Construction faults, age, gender, and relative medical health: factors associated with complaints in complete denture patients

Unveiling denture-induced oral lesions: A comprehensive study on classification and pain assessment

BACKGROUND

Denture-induced oral Lesions (DIOLs) often manifests shortly after the placement or adjustment of new or realigned dentures, frequently resulting in severe pain and discomfort.

OBJECTIVES

This study aimed to classify DIOLs placing a particular emphasis on assessing the associated pain.

METHODS

A prospective case study was conducted involving 126 patients who were fitted with a total of 193 dentures of various types at the Hadassah School of Dental Medicine. All patients underwent comprehensive intra-oral examinations within 1-8 weeks following denture delivery, completed symptom questionnaires and had their medical records reviewed. Key variables documented included age, gender, overall health status, denture type, and a detailed description of the DIOLs. The description encompassed factors such as lesion location, shape, colour, size, border characteristics, ulcerative appearance, membrane coverage, 3D morphology (elevated, immersed and flat) and patient-reported Verbal Pain Score (VPS) when touching the DIOLs, when wearing the denture, and when not wearing the denture.

RESULTS

Notably, 25.4% of denture wearers required no adjustments, while 14.4% necessitated more than three revisions. A majority (71.8%) of DIOLs cases were associated with mandibular complete dentures, primarily situated on the alveolar ridge. The mean VPS indicated a pain intensity of 7 ± 2.1, with temporary dentures in both jaws causing the most discomfort. Implant-supported overdentures were particularly painful when placed in the mandible. Additionally, VPS scores were higher among older individuals and those with prior prosthetic experiences. A significant correlation was observed between pain intensity and presence of chronic health condition (0.036).

CONCLUSIONS

This study revealed distinct characteristics of DIOLs and highlighted the multifactorial nature of pain experienced following the development of DIOLs. Insights into the influence of patient and denture characteristics on DIOLs and pain intensity can guide healthcare professionals in optimising patient comfort and satisfaction.

Agreement between self-rated denture condition and clinical examination in older adults

OBJECTIVES

This study aimed to compare differences between complete denture conditions self-rated by older adult wearers and clinically exanimated by a professional based on standardised aesthetics and functional criteria.

MATERIALS AND METHODS

Complete denture clinical examination was based on the functional (stability, retention, occlusion and articulation, vertical dimension of occlusion) and aesthetics criteria. Data on self-rated complete denture conditions were measured using the Patient's Denture Assessment (PDA) questionnaire based on standardised aesthetic and functional criteria (n = 122). Prevalence rates of clinical and self-rated complete denture condition, sensitivity, specificity, positive and negative predictive values, and absolute and relative bias were calculated.

RESULTS

The highest sensitivity (66.7% [95% CI 55.3-76.7]) was obtained for aesthetic criterion, whereas occlusion revealed the lowest sensitivity (14.9% [95% CI 6.2-28.3]). Stability had the highest specificity (91.3% [95% CI 72.0-98.9]) and aesthetics the lowest (21.4% [95% CI 8.3-41.0]). Stability also yielded the highest positive predictive value (83.3% [95% CI 51.6-97.9]), and vertical dimension of occlusion the lowest (26.3% [95% CI 9.1-51.2]). The vertical dimension of occlusion yielded the highest negative predictive value (71.2% [95% CI 58.7-81.7]). Self-rated data underestimated the complete denture condition in 6.5% compared with clinical examinations when the aesthetic criterion was excluded from the analysis and 7.6% when added.

CONCLUSIONS

Older adult wearers better identified the condition of their complete denture when the aesthetic criterion was excluded from examination. In contrast, considering functional criteria (retention, stability, occlusion and vertical dimension of occlusion), self-rated complete denture conditions underestimated clinical examination.

CLINICAL RELEVANCE

Using standardised aesthetic criteria in epidemiological studies for assessing complete denture conditions self-rated by wearers could avoid underestimating or overestimating the information regarding the use or need for dental prostheses.

A randomized clinical study to assess the performance of a marketed denture adhesive in a model of food infiltration in healthy, edentulous adults

OBJECTIVES

An optimized food infiltration methodology was utilized to assess the objective and subjective efficacy of a marketed denture adhesive regarding denture dislodgment and infiltration and perception of food particles under maxillary and mandibular dentures. A pilot study helped optimize methodologies before the efficacy study.

MATERIALS AND METHODS

Participants were healthy adults (n =48 for both studies) with fair- to well-fitting and well-made full maxillary and mandibular dentures. In the pilot, groups were a denture adhesive applied in a conventional dabbed-on pattern, a denture adhesive applied in continuous strips, or no adhesive. In the efficacy study, groups were the Test denture adhesive (continuous strips pattern application) or no adhesive, employed in a crossover design. Food infiltration was investigated through measurement of peanut particle mass retrieved from under each denture (30-32 g chewed). No formal statistical testing was performed in the pilot. Statistical analysis in the efficacy study was performed using analysis of variance. Primary efficacy evaluation was combined peanut particle mass from both dentures. Secondary efficacy evaluations included peanut particle mass under separate dentures, participant-reported denture dislodgements, and awareness/rates of how bothersome peanut particles under dentures were.

RESULTS

In the pilot, the median peanut particle mass was lower with either pattern application compared with no adhesive. In the efficacy study, peanut particle mass under combined dentures was lower with than without adhesive (geometric mean [product of values]: 5.56 vs. 29.13 mg) with a between-group geometric mean ratio (adhesive over no adhesive) of 0.19 (95% confidence interval: 0.12, 0.30) favoring the Test adhesive (p < .0001). Similar Test adhesive beneficial outcomes in both studies included significantly fewer denture dislodgements and awareness and how bothersome peanut particles under dentures were. Treatments were generally well-tolerated.

CONCLUSIONS

These findings, including reduced peanut particle infiltration, fewer denture dislodgments, and lower ratings of bothersomeness, corroborate those studies investigating the benefits of denture adhesive in preventing food infiltration.

Challenges faced by edentulous patients (EDPs) during complete denture prostheses (CDP) service delivery in Fiji - a qualitative study

BACKGROUND

Edentulism is a state of having no teeth in the oral cavity, an irreversible condition popularly known as the marker of disease burden on the oral health. For edentulous patients (EDPs) Complete Denture Prostheses (CDP) is a means to improve oral health. Due to limited studies in this area, this research aimed to explore the challenges faced by the EDPs during CDP service delivery in Fiji.

METHODS

A directed descriptive qualitative study was conducted among EDPs attending Dental Prosthetic Clinics (DPCs) at the four centres in Fiji under purposive sampling. A semi-structured questionnaire with open ended questions was used for in-depth interview with EDPs who had worn CDP for 1 year via telephone. Participant responses were recorded, transcribed verbatim and analyzed manually using thematic analysis.

