Search

TARAMAPUBMED TARAMASCOPUS Statement of problem: Sleeping without conventional complete dentures (CCDs) has been stated by some to induce negative effects on the cardiorespiratory functions of edentulous patients with obstructive sleep apnea (OSA), although others have reported the exact opposite. Therefore, a consensus on nocturnal CCD usage is lacking. Purpose: The purpose of this clinical study was to assess the effects of nocturnal denture usage on cardiorespiratory stability by using pulse oximetry (PO). Materials and methods: Thirty CCD wearers were enrolled in the study. The first nocturnal pulse oximetry (FNPO) recordings were made on 3 different nights while the participants were sleeping without dentures (WOD). Oxygen desaturation index (ODI) and other PO parameters of the participants, including total respiratory event (TRE), basal SpO2 (BSpO2), time≤88 (T88), average low SpO2 (ALSpO2), total pulse event (TPE), average pulse rate (APR), and heart rate variability index (HRVI), were processed and the obtained data were recorded as WOD condition values. According to the ODI scores, the OSA status of the participants was grouped as normal (ODI30). Complete dentures were fabricated by an experienced prosthodontist and a dental laboratory technician by following conventional procedures. At the end of the first month of the follow-up period, the second nocturnal PO recordings (SNPO) were made on 3 different nights while the participants slept wearing dentures (WID), and the data obtained were recorded as WID condition values. The comparison of mean PO values obtained from WOD and WID were analyzed with the Wilcoxon signed- rank test (α=.05). Results: Significant differences were found between WOD and WID values in terms of TRE (P=.01), ODI (P=.001), ALSpO2 (P=.006), TPE (P=.001), and HRVI (P=.001) parameters. The significance of the improvements in the WID condition increased with the severity of OSA. Conclusions: Improvements were observed in substantial cardiorespiratory parameters such as the ODI and HRVI of the participants wearing dentures nocturnally.

Previous studies on single-implant mandibular overdentures have reported favorable results for clinical and patient-reported outcomes. However, information from longer term clinical studies is lacking.The purpose of this clinical study was to assess clinical, radiographic, and patient-reported outcomes of edentulous individuals rehabilitated with single-implant mandibular overdentures after a 5-year follow-up.A prospective clinical study was performed including completely edentulous individuals who received new conventional complete dentures and then an external hexagon implant in the mandibular midline region, followed by the incorporation of a retention system (O-ring/ball attachment; Neodent). Data collection occurred at baseline and 3, 6, 12, 24, and 60 months after implant loading. Assessed outcomes included implant stability, peri-implant soft tissue condition, peri-implant marginal bone level, satisfaction with the prostheses, and oral health-related quality of life (OHRQoL). Clinical maintenance events were also recorded. Descriptive statistics, incidence rates, Wilcoxon Signed Ranks test, and Generalized Estimating Equation regression were used for data analysis (α=.05).Thirty of 34 eligible participants attended the 5-year follow-up visit, mean ±standard deviation age was 68.1 ±7.8 years, and 70% were women. The overall implant survival rate was 88.9%. After 5 years, the OHRQoL showed statistically significant improvement for all evaluation periods compared with baseline (P.001). Regarding satisfaction with the mandibular denture, a significant increase was found between all evaluation periods compared with baseline in terms of comfort, stability, and ability to masticate (P.001). Implant stability significantly increased (P=.003), and a mean bone loss of 1.46 mm was observed compared with baseline measures. The most frequent maintenance event was replacement of the O-ring matrix (n=80). Twenty-one midline fractures of the overdenture occurred in 14 study participants. No significant changes in peri-implant soft tissue conditions were observed.A single-implant mandibular overdenture effectively maintained the positive effect of the intervention on oral health-related quality of life and patient satisfaction, stable peri-implant condition, and acceptable rates of prosthetic events.

Clinical studies regarding satisfaction and occlusal forces with the complete denture in relation to the menopause are sparse.The purpose of this clinical study was to compare satisfaction levels and occlusal force with complete dentures in premenopausal and postmenopausal Indian women.Twenty premenopausal (group pre-MP) and 20 postmenopausal (group post-MP) completely edentulous participants were selected based on inclusion and exclusion criteria, and estradiol levels were measured. Complete dentures were delivered to all participants following standard fabrication and insertion protocols. Three months after denture insertion, when participants were free of postinsertion complaints, satisfaction level (by using a valid and reliable questionnaire), depression level by using the Patient Health Questionnaire, (PHQ-9) and occlusal force (with a gnathodynamometer) were measured. The obtained data of all parameters were tabulated and compared by using a statistical software program (α=.05).For questions pertaining to the overall satisfaction of maxillary and mandibular dentures, the 2 study groups encountered a significant difference with the premenopausal group showing significantly higher satisfaction levels (P.001). Depression scores in the postmenopausal women group were significantly higher than those of the premenopausal women group (P.001). A negative correlation was found between the overall satisfaction with complete dentures and depression levels in the participants indicating decreased overall satisfaction with increasing depression levels in participants (rho=-0.698). The premenopausal group recorded significantly higher estradiol levels than the postmenopausal group (P.001). Mean occlusal force with complete dentures in the premenopausal women group was significantly higher than that of the postmenopausal women group (P.001). A positive correlation was found between the estradiol levels and occlusal forces in the participants indicating that with decreasing estradiol levels, the occlusal forces decrease in the participants (r=0.740).Satisfaction levels and occlusal force with complete dentures were significantly higher in premenopausal women group than in the postmenopausal group.

Objective. To improve the level of clinical diagnosis and treatment, reduce the incidence of complications, and provide the basis for clinicians to choose an appropriate treatment, this research explores the removal methods of the impacted denture in the esophagus by endoscopy. Methods. Based on the clinical information, treatment methods and complications of 72 patients with denture impaction in the esophagus admitted to our hospital from January 2016 to March 2021, which were divided into the group treated with painless endoscopy and the group treated with conventional endoscopy, retrospective analysis of the therapeutic effect and complications was conducted. Results. There was no statistically significant difference between the two groups in terms of denture removal rate ( P > 0.05 ). There were statistically significant differences between the two groups in terms of operating time and incidence rates of complications during and after the procedure. The operating time of the group treated with painless endoscopy was significantly shorter than the group treated with conventional endoscopy ( P < 0.05 ). The incidence rates of complications during and after the procedure of the group treated with painless endoscopy were significantly lower than the group treated with conventional endoscopy ( P < 0.05 ). Conclusions. Compared with the conventional endoscopy, painless endoscopic management of denture impaction in the esophagus under general anesthesia with tracheal intubation improves the clinical efficacy and reduces the adverse reactions. Thus, it is worthy of clinical popularization and application.

Introduction This study was conducted to characterise the oral health conditions of residents in Jiangsu Province, China. Methods In this descriptive study, 5 groups of participants were selected by a multistage stratified equal capacity random sampling, including 3- to 5-year-olds, 12- to 15-year-olds, 35- to 44-year-olds, 55- to 64-year-olds, and 65- to 74-year-olds. The data were collected by using the fifth edition of Oral Health Surveys-Basic Methods recommended by the World Health Organization (WHO). Results In these 5 groups, the mean DMFT/dmft of coronal caries were 3.07, 0.69, 4.03, 7.15, and 11.97, respectively, resulting in prevalence rates of 59.69%, 34.98%, 52.05%, 56.86%, and 72.19%, respectively. However, the filling rates were low in all age groups (1.88%, 17.53%, 29.88%, 16.13%, and 19.36%, respectively). Only 3.58% of the 12-year-old participants had good pit and fissure sealants. The adults include three groups, 35- to 44-year-olds, 55- to 64-year-olds, and 65- to 74-year-olds, and the prevalence rates of clinical attachment loss (CAL ≥4 mm) were 32.19%, 76.47%, and 85.43%, respectively. The proportions of adult groups with implant dentures, fixed dentures, removable partial dentures, complete dentures, and substandard dentures were 0%, 26.44%, 11.11%, 0.67%, and 4.89%, respectively. Additionally, 49.64% of adults had missing teeth that were not replaced. Conclusions Dental caries and periodontal disease were frequent and common in Jiangsu, China. But only a few of the residents sought treatment. Oral diseases continued to be a major problem for local residents.

