Search

Introduction: Edentulism is the partial or total loss of teeth, it is irreversible and disabling due to its sequelae in the masticatory, phonetic and aesthetic function that affect the quality of life., Objective: To establish the impact of edentulism and sociodemographic factors on the quality of life of the Salvadoran population., Materials and Methods: Secondary cross-sectional analysis of data in 3322 users of the Public Health System of El Salvador, aged 15 to > 60 years. The variables under study were sociodemographic, edentulismo and quality of life. Edentulism was determined by clinical examination using the Oral Impact on Daily Performance scale. The statistical analysis was performed using χ 2 , OR, multiple regression analysis and set the significance threshold at p < 0.05., Results: Partial edentulism in the upper jaw was present in 68.24% people, partial edentulism in the lower jaw was present in 72.42% people and complete edentulism was observed in 2.02% people. There were significant sex differences and a relationship between sex and quality of life (p < 0.004); the self-perception of severe/very severe impacts was greater in women. People without education or with primary or secondary education only were the most affected (p < 0.05). Tooth loss increases with age, affecting quality of life in a severe/very severe manner. Complete edentulism had greater impacts on quality of life in terms of eating (25.64%), speaking (21.15%), and socializing/enjoying contact with people (10.90%). A severe/very severe impact on quality of life of teeth lost was reported mainly by those over 60 years of age, with an average of 11 missing posterior teeth, 6 missing anterior teeth and 13 missing teeth per patient. Those missing up to 6 anterior teeth were times more likely to perceive severe/very severe impacts on quality of life than those without any missing teeth (OR:5.788). Edentulism affected the quality of life of those examined, especially the loss of upper anterior teeth., (© 2024. The Author(s).)

Background: Edentulism remains a major disability worldwide, especially among the elderly population, although the prevalence of complete edentulism has declined over the last decades. In Uganda, the prevalence of edentulism in people aged 20 years and above is 1.8%. The therapy for edentulous patients can be realized through the use of conventional removable complete dentures, implant-supported prostheses, and computer-aided design and computer-aided manufacturing (CADCAM), however, the provision of removable complete dentures continues to be the predominant rehabilitation for edentulous patients. However, no published study has explored the lived experiences with removable complete dentures among the Ugandan population. The aim of the present study was to explore patients' lived experiences on the usage of removable complete dentures among Ugandan edentulous patients attending Makerere University Dental Hospital., Methods: This was a qualitative study approach using purposive sampling. Fifteen (15) respondents were selected across social demographics. Interviews were recorded and transcribed and themes were generated to draw a deeper meaning to the usage of removable complete dentures. A qualitative statistical package, Atlas Ti software was used to generate themes from the interviews followed by an interpretation of the generated data and the results were presented as text and in a table., Results: The reported key positive experiences due to removable complete denture rehabilitation were the improvement in speech, eating ability, regaining good facial appearance, better oral hygiene management, self-esteem and confidence to smile in public, and a feeling of completeness. However, respondents complained of pain and discomfort due to the looseness of dentures, inability to eat certain foods, and regular cleaning of dentures. The respondents did not go through proper informed consent processes before getting removable complete dentures., Conclusion: The study found that patients were satisfied with their removable complete dentures rehabilitation due to the positive experiences registered, such as the ability to eat and talk well, and restoration of self-esteem, all of which improved their quality of life. However, they experience pain and discomfort due to the looseness of dentures., (© 2024. The Author(s).)

Purpose: To evaluate whether complete dentures (CDs) relined with long-term resilient liners (LTRLs) favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to conventional CDs., Materials and Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in PROSPERO (the International Prospective Register of Systematic Reviews; CRD42021258700). The population, intervention, comparison, and outcome (PICO) purpose was to determine whether CDs relined with LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients when compared to CDs. Searches were performed in the PubMed/MEDLINE, Embase, Scopus, Lilacs, BBO, and OpenGrey databases. Manual searches were also performed to identify additional primary studies., Results: Overall, 3,953 articles were found. After removing duplicates, reading the articles, and applying the inclusion and exclusion criteria, 15 articles were selected for qualitative analysis, totaling 422 patients with follow-up periods ranging from 1 week to 3 years. Among these, 8 studies assessed masticatory function using different methods, 2 assessed satisfaction, 1 assessed quality of life, and 4 assessed more than one outcome. Through qualitative analysis, LTRLs showed satisfactory results in most studies when compared to CDs in relation to masticatory function, satisfaction, and quality of life., Conclusions: LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to CDs.

Aim: The present study assessed the impact of demographics and tobacco habits on oral health related quality of life (OHRQoL) among complete denture patients., Setting and Design: Prospective cohort study design., Materials and Methods: Two hundred and eighty four edentulous patients, aged above 30 years, were chosen as the sample for the study after taking informed consent. Information regarding demographic data and smoking status was obtained from each participant. OHRQoL was evaluated using the Oral Health Impact Profile Edentulousness (OHIP EDENT) quantifying various domains, namely functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap., Statistical Analysis Used: Data were analyzed using the Statistical Package for the Social Sciences version 23.0 (IBM; Chicago, Illinois, USA). Mann-Whitney U test was applied to find significant differences in OHRQoL between gender, age, and smoking status. P < 0.05 was considered to be statistically significant., Results: It was seen that complete denture wearers above 65 years had higher OHIP EDENT scores as compared to younger counterparts suggesting the compromised quality of life in the functional domain which was statistically significant. Psychological discomfort was greater in females while physical disability seemed higher in males. Smoking was found to be a factor associated with decreased OHRQoL., Conclusion: Older age groups, female gender, and smoking were factors associated with decreased OHRQoL among complete denture patients., Competing Interests: None

