Oral Health-Related Quality of Life, Dry Mouth Sensation, and Level of Anxiety in Elderly Patients Rehabilitated with New Removable Dentures

Influence of new complete dentures on the touch perception threshold and quality of life of edentulous patients

OBJECTIVE

To evaluate the touch perception threshold of the alveolar mucosa and quality of life of edentulous patients before (T0) and 30 days after (T1) the insertion of new complete dentures.

BACKGROUND

Touch perception is important so that edentulous patients can detect the position of complete dentures in their mouth.

MATERIALS AND METHODS

This study included 32 complete denture wearers with good oral and systemic health and no temporomandibular disorders for at least 5 years. At each time point (T0 and T1), two tests were performed (touch perception threshold and quality-of-life scale). The touch perception threshold (Von Frey or Semmes-Weinstein test) was assessed using nylon monofilaments on the regions of the alveolar mucosa of the maxilla and mandible. The Oral Health Impact Profile for edentulous individuals (OHIP-EDENT) was administered to evaluate oral health-related quality of life.

RESULTS

In the maxilla and mandible, the touch perception thresholds for all regions of the alveolar mucosa were significantly lower at T1 than at T0. The OHIP-EDENT mean scores showed that the overall quality of life was significantly better at T1 (3.6) than at T0 (4.7), and a significant improvement in quality of life was observed in all domains of the OHIP-EDENT at T1. For touch perception threshold, effect sizes ranged from 0.4 to 0.8; and for quality of life, effect sizes ranged from 0.4 to 1.0.

CONCLUSIONS

New complete dentures reduced the touch perception threshold of the alveolar mucosa of both edentulous arches and improved individuals' quality of life.

Correlation between Periotest value and implant stability quotient: a systematic review

OBJECTIVES

To determine, through clinical studies, whether there is a correlation between the Periotest value (PTV) and the implant stability quotient (ISQ).

CONTENT

Methods to evaluate the stability of dental implants.

SUMMARY

A search was performed in the PubMed, Scopus, and Web of Science databases for articles on the proposed subject up to January 29, 2023, using search terms that combined "resonance frequency analysis" and "Periotest" with "correlation" or "relationship"; and combinations of "implant stability quotient" and "Periotest" with "correlation" or "relationship." The inclusion criteria were clinical studies in English involving human subjects who received dental implants and evaluating the correlation between PTV and ISQ. A total of 46 articles were screened, of which 10 were selected for full-text analysis, and eight articles were included in this review. Based on three articles, 75 % of the results of this systematic review showed a negative correlation between PTV and ISQ, regardless of the type of stability assessed. Based on the remaining five articles, 100 % (regardless of the patient's gender) and 66.66 % of the results showed a negative correlation for primary and secondary stability, respectively. There is a negative correlation between PTV and ISQ for both primary and secondary dental implant stability.

OUTLOOK

This review can serve as a reference for the development of methodologies for future clinical studies on this topic.

Anticholinergic Burden and Xerostomia in Critical Care Settings

BACKGROUND

Although previous studies have established the association of medications with anticholinergic adverse effects and xerostomia, anticholinergic burden and xerostomia in critical care settings are poorly characterized. The objective of this study was to determine the impact of medication burdens associated with anticholinergic adverse effects, particularly the occurrence of xerostomia (dry mouth) in a critical care setting. In addition, this study explored the correlation between the timing of the first instance of xerostomia and the administration timing of medication known to have anticholinergic adverse effects.

METHODS

A retrospective case-control study was used with the MIMIC (Medical Information Mart for Intensive Care) III database. The MIMIC-III clinical database is a publicly available, deidentified, health-related database with more than 40 000 patients in critical care units from 2001 to 2012. Cases of xerostomia (n = 1344) were selected from clinical notes reporting "dry mouth," "xerostomia," or evidence of pharmacological treatment for xerostomia; control (n = 4032) was selected using the propensity analysis with 1:3 matching on covariates (eg, age, sex, race, ethnicity, and length of stay). The anticholinergic burden was quantified as the cumulative effect of anticholinergic activities using the Anticholinergic Burden Scale.

RESULTS

Anticholinergic burden significantly differed between xerostomia patients and control subjects (P = .04). The length of stay was a statistically significant factor in xerostomia. The probability of developing the symptom of xerostomia within 24 hours was .95 (95%) for patients of xerostomia.