RESULTS

A total of 30 EDPs participated in the study. Six themes were identified as challenges faced by the EDPs during CDP service delivery in Fiji: lack of information, non-compliance, overwhelmed by illness, reduction on quality of life (QoL) financial barriers to CDP treatment care and personal acceptance. 77% of EDPs felt they did not receive adequate information on CDP when attending DPCs which indicated the non-compliance nature irrespective of using and cleaning CDP on a daily basis. The Dental Professionals (DPs) at the DPCs gave their full support in attending to the CDP challenges faced by the EDPs in Fiji during the review clinics.

CONCLUSION

The EDPs expressed a variety of challenges that was faced while seeking appropriate CDP services in Fiji. The findings demonstrate the need to explore approaches to develop patients' engagement practices during CDP service delivery by the Dental professionals (DPs), which leads to effective oral health promotion in Fiji for CDP wearers.

A simulation model used in teaching denture border adjustment: Randomized controlled trial

OBJECTIVES

The goal was to propose a new simulation model as a training tool in complete denture (CD) flange adjustment and to evaluate if the model can improve student competencies in different learning domains.

METHODS

Fourth-year undergraduate dental students (n = 100) were equally divided into control and test groups. Both groups received didactic instructions for CD post-insertion procedures, but the test group had additional simulation training using modified working casts. Both groups then performed CD flange adjustment on real patients, and their skills were evaluated using a specific checklist. The data were assessed by independent samples t-test and a chi-square test at α = 0.05.

RESULTS

The students in the test group showed significantly better overall performance (57.94%) compared with the control group (30.14%) in clinical post-insertion CD flange adjustment procedures (p < 0.001). However, the psychomotor skills of the male students in the test group were not significantly influenced (p = 0.268). Considering the competencies for different tasks, more students that were competent were present in the test group compared to those in the control group regarding most of the knowledge (p ≤ 0.012) and all of the cognitive skill tasks (p ≤ 0.021). More students were competent for half of the psychomotor skill tasks (p ≤ 0.027). However, when considering gender, the number of competent male students was significantly greater in the test group only for one of the psychomotor tasks.

CONCLUSION

The simulation model significantly improved the overall clinical skills of the students, allowing them to learn the common CD post-insertion maintenance procedures before performing the procedure clinically.

Impact of sociodemographic factors, duration of edentulism, and medical comorbidities on the mental attitudes of individuals with complete edentulism

STATEMENT OF PROBLEM

Understanding the attitude of elderly patients is important for successful complete denture therapy. However, data regarding the impact of sociodemographic factors, impact of medical comorbidities, and duration of edentulism on the mental attitudes of such patients are lacking.

PURPOSE

The purpose of this clinical study was to explore the association of sociodemographic factors, duration of edentulism, and medical comorbidities on the attitudes of completely edentulous patients.

MATERIAL AND METHODS

The study was conducted among 125 completely edentulous patients visiting the Department of Prosthodontics, Nepal Medical College from August 2020 to October 2020. General information including age, sex, education level, medical history, and duration of edentulism were collected during a routine clinical evaluation. The mental attitudes of the participants were categorized according to M.M. House Classification into philosophical mind, exacting mind, hysterical mind, or indifferent mind. The participants were categorized into 3 age groups: 45 to 54 years, 55 to 64 years, and 65 years and above. Similarly, they were divided into 3 categories depending upon the duration of edentulism: 0 to 2 years, 2 to 5 years, and more than 5 years. Data were entered in a statistical software program for descriptive analysis using frequency distributions, and the chi-square statistical test and the Freeman-Halton extension of the Fisher exact test were used to determine the association between categorical variables.

RESULTS

The highest number of participants was in the philosophical category (34.4%) with the fewest in the hysterical group (12%). Men had more philosophical and indifferent attitudes, whereas women were more exacting (P<.001). Those with a recent history of extraction had an increased exacting attitude (P<.001). The respondents without any comorbid diseases were more philosophical, whereas a higher percentage of respondents with different comorbid conditions were assessed to be in the hysterical category (P<.001). Significant relationships were not found between mental attitude and educational status or age (P>.05).

CONCLUSIONS

Socioeconomic factors, duration of edentulism, and existing comorbidities had a significant impact on the attitudes of edentulous patients. The role of these factors should be assessed during the appraisal of the mental attitudes of edentulous patients.

Effect of Edentulism and Oral Quality of Life on Sexual Functions in Men: A Cohort Prospective Study

INTRODUCTION

Edentulism has a serious impact on quality of life (QoL), and changes in QoL can affect sexual functioning.

AIM

To assess the correlation between oral health-related quality of life (OHQoL) and sexual function in edentulous men.

METHODS

A total of 148 men (18-70 years) with incomplete natural dentition completed the International Index of Erectile Function (IIEF) and Oral Health Impact Profile (OHIP-14) at 4 time points: before (T₀), during (T₁), 4 weeks after (T₂), and 1 year (T₃) after dental treatment. Kruskal-Wallis, Friedman, and Spearman's rank correlation tests were used for statistical analyses (significance at P < .05).

RESULTS

IIEF total scores differed significantly between the time points (P < .001), with medians and interquartile ranges (IQR) of 46 (7), 42 (8), 49 (6), and 52 (5) at T₀, T₁, T₂, and T₃, respectively. The highest rate of sexual dysfunction was detected at T₁ (42.2%) and the lowest at T₃ (26.6%). IIEF domain scores also decreased at T₁ and increased at T₂ and T₃ compared with T₀ (P < .05). Median (IQR) OHIP-14 scores were 26.0 (8), 28.0 (8), 20.0 (6), and 18.0 (5), respectively (P < .001). OHIP score was significantly correlated with IIEF domain scores (P < .05) and there were strong negative correlations between OHIP and total IIEF scores at T₀ (r = -0.737), T₁ (r = -0.802), T₂ (r = -0.831), and T₃ (r = -0.722) (P = <.001 for all).

MAIN OUTCOME MEASURE

Changes and correlations in IEFF and OHIP-14 scores; SD and ED prevalances at T₀; T₁; T₂ and T₃ periods.

CLINICAL IMPLICATIONS

Sexual functions was significantly correlate with OHQoL; thus patients with ED should also be examined in terms of toothlessness.

CONCLUSION

OHQoL was significantly associated with sexual function in men. However, correcting the problem of edentulism improved OHQoL and sexual function, with the best results observed after 1-year follow-up. H Turgut, S Turgut. Effect of Edentulism and Oral Quality of Life on Sexual Functions in Men: A Cohort Prospective Study. Sex Med 2021;9:100305.