Objectives: To compare the degree of satisfaction (SD) and the impact on oral health-related quality of life (OHRQoL) of edentulous patients treated with conventional complete dentures (CCDs) and mandibular overdentures (IODs) with a short anteroposterior spread (S-APS) or a large antero-posterior spread (L-APS)., Materials and Methods: Edentulous patients were treated with CCDs and subsequently randomly allocated to receive a bar clip mandibular overdenture retained by 2 interforaminal implants (Control) or 4 (Test: 2 additional implants distal to the mental foramen). The Oral Health Impact Profile Edent questionnaire (OHIP-20E) and the Visual Analogue Scale (VAS) were applied at a mean follow-up of 38.5 months to assess the impact on OHRQoL and DS, respectively. Comparisons between the type of prosthesis and the extension of the AP spread were made with Student's t test for paired samples and for independent samples, respectively, at a significance level of 5%., Results: The IODs had significantly lower OHRQoL values ​​in the dimensions "functional limitation" (p=0.03), "physical pain" (p=0.02), "psychological discomfort" (p<0.01), "disability physical" (p<0.01) and "general score" (p<0.01) (n=20 patients). The IODs presented DS values ​​significantly for "aesthetics" (p=0.04), "stability" (p=0.03), "masticatory capacity" (p<0.01), "function" (p<0.01) and "oral condition" (p=0.03). The S-APS group (control) resulted in significantly lower values ​​in the dimensions "physical pain" (p<0.01) and "general score" (p<0.01) and no domain with statistical difference in the VAS scale., Conclusions: IODs significantly improved OHRQoL and DS. The increase in AP spread did not result in benefits for the patient's OHRQOL and DS in this clinical study. (Study Protocol Number: 1.452.492) CLINICAL SIGNIFICANCE: Implantology has experienced in the last 20 years a permanent evolution that aim at increasing predictability and improving long-term clinical performance. Placement of short implants distally to the mental foramen, for instance, and the resulting increase of the anterior-posterior spread, is a promising approach and is worthy of investigation., Competing Interests: Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier Ltd.)

Statement of Problem: Clinical studies regarding satisfaction and occlusal forces with the complete denture in relation to the menopause are sparse., Purpose: The purpose of this clinical study was to compare satisfaction levels and occlusal force with complete dentures in premenopausal and postmenopausal Indian women., Material and Methods: 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)., Results: 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)., Conclusion: Satisfaction levels and occlusal force with complete dentures were significantly higher in premenopausal women group than in the postmenopausal group., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Aim: The present study was conducted to evaluate differences in Oral Health-Related Quality of Life (OHRQoL) in denture wearers based on psychological classification and patient satisfaction., Settings and Design: A prospective study., Materials and Methods: 284 patients, aged 30 years and above who fulfilled the eligibility criteria were recruited. Participants answered the OHIP - EDENT questionnaire at the time of denture insertion and 6 months later. Psychological categorization was based on MM House classification. Patient satisfaction was graded from totally satisfied to not very satisfied., Statistical Analysis Used: SPSS 23 version was used for analyzing descriptive and inferential statistics. ANOVA was used to find significant differences for OHRQoL based on psychological classification and patient satisfaction. Before and after intervention analysis was assessed using student 't' test., Results: Philosophical and exacting patients had better adaptation to dentures than the hysterical and indifferent class of denture wearers. Totally satisfied and very satisfied patients with dentures had lesser mean scores as against the other categories which was significant in all domains suggesting better. Overall, OHIP - EDENT score decreased from 20.253 ± 12.466 to 17.168 ± 14.143, which were significant at P =0.043, thus showing an improvement after a 6 month follow up., Conclusions: Psychological attitude of denture wearers must be considered by the prosthetic specialist for effective adaptation and acceptance by the edentulous patient., Competing Interests: None

Tobacco smoking is responsible for several health problems, including mouth diseases. The aim of the present study was to establish the association between smoking and dental status and self-perceived oral health in a large group of elderly Colombian adults. Analysis of 18,937 survey records of participants aged ≥ 60 years old was conducted. Information regarding age, sex, skin color, socioeconomic level, education, marital status, denture use, partial tooth loss or edentulism, Geriatric Oral Health Assessment Index (GOHAI) and tobacco smoking was retrieved from the database. A descriptive analysis and multivariate logistic regression analysis were performed. Half of the participants were edentulous in the maxilla while mandibular teeth were more frequently retained in more than 60% of the participants. After adjusting for sex and age, smoking consistently increased the odds of partial or complete edentulism in the maxilla (OR 1.05; 95% CI 1.02-1.09) and mandible (OR 1.04; 95% CI 1.00-1.08). Nonetheless, the increase in the odds in the mandible was not statistically significant. The habit of smoking was associated with increased tooth loss that in the long-term may result in poor oral health affecting the quality of life of elderly people.

Objectives: To compare the psychometric properties of three OHRQoL indicators (GOHAI, OHIP-14, and OHIP-EDENT) in a group of complete edentulous subjects and to explore the ability of these instruments to distinguish between individuals with different prosthetic and oral health status., Methods: This was a cross-sectional study. Edentulous individuals aged 60 years and more were recruited between January 2019 and February 2020 in a medical and dental care centers. The Lebanese versions of GOHAI, OHIP-14, and OHIP-EDENT were used. External and internal consistencies were assessed using intraclass correlation coefficient (ICC) and Cronbach alpha, respectively. The concurrent validity was evaluated by testing the indicators against a proxy measure of a similar concept. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile, respectively, and multivariate analyses were performed using sociodemographic, clinical, and subjective health parameters as explanatory variables., Results: Two hundred and two edentulous subjects (age: 72.94 ± 7.378 years) were included. The proportion of subjects with no impact was lower for OHIP-EDENT (7.9%) compared to GOHAI (28.2%) and OHIP-14 (38.6%). Reproducibility was satisfactory for all OHRQoL tools since they were able to reproduce the results consistently in time (ICC > 0.80). The Cronbach alpha values were greater than 0.8 indicating acceptable internal consistency. The concurrent validity of the three tools was acceptable since subjects with lower OHRQoL score were less satisfied with their dentures and reported a higher need for self-rated therapy. Concerning the discriminant validity, OHIP-EDENT was more discriminant than OHIP-14 and GOHAI, since it was more able to identify patients with poor prosthetic issues or using instable denture., Conclusion: The OHIP-EDENT was more effective in identifying edentulous individuals with oral and prosthetic problems. Our results can help decide which dental instrument to use to assess the perception of oral health in edentulous individuals. More prospective studies are required to compare their evaluative properties.