CONCLUSIONS

Anticholinergic Burden Scale is associated with xerostomia in the critical care setting, particularly within 24 hours after admission. It is crucial to carefully evaluate alternative options for medications that may have potential anticholinergic adverse effects. This evaluation should include assessing the balance between the benefits and harms, considering the probability of withdrawal reactions, and prioritizing deprescribing whenever feasible within the initial 24-hour period.

Halitosis and Pain Threshold of Peri-Implant Tissues: An Observational Cohort Study

In this study, we aimed to evaluate the halitosis and pain threshold of the peri-implant soft tissues in individuals rehabilitated with implant-supported prostheses. Forty-eight subjects were divided into four groups (n = 12) according to their prosthetic rehabilitation: single-tooth fixed prosthesis, multi-tooth fixed prosthesis, overdentures, and the Brånemark protocol. Halitosis was measured using a halimeter, whereas the pain threshold was measured using Von Frey monofilaments. Measurements were taken before (t0) and 30 days after (t1) placement of healing caps, and at the time of (t2) and 30 days after (t3) prosthetic placement. Halitosis data were analyzed using the chi-square test and Bonferroni correction (p < 0.05). Two-way ANOVA and Tukey's test (p < 0.05) were used to analyze pain threshold data. We noted an association between halitosis and time for the Brånemark protocol [X2(6) = 18.471; p = 0.005] and overdenture groups [X2(6) = 17.732; p = 0.007], and between halitosis and type of prosthesis only at t0 [X2(6) = 12.894; p = 0.045]. The interaction between time and the type of prosthesis significantly interfered with the mean pain threshold values (p = 0.001). At most time points, the majority of participants in each group had clinically unacceptable halitosis. After 30 days of using the prostheses, the overdenture group had a lower pain threshold compared to the Brånemark protocol group.

Postinsertion adjustment appointments and their association with cast removable partial denture survival

STATEMENT OF PROBLEM

Successful outcomes with cast removable partial dentures (RPDs) are dependent on adequate fabrication and adjustments at the delivery appointment. Evaluation of the number and frequency of postinsertion follow-up appointments helps determine whether the prosthesis continues to fit comfortably and whether function and esthetics continue to be satisfactory. Reports on the number of appointments and frequency and type of adjustments required for RPDs following insertion are sparse.

PURPOSE

The purpose of this university-based population study was to determine the number of appointments and type of adjustments following RPD insertion and their association with patient demographics, type of RPD, and denture survival.

MATERIAL AND METHODS

This retrospective clinical study examined the records of 257 patients at the University of Toronto, Faculty Dentistry, wearing 308 RPDs inserted between 2013 and 2014 with a 5-year follow-up. The outcome measures investigated included postinsertion appointments, type of adjustments, and denture survival.

RESULTS

A total of 48.1% of the dentures (19.5% tissue supported; and 28.6% tooth supported) were maxillary, and 51.9% (34.7% tissue supported; and 17.2% tooth supported) mandibular. Most patients (68.9%) had 1 to 3 postinsertion appointments, with 78.6% having no major adjustments. Twenty-six dentures failed (failure rate 8.4%), with the failure-free time estimated at 4.58 years (95% confidence interval (CI) 4.42-4.73 years, Kaplan-Meier survival analysis). Failed dentures were significantly associated with more minor adjustments (Mean (M)=4.12, SD=3.90, Kruskal-Wallis (K-W) P=.027; OR=1.18; 95% CI 1.05-1.32, P=.006). More minor adjustments were needed for mandibular dentures (multivariable Poisson regression (MPR) P=.003) compared with maxillary dentures. More major adjustments were needed for maxillary dentures (MPR P=.030) compared with mandibular dentures. More minor and major adjustments were needed for dentures that were remade from within 5 years to beyond 10 years compared with first time denture wearers (MPR P<.001). Patients with musculoskeletal disorders required a significantly higher number of minor adjustments (M=3.67, MPR P<.001) and appointments (M=3.87, MPR P<.001) than those without these disorders.

CONCLUSIONS

The 5-year survival of RPDs following insertion was estimated at 91.6%. Most patients required 1 to 3 appointments after insertion. Mandibular RPDs required significantly more minor adjustments, and maxillary RPDs more major adjustments. More minor and major adjustments were needed for dentures that were remade at any time previously compared with first time denture wearers.

Fit Accuracy of Complete Denture Base Fabricated by CAD/CAM Milling and 3D-Printing Methods

OBJECTIVE

 Digital complete denture fabrication can be accomplished by either milling or three-dimensional (3D)-printing approach in which minimal distortion during processing contributes to effective denture base adaption, which leads to good denture retention. The purpose of this study was to compare the fit accuracy of milled and 3D-printed complete denture bases.

