Adhesion of Candida Albicans to digital versus conventional acrylic resins: a systematic review and meta-analysis

BACKGROUND

The present systematic review and meta-analysis investigated the available evidence about the adherence of Candida Albicans to the digitally-fabricated acrylic resins (both milled and 3D-printed) compared to the conventional heat-polymerized acrylic resins.

METHODS

This study followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). A comprehensive search of online databases/search tools (Web of Science, Scopus, PubMed, Ovid, and Google Scholar) was conducted for all relevant studies published up until May 29, 2023. Only in-vitro studies comparing the adherence of Candida albicans to the digital and conventional acrylic resins were included. The quantitative analyses were performed using RevMan v5.3 software.

RESULTS

Fourteen studies were included, 11 of which were meta-analyzed based on Colony Forming Unit (CFU) and Optical Density (OD) outcome measures. The pooled data revealed significantly lower candida colonization on the milled digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (MD = - 0.36; 95%CI = - 0.69, - 0.03; P = 0.03 and MD = - 0.04; 95%CI = - 0.06, - 0.01; P = 0.0008; as measured by CFU and OD respectively). However, no differences were found in the adhesion of Candida albicans between the 3D-printed digitally-fabricated compared to the heat-polymerized conventionally-fabricated acrylic resin materials (CFU: P = 0.11, and OD: P = 0.20).

CONCLUSION

The available evidence suggests that candida is less likely to adhere to the milled digitally-fabricated acrylic resins compared to the conventional ones.

Oral health practices and self-reported adverse effects of E-cigarette use among dental students in 11 countries: an online survey

OBJECTIVES

E-cigarette use has become popular, particularly among the youth. Its use is associated with harmful general and oral health consequences. This survey aimed to assess self-reported oral hygiene practices, oral and general health events, and changes in physiological functions (including physical status, smell, taste, breathing, appetite, etc.) due to E-cigarette use among dental students.

METHODS

This online, multicounty survey involved undergraduate dental students from 20 dental schools across 11 different countries. The questionnaire included demographic characteristics, E-cigarette practices, self-reported complaints, and associated physiological changes due to E-cigarette smoking. Data were descriptively presented as frequencies and percentages. A Chi-square test was used to assess the potential associations between the study group and sub-groups with the different factors. Statistical analysis was performed using SPSS at P < 0.05.

RESULTS

Most respondents reported regular brushing of their teeth, whereas only 70% used additional oral hygiene aids. Reported frequencies of complaints ranged from as low as 3.3% for tongue inflammation to as high as 53.3% for headache, with significant differences between E-cigarette users and non-users. Compared to non-smokers, E-cigarette users reported significantly higher prevalence of dry mouth (33.1% vs. 23.4%; P < 0.001), black tongue (5.9% vs. 2.8%; P = 0.002), and heart palpitation (26.3%% vs. 22.8%; P = 0.001). Although two-thirds of the sample reported no change in their physiological functions, E-cigarette users reported significant improvement in their physiological functions compared to never smokers or tobacco users.

CONCLUSION

Dental students showed good oral hygiene practices, but E-cigarette users showed a higher prevalence of health complications.

Perception of orofacial appearance among laypersons with diverse social and demographic status

BACKGROUND

The perception of dentofacial esthetics differs considerably between patients and dentists. Patient's expectations regarding his/her esthetics are important and should be assessed ahead of any planning of esthetic treatment. The aim of this study was to explore the differences in perception of orofacial appearance by laypersons with different social and demographic status.

MATERIALS AND METHODS

Self-administered questionnaires were distributed to 400 subjects. The questionnaire comprised three parts; the first part addressed the demographic variables. The second part queried about dental prosthesis, orthognathic or plastic surgery, and/or ongoing or previous orthodontic treatment. The third part included the Arabic version of the-8-item Orofacial Esthetic Scale (OES-Ar) whose responses were scored in the 5-point Likert scale. These scores were compared by different grouping factors (age, gender, marital status, and education) using non-parametric Mann-Whitney U and Kruskal Willis tests with 95% confidence interval (α > 0.05).

RESULTS

A total of 268 questionnaires were eligible for analysis, representing 67% response rate. The satisfaction with facial profile appearance was the highest (4.0±1.1) followed by facial appearance (3.9±1.1), while the color of teeth was the least satisfying item (3.1±1.3). No significant differences were found between age groups for the mean summary score as well as for each item independently. No significant difference was found between both sexes except for the last item "overall impression". Married subjects rated one item (alignment of teeth) better than their counterparts. Positive perception of orofacial appearance increased significantly with the increase of education level, the perception of the oral health status, and the perception of the general health status.

CONCLUSION

Good oral health and/or high education level are significant determinants of more positive perception of orofacial esthetic appearance. Patients with these characteristics might be more concerned about their orofacial appearance, and this should be taken into consideration before planning any esthetic restorative dental treatment.

Happiness among dentists: a multi-scale, multi-national study from 21 countries

OBJECTIVES

The extent to which dentists are happy with their profession and their life has not been well studied. The present study aimed to explore the level of happiness, satisfaction with life and psychological well-being among a sample of dental professionals from 21 countries.

MATERIALS AND METHODS

The sample comprised 2,200 dentists from 21 countries. Three scales - Subjective Happiness Scale (SHS), Satisfaction With Life Scale (SWLS), and Affect Balance Scale (ABS) - were used to measure the subjective responses. Data related to demographic and social characteristics were recorded. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Scales were correlated, and multiple linear regression analyses were employed to identify the independent determinants of SHS, SWLS and ABS. Data were analysed using the SPSS software program; a value of P <0.05 was considered significant.

RESULTS

The overall mean scores of SHS, SWLS and ABS were 18.53 ± 5.06, 23.06 ± 6.25 and 1.26 ± 2.40, respectively, with significant differences found across countries: dentists working in Croatia, Peru and Serbia recorded the highest scores, unlike dentists practicing in Yemen, Syria, and Iraq, who recorded the lowest scores. There were significant, moderately positive correlations between the various scales: SHS and SWLS: r = 0.535, P < 0.001; SHS and ABS: r = 0.58, P < 0.001; and SWLS and ABS: r = 0.533, P < 0.001. Country of practice, age, qualification and monthly income were the significant independent predictors of SHS, SWLS and ABS.

CONCLUSION

Country of residence and social characteristics were associated with dentists' responses regarding their feelings and subjective well-being.

Confirmatory factor analysis of the Oral Health Impact Profile

Previous exploratory analyses suggest that the Oral Health Impact Profile (OHIP) consists of four correlated dimensions and that individual differences in OHIP total scores reflect an underlying higher-order factor. The aim of this report is to corroborate these findings in the Dimensions of Oral Health-Related Quality of Life (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the project's Validation Sample (n = 5022), we conducted confirmatory factor analyses in a sample of 4993 subjects with sufficiently complete data. In particular, we compared the psychometric performance of three models: a unidimensional model, a four-factor model and a bifactor model that included one general factor and four group factors. Using model-fit criteria and factor interpretability as guides, the four-factor model was deemed best in terms of strong item loadings, model fit (RMSEA = 0·05, CFI = 0·99) and interpretability. These results corroborate our previous findings that four highly correlated factors - which we have named Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact - can be reliably extracted from the OHIP item pool. However, the good fit of the unidimensional model and the high interfactor correlations in the four-factor solution suggest that OHRQoL can also be sufficiently described with one score.

Exploratory factor analysis of the Oral Health Impact Profile

Although oral health-related quality of life (OHRQoL) as measured by the Oral Health Impact Profile (OHIP) is thought to be multidimensional, the nature of these dimensions is not known. The aim of this report was to explore the dimensionality of the OHIP using the Dimensions of OHRQoL (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the project's Learning Sample (n = 5173), we conducted an exploratory factor analysis on the 46 OHIP items not specifically referring to dentures for 5146 subjects with sufficiently complete data. The first eigenvalue (27·0) of the polychoric correlation matrix was more than ten times larger than the second eigenvalue (2·6), suggesting the presence of a dominant, higher-order general factor. Follow-up analyses with Horn's parallel analysis revealed a viable second-order, four-factor solution. An oblique rotation of this solution revealed four highly correlated factors that we named Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact. These four dimensions and the strong general factor are two viable hypotheses for the factor structure of the OHIP.

