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Statement of Problem: Adjusting and polishing a denture base affects surface roughness and, consequently, microbial adhesion. Since various computer-aided design and computer-aided manufacturing (CAD-CAM) denture base materials are available, the efficiency of chairside polishing systems to achieve a proper surface roughness should be investigated., Purpose: The purpose of this in vitro study was to compare the surface roughness of milled and 3-dimensional (3D) printed denture base materials with that of heat-polymerized acrylic resin after the use of 2 different chairside polishing systems., Material and Methods: Heat-polymerized (control), milled, and 3D printed denture base materials were tested. Laboratory polished and unpolished denture bases served as positive and negative controls. Specimens were divided into 2 chairside silicone polishing systems (AcryPoint system and Exa technique). Surface roughness was measured before and after polishing. Surface morphology of the unpolished and polished specimens was observed via scanning electron microscopy. The surface hardness of unpolished specimens was measured using a Vickers hardness tester. Stress-strain behavior of the silicone matrix and abrasive filler size of each polisher was assessed. The effects of denture base materials and polishing systems on surface roughness and hardness were evaluated using 1-way, 2-way, and repeated measures analyses of variance (ANOVA) (α=.05), along with Weibull proportional hazards regression to assess the likelihood of achieving clinically acceptable surface roughness. The Spearman correlation assessed the relationship between the hardness of unpolished denture bases and final surface roughness., Results: The surface roughness of all denture bases decreased with increased polishing duration, reaching a plateau after 60 seconds. For the heat-polymerized and milled dentures, the Exa technique consistently yielded lower roughness than the AcryPoint system (P<.001). Conversely, both polishing systems produced comparable surface roughness on the 3D printed denture base. The Vickers hardness of the unpolished milled denture was significantly higher than of the others (P=.010). The stress-strain behavior of the polisher matrix revealed distinct characteristics between coarse or medium and fine polishers within each polishing system. The abrasive filler size of the AcryPoint coarse polisher was relatively larger than that of the Exa technique., Conclusions: Regardless of polishing protocols, the 3D printed denture base exhibited the highest surface roughness, followed by heat-polymerized and milled denture bases. The surface roughness of the polished denture was not related with the material hardness. For heat-polymerized and milled dentures, a chairside silicone polishing system can be used to attain a level of surface roughness similar to that of laboratory polishing, depending on the properties of the chairside silicone polishing system., Data Availability Statement: The data that support the findings of this study are available upon request from the corresponding author., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: This study aimed to evaluate the clinical performance of ceramic veneers after 9-10 years, assess patient-reported outcomes, and examine their associations., Materials and Methods: Thirty patients with ceramic veneers aged 9-10 years were recalled for a clinical examination. Each participant completed a questionnaire on satisfaction and oral health-related quality of life, specifically using the Oral Impact on Daily Performance (OIDP) scale. The chi-square or Fisher exact test was used to assess the associations between tooth position and professional evaluations of veneer success and individual items. Consistency between professional evaluations of the veneers and patient-reported outcomes was evaluated using Weight Kappa., Results: A total of 30 patients with 233 veneers participated in the study. Clinical evaluations deemed 9.87% (n = 23) of veneers as successful, 79.40% (n = 185) as surviving with complications, and 10.73% (n = 25) as a failure. The most common complications were marginal adaptation, gingival inflammation, and marginal discoloration. The participants were most frequently dissatisfied with the function of the veneers, food impaction, and cleaning difficulties. The OIDP assessment indicated that problems on daily activities such as cleaning, eating, and sleeping were predominantly affected. There were significant consistencies between certain clinical performance attributes and patient-reported outcomes., Conclusions: The survival rate of ceramic veneers was 89.3% after 9-10 years of follow-up. Among these, 79.4% had survived with complications such as material defects, secondary caries, and gingival problems. Given the discrepancies between patient-reported outcomes and clinical evaluations, further investigations into patient perception are needed alongside traditional clinical assessments., Clinical Significance: Educating patients about the potential complications associated with veneer restoration, especially specific to tooth location, is essential. Additionally, advising patients on proper oral hygiene practices is recommended to minimize the risk of gingival inflammation to enhance the longevity of the restoration., (© 2024 Wiley Periodicals LLC.)

Statement of Problem: Scan bodies play a crucial role in the accuracy of digital implant scans by serving as implant-positioning transfer devices. Previous literature has demonstrated the effects of scan body characteristics on the accuracy of digital implant scans. However, the optimal application methods of scan bodies to enhance scanning accuracy remain unclear., Purpose: The purpose of this systematic review was to determine the optimal application methods of scan bodies to enhance the accuracy of digital implant scans., Material and Methods: An electronic search was conducted by using the PubMed (MEDLINE), Web of Science, Cochrane Library, and Embase databases from November 2018 to 2023. Relevant references from the included studies were further screened manually for eligibility. Following the population, intervention, comparison, and outcome (PICO) criteria, a research question focused on identifying the optimal application method for effectively using scan bodies to enhance scanning accuracy was developed. Specific inclusion criteria involved in vitro and in vivo studies. The Checklist for Reporting In Vitro Studies (CRIS) guidelines were followed and the assessment of the risk of bias in the included studies was conducted., Results: Sixteen articles that met the eligibility criteria were included in this systematic review. Two studies investigated the effect of scan body bevel orientation on the accuracy of digital implant scans, and 3 examined the impact of tightening torque on scan bodies. Among the studies focusing on completely edentulous arches, 5 recommended the use of auxiliary geometric devices on the dental arch to enhance scanning accuracy. However, 2 studies reported no improvements in accuracy after splinting scan bodies with thread., Conclusions: Different techniques for applying scan bodies, such as configuring bevel orientation, adjusting tightening torque, and attaching auxiliary geometric devices, influence the accuracy of digital implant scans. For scanning completely edentulous arches, attaching auxiliary devices to scan bodies to cover the edentulous ridge effectively enhances scanning accuracy., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Ensuring a strong bond between chairside autopolymerized acrylic resin to denture base is essential for denture repair and reline procedures. However, there is no established protocol to enhance bond strength between autopolymerizing resin and computer-aided design and computer-aided manufacturing (CAD-CAM) denture base materials. The purpose of this study was to determine shear bond strength of CAD-CAM denture bases and autopolymerizing acrylic resin after mechanical and chemical surface treatments compared with heat-polymerized acrylic resin. Heat-polymerized, milled, and 3-dimensional (3D) printed denture bases were divided into 4 surface treatment protocols: none (control), airborne-particle abrasion (APA), tetrahydrofuran, and Vitacoll application. Autopolymerizing acrylic resin cylinders were bonded to denture surface. Shear bond strength and failure modes were determined after thermocycling. Denture base surfaces were assessed for surface roughness, surface morphology, and microhardness before and after surface treatment. Data was analyzed using two-way ANOVA and multiple comparison tests. The results showed that APA significantly increased shear bond strength and surface roughness of all denture base materials. Tetrahydrofuran and Vitacoll application improved shear bond strength of heat-polymerized acrylic resin, but did not reach the level achieved by APA. Conversely, tetrahydrofuran application improved bond strength of 3D-printed denture to the level of APA. Tetrahydrofuran and Vitacoll application significantly reduced denture base hardness, compared with control and APA. In conclusion, mechanical surface treatment using APA enhances the adhesion of autopolymerizing acrylic resin to heat-polymerized and CAD-CAM denture bases. Tetrahydrofuran and Vitacoll chemical surface treatment improved adhesion to heat-polymerized acrylic resin, with only tetrahydrofuran enhancing bond strength of 3D-printed denture to the level of APA. Without surface treatment, the highest bond strength was shown in 3D-printed denture base material., (© 2024. The Author(s).)