Background: Due to improved healthcare, more people reach extreme ages. Oral health in the oldest-old has thus far been poorly described. Here, we investigated self-reported oral health factors, use of professional oral health care, and associations with clinical measures in centenarians considered cognitively healthy., Methods: In this observational cohort study, we included 162 (74% female) centenarians from the Dutch 100-plus Study cohort who self-reported to be cognitively healthy, as confirmed by a proxy. Centenarians were questioned about their physical well-being including medication use and their cognitive functioning was evaluated using the Mini-Mental State Examination. Questions regarding oral health included preservation of teeth, oral pain or discomfort, chewing ability, xerostomia, and time since last visit to an oral health care provider. Associations between oral health and clinical measures were investigated with ordinal logistic or linear regression analyses, adjusted for gender, age, and education., Results: The majority of the centenarians indicated to have good oral health: 76% felt no oral pain/discomfort, 65% indicated to chew well; while only 18% had symptoms of xerostomia. Of all centenarians, 83% were edentulous and were wearing removable complete maxillary and mandibular dental prostheses, 1% was edentulous with no dental prosthesis, while 16% was dentate with or without removable partial dental prostheses (10 and 6% respectively). Dentate and edentulous centenarians experienced similar levels of oral pain and/or discomfort, chewing ability, xerostomia, and their cognitive functioning was similar. No relationship between cognitive functioning and chewing ability was found. Xerostomia was associated with medication use (p = .001), which mostly regarded medications for cardiovascular diseases, diuretics, anti-coagulants, and antacids. Only 18% of the centenarians visited an oral health care provider during the year prior to the interview, of whom 48% were dentate centenarians. Notably, 49% of the centenarians had not visited an oral health care provider for ≥10 years., Conclusions: Most centenarians were edentulous and did not report oral complaints. Less than one-fifth of the centenarians continued to seek regular professional oral health care. Since the proportion of dentates in the oldest-old will increase in the near future, a proactive attitude toward this group is necessary.

Objectives: This study tests whether total tooth loss is a risk indicator for difficulty eating among a population with intellectual disability and whether complete denture wear mediates this risk., Methods: Dentate status and difficulty eating were reported for a Nationally representative sample of 690 adults over forty with intellectual disabilities as part of The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA). A logistic regression model tested the relationship between the Difficulty eating and Dentate status, controlling for the effects of other factors., Results: Of the 690 participants, 505 had some teeth (Group 1), 56 had no teeth and reported wearing dentures (Group 2) and 129 had no teeth, not using dentures (Group 3). A parsimonious regression model was developed including all 406 cases with no missing data. Adjusting for the effects of other factors, it was found that, compared to Group 1, the odds of difficulty eating was twice as great (OR = 2.01, 95% CI = 1.02-4.03) among people without teeth, not using dentures (Group 3). Conversely, edentulous participants who had dentures (Group 2) had far lower odds (OR = 0.21, 95% CI = 0.06-0.64) of reporting difficulty eating compared with Group 1., Conclusions: For adults with ID, total tooth loss was predictive of difficulty eating only when untreated. People with disabilities should be encouraged to maintain a functional dentition through preventive and conservative treatment. When adults with ID become edentulous, oral rehabilitation may reduce the risk of difficulty eating. Dental assessment should be undertaken if people with ID present with difficulty eating., (© 2018 John Wiley & Sons Ltd.)

Objective: This study aimed to explore the perceptions and long-term experiences of edentulous patients rehabilitated with single-implant mandibular overdentures (SIMO)., Methods: Thirteen participants, mean age 65.7 years, 69.2% women, who had had their treatment completed for at least 1 year, were invited and included in the study. Focus groups including four to five participants each were conducted, audio and video recorded and transcribed verbatim. Subsequently, the transcripts were analysed according to the principles of thematic analysis., Results: Four major themes emerged as follows: before decision to undergo treatment with SIMO, implant surgery experience, perception of treatment outcomes and impressions about the care received. Lack of information, cost, comorbidities, older age and fear were initial barriers to the decision for treatment. Dissatisfaction with previous treatment and a sense of opportunity motivated the decision. There were ambivalent reports of absence of pain during surgery and discomfort during anaesthesia. Post-surgical recovery exceeded the pre-surgical negative expectations in most cases. There was a tendency for a positive impact of SIMO on the patients' quality of life, comprising improved ability to chew and communicate, dietary diversification, greater comfort and safety, increased self-confidence and social interaction. Few minor inconveniences were reported such as the feeling of insecurity after an episode of denture fracture and the need to use adhesive paste. Satisfaction with the care received and the trust in the dentist and dental team were evident., Conclusion: In general, participants presented positive perceptions and rewarding experiences after rehabilitation with SIMO., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Statement of Problem: Clinicians are currently unable to quantify the psychosocial, functional, and esthetic effects of prosthetic interventions to replace teeth. Understanding the effects of treatment to replace teeth on oral health-related quality of life (OHRQoL) is important for informed consent. A systematic review of the evidence of OHRQoL improvements with prosthodontic tooth replacement and a comparison of outcomes between treatment modalities is therefore indicated., Purpose: The purpose of this systematic review was to examine the OHRQoL of patients with partial edentulism after different dental prosthetic treatments., Material and Methods: Electronic database and manual searches were conducted to identify cohort studies and clinical trials reporting on the OHRQoL of individuals receiving implant-supported crowns (ISCs), implant-supported fixed dental prostheses (IFDPs), implant-supported removable dental prostheses (IRDPs), tooth-supported fixed dental prostheses (TFDPs), and removable partial dentures (RPDs). Two reviewers independently conducted article selection, data extraction, and quality assessment. Random-effects models were used to compare OHRQoL change scores (standardized mean change, 95% confidence intervals)., Results: Of the 2147 identified studies, 2 randomized controlled trials and 21 cohort studies met the inclusion criteria. Overall, studies were of low or moderate risk of bias. Pooled mean OHRQoL change ≤9 months was 15.3 for TFDP, 11.9 for RPD, and 14.9 for IFDP. Pooled standardized mean change OHRQoL change >9 months was 13.2 for TFDP and 15.8 for IFDP. Direct comparisons ≤9 months between TFDP against IFDP and RPD against IFDP significantly favored IFDP in both cases., Conclusions: TFDP and IFDP had short- and long-term positive effects on OHRQoL. RPDs positively affected OHRQoL in the short term. IFDP showed greater short-term improvement in OHRQoL than RPD and TFDP., (Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Several instruments have been used to measure oral health-related quality of life (OHRQoL). The Oral Health Impact Profile (OHIP) questionnaire was based on the concept that sequential events related to oral diseases can cause discomfort, functional limitations and consequently, result in dysfunctions and even disabilities. There are few studies in the literature that structurally analyze the instruments to verify whether they measure the requirements to which they were designed to. The objective of the study was to evaluate the internal structure of the OHIP-Edent questionnaire. The OHIP-Edent was administered to 54 edentulous patients' wearers of conventional complete dentures. For structural analysis, an exploratory factorial analysis (EFA) was carried out. After determining the internal consistency of the model (Cronbach's alpha = 0.88), the fit was checked using the root mean square error approach (value 0.04), the comparative fit index (value 0.982) and the Tucker-Lewis index (value 0.976). After analysis of the 19 questions and the seven domains proposed in the OHIP-Edent questionnaire, the hypothetical factorial model showed three dimensions denominated "Physical Impact", "Psychological Impact" and "Social Impact". In this sample of conventional complete denture wearers, the OHIP-Edent seems adequate to measure the "Physical Impact", "Psychological Impact", and "Social Impact" of the OHRQoL. The confirmatory factorial analysis confirmed the model and, through adjustment indexes, it was verified that the three dimensions have convergence and consistence adequate in order to characterize the OHRQoL construct with validity.