PURPOSE To establish a recording method for edentulous jaw relations and to perform quantitative accuracy evaluation in vitro. MATERIALS AND METHODS Maxillary and mandibular edentulous arch models and complete dentures were mounted on an articulator, simulating protrusion (A), left and right laterotrusion (B and C), and small opening jaw relations (D), aided by metal foil wax record. Using the tracking system, 3D trajectories of targets were recorded from intercuspation to A, B, C, and D, then used to rehabilitate digital arch relations of A, B, C, and D in the test group. Axial model surfaces were pasted with six pairs of positioning cylinders. The center points of the bottom surfaces of the cylinders in A, B, C, and D were measured to rehabilitate digital arch relations in the control group. With the maxilla as the common area, arch relations of the test group were registered in the control group; 3D deviations of the mandible were calculated, and displacements in horizontal left/right, horizontal anterior/posterior, and vertical directions were analyzed. RESULTS 3D deviations of the mandible in A, B, C, and D were 131 ± 39 μm, 133 ± 44 μm, 120 ± 51 μm, and 112 ± 52 μm, respectively. Mean absolute values of displacements of the mandible were less than 200 μm. CONCLUSION By using the optical jaw tracking system, the accuracy of jaw relation records as measured on an articulator was acceptable for clinical demand. Further investigations among patients are required to clinically verify the results of this study.

The excessive occlusal wear of complete-arch implant-supported prostheses made with metal and acrylic resin is a clinical complication that can require repeated maintenance in certain patients. A patient who presented with moderate occlusal wear of the prosthetic teeth and substantial fracture of the maxillary anterior acrylic resin base only 2 years after a previous replacement of the acrylic resin base and denture teeth is described. Because of the patient's history and existing wear, both the maxillary and mandibular prostheses were repaired by replacing the acrylic resin bases and resin denture teeth but with the addition of cast gold occlusal surfaces on the posterior prosthetic teeth. The provided treatment helped this patient, who was likely to need more frequent maintenance visits in the future because of his history of accelerated occlusal wear and increased occlusal force.

Patients with Sjögren syndrome (SS) experience difficulties in wearing conventional dentures. After removal of all teeth, the oral rehabilitation is challenging and time consuming using conventional treatment protocols. Although implant-retained overdentures are beneficial for this specific patient group, the average total oral rehabilitation time (TORT) usually takes at least 9 months and needs to be reduced to increase patients' quality of life (QoL). In this paper, we report on a new treatment concept for immediate implant-based oral rehabilitation in a 77-year-old patient with partial edentulous SS. Because of persistent pain, discomfort, and retention problems with the conventional prosthetic devices, full clearance of the remaining mandibular dentition and immediate oral rehabilitation with an implant-retained overdenture were suggested. The treatment protocol included virtual surgical planning (VSP), combining a guided bone reduction of the mandibular alveolar process, immediate dental implant placement, and restoration using a prefabricated bar and placement of the overdenture. This method demands the use of ionizing 3D imaging optionally combined with an optical dental scan or a conventional impression. Furthermore, one needs to gain experience using VSP software. This novel treatment concept for immediate implant-based oral rehabilitation using VSP proved to be feasible and safe in a patient with SS, resulting in a significantly reduced TORT and improved QoL. Further research is needed to what extent this treatment concept could be beneficial to other patient groups, such as patients with head and neck cancer.

PURPOSE To investigate the volumetric facial soft tissue changes associated with wearing complete dentures using 3D face scans. MATERIALS AND METHODS Forty volunteers, 20 men and 20 women, were recruited for the study and treated with maxillary and mandibular complete dentures. Six facial scans were taken of each subject. Three scans were wearing a complete denture, and three without them. The 3D face scans were captured with the volunteers in three mouth positions: closed, relaxed, and smiling. Each scan was superimposed in order to analyze and quantify the linear measurements of 14 soft tissue landmarks and the total volume that the subject gained with the prosthesis. RESULTS Three variables were evaluated in each analysis: gender, mouth attitude, and age category. In the analysis of the soft tissue landmarks, there was a significant effect of age, with patients older than 75 years showing the greatest changes (P < .05). The landmarks that showed the most changes were those located around the mouth. In the volume analysis, the variable with the highest influence was gender, with men gaining more volume than women (P < .05). CONCLUSION Complete dentures have a significant effect on volumetric change in perioral tissues. These changes are marked in patients older than 75 years. Compared to women, men depicted greater volumetric changes with complete dentures. These results open a new avenue for clinicians and developers using face scans to design future restorations for edentulous patients.

Purpose The aim of this study was to establish guidelines for the selection of cast and wrought-wire clasps for removable partial dentures (RPDs) that would be appropriate for clinically encountered undercuts and facial curvatures. Methods Randomly selected discarded casts were collected and 30 premolars and 30 molars were surveyed, sectioned to a line representing the clasp and scanned using a flatbed scanner. The average clasp curvature and length for each group was determined and a three-dimensional model printed, to which wrought wire clasps of 0.9- and 1.0-mm diameter were adapted. Standard wax clasp patterns were adapted and cast in a stellite alloy. Each clasp was deformed beyond its proportional limit; and the forces exerted at that limit and at deflections of 0.25 mm, 0.5 mm, and 0.75 mm were measured, and a safety limit was calculated that would ensure elastic deformation at the required undercuts. Results A table was produced with guidelines for those clasps that would provide the highest retentive force within the proposed safety limit. The highest forces were provided by cast clasps in a 0.25-mm undercut. Wrought round wire of 1-mm diameter provided the next highest retentive forces, in a 0.25-mm undercut for premolar clasps arms and 0.5-mm for molar clasps. Conclusions The results provide valid guidelines for the use of combinations of clasp material and undercut that would exert the maximum retentive force without deformation for both short (premolar) as well as long (molar) clasps, for wrought and cast clasps.

Purpose This study comprehensively reviewed the current status of digital workflows in fabricating removable partial dentures (RPDs) using evidence from clinical trials and case reports. Study selection We performed a systematic review of the literature on the materials and fabrication of RPDs using digital technologies published in online databases from 1980 to 2020. We selected eligible articles from the search results, retrieved information on digital RPDs from these, and conducted a qualitative analysis. We report evidence from clinical papers and case reports, digital impression-taking methods, and maxillomandibular relationship (MMR) records. Results A case report electronically published in 2019 introduced a clasp-retained RPD fabricated via a full-digital workflow without a gypsum definitive cast. Computer-aided design and computer-aided manufacturing of double-crown-retained RPDs with nonmetal materials were described in some case reports. Intraoral scanners were used to obtain digital impressions and MMR records in the fabrication of digital RPDs, which have potential advantages for reducing the number of clinical appointments and simplifying laboratory procedures. Evidence from clinical trials is scarce; a randomized controlled trial reported higher patient satisfaction with digital clasp-retained RPDs than with conventional RPDs. Conclusions Full-digital RPDs can be fabricated without a gypsum definitive cast. However, the indication for full-digital RPDs is limited to cases with Kennedy Class III/IV partially edentulous arches with several missing teeth. Challenges in digital impression-taking and MMR recording remain to be solved to extend these indications. More evidence from clinical trials is required to evaluate the efficacy and usefulness of digital R PDs.