Initial effects of a treatment by fixed partial dentures supported by mini dental implants from a patient's point of view

Mini dental implants (MDIs) in dentistry are recommended for cases with adequate bone quality and height, but a lack of alveolar bone width. Some studies well documented successful usage of MDIs for a removable denture support, but studies of MDIs supporting fixed prosthodontic restorations are scarce. We aimed to study the effect of fixed partial dentures (FPD) therapy supported by MDIs or by MDIs and natural teeth, on patients self perceived oral health related quality of life (OHRQoL), self perceived oral aesthetics and self perceived chewing function. A total of 23 patients (10 female and 13 men, age range from 54 to 78 years) were included and 61 MDIs were inserted, 10 in the maxilla and 51 in the mandible. In 14 patients FPDs were constructed only on MDIs and in 9 patients FPDs were constructed on both, MDIs and natural teeth. FPDs on MDIs were replacing mostly mandibular incisors, the second maxillary incisors and the first maxillary premolars. Those FPDs supported by both, MDIs and natural teeth had some MDIs inserted in frontal regions to allow a FPD construction. The three questionnaires: the OHIP-CRO14 for the assessment of OHRQoL, the OES-CRO for assessment of oral aesthetics and the Chewing function questionnaire (CFQ) for assessment of chewing function have been administrated twice:prior to the MDIs insertion and three months after the FPD treatment supported by MDIs had been finished. The CFQ and the OHIP summary scores significantly decreased revealing better OHRQoL and better chewing ability after treatment, and the OES scores significantly increased indicating increased self perceived oral aesthetics (p < 0.01). Clinical examination revealed no periimplant inflammation. Patients' data supplement the initially promising clinical findings. However, further follow ups will be necessary to finally confirm the long term clinical benefit of MDIs.

Prosthetic modalities used to treat cleft palate patients in a university clinic: a 10-year review

Cleft palate patients are not usually seen in general dental clinics, but this congenital anomaly is one of the most frequent of cases. General dental practitioners are usually unwilling or/and not sufficiently trained to treat such patients for whom rehabilitation and interdisciplinary cooperation is often needed. The aim of this study was to determine the incidence of prosthetic modalities most frequently used by licensed prosthodontists for prosthetic rehabilitation of cleft palate patients. Participants in this study were 56 cleft palate patients (aged 23-66 years) who received prosthetic treatment between 2000 and 2010. Patients' dental status and prosthetic modalities used were noted from patient records archived at Department of Prosthodontics, School of Dental Medicine, University of Zagreb. Data analyses revealed that combined prosthetic constructions (fixed + removable, p < 0.05) were the most frequently used. In a group of molar teeth, the most frequent fixed prosthetic modalities were crowns with rests; in a group of premolar teeth, telescopic crowns; on canines, metal ceramic crowns and telescopic crowns; and in a group of incisors, metal ceramic pontics (p < 0.05). Understanding the distribution of prosthetic modalities for cleft palate patients could serve to guide dental practitioners towards planning adequate prosthetic treatment for their patients since only a well-planned prosthetic therapy will result in satisfactory function and alleviation of the deformities.

Factors related to oral health related quality of life in TMD patients

The aims of the study were to determine the impact of temporomandibular disorders (TMD) on self-percieved oral health related quality of life (OHRQoL) and to compare OHRQoL of patients with TMD with a control group. A total of 81 TMD patients participated in a study group and 400 adults served as the control group. The mean OHIP summary scores were computed for all patients with the same diagnosis and the same subgroup of axis I according to the RDC/TMD exam form. The mean OHIP subscores for all seven domains of the OHIP questionnaire were compared between the study and the control group. The hierarchical linear regression model was used to assess the most important variables according to the RDC/TMD protocol that contribute to OHRQoL in TMD patients with the OHIP summary score as dependent variable. According to this study, TMD had a high association with reduced OHRQoL (p < 0.001). More diagnoses of axis I according to the RDC/TMD protocol (p < 0.001), higher age of TMD patients (p < 0.001) and diagnoses associated with limited jaw movements contributed to more impaired OHRQoL (p = 0.008 and p = 0.030, respectively). Female TMD patients had no significantly different OHRQoL compared to male patients (p = 0.436). According to regression analysis, higher age (p < 0.001), more physical diagnoses (p = 0.018) and diagnosis Ib (p = 0.169) explained 39.1% of the variability (p < 0.001) of the OHIP summary score in TMD patients.

Development of a new chewing function questionnaire for assessment of a self-perceived chewing function

OBJECTIVE

To develop a new unidimensional questionnaire for patients' self-assessment of their chewing function (chewing function questionnaire: CFQ) and to test its psychometric properties.

METHODS

A focus group of 7 dentists and 15 prosthodontic patients generated a pool of 30 relevant items. A 5-point Likert scale (0-4) was used. A focus group reduced some redundant items, and 21 items remained for pilot testing after which additional four items were eliminated. Then, the 17-item questionnaire was tested on a larger sample (200 participants). Factor analysis was obtained to investigate the dimensionality of the questionnaire. Finally the 10 items remained, and the CFQ was unidimensional. To test the psychometric properties, the CFQ was administrated to 224 individuals: 100 patients were already removable denture wearers (RDWs), 24 patients needed a removable prosthodontic treatment, and 100 individuals had natural teeth (NT group). Discriminative validity was tested between the RDWs and the NT groups. Convergent validity and internal consistency were tested on 200 subjects. The internal consistency was assessed by calculating the Cronbach's alpha coefficient and the average interitem correlation. The test-retest reliability was tested on 60 subjects. Responsiveness was tested on 24 patients who received new removable prosthodontic treatment.

RESULTS

The initial factor analysis revealed that the items had been grouped in three different dimensions. By eliminating items with complexities greater than one, additional six questions were eliminated. One more item with the lowest correlation was further eliminated. The final questionnaire included 10 items. Discriminative validity showed significant differences between the NT group and the RDWs, as predicted (P < 0.001). Convergent validity was confirmed by the Spearman's rank correlation. A significant positive association (P < 0.001) was found between the CFQ and one general question about chewing difficulties, as well as between the CFQ and five items from the OHIP49 related to chewing. The test-retest reliability showed high intraclass correlation and no significant differences between the two administrations of the CFQ (P > 0.05). The internal consistency showed satisfactory Cronbach's alpha values (0.916 for all subjects, 0.742 for the NT group, and 0.852 for the RDWs). Responsiveness was confirmed by a significant difference between the baseline and the follow-up score (P < 0.001) and a high effect size (0.95).

CONCLUSIONS

The developed CFQ provides an assessment instrument of the hypothetical construct invoked to explain the chewing function. Psychometric properties are satisfactory demonstrating that the instrument is suitable for the assessment of a self-perceived chewing function.

Denture relining as an indicator of residual ridge resorption

AIM

Residual ridges change in shape and reduce in size due to alveolar bone resorption. Therefore, the purpose was to investigate changes in denture base thickness (DBT) and interocclusal rest space (IRS) with regard to the denture relining procedure.

METHODS

The IRS and DBT were measured (before and after denture relining) in the case of 74 patients and their removable dental prostheses by using a precise sliding gauge. The DBT measuring was performed in 6 points for maxillary and in 3 points for mandibular removable dental prosthesis. The IRS values were measured as the distance (in mm) between the incisal edges of the maxillary and mandibular central incisors with patient's mandible in a physiological "rest position" with head and neck in the upright posture.

RESULTS

In a group of patients wearing maxillary and mandibular removable dental prosthesis mean values of DBT after denture relining were statistically significantly higher (p <0.05) in almost all measuring points. The IRS mean values after relining were statistically significantly lower (p <0.05). Statistically significant differences (p <0.05) of DBT were also observed in groups of "day-night time" and "day time" denture wearers, and in a group of patients for whom a period shorter than one year had passed since the last tooth extraction and the time when a functional impression for removable dental prostheses was taken.

