Search

Purpose: A completely edentulous or partially edentulous maxilla involving missing anterior teeth may impact speech production and lead to reduced speech intelligibility. The aim of this study was to prospectively evaluate the effect of a dental prosthetic rehabilitation on speech intelligibility in patients with a toothless or interrupted maxillary arch by means of an automatic, standardized speech recognition system. Materials and Methods: The speech intelligibility of 45 patients with complete tooth loss or a loss including missing anterior teeth in the maxilla was evaluated by means of a polyphone-based automatic speech recognition system that assessed the percentage of correctly recognized words (word accuracy). To replace inadequate maxillary removable dentures, 20 patients from the overall sample had been rehabilitated with complete dentures and 25 patients with telescopic prostheses. Speech recordings were made in four recording sessions (with and without existing prostheses and then at 1 week and 6 months after placement of newly fabricated prostheses). Results: Significantly higher speech intelligibility was observed in both patient groups compared to the original results without the dentures inserted. After 6 months of adaptation, both groups had reached a level of speech quality that was comparable to the healthy control group. However, patients receiving new telescopic prostheses showed significantly higher levels of speech intelligibility compared to those receiving new complete dentures. Within 6 months, speech intelligibility did not significantly improve from the level found 1 week after insertion of new prostheses for both groups. Conclusion: Patients benefit from the fabrication of new dentures in terms of speech intelligibility, regardless of the type of prosthesis. However, telescopic crown prostheses yield significantly better speech quality compared to complete dentures. Int J Prosthodont 2012;25:24-32. [ABSTRACT FROM AUTHOR]

PURPOSE: This prospective clinical trial investigated the effect of different fabrication techniques on screw-joint stability in implant-retained frameworks. MATERIALS AND METHODS: Seventy-nine dental implants (39 Brånemark System and 40 Straumann) were inserted into 20 patients with an edentulous mandible. One of two fabrication techniques was randomly chosen as a definitive restoration, either a cast bar or a bar superstructure modified with the Cresco Ti Precision (CTiP) technique. The patients were divided into four groups depending on the type of implant and prosthetic superstructure: Straumann-conventional (Sc), Straumann-Cresco (SCr), Brånemark-conventional (Bc), and Brånemark-Cresco (BCr). Initial torque values and removal torque values were recorded with a custom-made digital torque controller both 1 week (T1) and 3 months (T2) after clinical function. RESULTS: Statistical analysis revealed significant differences in absolute detorque values at T1 (P = .002) with 4.51 Ncm (SD = 3.80) for the Sc group, 10.65 Ncm (SD = 4.42) for SCr, 11.24 Ncm (SD = 4.00) for Bc, and 9.02 Ncm (SD = 3.81) for BCr. At T2 (P = .000) the median values of lost torque were 5.08 Ncm (SD = 4.05) for the Sc group, 10.51 (SD = 3.00) for SCr, 7.50 (SD = 5.86) for Bc, and 9.41 Ncm (SD = 4.54) for BCr. However, when correlation of detorque values to initial torque values was performed, no statistical differences were found between groups or time points. The percentage of lost torque at T1 (P = .849) and T2 (P = .058) was 28.60% (SD = 21.80) and 32.85% (SD = 24.65), 30.04% (SD = 12.49) and 30.80% (SD = 8.66), 32.11% (SD = 11.37) and 21.03% (SD = 16.53), and 25.33% (SD = 10.69) and 27.83% (SD = 12.57) for the Sc, SCr, Bc, and BCr groups, respectively. CONCLUSIONS: The screw-joint stability of passivated bars is not superior to cast superstructures. A general decrease of approximately 30% of initial torque values can be expected in clinical situations, independent of the implant system used. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this study was to assess and compare clinical outcome results of tooth-implant-supported fixed and removable partial dentures in a selected population group of partially edentulous patients. Biological and technical complications were recorded and reviewed. MATERIALS AND METHODS: A retrospective analysis of the dental charts of 224 patients (174 men, 50 women) with a mean age of 51.3 years was carried out. The evaluation included details regarding the survival and technical complications of the prescribed prostheses, as well as the biological and technical complications associated with both types of abutments used, ie, teeth and implants. RESULTS: A total of 229 prostheses were supported by 459 implants and 449 teeth. They were monitored for a period of 2 to 10 years (median follow-up time: 6.7 years). At the end of the different observation periods, 14% of the tooth-implant-supported prostheses had undergone technical modifications, with no statistical difference in the occurrence of technical complications between the 2 types of prosthesis. Three of the functionally loaded implants were removed, while 23 abutment teeth were lost (15 had undergone endodontic treatment). Abutment teeth with a reduced attachment level after prosthesis insertion were significantly affected by biological complications (P = .04). CONCLUSIONS: The survival data for both types of prosthesis were comparable to prostheses supported solely by implants. There was no difference in the complication rate between primary splinting (fixed) and secondary splinting with telescopic systems (removable). A greater risk of biological complications was recorded for endodontically treated abutments or teeth with a reduced attachment level. [ABSTRACT FROM AUTHOR]