PURPOSE To evaluate whether poor oral health is associated with a higher risk of malnutrition based on the Mini Nutritional Assessment (MNA) or MNA-SF (short form) in older adults. STUDY SELECTION For this meta-analysis, cohort and cross-sectional studies with adults 65 years and older, reporting oral health outcomes (i.e. edentulism, number of teeth) and either the MNA or MNA-SF were selected. Four electronic databases were searched (Medline via PubMed, Web of Science, Cochrane Library and EMBASE) through June 2020. Risk of bias was assessed with the checklist by the Agency for Healthcare Research and Quality scale. RESULTS A total of 928 abstracts were reviewed with 33 studies, comprising 27,559 participants, aged ≥65 being ultimately included. Meta-analyses showed that the lack of daily oral hygiene (teeth or denture cleaning), chewing problems and being partially/fully edentulous, put older adults at higher risk of malnutrition (p < 0.05). After adjustment for socio-demographic variables, the included studies reported lack of autonomy for oral care, poor/moderate oral health, no access to the dentist and being edentulous with either no dentures or only one denture were risk factors significantly associated with a higher risk of malnutrition (p < 0.05). CONCLUSIONS These findings may imply that once elders become dependent on others for assistance with oral care, have decreased access to oral healthcare, and lack efficient chewing capacity, there is increased risk of malnourishment. Limitations of the study include heterogeneity of oral health variables and the observational nature of the studies. Further studies are needed to validate our findings.

PURPOSE The purpose of the present study was to explore the factors related to oral health-related quality of life (OHRQoL) in elderly patients who underwent prosthetic treatment with removable dentures through several objective and subjective examinations and to analyze their interrelationships. METHODS The current study involved 78 denture wearers, aged 65 years or above, who underwent treatment at the clinic of prosthodontics and undertook routine checkups. The present study used eight age-matched patients with healthy dentition as controls. The following items were evaluated: OHRQoL (Oral Health Impact Profile), main occluding area, maximal occlusal force, masticatory performance, and masticatory ability. Spearman's rank correlation coefficient was used to assess the correlation between the OHIP score and each item and multiple linear regression analysis with the backward elimination method was used to analyze the factors affecting the OHIP score (α = 0.05). RESULTS The OHIP summary score was significantly correlated with the number of occlusal supports, number of remaining teeth, maximal occlusal force, and the masticatory ability score. The multiple regression analysis revealed that the number of occlusal supports, the number of remaining upper teeth, whether the upper main occluding area was the remaining tooth or not, and the masticatory ability score were the significant independent variables that affected the OHIP summary scores. CONCLUSIONS The present study verified the relationship between the OHRQoL and the occlusion of remaining teeth or the items derived from the main occluding areas. The current results suggest that retaining the maxillary first molar is a key factor in the OHRQoL.

PURPOSE This study aims to evaluate the effect of rehabilitation with complete dentures versus implant-retained overdenture on activity in various parts of the brain cognition in a geriatric edentulous population via Functional MRI (fMRI) studies and the Mini-Mental State Examination (MMSE). METHODS Ten completely edentulous patients were rehabilitated with both complete dentures and two-implant retained overdentures for three months each. fMRI studies were performed for each modality during chewing and recall tasks at three time periods: T0: Completely Edentulous(CE) T1: after three months of wearing Conventional Complete Dentures(CD) and T2: after three months of wearing Implant-retained Overdentures (IOD). The Z scores obtained from the fMRI at these phases of examination were tabulated and correlated with MMSE scores obtained at the corresponding time periods. RESULTS Z scores obtained during the memory recall tasks at T2 were the greatest (Prefrontal Cortex (p=0.059) and Hippocampus (p=0.036). The MMSE scores obtained were significantly higher for the IODs when compared to the CDs and Baseline values (p < 0.05)Conclusion: IODs may potentially result in superior sensory feedback in edentulous patients and lead to improved cognitive performance when compared to conventional complete dentures.

Swallowed partial dentures in elderly patients is an emergency situation that requires a swift response. Here, we report a case involving a patient with severe intellectual disability who swallowed his denture, which lodged at the oesophagus inlet. After failure of endoscopic removal, denture with clasp was removed using long forceps through intraoral approach under intravenous sedation. At the pharynx and oesophagus inlet level, removal of foreign body via intraoral approach should be preferentially considered over open surgery for faster patient recovery.

Purpose To evaluate the efficacy of manual and machine-aided cleaning to remove matured plaque from removable partial dentures (RPD). Materials and methods A total of 32 patients with bilateral free-end saddle RPDs were included. The plaque was stained, and the RPD was photographed on all sides. One saddle was randomly allocated to manual cleaning, while the other was allocated to no cleaning. The patient manually cleaned the saddle by applying a denture brush and gel. The whole RPD was then cleaned with the aide of a machine using a rotating needle device. After each step, plaque dyeing and photographing were repeated. The plaque proportions (% pixel) were measured using special software. For statistical analysis, mixed models were used to adjust for baseline covariates, including plaque and surfaces, and to cover all time points. Results The mean plaque area without cleaning at the fitting surface was higher than at the buccal/lingual surfaces (32.8% [95% CI: 28.1% to 36.4%] vs 15.3% [13.1% to 17.4%], respectively). Manual cleaning was not substantially better than no cleaning (4.6% [-0.1% to 9.2%] for the difference at fitting surfaces; disclaiming a substantial difference of > 10%; the difference found was even smaller at buccal/lingual surfaces). Machine-aided cleaning was substantially better than manual cleaning (16.1% [12.0% to 20.2%] for the difference at fitting surfaces and 7.3% [4.6% to 10.0%] at buccal/lingual surfaces). The combination of manual and machine-aided cleaning was not better than machine-aided cleaning alone (-0.2% [-2.6% to 2.1%] difference at fitting surface). Conclusion Manual cleaning is insufficient in removing matured denture plaque. Machine-aided cleaning is clearly superior to manual cleaning, especially at fitting surfaces.

Oligodontia demands multidisciplinary management due to its repercussions on dentofacial growth. To place implants to realize implant-borne fixed denture, preimplant surgery may be necessary if bone volumes are insufficient. Our aim was to assess bone increase following autogenic bone grafting and to discuss prosthetic options. Twenty patients followed for oligodontia, who underwent bone grafting, were treated from 2008 to 2019. Transversal and vertical bone levels were measured pre- and postoperatively to assess alveolar ridge augmentation. Mean horizontal grafting increase was 4.60 mm [standard deviation (SD) 0.79 mm], mean sinus lift increase was 9.95 mm (SD 2.35 mm). Mean implants placed per patient was 9, mean implants placed on grafted site was 5 per patient. Overall implant survival rate was 100%. All patients benefited from prosthetic procedures when it was planned to perform implant-borne fixed dentures. Within the framework of a complete treatment plan (involving paediatric dentistry, dentofacial orthopaedics, oral and maxillofacial surgery, and prosthodontics), autologous bone grafting combined or not with orthognathic surgery is fully adapted to patients with oligodontia. It allows reconstruction of favourable bone volumes for placement of implants to realize implant-borne fixed dentures, with high implant survival rates and great improvements to quality of life.