CONCLUSION

The DBT and IRS values change after the denture relining procedure due to the alveolar bone resorption. Therefore, these measures could be used as resorption indicators in dental practice.

Psychometric properties of the Albanian language version of the OHIP-ALB49 Questionnaire in the Republic of Kosovo

The aim of the study was to develop and to test psychometric properties of the Albanian language version of the Oral Health Impact Questionnaire (OHIP-ALB49) in the new typical cultural context. The construct validity was tested: the convergent validity was tested on 389 subjects (general population (n = 119), removable prosthodontic patients (n = 213) and students (n = 57)), and the discriminative validity was tested in edentulous patients wearing dentures (CDWs) (n = 180) and edentulous patients having no dentures at all (n = 33). The test-retest reliability was tested on 57 subjects (27 dental students and 30 complete denture wearers), the internal consistency on 389 subjects, and the responsiveness on 33 patients with a treatment demand (complete dentures). The significant association between the OHIP summary scores and the self-reported oral health (p < 0.001) confirmed the convergent validity. The discriminative validity was confirmed by significant difference between the CDWs and the edentulous subjects without any dentures. The test-retest reliability was confirmed by high intraclass correlation coefficients and no significant differences between the two administrations (p > 0.05). The internal consistency showed high Cronbach's alpha (0.94 in general population and in prosthodontic patients, 0.96 in the student group). The responsiveness was confirmed by the statistically significant difference between the mean OHIP score at the baseline and the follow-up (p < 0.001) and by the high effect size (2.19 for the OHIP Summary Score) in the edentulous patients with a treatment demand). The psychometric properties of the OHIP-ALB49 prove that the instrument is suitable for the assessment of the Oral Health Related Quality of Life in Kosovo.

Changes of the dental service delivered to patients with intellectual disability under general anaesthesia in Dental Polyclinic Split, Croatia, during the years 1985-2009

People with intellectual disability (ID) usually have a poor quality of oral health, which include poor oral hygiene, untreated caries and high proportion of missing teeth. Due to their fear and repulsive attitude towards medical staff general anesthesia is often a useful method for dental treatment. One thousand and fifty four intellectual disability patients for the period of 1985-2009 who received dental treatment under general anesthesia in Dental Polyclinic Split, were included in the study. Patients were divided into five groups based upon the period when a specific dental treatment had been received. Each period was analyzed for the number of ID patients treated and the type of dental treatment. The results showed that the most services provided were 4006 fillings, followed by 3225 extracted teeth and finally 274 endodontic treatments. Significantly the lowest number of fillings and endodontic treatments were found among patients in group II (1990-1994), with significantly the highest number of extracted teeth. In Conclusion, the types of dental treatment have changed during twenty five years. Number of extracted teeth decreased while the number of fillings and endodontic treatment increased. However, dental status of people with intellectual disability should be improved with more restorative treatments and with better oral health prevention program.

Patient's satisfaction with removable dentures after relining

AIM

To reveal patients' satisfaction with their old, usually poorly fitting dentures and the effect of denture relining to the patient's satisfaction.

METHODS

Thirty seven denture wearers participated in study by filling out questionnaires about their satisfaction with dentures before and after relining. In that way the data indicating the subjective patient's experience and satisfaction were collected.

RESULTS

Relined removable dentures included in study were on average 5.52 years (upper) or 4.86 years old (lower). Most of study participants (57%) were satisfied with their poor fitting dentures. Statistically significant was correlation between chewing discomfort and satisfaction, and the time elapsed from last tooth extraction to denture production. As this period was shorter, chewing discomfort was greater and satisfaction with chewing lower. Majority (53.3%) of denture wearers were considerably more satisfied with the chewing ability and felt better regarding the chewing discomfort after denture relining. Minority of the patients (22%) still used an adhesive for fixing the dentures after relining.

CONCLUSION

Denture relining affects patient's satisfaction with their dentures. After relining patient's masticatory function was improved, satisfaction with chewing ability and comfort were greater, and denture hygiene better. Denture relining should be performed in order to improve denture fitting to a denture bearing area, thus positively affecting patient's satisfaction with his denture(s).

Prosthetic rehabilitation of a patient with mandibular resection prosthesis using mini dental implants (MDIs)--case report

Physical disfigurement and functional impairments associated with facial trauma are a challenge to a prosthodontist, because even novel sophisticated surgical reconstructive techniques fail to provide adequate support for dental resection prosthesis. Therefore, different endosseous implants are often used as prosthesis-supporting elements. Manufacturers of dental implants have recently presented mini dental implants (MDIs) with diameter of only 1.8-2.4 mm. These implants allow very suitable prosthetic solutions within the range of their indications due to good osseointegration success rates, simple surgical technique, and immediate loading possibility. In this report, a case was presented for prosthetic rehabilitation including implantation of two Sendax type (IMTEC, Ardmore, Oklahoma, USA) MDIs in mental region, to obtain better retention and stability of the mandibular resection prosthesis and to improve function, phonation and aesthetics. The use of these implants, among aforementioned preferences, is also very cost-effective, so this implantation possibility should be taken into consideration during prosthetic treatment planning.

Residual ridge atrophy in complete denture wearers and relationship with densitometric values of a cervical spine: a hierarchical regression analysis

BACKGROUND

The rate of residual ridge atrophy (RRR) and its association with mineral density of other bones have not yet been fully explained.

OBJECTIVE

To measure RRR over a 5-year period in complete denture wearers and relate it to the density of a cervical spine (CSBD).

MATERIALS AND METHODS

Sixty-two patients (different gender, age, body mass index, duration of edentulousness (DE) and different denture-wearing habits) participated. A copper stepwedge was attached to the cassette, and 50 lateral radiograms met the criteria to be included.

RESULTS

A significant decrease in vertical height was observed in all measured sites. The amount of RRR was highest in frontal areas of both jaws and decreased gradually towards lateral regions. Hierarchical regression analysis revealed that the amount of RRR in the maxillary frontal area could be explained up to 48.4% by the variable DE and only up to 6.1% by the CSBD, while gender had almost no influence (1%). Similar results were obtained for the lateral maxillary RRR (33.9%; 7%; 2%), frontal mandibular RRR (40; 8.4; 0.4%) and lateral mandibular RRR (31.5%; 3.4%; 7.7%).

CONCLUSION

Skeletal bone density, reflecting systemic and hereditary factors, is weakly related to RRR (3.4-8.4%).

Depression, somatization and anxiety in female patients with temporomandibular disorders (TMD)

The aim of this research was to determine the possible differences in degrees of depression, somatization and anxiety between the acute and chronic female patients with temporomandibular disorders (TMD), and whether these differences exist in healthy female patients. Ninety female patients were involved in this research; 60 of them were TMD patients of the Dental Polyclinic, while other 30 females came for a routine recall visit and had no problem related to TMD. Patients were aged 22 to 67 years, the average age being 38.5 +/- 12 years. All patients were asked to fill in the RDC/TMD protocol and three psychological tests (Emotions Profile Index, Somatization Scale and life Events Scale). Following the analysis of the RDC/TMD protocol and psychological tests, it was determined that the chronic female patients had higher depression and somatization scores in comparison with the acute patients (p < 0.01); the acute patients self-perceive higher levels of anxiety in relation to the control group; furthermore, the patients reporting higher levels of depression were more inclined to somatization and had experienced a greater number of stress events in the past six months. It is beyond doubt that patients suffering from the TMD's exhibit higher levels of depression, somatization and anxiety compared to the healthy ones, which proves that physiological factors may play a predisposing role in combination with reduced level of body tolerance to pain, and a decreased tolerance to stress.

