Oral health-related quality of life and masticatory function after conventional prosthetic treatment: A cohort follow-up study

Factors influencing speech improvement following maxillary complete-arch implant-supported restorations: A retrospective study

OBJECTIVE

This study explored factors affecting speech improvement in patients with an edentulous maxilla after the delivery of a complete-arch implant-supported fixed dental prosthesis (IFDP).

MATERIALS AND METHODS

Patients who had received IFDP for edentulous maxilla were enrolled, and various potential speech improvement-related factors were considered, including patient demographics, anterior residual bone volume, preoperative facial features, preoperative acoustic parameters, and adaptation time. Acoustic analysis and perceptual ratings were used to assess three fricatives [s], [f], and [ɕ]. Correlation and regression analyses were conducted to assess the association between changes in fricatives and potential factors (α = .05).

RESULTS

The study included 50 patients (18 females and 32 males, aged 50.62 ± 15.71 years, range 19-76). Significant correlations were found among the change in the center of gravity (ΔCoG) of [s] and anterior residual bone volume, zygomatic implants number and proportion (p < .05). These correlations were largely mirrored in the perceptual score (ΔPS) changes. After controlling for age, sex, preoperative acoustic parameters, and adaptation time, the ΔCoG and ΔPS of fricatives were mainly correlated with the anterior residual bone volume, preoperative acoustic parameters, and adaptation time.

CONCLUSION

Speech improvements post-IFDP delivery are mainly related to preoperative speech characteristics, anterior residual bone volume, and adaptation time. The residual bone volume's impact on consonants varies with specific articulatory gestures. This study provides insights into forecasting speech outcomes following IFDP restoration and provides recommendations and methods for data collection in developing future prediction models.

Masticatory function in edentulous patients wearing implant overdentures after graftless maxillary sinus membrane elevation

BACKGROUND

Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials.

OBJECTIVES

This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation.

METHODS

The study group consisted of patients who had received a graftless sinus lift procedure in a split-mouth design and was compared to patients with maxillary implant-supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction.

RESULTS

Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant-retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'.

CONCLUSIONS

Patients with implant-supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant-retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical-technical aspects and patient's preferences.

Masticatory performance, self-perception of oral health, oral health-related quality of life and nutritional status of completely edentulous elderly patients submitted to different rehabilitation treatments: A cross-sectional study

BACKGROUND

The impact of treatments on completely edentulous individuals on masticatory performance (MP), oral health-related quality of life (OHRQoL), nutritional status (NS) and socio-economic profile (SP) is unclear in the literature.

OBJECTIVE

To compare the MP, OHRQoL, NS and SP of totally edentulous elderly users of bimaxillary complete dentures (CD) and users of lower implant-supported fixed complete dentures (IFCD).

METHODS

Forty participants were allocated into groups according to rehabilitation treatment (n = 20): bimaxillary CD (G1) and lower IFCD, and upper CD (G2). The evaluation of MP used almonds by the method of sieves. Four questionnaires (Geriatric Oral Health Assessment Index-GOHAI and Oral Health Impact Profile Edent-OHIP-Edent, Brazilian Economic Classification Criteria-ABEP and Mini Nutritional Assessment-MNA) were applied to assess the OHRQoL, SP and NS of the elderly, respectively. After evaluating the statistical assumptions, the Mann-Whitney (α = .05) test was applied to compare the groups regarding MP, OHRQoL, NS and SP. Spearman's correlation (α = .05) was performed to verify the correlation between the MP, the OHRQoL and the NS of the participants.

RESULTS

G2 showed better MP (p < .05) in all masticatory cycles, OHRQoL (p < .05) and NS than the G1. However, the participants' self-perception of oral health did not differ between groups (p < .05). A moderate negative correlation was found between MP and OHRQoL for 40 masticatory cycles (r2  = -0.513; p = .001).

