Epidemiological survey on edentulousness

Evaluation of flexural strength and microhardness in Vaccinium macrocarpon (cranberry)-added self-cure polymethyl methacrylate dental resin: An in vitro study

AIM

Occurrence of denture stomatitis and prosthesis breakage are common problems faced by elderly people wearing removable dentures. To overcome this, several attempts are made to improve the denture material by addition of antimicrobials without compromising original properties. The aim of the study was to evaluate flexural strength and microhardness of self-cured polymethyl methacrylate (PMMA) denture base resin after addition of Vaccinium macrocarpon (commonly called as cranberry), extract as antimicrobial, at varying proportions.

STUDY SETTING AND DESIGN

Experimental in vitro study.

MATERIALS AND METHODS

Frozen cranberry fruits were subjected to extraction process in the presence of aqueous solvents. Lyophilized extract was added in proportions of 0, 0.5, 1.0, 1.5, and 2.0 dry wt/wt % into polymer of self-cure PMMA denture base resin. Based on cranberry inclusion, the study comprised one control (0%) and four test groups (0.5%-2%) with total of 100 samples. A three-point bending test for flexural strength was done for fifty study samples (n = 10). Surface of fractured samples was analyzed using a scanning electron microscope (SEM). Microhardness was determined using Vickers hardness test.

STATISTICAL ANALYSIS USED

One-way statistical ANOVA test was done to find the difference between groups, followed by Tukey's post hoc test for multiple pairwise comparison.

RESULTS

Flexural strength ranged from 66.80 to 69.28 MPa, and a statistically insignificant difference was observed between groups (P > 0.05). SEM evaluation showed uniformly dispersed strands of cranberry extract in PMMA matrix. With higher concentration, less voids were seen. Vickers microhardness value significantly decreased from 15.96 in the control group to 14.57 with 2% cranberry addition (P < 0.05).

CONCLUSION

Incorporation of cranberry extract into self-cure PMMA denture base resin, up to 2 dry wt %, did not decline the flexural strength. However, there was a significant decrease in Vickers microhardness values when compared against the control group (0% cranberry inclusion).

Projecting trends in the disease burden of adult edentulism in China between 2020 and 2030: a systematic study based on the global burden of disease

Purpose

This study was based on the Global Burden of Disease (GBD) database and aimed to analyze the trend of disease burden for complete edentulism in Chinese adults between 1990 and 2030, and to provide valuable information for the development of more effective management and preventive measures.

Methods

Data on Chinese adults with complete edentulism from 1990 to 2019 was analyzed using GHDx data. Descriptive analyses were used to analyze changes in the prevalence and burden of complete edentulism, gender and age distribution between 1990 and 2019. In addition, we used an autoregressive integrated moving average (ARIMA) model to predict the trend of disease burden for Chinese adults with complete edentulism between 2020 and 2030.

Results

The incidence, prevalence, and rate of YLDs in adults with complete edentulism in China showed an increasing trend from 1990 to 2019. In 2019, the incidence was 251.20 per 100,000, the prevalence was 4512.78 per 100,000, and the YLDs were 123.44 per 100,000, marking increases of 20.58, 94.18, and 93.12% from 1990. Males experienced a higher increase than females. However, the standardized rates decreased over the same period. The ARIMA model predicts a subsequent upward and then downward trend for all indicators between 2019 and 2030, except for the standardized incidence rate which remained essentially unchanged. Specifically, the incidence is predicted to decrease from 388.93 to 314.40 per 100,000, prevalence from 4512.78 to 3049.70 per 100,000, and YLDs from 123.44 to 103.44 per 100,000. The standardized prevalence and YLDs rates are also expected to decrease.

Conclusion

The burden of complete edentulism in China is projected to show an increasing trend from 2020 to 2022 and a decreasing trend from 2023 to 2030. Despite the decline in the burden of disease associated with complete edentulism in China, many problems remain to be solved.

An Innovative Technique for Assessment of Bone Change, Bite Force, and Retention of the Single-Implant-Supported Mandibular Overdenture: A Clinical Study

This study is the first study to incorporate a novel approach to single-implant-retained mandibular overdenture with a bar attachment on a single implant in the symphysis region. The use of a single-implant-retained bar overdenture significantly improved patients' chewing efficiency, indicating enhanced overdenture retention and stability.