Decreasing of residual alveolar ridge height in complete denture wearers. A five year follow up study

The resorption of the residual alveolar ridges is a chronic and continuous process of bone remodeling. The aim of this study was to analyse the rate of residual ridge resorption at different sites in the both jaws in complete denture wearers, through a five-year period of denture wearing. Residual ridge changes were measured on successive lateral cephalograms at 5 measurement points of the maxilla and the mandible. The first lateral radiograph was obtained at the delivery of complete dentures. The second lateral cephalogram was obtained after five years of denture wearing. Measurements were performed using a calibrated grid. The results of this study showed the existence of a significant alveolar ridge resorption at all five measurement points of the maxilla and the mandible. The observed variables, such as body mass index and the night time denture wearing had no significant influence on the rate of residual alveolar ridge resorption (p > 0.05). The duration of edentulousness had a significant influence on the rate of residual ridge resorption with significantly higher amounts of alveolar bone height decrease in those patients who had lost the last remaining teeth more recently.

A study of the surface topography and roughness of glazed and unglazed feldspathic ceramics

The aim of this study was to obtain the 3-D qualitative and quantitative nanoscale data of the surface topography and surface roughness of glazed and unglazed feldspathic ceramics. Twelve samples composed of Ni-Cr alloy (Wiron 99, Bego Germany) and feldspathic ceramics (IPS Classic, Ivoclar-Vivadent, Schaan, Liechtenstein) were prepared, and divided into two groups, dependent of the surface final finishing; 6 unglazed and 6 glazed samples. The surface of the samples was recorded and analysed by atomic force microscopy (AFM, Veeco Instruments, Santa Barbara, CA, U.S.A.). According to the results of this study, unglazed ceramic surface is significantly rougher than the glazed one, showing significantly higher root mean square (RMS), mean roughness (Ra) and maximum height (Z range values) (p < 0.01), higher crystallites with sharper peaks and deeper pores. The roughness parameters of the unglazed samples were almost twice or even more higher than of the glazed samples. Exposed unglazed ceramic surfaces can therefore promote antagonistic tooth wear.

The Slovenian version of the Oral Health Impact Profile Questionnaire (OHIP-SVN): translation and psychometric properties

The aim of the study was to develop and to test the psychometric properties of the Slovenian version (OHIP-SVN) in the new cultural context. Construct validity was tested on 430 subjects, test-retest reliability on 60 subjects, internal consistency on 460 subjects, and responsiveness on 30 patients with a treatment demand (toothache). The significant association between the OHIP summary scores and the self-reported oral health (p < 0.001) confirmed the construct validity. The test-retest reliability showed high intraclass correlation coefficients and no significant differences between the two administrations (p > 0.05). The internal consistency showed high Cronbach's alpha (0.97). The responsiveness was confirmed by the statistically significant difference between the mean OHIP score at baseline and follow-up (p < 0.001) and by a considerable effect size in the patients with a treatment demand (0.515). The OHIP-SVN, as one of the first translation into one of the Slavic family of the languages proves that this instrument is suitable for the assessment of the Oral Health Related Quality of Life in Slovenia.

The Croatian version of the Oral Health Impact Profile Questionnaire

Purpose of this study was to develop a Croatian version of the Oral Health Impact Profile questionnaire (OHIP--CRO49), following the accepted cross-cultural adaptation technique guidelines. The original version was translated by using a forward-backward translation method. The psychometric properties of the OHIP-CRO49 were tested. To test the construct validity 163 randomly selected subjects and 26 prosthodontic patients participated. The construct validity was supported by the association between the OHIP-CRO49 sum-scores and the self-reported oral health and five oral disorders. The test-retest reliability was tested on 30 prosthodontic patients and 30 students, and it was supported by high intraclass correlation coefficients (r = 0.63 to 0.95). To test the internal consistency 163 randomly selected subjects (general population), 26 prosthodontic patients and 29 dental students participated, and it was supported by high Cronbach's alpha coefficients (0.60 to 0.97). The resposiveness was tested on 21 patients with a treatment demand (toothache), and was supported by a statistically significant mean OHIP-CRO49 score difference (from 108.48 to 27.57) and a high effect size (2.96 and 3.48). Adequate psychometric properties in a typical patients' population make the new instrument suitable for assessment of Oral health-related quality of life (OHRQoL) in Croatia.

Relations between anterior permanent teeth, dental arches and hard palate

The width and length of the anterior teeth, the dimensions of the frontal dental arches and the dimensions of the hard palate were measured (24 men and 56 women, age range of 18-30 years). The results showed gender-related dimorphism only for the cervical width of the maxillary canine, which were wider in men, p < 0.05. The width-to-length ratios of the maxillary frontal teeth varied from 0.82 to 0.91. The tooth-to-tooth width ratios among different maxillary frontal teeth varied from 0.78 to 0.91. The sum of all anterior maxillary teeth widths was equal to the hamular width and to the distal maxillary arch width (p > 0.05), meaning that the sum of the frontal artificial teeth width may be selected upon the measurement of the hamular width on the hard palate. The ratios between the maxillary and the mandibular frontal dental arch dimensions are representative values for the skeletal class I.

Psychometric properties of Croatian and Slovenian short form of oral health impact profile questionnaires

AIM

To develop Croatian and Slovenian versions of the 14-item Oral Health Impact Profile (OHIP) Questionnaire.

METHODS

The English original version of the OHIP questionnaire was translated into Croatian (OHIP-CRO14) and Slovenian (OHIP-SVN14) language by a forward-backward translation method. The psychometric properties of the OHIP-CRO14 and OHIP-SVN14 were tested. Concurrent validity was tested on 623 subjects (193 Croatian and 430 Slovenian), test-retest reliability on 115 subjects (55 Croatian and 60 Slovenian), internal consistency on 678 subjects (218 Croatian and 460 Slovenian), and responsiveness on 51 patients (21 Croatian and 30 Slovenian) in demand of treatment (toothache).

RESULTS

Concurrent validity was confirmed by the association between the OHIP summary scores and self-reported oral health (correlation coefficients ranged from 0.40 to 0.60, P<0.001). Test-retest reliability showed high intraclass correlation (correlation coefficients, 0.79-0.94). Internal consistency showed high Cronbach alpha (0.77-0.91). Responsiveness was confirmed by a significant difference between the mean OHIP score at baseline and follow-up (P<0.001 for both Croatian and Slovenian patients) and high effect size in Croatian and Slovenian patients in demand of treatment (3.00 and 0.57, respectively).

CONCLUSION

Psychometric properties of OHIP-CRO14 and OHIP-SVN14 render these instruments suitable for the assessment of Oral Health Related Quality of Life in Croatia and Slovenia.

Linear vertical jaw resorption potential in elderly complete denture wearers: a five-year follow-up study

Human bones decrease in quality and increase in porosity beginning at about the third decade of life. The aim of this study was to establish an equation to predict the maxillary and mandibular linear vertical resorption potential for elderly edentulous patients on the basis of the analysis of the cervical vertebrae in a single cephalometric radiograph. The morphology of the bodies of the third and fourth cervical vertebrae and measurements of linear vertical resorption in the frontal region of the jaws were analyzed in two consecutive cephalometric observations of 26 elderly edentulous patients over the five-year period of wearing complete dentures. An equation was determined to obtain maxillary and mandibular linear vertical resorption on the basis of measurements in the third and fourth cervical vertebral bodies and the average errors between the predicted and the actual values were 0.14 mm. The cervical vertebrae exhibited significant decrease in the height and width, and residual alveolar ridges exhibited significant decrease in the height over the 5-year period of wearing dentures (p < 0.01). These results suggest that using cervical vertebral measurements might allow predicting the maxillary and mandibular resorption for edentulous elderly patients wearing complete dentures.

Oral health related quality of life in Slovenian patients with craniomandibular disorders

Sixty eight consecutive Slovenian patients with craniomandibular disorders (CMD) participated as the study group and another 400 adults from the regional population sample participated as the control group. The aim was to determine the impact of craniomandibular disorders to the self-perceived oral health related quality of life (OHRQoL) and to compare the OHRQoL with a control group. The mean Oral Health Impact Profile (OHIP) summary scores were computed for all patients with the same diagnosis and for the same subgroups of the axis I according to the RDC/TMD exam protocol. The mean OHIP subscores for the seven domains of the OHIP questionnaire were compared between the study and the control group. Significantly higher OHIP summary scores and all the OHIP subscores were obtained in the CMD patients in comparison with the control group (p<0.05). Furthermore, in the CMD group, patients with two related diagnoses had significantly higher impaired OHRQoL than patients with a single one. The results revealed: 1. The CMD subjects are highly associated with the reduced OHRQoL, 2. Higher number of diagnoses of the axis I according to the RDC/TMD results in the more impaired OHRQoL, 3. The higher age of the patients revealed the more impaired OHRQoL.