Objectives: To determine the patient-oriented outcomes after complete denture (CD) treatment using neutral zone (NZ) techniques compared with those of conventional dentures., Materials and Methods: Electronic and hand searches were conducted up to December 2023 based on PICOS criteria. Population (P) was patients with complete edentulism on maxillary and mandibular arches and were either or not wearing CDs. Intervention (I) focused on the fabrication of mandibular and/or maxillary CD using NZ techniques. Comparators (C) included other CD fabrication approaches, such as conventional and simplified techniques, and the use of old or existing CDs. Outcomes (O) were patient-oriented treatment outcomes. Study design (S) included human studies., Results: Eleven human experimental studies were included. NZ dentures demonstrated better patient-reported outcomes, by providing greater comfort, enhancing denture stability and retention, reducing food traps underneath the denture, as well as improving appearance, chewing efficiency and speech. Objective findings varied, with most studies showing equivalent outcomes for NZ and conventional dentures. However, one study indicated superior, and another demonstrated worse outcomes for NZ dentures., Conclusions: NZ dentures generally improve patient-reported outcomes more than conventional dentures. However, their impact on objective outcomes compared with a conventional denture remains uncertain., (© 2024. The Author(s).)

Objectives: To assess the attitude and practices of dentists and dental assistants in managing dust particles generated during dental prostheses or appliances grinding and polishing., Materials and Methods: Data were collected from 207 dentists and 125 dental assistants through an online questionnaire. The questionnaire included adjusted prosthesis types, self-protective methods, types and frequency of protective device use, and reasons for non-frequent use., Results: Protective grinding devices, including dust protective boxes and mounted plastic sheets, were commonly used for substantial acrylic resin adjustments, while air blowing was preferred for minor adjustments. Post-COVID-19, there was a 3-fold increase in the use of protective grinding devices among dentists and a 1.3-fold increase among dental assistants. During try-in procedures, dentists commonly rinsed prostheses with water rather than using disinfectants. Non-frequent users adopted self-protection methods, such as face shields and air filters. Surgical drapes and high-volume evacuators were used for patient's protection., Conclusion: Despite an increased tendency of the use of protective grinding devices following COVID-19, a significant number still report infrequent use. Identified protective devices in this study have drawbacks not fully meeting dentists' expectations. Invention of a more user-friendly device is necessary to ensure regular use, preventing potential toxicity from dust particles., (© 2024. The Author(s).)

Background: In partial edentulous individuals, a partial removable dental prosthesis (PRDP) is a common dental replacement option to improve oral function and quality of life. However, some patients discontinue using their denture over time. The aim of this study was to determine the prevalence and characteristics of partial edentulous patients who no longer wear their dentures, explore their reasons, and assess their oral health-related quality of life (OHRQoL)., Methodology: This cross-sectional study, conducted at Chulalongkorn University Dental School from 2013 to 2019, involved patients who received PRDP treatment. They were contacted via phone calls and asked about their denture usage. Eligible participants were patients who had stopped or rarely used their PRDPs. Data on oral status, health insurance, and PRDP variables were collected from hospital records. Telephone interviews were conducted to collect the initial reasons for seeking PRDP treatment, reasons for discontinuation, desire for a new PRDP, and OHRQoL. The Oral Impacts on Daily Performances index was used to assess the OHRQoL. The score was dichotomized into the absence or presence of oral impacts. Chi-square tests and multivariable binary logistic regression were employed to determine the associations between oral impacts and various factors in the participants who discontinued PRDP usage., Results: Among the 975 contacted participants, 175 (17.9%) discontinued using their PRDPs. Most of these individuals had at least 20 remaining natural teeth and/or 4 posterior occluding pairs. The primary initial reason for seeking PRDP treatment was often based on a dentist's suggestion. Although many participants reported no impact on OHRQoL and did not express the need for new PRDPs, those experiencing oral impacts were more likely to seek replacements., Conclusions: With up to 7 years follow-up duration, individuals with partial edentulism and sufficient remaining functional dentition without oral impacts were more inclined to discontinue PRDP usage. Those with maxillary anterior teeth loss were less likely to discontinue using their PRDP. The primary initial reason for seeking PRDP treatment was often a dentists' suggestion. However, the individuals reporting oral impacts expressed their needs for new denture replacements. This highlights the significance of incorporating patient needs and preferences in prosthodontic decision-making., (© 2024. The Author(s).)

