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

The knowledge regarding the impacts and management of black triangles among dental professionals and laypeople

This study aimed to assess the knowledge regarding impacts, causes and management of black triangles (BT) among participants from different educational backgrounds including dental students, dentists and laypeople. This descriptive cross-sectional observational research included 435 participants who comprised 4 groups: pre-clinical (3rd year) dental students, clinical (4th and 5th year) dental students, dentists, and laypeople. A constructed self-reported questionnaire was utilized to assess participants' demographic data and their knowledge of the impacts, causes and management of BT. The VAS scale was used to assess participants' ratings for the impacts of BT on esthetics, with 0 meaning no impact and 10 meaning very severe negative impacts. The most reported treatments for BT were "cannot be treated" 99.3% and "non-surgical periodontal treatment" 67.1%. Meanwhile, the least reported was "modify the porcelain" 41.8%. The most reported cause of BT was "periodontal disease" 85.1%. However, the least reported were "parafunction" and "deep implants" 33.1% each. Dental professionals had better knowledge of the causes (t = 8.189, P < 0.001) and management (t = 8.289, P < 0.001) of BT than the non-dental participants. The dentists had the best knowledge, while the laypeople had the least knowledge of the causes (F = 62.056, P < 0.001) and treatment (F = 46.120, P < 0.001) of BT. The knowledge of the causes (t = 0.616, P = 0.538) and treatment (t = 1.113, P = 0.266) for BT was not significantly different between males and females. Age was not significantly related to the total knowledge about the causes (r = -0.034, P = 0.475) or treatment (r = -0.034, P = 0.482) for BT. Dental professionals had better knowledge of the impacts, causes and management of BT than the non-dental participants. The dentists were the best, while the laypeople were the worst in this regard. Age and gender had no relationships with the knowledge of causes or management of BT.

Relationships between perception of black triangles appearance, personality factors and level of education

This analytical cross-sectional study evaluated the perception of black triangles (BT) and examined the relationships between the perception of BT, personality factors, different educational backgrounds and demographic factors. 435 participants were included and divided into four groups: dentists, clinical (4th and 5th year) dental students, pre-clinical (3rd year) dental students, and laypeople. Participants' perception of the attractiveness of smile profiles of maxillary and mandibular anterior dentition with BT was rated using a ten-point VAS scale with 0 being the least, and 10 being the most attractive smile profile. The personality was assessed using the NEO-FFI personality questionnaire. The smile profile with multiple large BT was rated the least attractive for the maxillary (mean = 3.6) and mandibular (mean = 3.9) tested profiles. The smile profile without BT was rated the most attractive for the maxillary (mean = 9.1) and mandibular (mean = 8.8) tested profiles. The dental professionals perceived the maxillary smile profile with multiple large BT as less attractive than the non-dental participants (t = - 2.715, P = 0.007). Being a male, having dental education, having lower Neuroticism scores, as well as having higher Openness, Agreeableness, Conscientiousness, and Extraversion scores predicted and contributed more towards perceiving various tested smile profiles as more attractive. These findings show that black triangles negatively impacts the perception of smile attractiveness, and that personality traits and having dental education impact the perception of smile attractiveness for smiles with black triangles.

Assessment of Clinical and Patient-Centered Outcomes in Nonsurgical Periodontal Therapy

Aim  The study was conducted to assess the clinical and patient-centered outcomes among the patients who had undergone nonsurgical periodontal therapy (NSPT). Methodology The participants for this study were 40 individuals with generalized chronic periodontitis. Numerous clinical parameters including clinical attachment level (CAL), probing pocket depth (PPD), plaque index (PI), and gingival index (GI) were evaluated along with the administration of a customized questionnaire before and after three months of therapy to evaluate patient-centered outcomes. Results Clinical parameters showed significant (p < 0.05) improvement post-NSPT. There was 100% satisfaction in few patient-centered outcomes such as bleeding gums, bad breath, food entrapment, and mobility. Conclusion A significant improvement in the clinical parameters does not guarantee improvement in patient-centered outcomes. Achieving the improvement in patient-centered outcomes can improve the overall quality of life (QOL), marking this a holistic treatment.