The occlusion of choice is a controversial topic in conventional complete denture (CCD) treatment. This study aimed to compare patient satisfaction with CCD with partially group-function occlusion (PGFO), fully bilateral balanced occlusion (FBBO), buccalised occlusion (BO), lingualised occlusion (LO) and the entire balanced group. Participants received new CCDs with PGFO. All steps of patient enrolment, denture fabrication, assessments during the follow-up period and data collection were carried out exactly the same as part 1 of this research project. All patients were recalled at 1 and 3 months after delivery for data collection using the shortened version of oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire and 7 visual analog scales (VASs) for the quality of CCD based on general patient satisfaction, masticatory function, ability to speak, comfort, stability, retention and aesthetics. Data were analysed using the Wilcoxon signed-rank test, the Kruskal-Wallis test and Mann-Whitney test via SPSS version 18.0 (α = 0.05). Thirty participants completed the follow-up period for PGFO group. The mean age ± standard deviation of the new participants was 57.97 ± 6.93 years. Participants reported significantly less satisfaction in terms of comfort, stability and retention of denture with PGFO compared to balanced groups. Also, using OHIP-EDENT questionnaire, significantly higher physical pain score was noted for PGFO group compared to BO and LO. Higher physical disability score was noted in PGFO compared to LO. Participants receiving CCDs with PGFO reported lower satisfaction in terms of comfort, stability and retention of denture and higher physical pain and physical disability than the balanced occlusal schemes., (© 2018 John Wiley & Sons Ltd.)

Purpose: To assess the reliability and to validate the translated Nepalese version of the Oral Health Impact Profile (OHIP-EDENT-N) in Nepalese edentulous subjects., Materials and Methods: The international guidelines for translation and cross-cultural adaption of OHIP-EDENT were followed, and a Nepalese version of the questionnaire was adapted for this study. Eighty-eight completely edentulous subjects were then selected for the study and completed their responses for the questionnaire. The reliability of the OHIP-EDENT-N was evaluated using internal consistency. Validity was assessed as construct and convergent validity. Construct validity was determined using exploratory factor analysis (EFA). The correlation between OHIP-EDENT-N subscale scores and the global question was investigated to test the convergent validity., Results: Cronbach's alpha for the total score of OHIP-EDENT-N was 0.78. Construct validity was assessed by factor analysis: 70.196% of the variance was accountable to five factors extracted from the factor analysis. Factor loadings above 0.40 were noted for all items. In terms of convergent validity, significant correlations could be established between OHIP-EDENT-N and global questions., Conclusions: This study has been able to establish the reliability and validity of the OHIP-EDENT-N, and OHIP-EDENT-N can be a considered a reliable tool to assess the oral health related quality of life in the Nepalese edentulous population., (© 2016 by the American College of Prosthodontists.)

Purpose: The Japan Prosthodontic Society developed a multi-axis assessment protocol to evaluate the complex variations in patients who need prosthodontic care, and to classify the level of treatment difficulty. A previous report found the protocol to be sufficiently reliable. The purpose of this multi-center cohort study was to evaluate the validity of this multi-axis assessment protocol., Methods: The treatment difficulty was evaluated using the multi-axis assessment protocol before starting prosthodontic treatment. The time required for active prosthodontic treatment, medical resources such as treatment cost, and changes in the oral health-related QOL before and after treatment, were evaluated after treatment completion. The construct validity of this protocol was assessed by the correlation between the dentist's pre-operative subjective assessment of the treatment difficulty, and the level of difficulty determined by this protocol. The predictive validity was assessed estimating the correlations between a "comprehensive level of treatment difficulty" based on the four axes of this protocol and total treatment cost, total treatment time, and changes in the oral health-related QOL before and after treatment., Results: The construct validity of this protocol was well documented except for psychological assessment. Regarding the predictive validity, the comprehensive level of treatment difficulty assessed before treatment was significantly correlated with the three surrogate endpoints known to be related to the treatment difficulty (total treatment cost, treatment time, and improvement in the oral health-related QOL). To further clarify the validity of the protocol according to patients' oral condition, a subgroup analysis by defects was performed. Analyses revealed that treatment difficulty assessment before treatment was significantly related to one or two surrogate endpoints in the fully edentulous patients and the partially edentulous patients. No significant relationship was observed in the patients with mixture of full/partial edentulism and the patients with teeth problems, possibly due to the small sample size in these groups., Conclusion: This study revealed that the multi-axis assessment protocol was sufficiently valid to predict the level of treatment difficulty in prosthodontic care in patients with fully edentulous defects and with partially edentulous defects., (Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.)

Objectives: This study examined whether oral health is a neglected aspect of subjective well-being (SWB) among older adults. The key research question was whether deterioration in oral health among dentate older adults living in England was associated with decreases in SWB, using measures of eudemonic, evaluative, and affective dimensions of well-being., Methods: This secondary analysis used data from the third (2006-2007) and fifth (2010-2011) waves of respondents aged 50 and older from the English Longitudinal Study of Ageing (ELSA). We fitted multivariable regression models to examine the effects of changes in oral impacts on daily life and edentulism (complete tooth loss) on SWB (quality of life, life satisfaction, and depressive symptomatology)., Results: A worsening in both oral health measures was associated with an increase in depressive symptoms even after adjusting for time-varying confounders including declining health, activities of daily living, and reduced social support. Becoming edentate was also associated with decreases in quality of life and life satisfaction., Discussion: A deterioration in oral health and oral health-related quality of life increases the risk of depressive symptoms among older adults and highlights the importance of oral health as a determinant of subjective well-being in later life.

This literature review aims to investigate how a poor oral health impacts on general health and healthy lifestyle of elderly people. The literature review was performed using ScienceDirect, Scopus and PubMed databases to identify relevant published studies. The year of publication was limited to over the past 5 years and the language was limited to English. Having considered the relevant articles' abstracts the 36 articles were selected. Systematical literature revision shows that recently, the older population has increased worldwide and it is being predicted to keep growing in near future. As age-related changes are observed in oral cavity, geriatric dentistry becomes more relevant to investigate oral disorders and to take relevant measures in elderly population. There is an urgent need to clarify the correlations between oral and general health. Unsatisfactory oral conditions lead to serious systemic diseases. Based on the currently available evidence, better collaboration between medical and dental fields is required in order to create and maintain healthy elderly population. A special association with professional group is important for implementation of new programs, in order to enhance and maintain satisfactory oral hygiene, oral health and oral health related quality of life.

