2±12.9 vs 8.5±14.0, respectively; p > 0.05). However, females presented the higher severity of depressive symptoms measured by the PHQ-9 questionnaire (4.0±4.1 vs. 2.8±3.8; p<0.001).

CONCLUSION

It can be concluded that the independent predictors which significantly affect the high QoL scores on the EQ-5D scale were found to be female gender, age below 75, high or middle income, independence in daily life, a low number of comorbidities, lack of oral treatment needs.

Factors associated with the need for a complete denture in one arch or both arches among the elderly population

This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04-2.29), with fewer household goods (OR = 2.25; CI95%:1.50-3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27-9.35), R$1501-2500 (OR = 4.11; CI95%:1.50-11.27), R$2501-4500 (OR = 2.76; CI95%:1.10-6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08-7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06-3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06-3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06-1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71-11.60), R$501-1500 (OR = 4.01; CI95%:2.14-7.51), R$1501-2500 (OR = 2.95; CI95%:1.64-5.32), < 3 years of education (OR = 1.45; CI95%:1.13-1.85), feeling unhappy (OR = 2.74; CI95%:1.35-5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75-12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64-3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85-6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85-6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.

Impacts of Denture Retention and Stability on Oral Health-Related Quality of Life, General Health, and Happiness in Elderly Thais

Purpose

This study investigated denture and patient related factors associated with oral health-related quality of life (OHRQoL) of complete denture wearers and their association with general health and happiness.

Methods

This retrospective cohort study comprised 130 participants with complete edentulism, with maxillary and mandibular complete dentures treated at Chulalongkorn University Dental School during 2010-2017. The primary outcome was the presence of overall and domain-specific Oral Impacts on Daily Performances (OIDP). Secondary outcomes were diagnosed and perceived general health, and happiness. Denture retention and stability were classified as acceptable or unacceptable following the CU-modified Kapur criteria. Five esthetic-assessment criteria of the harmonization and proportions between facial and dental anatomical landmarks were measured from patient's photographs. Age, sex, previous complete denture experience, and denture age were recorded. The associations between each variable and oral impacts were analyzed using bivariate logistic regression, and the factors with p < 0.25 were further adjusted using multivariable analysis. Associations between oral impact scores and general health and happiness were assessed using Spearman's rank correlation.

Results

The most frequent oral impacts were on physical domain, while social domain was the least affected. Denture retention/stability was significantly associated with both overall and specific domains of oral impact. Happiness was found to be strongly correlated with perceived general health, but marginally with oral impact scores.

Conclusions

Unacceptable complete denture retention and stability are substantial risk factors for impaired OHRQoL in complete edentulism. Maintaining optimal denture retention and stability in denture wearers is essential for good oral health and well-being with the goal of enhancing happiness.

Number of remaining teeth and health-related quality of life: the Korean National Health and Nutrition Examination Survey 2010-2012

Objectives/aims

With the Euro-Qol-5 dimension (EQ-5D) system, we investigated the relationship between the number of remaining teeth and QoL using data from the Korean National Health and Nutrition Examination Survey (KNHANES), 2010–2012. A total of 17,417 participants, more than 19 years old, were finally included in this study (men = 7394 and women = 10,023). Through this study, we have discovered that the remaining teeth affect overall health and that the fewer number of them may indicate a lower quality of life, as well.

The quality of life according to the number of remaining teeth was assessed among Koreans using the Euro-Qol-5 dimension (EQ-5D) system.

Method

The Euro-Qol-5 dimension (EQ-5D) system was used to measure the health-related QoL. Its five dimensions included mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The respondents were asked to choose one of the followings: G 1, no problems; G 2, some problems; and G 3, problematic, to best describe their health status for the five dimensions. Then, we assigned low QoL to G2 + G3 and high QoL to G1.

We used age, gender, economic income, educational level, residence, and marital status for the demographic variables and, drinking, smoking, exercise, BMI, and metabolic syndrome for health behaviors. Multiple logistic regression analysis was performed to examine the odds ratios (ORs) and confidence intervals (CIs) for the high QoL (G1) on the five categories of EQ-5D according to the number of remaining teeth. On the basis of the 0–15 remaining teeth group, we drew a comparison of the QoL between the 16–20 and 21–28 remaining teeth groups.