Functional performance and impact on the quality of life of three treatment strategies for mandibular edentulism: Results of a parallel 3-group cross-sectional study

OBJECTIVES

This parallel cross-sectional study compared masticatory function and patient-centered outcomes among 3 removable treatment strategies for mandibular edentulism.

METHODS

Thirty-six edentulous participants rehabilitated using 3 removable treatment strategies for mandibular edentulism were allocated to one of the three groups (n=12): CCD (control), 2-IMO, and 3-IMO. Narrow diameter implants were installed using single-stage surgery and conventionally loaded with stud abutments. After 3 months of usage, the quality of life, maximum bite force, and masticatory function were evaluated. Data were analyzed with the Kruskal-Wallis test and post hoc pairwise Mann-Whitney tests with Bonferroni correction (α=0.05).

RESULTS

The 2-IMO and 3-IMO wearers did not show significant differences in any outcome, except for the 2 domains of 3-IMO wearers quality of life that obtained better Pain and General Performance scores. Both IMO groups presented significantly higher maximum bite force than CCD wearers. The 2-IMO wearers showed superior outcomes to the CCD group in all outcomes of the masticatory performance test and the X50, B and ME5.6 outcomes of the swallowing threshold test (p = 0.01), while 3-IMO participants only showed superior masticatory performance in terms of lower X50 values (19.86%, p = 0.02) and higher ME 2.8 (141.15%, p = 0.04) than CCD wearers.

CONCLUSIONS

Compared to 2-IMO wearers, 3-IMO wearers report superior impact of treatment on daily living activities in the Pain and General Performance domains. 2-IMO and 3-IMO wearers showed no significant differences between them for all evaluated bite force and masticatory function parameters.

CLINICAL SIGNIFICANCE

Although overdentures retained by 3 implants (3-IMO) provide biomechanical advantages over those retained by 2 implants (2-IMO), superior clinical and functional effectiveness is not yet proven.

The Attitude and Perception of Dental and Medical Interns Toward Dental Smile Enhancing Treatments

Background:

Perception of beauty is different from one individual to another, and this may influence their desire for aesthetic treatment. There are many studies that compared dentists to the general population’s perception of smile treatments. However, only a few studies were carried out to compare the perception of fresh graduate dentists with a comparable group of another medical medical background.

Objective:

This study aimed to compare how medical and dental interns perceive dental smiles and how much they ask for dental enhancement treatments.

Methods:

A cross-sectional study targeting dental and medical interns in the kingdom of Saudi Arabia using an online survey. An online questionnaire was formulated and distributed through social media. Comparisons between groups were made using the Chi-square test with a p-value of significance kept under 0.05.

Results:

204 participants responded to the survey, 107 dental and 97 medical interns (52.5%, 47.5%), respectively. When the participants were asked to rate their satisfaction with their smiles, almost 60% of the dental interns rated their smiles 8/10 or more on a scale of (1-10). When they were asked about the cause of the dissatisfaction, their responses were varying. About 84% of dental interns reported having complications of varying sources because of the smile-enhancing treatment, compared to only 50% of the medical interns.

Conclusion:

Dental and medical interns interacted in the same manner toward smile-enhancing treatments. Dental interns seem to show more satisfaction with their smiles. They also showed more ability to spot and identify the harmful effects of those procedures.

Incidence and risk factors for non-adaptation of new mandibular complete dentures: a clinical trial

OBJECTIVE

To investigate the incidence and risk factors for non-adaptation of the conventional mandibular complete denture (CMCD).