CONCLUSION

Individuals rehabilitated with IFCD had a higher average monthly family income and achieved superior behaviour in MP and OHRQoL, in addition to lower risks of malnutrition when compared to individuals using bimaxillary CD.

Articulation distortion in Mandarin-speaking individuals with complete arch maxillary implant-supported fixed dental prostheses

STATEMENT OF PROBLEM

Implant-supported fixed dental prostheses (IFPs) have been increasingly used to restore edentulous jaws, yet few studies have utilized acoustic analysis for objective evaluation of postrestoration speech outcomes.

PURPOSE

The purpose of this clinical study was to assess speech articulation in edentulous individuals before and after the provision of IFPs by combining the results of subjective evaluations and objective acoustic analysis parameters.

MATERIAL AND METHODS

The study included thirty-four individuals who had an edentulous maxilla and had been provided with an IFP for over 6 months, along with 6 dentate controls. Acoustic analysis was conducted, and mean opinion scores (MOS) were rated from recordings. The participants were interviewed about perceived speech changes. Changes in the parameters were evaluated using the paired t test or Wilcoxon signed-rank test (α=.05). A comparison between dentate controls and edentulous individuals (with or without prostheses) was made using an independent t test or Mann-Whitney U test (α=.025).

RESULTS

Following restoration, the center of gravity (CoG) changes occurred in 11 of 12 consonants in edentulous individuals (P<.05). Prosthesis use allowed the CoG of all affricates and fricatives to appear larger and closer to control values. Before restoration, the CoG of 9 of 12 consonants in edentulous individuals differed from controls (P<.01); after restoration, this reduced to 3 out of 12 (P<.01). MOS improved in 10 of 12 consonants (P<.01), nearing a score of 4. Despite restoration, the CoG of alveolo-palatals [tɕh], [tɕ], and [ɕ] remained different from controls (P<.01). Most participants were satisfied with the improvement, with few reporting discomfort with alveolars [s] and [tsh].

CONCLUSIONS

IFPs can enhance speech in edentulous individuals, yet articulation distortions of alveolar and alveolo-palatal consonants persist. The improper palatal shape of IFPs or an abrupt joint between the IFP and atrophic natural bone may contribute to these distortions.

The impact of poor dental status and removable dental prosthesis quality on body composition, masticatory performance and oral health-related quality of life: a cross-sectional study in older adults

Background

To determine the impact of dental status, types, and quality of dental prostheses on body composition, masticatory performance and oral health-related quality of life (OHRQoL). Potential associations between body composition, masticatory performance and OHRQoL were also investigated.

Methods

This cross-sectional study included 110 older adults who received prosthodontic treatment at the Dental Faculty Clinics at Chulalongkorn University. Participants were categorized according to their dental prostheses: complete denture (CD), removable partial denture (RPD) and fixed partial denture (FPD). Retention and stability of the RPD and CD were evaluated using the CU-modified Kapur and the modified NHANES III criteria to classify denture quality into acceptable and unacceptable. Dental status including posterior occluding pairs and number of remaining natural teeth were assessed intraorally. Dependent variables were body composition, masticatory performance and OHRQoL. Body composition, including muscle mass (kg), bone mass (kg), basal metabolic rate (kcal) and visceral fat (%) were determined through a bioelectrical impedance analysis. Masticatory performance was assessed using a multiple sieve method of peanut mastication. OHRQoL was assessed using the validated Thai version of Oral Impacts on Daily Performances (Thai-OIDP) index. After adjusting for covariates, including age and sex, the associations between oral and dental prosthesis status and body composition, masticatory performance as well as OIDP score were analyzed using multivariable linear and negative binomial regression analyses. Spearman’s correlation was used to determine the potential associations between body composition, masticatory performance and OHRQoL.