Background: Occlusal scheme can affect denture retention, stability, occlusal force distribution, aesthetics, masticatory function, patient comfort and general patient satisfaction with dentures., Objectives: This study aimed to compare the patient satisfaction with 3 types of complete denture occlusion including fully bilateral balanced occlusion (FBBO), newly presented buccalised occlusion (BO) and lingualised occlusion (LO)., Methods: In this parallel randomised clinical trial, new conventional complete dentures were fabricated for 86 volunteers. Participants were randomly allocated to 3 groups with 3 different occlusal schemes. All patients were recalled at 1 and 3 months after delivery for data collection. The 19-item version of Oral Health Impact Profile for Edentulous Patients questionnaire was used in this study. The visual analogue scale (VAS) was used for assessment of the prosthodontist's attitude towards denture quality, patient's attitude towards different occlusal schemes and evaluation of patient satisfaction. Data were analysed using the Wilcoxon signed rank test, the Kruskal-Wallis test and the post hoc Dunn test via SPSS version 18.0 (P ≤ .05)., Results: Eighty-six patients completed the study, and their data were analysed (mean age ± standard deviation = 57.78 ± 9.98 years). The only significant difference when comparing the 3 groups was physical pain, which was significantly higher in FBBO group. No significant differences were found for the VAS scores of patient and prosthodontist satisfaction or the domain scores among the 3 occlusal schemes either at 1 or at 3 months post-delivery. The VAS score of patient satisfaction and prosthodontist satisfaction increased at third compared to first month after delivery., Conclusion: The results of this randomised clinical trial provided evidence that BO is as effective as LO for the fabrication of complete dentures., (© 2017 John Wiley & Sons Ltd.)

Background: To evaluate oral health related quality of life (OHQoL) in edentulous patients treated with immediately loaded implants in the maxilla., Methods: Fifty-one edentulous patients in two centers received six maxillary implants each were loaded within 24 h with provisional restoration. Definitive restoration was delivered 20-24 weeks later. OHQoL was evaluated preoperatively with the Oral Health Impact Profile 49 questionnaire (OHIP-49) and on five subsequent occasions. OHIP-49 includes seven domains representing functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. A reduction in OHIP scores indicated an improved OHQoL., Results: Forty-five patients reached the three-year follow up. OHQoL improved after treatment. A plateau of OHQoL improvement was observed at 12 months after surgery. The seven domains improved at different pace, 12 weeks to 12 months after treatment. OHIP showed continuously low scores with no significant changes at consecutive visits 12 months to three years after treatment. Dental status with removable prosthesis in the mandible had a negative impact on OHQoL prior to and during treatment, but did not affect OHQoL after permanent restoration was placed. Patients age or gender did not affect OHQoL., Conclusions: Patients with edentulous maxilla who received prosthetic rehabilitation on immediately loaded implants experienced the highest improved OHQoL 12 months after implant installation. Quality of life related to oral health continued to be high after three years. Edentulous patients with atrophy of the maxilla experience an improved OHQoL after implant treatment with immediate loading protocol., Trial Registration: ClinicalTrials.gov Identifier NCT00711022 .

Objective: To investigate the combined effect of complete denture renewal and simple dietary advice., Methods: A randomized controlled trial was performed with edentulous patients who required new complete dentures. All participants received complete denture treatment. In addition, the intervention group received dietary advice in a pamphlet form, while the control group received advice pertaining to the care and maintenance of the dentures. The advice was given by dentists for each group. The participants' food intake was assessed at baseline and 3 months after intervention using a diet history questionnaire and an oral health related quality of life assessment measured using the Japanese version of the Oral Health Impact Profile for edentulous people (OHIP-EDENT-J)., Results: Among 70 participants who were randomized, 62 participants finished all parts of this trial. At baseline, there was no significant difference in the food intake between the two groups. At the 3-month assessment, the intervention group showed significantly greater intake of chicken (P=0.013), fish with bones (P=0.012), and carrots and pumpkins (P=0.025) compared to the control group. However, at baseline and at the 3-month assessment, there was no significant difference in the OHIP-EDENT-J scores between the groups, but the OHIP-EDENT-J scores significantly improved for both groups at the 3-month assessment. There were more significant improved dimensions of OHIP-EDENT-J in the intervention group than in the control group at the 3-month assessment., Conclusions: Simple dietary advice combined with complete denture treatment could improve food intake of edentulous patients., Clinical Significance: The present study suggests that brief dietary advice provided by dentists can improve food intake of edentulous elderly. This simply diet advice is much easier compared to customized forms, might enable normal dentists provide patients it. The result of this study broadens possibility of nutritional counseling in daily clinical practice., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

There is widespread consensus that the neutral zone (NZ) concept contributes to improved stability for mandibular complete dentures (CDs). However, little is known about its impact on oral health-related quality of life (OHRQoL) of edentulous patients compared to conventionally (CV) manufactured dentures. In this prospective crossover trial, performed at the Oral Health Centre of the University of the Western Cape, CV and NZ mandibular dentures were made for each patient. Scores from the 20-item oral health impact profile (OHIP-20) for both types of dentures were compared with pre-treatment scores using paired t-tests. Treatment effect size (ES) was established. Associations of OHIP-20 scores and several patient variables (age, gender, period of edentulousness, quality of the denture-bearing tissue, denture dimensions, preference) were performed using the generalised linear model. Significance was set at P = 0·05. Records of thirty-five participants were included in the study (mean age of 62·3 years, range 47-85 years). There were highly significant differences between pre-treatment and both post-treatment OHIP-20 scores with t = 6·470 for CV and t = 6·713 for NZ. Treatment ES was large for both types of dentures (>0·8). Difference of ES between NZ and CV dentures was small (ES < 0·2). None of the patient variables showed significant associations with OHIP-20 scores of the two types of dentures, except for preference and NZ OHIP-20 scores. For this group of patients, both treatment methods improved OHRQoL significantly and patient-related factors did not influence impact on OHRQoL differently for both interventions., (© 2017 John Wiley & Sons Ltd.)