MATERIALS AND METHODS

A total of 108 edentulous patients were rehabilitated with complete dentures (CDs) and followed up at 3- and 6-month intervals. Adaptation was confirmed based on chewing, phonetics, and comfortable swallowing with the CDs. The risk factors among sociodemographic and patient-centered factors were analyzed. Statistical analyses included the chi-square test and then a multivariate analysis.

RESULTS

After 3 months, 38.0% of patients showed non-adaptation to CMCDs. Non-adaptation was significantly associated with the absence of previous mandibular denture experience (p = 0.042), ulcerations after 15 days of rehabilitation (p < 0.001), and a reduced posterior mandibular ridge (p = 0.035). After 6 months, this incidence decreased to 14.1%. The factors associated with non-adaptation were ulcerative lesions after 15 (p < 0.001) and 30 (p < 0.001) days of the delivery of CDs and the non-regular use of mandibular CDs (p < 0.001).

CONCLUSION

The incidence of non-adaptation was higher after 3 months, with reduction after 6 months. Sociodemographic variables did not influence the adaptation. After 3 months, the absence of previous experience, traumatic ulcers, and reduced mandibular ridges hindered the adaptation of patients to mandibular CDs. After 6 months, only the occurrence of ulcerative lesions and non-regular wear of dentures were risk factors for non-adaptation.

CLINICAL RELEVANCE

A considerable number of patients have difficulties in adapting to the mandibular dentures. Identifying the factors of non-adaptation of the dentures will contribute to increasing the predictability of this critical adaptation period.

Self-Perception of Dental Esthetics among Dental Students at King Saud University and Their Desired Treatment

Objective

Dental esthetic procedures are popular worldwide, and dentists are responsible for recommending several treatment options to their patients. To do this competently, dentists must have an educated opinion of their features. Therefore, we aimed to evaluate the self-perception of dental esthetics among male and female dental students and assess its effect on their desired treatment. Methodology. We conducted a questionnaire-based cross-sectional study involving 450 male and female dental students from five academic years with different grade point averages (GPAs) and monthly household incomes. The questionnaire comprised four sections. The subjects selected their teeth-color preferences using a commercial shade guide. The outcomes were presented using descriptive statistics and were compared with Pearson's chi-square test. The level of statistical significance was set at a p-value of 0.05.

Results

Female students (52%) showed a significantly higher preference for changing their tooth color (shade B1 was desired most often), whereas male students reported a higher need for orthodontic treatment and ceramic veneers (p < 0.0001 and p=0.002). Fifth-year students were more satisfied with their teeth color as compared with 1st-year students (p=0.047). High-GPA students showed significantly lower confidence regarding their smiles (p=0.030). A high percentage of students (39.1%) with household incomes of less than 10,000 SR preferred tooth-colored restorations.

Conclusion

We concluded that the majority of dental students were confident about their smiles. Senior students were more satisfied with their teeth color, while younger students desired whiter teeth. Bleaching and orthodontics were the most desired treatment options.

Body image perception and its psychological influence on prosthesis satisfaction

AIM

To identify the body image perception of an individual utilising figure rating scale and assess its psychological influence in altering the prosthetic satisfaction.

METHODS

One hundred five of 140 participants were categorised into Groups I, II and III according to their body image satisfaction. Pre- and posttreatment denture satisfaction questionnaires, and pretreatment Big Five personality, Life Satisfaction questionnaires were given to the participants in each group. Analysis of variance (ANOVA) and Tukey post hoc tests assessed the significant relation between the groups.

RESULTS

Body image satisfied group (I) was highly contented with the prosthetic treatment (46.90), while body image dissatisfied groups (II and III) had lower denture satisfaction scores (36.80 and 29.70). Neurotic score was significantly different in pairs; Groups I and III, and Groups II and III (P < .001), with high mean for Group III (75.30). The agreeable score was significantly different in Groups I and II (P < .05), with a high mean for Group I (83.60). Life Satisfaction score was significantly different in pairs; Groups I and III, and Groups I and II (P < .001), with a high mean for Group I (30.60).