Statement of Problem: Decision making for compromised teeth involving the choice between endodontic treatment and tooth extraction followed by an implant-supported prosthesis is challenging. However, systematic reviews examining studies using the same patients or clinical settings to provide conclusive evidence regarding the best approach are lacking., Purpose: The purpose of this systematic review was to compare the survival rate, complications, failure, and patient-reported outcomes of endodontically treated teeth and implant-supported prostheses., Material and Methods: After the protocol had been registered at the International Prospective Register of Systematic Reviews (PROSPERO), PubMed, Scopus, and the Cochrane Database of Systematic Reviews were searched from database inception to July 2023 with no language restriction. A manual literature search was performed. The review protocol was based on the population, intervention, comparator, outcome, and study design (PICOS) criteria and included all observational and experimental human studies that directly compared the survival, complications, and patient-reported outcomes of teeth with pulpal and periapical disease after all types of endodontic treatment and subsequent restoration and tooth extraction followed by an implant-supported prosthesis. The risk of bias of the included studies was assessed by using the modified Newcastle-Ottawa scale., Results: Eight observational studies were included in this systematic review: 3 retrospective cohort and 5 case-control studies. Three included studies revealed no difference in survival rate between endodontically treated teeth and implant-supported prostheses during the first 3 years, but the survival of endodontically treated teeth declined over time with a higher failure rate than implant-supported prostheses. In contrast, the other 3 included studies reported lower survival rate for implant-supported prostheses and more complications. In terms of patient-reported outcomes, patients were generally satisfied with both treatment modalities, with notable improvements in oral health-related quality of life in those receiving endodontic treatment., Conclusions: Whether implant-supported prostheses or endodontically treated teeth are better in terms of survival outcome is unclear. Improved oral health-related quality of life was found after endodontic treatment., (Copyright © 2024 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The integration of digital dentistry in the fabrication of complete dentures (CDs) has been facilitated through the use of intraoral scanners and computer-aided design and manufacturing (CAD/CAM). However, the financial implications associated with the fabrication of digital CDs have been rarely explored. This study is aimed at presenting two different approaches to CD fabrication, combining conventional with digital techniques, and comparing the total cost of fabrication. The first case involved a 70-year-old woman without existing denture, while the second case involved a 97-year-old woman with inadequate retention and stability of CDs in both jaws. In the first patient, who lacked information about her old denture, the first approach was employed, utilizing milling technology for denture processing. The second patient, who already had an existing denture, underwent the second approach, which employed printing technology for denture processing. CAD/CAM replicas of the existing dentures were used for the final impression, bite registration, and as a guide for tooth arrangement. Two digital protocols and laboratory cost in CD fabrication have been proposed. The relatively high cost of CAD/CAM CDs restricts the widespread of digital technology in CD fabrication., Competing Interests: The authors for this study declare no conflict of interests., (Copyright © 2024 Siraphob Techapiroontong et al.)

Purpose: To evaluate the impact of occlusal splint plus laser therapy (OS + LT) compared with OS alone on the patient-reported outcomes and clinical parameters of patients with temporomandibular disorders (TMDs)., Methods: Twenty-three patients with TMDs were randomly assigned to two treatment approaches: OS and OS + LT (multiwave locked system). The two outcomes were clinical parameters (mouth-opening distances, number of muscles and TMJs with pain) and patient-reported outcomes (pain score and oral health-related quality of life [OHRQoL] determined using the 14-item oral health impact profile [OHIP-14]). The outcomes were measured at four time points: baseline, 2 weeks, 1 and 3 months after treatment. According to DC/TMD Axis I classification, the participants were diagnosed as having pain only and pain with intraarticular joint disorder. Adjusting for age and sex, the outcome changes were analysed using generalized estimating models at a 5% significance level., Results: The pain-free mouth-opening distance of the patients who received OS + LT continuously increased from 2 weeks to 3 months. However, the value was significantly increased at 3 months in patients who received OS alone. The unassisted mouth-opening distance significantly increased after 3 months in both groups. In both treatment approaches, the number of muscles and TMJs with pain, as well as the pain and OHIP-14 scores gradually decreased from baseline to 3 months., Conclusions: The patients who received OS and OS + LT demonstrated better OHRQoL and clinical parameters during 3 months after treatment. An improvement in the pain-free mouth-opening distance at 2 weeks was found only in OS plus LT group; however, this difference may not be clinically significant., (© 2023 John Wiley & Sons Ltd.)

Background: Developing competency in removable prosthodontics (RP) is challenging for undergraduate dental students because it involves threshold concepts and tacit knowledge. Understanding this process can enhance learning and professional development in RP. The objective of this study was to identify the barriers hindering knowledge (threshold concept) and skill (tacit knowledge) development, and to propose strategies for achieving RP competency., Methods: Adopting critical theory, quantitative and qualitative approaches were implemented. The participants were third- to sixth-year dental students and recent dental school graduates. An online questionnaire was used to investigate the knowledge and skills required for achieving RP competency and barriers to RP competency development. Four focus groups were conducted to gather in-depth information. The data was analyzed using descriptive statistics and thematic analysis., Results: A total of 322 respondents completed the questionnaire (67% response rate), and 26 of them participated in focus group interviews. The four threshold concepts to achieve RP competency were the basic principles of RP, removable partial denture design, occlusion, and dental materials. The two main tacit knowledges were impression making and material handling skills. The curriculum should integrate strategies to assist dental students in overcoming intrinsic barriers such as self-experience, revision, and spatial-temporal relationship, along with extrinsic factors such as clinical correlations of content, discussions, and immediate feedback., Conclusions: Threshold concepts and tacit knowledge in RP for undergraduate dental students have been proposed The strategies to overcome barriers comprise intrinsic and extrinsic factors that include the adoption of experiential learning. This study suggests effective teaching methods and learning strategies to maximize student learning and RP competency development when designing the undergraduate RP curriculum in dental education., (© 2024. The Author(s).)

Background: Despite the implementation of various government policies to retain Thai dentists in public sector, a high turnover rate among early career dentists has persisted for decades. This study aims to explore factors relating to early career dentists' choice of the public sector as their preferred workplace and decisions relating to staying, resigning, or relocating from the workplace after one-year employment., Methods: A one-year cross-sectional survey was conducted among Thai early career dentists who began working in 2020 using two sets of online questionnaires. The first survey assessed factors influencing dentists' decision to choose the public sector as their preferred workplace at the beginning of the year. The second survey investigated factors influencing dentists' decision to stay, resign, or relocate from the same workplace at one-year after employment. Descriptive statistics and multivariable binary logistic regression were used for data analysis., Results: A total of 198 early career dentists completed the online survey questionnaire at the starting point (December 2020-January 2021), and 186 dentists completed the one-year employment questionnaire. The living environment and provided amenities and facilities were the most influential factors in their decision to choose and remain in the public sector. Conversely, their attitude toward unrelated job descriptions and an increased opportunity to pursue postgraduate studies were the most relevant factors when deciding to relocate to a new workplace. Factors such as delayed authority in bureaucracy, hometown location, and being in relationship status were the most significant contributors to resignation from the public sector., Conclusions: The major factors influencing dentists' choice and retention in the public sector include the living environment, supportive supervisors and colleagues, and the availability of opportunities for further postgraduate education. Meanwhile, factors impacting retention after one year of work are related to hometown location and the bureaucracy system. Collaborations among ministries, tailored to each local community's specific requirements, may enhance dentists' retention in public sectors., (© 2023. The Author(s).)

