Effect of the quality of removable prostheses on patient satisfaction

AIM

The objective of this study was to evaluate patient satisfaction with removable prostheses and its relationship with denture quality.

METHODS AND MATERIALS

Sixty-seven patients who received 119 new removable prostheses over a period of one year at the College of Dentistry, King Saud University, were recalled for an interview with regard to their satisfaction with their dentures and a clinical examination. Prosthetic quality was determined using the California Dental Association criteria.

RESULTS

Results showed 75% and 66% of upper and lower dentures, respectively, were reported by patients as satisfactory. Of all the upper prostheses rated as being of acceptable quality, 94% were also reported by patients as satisfactory, but of those of unacceptable quality, only 52% were reported by patients as unsatisfactory. The corresponding figures for lower dentures were 91% and 71%, respectively. No significant associations were found between patient satisfaction and age, or denture experience.

CONCLUSION

Although acceptable quality of removable prostheses usually resulted in patient satisfaction, the finding that some patients were satisfied with their prostheses despite unacceptable quality suggests other factors besides quality affect outcomes.

CLINICAL SIGNIFICANCE

Patient satisfaction with removable dentures cannot be fully predicted from only the quality standards of those dentures.

Sentiments expressed in relation to tooth loss: a qualitative study among edentulous Saudis

PURPOSE

The objective was to explore and gain insight into the sentiments surrounding tooth loss in a group of edentulous Saudis.

MATERIALS AND METHODS

Using a qualitative methodology, 44 edentulous patients who were receiving complete denture treatment were interviewed in private, in the Arabic language. Interviews were tape recorded and semistructured, following a list of predetermined and piloted topics, but dialogue also took place, with the freedom for both interviewer and interviewee to explore areas of interest. All recordings were transcribed, translated into English, and interpreted independently by two members of the team to identify the core themes associated with tooth loss.

RESULTS

The mean age of participants was 58.9 years (range 35 to 72 years), and they had been edentulous for a mean of 7.1 years (range 3 months to 22 years). The main themes related to tooth loss were unqualified acceptance, inevitability with old age, behavior changes with respect to eating comfort, aged appearance, self-responsibility, positively perceived benefits, high prosthetic expectations and reduced level of denture satisfaction, and some need for privacy.

CONCLUSION

The lack of any outward indication that participants experienced bereavement suggests that outlook on life can influence the impact of tooth loss. Participants' unqualified acceptance of their edentulous fate, yet their clear need to "normalize" oral function, reflects a degree of pragmatism toward life events. The strong influence of religion in Saudi society is a possible factor in the sentiments expressed.

A retrospective analysis of factors associated with the periapical status of restored, endodontically treated teeth

PURPOSE

The purpose of this study was to explore possible associations between prosthodontic, occlusal, endodontic, and periodontal factors and the endodontic status of endodontically treated teeth.

MATERIALS AND METHODS

Forty-six patients who had received endodontic treatment followed by a fixed restoration for at least one of their teeth were recalled and examined clinically and radiographically according to a predetermined set of evaluation criteria. A total of 89 teeth were included, and data obtained included assessments of the coronal restoration and post and core, occlusal contact relationships, a number of endodontic parameters, and periodontal status of the study teeth. For the latter assessment, 54 contralateral teeth were available for purposes of comparison. Teeth were grouped into those with and without periapical radiolucencies, and differences between the groups, with respect to all parameters, were analyzed by logistic regression.

RESULTS

Three factors were significantly associated with the presence of radiolucency: confirmed occlusal contact, by virtue of the tooth being either involved in group function or the only contact in working-side and protrusive movements, and endodontic filling and crown margins of poor quality. None of the other independent variables showed significant associations with the dependent variable of periapical radiographic appearance. Contralateral teeth had better periodontal conditions than restored study teeth.

CONCLUSION

The finding that a good-quality endodontic filling and crown margin improve endodontic outcome corroborates many other similar reports; however, with occlusal contact shown to be associated with failing endodontic treatment, the range of factors that may influence endodontic outcome appears to have widened.

EMG and pain severity evaluation in patients with TMD using two different occlusal devices

PURPOSE

The purpose of this study was to compare the electromyographic (EMG) activity level and signs and symptoms in patients with myogenous temporomandibular disorders (TMD) treated with two different types of occlusal devices.

MATERIALS AND METHODS

Eleven TMD patients were treated with maxillary occlusal devices. The first group received a flat-plane stabilization occlusal device, while the second group received an anatomic occlusal device that maintained the anatomy of the original occlusal surfaces. The severity of signs and symptoms and the masseter EMG activity were recorded and evaluated before treatment and at 72 hours, 2 weeks, and 4 weeks following the delivery of the occlusal device. EMG activity was measured during maximum clenching and during chewing on the right and left sides. The EMG was also recorded for seven normal subjects as a control group.

RESULTS

All patients showed reduction of reported and clinically found muscle pain, with no statistically significant differences between the two groups. A reduction in the EMG activity level at maximum clenching was seen in both patient groups, but was significant only with the anatomic occlusal device. Mean EMG activity during chewing was highly variable within and between groups.

CONCLUSION

The subjective and objective improvements with both types of occlusal devices suggest that either type of occlusal device can be beneficial to TMD patients.