A randomized clinical study to evaluate the effect of denture adhesive application technique on food particle accumulation under dentures

Food ingress under dentures is a common problem that may be reduced by denture adhesive use. The objective of this study was to explore the effect of the mode of application of a denture adhesive on reducing accumulation of food particles under dentures. This was a single-centre, controlled, single-blind, randomized, three-treatment, three-period, crossover study in participants with complete, removable well-fitting, well-made upper/lower dentures. Treatments were: 1) experimental denture adhesive application (test adhesive) applied with a precision applicator as continuous strips; 2) marketed denture adhesive (positive control) applied using a flat ribbon nozzle as dabs; 3) no adhesive. Food-occlusion testing was performed by assessing peanut particle migration under dentures with denture retention/stability evaluated using the Kapur Index (Olshan modification). Differences were assessed using an ANOVA model. Adhesive oozing and perceptions of the adhesives were assessed by questionnaire. All 83 randomized participants completed the study. There were no significant differences between positive control or test adhesives versus no adhesive, or between test adhesive and positive control, for mass of peanut particles recovered from dentures. Both adhesives had significantly higher retention and stability scores compared with no adhesive (all P < .01). Participants reported significantly higher scores for denture comfort, confidence, satisfaction and movement with both adhesives versus no adhesive (all P < .01). No differences in adhesive ooze were reported between adhesives. No adverse events were reported. In conclusion, there was no difference in performance, as measured by peanut particle mass recovered from upper/lower dentures, for the test adhesive, positive control and no adhesive.

The Effect of Complete Dentures on the Quality of Life of Edentulous Patients in the South Indian Population Based on Gender and Systemic Disease

Purpose

Different socio-demographic variables, such as age, gender, and systemic disease, may affect satisfaction with complete dentures. Several studies have failed to show strong correlations either between patient satisfaction with their dentures and their quality or between denture satisfaction and the quality of the denture-supporting tissues. Hence, this study utilized a standardized questionnaire that included questions from domains such as mastication, appearance, speech, comfort, health, denture care, and social status. These questionnaires were used to determine the level of complete denture satisfaction along with socio-demographic variables such as age, gender, and systemic condition.

Materials and method

A total number of 128 completely edentulous patients aged between 40 and 50 years were selected. A standardized questionnaire, with 19 questions based on denture satisfaction level and masticatory capacity in the domains of functional limitation (FL), psychological discomfort (D1), psychological disability (D2), and social disability (D3), was administered. All the questions were recorded on a scale of 2, 1, 0 based on satisfied, moderately satisfied, and not satisfied, whereas hardly ever, occasionally, and very often were used for masticatory capacity. Questions on denture satisfaction were asked based on the post-treatment satisfaction with the new maxillary/mandibular complete dentures of the patients.

Results

Based on gender, the distribution of samples was 46.09% for male patients and 53.91% for female patients among the 128 patients selected. Similarly, based on systemic diseases, 66.41% had the presence of systemic disease while 28.13% did not have any systemic disease. Around 5.47% of the sample did not have any medical records. The predominance of psychological satisfaction was more for female patients. Based on systemic disease, it was observed that patients with the presence of systemic disease (Pn) were more psychologically comfortable than those who did not have systemic disease. The predominance of functional satisfaction was not marked in both genders. Based on systemic disease, it was observed that patients with the presence of systemic disease (Pn) had less functional comfort on mastication than those who did not have a systemic disease.

Conclusion

The acceptance of and satisfaction with complete denture treatment were comparatively higher in patients who had a systemic disease than in those with a non-systemic disease in terms of psychological and social comfort, whereas, in functionality, patients with a non-systemic disease had a higher satisfaction level.

Randomized controlled clinical investigation on the association between personality profiles and the impacts of two types of maxillary anterior implant-supported crown restorations on daily living and dental satisfaction

BACKGROUND

Personality factors might influence participants' satisfaction and the effects of dental management on daily living.

PURPOSE

This randomized controlled clinical trial aimed to assess the impacts of two types of implant-supported maxillary anterior crown restorations on daily living and participants' satisfaction, and its correlations with personality profiles.

MATERIALS AND METHODS

One hundred and seventy participants (84 males and 86 females; mean age = 35 ± 9 years) obtained maxillary anterior implant-supported crowns. They were allocated into two treatment groups (85 participants each: 43 females and 42 males). Group 1 was treated with titanium abutment-supported porcelain fused to metal (PFM) restorations. Group 2 was treated with zirconium abutment-supported ceramic restorations. A control group (85 participants each: 43 females and 42 males) that matched the treatment groups in gender and age was recruited. Precise clinical standards were followed to judge the clinical success of treatment. The NEO Five-Factor Inventory was used to evaluate participants' personality profiles. The dental impact on daily living questionnaire (DIDL) was used to evaluate restoration impacts on daily living and participants' satisfaction. Statistical analysis was carried out with probability of α = .05.

RESULTS

Higher DIDL scores were reported after crown treatments (P < .001). Group 2 participants reported highest levels of satisfaction with appearance (P = .007). DIDL scores were significantly associated with neuroticism, extraversion, and openness scores (P < .05) before restoration, and, with neuroticism, extraversion, agreeableness, openness, and conscientiousness scores (P < .05) after restoration.

CONCLUSION

Implant-supported crown restorations in anterior maxillary region were associated with positive impacts on daily living and participants' satisfaction. Implant-supported ceramic crowns and abutments were accompanied with higher levels of satisfaction with appearance than implant-supported PFM crowns and titanium abutments. Certain personality and psychological features (neuroticism, extraversion, agreeableness, openness, and conscientiousness) might affect and predict dental satisfaction and impacts on daily living.

Verification of the reliability of current perception threshold and pain threshold testing by application of an electrical current stimulus to mandibular mucosa in young adults

BACKGROUND

There is little evidence regarding the reliability of CPT and PT measurements to gauge mandibular perception. Thus, this study aimed to evaluate the test-retest reliability of CPT and PT values obtained from the mandibular oral mucosa and to test the bilateral differences in CPT and PT values obtained from the mental foramen region and buccal shelf region by a single operator.

METHODS

CPT and PT values were obtained from the mental foramen and buccal shelf regions of 20 volunteers (10 males and 10 females; average age: 26.4 ± 2.6 years) by using the Neurometer CPT/C® device to deliver electrical stimulation.

RESULTS

Relative and absolute reliabilities were confirmed over two measurements of CPT and PT over a 7- to 10-day measurement interval. Intra-class correlation coefficients (ICCs) for CPT and PT table obtained from the mental foramen region were >0.8, while most ICC for the buccal shelf region were <0.8. Standard error of measurement, minimal detectable change and Bland-Altman analyses showed that the CPT and PT measurements had no systematic error and could serve as useful methods. At all frequencies, the bilateral difference in CPT and PT values at the mental foramen and buccal shelf region was not significant.