Objectives: To assess the shear bond strength (SBS) between metal orthodontic brackets and zirconia after receiving different mechanical and chemical surface treatments, and different types of resin adhesive. The failure mode of each treatment protocol was also evaluated., Materials and Methods: The present in vitro experimental study consisted of six surface treatment protocols with two different resin adhesives. One-hundred and forty-four rectangular-shaped 3 mol% yttrium-stabilized tetragonal zirconia polycrystal blocks were milled, sintered, and embedded in acrylic resin. They were randomly divided into three mechanical (none, air abrasion, and bur grinding) and two chemical surface treatment conditions (no primer and Z-primer). The specimens were divided into two groups according to the resin adhesive received: self-cured (RelyX U200) and light-cured adhesives (Transbond XT). The SBS between the metal bracket and zirconia was tested using a universal testing machine (1-mm/min crosshead speed), and the failure mode was evaluated. Differences in SBS and failure mode were analyzed using Welch ANOVA followed by post-hoc comparison and Fisher's Exact test, respectively., Results: Bur grinding produced the highest SBS, followed by air abrasion. Z-primer application typically provided a higher SBS regardless of resin adhesive used (p < 0.001). Without primer application, RelyX U200 provided a higher SBS than Transbond XT (p < 0.001). After grinding, using Z-primer and RelyX U200 resulted in a higher SBS than no primer and using Transbond XT (p < 0.001). Adhesive failure at the zirconia-adhesive interface occurred only when Transbond XT was applied without bur grinding, and when using Transbond XT after grinding, but no Z-primer application., Conclusion: Bur grinding combined with applying an MDP-containing primer and resin adhesive enhances the SBS between zirconia and metal orthodontic brackets., (© 2023. The Author(s).)

Objective:  This article evaluates the effect of multipurpose polishing kit on surface roughness and hardness of three computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic materials at different polishing durations. Weight changes of the polishing bur were also determined., Material and Methods:  Three CAD/CAM ceramic materials were lithium disilicate glass ceramic (IPS e.max CAD), translucent zirconia (VITA YZ), and zirconia-reinforced lithium disilicate ceramic (Celtra Duo). Ceramics were ground with a diamond bur, and polished with the multipurpose polishing kit (Eve Diacera HP), which comprises coarse and fine polishing burs. Surface roughness value (Ra) was measured using a noncontact optical profilometer ( n  = 10 per group) after grinding and every 15 seconds of coarse and fine polishing until 60 seconds. The complete polishing Ra was compared with the lab as-received specimens and human enamel. Surface morphology was examined using a scanning electron microscope after 60-second coarse and fine polishing and compared with the lab as-received specimens. Hardness was measured using a Vickers hardness tester on the lab as-received specimens and after the final polishing process ( n  = 4 per group). Changes in surface roughness and polishing bur weight of each material were analyzed using one-way repeated-measures analysis of variance (ANOVA) and dependent t -test. One-way ANOVA was used to detect differences in surface roughness, Vickers hardness, and bur weight among materials within the same polishing duration ( α  = 0.05)., Results:  From grinding to complete polishing, the greatest Ra reduction was found in VITA YZ, followed by Celtra Duo and IPS e.max CAD. Final Ra values of all ceramics after 60-second fine polishing were not significantly different, and were similar to that of enamel and lab as-received specimens. Vickers hardness of ceramic materials did not change after grinding and polishing. Coarse polishing bur demonstrated the highest weight loss after polishing VITA YZ, followed by Celtra Duo and IPS e.max CAD., Conclusion:  The multipurpose polishing kit reduced surface roughness of CAD/CAM ceramic materials to the similar level of the lab as-received specimen and enamel regardless of material's hardness. The reductions of surface roughness and a coarse polishing bur weight were highest in VITA YZ, followed by Celtra Duo and IPS e.max CAD., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Objectives: This study aimed to conduct a cross-cultural translation of the revised oral assessment guide (ROAG) into Thai language and to modify the tool to increase its validity and reliability., Materials and Methods: The present study was a cross-sectional design conducted in dental and hospitalized patients, and community-dwelling people. The original English-version of the ROAG was translated into Thai, which was evaluated for validity and reliability. The tool was then revised to develop the modified ROAG for non-dentist (ndROAG) comprising 9 oral assessment categories with a three-level response; healthy, mild, and severe alteration. The criterion validity of the ndROAG was tested in 82 adult and older participants, and 46 non-dentists comprising dental assistants, dental hygienists, community health volunteers, and nurses, using a calibrated dentist as the reference standard. The ndROAG was translated back into an English version. The criterion validity was evaluated using weighted Kappa (K w ) and intraclass correlation coefficient (ICC). Internal consistency was determined using Cronbach alpha. The three-level response was dichotomized into healthy and changed to determine the sensitivity and specificity., Results: The K w values, ICC, and Cronbach alpha values of the ndROAG were higher than those of the pre-test ROAG. The sensitivity of the ndROAG in identifying the healthy and changed state ranged from 57.1 to 100.0% with the lowest value in the saliva category, whereas the specificity ranged from 90.9-100.0%., Conclusion: The original ROAG was translated and revised into the ndROAG with improved validity and reliability. The ndROAG can be used by non-dentists to assess the oral health of adult and older individuals to detect oral changes, which includes self-care instructions and patient referral guidance., (© 2023. British Dental Association.)