MATERIALS AND METHODS

 The reference edentulous maxillary arch model was scanned to generate virtual denture bases using computer-aided manufacturing software that exports as standard tessellation language files. Denture bases were constructed using a milling and 3D-printing technique using digital light processing method (n = 10). Intaglio surfaces of denture bases were scanned and superimposed on the reference model. The fit accuracy was quantified as root mean square error and evaluated statistically using independent t-test comparisons with a significance level of 0.05.

RESULTS

 Milled denture bases were significantly more accurate in adaptation than 3D-printed dentures in the overall intaglio area and primary bearing area of denture bases. 3D-printed denture bases demonstrated significantly greater accuracy in adaptation than milled denture bases in the peripheral/posterior palatal seal area.

CONCLUSION

 Milled denture bases fit better in the overall and primary stress-bearing areas than 3D-printed dentures, while 3D-printed dentures appeared more accurate in the peripheral seal area, which had a minor undercut that is not suitable for using milling technology.

Increased Oral Dryness and Negative Oral Health-Related Quality of Life in Older People with Overweight or Obesity

This cross-sectional study was to evaluate the association between the oral health-related quality of life (OHRQoL) of older Thai people with obesity and oral health indicators. General and oral conditions were assessed. Oral dryness was determined using the Xerostomia Inventory-11 (XI-11) and clinical oral dryness score (CODS). OHRQoL was evaluated by the oral health impact profile (OHIP-14). Participants were aged 60-86 years; 73 (59.3%) were overweight or obese, and 50 (40.7%) were normal weight. Older patients with obesity had almost four times the rate of hypertension (OR = 3.59; 95%CI:1.34-9.60; p = 0.002), more missing teeth (p = 0.025), and higher CODS (p = 0.014) than those without obesity. The total XI-11 scores were positively associated with the total CODS, after adjusting for BMI (r = 0.267, p = 0.003). Those with obesity had almost three times the tendency for a negative OHRQoL compared with the non-obese (OR = 2.73; 95%CI:1.12-6.71; p = 0.04). After adjusting for all related factors, the chances of predicting an OHIP-14 score of four based on obesity and total XI-11 score were 4.42 (95%CI:1.57-12.47; p = 0.005) and 1.11 (95%CI:1.02-1.20; p = 0.013), respectively. Obesity had an increasingly undesirable negative impact on the OHRQoL of older Thai people and was influenced by BMI and oral dryness.

The effect of denture-wearing on physical activity is associated with cognitive impairment in the elderly: A cross-sectional study based on the CHARLS database

BACKGROUND

Currently, only a few studies have examined the link between dental health, cognitive impairment, and physical activity. The current study examined the relationship between denture use and physical activity in elderly patients with different cognitive abilities.

METHODS

The study data was sourced from the 2018 China Health and Retirement Longitudinal Study (CHARLS) database, which included information on denture use and amount of daily physical activity undertaken by older persons. Physical activity was categorized into three levels using the International Physical Activity General Questionnaire and the International Physical Activity Scale (IPAQ) rubric. The relationship between denture use and physical activity in middle-aged and older persons with varying degrees of cognitive functioning was studied using logistic regression models.

RESULTS

A total of 5,892 older people with varying cognitive abilities were included. Denture use was linked to physical activity in the cognitively healthy 60 + age group (p = 0.004). Denture use was positively related with moderate physical activity in the population (odds ratio, OR: 1.336, 95% confidence interval: 1.173-1.520, p < 0.001), according to a multivariate logistic regression analysis, a finding that was supported by the calibration curve. Furthermore, the moderate physical activity group was more likely to wear dentures than the mild physical activity group among age-adjusted cognitively unimpaired middle-aged and older persons (OR: 1.213, 95% CI: 1.053-1.397, p < 0.01). In a fully adjusted logistic regression model, moderate physical activity population had increased ORs of 1.163 (95% CI: 1.008-1.341, p < 0.05) of dentures and vigorous physical activity population had not increased ORs of 1.016 (95% CI: 0.853-1.210, p > 0.05), compared with mild physical activity population.

CONCLUSION

This findings revealed that wearing dentures affects physical activity differently in older persons with different cognitive conditions. In cognitively unimpaired older adults, wearing dentures was associated with an active and appropriate physical activity status.