Effect of denture adhesives on oral moisture: A multicenter randomized controlled trial

Influence of different denture adhesives on patient-based outcomes: A crossover randomized controlled trial

STATEMENT OF PROBLEM

The influence of different denture adhesive forms on retention, stability, denture movement, and masticatory efficiency have been studied. However, studies that investigated their effect on patient-based outcomes are scarce.

PURPOSE

The purpose of this crossover randomized controlled trial was to investigate the influence of 3 different denture adhesive forms on patient satisfaction and oral health-related quality of life (OHRQoL) in edentulous individuals.

MATERIAL AND METHODS

A total of 30 edentulous participants were enrolled. They initially received conventional dentures, which they used for 3 months. They were then instructed to use 3 forms of denture adhesives (cushion, paste, and powder) for 3 months each. Patient satisfaction was assessed by using a visual analog scale (VAS), and OHRQoL was assessed by using the oral health impact profile in the edentulous adults instrument. Assessments were done 3 months after wearing the conventional dentures, then after by using each denture adhesive form for 3 months, with a 1-month washout period. The average retention duration for each form and participant preference were also evaluated. Statistical analysis was conducted by using the repeated measures ANOVA test followed by the Scheffé test for VAS scores and retention duration. The Friedman test followed by the Wilcoxon signed-rank test was used for OHRQoL scores (α=.05).

RESULTS

Irrespective of their forms, denture adhesives significantly improved patient satisfaction in most aspects (P<.001) and significantly improved OHRQoL (P<.001). VAS scores for the cushion form were significantly higher than those for the other 2 forms regarding general satisfaction, comfort, and ease of cleaning dentures and tissues. For stability and masticatory ability, the cushion and paste forms were significantly better (P<.05) than the powder form. OHRQoL scores were significantly higher (worse) for the powder form compared with the other 2 forms for the functional limitation, physical pain, and physical disability domains, with insignificant differences between the cushion and paste forms (P>.05). The powder form found the shortest retention duration and the least preference.

CONCLUSIONS

Denture adhesives significantly improved OHRQoL and almost all aspects of patient satisfaction. The cushion form provided higher satisfaction levels for most aspects, followed by paste and then powder. OHRQoL outcomes were comparable for all forms, except for the functional limitation, physical pain, and physical disability domains, which were significantly better with the cushion and paste forms. The cushion and paste forms were more retentive and more preferred by the participants than the powder form.

Multi-parameter viscoelastic material model for denture adhesives based on time-temperature superposition and multiple linear regression analysis

BACKGROUND

Restorative solutions designed for edentulous patients such as dentures and their accompanying denture adhesives operate in the complex and dynamic environment represented by human oral physiology. Developing material models accounting for the viscoelastic behavior of denture adhesives can facilitate their further optimization within that unique physiological environment. This study aims to statistically quantify the degree of significance of three physiological variables - namely: temperature, adhesive swelling, and pH - on denture adhesive mechanical behavior. Further, based on these statistical significance estimations, a previously-developed viscoelastic material modelling approach for such denture adhesives is further expanded and developed to capture these variables' effects on mechanical behavior.

METHODS

In this study a comparable version of Denture adhesive Corega Comfort was analysed rheologically using the steady state frequency sweep tests. The experimentally derived rheological storage and loss modulus values for the selected physiological variables were statistically analyzed using multi parameter linear regression analysis and the Pearson's coefficient technique to understand the significance of each individual parameter on the relaxation spectrum of the denture adhesive. Subsequently, the parameters are incorporated into a viscoelastic material model based on Prony series discretization and time-temperature superposition, and the mathematical relationship for the loss modulus is deduced.

RESULTS

The results of this study clearly indicated that the variation in both the storage and loss modulus values can be accurately predicted using the oral cavity physiological parameters of temperature, swelling ratio, and pH with an adjusted R2 value of 0.85. The R2 value from the multi-parameter regression analysis indicated that the predictor variables can estimate the loss and storage modulus with a reasonable accuracy for at least 85% of the rheologically determined continuous relaxation spectrum with a confidence level of 98%. The Pearson's coefficient for the independent variables indicated that temperature and swelling have a strong influence on the loss modulus, whereas pH had a weak influence. Based on statistical analysis, these mathematical relationships were further developed in this study.

CONCLUSIONS

This multi-parameter viscoelastic material model is intended to facilitate future detailed numerical investigations performed with implementation of denture adhesives using the finite element method.

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.

The effect of using denture adhesives on patient satisfaction with complete dentures; a randomized clinical trial

BACKGROUND

Denture adhesives can be useful in improving patients' satisfaction with complete dentures. However, comparison clinical trials are lacking. The purpose of this randomized clinical trial was to assess the satisfaction of edentulous patients and their oral health impact profile when provided with 3 types of denture adhesives.