Background: Oral hypofunction comprises 7 oral function conditions, including mastication, swallowing, pronouncing, oral hygiene, and oral dryness. However, it remains unresolved whether having oral hypofunction and each individual condition adversely affect general health. This study aimed to investigate the association between oral hypofunction and general health, encompassing physical, psychological, and social dimensions., Methods: Oral hypofunction was diagnosed following the criteria proposed by the 2016 Japan Society of Gerodontology, comprising 7 oral function conditions. Oral hypofunction was diagnosed when at least 3 conditions presented. The selected studies eligible for reviewing were based on the PI(E)CO criteria: P (population), adult and older adults; I/E (intervention/exposure), having oral hypofunction by considering overall and individual 7 oral function conditions; C (comparator), not having oral hypofunction; O (outcome), the general health status, encompassing physical, psychological, and social dimensions. Electronic search limited to English articles was performed through PubMed, Scopus, and Cochrane Database of Systematic Reviews databases from January 2016 to June 2023. The included studies were assessed for quaility and risk of bias using the modified Newcastle-Ottawa scale. Qualitative analyses were performed on the general outcome, and having oral hypofunction considering overall and individual oral function conditions., Results: Ten studies were included in the final syntheses. One was a prospective cohort, one was a case-control, and the others were cross-sectional studies. All included studies were high quality. General health outcomes were mostly frailty, sarcopenia, and malnutrition, whereas mild cognitive impairment,social withdrawal, and gastric cancer prognosis were identified in one of the included studies. The association between general health and having oral hypofunction was stronger than when considering an individual condition. The health outcomes were predominantly associated with mastication and swallowing, whereas their relationships with oral hygiene and dryness were less likely to be reported., Conclusions: The present review found an association between the presence of oral hypofunction and impaired general health. However, the specific impact on individual physical, psychological, and social dimensions cannot be distinctly delineated. Further prospective studies are required to clarify the causal-effect relationship between oral and general health., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Digital workflows have been used in the oral rehabilitation of patients with maxillofacial defects. However, dental techniques for fabricating a denture obturator for patients with a total maxillectomy are lacking. This technical report describes the use of digital technology to produce a milled complete denture obturator using an intraoral scanner, a computer-aided design software program, and computer-aided manufacturing. The limited size of the milled polymethylmethacrylate disk was resolved by separating the prosthesis into 3 pieces: the obturator base, denture base, and artificial teeth., (Copyright © 2023 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: To facilitate dental disease screening program in prisoners by testing the diagnostic accuracy of teledentistry examination in comparison to direct oral examination by a dentist., Materials and Methods: This crossover study comprised three phases. Phase I, prisoner health volunteers (PHVs) enrolled teledentistry training for an intraoral camera (IOC) use. Phase II, the PHV used IOC for examining dental diseases of prisoners who reported dental-related problems, and captured symptomatic areas. The PHV and dentist independently determined tentative dental treatment need, comprising dental fillings, scaling, extraction, and surgical removal of impacted tooth. Phase III, another dentist performed direct oral examination of the prisoners who reported problems in phase II and determined dental treatment needs. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, using direct oral examination by dentist as a true positive., Results: Diagnostic accuracy was determined in 152 prisoners with 215 teeth. Sensitivity, specificity, PPV, and NPV of teledentistry and direct examination between two dentists were above 80%. The lowest sensitivity and specificity of teledentistry examination by the PHV were scaling and surgical removal., Conclusions: IOC use in teledentistry facilitates dentists in dental diseases screening for prisoners with acceptable diagnostic accuracy in identifying possible treatment needs. However, the imaging obtained from teledentistry is not adequate to accurately identify all dental treatment needs., (© 2023. The Author(s).)

Purpose: To determine the effect of a dynamic impression lining material (DIL) on the retention and stability of mandibular complete dentures (LCD), masticatory performance, and the oral health-related quality of life (OHRQoL) of the patients wearing complete denture (CD) compared with those wearing a denture with conventional hard denture liner (HL)., Methods: Twenty-five patients who wore CD with an ill-fitting LCD were randomly assigned to two groups: LCD relined with DIL (Dynamic impression lining material) or HL (Tokuyama® Rebase II (fast)). Three objective measures (denture retention, stability, and masticatory performance) were measured. The OHRQoL was also measured using the Thai version of oral impacts on daily performance. Outcomes were measured at six time points: baseline, 3 days, 1 week, 1 month, 3 months, and 6 months after relining. Outcome changes were analyzed using a generalized estimating equation, and all models were adjusted for age, mandibular ridge form, and CD age at a 5% significance level., Results: After LCD relining, the frequency and severity of adverse oral impacts significantly decreased. In the DIL group, denture pain occurred on and off over six months, and an ill-fitting denture impacted at one month. In the HL group, denture pain continuously decreased over time. At 3 months, changes in the clinical properties of DIL were observed, including perceived odor. The material also peel-off from the denture base, and plaque accumulation was observed. In contrast, the HL properties remained stable for over 6 months., Conclusions: Although DIL improves denture retention and stability, masticatory performance, and the OHRQoL of the patients who wear CD, oral adverse effects were not eliminated. The clinical properties of DILs changed at 3 months, while the HL remained relatively stable for up to 6 months.(The clinical trial registration number: Thai Clinical Trials Registry (TCTR) number TCTR20210625005.).

Statement of Problem: Different criteria have been developed and used for the clinician evaluation of removable complete denture (CD) quality. However, the optimal criteria under a specific clinical or research purpose are unclear., Purpose: The purpose of this systematic review was to identify the development and clinical parameters of criteria for the clinician evaluation of CD quality and to evaluate the measurement properties of each criterion., Material and Methods: An electronic search was conducted through PubMed, Scopus, and Cochrane Database of Systematic Reviews from database inception to April 2022. A hand search was conducted based on the references in the included studies. The measurement properties of the included CD quality criteria were assessed based on the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist and a previous study. The articles that supported the measurement properties of the original CD quality criteria were also included., Results: Of the 282 abstracts reviewed, 22 clinical studies were included; 17 original articles that developed a new CD quality criterion and 5 articles that additionally supported measurement properties of the original criterion. There were 18 CD quality criteria with 2 to 11 clinical parameters in each criterion, predominantly denture retention and stability, followed by denture occlusion and articulation, and vertical dimension. Sixteen criteria possessed criterion validity shown by its associations with patient performance or patient-reported outcomes. Responsiveness was reported when a CD quality change was detected after delivery of a new CD, denture adhesive use, or during postinsertion follow-up., Conclusions: Eighteen criteria have been developed for clinician evaluation of CD quality with various clinical parameters, predominantly retention and stability. None of the included criteria met all measurement properties in the 6 assessed domains, but more than half of them had relatively high-quality assessment scores., (Copyright © 2023 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this study was to assess two patient-based outcomes of complete denture (CD) wearers who continued or discontinued using denture adhesive (DA) after one-month run-in period of DA use., Methods: This quasi-experimental study comprised 76 CD wearers. The two patient-based outcomes were oral health-related quality of life and masticatory performance, determined by the Thai-version of oral impacts on daily performances index and multiple sieve method of 20-stroke peanut mastication. Denture retention and stability were evaluated using the CU-modified Kapur criteria to classify the CD into acceptable or unacceptable quality. The outcomes were collected at 3 time points: 1) at baseline (T0), 2) after a 1-month run-in period of DA use (T1), at which time the participants decided whether to continue using DA, and 3) 1-month after continuing or discontinuing using DA (T2). Changes in the percentages of having an oral impact from T0 to T2 were evaluated using the McNemar's test. The effect of denture quality and the decision to use DA on peanut particle size across time points were assessed using repeated measures ANOVA. The peanut particle size changes in each group between time points were evaluated using the one-way repeated measures ANOVA and Tukey post-hoc comparison test., Results: The participants who continued using DA at T2 had greater oral impact reduction after the 1-month run-in period of DA use, whereas cleaning and emotional impacts emerged in those who discontinued using DA. At T1 and T2, the peanut particle size of the participants who continued and discontinued using DA was not significantly changed from T0, except for the acceptable CD wearers who discontinued using DA at T2, whose peanut particle size decreased from T0 to T2., Conclusions: Baseline oral impacts and their change influenced CD wearers' decision whether to continue using DA. However, masticatory performance did not affect the patients' decision., Competing Interests: The authors declare that there is no potential conflict of interest in this study., (Copyright: © 2022 Limpuangthip et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: To determine the oral health-related quality of life (OHRQoL) of temporomandibular disorder (TMD) patients at the final follow-up visit, and to investigate the associated factors., Materials and Methods: This cross-sectional study comprised 227 TMD patients. Dependent variable was OHRQoL determined by telephone interview using the 14-item Oral Health Impact Profile (OHIP-14) questionnaire after the final follow-up visit. Independent variables were collected from dental records, comprising age, sex, treatment duration, diagnosis, clinical parameters (mouth-opening distances), and pain perception. TMD patients were diagnosed as having masticatory muscle disorders (TMDM), temporomandibular joint (TMJ) disorders (TMDJ), or combined muscle and TMJ disorders (TMDC). Bivariate analyses and multivariable linear regression were used to analyze the factors associated with OHIP-14 scores., Results: Bivariate analyses demonstrated higher OHIP-14 scores in younger patients, females, having TMDC, and lower mouth-opening distance. Multivariable analysis demonstrated the association of higher OHIP-14 scores with being younger and having TMDC. Participants with TMDC demonstrated greater improvement in unassisted mouth-opening distance, compared with the other clinical diagnosis groups., Conclusions: At the final follow-up visit, oral health impact problems were reported mainly in physical pain and psychological discomfort domains. Better OHRQoL was found in older, and TMDM or TMDJ patients., (© 2022. The Author(s).)