Materials and Methods

Ten maxillary and mandibular completely edentulous patients were enrolled in the study. A complete denture was fabricated for them. On completion, bite force, retention force, and bone change were recorded. Bite force was recorded with the strain gauge, retention force with the force measurement gauge, and bone changes with radiographs.

Conclusion

Single-implant-supported bar mandibular overdenture (SISBOD) can be a suitable standard economic option for edentulous mandible and can greatly improve the quality of life of patients.

Influence of type 2 diabetes on immunohistochemical detection of TRAF6, cFos and NFATC1 in the gingiva in cases of chronic periodontitis

Type 2 diabetes (T2D) and chronic periodontitis (CP) are common diseases worldwide. Although T2D increases the severity of CP and alveolar bone loss, the mechanism of this is not well understood. We investigated using immunohistochemistry the expression of three osteoclast proteins, TRAF6, cFos and NFATc1, in gingival tissues. Gingival tissues were obtained from three groups: HC group, healthy controls; CP group, patients with CP; T2D + CP group, patients with both T2D and CP. Strong immunostaining for TRAF6, cFos and NFATc1 was observed in the gingival epithelium as well as in inflammatory cells in the CP and T2D + CP groups. Immunostaining was most intense in the T2D + CP group. We found strong up-regulation of TRAF6, cFos and NFATC1 in gingiva tissue of subjects with both T2D and CP, which corroborates our hypothesis that T2D potentiates osteoclastogenesis in CP.

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.

Is parity a cause of tooth loss? Perceptions of northern Nigerian Hausa women

BACKGROUND

Reproduction affects the general health of women, especially when parity is high. The relationship between parity and oral health is not as clear, although it is a widespread customary belief that pregnancy results in tooth loss. Parity has been associated with tooth loss in some populations, but not in others. It is important to understand the perceptions of women regarding the association between parity and tooth loss as these beliefs may influence health behaviors during the reproductive years.

AIM

To explore the views of Hausa women regarding the link between parity and tooth loss.

METHODS

Qualitative data were collected through a grounded theory approach with focus group discussions (FGDs) of high and low parity Hausa women (n = 33) in northern Nigeria. Responses were elicited on the causes of tooth loss, effects of tooth loss on women's quality of life, issues of parity and tooth loss, and cultural beliefs about parity and tooth loss. The data were analyzed thematically using ATLAS-ti.

RESULTS

Respondents associated tooth loss with vomiting during labor, a condition termed 'payar baka'. Poor oral hygiene, excessive consumption of refined carbohydrates, tooth worm, cancer and ageing were also believed to cause tooth loss. The greatest impacts of tooth loss on the lives of the respondents were esthetic and masticatory changes.

CONCLUSION

Respondents perceived that parity is indirectly linked to tooth loss, as reflected in their views on the association between vomiting during labor and tooth loss.

Association between Periodontal Disease and Subsequent Sjögren's Syndrome: A Nationwide Population-Based Cohort Study

Xerostomia (dry mouth) is the cardinal symptom of Sjögren’s syndrome (SS), which is an autoimmune disease involving the exocrine glands and other organs. Xerostomia may predispose patients to periodontal disease (PD) and an association between SS and PD has been reported. This association may be bidirectional; therefore, we conducted this study to investigate the risk of SS in patients with PD using data from the National Health Insurance Research Database of Taiwan. A total of 135,190 patients were enrolled in our analysis. In all, 27,041 patients with PD were matched by gender, age, insured region, urbanization and income, with cases and controls in a 1:4 ratio. Both groups were followed and the risks of SS were calculated by Cox proportional hazards regression. Finally, 3292 (2.4%) patients had newly diagnosed SS. Patients with PD had a significantly higher risk of subsequent SS (903 (3.3%) vs. 2389 (2.2%), adjusted hazard 1.47, 95% confidence interval: 1.36–1.59). In conclusion, patients with PD had an approximately 50% increased risk of subsequent SS. Physicians should be aware of the symptoms and signs of SS in patients with PD.

Prevalence and pattern of partial edentulism among dental patients attending College of Dentistry, Aljouf University, Saudi Arabia

Objective:

The current study aimed to determine the prevalence and pattern of partial edentulism among dental patients attending the College of Dentistry, Aljouf University, Saudi Arabia.