CONCLUSION

CPT and PT measurements using a custom-made device that applied an electrical current to the mental foramen region have appropriate reliability to assess intra-oral sensitivity to electrical stimulation in young adults.

Final-impression techniques and materials for making complete and removable partial dentures

BACKGROUND

Edentulism is relatively common and is often treated with the provision of complete or partial removable dentures. Clinicians make final impressions of complete dentures (CD) and removable partial dentures (RPD) using different techniques and materials. Applying the correct impression technique and material, based on an individual's oral condition, improves the quality of the prosthesis, which may improve quality of life.

OBJECTIVES

To assess the effects of different final-impression techniques and materials used to make complete dentures, for retention, stability, comfort, and quality of life in completely edentulous people.To assess the effects of different final-impression techniques and materials used to make removable partial dentures, for stability, comfort, overextension, and quality of life in partially edentulous people.

SEARCH METHODS

Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 22 November 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Register of Studies, to 22 November 2017), MEDLINE Ovid (1946 to 22 November 2017), and Embase Ovid (21 December 2015 to 22 November 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status when searching the electronic databases, however the search of Embase was restricted by date due to the Cochrane Centralised Search Project to identify all clinical trials and add them to CENTRAL.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) comparing different final-impression techniques and materials for treating people with complete dentures (CD) and removable partial dentures (RPD). For CD, we included trials that compared different materials or different techniques or both. In RPD for tooth-supported conditions, we included trials comparing the same material and different techniques, or different materials and the same technique. In tooth- and tissue-supported RPD, we included trials comparing the same material and different dual-impression techniques, and different materials with different dual-impression techniques.

DATA COLLECTION AND ANALYSIS

Two review authors independently, and in duplicate, screened studies for eligibility, extracted data, and assessed the risk of bias for each included trial. We expressed results as risk ratios (RR) for dichotomous outcomes, and as mean differences (MD) or standardised mean differences (SMD) for continuous outcomes, with 95% confidence intervals (CI), using the random-effects model. We constructed 'Summary of findings' tables for the main comparisons and outcomes (participant-reported oral health-related quality of life, quality of the denture, and denture border adjustments).

MAIN RESULTS

We included nine studies in this review. Eight studies involved 485 participants with CD. We assessed six of the studies to be at high risk of bias, and two to be at low risk of bias. We judged one study on RPD with 72 randomised participants to be at high risk of bias.Overall, the quality of the evidence for each comparison and outcome was either low or very low, therefore, results should be interpreted with caution, as future research is likely to change the findings.Complete denturesTwo studies compared the same material and different techniques (one study contributed data to a secondary outcome only); two studies compared the same technique and different materials; and four studies compared different materials and techniques.One study (10 participants) evaluated two stage-two step, Biofunctional Prosthetic system (BPS) using additional silicone elastomer compared to conventional methods, and found no evidence of a clear difference for oral health-related quality of life, or quality of the dentures (denture satisfaction). The study reported that BPS required fewer adjustments. We assessed the quality of the evidence as very low.One study (27 participants) compared selective pressure final-impression technique using wax versus polysulfide elastomeric (rubber) material. The study did not measure quality of life or dentures, and found no evidence of a clear difference between interventions in the need for adjustments (RR 0.81, 95% CI 0.38 to 1.70). We assessed the quality of the evidence as very low.One study compared two stage-two step final impression with alginate versus silicone elastomer. Oral health-related quality of life measured by the OHIP-EDENT seemed to be better with silicone (MD 7.20, 95% CI 2.71 to 11.69; 144 participants). The study found no clear differences in participant-reported quality of the denture (comfort) after a two-week 'confirmation' period, but reported that silicone was better for stability and chewing efficiency. We assessed the quality of the evidence as low.Three studies compared single-stage impressions with alginate versus two stage-two step with elastomer (silicone, polysulfide, or polyether) impressions. There was no evidence of a clear difference in the OHIP-EDENT at one month (MD 0.05, 95% CI -2.37 to 2.47; two studies, 98 participants). There was no evidence of a clear difference in participant-rated general satisfaction with dentures at six months (MD 0.00, 95% CI -8.23 to 8.23; one study, 105 participants). We assessed the quality of the evidence as very low.One study compared single-stage alginate versus two stage-two step using zinc-oxide eugenol, and found no evidence of a clear difference in OHIP-EDENT (MD 0.50, 95% CI -2.67 to 3.67; 39 participants), or general satisfaction (RR 3.15, 95% CI 0.14 to 72.88; 39 participants) at six months. We assessed the quality of the evidence as very low.Removable partial denturesOne study randomised 72 participants and compared altered-cast technique versus one-piece cast technique. The study did not measure quality of life, but reported that most participants were satisfied with the dentures and there was no evidence of any clear difference between groups for general satisfaction at one-year follow-up (low-quality evidence). There was no evidence of a clear difference in number of intaglio adjustments at one year (RR 1.43, 95% CI 0.61 to 3.34) (very low-quality evidence).

AUTHORS' CONCLUSIONS

We conclude that there is no clear evidence that one technique or material has a substantial advantage over another for making complete dentures and removable partial dentures. Available evidence for the relative benefits of different denture fabrication techniques and final-impression materials is limited and is of low or very low quality. More high-quality RCTs are required.

Structurofunctional analysis based on postinsertion problems with complete dentures in Moradabad, North India: A cross-sectional study

Background:

Complaints with complete dentures is a common and expected phenomenon. However the type and character of complaint varies between population and is influenced by the socio economic condition, prevalent dental awareness etc. This study attempts to find the most common complaints with complete dentures, their causes and also presents a classification of the same.

Method:

A cross-sectional analytical study was conducted by performing a survey on a sample of population over an 18 month period utilizing a customized questionnaire. The complaints were divided into four categories viz. discomfort, retention, esthetics and miscellaneous. Consequently each denture was evaluated for structural and functional defects. The findings were classified into error in denture base, physiopsychological, error in occlusion and teeth selection. The data was statistically analyzed.

Results:

Error in denture base was the predominant cause of complaints. However physiopsychological and error in occlusion and teeth selection were also important second factors in certain groups of complaints. Highest number of complaints (23.07%) belongs to discomfort in mandibular posterior region. While the least number of complaints are concerned with speech as reported by both males and females (both at 2.02%).

Conclusion:

Discomfort with complete dentures was the largest complaint reported followed by loss of retention with esthetics and miscellaneous complaints. Discomfort in mandibular posterior region was the most frequent complaint reported while speech related complaints were least in number. Most common cause of complaints was error in denture base.

Quantitative sensory testing for assessment of somatosensory function in human oral mucosa: a review

OBJECTIVE

This narrative review provides an overview of the quantitative sensory testing (QST) to assess somatosensory function in human oral mucosa.