Background: To determine the impact of dental status, types, and quality of dental prostheses on body composition, masticatory performance and oral health-related quality of life (OHRQoL). Potential associations between body composition, masticatory performance and OHRQoL were also investigated., Methods: This cross-sectional study included 110 older adults who received prosthodontic treatment at the Dental Faculty Clinics at Chulalongkorn University. Participants were categorized according to their dental prostheses: complete denture (CD), removable partial denture (RPD) and fixed partial denture (FPD). Retention and stability of the RPD and CD were evaluated using the CU-modified Kapur and the modified NHANES III criteria to classify denture quality into acceptable and unacceptable. Dental status including posterior occluding pairs and number of remaining natural teeth were assessed intraorally. Dependent variables were body composition, masticatory performance and OHRQoL. Body composition, including muscle mass (kg), bone mass (kg), basal metabolic rate (kcal) and visceral fat (%) were determined through a bioelectrical impedance analysis. Masticatory performance was assessed using a multiple sieve method of peanut mastication. OHRQoL was assessed using the validated Thai version of Oral Impacts on Daily Performances (Thai-OIDP) index. After adjusting for covariates, including age and sex, the associations between oral and dental prosthesis status and body composition, masticatory performance as well as OIDP score were analyzed using multivariable linear and negative binomial regression analyses. Spearman's correlation was used to determine the potential associations between body composition, masticatory performance and OHRQoL., Results: The presence of fewer natural teeth or wearing an unacceptable removable denture were factors associated with lower bone mass, muscle mass and basal metabolic rate, and with a higher visceral fat. Similar dental and removable denture status were also associated with larger peanut particle size and higher OIDP score. Masticatory performance and OHRQoL variables were moderately correlated (Spearman's rho = 0.44). However, body composition was not correlated with masticatory performance or OHRQoL., Conclusions: In individuals wearing dental prostheses, factors such as severity of tooth loss, types, and quality of dental prostheses, particularly retention and stability, negatively impacted not only masticatory function and OHRQoL, but also their overall body composition and health., (© 2022. The Author(s).)

Background and Objective: Poor oral health increases systemic inflammation, which has complex pathophysiologic links with atrial fibrillation (AF). The aim of this comprehensive systematic review was to investigate the association between oral health and AF in terms of new-onset AF and AF recurrence., Methods: After PROSPERO protocol was registered, PubMed, Scopus, and Cochrane Database of Systematic Reviews were standardly searched from database inception to February 2021. The included studies were assessed for quality and risk of bias using the modified Newcastle-Ottawa scale. The indicators of poorer oral health were the presence of periodontitis, lower frequency of dental scaling, lower frequency of toothbrushing, and lower number of missing teeth., Results: We initially identified 424 studies; however, only 5 studies met the inclusion criteria. The included studies comprised 3 nationwide population-based retrospective cohort studies, 1 large prospective cohort study, and 1 case-control study that reported the association between oral health and AF. These studies demonstrated that poor oral health was associated with new-onset AF, and may promote AF recurrence and progression. Moreover, AF patients with poorer oral health may have a higher risk of arrhythmias and major adverse cardiovascular events during long-term follow-up., Conclusion: Improved oral health potentially reduces new-onset AF. Periodontitis prevention, regular dental visits for professional dental scaling, and frequent tooth brushing, are oral health care interventions that contribute to AF protection. Therefore, promoting oral health should be integrated as a part of AF primary prevention., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Objectives: The aim of this pilot study was to develop a Thai-version of a simple swallowing questionnaire, called the T-SSQ, and to evaluate the association between malnutrition risk and swallowing ability, determined objectively by tongue strength and subjectively by the T-SSQ. Sensitivity analysis was also performed to determine which swallowing indices better estimate malnutrition in older adults., Methods: This cross-sectional study comprised two phases: Phase I, development and cross-cultural translation of the T-SSQ; and Phase II, application of the T-SSQ in 60 older adults. In Phase I, content and face validity of the T-SSQ was evaluated by 10 experts and 15 older adults. In Phase II, the convergent validity of the T-SSQ was evaluated by determining its association with objective tongue strength. Nutritional status was evaluated using the Thai-version of the Mini-Nutritional Assessment. Covariates included sociodemographic characteristics, and oral and health-related status. Adjusting for covariates, the associations between the two swallowing indices and malnutrition risk were determined using multivariable regression analyses. A cut-off value for low tongue strength was determined using a receiver operating characteristic (ROC) curve, and sensitivity analysis between the swallowing indices and malnutrition risk was performed., Results: The T-SSQ comprised 4-items of common signs and symptoms of a swallowing problem. Its content and face validity were verified. Older adults were considered as having a swallowing problem when at least one item was reported. Convergent validity of the subjective index was shown by significantly different tongue strength values between the participants with and without a swallowing problem (p for independent t-test = 0.014). Based on the highest area under the ROC curve, an 18-kPa cut-off value was chosen to classify low tongue strength. Having a swallowing problem and low tongue strength was significantly associated with malnutrition risk. The positive predictive value of the subjective swallowing index was 1.8-fold higher than objective tongue strength., Conclusions: Self-reported swallowing problems determined by the T-SSQ can be used as a subjective index for evaluating swallowing ability in older adults. Subjective swallowing problems and objective tongue strength were associated with malnutrition risk. However, the T-SSQ estimated malnutrition risk better than the objective index., Competing Interests: The authors have declared that no competing interests exist.