CONCLUSION

The individual's perception of body image had an effect on their denture satisfaction level, and figure rating scale would help in identifying the psychological profile of the patient.

Comparison of stress induced in mandible around an implant-supported overdenture with locator attachment and telescopic crowns - a finite element analysis

Introduction

One of the principle factors for the success of implant supported/retained overdentures (IOs) is the manner in which the stresses are transferred to the surrounding bone. Hence, the aim of the present study is to compare the stress induced in the mandible around IOs, using two different attachment systems, locator and telescopic.

Methods

3D finite element models were prepared using Pro/ENGINEER or PTC Creo to simulate 4 clinical situations: IOs using two different attachment systems, locator and telescopic, with and without splinting. A vertical compressive load of 35N was directed toward the central fossa in the molar region of each overdenture. Non-linear static contact analysis was carried out to determine the stress distribution in various components of IOs. Then, the models were analyzed by a finite element program ABAQUS, and displayed using Von Mises stress patterns.

Results

The contact stress values developed on the implant and attachment components were lower with locator attachment, in both splinted and non-splinted models. On the other hand, the stress distribution to the cortical bone was more with non-splinted/splinted locator attachments (3.73/4.12 Mega Pascals) when compared to the non-splinted/splinted telescopic attachments (2.66/3.7 Mega Pascals). The stresses in all the components of overdenture were greater with the splinted model compared to non-splinted, in both the attachment systems.

Conclusion

The locator attachment might demonstrate superior clinical performance, as the stresses on implant and attachment components were less compared to telescopic. Non-splinted model showed better results in both the attachment types.

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.

Management of denture-related traumatic ulcers using ozone

STATEMENT OF PROBLEM

Management of denture-related traumatic ulcers using ozone may improve tissue healing and reduce patient pain and discomfort.

PURPOSE

The purpose of this clinical investigation was to assess the efficacy of ozone in the treatment of denture-related traumatic ulcers.

MATERIAL AND METHODS

Seventy-five participants (study group) with denture-related traumatic ulcers were evaluated in this blinded, controlled cohort observational investigation. A control group (n=75) of participants with denture-related traumatic ulcers who matched the study group in sex and age were also recruited. Ulcers were treated with ozone gas for 60 seconds in the study group and with air for 60 seconds in the control group. Pain levels were evaluated by means of a visual analog scale (VAS), and ulcer sizes were measured in each participant at experiment baseline and each day for 15 days. Ulcer duration was established by calculating the period it took to completely heal and disappear. Major outcome measurements were ulcer duration, ulcer size, and levels of pain.

RESULTS

Ulcer size decreased from day 2 in the study group (after ozone application) (P≤.01) and from day 4 in the controls (P≤.001). Recorded pain levels decreased from the first day soon after ozone application in the study group (P≤.001) and from day 3 in the controls (P<.001). Ulcer duration, ulcer size from day 3 to day 10, and reported pain levels from day 1 to day 10 decreased more in the study group (P≤.004).

CONCLUSIONS

Exposure of denture-related traumatic ulcers to 60 seconds of ozone gas was associated with better ulcer healing and decreased pain levels, ulcer size, and ulcer duration.

How fast can treatment with overdentures improve the masticatory function and OHRQoL of atrophic edentulous patients? A 1-year longitudinal clinical study

OBJECTIVES

The aim of this prospective clinical study was to evaluate the masticatory function (MF) and subjective perception of patients with poor denture-bearing tissue in relation to change and the time required to identify an improvement in these parameters after rehabilitation with mandibular overdentures (MO) by two narrow-diameter two-piece implants.