MATERIAL AND METHODS

A literature search was conducted in the PubMed database to identify studies in vivo on human oral mucosa using QST methods. A list of 149 articles was obtained and screened. A total of 36 relevant articles remained and were read in full text. Manual search of the reference lists identified eight additional relevant studies. A total of 44 articles were included for final assessment.

RESULTS

The included studies were divided into six categories according to the study content and objective. In each category, there was a great variety of aims, methods, participants and outcome measures. The application of QST has nevertheless helped to monitor somatosensory function in experimental models of intraoral pain, effects of local anesthesia, after oral and maxillofacial surgery and after prosthodontic and orthodontic treatment.

CONCLUSIONS

QST has been proved to be sufficiently stable and reliable, and valuable information has been obtained regarding somatosensory function in healthy volunteers, special populations and orofacial pain patients. However, as most of the studies were highly heterogeneous, the results are difficult to compare quantitatively. A standardized intraoral QST protocol is recommended and expected to help advance a mechanism-based assessment of neuropathies and other intraoral pain conditions.

Factors Affecting Oral Health-Related Quality of Life Among Elderly Croatian Patients

OBJECTIVE OF WORK

Oral health-related quality of life (OHRQoL) as a multidimensional concept is affected by many factors. Therefore, the aim of this study was to determine which demographic and subjective factors are significantly affecting the OHRQoL among the elderly people wearing complete removable dental prostheses (CRDP).

MATERIALS AND METHODS

This questionnaire-based study included 301 participants, residents of elderly care homes (in Zagreb and Slavonski Brod, Croatia) wearing maxillary and/or mandibular CRDP. The questionnaire used in this study consisted of two sections; the first section included questions giving general information and in the second section the Croatian version of Oral Health Impact Profile (OHIP)-49 questionnaire with 49 items representing seven OHIP domains was used.

RESULTS

Participants were aged between 60-99 years, with average age of 74 ± 12.1 years. OHIP summary score was 26.5. The highest average OHIP mean values in the domain of functional limitation amounted to 6.7, physical pain 5.1, and physical disability 5.9. The participants' age, education, profession, residence place size, type of CRDP, and the time of denture wearing period all statistically significantly affected OHRQoL (p < 0.05).

CONCLUSIONS

General and sociodemographic factors had a significant influence on the participant's subjective perception of oral health and OHRQoL. Younger participants, participants from rural places, those with lower levels of education, and shorter period of denture wearing demonstrated a higher impact on OHRQoL.

Factors associated with mucosal pain in patients with partial removable dental prostheses

The aim of this study was to investigate factors associated with mucosal pain in patients with partial removable dental prostheses (PRDPs). In this hospital-based cross-sectional study, 333 patients wearing 500 PRDPs (mean age 71·4 years, men 33·3%) were consecutively recruited from prosthetic clinic of a dental hospital in Japan. Subjects rated pain intensity and frequency of denture-bearing mucosa. An examiner recorded age, gender and systemic diseases as well as dental, mucosa, denture, sensory, behavioural- and psychological-related characteristics that were possibly associated with the mucosal pain. Multivariate analyses were performed to analyse factors related to mucosal pain. Pain intensity was rated as more than score 0 (presence) in 34·2% (171/500) PRDPs, and pain was experienced after denture delivery in 42·8% (214/500) PRDPs. Logistic regression analyses showed that younger age, mucosal damage, poor mucosal condition, bone prominence, poor residual ridge, higher pain sensitivity, presence of awake bruxism, perception of oral dryness, interim denture wear and high number of missing teeth were significant independent predictors for the presence of the mucosal pain intensity and/or frequency (P < 0·05). Multiple factors are associated with mucosal pain in patients with PRDPs. Oral mucosal characteristics, age, pain sensitivity and behavioural factors seem to be more critical for mucosal pain than distribution of missing teeth and number of abutment teeth.

Correlation of patient's mental attitude with age, sex, and educational level: A survey

Objective:

The aim of this study was to determine any relationship, if exists, between the patient's mental attitude with age, sex, or educational qualification.

Methods:

A total of 200 patients who attended the outpatient department during a span of 1 year, for the fabrication of new complete dentures, were chosen for the study. After completing a routine case history and examination, a questionnaire was filled by the clinician as answered by the patient. Participants were evaluated and categorized based on the questionnaire and clinical experience during treatment according to a predefined classification of determining mental attitudes. Outcomes from the survey were correlated with participant gender, age, and educational status.

Results:

The male to female ratio was 83:117, out of the 200 enrolled participants. The results from the questionnaire showed that females were found to be more exacting (P = 0.007) in nature, while males, on the other hand, revealed more indifferent attitude (P = 0.02); both differences being statistically significant. Of the three age group categories: Participants in the age group of 45–54 years revealed a significant inclination toward an exacting attitude when compared with other age groups (P < 0.001). In regards to educational status, an illiterate or minimally educated group significantly outnumbered the college graduates in the indifferent attitude group (P < 0.001).

Conclusions:

Within the limitations of this study, it could be said that the mental attitudes of patients could vary according to gender, age, and educational status, which could affect patient cooperation and satisfaction with oral rehabilitation, eventually manipulating the overall success of the treatment rendered.

Relationship between impact of maxillary anterior fixed prosthodontic rehabilitation on daily living, satisfaction, and personality profiles

STATEMENT OF PROBLEM

Personality profiles may affect the impact of dental treatment on daily living and patient satisfaction.

PURPOSE

The purpose of this clinical trial was to evaluate the impact of maxillary anterior fixed prosthodontic rehabilitation on daily living and the satisfaction of patients and to investigate its relationship with personality profiles.

MATERIAL AND METHODS

Fifty-nine participants (25 men and 34 women; mean age 32.4 ± 6.9 years) received maxillary anterior partial fixed dental prostheses. The clinical success of the prostheses was evaluated following specific criteria. The Dental Impact on Daily Living (DIDL) questionnaire was used to measure satisfaction with the prostheses and their impact on daily living. The Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) was used to measure patients' personality profiles. The paired sample t test was used to compare satisfaction and personality scores before and after treatment (α=.05).

RESULTS

Participants' total satisfaction and their satisfaction with appearance, pain tolerance, oral comfort, general performance, and eating improved after treatment (P<.05). Before treatment, women were less satisfied with general performance (P=.047) and scored higher on the Neuroticism score (P=.039); however, after treatment, women were more satisfied with appearance (P=.004). Age and sex had no significant correlation with personality profiles after treatment. Before treatment, Neuroticism, Openness, and Conscientiousness scores were associated with dental satisfaction and impact on daily life (P<.05). After treatment, Neuroticism, Openness, and Extraversion scores were associated with dental satisfaction and impact on daily life (P<.05).