Objectives: The study objectives were: 1) to develop a masticatory index for evaluating masticatory ability in patients wearing a dental prosthesis, including complete dentures (CD), removable partial denture (RPD), and fixed partial denture (FPD), 2) to test the reliability and validity of the index, and 3) to determine whether the index better reflected patients' masticatory ability compared with conventional subjective and objective measures., Methods: The present cross-sectional study consisted of 2 phases: 1) developing the Chulalongkorn University masticatory index (CUMI) consisting of 20 food items in 5 masticatory difficulty grades using a 3-point Likert scale, and 2) application of the CUMI in 110 patients wearing a dental prosthesis, including CD, RPD, and FPD (control group). The CUMI test-retest reliability was reevaluated 2 weeks later. The convergent validity was compared with objective masticatory performance evaluated with a standard peanut chewing test, and subjective eating impacts evaluated by the Oral Impacts on Daily Performances Index. Oral and denture status were determined clinically. The associations between CUMI score, peanut particle size, and eating impact score was identified using Spearman's correlation coefficient. To evaluate discriminant validity, the associations between masticatory ability measurements and oral and denture status were analyzed using regression analyses., Results: The CUMI's Cronbach's alpha and intraclass correlation coefficient values were 0.89 and 0.95, respectively. The convergent validity was shown by significant associations between the increased CUMI score, smaller peanut particle size and decreased eating impact score. Multivariable analyses found that the CUMI score, peanut particle size, and percentage of having an eating impact were significantly associated with the number of remaining teeth and posterior occluding pairs, and type and quality of dental prosthesis. However, the CUMI demonstrated better discriminant validity because significant dose-response relationships were found only between the decreased CUMI score and increased tooth loss severity, and unacceptable denture quality. Adjusted R2 values of the CUMI models were the highest, followed by those of peanut particle size and eating impact., Conclusion: CUMI is a reliable and valid tool to evaluate masticatory ability of patients wearing a dental prosthesis, including CD, RPD, and FPD. Due to a better discriminant validity, the CUMI better reflects masticatory ability of patients compared with conventional subjective and objective masticatory ability measures., Competing Interests: The authors have declared that no competing interest exist.

Background: Thailand has encountered an imbalanced dentist distribution and an internal brain drain of dentists from public to private health care facilities. To tackle these challenges, the compulsory service (CS) program, which has been initially implemented for physicians, was extended for dentists., Method: This policy and workforce document review describes the background, development, and policy implementation of the CS program in Thailand during the past three decades. Outcomes after policy implementation and future directions are also discussed. The information was gathered from the relevant policy and workforce documents available from 1961 to 2021., Results: In Thailand, junior dentists, specifically newly graduates, have to enroll in the CS program by working as oral health practitioners in public hospitals for at least 3 years. Dentists must pay a maximum fine of 400 000 baht (~ 12 571 USD) if they wish to skip the program. This fine is lowered according to the number of attending years in the program. CS program conditions are related to each university's admission track. The CS enrolled dentists receive several financial and non-financial benefits, including educational, employment-related, and living provisions. Altogether, successive Thai governments have launched directive policies to increase dentist distribution in rural areas and their retention in public hospitals. These policies have been implemented in 3 stages: (1) increase production of new dentists, (2) allocation of newly dental graduates to public hospitals, and (3) provide benefits for working in public hospitals., Conclusion: During the past three decades, several public policies have been implemented to improve dentist retention and distribution to public hospitals across Thailand, particularly in rural areas. The present CS program may not completely resolve the oral health inequalities because the dentist retention rate in public hospitals depends on multi-dimensional considerations. Further modifications on the CS program and future well-planned policies are needed., (© 2021. The Author(s).)

Objective: There is no core competency for geriatric dentistry and special patient care (GSP) in Thailand. Therefore, GSP program was developed as a knowledge-based curriculum. This study aimed to describe the development and architecture of the GSP curriculum by analyzing patients' information and students' evaluation to move toward a competency-based curriculum. Comparisons with the original GSP curriculum and future direction are discussed., Methods: Development and architecture of the GSP curriculum were described. Information of 130 patients attending the GSP clinic, and those who participated in a maintenance recall was analyzed. Students' evaluation was performed using a 21-item questionnaire within seven domains based on the ASEAN University Network-Quality Assurance (AUN-QA) checklist. The responses were made using a five-point ordinal scale ranging from totally agree to totally disagree., Results: Only 50% of the patients attended a maintenance recall. Among the recalled patients, 74.2% reported emerging problems. The AUN-QA questionnaire responses indicated that students mostly agreed with the program specification, teaching and learning approach, students' assessment methods, student quality, and support domains. The modified curriculum was developed based on the patients' information and students' evaluation. The original and modified GSP curricula were compared., Conclusions: Information analysis of the patients and students' evaluation are essential to move a knowledge-based curriculum for geriatric and special patient care dentistry toward a competency-based curriculum that is appropriate for patients' condition and serves students' requirements. Oral health care in elderly and special care patients requires a multidisciplinary approach, and should encompass oral disease problems, behavior, and social context., (© 2021 American Dental Education Association.)