Results

The presence of fewer natural teeth or wearing an unacceptable removable denture were factors associated with lower bone mass, muscle mass and basal metabolic rate, and with a higher visceral fat. Similar dental and removable denture status were also associated with larger peanut particle size and higher OIDP score. Masticatory performance and OHRQoL variables were moderately correlated (Spearman's rho = 0.44). However, body composition was not correlated with masticatory performance or OHRQoL.

Conclusions

In individuals wearing dental prostheses, factors such as severity of tooth loss, types, and quality of dental prostheses, particularly retention and stability, negatively impacted not only masticatory function and OHRQoL, but also their overall body composition and health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02103-7.

Masticatory index for patients wearing dental prosthesis as alternative to conventional masticatory ability measures

OBJECTIVES

The study objectives were: 1) to develop a masticatory index for evaluating masticatory ability in patients wearing a dental prosthesis, including complete dentures (CD), removable partial denture (RPD), and fixed partial denture (FPD), 2) to test the reliability and validity of the index, and 3) to determine whether the index better reflected patients' masticatory ability compared with conventional subjective and objective measures.

METHODS

The present cross-sectional study consisted of 2 phases: 1) developing the Chulalongkorn University masticatory index (CUMI) consisting of 20 food items in 5 masticatory difficulty grades using a 3-point Likert scale, and 2) application of the CUMI in 110 patients wearing a dental prosthesis, including CD, RPD, and FPD (control group). The CUMI test-retest reliability was reevaluated 2 weeks later. The convergent validity was compared with objective masticatory performance evaluated with a standard peanut chewing test, and subjective eating impacts evaluated by the Oral Impacts on Daily Performances Index. Oral and denture status were determined clinically. The associations between CUMI score, peanut particle size, and eating impact score was identified using Spearman's correlation coefficient. To evaluate discriminant validity, the associations between masticatory ability measurements and oral and denture status were analyzed using regression analyses.

RESULTS

The CUMI's Cronbach's alpha and intraclass correlation coefficient values were 0.89 and 0.95, respectively. The convergent validity was shown by significant associations between the increased CUMI score, smaller peanut particle size and decreased eating impact score. Multivariable analyses found that the CUMI score, peanut particle size, and percentage of having an eating impact were significantly associated with the number of remaining teeth and posterior occluding pairs, and type and quality of dental prosthesis. However, the CUMI demonstrated better discriminant validity because significant dose-response relationships were found only between the decreased CUMI score and increased tooth loss severity, and unacceptable denture quality. Adjusted R2 values of the CUMI models were the highest, followed by those of peanut particle size and eating impact.

CONCLUSION

CUMI is a reliable and valid tool to evaluate masticatory ability of patients wearing a dental prosthesis, including CD, RPD, and FPD. Due to a better discriminant validity, the CUMI better reflects masticatory ability of patients compared with conventional subjective and objective masticatory ability measures.

Deterioration of periodontal status affects declines in masticatory performance: The Suita study

AIM

We aimed to clarify the association between deterioration of periodontal status and masticatory performance in a longitudinal follow-up study of a general urban population.

MATERIALS AND METHODS

This study investigated 663 participants in the Suita study with no changes in the number of functional teeth or occlusal support areas during a 5-year follow-up period. Participants were classified into three groups according to changes in periodontal status during the survey period: a recovered group; a stable group; and a deteriorated group. Rate of masticatory performance change was calculated by subtracting the value at baseline from the value at follow-up and dividing the resulting value by the baseline value.

RESULTS

Median rates of masticatory performance change were -11.7% in the recovered group, -19.2% in the stable group, and -30.8% in the deteriorated group, and these values were significantly different (p < .001). Multiple regression analysis revealed periodontal status group (recovered group: reference; stable group: p = .029; deteriorated group: p = .006) as an independent variable was significantly associated with the rate of masticatory performance change.

CONCLUSION

The present results suggest that deterioration of periodontal status increases the risk of age-related declines in masticatory performance.