CONCLUSIONS

Patient satisfaction with their oral condition improved after partial fixed dental prosthetic rehabilitation in the maxillary anterior esthetic zone. Psychological profiles (Neuroticism, Extraversion, Openness, and Conscientiousness) may be involved in and explain the impact on daily living and the degree of patient satisfaction with their prostheses.

Endodontics and the ageing patient

Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient.

Double Full-Arch Versus Single Full-Arch, Four Implant-Supported Rehabilitations: A Retrospective, 5-Year Cohort Study

PURPOSE

To report the 5-year outcome of the All-on-4 treatment concept comparing double full-arch (G1) and single-arch (G2) groups.

MATERIALS AND METHODS

This retrospective cohort study included 110 patients (68 women and 42 men, average age of 55.5 years) with 440 NobelSpeedy groovy implants. One hundred sixty-five full-arch, fixed, immediately loaded prostheses in both jaws were followed for 5 years. G1 consisted of 55 patients with double-arch rehabilitations occluded with implant-supported fixed prostheses, and G2 consisted of 55 patients with maxillary single-arch rehabilitations or mandibular single-arch rehabilitations occluded with natural teeth or removable prostheses. The groups were matched for age (±6 years) and gender. Primary outcome measures were cumulative prosthetic (both interim and definitive) and implant survival (Kaplan-Meier product limit estimator). Secondary outcome measures were marginal bone levels at 5 years (through periapical radiographs and using the patient as unit of analysis) and the incidence of mechanical and biological complications. Differences in survival curves (log-rank test), marginal bone level (Mann-Whitney U test), and complications (chi-square test) were compared inferentially between the two groups using the patient as unit of analysis with significance level set at p ≤ 0.05.

RESULTS

No dropouts occurred. Prosthetic survival was 100%. Five patients lost 5 implants (G1: n = 3; G2: n = 2) before 1 year, rendering an estimated cumulative survival rate of 95.5% (G1: 94.5%; G2: 96.4%; Kaplan-Meier, p = 0.645, nonsignificant). The average (SD) marginal bone level was 1.56 mm (0.89) at 5 years [G1: 1.45 mm (0.77); G2: 1.67 mm (0.99); p = 0.414]. The incidence rate of mechanical complications (in both interim and definitive prostheses) was 0.16 and 0.13 for G1 and G2, respectively (p = 0.032). The incidence rate of biological complications was 0.06 and 0.05 for G1 and G2, respectively (p = 0.669).

CONCLUSIONS

Based on the results, rehabilitating double- or single-arch edentulous patients did not yield significant differences on survival curves. The incidence of mechanical complications was significantly higher for double-arch rehabilitated patients but nevertheless, these mechanical complications did not affect the long-term survival of either the prostheses or the implants.

Decayed, Missing, and Filled Teeth Index and Periodontal Health in Osteoporotic Patients Affected by BRONJ: An Observational Study

The aim of this paper is to describe the incidence of decayed, missing, and filled teeth (DMFT) and periodontal disease in 32 osteoporotic patients affected by bisphosphonate-related osteonecrosis of the jaw (BRONJ). Moreover, an investigation between the obtained data and 20 patients treated with bisphosphonate drugs and with no evidence of ONJ has been performed. Osteonecrosis of the jaws is a rare complication in a subset of patients receiving bisphosphonate drugs. Based on a growing number of case reports and institutional reviews, this kind of therapy can cause exposed and necrotic bone specifically in the jawbones. From April 2009 to June 2012, 32 osteoporotic patients treated with oral or intravenous (I.V.) bisphosphonates have been recorded. The patients' oral health has been compared with 20 bisphosphonates patients with no ONJ. The incidence of decayed, missing, and filled teeth (DMFT) and periodontal disease was recorded in all patients and student's t-test was applied for comparing the two investigated groups data. Data demonstrated how the poor dental hygiene and periodontal disease of the BRONJ patients' are connected with the occurrence of jawbone necrosis.

Effect of dentist's clinical experience on treatment satisfaction of a complete denture

The relationship between the prosthodontic experience of dentists and satisfaction of complete denture wearers remains unknown. To investigate whether a prosthodontist's clinical experience affects treatment satisfaction of a complete denture wearer. From April 2004 to July 2006, we conducted a randomised controlled trial at two centres, including 74 edentulous patients; of these, 32 and 30 were randomly allocated to the ED or ID group, respectively. All the patients rated their satisfaction with dentures, including general satisfaction and satisfaction of chewing ability, speaking, cleaning, stability, retention, comfort and aesthetics. These satisfaction ratings were measured by a 100-mm visual analog scale (VAS). Perceived chewing ability to foods, divided into five grades, was measured using a questionnaire. The mastication index (MI) was calculated for each grade. General satisfaction and satisfaction of speaking, stability and retention were significantly higher in the ED than in the ID group (P = 0·049, 0·003, 0·019 and 0·041, respectively). No significant difference existed between the MI of the ED (71·3 ± 18·4) and ID group (64·1 ± 16·53). However, the perceived chewing ability of grade 5 food, whose texture was the hardest among all the grades, was significantly higher in the ED group than in the ID group. Within its limitations, this study showed that a clinician's prosthodontic experience affects a complete denture wearer's satisfaction ratings.

A survey of complete denture patients experiencing difficulties with their prostheses

OBJECTIVE

The objective of this study was to investigate the problems faced by patients having complete dentures and the cleanliness of dentures by the patients.

MATERIALS AND METHODS

This cross-sectional study is done with a sample of 178 patients having complete prosthesis since 1 year. A self-administered structured questionnaire pretested through a pilot survey was used in the study. The data were analyzed using the SPSS version 16.0. The Student's t-test, ANOVA and post hoc test were used as test of significance.

RESULTS

Mastication discomfort and looseness of denture were the most common complaints followed by lack of retention (35.4%), bad breath (29.8%), tongue restriction (26.4%) and food accumulation (24.7%). There was a significant relationship of complaints with age groups (p=0.00).

CLINICAL SIGNIFICANCE

This study concluded that most of the patients were present with complaints due to dentures. So, dental professionals should pay serious attention to their patients for subjective acceptable result of the dentures and also advice them to properly maintain hygiene of dentures.

Association of cephalometric changes after 5 years of complete dentures wearing and oral health-related quality-of-life

OBJECTIVE

The aim was to investigate cephalometric changes after 5 years of wearing complete dentures (CDs) and to asses a possible relationship between changes in cephalometric parameters and patients' oral health-related quality-of-life (OHRQoL).