Patients and Methods:

A total of 142 patients were selected, and the prevalence of partial edentulism among the selected patient was recorded. Patients were grouped into three age groups; Group I: 21–30 years, Group II: 31–40 years, and Group III: 41–50 years. Kennedy's classification was used to determine the pattern of partially edentulous arches. Modification areas were not included in the assessment to avoid complexity. Data was analyzed using the Statistical Package for the Social Sciences version 20.0 for windows.

Results:

The results showed that the occurrence of Kennedy Class III partial edentulism was 67.2 % in the maxillary arch and 64.1% in the mandibular arch. Followed by Class II in both maxillary and mandibular arch with an average of 16.3 % in maxillary arch and14.8% in the mandibular arch. Based on these results, class III has the highest prevalence in group II (31- 40 years). Class I and class II have the highest incidence among group III Patients (41–50 years).

Conclusions:

Among selected patients, Class III dental arch was the most prevalent pattern in maxillary and mandibular arches. Class IV being the least dominant pattern between all classes. There are a rise in Kennedy Class I and Kennedy Class II pattern and a decline in Class III and Class IV with an increase in age.

Partial Edentulism and its Correlation to Age, Gender, Socio-economic Status and Incidence of Various Kennedy's Classes- A Literature Review

Partial edentulism, one or more teeth missing is an indication of healthy behaviour of dental practices in the society and attitude towards dental and oral care. The pattern of partial edentulism has been evaluated in many selected populations in different countries by different methods. Most of the studies have evaluated partial edentulism by surveying of Removable Partial Dentures (RPDs), patients visiting clinics, clinical records and population in particular locality. The objective of the study is to review the prevalence of partial edentulousness and its correlation to age,gender, arch predominance, socio economic factors and incidence of various Kennedy's Classes. Key observations drawn from the review are as below. There is no gender correlation for partial edentulism.Prevalence of partial edentulism is more common in mandibular arch than maxillary arch.Younger adults have more Class III and IV RPDs. Elders have more distal extension RPDs Class I and II.

Association between dental prosthesis need, nutritional status and quality of life of elderly subjects

PURPOSE

To determine the effect of prosthesis need on nutritional status and oral health-related quality of life (OHrQoL) in elderly and to check the disparity between prosthesis need and prosthesis want in the Indian elderly.

METHODS

A total of 946 geriatric participants reporting to a geriatric medicine clinic were recruited in the study. Mini-nutritional assessment (MNA), geriatric oral health assessment (GOHAI) indices, prosthesis need according to WHO criteria, and prosthesis want was recorded along with age, gender, socioeconomic status and posterior occluding pair.

RESULTS

Significant associations exist between prosthesis need and age (p = 0.005), MNA (p = 0.006) and GOHAI (p = 0.000). Prosthesis demand too was influenced by age (p = 0.004), posterior occluding pairs (p = 0.000), MNA (p = 0.012) and GOHAI (p = 0.000). GOHAI was negatively correlated with upper (r = -0.445) and lower prosthesis need (r = -0.460). Participants with some prosthesis need had significantly lower MNA and GOHAI scores as compared to those with no prosthesis need. Though prosthesis need was high (79.7 %), demand was low (39.3 %).

CONCLUSION

Prosthesis need affects nutritional status and OHrQoL in elderly, and a wide gap exists between need and want of prosthesis.

Prevalence of loss of all teeth (edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa

Little information exists about the loss of all one’s teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO’s) Study on global AGEing and adult health (SAGE) Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367), Ghana (N = 4724), India (N = 7150), Mexico (N = 2315), Russian Federation (N = 3938) and South Africa (N = 3840). Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%–21.7%) than China, Ghana, and South Africa (3.0%–9.0%). In multivariate logistic analysis sociodemographic factors (older age, lower education), chronic conditions (arthritis, asthma), health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption) and other health related variables (functional disability and low social cohesion) were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention.

Comparison of chewing ability, oral health related quality of life and nutritional status before and after insertion of complete denture amongst edentulous patients in a Dental College of Pune

BACKGROUND

The relationship between tooth loss and nutritional intake is important. As people age, their diminished physical capacity and decreased income adversely affect their ability to maintain their teeth. The aim of the study was to assess and compare the chewing ability, oral health related quality of life and nutritional status before and after fabrication and insertion of complete denture amongst edentulous participants in a dental college.