Statement of Problem: The masticatory ability of complete denture (CD) wearers can be evaluated subjectively and objectively. Although an objective measure reflects a person's ability to masticate food, it is rarely used in clinical practice. Moreover, the factors associated with subjective and objective masticatory ability of CD wearers remain unclear., Purpose: The purpose of this clinical study was to identify subjective and objective measures that better reflect the masticatory ability of CD wearers and to investigate their associating factors., Material and Methods: Masticatory ability was evaluated in 130 CD wearers by using subjective and objective measures. The subjective indicators were oral impact on eating and denture satisfaction based on eating or mastication ability. Masticatory performance was objectively measured by using a median peanut particle size. The maximum occlusal force, number, and area of occlusal contacts were determined from a pressure-sensitive sheet. CD retention and stability were classified into acceptable and unacceptable denture quality following the CU-modified Kapur criteria. The occlusal pattern and oral conditions were examined and recorded. Intraexaminer reliability in determining CD quality and oral condition was shown by a Kappa score of 0.90 to 0.95. Multivariable linear and logistic regressions were performed to analyze the associations between CD quality, maximum occlusal force, and masticatory ability. The Spearman correlation was used to determine the association between subjective and objective measures. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) between subjective and objective measures were calculated., Results: Unacceptable CD quality was significantly associated with oral impact on eating, eating dissatisfaction, and larger peanut particle size (P<.001). Peanut particle size increased with lower maximum occlusal force, which was related to fewer occlusal contacts and the female sex. The highest to lowest adjusted R 2 values were related to masticatory performance, oral impact on eating, and eating satisfaction models. Among participants with unacceptable CD quality, 16% had higher masticatory performance, 25%, had no oral impact on eating, and 33% reported eating satisfaction. The sensitivity and specificity values of subjective measures in predicting lower masticatory performance were approximately recorded at 74% and 90%, respectively, whereas PPV and NPV were at 90% and 77%, respectively., Conclusions: CD retention and stability impact objective and subjective masticatory ability. Objective masticatory performance is the best measure for evaluating the masticatory ability of CD wearers, followed by oral impact on eating and eating satisfaction. A 3.6-mm peanut particle size is suggested as a cutoff value for identifying CD wearers with impaired masticatory ability., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Backgrounds: Tooth loss is one of the major oral health problems among older Thai people. However, there is the existence of socioeconomic-related inequalities in dental service utilization, especially denture service. The aim of this study was to assess the determinants associated with inequalities in denture service utilization among older Thai people using the Andersen Behavioural model., Method: This cross-sectional study involved secondary data analysis of the 2014 survey of older Thai people (N = 38,695). The dependent variable was a public denture service utilization over the past 5 years. Determinants were classified as predisposing and enabling factors. Predisposing variables included age, sex, education, economic condition and dependency status. Enabling variables included working status, health behaviours, health care utilization experience and social/community support. Data were analysed by using bivariate and multivariable analyses at α = 0.05. For bivariate analysis, chi-square test was used to determine the association between dependent and each independent variable. Then, all variables were incorporated into a multivariable binary logistic regression., Results: The odds of denture service utilization were significantly higher for individuals who were older, female, and had a higher educational level and health-promoting behaviors. A positive dose-response relationship was demonstrated between denture service utilization and increased quartile of household assets., Conclusions: Predisposing variables had a greater impact than enabling variables in denture service utilization among older Thai people. Despite free public denture service, socioeconomic-related inequalities persist. The government needs to reduce socioeconomic disparities to improve denture treatment inequality.

Purpose: This study investigated denture and patient related factors associated with oral health-related quality of life (OHRQoL) of complete denture wearers and their association with general health and happiness., Methods: This retrospective cohort study comprised 130 participants with complete edentulism, with maxillary and mandibular complete dentures treated at Chulalongkorn University Dental School during 2010-2017. The primary outcome was the presence of overall and domain-specific Oral Impacts on Daily Performances (OIDP). Secondary outcomes were diagnosed and perceived general health, and happiness. Denture retention and stability were classified as acceptable or unacceptable following the CU-modified Kapur criteria. Five esthetic-assessment criteria of the harmonization and proportions between facial and dental anatomical landmarks were measured from patient's photographs. Age, sex, previous complete denture experience, and denture age were recorded. The associations between each variable and oral impacts were analyzed using bivariate logistic regression, and the factors with p < 0.25 were further adjusted using multivariable analysis. Associations between oral impact scores and general health and happiness were assessed using Spearman's rank correlation., Results: The most frequent oral impacts were on physical domain, while social domain was the least affected. Denture retention/stability was significantly associated with both overall and specific domains of oral impact. Happiness was found to be strongly correlated with perceived general health, but marginally with oral impact scores., Conclusions: Unacceptable complete denture retention and stability are substantial risk factors for impaired OHRQoL in complete edentulism. Maintaining optimal denture retention and stability in denture wearers is essential for good oral health and well-being with the goal of enhancing happiness., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper.

Statement of Problem: Some complete denture wearers report difficulty with daily activities, especially activities related to denture retention and stability. However, no standard criteria are available for professionally based assessment of complete denture quality., Purpose: The purpose of this clinical study was to determine the association between professionally based assessment of complete denture quality, evaluated by conventional and Chulalongkorn University (CU)-modified Kapur criteria and multiple patient-based outcomes: oral health-related quality of life (OHRQoL), eating satisfaction, and masticatory performance. The sensitivity and specificity of these criteria in estimating the outcomes were investigated., Material and Methods: The participants were 126 individuals with removable acrylic resin complete dentures. Denture retention and stability were scored based on the Kapur method, with excellent intraobserver reliability indicated by a Kappa score of 0.91 to 0.99. The clinical quality of the complete denture was classified according to conventional and CU-modified Kapur criteria. The participants were interviewed for OHRQoL by using the Thai version of the Oral Impacts on Daily Performances (OIDP) index and responses were reported as the absence or presence of oral impacts. Participants' satisfaction eating with their dentures was determined by using a 5-point Likert scale and dichotomized into satisfied and dissatisfied categories. Masticatory performance was evaluated by the multiple sieve method of peanut mastication. After adjusting for covariates, the associations between denture quality and overall and condition-specific (CS) impacts on eating and on eating satisfaction were analyzed by using binary logistic regression, while its association with masticatory performance was determined using linear regression. Goodness-of-fit post estimation was conducted to determine the sensitivity and specificity of each denture quality criterion in estimating patient-based outcomes., Results: Complete denture retention and stability, evaluated by conventional and CU-modified Kapur criteria, were associated with multiple patient-based outcomes. However, denture stability showed a stronger association than retention. The CU-modified criteria assessed the quality of maxillary and mandibular dentures individually and revealed a higher sensitivity in estimating all patient-based outcomes., Conclusions: Retention and stability were important indicators in estimating the masticatory ability and OHRQoL of complete denture wearers. The CU-modified Kapur criteria can identify impaired masticatory ability and OHRQoL in complete denture wearers better than conventional criteria., (Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)