MATERIALS AND METHODS

New complete maxillary and mandibular dentures were fabricated for 30 participants. Two lateral radiographs were obtained from each participant with their CDs in the position of maximal intercuspidation (centric relation): the first radiograph was obtained at the CDs delivery and the second one after 5 years of CDs wearing. A questionnaire (OHIP 14) was given to all participants at the 5-year appointment.

RESULTS

Significant differences in most linear and angular cephalometric measurements were found after 5 years of CDs wearing, due to the reduction of the height of the lower third of the face and the forward shifting of the mandible. A significant correlation between the OHIP summary scores and five cephalometric variables was found (ANS-Xi/Xi-Pm angle, FH/N-Pog angle, SN/Go-Gn angle, Go-Gn/ANS-PNS angle and occlusal plane/FH), indicating that more severe cephalometric changes were related with the increase of OHIP scores.

CONCLUSION

Changes of cephalometric angles due to lowering of the face and forward shifting of the mandible were related to the decreased OHRQoL (increased OHIP scores).

Desordens temporomandibulares em usuários de prótese parcial removível: prevalência de acordo com a classificação de Kennedy

OBJETIVO: O objetivo deste estudo foi determinar a prevalência das desordens temporomandibulares em pacientes com prótese parcial removível, de acordo com a classificação de Kennedy. MÉTODO: A população estudada consistiu de pacientes que procuraram tratamento na Universidade Estadual de Ponta Grossa. Os pacientes selecionados eram usuários de prótese total superior e prótese parcial removível inferior, e esse uso, à época do estudo, fazia entre 1 e 5 anos. Os pacientes foram divididos em cinco grupos (n = 15): G1: usuários de prótese total superior e prótese parcial removível inferior Classe I (Kennedy); G2: usuários de prótese total superior e prótese parcial removível inferior Classe II (Kennedy); G3: usuários de prótese total superior e prótese parcial removível inferior Classe III (Kennedy); G4: usuários de prótese total superior e prótese parcial removível inferior Classe IV (Kennedy), e G5: pacientes totalmente dentados (grupo controle). O questionário de Fonseca foi aplicado para verificar o grau de DTM. O teste qui-quadrado (α = 0,05) foi usado para avaliar a associação entre as variáveis. RESULTADO: Nenhuma diferença estatística (P > 0,05) foi encontrada entre os grupos. Em todos os grupos, os pacientes apresentaram DTM leve ou moderada. CONCLUSÃO: Os resultados deste estudo clínico mostraram que a presença de DTM em pacientes usuários de prótese não pôde ser correlacionada ao uso de prótese, já que a presença de DTM para pacientes desdentados e dentados apresentou-se semelhante.

Qualidade técnica e satisfação relacionadas às próteses totais

A perda dentária é muito prevalente no Brasil, sobretudo entre idosos, onde mais de 3 milhões precisam de prótese total bimaxilar. Para mudar este quadro, o governo Federal instituiu os Centros de Especialidades Odontológicas (CEO). Assim, este estudo avaliou uma das atribuições desses Centros, a provisão de próteses totais convencionais (PTC) sob a ótica da qualidade e satisfação relacionadas a este produto. Para tanto, fez-se um estudo seccional com 149 indivíduos reabilitados em CEO do Rio Grande do Norte com tais próteses entre 2007 a 2009. Os dados foram obtidos por questionário e exame clínico da PTC quanto a sua retenção, estabilidade, estética e fixação. Das 233 PTC avaliadas; 52,7% das superiores e 9,5% das inferiores foram tecnicamente satisfatórias. Contudo, 69,1% (n = 103) dos entrevistados relataram satisfação com suas próteses. Quanto a associação entre qualidade técnica e satisfação, o teste Qui-quadrado indicou que PTC superiores tecnicamente adequadas (p = 0,041), sobretudo quanto a retenção (p = 0,002) e estabilidade (p = 0,000), estavam associados à satisfação positiva do usuário. Assim, as próteses satisfizeram à população assistida, apesar dos déficits técnicos. No entanto, essa satisfação pode advir da reabilitação em si e não de sua funcionalidade.

Periodontal health and caries prevalence evaluation in patients affected by Parkinson's disease

Parkinson's disease (PD) is a progressive neurodegenerative disorder related to the loss or absence of dopaminergic neurons in the brain. These deficits result in slowness of movement, tremor, rigidity, and dysfunction of behaviour. These symptoms negatively influence the patient's capability to carry out the daily oral hygiene manoeuvres. The aim of this work is to record the oral health condition of PD patients evaluated at the IRCSS Bonino-Puleio in Messina. The oral health of 45 consecutive PD patients (study group) with neurologic diagnosis based on United Kingdom Brain Bank Criteria has been compared with that of another 45 no PD patients of the same age (control group). The evaluation of the general oral condition was recorded underlining tooth loss, active periodontal disease, and presence of untreated caries. The frequency of untreated caries, periodontal diseases, and missing teeth of the study group was significantly higher than in control group. Based on the data results, clinicians should direct high attention to the oral hygiene of patients with PD, above all at the early stages of the caries or periodontal disease, in order to prevent serious evolution of those pathologic dental conditions that may finally result in the tooth extraction event.

Kinesiographic study of mandibular movements during functional adaptation to complete dentures

After complete denture insertion, edentulous patients usually present transitory difficulties. This is one of the most critical stages of prosthetic treatment and it is strongly related to the prostheses acceptance. The aim of this study was to evaluate potential changes in the mandibular movement pattern related to insertion of the complete denture during the functional adaptation period. The kinesiograph instrument K6-I (Myotronics Research Inc., Seattle, WA) was used to evaluate eight edentulous patients that received conventional complete denture treatment. Recordings of opening and closure movement limits, movement velocity, postural rest position, chewing cycle and limits of eccentric movements were performed. Each patient was evaluated in four different stages: with the old dentures, immediately after insertion of the new dentures, and 30 days and 6 months after insertion of the dentures. The results showed that there were no remarkable changes in the mandibular motion patterns after insertion of the new dentures. It was suggested that the problems related to the process of utilization of new dentures are not strictly associated to the mandibular movement. Therefore, functional adaptation after denture insertion is not directly related to functional changes, but to the quality of the dentures and to individual features.

Effects of complete dentures on respiratory performance: spirometric evaluation

OBJECTIVES

There is a lack of data regarding whether edentulous subjects should remove dentures during spirometric measurements or not. The purpose of this study is to determine influences of complete dentures on spirometric parameters in edentulous subjects.

MATERIALS AND METHODS

A total of 46 complete denture wearers were included in this study. Respiratory functions of the subjects were evaluated by spirometric tests that were performed in four different oral conditions: without dentures (WOD), with dentures, lower denture only and upper denture only. Forced vital capacity (FVC), peak expiratory flow, forced expiratory volume in 1 s and forced expiratory flow between 25% and 75% were evaluated. The data were analyzed with Friedman, Wilcoxon and paired-samples t tests (α = 0.05).