Determinants of masticatory performance assessed by mixing ability tests

STATEMENT OF PROBLEM

Studies determining the main predictors of masticatory performance by using mixing ability tests are sparse.

PURPOSE

The purpose of this clinical study was to identify potential determinants of masticatory performance assessed by analyzing a patient's masticatory ability using bicolored chewing gum and visual, quantitative, and interactive methods.

MATERIAL AND METHODS

Nondental participants attending healthcare centers were consecutively recruited in Granada, Spain. The inclusion criteria were older than18 years and resident in the coverage area of the reference healthcare centers for at least the previous 6 months. The participants were excluded if they had received dental treatment in the previous 6 months or they were unable to communicate. The masticatory performance was determined by using 2-colored chewing gum (Kiss 3 white and blue; Smint) that was masticated for a total of 20 strokes. The masticated gum was crushed between 2 transparent glass slides, creating a 1-mm-thick specimen that was subsequently scanned. The mixed-color area was calculated as a percentage by using Photoshop as described by Schimmel et al and designated as the gold standard method. In addition, all images made were analyzed by using the Web application the Chewing Performance Calculator. In addition, the masticated bolus was inspected visually, and mastication performance was classified as being poor, moderate, or good. Sociodemographic data, as well as data on behaviors, medical and nutritional status, health-related quality of life, saliva, and general oral health, were collected for all participants to identify the main determinants of masticatory performance.

RESULTS

One hundred thirty-seven participants were enrolled. The masticatory performance values obtained using both methods (gold standard method and Chewing Performance Calculator) were significantly greater for well masticated gum (P<.001), which had been visually classified as being poorly masticated (69.1% for gold standard method and 43.5% for Chewing Performance Calculator), moderately masticated (89.7% for gold standard method and 67.3% for Chewing Performance Calculator), and well masticated (97.3% for gold standard method and 80.3% for Chewing Performance Calculator). The bivariate analyses revealed that masticatory performance was significantly higher in younger people (<65 years) (P=.008), who also had a higher basal salivary flow rate (P<.001), were nondenture users (P=.002), and had more standing teeth and occlusal units (P<.001). However, the multiple regression analyses showed that the number of occlusal units was the only significant predictor of masticatory performance. In addition, the mean masticatory performance (95% confidence interval: 47.7% to 56.8%) was found to be greatly improved (by 1.2% to 2.2%), with each occlusal unit, in accordance with the Chewing Performance Calculator and between 0.8% and 1.8% according to the gold standard method; the basal masticatory performance was calculated as 72.1% to 81.2% (95% confidence interval).

CONCLUSIONS

The number of occlusal units is one of the main predictors of masticatory performance when a 2-color bolus is used to test mixing ability.

Attachment-retained removable prostheses: Patient satisfaction and quality of life assessment

STATEMENT OF PROBLEM

Studies on the impact of incorporating attachments in removable prostheses on patient-based outcomes are scarce.

PURPOSE

The purpose of this clinical study was to investigate oral health-related quality of life (OHRQoL) and patient satisfaction in partially edentulous participants before and after rehabilitation with mandibular attachment-retained removable prostheses as compared with conventional removable prostheses.

MATERIAL AND METHODS

This crossover study included 74 participants (aged 36 to 57). Initially, 56 received conventional clasp-retained removable dental prostheses (RDPs), and 18 received conventional overdentures (ODs) based on their mandibular partially edentulous state. Two months later, of the 56 RDP participants, 24 had received extracoronal attachment-retained RDPs, 17 received telescope-retained RDPs, and 15 received bar-attachment retained RDPs. The 18 OD participants received ball attachment-retained ODs. Assessments included Oral Health Impact Profile-short version-14 for OHRQoL and a visual analog scale (VAS) for patient satisfaction. Assessments were done before treatment and 2 months after wearing each prosthesis with a 1-month washout period. Statistical analysis included the Friedman then the Wilcoxon signed rank test for Oral Health Impact Profile-short version-14 scores and repeated measures ANOVA then the Bonferroni or paired t test for VAS scores (α=.05).