PURPOSE: The objective of this study was to use an oral stereognosis test to evaluate possible intraoral/sensorimotor causes in patients with a psychologic diagnosis of psychogenic prosthesis incompatibility, and to evaluate possible correlations between oral stereognosis and the psychologic diagnostic tools Symptom Checklist-90-R (SCL-90-R) and Center of Epidemiological Studies Depression Scale (CES-D). MATERIALS AND METHODS: The study cohort comprised 83 patients with complete dentures fabricated according to a standardized protocol. Twelve patients diagnosed with psychogenic prosthesis incompatibility (11 women, 1 man) using the SCL-90-R and CES-D scales in a previous study and a group of 24 randomly selected control subjects (14 women, 10 men) underwent an oral stereognosis test with 10 neutral-tasting plastic test specimens with a maximum edge length of 8 mm in 2 test cycles. RESULTS: The results revealed no significant differences in oral stereognostic ability between patients with diagnosed psychogenic dental prosthesis incompatibility and the control patients. The patients in the test group expressed clear dissatisfaction with their dentures. No correlation was found between oral stereognostic ability and the SCL-90-R or CES-D values. CONCLUSIONS: This study is the first to use oral stereognosis tests for patients with psychologically diagnosed psychogenic dental prosthesis incompatibility. The diagnosis of psychogenic prosthesis incompatibility by the SCL-90-R and CES-D scales is affirmed by the lack of correlations between the functional/anatomic aspects of oral stereognostic ability, psychologic diagnostic tools, and the clinical picture of psychogenic prosthesis incompatibility. Thus, psychogenic prosthesis incompatibility can be classified more explicitly as a psychosomatic disorder. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this pilot study was to evaluate and determine psychogenic aspects of prosthesis incompatibility by psychologic tests that define the (psychogenic) prosthesis incompatibility as a psychologic disorder. The patients' complaints with the restorations included taste disorders, odynophagia, pain sensations, and functional and esthetic dissatisfaction. MATERIALS AND METHODS: The study cohort comprised 83 patients with complete dentures fabricated according to a standardized protocol. A dental history questionnaire was used to evaluate whether the patients had adapted to their dentures 6 months after incorporation. Twelve patients with suspected psychogenic prosthesis incompatibility and a group of 24 randomly selected control subjects were evaluated by application of the psychologic tests Symptom Checklist-90-R (SCL-90-R) and the Center of Epidemiological Studies Depression Scale (CES-D). RESULTS: When compared with the control group, patients with suspected psychogenic dental prosthesis incompatibility showed statistically significant differences in the CES-D cumulative values (P = .015) and the SCL-90-R values Global Severity Index (P = .024) and Positive Symptom Distress Index (P = .049). CONCLUSION: This was the first documented study to use the SCL-90-R and CES-D scales on patients with suspected psychogenic dental prosthesis incompatibility with nonadaptation 6 months after incorporation. Adaptation problems were ruled out as a possible cause. Using the SCL-90-R and CES-D, it was possible to make a reliable initial diagnosis of the psychosomatic clinical situation regarding psychogenic prosthesis incompatibility. The results have direct implications on socioeconomic and forensic consequences for diagnosis and treatment by a dental clinician. [ABSTRACT FROM AUTHOR]

The aim of this prospective long-term clinical trial was to verify the clinical success of prefabricated precision attachments with regard to periodontal condition, wearing comfort, and stability of attachment friction. Twenty-eight patients were fitted with 35 prostheses with Swiss Mini-SG precision attachments. Following clinical investigation and monitoring over a 3-year period, 80% of the prostheses were functioning well. The average pocket depth of the abutment teeth at the buccal sites and the periodontal parameters Approximal Plaque Index and Sulcus Bleeding Index showed statistically significant improvements. The abutment tooth mobility (Periotest measurements) decreased. It is not advisable to support the attachments on single abutment teeth. [ABSTRACT FROM AUTHOR]

PURPOSE: This study examined the retentive forces of intracoronal precision attachments after wear cycling. MATERIALS AND METHODS: Three material combinations of an intracoronal cylindric T-attachment were tested. A total of 10,000 separating and joining movements were performed, and retentive forces were measured. RESULTS: Components made of gold alloy performed significantly better (P = .002) than other materials. The average proportional loss of retention was 90% for titanium and 47% for gold alloy components. CONCLUSION: Cyclic loading of metal precision attachment components results in loss of retention, which can be fully compensated by reactivating internal screws in the patrices. Machined, high-noble gold alloys show less wear than other materials. [ABSTRACT FROM AUTHOR]