Background: Several studies have covered oral health and dental decay in old age, but these studies mostly applied standard quantitative tools and did not include consideration of older people's views on oral problems, partial edentulism in particular., Objective: To explore people's perceptions in terms of the transition from being OK to NOT OK with tooth loss among a selection of older people in Iran., Materials and Methods: A qualitative content analysis study was chosen for the research by interviewing 15 older people using open-ended questions. Criteria for participation in the study were as follows: fitting the Kennedy class I or class I modification I category, having a minimum of four teeth but not more than 20 and being aged 60 years or more. The recorded interviews were then transcribed, and a coding process was applied based on a qualitative, conventional content analysis., Results: The four main themes that emerged were as follows: (i) gradual realisation of the need to deal with the problem; (ii) the search for information on dental health; (iii) the challenge of adaptation; and (iv) tendency towards dental rehabilitation., Conclusion: The turning point in the transition from being OK to NOT OK seemed to be associated with an edentulous crisis that had occurred from another problem such as stomach ache, distention, or nocturnal dyspnoea due to swallowing food that had not been properly chewed and had an affect on an elderly person's life, physically and mentally. It is important to recognise the concept of healthy eating in relation to edentulism., (© 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.)

Purpose: A lingualized occlusion (LO) for complete dentures reduces lateral inferences and occlusal force contacts and direction; thus, LO is theorized to be more suitable for patients with compromised ridges than fully bilateral balanced articulation (FBBA). However, no studies have yet provided evidence to support LO in edentate patients with compromised alveolar ridges. The purpose of this study was to compare LO and FBBA in edentulous individuals with compromised ridges., Methods: Sixty edentulous individuals were randomly allocated into groups and received dentures with either LO or FBBA. Following delivery, several denture-related satisfaction variables were measured using 100mm visual analogue scales; oral health-related quality of life (OHRQoL) was also assessed using the Oral Health Impact Profile (OHIP). Sub-group analyses of the effect of moderate and severe mandibular bone loss were also carried out., Results: No significant differences were detected between LO and FBBA with the primary outcome. At 6 months, participants with severely atrophied mandibles and FBBA rated their satisfaction with retention of mandibular dentures significantly lower than those with LO (median LO: 86, FBBA: 58.5, p=0.03). They also had significantly lower OHRQoL for the domain of Pain (median LO: 4, FBBA: 5, p=0.02). General satisfaction and total OHIP scores significantly improved between baseline and 6 months only for the LO subjects with severely atrophied mandibles (satisfaction: p=0.003, OHIP total score: p=0.0007)., Conclusions: The results indicate that the LO occlusal scheme with hard resin artificial teeth is more efficient for patients with severely resorbed mandibular ridges., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background & Aims: Improvement of nutritional status and perception of oral health are supposed to be different with complete conventional denture or implant-supported fixed or removable prostheses. Since no study has been conducted in Lebanon, the aim of our study was to assess the nutritional status and oral heath related quality of life (OHRQoL) in totally edentulous patients after treatment with complete denture or implant supported-prostheses., Material and Methods: This was an observational clinical prospective study. A convenient sample of Lebanese people aged 60 years or more was selected between September 2013 and July 2015 from the Departments of removable and fixed prosthesis at Saint-Joseph University of Beirut. The treatment options included complete denture, implant-supported complete denture and implant-supported fixed prostheses. Nutritional status and OHRQoL were assessed with the Mini-Nutritional Assessment Index (MNA) and the Geriatric Oral Health Assessment Index (GOHAI) respectively at Baseline (first visit before treatment), 2-3 weeks after treatment (t1), 3 months (t2) and 6 months (t3) after treatment., Results: Fifty-one participants (mean age: 69.39 ± 7.164 years) were included. The results have shown an improvement over time in nutritional status and OHRQoL for all treatment groups. However, 2-3 weeks after treatment the number of participants at risk of malnutrition was higher with complete removable denture, intermediate with implant-supported complete denture and lower with implant-supported fixed prostheses (p-value = 0.049). Moreover, the mean GOHAI score was significantly lower over time with complete removable denture compared to implant-supported prostheses (p-value <0.05)., Conclusion: Our study has shown an enhancement in the quality of life and the nutritional status for implant supported-prostheses compared to conventional removable dentures. Therefore, it is fundamental that dentists communicate with their patients about implant treatment to understand their expectations, to explain the outcomes and achieve the desired clinical result., (Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Objectives: This study explored the experiences of edentulous patients for their perceptions of tooth loss and patient attitudes to treatment options for rehabilitation of the edentate state., Methods: Purposive sampling was used to recruit edentate patients with varying denture-wearing experience from two dental hospitals in the Republic of Ireland. Sixteen edentate patients, aged 59 to 83 years, of whom 12 were women and four men were interviewed. Interviews were transcribed, and thematic analysis was undertaken., Results: Findings from this study reflect previous studies, whereby some patients indicated dissatisfaction with the functionality of their dentures. The majority of participants had no regret regarding the loss of their teeth, and despite dissatisfaction with dentures, they would not consider other forms of treatment. Finance was not considered an issue in determining whether to seek out treatment by these participants. These participants expressed a reluctance to get new dentures in case they were more problematic., Conclusion: This study illustrates that some elder edentate patients were dissatisfied with the functionality of their dentures and raised concerns that about the quality of dentures which may be provided to them by dentists. These participants identified clinical dental technicians as a preferred point of contact for their care. Consideration should be given to new oral healthcare delivery models which are accessible and acceptable to future elders., (© 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.)

Background: Individuals who are edentulous have a lower intake of fruit, vegetables, fiber, and protein compared with their dentate counterparts because tooth loss is accompanied by a decrease in ability to chew. Whether or not a combination of prosthetic rehabilitation and simple dietary advice produces improvement in dietary intake among edentulous persons is unclear. We aim to investigate the effect of a simultaneous combination of simple dietary advice delivered by dentists and provision of new complete dentures on dietary intake in edentulous individuals who request new dentures., Methods/design: Through a double-blinded, parallel, randomized controlled trial in which 70 edentate persons who request new complete dentures will be enrolled, eligible study participants will be randomly allocated to either a dietary intervention group receiving dietary advice or to a control group receiving only advice on the care and maintenance of dentures. Outcome measures include daily intake of nutrients and food items, assessed using a brief self-administered diet history questionnaire; antioxidant capacity, determined using blood and urine samples; nutritional status, assessed with the Mini-Nutritional Assessment-Short Form; oral health-related quality of life, assessed with the Japanese version of the Oral Health Impact Profile-EDENT and the Geriatric Oral Health Assessment Index; subjective chewing ability; masticatory performance, assessed using a color-changeable chewing gum and a gummy jelly; patient self-assessment of dentures; mild cognitive impairment, assessed with the Japanese version of the Montreal Cognitive Assessment; and functional capacity, assessed with the Japan Science and Technology Agency Index of Competence. Outcome measures, except for antioxidant capacity, are to be implemented at three time points: at baseline and at 3 and 6 months following intervention. Antioxidant capacity data are to be collected twice: at baseline and at 3 months following intervention. Differences between the groups at 3 and 6 months and within-group changes are to be compared using the paired t test., Discussion: Simple dietary advice that can be implemented by a dentist would be more practical in clinical practice than tailored dietary counseling. The results of this study will provide beneficial information on dietary intake changes for both edentulous individuals requesting new complete dentures and dentists., Trial Registration: University Hospital Medical Information Network Center Unique Trial Number: UMIN000017879 . Registered on 12 June 2015.

