Denture satisfaction and clinical performance in a paediatric population

Satisfaction with resilient denture liner versus acrylic resin telescopic prostheses for patients with ectodermal dysplasia: A nonrandomized crossover clinical trial

STATEMENT OF PROBLEM

Patients with ectodermal dysplasia are characterized by anodontia or oligodontia. How their challenging prosthodontic rehabilitation might be optimized is unclear.

PURPOSE

The purpose of this crossover study was to evaluate the effect of resilient denture liner versus acrylic resin copings in complete overdentures for patients with ectodermal dysplasia. Outcome measures included patient satisfaction, retention, and periodontal health of the abutment tooth.

MATERIAL AND METHODS

Ten partially edentulous participants diagnosed with ectodermal dysplasia were recruited from the Faculty of Dentistry, Cairo University, Egypt, and enrolled in this crossover clinical trial. All participants received acrylic resin coping-retained maxillary complete overdentures (group N, stage 1). The acrylic resin copings were then replaced by a resilient denture liner (group S, stage 2). Patient satisfaction, retention, and periodontal health parameters were evaluated 1 week and 3 months after the completion of each stage. Patient satisfaction was assessed with a validated, reliable questionnaire. The results of the periodontal probing depths were tested with repeated measures ANOVA followed by the Bonferroni correction for pairwise comparisons. Tooth mobility, patient satisfaction, retention, and gingival index were tested by using the Wilcoxon signed ranked test. Ordinal data as the sixth and seventh domains of patient satisfaction were tested by using the McNemar test for paired comparisons (α=.05).

RESULTS

Three months after overdenture delivery, a statistically significant difference was found between the groups regarding retention (P=.025), probing depth (P<.001), and gingival index (P=.011) favoring the acrylic resin coping-retained overdentures. Results of tooth mobility (P=.035), overall attitude (P=.041), ease of eating (P=.023), denture comfort (P=.024), and degree of teasing (P=.038) on wearing the denture showed a statistically significant difference between the groups, favoring the resilient denture liner.

CONCLUSIONS

In children with oligodontia and ectodermal dysplasia, the resilient denture liner-retained maxillary complete overdenture enhanced patient satisfaction and tooth mobility of anterior teeth, while minimally jeopardizing the periodontal condition of the abutment teeth.

Survival of intentionally retained permanent incisor roots following crown root fractures in children

Retaining tooth roots, following crown loss, confers a number of benefits including the preservation of alveolar bone. Intentional root retention in adults has been widely investigated but little is known about this treatment approach in children. Therefore, the aim of the present study was to investigate the clinical outcomes associated with permanent anterior root retention in a young population. The study group comprised 53 children who had received treatment in the paediatric dentistry clinic, Charles Clifford Dental Hospital, Sheffield, UK, over the past 10 years, following a complicated crown root fracture of a permanent maxillary incisor at or below the gingival margin. Data relating to patient age at crown root fracture, gender, previous trauma history, tooth vitality, treatments performed and clinical outcomes were obtained retrospectively using patient records. The mean age of the subjects at initial crown root fracture was 12.1 years (range 8.3-15.8 years) and there were more than twice as many males (n = 37, 70%) as females (n = 16, 30%). In just over half of the cases seen (n = 29, 54%), the tooth involved was already nonvital at the time of crown root fracture. For the majority of these nonvital teeth (n = 27, 93%), primary treatment had comprised placement/replacement of a calcium hydroxide root dressing. The remaining two teeth did not require root treatment as a satisfactory gutta percha root filling was already present. A variety of treatments was undertaken for the 24 vital roots: in 15 (63%) cases the pulp was extirpated and calcium hydroxide placed; three (12%) cases were subject to a pulpotomy; five (21%) cases were left untreated with the hope that vitality would be maintained following gingival healing and in one case the radicular pulp was extirpated and immediately obturated with gutta percha. The mean time that the roots were kept under review was 2.6 years (+/- 1.57, range 0.6-6.8). During this period, only five roots (9%) had to be removed due to persistent periapical infection. There were no complications associated with the five cases where vital root submergence had been permitted but all three cases which had initially undergone a pulpotomy subsequently presented with pulpal necrosis necessitating pulpal extirpation and calcium hydroxide therapy. These findings indicate that efforts to retain permanent anterior roots in a young population are justified in view of the high clinical success rate of over 90% over a 2-year period.