The addition of palatal rugae to complete dentures has been suggested to improve the satisfaction of patients with different oral functions. However, clinical studies to support these claims are lacking.The purpose of this randomized, single-blind, 2-period crossover trial was to assess the satisfaction of edentulous patients and their oral health impact profile when provided with complete dentures with palatal rugae compared with a polished palate.Edentulous patients aged 45 to 80 years, with no relevant medical conditions, seeking complete dentures at a university hospital between May and July 2019 were recruited. Each participant received new complete dentures. After a 1-week adaptation period, the participants were randomly allocated to 2 sequences through a computer-generated sequence. In the first sequence, palatal rugae were added to the complete dentures, and after 2 months, the palatal rugae were removed and the dentures used for another 2 months. In the second sequence, the opposite sequence was followed: polished palate first and palatal rugae second. After each period, a blinded dentist asked participants to rate their general satisfaction on a 100-mm visual analog scale (primary outcome) and to rate their satisfaction regarding eating, taste perception, speaking, phonetics, and ease of cleaning. Participants were also asked to fill the 20-item oral health impact profile for edentulous patients (OHIP-EDENT). The paired sample t test and the Wilcoxon test were used (α=.05).Fifty participants were randomized, of whom 6 dropped out. No significant differences were found between ratings for the 2 palatal contours in terms of general satisfaction 2.32 (95% confidence interval: -3.65 to 8.29, P=.438), eating 1.70 (95% confidence interval: -4.05 to 7.46, P=.554), taste perception 0.57 (95% confidence interval -5.04 to 6.17, P=.839), phonetics 1.48 (95% confidence interval -4.46 to 7.41, P=.618), or speaking 3.68 (95% confidence interval: -1.92 to 9.28, P=.192). However, satisfaction with ease of cleaning dentures with palatal rugae was significantly less 12.16 (95% confidence interval: 6.81 to 17.50, P.001). The differences in the OHIP-EDENT total scores were not significantly different -1.75 (95% confidence interval: -3.7 to 0.23, P=.082). Differences in each item ratings were also found to be not significantly different (P.05), except for the frequency of mealtime interruption (P=.041), which was reported to increase when rugae had been provided.Complete dentures with palatal rugae were not perceived to improve patient satisfaction or oral health-related quality of life. However, they were perceived to be more difficult to clean and to increase frequency of interruptions during eating.

This article aims to describe common complicating factors that impact on the success of complete denture treatment and present an overview of the challenges these pose in practice. The authors present a range of medical, oral and social factors to consider when providing treatment to edentulous patients, allowing the practitioner to identify cases which may require referral. The information is applicable to all dental practitioners, and is a useful aid to highlight complicating factors in individual patients and to make well-informed clinical decisions.

OBJECTIVE To systematically evaluate the effect of microwave disinfection on the dimensional stability of denture base acrylic resins. BACKGROUND Microwave disinfection has been considered as an alternative method for disinfecting complete dentures to help prevent and treat denture stomatitis. However, data on the impact of microwave disinfection on the dimensional stability of acrylic resins are still scarce. METHODS The PubMed/Medline, SCOPUS and EMBASE databases were searched in order to assess articles published in English up to January 2021 (CRD42021212267). We included studies that have assessed the effect of microwave disinfection, on the dimensional stability of acrylic resins, comparing them with negative or positive controls. RESULTS A total of seven in vitro studies were included. The qualitative synthesis demonstrated that, in general, microwave disinfection produced more distortion on the materials than do immersion in sodium hypochlorite, chloride solution, chlorhexidine, and water immersion. However, considering the dimensional stability of the specimens, microwave disinfection at 500 W for 3 minutes, and at 450 W for 5 minutes, produced similar or better outcomes than did control groups. CONCLUSION In general, microwave disinfection promotes changes in the dimensional stability of denture base acrylic resins, and should thus be used with caution. However, microwave disinfection protocols at lower power settings (500 and 450 W) and exposure times (3 and 5 minutes) produces similar or less distortion than chemical disinfection. More studies are still required in order to evaluate the clinical and long-term implications of microwave disinfection.

Objective This study aimed to investigate the potential relationship between oral hygiene and the risk of oral cancer and its subtypes after controlling the effects of several confounding factors. Materials and methods A large-scale case-control study was conducted from January 2010 to August 2019, recruiting a total of 1,288 oral cancer cases with newly diagnosed and 4,234 healthy controls. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were utilized to minimize confounding effects. Conditional logistic regression was used to evaluate the effects of oral hygiene indicators on oral cancer. Results A composite oral hygiene score was developed based on five indicators selected based on PSM and IPTW analysis (including tooth loss, dentures wearing, the frequency of tooth brushing, regular dental visits, and recurrent dental ulcer). Participants with a higher score, compared with their lower counterparts, showed a 49% increased risk (the odds ratio (OR) was 1.49 (95% confidence interval (CI): 1.26-1.75). A similar association pattern was found following IPTW analyses (OR = 1.32; 95% CI: 1.22-1.42). Of note, the adverse effects of poor oral hygiene were more evident among the sites of gingival and buccal (PSM analysis: 2.03-fold and 2.68-fold increased risk; IPTW analysis: 1.57-fold and 2.07-fold increased risk, respectively). Additionally, a greater positive association was observed between poor oral hygiene and oral squamous cell carcinoma, compared with other pathological types. Conclusion This study establishes a composite oral hygiene score and provides supportive evidence of poor oral hygiene associated with a higher risk of oral cancer, particularly in the gingival and buccal mucosa sites and in the squamous cell carcinoma. Clinical relevance The data highlights the importance of improving poor oral hygiene habits, which has public health implications for the prevention of oral cancer.

Aim: To investigate the within- and between-person longitudinal effects of tooth loss and the use of dentures, clinically assessed by dentists, on cognitive decline in a representative sample of community-dwelling older Brazilian adults. Methods: Data came from 1265, 1112 and 1021 individuals aged ≥60 years who participated in the second (2006), third (2010) and fourth (2015) waves, respectively, of the Health, Well-being and Aging study (SABE). Cognitive performance was evaluated with the abbreviated version of the Mini-Mental State Examination (MMSE). The number of natural teeth was classified according to three categories: none, 1–19 and ≥20 teeth. The presence of removable full or partial dentures in each dental arch (yes/no) was recorded. Hybrid regression models, adjusted for sociodemographic, behavior and health-related covariates, were used to estimate the between- and within-person effects of the longitudinal association between cognitive performance and oral health. Results: Participants with 1–19 and no teeth had, respectively, 1.15 (95% CI 0.65–1.66) and 1.54 (95% CI 0.99–2.09) units lower MMSE score than those with ≥20 teeth. Denture wearers had 1.54 (95% CI 1.13–1.95) units greater MMSE score than non-denture wearers, and those who started wearing dentures during the follow up had 0.83 (95% CI 0.21–1.45) units greater MMSE score after the transition. Conclusion: Our main findings showed that the use of dental prostheses might be a protective factor for cognitive decline. Geriatr Gerontol Int 2021; 21: 1093–1098.