METHODS

Sixty-four completely edentulous patients seeking complete dentures for their first time were randomly divided into 3 groups. Each group received a set of complete dentures, which were adjusted at review appointments until participants reported no complaints. After 1 month of using the dentures, participants rated their overall satisfaction and their satisfaction regarding comfort, retention, stability, and efficiency of mastication and speech on a 100-mm visual analog scale (VAS). Participants also filled out the oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire. Each group was then given 1 type of denture adhesive to use. Group C received Corega Ultra denture fixative cream (GlaxoSmithKline), Group O received Olivafix (Bonyf), and Group S received Sea. Bond adhesive strips (Sea.Bond). Mann-Whitney U test was used to analyze the differences in VAS scores before and after using the adhesive within each group and Wilcoxon-signed rank test was used to compare OHIP scores and total OHIP values before and after using the adhesive within each group (p = 0.05). Furthermore, Kruskal Wallis test was used to compare the differences before and after using the adhesives in VAS and OHIP values between the 3 groups.

RESULTS

Significantly higher VAS values were detected in all groups and significantly lower values for many OHIP items in addition to total OHIP values were detected in all groups after using the adhesives (P < 0.05), except for the ease of cleaning for Group O and Group S (P > 0.05). No significant differences were found in VAS and OHIP values between the 3 groups (P > 0.05), except for the ease of cleaning which was significantly different between Group C and Group S (p = 0.005).

CONCLUSIONS

Using denture adhesives for completely edentulous patients resulted in higher patient satisfaction as indicated by higher VAS scores as well as improved quality of life as indicated by lower OHIP-EDENT scores after using the adhesives. These improvements were not dependent on the type of adhesive, except for ease of cleaning as adhesive strips were easier to clean than paste type adhesives.

TRIAL REGISTRATION

This trial was registered at ClinicalTrials.gov (ID: NCT05496283) on 11/08/2022.

Effects of denture adhesives on denture retention and occlusal forces in complete denture wearers: A multicenter, randomized controlled trial

PURPOSE

This study aimed to determine the effects of denture adhesives on denture retention and occlusal force in complete denture wearers in a multicenter, randomized, parallel-group controlled trial.

METHODS

Two hundred edentulous patients wearing complete dentures were allocated to three groups: powder-type denture adhesive, cream-type denture adhesive, and control (saline solution). Denture adhesives and saline solution were applied to the dentures for 4 days. The retentive force of the dentures and occlusal force were measured using a force transducer occlusal force meter at baseline and after 4 days of intervention. In addition to between-group comparisons, subgroup analyses of denture retention and occlusal force were performed based on the level of difficulty of the edentulism treatment. The levels were ranked as I (easy), II, III, and IV (difficult).

RESULTS

Cream-type denture adhesives significantly improved the retentive force of the dentures (P<0.01) and occlusal force (P<0.05), with no significant differences between baseline and post-intervention forces in the powder-type denture adhesive and control groups. In within-group comparisons, cream-type denture adhesives improved both the retentive and occlusal forces at Level II (P<0.05), and powder-type denture adhesives improved the occlusal force at Level II (P<0.01).

CONCLUSIONS

Application of cream-type denture adhesives effectively improves the denture retention and occlusal force in complete denture wearers with a moderate degree of difficulty during edentulism treatment.

Influence of different presentations of denture adhesives on masticatory function of complete denture wearers: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Denture adhesives improve the mastication of complete denture wearers. However, the impact of denture adhesives with different presentations on mastication remains unclear.

PURPOSE

The purpose of this systematic review was to answer the focused question, "Do different presentations of denture adhesives affect the masticatory function of complete denture wearers?".

MATERIAL AND METHODS

This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and the non-peer-reviewed literature were searched up to July 2021. Only clinical studies (randomized clinical trials and nonrandomized clinical trials) comparing the use of different denture adhesive presentations (cream, powder, or strips) were included, without language or follow-up restrictions. The risk of bias was assessed by using the Cochrane tools (RoB 2.0 and ROBINS-I). Masticatory performance, by using single and multiple sieves, masticatory performance with color-changing chewing gum (mixing ability), swallowing threshold (particle size and number of cycles), jaw kinematics, and occlusal force were considered. Meta-analyses were conducted to evaluate masticatory performance (single sieve) and occlusal force outcomes (α=.05), and the certainty of the evidence was determined with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) evaluations.

RESULTS

Nine studies (6 randomized and 3 nonrandomized clinical trials) were included. The risk of bias was considered moderate. Meta-analyses showed no differences between cream and powder denture adhesives for masticatory performance (standard mean difference=0.02; 95% CI=-0.46 to 0.50, P=.93) or between cream and strip denture adhesives for occlusal force (mean difference=14.35; 95% CI=-11.14 to 39.84, P=.27). Similarly, in qualitative analysis, cream and powder denture adhesives' performances were similar regarding masticatory performance with color-changing chewing gum (mixing ability), occlusal force, swallowing threshold (particle size and number of cycles), and jaw kinematics (P>.05). However, for resorbed ridges, cream denture adhesive resulted in a higher masticatory performance than strip (P<.05). When comparing powder to strip denture adhesives, the occlusal force was higher in the powder group (P<.05). The certainty of evidence was very low for all evaluated outcomes.