Purpose: Edentulism usually leads to esthetic, functional, and emotional discomfort resulting in a loss of self-esteem and a decrease of the patient's quality of life. Dental implants provide new possibilities to ensure the comfort and efficacy of prosthetic rehabilitation. The aim of this study was to evaluate the satisfaction level of patients rehabilitated using the Brånemark protocol or overdenture implant-supported prostheses., Materials and Methods: Fifty-two patients were rehabilitated using the Brånemark protocol and 23 using overdenture prostheses. Then, an adapted oral health-related quality of life questionnaire was administered in addition to a clinical exam to determine the condition of the dental implants and prostheses. The results for treatment expectation, understanding of the type of treatment, phonetic function, chewing comfort, pain, and self-esteem improvement were analyzed with Fisher exact test (P ≤ .05)., Results: Both treatments presented satisfaction of above 87%, with no statistical difference between them. Eighty-two percent of patients treated with overdenture prostheses and 80.8% of those treated with the Brånemark protocol had no complaint of pain (P = .087)., Conclusion: The treatments analyzed in this study were highly satisfactory with regard to functional and esthetic factors, resulting in an increase in self-esteem and quality of life. The psychological factor is a complex variable in patient satisfaction that directly influences quality of life. Considering the desires of patients in choosing the type of prosthesis is critical to treatment success.

Background: The relationship between brain and prosthesis was previously assessed either by improving denture function or in fixed implant retained, wherein brain function was assessed only after crown placement., Purpose: To prospectively analyze the changes in brain activity and cognitive function of completely edentulous patients in edentulous state, with dentures and two-implant supported mandibular overdenture before and after loading, along with the effect of mastication in the change - a pilot study., Materials and Method: Ten completely edentulous (CE) non-denture wearers were selected. The mandibular prosthesis was loaded with two 3.3 mm × 13 mm myriad snap fit implants. To assess the brain activity and cognitive function, Electroencephalogram (Neurofax EEG 1000 Ver 05-90, Nihon Kohden corporation, Tokyo, Japan) and Mini-Mental State Examination (MMSE) questionnaire, respectively, were taken during the process of rehabilitation. EEG assessment was analyzed using Matlab 2011A 7.9 signal processing tool box. The results were statistically analyzed with SPSS 17.0 version using Wilcoxon signed rank and Friedman test, Results: Amplitude, power of alpha waves and cognitive scores increased gradually with highest mean rank for implant supported overdenture (IOD). The bivariate analysis between two groups showed there was significant difference between all the groups (p < 0.05) except for groups CE-I (completely edentulous - implant placement) and CD- I (complete denture insertion - implant placement) in amplitude of alpha waves while in group CD-I with respect to power of alpha waves. MMSE revealed the mean of cognitive scores in Complete Edentulous was 17.40, Complete Denture was 18.30 and finally with Implant Overdenture was 23.80., Conclusion: The present study has enlightened the significance of two implant supported mandibular overdenture in improving the mental state of an individual and that the enhancement was due to functional improvement with prosthesis when loaded with implants and not due to mere existence of implant without any function., (© 2015 Wiley Periodicals, Inc.)

There is little evidence of the effect of implants restored with fixed partial dentures on oral health-related quality of life (OHRQoL) in partially edentulous Kennedy class II and III patients. The aim of this study was to determine the change in OHRQoL in Kennedy classification II and III patients treated with a two-implant-supported fixed dental prosthesis (FDP). Kennedy class II and III patients received dental implants and an FDP. Oral health-related quality of life was measured by administration of the Oral Health Impact Profile-14 (OHIP-14NL) questionnaire at intake (T1), 2 weeks after surgery (T2) and after 1 year of loading (T3). The mean OHIP score at T1 was 6·5 ± 1·2, 2·4 ± 1·0 at T2, and 0·9 ± 0·3 at T3. There was a statistically significant difference between T1 and T2 (P = 0·002) and T1 and T3 (P < 0·001) but not between T2 and T3 (P = 0·407). The OHIP score in Kennedy II patients decreased from 4·8 ± 3·2 at T1 to 1·5 ± 2·0 at T2 and 1·1 ± 1·8 at T3, and that in Kennedy III patients decreased from 8·9 ± 9·6 at T1 to 3·6 ± 8·9 at T2 and 0·8 ± 2·2 at T3. There were no statistically significant differences in the reductions in Kennedy II and III patients. Oral health-related quality of life changed positively in patients treated with implants and an FDP in both groups. There was no change in OHRQoL between the times of implant placement and FDP placement., (© 2015 John Wiley & Sons Ltd.)

Objectives: The purpose of this study was to assess relationships among periodontal conditions, salivary antioxidant levels, and patients' satisfaction with their prostheses., Methods: This study was conducted at the Division of Prosthodontics, Department of Dentistry, Taipei Medical University Hospital. The periodontal condition of patients was based on an assessment of the plaque index (PI) and gingival index (GI). The pH value, flow rate, and buffer capacity of the saliva were estimated. The salivary total antioxidant status (TAS) and superoxide dismutase (SOD) level were also determined. Patients' satisfaction with prosthetic treatments was evaluated using the Chinese version of the short-form Oral Health Impact Profile (OHIP-14C). A multivariate regression model was used to determine whether patients' satisfaction with prosthetic treatment was affected by their oral health status., Results: In total, 35 edentulous patients were recruited. In the Spearman correlation analysis, salivary pH (r = -0.36, p = 0.03) and the buffer ability (r = -0.48, p<0.01) were associated with OHIP-14C scores. In the multivariate analysis, patients who had a higher GI also had a higher score of physical disabilities (β = 1.38, p = 0.04). Levels of SOD increased with the scores of psychological discomfort (β = 0.33 U/g protein, p = 0.04)., Conclusions: This study suggested that both the GI and SOD levels were associated with patients' satisfaction with prosthetic treatments. To the best of our knowledge, this is the first study to elucidate the relationship between OHIP scores and salivary oxidative markers in edentulous patients.