Background. The ultimate goal of the study was to approximate the burden and patterns of dyslipidemia in a subset of the elderly population (≥60–85 years) living in Asmara, Eritrea, and to identify modifiable risk drivers. Methods. A total of 319 (145 (45.5%) male vs. 174 (54.5%) female, mean age ± SD (68.06 ± 6.16 years), participants from randomly selected estates within Asmara were enrolled. Demographic and medical information was collected using a standardized questionnaire. Anthropometric, lipid panel, fasting plasma glucose (FPG), and blood pressure (BP) measurements were subsequently taken. Results. The prevalence of dyslipidemia was 70.5%. The proportions of dyslipidemias were (in order of decreasing frequency) high TC (51.2%), LDL-C (43.7%), low HDL-C (28.2%), and TG (27.6%). The average (±SD) concentrations in mg/dL of TC, LDL-C, non-HDL-C, TG, HDL-C, TC/HDL-C, and TG/HDL-C were 202.2 ± 40.63 , 125.95 ± 33.16 , 151.72 ± 37.19 , 129 ± 57.16 , 50.48 ± 10.91 , 4.11 ± 0.91 , and 2.72 ± 1.49 , respectively. Furthermore, 17.5%, 21.6%, 11.0%, and 5.0% had abnormalities in 1, 2, 3, and 4 lipid disorders with the copresence of TC+LDL-C abnormalities dominating. Regarding National Cholesterol Education Program Third Adult Treatment Panel risk strata, 18.5%, 14.5%, 28.2%, and 12.9% were in high or very high-risk categories for TC, LDL-C, TG, and HDL-C, respectively. The high burden of dyslipidemia coexisted with an equally high burden of abdominal obesity (43.1%), FPG ≥ 100 mg / dL (16%), hypertension (28.5%), and physical inactivity. Overall, dyslipidemia was associated with sex (females: aOR = 2.6 , 95 % CI = 1.1 – 6.1 , p = 0.017 ) and daily physical activity—higher in individuals undertaking physical activity for aOR = 2.6 , 95 % CI = 1.1 – 6.1 , p = 0.029 ), 1-2 hours ( aOR = 3.2 , 95 % CI = 1.24 – 8.5 , p = 0.016 ), and 2-3 hours ( aOR = 2.0 , 95 % CI = 0.7 – 5.8 , p = 0.192 ) (Ref: >3 hours). Additional associations included increasing FPG ( aOR = 1.02 , 95 % CI = 1.0 – 1.04 , p = 0.039 ), and BMI ( aOR = 1.19 , 95 % CI = 1.09 – 1.3 , p < 0.001 ). These factors, along with waist circumference (WC), consumption of traditional foods, systolic BP, and diastolic BP, were, with some variations, associated with disparate dyslipidemias. Conclusions. The burden of dyslipidemia in the elderly population in Asmara is high. Modifiable risk drivers included FPG, WC, physical inactivity, and low consumption of traditional food. Overall, efforts directed at scaling up early recognition and treatment, including optimal pharmacological and nonpharmacological therapy, at all levels of care, should be instituted.

The aim of this study was to evaluate the factors influencing edentulous patients’ willingness about mandibular implant-supported complete denture. A cross-sectional study was carried out with 117 bimaxillary edentulous patients wearing removable complete dentures (CDs). Patients were assessed concerning denture-related items (number of previous mandibular CDs, previous denture wearing period, dentures maker professional, and regular wearing of previous mandibular dentures) and individual-related aspects, such as mandibular edentulousness period, mandibular bone height, and willingness to the use of mandibular implant-supported complete denture. Masticatory performance was evaluated by the median particle diameter. Mandibular bone height and satisfaction were assessed using a validated method. The Chi-square test was used for data analysis and prevalence ratios were adjusted by using multivariate Poisson regression, both with 95% confidence interval. A total of 78 participants (66.7%) were interested in mandibular implant-supported overdenture (mean age 65.33 ± 9.49). Masticatory performance was not influenced by choosing mandibular implant-supported complete denture. The preference about mandibular implant-supported complete denture was correlated with longer mandibular complete denture experience (p = 0.021) and it was significantly associated with dissatisfaction about retention (p = 0.005). Previous experience with mandibular complete dentures and dissatisfaction about retention influence the willingness about mandibular implant-supported overdenture. Many factors are associated with rehabilitation preferences for edentulous patients and mandibular implant-supported complete denture is one of the available alternatives. Therefore, this study has demonstrated the factors influencing the decision to replace a mandibular conventional complete denture by dental implant treatment based on patient’s outcomes. Such finding may be considered as a relevant aspect towards shared decision-making for prosthodontic rehabilitation of edentulous patients.

Mild cognitive impairment (MCI) is a symptomatic predementia phase of the trajectory of cognitive decline, and its prevalence increases with age. Although the relationship between oral health and MCI have been explored previously, it is uncertain whether individuals with different tooth loss rates have altered MCI risks. We hereby conducted a longitudinal study by using data from the Chinese Longitudinal Healthy Longevity Survey to investigate the association. Tooth loss rate was defined as the difference of teeth between two interview waves divided by years of interval; participants were then grouped into four categories: stable, no tooth loss; mild, 0-1 tooth loss; middle, 1-2 tooth loss; and severe, more than 2 tooth loss per year. Cognitive function was assessed by the Chinese version of Mini-Mental State Examination. We used the generalized estimating equation model to estimate the odds ratio (OR) and the 95% confidence intervals (CIs) and applied the restricted cubic spline function to explore the dose-response association. Among 11,862 participants, 3,966 developed MCI in a median follow-up time of 5.93 years. Higher tooth loss rate was associated with an increased risk of MCI in elderly subjects. Compared with subjects with stable tooth, the corresponding ORs (95% CIs) were 0.94 (0.85-1.03), 1.16 (1.04-1.29) and 1.28 (1.17-1.40) for subjects with the mild, middle and severe rate of tooth loss. A nonlinear dose-response relationship was detected (Pnon-linearity = 0.0165). Similar results were observed in the subgroup analyses stratified by sex, age at baseline, and number of teeth at baseline. The positive association was only observed among denture nonwearers (OR middle vs stable: 1.19; 1.06-1.35; OR severe vs stable: 1.35; 1.22-1.50), but not among denture wearers. In conclusion, among elderly population in China, higher rate of tooth loss may be associated with an increased risk of MCI, while denture wearers may be less likely to develop MCI.

Background Cross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design. Methods This prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures. Results At baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs – but higher dental care use – than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures. Conclusions It was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants).

To analyze the clinical effect of digital impression combined with all-ceramic denture restoration on patients with dental defects.A study was conducted on 120 patients with dental defects admitted to Dongfeng Stomatological Hospital from June 2018 to June 2020. The two groups of patients were randomly divided into digital imprinting modules and silicone rubber imprinting modules using a random number table method. There were 60 cases in each group. The silicone rubber imprint module used traditional silicone impression combined with all-ceramic denture restoration, while the digital imprint module used digital impression combined with all-ceramic denture restoration.The clinical efficacy of the two groups was observed. Gingival index (GI), periodontal index (PI) before dental restoration, during dental restoration and 6 monthes after dental restoration were compared. The adjacent surface contact conditions, occlusion and adverse reactions of the two groups were compared. SPSS 22.0 software package was used for statistical analysis.The two groups of patients selected grade A and grade B for the evaluation of the restoration when the restoration was completed. The number of patients who chose grade A for the digital imprint module was more than that of the silicone rubber imprint module,but there was no significant difference(P＞0.05). Six months after the tooth was worn, GI and PI indexes of the two groups of patients increased. GI and PI indexes of the silicone rubber stamping module were significantly higher than those of the digital stamping module(P＜0.05). When dental restoration was completed and 6 months after the tooth was replaced, the pass rate of contact between the adjacent surfaces of the imprinting module patients was significantly higher than that of the silicone rubber imprinting module(P＜0.05). When dental restoration was completed, the occlusion of the digital imprinting module patients was significantly better than that of the silicone rubber imprinting module(P＜0.05). Six months after wearing the denture, there was no significant difference in occlusion between the two groups of patients(P＞0.05). When dental models of the two groups of patients were taken, the incidence of adverse reactions in patients with digital imprints was significantly lower than that of silicone rubber imprints(P＜0.05).The use of digital impressions combined with all-ceramic restorations to repair patients with dental defects can effectively improve the treatment effect, improve prognostic GI and PI indexes of the patients, increase the pass rate of the adjacent surface contact and occlusion of the tooth, and reduce the process of dental restoration. The incidence of adverse reactions are minimal, with good prognostic effects. It is worthy of clinical application.