Factors related to patients' general satisfaction with removable partial dentures: a stepwise multiple regression analysis

This study aimed to analyze factors related to patients' general satisfaction with removable partial dentures (RPDs), such as esthetics, retention, speech, chewing, and comfort. A total of 103 patients with Kennedy Class I RPDs (34 to 82 years old; mean age: 63; 35 men, 68 women) assessed their satisfaction with dentures. Stepwise multiple regression analysis was used to evaluate the relationship among the factors. Significant correlations were found between general satisfaction and each of the individual components (P < .05). The patients' assessment of esthetics explained almost 50% of general satisfaction in both arches (P < .05). Esthetics, chewing, and speech had significant effects on the patients' general satisfaction with dentures.

Analysis of width/length ratios of normal clinical crowns of the maxillary anterior dentition: correlation between dental proportions and facial measurements

This study aimed to determine how facial measurements explain the variability of dental proportions. The following measurements were obtained from 90 subjects: width and length of each maxillary anterior tooth, length of the nose, length of the upper lip, facial length (including the lengths of the facial thirds), intercanthal width, interalar width, intercommisural width while smiling, and maximum central incisor exposure while smiling. The combination of all facial measurements explained the variability of maxillary anterior teeth width/length ratios by only 20% to 38% in men and 16% to 27% in women. Within the population tested, the results suggest that the use of facial measurements for the selection of artificial denture teeth is generally inaccurate.

Selection of appropriate artificial frontal teeth size using dimensions of hard palate

Eighty dentate students participated as a study group and another 74 as a control group. The aim was to determine a possibility to reconstruct maxillary frontal teeth dimensions by use of certain hard palate dimensions. The height (IH) and the incisal (IW), contact point (CtW) and cervical width (CW) of maxillary central incisors (MCI), hamular width (HW) and the distance between the incisive papilla and the palatine foveas (IP-FP) were measured on the maxillary casts. CtW of maxillary lateral incisors and canines were measured too. In the study group the ratios were computed: HW/IW (5.71), HW/CtW (5.69), HW/CW (5.51) and IP-FP/IH (4.76). These ratios were multiplied by incisor's dimensions (obtained from the control group) to calculate the hard palate dimensions. No significant differences were obtained between the calculated and the measured (study group) hard palate dimensions. Furthermore, there was no significant difference between the HW and the Sum of contact-point widths of all maxillary frontal teeth (p > 0.05) in the both groups. The results revealed: 1. MCI width and height might be calculated by dividing dimensions of a patient's hard palate and appropriate ratio; 2. hamular width dimension can be used as a selection guide for the sum of contact-point widths of six maxillary frontal teeth.

Denture repairs in different regions of Croatia in relation to prosthodontic teams

The purpose of this paper is to evaluate the incidence of denture repairs in different districts of Croatia through the year of 2002. and to analyse the percentage of different repairs (relinings, simple repairs up to 2 elements and complicated repairs-more than 2 elements) in relation to prosthodontic teams. Data on the number of dentures, and the number and types of denture repairs delivered in the Croatian regions of Zagreb, Rijeka, Split and Karlovac were obtained from the Croatian Institute for Health Insurance for the whole of the year 2002. Information of the number of prosthodontic teams operating in those regions was also obtained. Proportionally more denture repairs were carried out in Karlovac (18%) than Split (5%). The smallest percantage of dentures that required relining was registered in Split and the highest in Rijeka (chi2 = 36.7, p < 0.01). The smallest percentage of simple repairs was registered in Rijeka and the highest in Split (chi2 = 24.3, p < 0.01). The smallest percentage of complicated repairs was registered in Split and the highest in Karlovac. In each region the proportion of denture repairs and types of repairs were correlated with a number of prosthodontic teams in that region. Karlovac had the smallest percentage of specialistic prosthodontic teams and the highest rate of denture repairs.

Ion release from gold/platinum dental alloy: could release of other elements be accountable in the contact allergy attributed to the gold?

OBJECTIVES

The release of metal ions (Al, Ag, Au, Ca, Cd, Co, Cr, Cu, Mg, Mo, Ni, Pd, Pt, Ti, and Zn) from the commercial gold/platinum (Au/Pt) dental alloy of declared composition was studied.

METHODS

Au/Pt was soaked in pH 6.0 phosphate buffer, 3.5 pH phosphate buffer and pH 3.5 mixture of lactic, formic and acetic acid, and incubated at 37 degrees C for 1, 2, 3, 4, 5, 6, 7, 14, 21, and 30 days. Six samples (n = 6) of every solution were prepared for any time period. Inductively coupled plasma atomic emission spectroscopy was used for analysis of the released elements.

RESULTS

Results demonstrated release of only Cr, Cu, Fe, and Zn from the tested Au/Pt dental alloy (ANOVA, p < 0.001 for buffer, time, and interaction, respectively); however, only Cu and Zn were declared.

CONCLUSIONS

The undeclared chromium from Au/Pt dental alloy, or some other element might be responsible for the contact allergy thus far attributed to the gold.

[Increase of newly--detected in situ cancers in non-palpable breast lesions]

Great importance in detecting cancer in the phase of in situ lays in the fact that the epithelial layer is deprived of blood and lymph vessels, so metastases may develop only when basal membrane has been broken. This paper includes 46 operated women in whom it preoperatively had been verified suspect non-palpable lesion. The preoperative diagnostics included use of high- resolution mammography, aimed mammography, palpatory examination, as well as fine-needle aspiration (FNA), biopsy and cytologic analysis of the sample. The methodology of this work implies the use of stereotaxic marking, specimen mammography and ex-tempore pathohistology analysis. Out of 46 investigated patients in clinical stage T0N0M0, in whom there were no signs of malignant disease, and according to suspect lesion of initial screening mammography, malignant lesions of breast tissue were diagnosed in 19 patients (41%) intraoperatively. Three of these lesions (15,8%) were histopathologically verified as in situ. Comparing our results with data of the Institute of oncology and radiology of Serbia hospital registry (IORS) for the year 2001, from 1173 patients registered with malignant lesions, only 16 ones (1,4%) had in situ cancer, operated on the basis of the suspect mammography of clinical stage T0N0M0. Statistically significant difference was found related to the number of detected cancers in this early phase of the breast malignant disease. This limits surgical intervention to tumorectomy, with preservation of the remaining breast tissue, what brings to healing, justifying in that way, screening examinations and routine application of the most contemporary diagnostic procedures.

Epidemiological study on removable denture deliveries in different districts of Croatia, 1996-2001 and 2002

Aim of this study was to determine the prevalence of removable denture (complete and partial) deliveries through Croatian Public Health Service (covered by insurance) in different districts of Croatia and to compare the two periods: 1996 to 2001 and 2002. Number of dentures delivered was obtained from Croatian Institute for Health Insurance for the district of Zagreb, Rijeka, Split and Karlovac. Information of the population living in the same districts was obtained from the National Institute for Statistics. The percentage of fully edentulous inhabitants varied from more than 13% to more than 20%, dependent on the district, while the percentage of partial edentulism reconstructed with removable partial dentures varied from more than 13% to more than 30%. The highest percentage (average for living population) of complete and removable partial dentures was delivered in Zagreb in the both observed periods. In all districts, the number of complete denture wearers increased in 2002, except in Split. The percentage of removable partial denture deliveries increased significantly in all examined districts. Partial and complete denture deliveries increased in higher percentage in population younger than 70 years than in older population. The percentage of metal framework removable partial dentures increased significantly in all districts. The prevalence of removable denture deliveries increased, especially in patients younger than 70 years. This was attributed not only to the consequences of the 1991-1995 war, the migrations from rural to urban areas, decrease of economic status, but also to the new rules of the Croatian Insurance System.