MATERIAL AND METHODS

Twenty-three edentulous patients were selected for MO installation. The masticatory function (MF) was evaluated with the masticatory performance (MP) and swallowing threshold (ST) tests. In the MP test, each volunteer was instructed to masticate a portion of Optocal (standardized artificial test food) for 40 masticatory cycles. During the swallowing threshold test, the patients were instructed to chew a new portion of Optocal cubes until they felt the desire to swallow. The MF tests were performed while complete denture (CD) wearers (baseline) and 1, 3, 6, and 12 months after MO loading. In addition, the subjective perception was assessed through the questionnaires Dental Impact on Daily Living (DIDL), Geriatric Oral Health Assessment Index (GOHAI), and Oral Health Impact Profile in Edentulous (OHIP- EDENT) at the baseline and 3, 6, and 12 months after MO loading.

RESULTS

A significant improvement in masticatory function (p < .05) was observed already in the first month of loading. Three months after MO loading, a significant improvement (p < .05) was found in the subjective perception of patients. The effect size indicates that the MO had the greatest impact on the domains related to function and comfort of all questionnaires and in relation to psychosocial domain of the GOHAI. The level of patient satisfaction increased significantly after the MO loading and reached >90% satisfied patients at 12 months.

CONCLUSION

The MO improved both the MF of the patient and their oral health-related quality of life and satisfaction regarding the prosthesis in a short time period.

Wearing complete dental prostheses - Effects on perioral morphology

Background

To adequately perform rehabilitation of edentulous patients by a complete removable dental prosthesis (CRDP) is from basic interest to dentists to understand the morphologic changes caused by re-establishment of a physiologic jaw relationship. Anthropometric analyses of standardized frontal view and profile photographs may help elucidate such changes.

Material and Methods

Photographs of 31 edentulous patients were compared in relaxed lip closure and after insertion of a CRDP in stable occlusion. 2232 anthropometric distances were raised. Eighteen anthropometric indices reflecting the perioral morphology and its integration in the vertical facial harmony were investigated.

Results

The intercanthal – mouth width index (p<.001), medial - lateral cutaneous upper lip height index (p=.007), lower vermilion contour index (p=.022), vermilion - total upper lip height index (p=.018), cutaneous - total upper lip height index (p=.023), upper lip - nose height index (p=.001), nose - upper face height index (p=.002), chin - mandible height index (p=.013), upper lip - mandible height index (p=.045), nose - lower face height index (p=.018), and nose - face height index (p=.029) showed significant pre- to post-treatment changes.

Conclusions

The investigated anthropometric indices presented reproducible results related to an increase in occlusal vertical dimension. Their application may be helpful in assessment, planning, and explanation of morphologic effects of CRDPs on the perioral and overall facial morphology, which may helps to improve the aesthetic outcome.

Key words:Dentures, removable dentures, anthropometry, perioral morphology.

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.

Satisfaction with appearance and the desired treatment to improve aesthetics

Objective. To identify participants' satisfaction with appearance and the desired treatment to improve aesthetics. Materials and Methods. 220 participants (127 males and 93 females, mean age = 21.4 ± 1.5 years) were recruited into the study. A structured questionnaire was used to assess patients' satisfaction with appearance and what treatment they desire to improve aesthetics. Participants scored the level of satisfaction with appearance using visual analogue scale. Results. The VAS mean score of satisfaction with general appearance was 6.8 ± 2.3. Half participants were dissatisfied with tooth appearance and 65.9% were dissatisfied with tooth colour. Higher VAS scores were associated with higher desire for all treatments that improve tooth appearance (P < .05). Dissatisfaction with tooth appearance increased with increased dissatisfaction with teeth colour, feeling of poor tooth alignment, presence of fractured anterior teeth, and increased desire for orthodontic, crowns, and dentures treatments (P < .05). Dissatisfaction with tooth colour was associated with increased desire for tooth whitening and tooth coloured fillings (P < .05). Conclusions. Participants had high levels of dissatisfaction with tooth appearance and tooth colour. Dissatisfaction with tooth colour contributed to the increased dissatisfaction with tooth appearance. Dissatisfaction with tooth appearance, colour, alignment, and condition was significantly related to high desire for aesthetic treatments.