Background Oral hypofunction is defined as the reversible stage preceding oral dysfunction. However, its assessment and management need further examination and consideration. Objective The present study aimed to examine the current state of oral hypofunction among outpatients at the university hospital. Methods New outpatients underwent medical interviews and detailed assessment of oral hypofunction at their initial visit to our dental department. Oral hypofunction was diagnosed if results of three of the following seven assessment items were below cutoff values: poor oral hygiene, oral dryness, reduced occlusal force, decreased tongue-lip motor function, decreased tongue pressure, decreased masticatory function, and deterioration of swallowing function. The relationships between factors used to diagnose oral hypofunction as well as the distributions of assessment values were clarified. Results Seventy-five of 209 patients (35.9%) were finally diagnosed with oral hypofunction. Diagnosis of oral hypofunction was significantly related to patient age, Eichner index, a chief complaint of dental or periodontal disease or ill-fitting dentures, and a history of neurodegenerative disease. The lowest quintile values for poor oral hygiene, oral dryness, and decreased masticatory performance were all above current cutoff values. Reduced occlusal force contributed strongly to the diagnosis of oral hypofunction. Conclusion Oral hypofunction in dental outpatients at a university hospital was associated with patient age, medical history, and chief complaint at presentation. Diagnosis of oral hypofunction can be closely related to reduced occlusal force. The validity of cutoff values for assessments of oral hypofunction needs further consideration.

A digital dental technique is described for registering functional borders of immediate complete dentures, by using an intraoral scanner, a dental computer-aided design software program, and a peripheral custom tray. This article also illustrates how to virtually match the recorded information in order to transform the initial intraoral scan into definitive digital scans.

OBJECTIVES To determine implant survival and success of four conventionally but initially asynchronously loaded implants in implant-supported overdentures for the edentulous maxilla, in participants with opposing mandibular two-implant overdentures. MATERIAL AND METHODS Twenty-six participants received four implants in the region of the maxillary canines and molars. After healing, 24 of these participants (mean age: 68.3 years) were randomly allocated to one of two treatment groups, and the adapted overdenture was attached to two unsplinted cylindrical attachments. The other two matrixes remained unattached to the implants for 3 months. After this period, the other two implants were loaded for 3 months (cross-over design). Then, all four implants were loaded for another 3 months. Kaplan-Meier curves were used to evaluate survival and success of implants and dentures. RESULTS During the active prosthetic study phase, three participants lost one implant. Two participants lost three implants during the recall period. Implant survival after loading was 93.8% after a mean observation period of 3.1 years. Denture survival was 100%, but denture success was 95.8%, due to major prosthetic complications. Most participants preferred four implants to two. CONCLUSIONS Within the limitations of the study, it can be concluded that maxillary implant overdentures on two or four implants are both recommendable treatment options. Two posterior implants are not superior to two anterior implants under overdentures retained by unsplinted cylindrical attachments. Implant and prosthetic complications and aftercare measures are common but are mostly easy to handle. However, 23 of the 24 participants preferred the 4-implant maxillary overdenture.

Introduction: A key purpose of denture provision is to enable eating, yet the body of evidence pertaining to the impact of dentures on wide-ranging nutritional outcomes has not been systematically reviewed. Objectives: To systematically review published evidence pertaining to the effect of wearing removable dental prosthesis on dietary intake, nutritional status, eating function, and eating related–quality of life (ERQoL). Methods: Eight questions relating to the impact of wearing dentures on nutritional outcomes were addressed. The target population was healthy adults aged ≥18 y. Data sources included Medline, Embase, CINAHL, and PubMed. Included were all human epidemiologic studies. The Newcastle-Ottawa score was used for appraisal of study quality. Harvest plots, vote counting, and accompanying narrative provided the basis for synthesis. Results: Of the 1,245 records identified, 134 were retrieved and eligibility assessed by 2 reviewers, and 41 studies were included in the synthesis (14 rated good quality, 20 fair, and 7 poor). The balance of data supported a positive impact of wearing full (5/7 studies) or partial (3/3 studies) dentures (vs. no dentures) on nutritional status, though no clear direction of effect was detected for the impact of dentures on dietary intake. The balance of data clearly showed that objective measures of eating function were compromised in full (14/15 studies) and partial (6/7 studies) denture wearers as compared with the dentate. Data showed that ERQoL was also compromised in denture wearers as compared with the dentate (3/3 studies). However, data showed a positive impact of wearing dentures on ERQoL (5/5 studies) as opposed to wearing no dentures. Conclusion: The balance of evidence shows that despite no clear pattern on impact of wearing dentures on measured dietary intake, in those with tooth loss, wearing dentures can have a positive impact on nutritional status and enjoyment of eating. Knowledge Transfer Statement: The results of this systematic review can be used to advocate for health care services to address prosthodontic need to benefit nutritional outcomes. The findings will be of use in educating health care professionals on the impact of wearing dentures and not addressing prosthodontic need on nutritional outcomes.

The ability to provide high-quality complete dentures is a key skill for the GDP. The increasing prevalence and utilisation of implant-supported overdentures has opened the possibility of a wide variety of treatment options to support patient care, while also creating the need for primary care practitioners to have a greater awareness of commonly used prosthetic attachments.A thorough understanding of the advantages and disadvantages of implant-supported overdentures is essential to ensuring appropriate treatment planning, consent and maintenance. This two-part series explores various aspects of implant-supported overdentures including assessment of the patient, treatment planning, different attachment systems and maintenance requirements.Part one will explore availability of implants in the NHS, the commonly available implant attachment systems, including their relative advantages and disadvantages.

Statement of problem Implant-assisted removable partial dentures (IARPDs) have been proposed as a treatment option for partially edentulous patients. However, evidence regarding the outcome of implant-assisted removable partial dentures with implant surveyed prostheses is limited. Purpose The purpose of this retrospective clinical study was to evaluate the clinical status and complications of IARPDs combined with implant surveyed prostheses in terms of clinical tissue condition, marginal bone resorption, and prosthetic complications. Material and methods Patients treated with IARPDs combined with implant surveyed prostheses who had worn an IARPD for at least 12 months were included. Twenty-four participants (25 prostheses, 12 maxillary, and 13 mandibular) were evaluated, with 80 implants used as abutments for IARPDs. The average follow-up period was 27.6 months, and the maximum follow-up was 78 months. Implant cumulative survival rate, marginal bone resorption, probing depth, peri-implant inflammation, bleeding, plaque, calculus, and complications were evaluated. Results No implant failure occurred, and all implants functioned without clinical mobility. Mean marginal bone resorption of implants at 1 year after loading was 0.77 ±0.63 mm, and mean probing depth was 3.4 ±0.1 mm. No patient developed peri-implantitis, and no implant failed. Two clasp fractures, 1 rest fracture, 1 decementation, and 1 fracture of porcelain on an implant surveyed prosthesis were detected at 12 months after loading. Conclusions Well-planned IARPDs using implant surveyed prostheses were clinically successful. Longitudinal and systematic clinical studies are necessary to confirm these results.