MATERIAL AND METHODS

Non Randomized Intervention study. The study population consisted of 42 participants (16 females and 26 males), aged 50 years and above. Prior to commencement of the study, informed consent was obtained and validation and reliability test of the questionnaire were done. The data for chewing ability, GOHAI and nutritional status assessment was recorded at baseline, 3(rd), 6(th) and 12(th) month after denture fabrication and insertion. The statistical comparisons were performed by repeated measure ANOVA and Chi-square test. P value<0.05 was considered as statistically significant.

RESULTS

Chewing ability, GOHAI, BMI (Body Mass Index) and data from Food-intake questionnaire showed statistically significant improvement from baseline to 6(th) month but no statistically significant improvement was observed from 6(th) month to 12(th) month. Nutritive value of food (protein, energy and fat) showed no significant difference over a period of 12 months (p<0.05).

CONCLUSION

Thus, it was concluded that the intervention (denture insertion) was effective in increasing the chewing ability, body weight, food-intake, and oral health related quality of life.

Physical properties of polyamide-12 versus PMMA denture base material

OBJECTIVES

Polyamide-12 (PA) is a flexible material suited for denture bases and clasping. This study investigated its potential aging effects with a focus on surface roughness, color stability, and elasticity.

METHODS

PA specimens (Valplast) of 40×10×2 mm and equally measuring PMMA specimens (Palapress) as control were fabricated. Color changes after storage in air, water, coffee, and red wine (n=10) were measured using the CIE L*a*b* color specification. Elasticity after thermocycling (1000, 3000, and 7000 cycles,  n=15) was measured by three-point bending testing. Mean surface roughness (Ra) was determined after storage in the liquids mentioned above and thermocycling (n=10).

RESULTS

Tukey's HSD test (P<0.05) revealed statistically significant color changes of PA in red wine (ΔE=4.27 after 12 days, ΔE=6.90 after 12 days) and coffee (ΔE=3.93 after 36 days) but no color changes in PMMA. Elastic modulus of PA was 845 MPa and not affected by thermocycling (Tukey's HSD test,  P>0.81). Dry specimens showed significantly decreased elasticity (P<0.001). Mean surface roughness (PA 0.20  μ m, PMMA 0.28  μ m) did not change significantly after thermocycling or storage (Mann-Whitney U-test,  0.16<P<0.65).

SIGNIFICANCE

PA exhibited a higher susceptibility to discoloration than PMMA. Neither surface roughness nor elasticity of PA was altered by artificial aging.

Prevalence of Dentulism, Partial Edentulism and Complete Edentulism in Rural and Urban Population of Malwa Region of India: A Population-based Study

Background

The objective of this study was to evaluate the prevalence of dentulism, partial edentulism and complete edentulism in rural and urban population of Malwa region of India, who visited at department of prosthodontics for the first time.

Materials and methods

An institution-based, cross-sectional study using the random sampling method was used to select the study sample of 1000 males and females. Data were collected using questionnaires and oral examination. Data were statistically analyzed using Chi-square test.

Results

Nearly, 38.5 and 63.1% of the rural and urban females were dentulous in the age of below 53 and 43 years. 61.4 and 36% of rural and urban males were dentulous in the age of below 53 and 43 years. Nearly, 41.9 and 48.2% of the rural and urban females were partial edentulous in the age of above 53 and 43 years. Fifty-eight and 51.7% of rural and urban males were dentulous in the age of above 53 and 43 years. Nearly, 22.4 and 55.8% of the rural and urban females were completing edentulous in the age of above 43 years in both population. 77.5 and 44.1% of rural and urban males were completing edentulous in the age of above 33 and 53 years.

Limitation

The study was conducted in an institution-based set-up. Hence, any interpretation of the results of this study must bear this limitation in mind.

Conclusion

It is essential to identify feasible strategies to provide primary dental health education and treatment to all rural and urban elderly in the future. We suggest community dental health services to be included in general health of the elderly rather than a special health need of the community.

How to cite this article

Sonkesariya S, Jain D, Shakya P, Agrawal R, Prasad SVS. Prevalence of Dentulism, Partial Edentulism and Complete Edentulism in Rural and Urban Popu- lation of Malwa Region of India: A Population-based Study. Int J Prosthodont Restor Dent 2014;4(4):112-119.