Aims: Complete maxillary edentulism and prosthetic rehabilitation with removable full dentures are known to affect speech intelligibility. The aim of this study was to prospectively investigate the long-term effect of time on speech intelligibility in patients being rehabilitated with newly fabricated full maxillary dentures., Materials and Methods: Speech was recorded in a group of 14 patients (male = 9, female = 5; mean age ± standard deviation [SD] = 66.14 ± 7.03 years) five times within a mean period of 4 years (mean ± SD: 47.50 ± 18.16 months; minimum/maximum: 24/68 months) and in a control group of 40 persons with healthy dentition (male = 30, female = 10; mean age ± SD = 59 ± 12 years). All 14 participants had their inadequate removable full maxillary dentures replaced with newly fabricated dentures. Speech intelligibility was measured by means of a polyphone-based speech recognition system that automatically computed the percentage of accurately spoken words (word accuracy [WA]) at five different points in time: 1 week prior to prosthetic maxillary rehabilitation (both with and without inadequate dentures in situ) and at 1 week, 6 months, and a mean of 48 months after the insertion of newly fabricated full maxillary dentures., Results: Speech intelligibility of the patients significantly improved after 6 months of adaptation to the new removable full maxillary dentures (WA = 66.93% ± 9.21%) compared to inadequate dentures in situ (WA = 60.12% ± 10.48%). After this period, no further significant change in speech intelligibility was observed. After 1 week of adaptation, speech intelligibility of the rehabilitated patients aligned with that of the control group (WA = 69.79% ± 10.60%) and remained at this level during the examination period of 48 months., Conclusion: The provision of new removable full maxillary dentures can improve speech intelligibility to the level of a healthy control group on a long-term basis.

The present clinical case history report describes an interdisciplinary treatment protocol that combines maxillary tumor resection with immediate reconstruction to achieve functional rehabilitation. A fibula flap that received four dental implants and a split-thickness graft epithelial layer was prefabricated for a 31-year-old man. The flap was designed so that it could be adapted to fit in different extents of tumor resection. Resection and immediate reconstruction were successfully performed 6 weeks after flap prefabrication, with the final bar-retained dental prosthesis delivered 4 weeks later.

Purpose: Tooth loss and its prosthetic rehabilitation significantly affect speech intelligibility. However, little is known about the influence of speech deficiencies on oral health-related quality of life (OHRQoL). The aim of this study was to investigate whether speech intelligibility enhancement through prosthetic rehabilitation significantly influences OHRQoL in patients wearing complete maxillary dentures. Speech intelligibility by means of an automatic speech recognition system (ASR) was prospectively evaluated and compared with subjectively assessed Oral Health Impact Profile (OHIP) scores., Materials and Methods: Speech was recorded in 28 edentulous patients 1 week prior to the fabrication of new complete maxillary dentures and 6 months thereafter. Speech intelligibility was computed based on the word accuracy (WA) by means of an ASR and compared with a matched control group. One week before and 6 months after rehabilitation, patients assessed themselves for OHRQoL., Results: Speech intelligibility improved significantly after 6 months. Subjects reported a significantly higher OHRQoL after maxillary rehabilitation with complete dentures. No significant correlation was found between the OHIP sum score or its subscales to the WA., Conclusion: Speech intelligibility enhancement achieved through the fabrication of new complete maxillary dentures might not be in the forefront of the patients' perception of their quality of life. For the improvement of OHRQoL in patients wearing complete maxillary dentures, food intake and mastication as well as freedom from pain play a more prominent role.

Purpose: The aim of this research was to test the hypothesis that patients' attitudes toward their body affect their capacity to accurately select their existing natural tooth color., Materials and Methods: Standard validated psychologic assessments were used to determine a person's perception of body image and experience. Oral images were compared with the patients' perceptions of their natural tooth color, which were then compared with the actual tooth color judged by a dental professional., Results: For the vital body dynamic and disliking body experience subscales, women exhibited a significantly more negative attitude toward their bodies than men (P = .000). Patients with a negative attitude toward their body tended to choose a lighter tooth color. The correlation between patients' and the testing physician's choices of color was r = 0.540 for women and r = 0.746 for men., Conclusions: Unhappiness with body image and experience results in poor perception of a patient's own oral image, which in turn results in a patient perceiving that his or her natural tooth color is lighter than that judged by a dental professional. This has clinical implications when trying to achieve patient satisfaction with dental prostheses.