CONCLUSIONS

Different presentations of denture adhesives seem to improve the masticatory function of complete denture wearers in a similar way. However, the qualitative analysis showed that, in patients with a resorbed ridge, a cream denture adhesive may be better than strips to improve mastication, although the certainty of evidence was very low.

Cytotoxic Potential of Denture Adhesives on Human Fibroblasts—In Vitro Study

(1) In recent years, there has been a significant increase in the availability of denture adhesives for stabilizing removable dentures. The aim of the present study was to assess the cytotoxicity of three denture adhesives on human fibroblasts. (2) Methods: Three denture adhesives were analyzed. Fibroblast cultures were established for the study and control groups in order to assess the incidence of necrosis and to evaluate the microscopic intracellular alterations induced. Following incubation with (study groups) or without adhesives (control group), trypan blue dye exclusion assay was used to determine the number of viable and/or dead cells. Microscopic specimens were stained with haematoxylin and eosin, scanned, digitally processed and then analyzed by a histopathologist. (3) Results: All three denture adhesives analyzed demonstrated various toxic effects in vitro on human fibroblast: quantitative evaluation—45.87–61.13% reduction of cell viability (p = 0.0001) and slight to moderate cytotoxicity in qualitative evaluation. (4) Conclusions: Denture adhesive creams demonstrated a toxic effect on human fibroblasts in vitro in quantitative and qualitative evaluation. In vivo observations are needed to find out if denture adhesives present a cytotoxic effect in patients.

A systematic review and meta-analysis to evaluate the efficacy of denture adhesives

OBJECTIVES

This systematic review aims to investigate the efficacy of denture adhesives (DAs) for complete dentures (CDs), and to provide clinical recommendations for prosthodontists and general practitioners.

DATA/SOURCES

Electronic databases (Medline, Embase, CENTRAL) and gray literatures were searched (up to March 2020) for relevant randomized and non-randomized controlled clinical trials (RCTs and CCTs) evaluating the efficacy of DAs when applied to CDs. Primary outcomes were objectively assessed variables directly related to mastication (denture retention, maximum bite force and masticatory efficiency). Secondary outcomes included other objectively assessed variables and patient-reported outcomes.

STUDY SELECTION

Of the 1729 records identified, 39 studies (43 articles) were included in the analysis. Among them, 23 were RCTs and 16 were CCTs, with two multicenter clinical trials (1 RCT and 1 CCT). Meta-analysis results indicated that DAs provided significantly higher retention (SMD 1.34, 95 % CI: 0.89-1.79, P < 0.001) for CDs. Bite force (SMD 0.98, 95 % CI: 0.50-1.47, P < 0.001) and masticatory performance (SMD 0.72, 95 % CI: 0.23-1.22, P = 0.004) of the CD wearers were also improved after using DAs, but the effect size was relatively smaller.

CONCLUSION

Based on the results of this systematic review, it is concluded that DAs can improve denture retention, bite force and masticatory performance of CD wearers.

CLINICAL SIGNIFICANCE

This study investigated the effects of all types of DAs for CDs in terms of their effects on denture retention, masticatory performance, oral health-related quality of life and oral microorganisms for CD wearers.

Does the use of an adhesive improve conventional complete dentures? A systematic review of randomized controlled trials

STATEMENT OF PROBLEM

A consensus on whether the use of a complete-denture adhesive provides a clinical benefit remains unclear.

PURPOSE

The purpose of this systematic review of randomized controlled trials was to evaluate the use of adhesive in complete dentures in terms of retention and stability, patient-reported outcomes measures, and masticatory performance.

MATERIAL AND METHODS

A search was performed in PubMed, Web of Science, and Cochrane Library for articles up to October 2020. The Cochrane collaboration tool was used to analyze the risk of bias. The grading quality of evidence and strength of recommendations (GRADE) tool was used to assess the certainty of the evidence.

RESULTS

Thirteen studies were included with a total of 516 participants with a mean age of 65.5 years. Most studies reported a significant improvement in the retention and stability, patient-reported outcomes measures, and masticatory performance of complete dentures with the use of denture adhesive compared with no-denture adhesive. Newly developed denture adhesives were reported to have promising results. Most studies presented a low risk of bias, but the certainty of the evidence was classified as low to moderate.

CONCLUSIONS

Participants had improved treatment outcomes when using denture adhesives because they significantly improve the retention and stability, patient-reported outcomes measures, and masticatory performance. However, further high-quality studies are needed to confirm these results with newly developed denture adhesives.