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

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.

Flipped clinical training: a structured training method for undergraduates in complete denture prosthesis

PURPOSE

To design and implement flipped clinical training for undergraduate dental students in removable complete denture treatment and predict its effectiveness by comparing the assessment results of students trained by flipped and traditional methods.

METHODS

Flipped training was designed by shifting the learning from clinics to learning center (phase I) and by preserving the practice in clinics (phase II). In phase I, student-faculty interactive session was arranged to recap prior knowledge. This is followed by a display of audio synchronized video demonstration of the procedure in a repeatable way and subsequent display of possible errors that may occur in treatment with guidelines to overcome such errors. In phase II, live demonstration of the procedure was given. Students were asked to treat three patients under instructor's supervision. The summative assessment was conducted by applying the same checklist criterion and rubric scoring used for the traditional method. Assessment results of three batches of students trained by flipped method (study group) and three traditionally trained previous batches (control group) were taken for comparison by chi-square test.

RESULTS

The sum of traditionally trained three batch students who prepared acceptable dentures (score: 2 and 3) and unacceptable dentures (score: 1) was compared with the same of flipped trained three batch students revealed that the number of students who demonstrated competency by preparing acceptable dentures was higher for flipped training (χ²=30.996 with p<0.001).

CONCLUSION

The results reveal the supremacy of flipped training in enhancing students competency and hence recommended for training various clinical procedures.

Prognoses of new complete dentures from the patient's denture assessment of existing dentures

OBJECTIVES

The aim was to determine prognostic factors affecting frequent post-delivery adjustments of new complete dentures using patients' assessments of existing complete dentures.

MATERIALS AND METHODS

A total of 125 edentulous participants (56 men, 69 women; mean age, 76.4 years) who required new complete dentures evaluated existing dentures using the patient's denture assessment (PDA), a questionnaire regarding the self-assessment of dentures composed of 22 question items and containing six subscales: "function," "lower denture," "upper denture," "expectation," "esthetics and speech," and "importance." Moreover, the numbers of post-delivery adjustments of new dentures were recorded. A multiple logistic regression analysis was performed to identify significant factors for frequent adjustments of new dentures with five subscales of the PDA (excluding "importance"), level of mandibular ridge resorption, and age as independent variables.

RESULTS

The analysis showed that "function," "esthetics and speech," and level of mandibular ridge resorption were significant variables for a frequent number of post-delivery adjustments of new complete dentures.

CONCLUSIONS

The results suggested that patients' assessments of existing dentures using the PDA might allow a prediction of prognosis for complete denture treatments. Additionally, low "function" scores and high "esthetics and speech" scores for existing dentures and high levels of mandibular ridge resorption were significant prognostic factors affecting frequent post-delivery adjustments of new complete dentures.

CLINICAL RELEVANCE

It may be difficult for edentulous persons to adapt to new complete dentures, especially those who have complaints about mastication and swallowing with existing dentures and poor mandibular ridges, but are satisfied with esthetics and speech.