Thickness of masticatory mucosa in the human hard palate and tuberosity dependent on gender and body mass index

The aim of this study was to clinically determine the thickness of masticatory mucosa in the hard palate and tuberosity as potential donor sites for subepitelial grafts for ridge augmentation procedures of small and moderate alveolar ridge defects to improve aesthetics of a pontic area of fixed partial dentures. In 102 periodontally healthy fully dentate subjects the thickness of mucosa was assessed by bone sounding with a periodontal probe. Twenty measurement points were defined, 18 on hard palate located on 3 lines running at different distances parallel to gingival margin and 2 on tuberosity. Data were analysed to determine differences between gender and different body mass index using t-test. The mucosa on the hard palate was significantly thicker than on the tuberosity. The thickest mucosa was registered on the second and the third line behind canines and on all 3 lines behind the first premolar. These areas are recommended as potential donor sites. Males had significantly thicker mucosa than females (p < 0.01), except for the sites behind the first molar (p > 0.05) where the mucosa was the thinnest in the both gender, which was attributed to the protuberance of the palatal root of the first molar. The same was with the body mass index. Therefore canine-premolar palatal region is recommended for harvesting free subepitelial grafts for moderate augmentation of alveolar ridges for achieving optimal aesthetics of the pontic area.

Use of digital photographs for artificial tooth selection

Digital photography has become available to everybody. The aim of this study was to examine possibility of calculating the width of a missing central incisor using digital photographs. Digital photographs were obtained from 51 dentate subjects using a 3.1 Megapixel digital camera from various distances: 35 cm, 70 cm, 1 m and 1.5 m. For the calculation of the width of maxillary left central incisor (MLI), the following equation was used: MLI(calculated) = Photographic width of MLI x IPD / photographic IPD. Statistical analysis was made (Kolmogorov-Smirnov test, dependent sample t-test, correlation and frequencies) using SPSS 10.0 for Windows. Results revealed no significant difference between the calculated MLI (70 cm, 1 m and 1.5 m distance) and actual MLI, however calculated MLI from 35 cm distance was significantly different from the actual MLI value (p < 0.01). The highest correlation was between calculated MLI (70 cm distance) and actual MLI. However, the highest percentage of results from a distance of 70 cm also fitted within +/- 0.3 mm; +/- 0.5 mm and +/- 1 mm difference from the actual MLI values. However, the results obtained from 1 m distance were also satisfactory. The technique of use of digital photography is of proven value in calculating the width of a maxillary central incisor. The photographs using a simple digital camera should be taken from a distance from 70 cm to 1 m. Saving such photographs in a dental office may eventually be helpful for calculating dimensions of artificial teeth.

Influence of body mass index and the time of edentulousness on the residual alveolar ridge resorption in complete denture wearers

Alveolar bone loss (RRR) is a continuous process following tooth extraction, more pronounced during the first few months after the tooth extraction than later. The RRR in the mandible is twice that of the maxilla during a 1-year period and the mandibular: maxillary resorption ratio increases further to 4:1. So far, the etiology of RRR has not been elucidated. It has been speculated that both systemic and local factors contribute. The aim of this study was to analyse the rate of RRR in five different regions of both jaws on lateral cephalograms of 100 complete denture wearers during a one-year period and to compare the rate of RRR between patients being edentulous over a different period of time and between patients with different body mass index. The height of residual ridges was measured on 5 different sites at the delivery of the dentures and a year later using a calibrated grid. The results revealed significant RRR in a one year period. Body mass index had no significant influence on the rate of RRR on any of the five examined sites of the maxilla or the mandible (p > 0.05), while the period of edentulousness had a significantly higher rate of resorption in first 3 sites of measurement (anteriorly) in patients being edentulous less than 1 year than in patients being edentulous for 1-10 years or for over 10 years (ANOVA, p < 0.05).

Mandibular bone mineral density changes in complete and removable partial denture wearers: a 6-month follow-up study

PURPOSE

The purpose of the study was to determine the changes in bone mineral density of the mandible in complete and removable free-end saddle denture wearers over a 6-month period.

MATERIALS AND METHODS

Twenty removable partial denture patients and 20 complete denture wearers participated. Two dental panoramic radiographs were taken from each patient, the first prior to denture delivery and the second after 6 months of denture wearing. Bone mineral density measurements were performed on panoramic radiographs with a five-step copper stepwedge attached to each film cassette. Bone mineral density values of the measured regions of interest were expressed in equivalents of the stepwedge thickness (mm).

RESULTS

The results revealed minor changes in bone mineral density values of the examined regions in the 6-month period. Under the distal end of complete denture saddles, the bone mineral density values decreased, whereas the values under the distal end of removable partial dentures increased. However, the difference between the first and second measurements was not significant. In each of the examined groups, the bone mineral density values at the gonion increased significantly by approximately 20%. This was attributed to the increased strain forces of the masseter muscle at the gonion after denture delivery.

CONCLUSION

Significant increase of bone mineral density values was registered 2 mm above the gonion in both complete and removable partial denture wearers. Age and gender were not related to the bone mineral density changes over a 6-month period.

Factors Related to Patient Satisfaction With Complete Denture Therapy

BACKGROUND

Except for denture quality, many other factors are related to a patient's satisfaction with complete dentures (CDs).

METHODS

A total of 222 patients with CDs took a part in this study. A questionnaire divided into 3 parts was completed by both the patients and the dentist, independently. The patients rated their dentures using a scale ranging from 1 to 5 (1 = dissatisfaction to 5 = excellent), and a dentist rated the quality of the denture and the denture-bearing area.

RESULTS

Patients were mostly satisfied with the quality of their CDs. Only 7.2% of the patients were absolutely not satisfied with their dentures. Patients with a low level of education were more satisfied in general with their aesthetic appearance. Patients with better self-perception of their affective status and quality of life showed higher levels of general satisfaction. Patients with better self-perception of their economic status showed lower levels of satisfaction. Younger patients wearing dentures for the first time, with short periods of being edentulous, and with better quality maxillary denture-bearing areas were more satisfied with the retention of maxillary CDs. In contrast, younger patients with first-time dentures, a short period of being edentulous, and with better quality mandibular denture-bearing areas gave lower ratings to the retention and comfort of wearing mandibular dentures.

CONCLUSIONS

Level of education, self-perception of affective and economic status, and quality of life are all related to patient satisfaction. However, the quality of dentures shows the strongest correlation with patient satisfaction. Not only the quality of the denture-bearing area but the denture-wearing experience itself seems to be more important in determining patient satisfaction with mandibular CDs.

A comparison of patient's satisfaction between complete and partial removable denture wearers

OBJECTIVES

The aim of this study was to compare satisfaction between complete denture (CD) and Kennedy Class I removable partial denture (RPD) wearers.

MATERIALS AND METHODS

A total of 156 CD and 112 RPD wearers took a part in this study. From the primary group of the examined patients, only those whose RPDs and CDs were assessed as excellent or very good by the dentist, took a part in this study. Patients graded satisfaction of their dentures by using an analogue scale from 1 to 5 (1=unsatisfactory; 5=excellent).

RESULTS

Both CD and RPD wearers were mostly satisfied with their dentures (the distribution of the scores of the patients' assessments was skewed towards the highest scores; more than half of the patients scored all the examined variables to the best score category). Complete Denture wearers were significantly more satisfied with chewing, speech and retention of maxillary denture than RPD wearers (P<0.05). Removable partial denture wearers were significantly more satisfied with the retention and the comfort of wearing mandibular denture (P<0.05). There was no significant difference between CD and RPD wearers for general satisfaction with their dentures, aesthetics and comfort of wearing maxillary denture (P>0.05; N.S.).

CONCLUSIONS

A majority of CD and RPD wearers were satisfied with the dentures. CD wearers were more satisfied with speech, chewing and retention of maxillary denture, while RPD wearers were more satisfied with the retention and the comfort of wearing mandibular denture. Different groups of denture wearers have to make significant, but different adjustments to wear their dentures successfully.