RESULTS

Significant differences were found between spirometric parameters in different oral conditions (p < 0.05). In all spirometric parameters, the most important significant differences were found between conditions WOD, FVC and with lower dentures (FVC), and WOD (forced expiratory volume in 1 s) and with upper dentures (forced expiratory volume in 1 s) (p < 0.001).

CONCLUSION

It was observed that complete dentures may unfavourably affect spirometric values of edentulous subjects. However, current findings need to be confirmed with advanced respiratory function tests.

Assessment of dental anxiety and its correlation with denture satisfaction in edentulous patients

OBJECTIVE

The objectives of this study were to measure the level of dental anxiety and its correlation with dental history, denture satisfaction and other variables.

MATERIALS AND METHODS

A cross-sectional study was conducted on 150 completely edentulous patients reporting to the Department of Prosthodontics, KLES's Institute of Dental Sciences, Belgaum, over a period of 17 months (August 2005 to March 2007). The anxiety level of the patients was assessed with the help of a questionnaire, after obtaining an informed consent. Reliability of the dental anxiety scale was assessed by means of coefficient alpha.

RESULTS

The results of this study concluded that dental anxiety scale for edentulous patients was a reliable scale for measuring dental anxiety. The anxiety score was higher for female than male patients. A significant correlation was found between denture satisfaction score and anxiety.

DISCUSSION

Anxiety plays a major role in denture satisfaction. The variables included: Previous denture experience, occupation, medical history, age, gender, dental anxiety scale, period of edentulousness, age of previous dentures, number of complete dentures, denture satisfaction score, and the score on the Hamilton anxiety scale.

CONCLUSION

The study indicated that gender correlates significantly with dental anxiety. Patients with medical history were found to be more anxious than normal patients. Patients with higher anxiety values were less satisfied with the treatment. Lastly, subjects with higher general anxiety showed greater values on the dental anxiety scale.

CLINICAL SIGNIFICANCE

The assessment of dental anxiety will help the prosthodontist in the management of anxious patients and secondly to provide evidence-based research into this psychological construct which has been shown to predict dental avoidance.

Distribution Patterns of E-Cadherin, Type VII Collagen and Fibronectin in Denture-Related Stomatitis: A Preliminary Study

The distribution of epithelial E-cadherin, basement membrane type VII collagen, and underlying connective tissues fibronectin were investigated immunohistochemically and compared in normal palatal mucosa and in denture-related stomatitis (DRS) derivatives using monoclonal antibodies.Biopsies of palatal mucosa were obtained from twelve patients enrolled in this study, 8 with type II DRS and 4 with healthy mucosa.Our findings bring to the fore, using the expression of three components (E-cadherin, collagen type VII, fibronectin), the continuities of the disorder among epithelial, basement membrane and connective tissue in the case of DRS. In type II denture-related stomatitis, we found an expression of E-cadherinin all the strata of epithelia, and the diffuse and strong expression of type VII collagen at the interface between connective tissue and epithelial cells with discontinuities in BM. The strong expression of fibronectin in underlying connective tissue with penetration in some areas of the palatal mucosa may be an early consequence of advanced DRS. Nevertheless; no single change is pathognomonic of this inflammatory process.In normal tissues (healthy clinical aspect), E-cadherin was found to be restricted to the upper strata of the epithelia, and type VII collagen revealed thin linear staining in the basement membrane and fibronectin in underlying connective tissue combined epithelia.In the case of denture-related stomatitis DRS, these three markers reflect the immunohistological modifications from the superficial layer of the epithelium to the lamina propria.

Frequency of Traumatic Ulcerations and Post-insertion Adjustment Recall Visits in Complete Denture Patients in an Iranian Faculty of Dentistry

Background and aims

The first few days following the insertion of complete dentures are critical for the patients since they are struggling to adapt to their new dentures. This study aimed to evaluate the most common locations of traumatic ulcerations, their frequency and also the duration and number of adjustment visits required to achieve patient comfort fol-lowing placement of complete dentures.

Materials and methods

Sixty patients were selected from edentulous patients referring to a removable prosthodontics department. Complete dentures were fabricated for the patients. After placement of dentures, all the patients were evaluated from the day after placement until patient comfort was achieved. Descriptive analysis was performed and chi-squared test was used to evaluate the associations between lesions, post-insertion visits and gender.

Results

A total of 85.8% of patients required denture adjustment because of mucosal injuries during their first visit fol-lowing denture placement. Maxillary and mandibular dentures did not require further adjustments after fourth and sixth visits, respectively. No significant differences were detected between males and females in the number of mucosal injuries in the anatomical areas evaluated in the maxilla and mandible using Fisher's exact test (P > 0.05). Furthermore, the number of mandibular dentures requiring adjustments was significantly higher than maxillary dentures in all the post-insertion ap-pointments (P < 0.001).

Conclusion

Since most mucosal injuries are located in the vestibule, adequate extension of denture flanges, especially during border molding, and use of pressure indicators that reveal over-extended borders, play an important role in decreas-ing mucosal injuries and improving patient comfort following complete denture placement.

Relationship between impacts of complete denture treatment on daily living, satisfaction and personality profiles

OBJECTIVES

To investigate the association between satisfaction with conventional complete denture prostheses (CDs), impacts of CDs on daily living and personality profiles.

MATERIALS AND METHODS

Fifty-six patients (28 males and 28 females; mean age 53.79 ± 7.762 years) with fitted upper and lower removable CDs were recruited for this study. Clinical success of CDs was assessed according to specific clinical criteria. The dental impact on daily living questionnaire (DIDL) was used to measure satisfaction with CDs and their impacts on daily living. NEO five factor inventory (NEO - FFI) was used to measure patients' personality profiles. Pearson correlation test and regression models were used to analyze the collected data.

RESULTS

Females were more satisfied with appearance and less satisfied with eating and scored higher on neuroticism, and lower on extraversion and openness personality domains (p < 0.05). Older patients were more satisfied with appearance and less satisfied with oral comfort and general performance (p < 0.05). Neuroticism, extraversion, openness and agreeableness personality profiles could predict and had significant relationship with CDs impacts on daily living and satisfaction with CDs.

CONCLUSION

Psychological profiles (e.g. neuroticism, extraversion, openness and agreeableness) might play a role and explain CDs impacts on daily living and patients' satisfaction with their oral status and CD treatment, therefore, might be used to predict satisfactory outcomes of CD treatment. In this regard, technical aspects of CDs are less essential when the prosthesis is clinically successful.

CLINICAL SIGNIFICANCE

Psychological factors may play a role and also provide valuable information for the prediction of satisfactory outcomes of complete denture treatment.