Results

Subjects with 21–28 remaining teeth had higher QoL scores and had higher ORs of high QoL, especially for mobility (OR = 1.256, 95% CI = 1.056–1.495), self-care (OR = 1.441, 95% CI = 1.096–1.894), and usual activities (OR = 1.241, 95% CI = 1.022–1.508, respectively), than those with 0–15 remaining teeth after adjusting for age, sex, body mass index, smoking, drinking, exercise, income, education, and metabolic syndrome.

ORs from the high QoL had the tendency to increase as the number of remaining teeth increased (all p for trend < 0.05). However, there was no relationship between the number of remaining teeth and QoL in the pain/discomfort and anxiety/depression dimensions.

Conclusion

The number of remaining teeth was associated with QoL, and subjects who had more teeth obtained higher QoL scores. The subjects in the high QoL group were especially associated with the components of EQ-5D such as mobility, self-care, and daily living.

Technical Quality of Complete Dentures: Influence on Masticatory Efficiency and Quality of Life

PURPOSE

To evaluate the effect of the technical quality of conventional complete dentures (CD) on masticatory efficiency and quality of life (QoL) of denture wearers during a 1-year follow-up.

MATERIALS AND METHODS

A prospective clinical trial with 32 edentulous patients (mean age of 60.2 years) wearing mandibular and maxillary dentures was conducted. All patients were evaluated wearing their preexisting dentures and after 3, 6, and 12 months postinsertion of new dentures. A reproducible method for objective evaluation of the technical quality of CDs was employed. Masticatory efficiency was evaluated by the colorimetric method using beads as artificial testing food. The oral health impact on patient QoL was measured using the OHIP-EDENT (Oral Health Impact Profile in Edentulous Adults) questionnaire. The nonparametric Wilcoxon test was applied to reveal any differences in technical quality between the preexisting and new dentures. The Friedman test was used to detect differences in masticatory efficiency and oral health impact on QoL. Spearman's correlation was applied to reveal correlation between the variables.

RESULTS

Comparing preexisting and new dentures, significant improvement was found in technical quality between the dentures (p < 0.001). There was no statistically significant difference in masticatory efficiency. A significant decrease was found in the total OHIP-EDENT scores after denture replacement. A positive correlation was found between technical quality and OHIP in the new denture wearers (p = 0.011).

CONCLUSIONS

According to the results of this study, denture quality significantly improved patients' oral health-related QoL; however, insertion of new dentures did not influence masticatory efficiency.

Short-Term Assessment of the OHIP-14 Scale on Denture Wearers Using Adhesives

PURPOSE

The purpose of this study was to assess differences of the Oral Health Implant Profile-14 (OHIP-14) scale over a month and determine association with gender, supporting tissues (KIS), and denture base (KID) among patients wearing complete dentures using denture adhesives.

MATERIALS AND METHODS

Sixteen denture wearers, candidates for a new set of complete dentures, were selected. OHIP-14 scores were recorded at the beginning of the study, 6 weeks after fitting of the new set (T0 ), 15 days (T1 ), and finally 30 days (T2 ) after daily use of a denture adhesive as instructed. The KIS and KID were clinically examined and rated according to the Kapur Index. Statistical analyses were based on repeated-measures ANOVA, Mann-Whitney test, regression analysis, and Friedman test at a = 0.05.

RESULTS

The OHIP-14 scale was found to have a high reliability (alpha = 0.847) and a high test-retest consistency (ICC = 0.889); however, domain 1 had the lowest item-total correlation (rho = 0.144) and item 7 a negative one (rho = -0.414). Trend analysis indicated a significant negative linear trend over time (slope = -3.156, p = 0.002), while repeated-measures ANOVA showed differences in OHIP-14 between T2 and T1 (p = 0.003) or T0 (p = 0.005) intervals. OHIP-14 groups were found to be positively associated with KIS (p = 0.010) and negatively with KID (p = 0.047) groups, but not with gender (p = 0.272).

CONCLUSIONS

The study shows that OHIP-14 has a high internal reliability and consistency when applied to new denture wearers, and its score decreases if denture adhesives are used for at least 15 days. Low KIS and high KID contributes to this trend. Some OHIP-14 items are more associated than others with the total score trend over time.