A survey of treatment outcomes with removable partial dentures

The patient's satisfaction with removable partial denture (RPD) therapy has become an increasingly important factor in prosthetic treatment. This study examined patients' satisfaction with RPDs in relation to some socio-economic variables, patients' habits of wearing and cleaning RPDs, comfort of wearing RPDs and different RPDs characteristics. A questionnaire was devised for the purpose. Two hundred and five patients were required to assess satisfaction with RPDs. They graded RPDs, depending on the level of satisfaction, on scale ranging from 1 to 5. A dentist determined Kennedy classification, material and denture support, denture base shape, number of missing teeth and evaluated denture construction. Majority of the patients were satisfied with the prosthesis. The patients of a higher education level gave lower grades (P < 0.05) to aesthetics of maxillary RPDs. Almost half of the patients were wearing RPDs during the day. Most of the patients cleaned RPDs three times a day. A significant difference was found between the patients' grades for comfort of wearing mandibular RPDs and number of missing teeth and between hygiene of mandibular RPDs and habits of cleaning them. Majority of the patients treated with RPDs were satisfied with the prosthesis. Dissatisfaction was related to mastication, esthetics, number of missing teeth and maintenance of oral hygiene.

Clinical bone densitometric evaluation of the mandible in removable denture wearers dependent on the morphology of the mandibular cortex

STATEMENT OF PROBLEM

Wide normal variations have been found in the structure and density of the human skeleton, as well as of the mandible.

PURPOSE

The objective of this study was to determine whether the mandibular bone mineral density is correlated with the classification of the structure of the inferior cortex on panoramic radiographs in complete and removable partial denture wearers.

MATERIALS AND METHODS

The mandibular cortical index of 136 randomly selected complete and removable partial denture wearers was evaluated via panoramic radiographs. The criteria for the mandibular cortical index were as follow: category 1, sharp endosteal margin of the inferior cortex; category 2, semilunar defects; and category 3, thick cortical residues on endosteal margin. Forty male patients (mean age 72.7; range 56 to 84 years) and 96 female patients (mean age 69.7; range 48 to 86 years) participated. With a copper stepwedge and DenEx 2001 computer program, the mandibular bone mineral density was investigated densitometrically on dental panoramic radiographs. Four experienced observers and 6 general dental practitioners made the observations on all panoramic radiographs. All bone mineral density values were expressed in equivalents of the actual stepwedge thickness. An independent t test (alpha =.05) was used.

RESULTS

The severity of changes in the mandibular cortex was significantly related to all measured mandibular bone mineral density values (t test: P<.01). Mandibular cortical index category 3 had significantly lower bone mineral density values in all measured regions of interest. Interobserver and intraobserver agreement in mandibular cortical index assessment was excellent.

CONCLUSION

Patients having lower bone mineral density values in the mandible have much more porous cortical layer of the inferior border of the mandible.

In vitro release of metal ions from a gold-platinum alloy in saliva-simulated conditions

The aim of this study was to evaluate the behavior of high-noble gold-platinum alloy samples (18 + 8 Rafinerija plemenitih kovina, Zagreb, Hrvatska), in a phosphate buffer pH 6.0. The aim of the study was to determine the type and amount of released metal ions from the alloy, and to evaluate how the time of exposure to the phosphate buffer pH 6.0 influences the release of metal ions from the alloy. Manufacturer samples 8.0 x 6.5 x 1.0 mm in size, with a surface area of 133 mm2 were used. The release of metal ions from the tested alloy was measured in ten time periods (after 1, 2, 3, 4, 5, 6, 7, 14, 21 and 30 days). Six samples were used (n = 6) for each time period that the alloy was in the solution, which means that a total of 60 samples was analyzed. Solutions, in which the samples were placed, were analyzed with the inductively coupled plasma atomic emission spectrometer (ICP-AES, JY 50P, Jobin-Ywon, France). It was found that four metal ions were released; zinc ions (Zn), chromium ions (Cr), copper ions (Cu) and iron ions (Fe). The most released ions from the gold-platinum alloy were those of zinc (Zn), and the least released were those of iron (Fe) (p < 0.01). The results of the study show that the time the tested alloy spent in the phosphate buffer pH 6.0 solution has an effect on the release of ions (p < 0.01).

Three-month change in the radiodensity of alveolar bone supporting partial-denture abutment teeth

This study uses the intraoral microdensitometric method to examine the impact of masticatory pressure on the alveolar bone around the abutment teeth clasp. Two retroalveolar radiographs were carried out on all 30 subjects over a period of 3 months using a copper calibration stepwedge. The dental radiographs were digitized and converted into positive. Grey level values on dental radiographs in the alveolar bone area in 7 region of interest (ROI) were measured. They were converted into the equivalent thickness of the calibration stepwedge using mathematical methods and the difference of the bone density between the two radiographs was calculated. The results demonstrated that there were no statistically significant differences between the 1st and 2nd radiographs in any of ROI (p > 0.05).

Screening of fixed prosthodontic dentures after five years of use in relation to material and construction

The aim of this study was to screen patients with fixed prosthodontic appliances that were in oral cavity for a period of 5 years or more and to assess clinically and radiologically root caries, gingival recession, pocket formation, alveolar ridge resorption, as well as gingival (GI) and plaque index (PI). The aim also was to find out the differences between materials and constructions, between abutment and non-abutment teeth, and to find out the need for replacement. A total of 260 patients and their orthopantomograms were examined, with a total of 2,265 teeth, 610 being bridge abutments and 246 being crowns. The most frequent were metal+ acrylic veneer crowns or bridges. Root caries was found under the abutments in 10-20%; however abutments with ceramic crowns had the lowest percentage of caries (p < 0.01). Alveolar ridge resorption, pocket formation deeper than 3 mm and gingival recession of various degree was found in 50% of the cases, again with the lowest percentage of ceramic-fused-to-metal appliances (p < 0.01). Pocket depth was registered in significantly higher percentage in metal-acrylic veneer appliances compared to natural teeth (p < 0.01), while there was no significant difference between metal-ceramic appliances and natural teeth (p > 0.05). Although the worst findings were recorded for metal- + acrylic veneer crowns for PI, no significant difference existed between crowns of different material or non-abutment teeth (p > 0.05). There was statistically significant difference between abutments with metal + acrylic veneer crowns, full metal crowns, metal ceramic crowns and non-abutments for GI scores. Higher percentage of scores 0 and 1 was recorded for metal ceramic crowns and non-abutments and significantly higher percentage of scores 2 and 3 was recorded for metal + acrylic veneer crowns and full metallic crowns. Almost 50% of metal-ceramic abutments had no pathologic findings. Almost 30% of the patients needed replacement, or even some abutments to be extracted and therefore a new prosthodontic appliance.

A method to evaluate and compare two different intraoral radiographs of the same patient

Objective of this study was to determine the accuracy of the method of the clinical intraoral densitometry, to compare differences in the calculation with or without subtraction of the background adjacent soft-tissues from the stepwedge (SW) and to verify which regression model best fitted the experimental data in order to express the measured values in equivalents of SW thickness. Two intraoral radiographs, one after another, were made for each of 6 patients. A copper SW (6 steps, thickness 0.05-0.3 mm) was attached to each radiograph, trying to avoid the superimposition of the bony structures. Films were processed and digitized. Grey levels were measured on each step of the SW, on the background of the SW and on the same 3 randomly chosen regions of interest (ROIs) on each digitized image. The measurement with and without the subtraction of optical densities of the background around the SW from the optical densities of the SW was performed. For the calculation of the SW thickness equivalents, the regression analysis was performed by using different regression models. The best fitting regression model was the 3rd degree polynomial. The results were more precise when using the subtraction of the background overlapping the SW.

