Tongue support of complete dentures in the elderly

Patient satisfaction and masticatory performance of zirconia bar compared to cobalt chromium bar retaining mandibular implant overdenture: A crossover study

OBJECTIVES

The aim of this crossover clinical study was the evaluation and comparison of patient satisfaction and masticatory performance for patients rehabilitated with mandibular two implant overdentures retained with two different bar attachments: zirconia bar and cobalt chromium bar.

MATERIAL AND METHODS

Twenty completely edentulous patients were divided into two equal groups: Group I (ZrO2), each patient received mandibular implant overdenture retained with CAD/CAM zirconia bar on two implants in the canine region, and Group II (Co-Cr), each patient received mandibular overdenture retained with conventional casted cobalt chromium metal bar. Patient satisfaction was measured with a survey questionnaire (PSQ-18), and masticatory performance was also evaluated with the two-colour mixing ability test after 3 months of overdenture insertion; then, each patient received a bar attachment from the other type and evaluations were repeated.

RESULTS

Significant differences were observed regarding psychological acceptance (appearance), time, hygiene, undergo procedures, recommend procedures and the overall experience. In contrast, insignificant difference was observed regarding speech, chewing capacity, restorative procedures, complications and information prior to treatment. No significant difference was reported when comparing chewing performance between the two types of bar attachment.

CONCLUSION

Within this clinical study limitations, patient satisfaction with zirconia bar was higher than Co-Cr bar in terms of appearance, time, hygiene, undergo procedures, recommend procedures and the overall experience. Zirconia can become a suitable alternative to cobalt chromium alloys as a bar attachment. Combining the advantages of implant supported overdenture, CAD/CAM zirconia bar as an attachment, a satisfactory non-metal prosthesis could be provided.

The Influence of Oral Health Factors on the Quality of Life in Older People: A Systematic Review

BACKGROUND AND OBJECTIVES

The number of people aged 65 years or older is growing substantially. As a result of increased health burden and tooth retention, more oral health problems are expected in this age group. A poor oral health-related quality of life (OHQoL) can compromise a person's psychological state, social relationships, personal beliefs, and physical health. The aim of this systematic review was to identify oral health factors associated with OHQoL in people aged 65 years or older and to give a comprehensive overview of the body of literature for each oral health factor separately.

RESEARCH DESIGN AND METHODS

A comprehensive search was performed in five databases. The following terms were used as index terms or free-text words: "Oral Health," "Quality of Life," "Older People." Two researchers independently assessed studies for eligibility based on predefined criteria.

RESULTS

Of 3,702 references retrieved from the databases, 68 studies were eligible and included (9 randomized clinical trials, 6 cohort studies, and 53 cross-sectional studies). All results were reported descriptively. OHQoL in people aged 65 years or older is positively associated with higher number of teeth, higher number of occluding pairs, implant-retained overdentures, and the shortened dental arch concept and negatively associated with xerostomia, orofacial pain, and poor chewing ability. In the current literature, there is no consensus on the association between edentulism, caries, and periodontal conditions and OHQoL.

DISCUSSION AND IMPLICATIONS

Having a functional dentition (either natural or prosthetic) is important for a good OHQoL, whereas painful or functional complaints are associated with impaired OHQoL.

Functional oral health-related quality of life impact: A systematic review in populations with tooth loss

Patients perceive the impact of oral disorder in four major areas, the dimensions of oral health-related quality life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. The functional aspect is essential given the need of chewing, biting, speech and swallowing. The objective of this study was to identify OHRQoL information for dental subjects with functional oral health problems. In a systematic review, distinct and clinically relevant groups of dental subject samples, in this study called "population groups," with such functional OHRQoL information based on the Oral Health Impact Profile (OHIP) were identified (PROSPERO registration: CRD42017064033). The search strategy was "Oral Health Impact Profile" or OHIP. Searches were conducted in the PubMed interface of the Medline database, EMBASE, Cochrane, CINAHL and PsyINFO on 8 June 2017 and updated on 14 January 2019. Published OHIP domain data of different versions were recalculated into OHIP-14`s Physical Disability domain score, characterising the subject's Oral Function impact. 3,653 potentially abstracts were screened. We identified 78 publications reporting dimensional information on 154 subject samples with 52 populations. A typical mean functional impact for partially dentate subjects was 1.6 units on a 0 to 8 unit metric, while for edentate subjects, the mean functional impact was 2.6 units. The functional impact score ranged from 0 to 7.9 units with 50% of the patient samples located between 0.8 and 2.6 units. For the first time, we provide normalised and therefore comparable metric information about the functional OHRQoL impact for a substantial number of functional oral conditions.

In vitro retention force measurement for three different attachment systems for implant-retained overdenture

AIM

The aim of this study is to compare the retention force of three different types of overdenture attachment systems used in implant-retained mandibular complete overdentures.

MATERIALS AND METHODS

Twenty-one similar acrylic resin blocks were prepared and divided into three study groups: Group A (snap attachment) - 10 specimens, Group B (locator attachment) - 1 specimen, and Group C (syncone attachment) - 10 specimens. A single rectangular heat cure acrylic resin block with two implant analogs 22 mm apart was used with all specimens. Each specimen was subjected to 5500 cycles of insertion and removal in the presence of artificial saliva, representing 5 years of usage. Retention was measured three times for each specimen using universal testing machine. Data were analyzed using one-way and two-way analysis of variance at 95% level of confidence.

RESULTS

Locator attachment group (Group B) showed the greatest retention level throughout the study, followed by snap attachment (Group A), and syncone attachment (Group C) showed the lowest retention level.

CONCLUSION

Regardless of the initial retention level of overdenture attachment, gradual loss of retention values is inevitable. However, the rate of retention loss in overdenture attachments is higher in types which comprised plastic parts within their components, rather than those totally made up of noble metals.

Relationship between the occlusal plane corresponding to the lateral borders of the tongue and ala-tragus line in edentulous patients

AIM

Definitions of the ala-tragus line (ATL) cause confusion, because the exact points of reference for this line do not agree. This study determined the relationship between the prosthetic occlusal plane (OP) corresponding to the lateral borders of the tongue and ATL which was established by using the inferior border of the ala of the nose and (1) the superior border of the tragus (ATL 1), (2) the tip (ATL 2) and (3) the inferior border of the tragus (ATL 3).

MATERIALS AND METHODS

Neutral zone moldings using phonation and autopolymerizing acrylic resin were recorded and leveled with the lateral borders of the tongue. Lateral cephalometric radiographs were taken of each subject by a standard method. Tracings were obtained on acetate paper to show the prosthetic OP and the three ATLs. The relationship between the prosthetic OP and each of ATL was measured for each subject. Mean and standard deviation values were then calculated for the relationship. Statistical analysis was performed using repeated measure analysis of variance followed by Bonferroni pairwise comparisons and Student's t-test (α = 0.05).

RESULTS

Significant difference was found between the three mean angles (p = 0.001). There was no significant difference between the mean angle (5.00° ± 4.38) formed by OP and ATL 2, and the mean angle (4.90° ± 3.50) formed by OP and ATL 3 (p = 1.00) which revealed the smallest.

CONCLUSION

The findings of this study indicated that ATLs, extending from the inferior border of the ala of the nose to (1) the tip of the tragus of the ear, and (2) the inferior border of the tragus presented the closest relationship to the prosthetic OP corresponding to the lateral borders of the tongue.

CLINICAL SIGNIFICANCE

When the ATL is used for orientation of the OP in denture construction, it would seem preferable to define it as running from the inferior border of the ala of the nose to the tip or to the inferior border of the tragus of the ear.