BACKGROUND Although microvascular free flaps are often used to reconstruct maxillary defects, dentoalveolar rehabilitation is arguably less common despite its importance to midface function and aesthetics. The aim of this study is to review the contemporary management of maxillary defects in a single quaternary referral institution to identify factors that assist or impede dentoalveolar rehabilitation. METHODS A retrospective review of maxillary reconstructions performed between February 2017 and December 2020 was performed. Patient characteristics, defect classification, operative techniques, complications and dentoalveolar outcomes were recorded. RESULTS A total of 85 maxillary reconstructions were performed in 73 patients. Of the 64 patients where dental rehabilitation was required, 31 received a functional denture (48%) with 24 (38%) being implant-retained. Significant predictors of successful rehabilitation included the use of virtual surgical planning (VSP; 86% vs. 25%, p

OBJECTIVE To measure impact of oral health in complete denture wearers and its effects on masticatory efficiency with new complete dentures over the period of three months. STUDY DESIGN Experimental study design. PLACE AND DURATION OF STUDY Department of Prosthodontics, Bahria University Medical and Dental College, Karachi, Pakistan from September 2019 to December-2019. METHODOLOGY Oral health impact profile (OHIP) was used to measure the oral health impact; and chewing gum method was used to measure the masticatory efficiency in this study. All participants were old denture wearers having the experience of at least 3 years and requiring new set of complete dentures. A total of 31 patients were asked to chew the gum from the routine site of mastication for 20 seconds. The weight reduction corresponded to the masticatory efficiency. The OHIP-14 score and masticatory efficiency was recorded at baseline and after three months of complete denture treatment. The data was analysed on SPSS version 23. RESULTS The average values of masticatory efficiency were significantly reduced from median (IQR) value 1.20 (1.20-1.30) to 0.90 (0.70-0.90), respectively (p

Objectives The opportunistic fungus Candida albicans is a component of denture plaque and is associated with denture-related stomatitis. Inter-kingdom interactions between C. albicans and bacteria exist in such multi-species biofilms, which may affect the microbial composition of the plaque. This study was performed to investigate the bacterial composition of denture plaques, and the correlation between the relative abundance of these bacteria and C. albicans. Methods Thirty denture plaque and 16 dental plaque samples were collected from 18 denture wearers (mean age, 80.3 years). After DNA extraction, a meta 16S rDNA amplicon library was constructed using PCR primers targeting the V3-V4 hypervariable region of bacteria. The amplicon was evaluated by high-throughput sequencing, followed by bacterial population analysis. The concentrations of both C. albicans DNA and total bacterial DNA were determined by real-time PCR. The correlation between the relative abundance of each bacterial genus and C. albicans was analyzed through Spearman’s rank correlation. Results The genera Streptococcus, Lactobacillus, Rothia, and Corynebacterium were found to be more abundant in dentures than in dental plaques. The predominant bacteria in healthcare-associated pneumonia also inhabited denture surfaces. Candida albicans was positively correlated with three acidogenic bacteria and negatively correlated with Leptotrichia and pathogens associated with periodontitis and endocarditis. Conclusions Dentures may be significant reservoirs of pathogens causing aspiration pneumonia. Bacteria showing negative correlation with C. albicans, such as Leptotrichia, may be useful for controlling the growth of C. albicans in antifungal therapies.

Candidiasis-causing Candida sp. forms biofilms with various oral bacteria in the dentures of the elderly, making it harder to kill and remove the microorganism due to the extracellular polymeric substances. We found that biofilms on dentures can effectively be removed by immersion in an unsaturated fatty acid salt solution. Using optical coherence tomography to observe the progression of biofilm removal by the fatty acid salt solution, we were able to determine that the removal was accompanied by the production of gaps at the interface between the biofilm and denture resin. Furthermore, microstructural electron microscopy observations and time-of-flight secondary ion mass spectrometry elucidated the site of action, revealing that localization of the fatty acid salt at the biofilm/denture-resin interface is an important factor.

Dentures are an excellent treatment modality for partial and edentate patients; however, improper denture care and hygiene can result in both decreased longevity of the prosthesis and increased risk of developing dental caries, periodontal disease and oral candidosis. Previously, it has been shown that patients and dental professionals are unaware of the different materials and methods available for optimum denture care and hygiene. This article provides an overview of the key legislation and main commercially available methods for denture cleanliness and hygiene, and serves as a basis for providing tailored denture hygiene for denture wearers.

OBJECTIVE Oral wound healing in healthy could be promoted by VEGF in saliva, and immediate denture wearing, but data in type 2 diabetes are lacking. Aims were to investigate the timeline of extraction wound healing in diabetic participants wearing immediate dentures and its correlation to salivary VEGF, as well as to examine the impact of the palatal plate on tissue VEGF during palatal wound healing in rat diabetic model. MATERIAL AND METHODS Healthy (42) and type 2 diabetic (36) denture wearers, candidates for teeth extractions were included. Extraction wound healing was followed via measurements of socket closure, gingival hyperaemia, pain and presence of necrosis on 3rd, 7th, 14th and on 21st-day post-extraction. Salivary VEGF was measured before and on the 3rd and 21st day after the extraction. In streptozotocin-induced diabetic (30) as well as non-diabetic rats (30), tissue VEGF was measured in palatal wounds healing under or without a palatal plate. RESULTS Type 2 diabetic prosthetic patients exhibit delayed socket closure, with pronounced hyperaemia, pain and necrosis. Salivary VEGF is increased in diabetes and positively correlates to socket closure while negatively with pain on 21st day after the extraction. Palatal incision induced VEGF increase in non-diabetic and diabetic, but less pronounced in diabetic rats. Wound healing under the palatal plate exhibit higher tissue VEGF. CONCLUSION Type 2 diabetes-induced increase in salivary VEGF may mitigate diabetes-induced detrimental effects on extraction wound healing. Lack of adequate tissue VEGF response to injury may underly dysregulation of diabetic oral wound healing.

To prevent single-implant overdenture (SIO) fracture, the inclusion of a framework in the overdenture has been suggested. However, no investigations verified their benefits.To evaluate prosthetic maintenance events, patient satisfaction, and mastication of SIO reinforced by metallic framework users.Fifteen volunteers had a new set of complete dentures converted into an SIO containing a framework. Maintenance events were recorded, while patient satisfaction was assessed using a visual analog scale. Masticatory performance (MP) was evaluated using the sieving method, maximum bite force (MBF) by pressure sensors, and masseter thickness by ultrasound. Measurements were performed 2, 12, and 24 months after SIO use. Repeated-measures ANOVA and paired Student's t-tests (p 0.05) were applied.Matrix exchange was the most prevalent maintenance event (83.6%), and no SIO was fractured during the entire follow-up. Satisfaction with the SIO stability decreased (p 0.01) after 12 months. MP did not change between evaluations (p 0.05). Conversely, MBF and masseter thickness improved after 12 and 24 months of SIO use (p 0.05).Reinforced SIO did not fracture during 2 years but requires maintenance. It improves bite force and muscle thickness, maintaining MP values. Satisfaction with SIO stability decreased in the first year of use.