Oral status, aesthetic materials and frequency of crowns and bridges in patients with fixed prosthetic appliances living in the Metković region

The aim of the study was to examine oral status in patients of the Metković region with fixed prosthodontic appliances. The aim was also to evaluate aesthetic materials used, and difference between the frequency of crowns and bridges dependent on patient's age and frequency of visits to dentist. The examination was performed on 212 dental patients with fixed prosthetic appliances, from the Public Health Center "Metković". A questionnaire was created for the purpose of this study and was filled in by the patients. The dentist registered oral status. Descriptive statistics and chi 2 tests were used for the data analysis. Following conclusions were made: 1. The examined patients had relatively high caries (tooth decay), gangrene and residual roots prevalence, the oral hygiene was not appropriate, calculus and gingivitis were diagnosed in all patients (100%) and these facts point out to the insufficient preventive oral health care in the Metković region, as well as to the insufficient self-perception on the proper oral hygiene maintenance. 2. Patients who visit their dentist regularly (once a year or more) have significantly more crowns than bridges than the patients who visit their dentist irregularly or when in pain (p < 0.01). 3. Almost all fixed prosthetic appliances not older than 10 years were made of porcelain (98%), while acrylic veneer crowns (or chromasite) were more frequent in appliances older than 10 or 15 years (p < 0.01). There was no gender difference dependent on the material used (p > 0.05). High frequency of porcelain was attributed to the high economic status of this region, as well as to a dentist's preference.

Relationship between body mass index and local quality of mandibular bone structure in elderly individuals

BACKGROUND

Human bones decrease in density and increase in porosity beginning at about the third decade of life. The objective of this study was to determine whether mandibular bone mineral density (BMD) and some linear radiomorphometric measurements on dental panoramic radiograph (DPR) are correlated with different categories of body mass index (BMI) in elderly individuals.

METHODS

Cortical width at gonion (GI), at antegonion (AI), and below mental foramen (MI) and the appearance of the cortex of the lower border of the mandible distal to the mental foramina due to resorptive changes (mandibular cortical index [MCI]) were measured bilaterally on the mandible on 136 DPRs of elderly individuals. Using DPRs and copper stepwedge, mandibular BMD was investigated densitometrically. All BMD values were expressed in equivalents of the actual stepwedge thickness. The patients with BMIs from 20 to 25 kg/m(2) were classified as category 1 (the generally accepted range of normal BMI), and the patients with BMIs higher than 25 were classified as category 2 (heavy individuals with a heavy skeleton and a large amount of fat in the body).

RESULTS

The results revealed statistically significant differences in all measured indices between different BMI categories (p <.05 for MI; p <.001 for GI and AI). Statistically significant differences were also found in BMD values between different BMI categories (p <.05); the differences were more pronounced in women. The patients with MCI category 3 had significantly lower BMD values in comparison to MCI category 2 (p <.01). Intraobserver agreement in GI, AI, MI measurement, and MCI assessments was excellent.

CONCLUSIONS

Heavy people have higher BMD and higher values in linear radiomorphometric measurements than lighter people.

Influence of age and gender on radiomorphometric indices of the mandible in removable denture wearers

The objective of this study was to measure and assess a number of radiomorphometric indices of the mandibular removable denture wearers taking into account age and gender. In a total of 136 dental panoramic radiographs (DPR) the following parameters were evaluated: MI = thickness of the mandibular cortex below the mental foramen, AI = thickness at the antegonion and GI = thickness at gonion; PMI = MI/distance between the low border of the mandible and the low border of the mental foramen, and MCI = mandibular cortical index, based on the assessment of the 3 categories of cortical appearance due to the resorptive changes. There were 40 male patients (mean age 72.7; range 56 to 84 years) and 96 female patients (mean age 69.7; range 48 to 86 years). Patients were grouped according to age into three age groups (1 = less than 65 years; 2 = 65-75 years; 3 = more than 75 years). The results revealed that MI, PMI, AI and GI showed a general downward trend with age for the both sexes until 75 years of age when the mean values of GI, AI and MI begun to fall down sharply for females compared to males. The difference was significant between age groups and gender for GI and AI. Only two categories (C2 and C3) of MCI have been recognized in our study sample, due to the relatively old age groups of patients with removable dentures. However, significantly higher incidence of C3 existed in the oldest group of females.

The effect of removable partial dentures on periodontal health of abutment and non-abutment teeth

BACKGROUND

A removable partial denture (RPD) is a common treatment available for restoration of partially edentulous ridges. Longitudinal studies indicate that RPDs have been associated with increased gingivitis, periodontitis, and abutment mobility.

METHODS

A total of 205 patients with RPDs participated in this study. There were 80 males and 125 females aged 38 to 89, with 123 maxillary and 138 mandibular RPDs. Patients were wearing existing RPDs for different periods ranging from 1 to 10 years. A two-part questionnaire was devised for this study. In the first part, patients answered questions on gender; age; smoking habits; denture age; denture wearing habits; mouth odor; and problems with food accumulating under the denture base, on the outside surface of the denture, and on the outside surface of remaining teeth after eating. The Kennedy classification, material, denture support, denture base shape, and number of teeth in contact, number of existing clasps, and occlusal rests were categorized. The quality of denture construction was also evaluated. In the second part of the questionnaire, baseline recordings of plaque (PI), gingival (GI), and calculus (CI) indexes were made, and Tarbet index (TI), as well as probing depth (PD), gingival recession (GR), and tooth mobility (TM) were measured, both on abutment and non-abutment teeth.

RESULTS

Significant differences (P <0.01) were noted for PI, Cl, GI, PD, TM, and GR between abutment and non-abutment teeth, with abutment teeth showing more disease.

CONCLUSIONS

RPD design plays an important role in the state of the periodontium. Appropriate design and good oral hygiene may decrease the appearance of periodontal disease.

Relationship between the face and the tooth form

The aim of this study was to re-examine Leon Williams geometric theory and to find the degree of correspondence between the face and the tooth form in the population of Zenica, Bosnia and Herzegovina. Two thousand individuals with intact frontal teeth, in age between 17 and 24 years, were measured for 3 horizontal distances on the face: temporal width (Ft-Ft), zygomatic width (Zyg-Zyg) and gonial width (Go-Go) and for 3 horizontal distances on the both upper incisors: cervical width (CW), contact point width (CPW) and incisal width (IW). The length of the face (Tr-Gn) as well as the length of the central maxillary incisors were also measured. The results revealed: 1. Men had significantly larger dimensions for all facial and tooth dimensions (p < 0.05) than women, except for the cervical tooth width (p > 0.05); the left and the right central incisors were of identical dimensions and forms (p > 0.05). 2. The width of upper central incisors were smaller approximately 1.5 mm than in west Europeans. 3. Upon the relation between the 3 horizontal dimensions measured on the face and upper maxillary incisor, 11 facial forms and 10 upper central tooth forms could be recognised in the study population, but 98% of the population had only 3 tooth and face forms. Face shapes: oval face--83.3%, square-tapered face--9.2% and tapered face--7%; tooth forms: tapered-square incisor--53%, oval incisor--30%, tapered incisor--16%. 4. Reversed and enlarged tooth form was in line associated with the facial form in only 30%, while the most common combination was of the oval face form and the tapered-square central incisor (45%). 5. These results disapprove William's theory and may be helpful for the choice of artificial teeth in complete denture construction and the dental industry.

Treatment outcomes with removable partial dentures: a comparison between patient and prosthodontist assessments

PURPOSE

This article presents the results from a survey of patients' degree of satisfaction with their removable partial dentures (RPD) and the comparison between patient and prosthodontist assessments.

MATERIALS AND METHODS

A total of 165 experienced RPD wearers filled in a questionnaire and graded their RPDs depending on their level of satisfaction. A scale ranging from 1 to 5 was used to assess general satisfaction with RPDs and to assess their esthetics, retention, and hygiene. A specialist in prosthodontics assessed the same prostheses using the same scale, not knowing the patient's opinion.

RESULTS

The patients' assessments were high, and more than half of them graded their dentures as excellent. On average, all variables were assessed higher by the patients than by the prosthodontist (P < .001). For the patients who gave the worst grades to their dentures, the grades were lower than the prosthodontist's (P < .001), while the satisfied patients graded their dentures much better than did the prosthodontist (P < .001).

CONCLUSION

On average, patient assessment of the treatment outcomes with RPDs was less critical than prosthodontist assessment. However, the few dissatisfied patients assessed their dentures worse than did the prosthodontist.