RESULTS

There were no dropouts. Rehabilitation, irrespective of prosthesis type, significantly improved OHRQoL in all domains and significantly increased overall patient satisfaction (P<.05). When compared with the conventional prostheses, attachment-retained prostheses significantly improved functional limitation, psychological discomfort, and physical limitation domains in all groups (P<.05), as well as the physical pain domain in the OD group (P=.041). General satisfaction, stability, comfort, ability to speak, and ability to masticate significantly increased (P<.05) with attachment-retained prostheses. Conventional prostheses were significantly easier to clean (P<.05) in all groups, except for the telescope-attachment group.

CONCLUSIONS

Both conventional and attachment-retained prostheses significantly increased patient satisfaction and improved OHRQoL in all domains as compared with before treatment. However, incorporation of attachments further improved functional limitation, psychological discomfort, and physical limitation domains in all groups, as well as the physical pain domain in the OD group. Participants were more satisfied with their attachment-retained prostheses in most aspects.

Oral health-related quality of life in tumour patients treated with patient-specific dental implants

Dental rehabilitation after surgically acquired bone deficiency related to tumour treatment remains a challenge. The insertion of patient-specific implants geared to the contour of the remaining bone is a feasible method of supporting fixed or removable dentures. As oral health-related quality of life (OHRQoL) is of great interest in these cases, 12 individuals treated with patient-specific implants for severe bone deficiency were surveyed and their Oral Health Impact Profile (OHIP) scores after dental rehabilitation were evaluated. The OHIP-G53 questionnaire was used to measure overall treatment outcomes. The distribution of OHIP sum-scores for participants treated with patient-specific implants was almost homogeneous when compared to those cited in the literature for patients treated with conventional dental implants. OHIP items related to functional impairment and physical pain showed the highest scores (occurring occasionally), and financial loss related to treatment was frequently stated. Moreover, higher scores were detected in almost all OHIP dimensions for participants with patient-specific implant-supported removable dentures. Conversely, those treated with patient-specific dental implants and fixed dentures showed lower psychosocial impact scores and equal or superior OHRQoL. Hence, patient-specific dental implants, especially combined with fixed dentures, can lead to a positive OHRQoL in patients with severe bone deficiencies related to tumour therapy.

Do implant-supported fixed partial prostheses improve masticatory performance in patients with unilateral posterior missing teeth?

OBJECTIVES

The purpose of this study was to determine the improvement in masticatory performance and satisfaction with chewing ability in partially edentulous patients after treatment with an implant-supported fixed partial prosthesis (ISFPP).

MATERIAL AND METHODS

This prospective study included 30 patients (mean age 59 years; 17 women) with unilateral posterior missing teeth treated with one-, two- or three-unit ISFPPs and 10 healthy individuals (mean age 36 years; 8 women) with complete natural dentition to establish the normal levels of mastication. Three variables were determined at baseline and at 3-months' follow-up in all participants: masticatory performance according to the median particle size (MPS) during freestyle mastication and unilateral mastication on each side, and satisfaction with chewing ability using a visual analog scale. Paired samples t test and Kruskal-Wallis test were used for intra-group and inter-group comparisons.

RESULTS

The MPS following freestyle mastication decreased significantly at 3 months in both groups. Significant reductions of 21%, 30%, and 42% in the MPS were obtained from unilateral mastication on the treated side after treatment with 1, 2, or 3 restorative units, respectively. Three months after ISFPP, satisfaction with chewing ability improved by 40% in the treatment group.

CONCLUSIONS

Freestyle masticatory performance may improve slightly within three months of treatment with an ISFPP and may be similar to that of subjects with complete natural dentition. Patients may obtain a 21%-38% improvement in unilateral mastication on the treated side and a 26%-54% improvement in satisfaction with chewing ability.