This report describes a prosthetically-driven implant planning method, guided by the alignment procedures between the cone beam computed tomography, intraoral digital scans, and digitized maxillary and mandibular interim complete dentures using intraoral composite resin markers as a common reference. The markers were attached to the keratinized oral mucosa of the edentulous ridges using cyanoacrylate and kept in place during the digitizing procedures. The technique provides a simpler and more economical alternative to conventional prosthetically-driven static implant planning methods.

Purpose CAD/CAM complete dentures have increased in popularity and a wide variety of systems are currently available. These prostheses present many advantages for clinicians, technicians and patients. Subtractive manufacturing is used by most of the available systems while a few manufacturers use an additive manufacturing technique. This article describes the currently available systems and materials available for the fabrication of CAD/CAM complete dentures and reviews the literature relative to their physical properties. Methods A comprehensive review of the literature was completed to enumerate the currently available techniques to fabricate CAD/CAM complete dentures and discuss their physical properties. A search of English language peer-reviewed literature was undertaken using MEDLINE and PubMed on research articles published between 2000 and 2019. A hand search of relevant dental journals was also completed. Results The literature indicates the physical properties of CAD/CAM milled poly(methylmethacrylate) or PMMA as it is commonly described is superior to conventionally processed PMMA for the fabrication of complete dentures. Conclusion The incorporation of CAD/CAM technology into complete denture design and fabrication streamlines the clinical and laboratory processes and provides improved physical properties that enhance denture quality.

PURPOSE To report changes in denture satisfaction and oral health-related quality of life (OHRQoL) in edentulous patients treated with two-implant mandibular overdentures (IODs) over a follow-up of 8 to 10 years. MATERIALS AND METHODS This is a follow-up of a previous study carried out between 1997 and 2005. The patients were originally randomly divided into one group receiving IODs and another group who had their conventional mandibular dentures relined (RCD group). The RCD group was offered and received IODs at the 2-year follow-up. The participants completed a self-administered questionnaire containing demographics, 15 variables related to denture satisfaction, and 20 questions from the Oral Health Impact Profile (OHIP-20). Changes over time were analyzed using multilevel linear models for denture satisfaction and multilevel ordinal regression analyses for OHIP-20 variables. Comparisons between groups were analyzed using Mann-Whitney U test for ordinal and t test for metric data. RESULTS Disregarding patients who passed away during follow-up, the 29 responders represented a response rate of 76%. The degree of denture satisfaction and the OHIP-20 scores remained high and stable in the IOD group over the 10-year observation period for all but one variable. The same factors showed only a modest improvement in the RCD group for the first 2 years; however, during the subsequent 8 years of the observation period (after receiving IODs), denture satisfaction and OHIP-20 scores improved to the same level as the original IOD group. CONCLUSION The positive effect on denture satisfaction and OHRQoL of edentulous patients treated with two-implant mandibular overdentures remained unchanged 8 to 10 years after treatment.

Purpose To evaluate the effects of 0.2% sodium hypochlorite, Efferdent (Prestige Consumer Healthcare), and 6.25% Ricinus communis on biofilm removal and antimicrobial action on dentures and brushes using nonimmersion or immersion protocols for the brushes. Materials and methods A total of 45 denture wearers were randomly assigned to a denture immersion protocol for 7 days: 0.85% saline solution for 20 minutes (control); 0.2% sodium hypochlorite for 20 minutes (SH); Efferdent for 3 minutes; or 6.25% Ricinus communis for 20 minutes (RC). The participants were also randomized to immersion (n = 23) or no immersion (n = 22) of their brushes with their dentures in the same solutions. For biofilm evaluation, the dentures were stained and photographed, and the area of the biofilm was measured using Image Tool 3.0 (University of Texas Health Science Center). To evaluate microbial load on dentures and brushes, the biofilm was collected, and the Candida spp and Streptococcus mutans colonies were counted. Results The SH, Efferdent, and RC groups showed reduced biofilm and Candida spp on dentures regardless of the immersion protocol for the brushes. However, no difference was found in the Candida spp counts collected from the brushes immersed compared to the brushes not immersed in the solutions. The SH and Efferdent groups showed reduced S mutans on both dentures and brushes, except for in the nonimmersion subgroups. Conclusion All solutions reduced denture biofilm and microbial load. However, immersion of brushes in the solutions did not contribute to reducing the microbial load.

Purpose A retrospective study to analyze the clinical performance of 3D printed complete dentures in edentulous patients compared with conventional complete dentures regarding post insertion visits and patient reported outcomes. Material and methods Electronic charts were reviewed to analyze 420 (maxilla 270, mandible 150) heat-polymerized conventional complete dentures (CCD) inserted between July 1, 2015 and June 30, 2016 and 217 (maxilla 130, mandible 86) 3D printed complete dentures (PCD) inserted between July 1, 2017 and June 30, 2018. Number of remakes, number of post insertion adjustments, type and number of repairs, and patient reported complications were compared between two types of complete dentures. The frequency of denture repair and patient reported complications were analyzed using chi-square of independence test. Results The frequency of pain and visible ulcer lesions in the maxilla was determined to be 46.67% with CCD and 36.15% in PCD (p = 0.047). There was no statistical significance in other items. The majority of esthetic concerns was dissatisfaction with the shape of dentures with CCD (4.67%) and they had statistically significant, less frequent, esthetic problems than PCD (11.63%) (p = 0.047). Conclusions Similar clinical performance was recorded between the two groups, but the overall pain and visible ulcer lesions were less in the printed complete dentures then the conventionally processed dentures. However, the esthetic aspect was better in conventionally processed complete dentures. This article is protected by copyright. All rights reserved.

The purpose of this clinical case report is to describe a fully digital workflow for the duplication of an existing implant retained overdenture, highlighting the benefits of digitally fabricated dentures. The patient presented with an existing mandibular implant retained overdenture on Locator attachments that needed to be replaced. The existing overdenture was duplicated/scanned with the use of an intraoral scanner and was 3D printed using acrylic resin. This resin duplicate was sectioned in the midline and served as a unilateral record base to digitally record maxillo-mandibular relationship. The occlusal relationship was scanned unilaterally with the record base (sectioned duplicate) in place, and the procedure was repeated for the opposite side. All scans (edentulous, bite registrations and preliminary scan) were superimposed and the software managed to position and stich everything together. A try-in copy denture (ProArtCAD Try in, Ivoclar Vivadent AG, Schaan, Liechtenstein) was milled in order to imitate the conventional wax teeth try-in. A definitive milled overdenture was fabricated and delivered. A reinforcing polyetheretherketone mesh was fabricated, utilizing computer assisted design/computer assisted manufacturing technology and was incorporated into the pre-designed customized space into the polymethylmethacrylate base, using indirect light-polymerized nano-filled composite resin (crea.lign; bredent GmbH & Co. KG). Occlusion was verified and the patient was instructed oral hygiene, home maintenance and was informed for the required recall visits.

Elderly patients with systemic disorders and immunocompromised patients seem to have a higher risk of developing morbidity from COVID-19. Candida albicans (C. albicans) is a potentially dangerous pathogen for these patients, especially for denture wearers with prosthetic stomatitis who require mechanical ventilation. C. albicans infection, the main candidiasis infection associated with denture wear, can complicate COVID-19 and increase the associated morbidity and mortality. Therefore, early diagnosis of C. albicans infection in COVID-19 patients is important to establish more effective antifungal treatment methods and prophylaxis strategies. Hospitalized COVID-19 patients should undergo an oral examination to assess their oral health, and those with poor oral health should receive the appropriate care and monitoring.