Objectives: To compare between the oral health-related quality of life (OHRQoL) of Thai elderly dental patients at the Faculty of Dentistry, Chulalongkorn University with at least 20 natural teeth (NT) and those with less than 20 NT, and between those with at least 4 posterior occluding pairs (POP) and those with less than 4 POP., Background: Thai government recommended that elderly people should have at least 20 NT and 4 POP., Materials and Methods: The participants comprised 240 Thai elderly dental patients who were interviewed and had their OHRQoL determined using the Oral Impacts on Daily Performances Index (OIDP). Higher OIDP score indicates poorer OHRQoL. We counted the functional NT and POP in each participant., Results: Participants with less than 20 NT or less than 4 POP had significantly higher OIDP scores than those with at least 20 NT or at least 4 POP. Moreover, when we evaluated one by one tooth loss, we found the first and the last significant differences between the OIDP scores in the participants with at least 23 teeth and with less than 23 teeth, and those in the participants with at least 5 teeth and with less than 5 teeth, in consequently., Conclusion: Thai elderly participants with at least 20 NT or at least 4 POP had greater OHRQoL than those with less than 20 NT or less than 4 POP, and in our study sample, we observed that 5 teeth may be an important clinical threshold for Thai elderly dental patients' quality of life., (© 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.)

Objective: The purpose of this study was to examine the association between participants (i) who reported having had clinical diagnoses of depression and anxiety with 6+ teeth removed and (ii) who reported having had clinical diagnoses of depression and anxiety with edentulism., Methods: The Behavioral Risk Factor Surveillance System (BRFSS) Survey 2010 was used for the study. Analyses involved using SAS 9.3® to determine variable frequencies, Rao-Scott chi-square bivariate analyses, and Proc Surveylogistic for the logistic regressions on complex survey designs. Participants eligibility included being 18 years or older and having complete data on depression, anxiety, and number of teeth removed., Results: There were 76 292 eligible participants; 13.4% reported an anxiety diagnosis, 16.7% reported a depression diagnosis, and 8.6% reported comorbid depression and anxiety. The adjusted logistic regression models were significant for anxiety and depression alone and in combination for 6+ teeth removed (AOR: anxiety 1.23; 95% CI: 1.10, 1.38; P = 0.0773; AOR: depression 1.23; 95% CI: 1.10, 1.37; P = 0.0275; P < 0.0001; and AOR: comorbid depression and anxiety 1.30; 95% CI: 1.14, 1.49; P = 0.0001). However, the adjusted models with edentulism as the outcome failed to reach significance., Conclusions: Comorbid depression and anxiety are associated independently with 6+ teeth removed compared with 0-5 teeth removed in a national study conducted in United States. Comorbid depression and anxiety were not shown to be associated with edentulism as compared with any teeth present., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Emerging evidence suggests that an individual's level of mastication may play a role in their cognitive status. This suggests that in edentate individuals wearing complete denture, non-optimal mastication via inadequate denture could be related to cognitive status., Objectives: To examine the impact of quality of denture on cognitive status of a sample of elderly edentate Brazilian individuals wearing complete denture., Methods: This study is a cross-sectional analysis of data collected from 117 edentate elders (mean age 73.7 ± 5.6 years) wearing complete denture, in southern Brazil. Cognitive impairment was assessed using the Brazilian version of the mini-mental state examination (MMSE). Clinical examination was conducted to evaluate the quality of dentures by use of the FAD (functional assessment of dentures) instrument. Masticatory ability was assessed by self-reported questions., Results: The mean MMSE score for the total sample was 23.1 (SD=4.4) and was associated with age (p=0.001), education (p<0.0001), depressive symptoms (p=0.003), as well as the masticatory ability (p=0.001) and functional quality of dentures (p<0.0001). Unsatisfactory masticatory ability was more frequent in edentate individuals with lower FAD score (p<0.0001) and led to a lower MMSE total score. Unsatisfactory masticatory ability was associated with MMSE scores (p=0.002) after adjustment., Conclusion: The study results support the potential role of optimal functional quality of dentures in maintaining cognitive activity in elders. This association may be explained via mastication pathway., Clinical Significance: The potential beneficial effect of functional dentures on cognitive status via mastication could encourage preventive strategies to decrease substantial risk of morbidity in elders., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Purpose: The aim of this study was to explore individual (ie, sociodemographic characteristics, patient personality) and clinical factors (ie, dentist-patient communication, denture quality) associated with complete denture satisfaction among the Taiwanese elderly population., Materials and Methods: A multistage sampling and cross-sectional design was used to collect data. A total of 387 fully edentulous citizens, aged 65 years and older and who had received new sets of complete dentures, were selected. The participants completed clinical dental examinations and questionnaires by personal interview to collect information on denture satisfaction and associated variables. The relationship among three groups of these participants (satisfied, neutral, and dissatisfied) and potential factors were simultaneously examined using polytomous logistic regression analysis., Results: Overall, 36.7% of the participants were dissatisfied with their dentures. Living status (crude odds ratio [COR] = 2.04), personality (COR = 4.86), dentist-patient communication (COR = 7.46), and denture quality (COR = 5.02) were associated with complete denture satisfaction. The multivariate regression model showed that dentist-patient communication (adjusted odds ratio [AOR] = 6.41) and denture quality (AOR = 4.40) were significant complete denture satisfaction factors that diluted the effect of living status and personality., Conclusions: Inadequate dentistpatient communication and low denture quality were associated with the dissatisfaction of patients with dentures. To increase complete denture satisfaction, the importance of training programs aimed at enhancing dentist-patient communication and denture quality cannot be overemphasized.

Purpose: An edentulous patient's psychosocial attributes that may have influence on the oral health-related quality of life (OHRQoL) are given little consideration in therapeutic care. The aim of this study was to assess the impact of complete denture therapy on overall OHRQoL in elderly edentulous patients. The possible role of the patient's initial expectation toward OHRQoL was also evaluated., Methods and Materials: OHRQoL was assessed using the OHIP-EDENT psychometric instrument, and 56 patients participated in the study. The assessment was done at three time points including pretreatment, after 1 month, and after 6 months. Significant differences in the OHIP-EDENT scores between pretreatment to after 1 month and pretreatment to after 6 months were calculated using Wilcoxon Signed Rank test (p < 0.05). Mann-Whitney test was used to analyze the association of patient expectations with OHIP-EDENT scores., Result: Statistically significant improvement in OHRQoL after complete denture therapy at both 1 and 6 months postinsertion was evident. Statistically significant difference in the mean scores between the genders was observed after 6 months. There was no statistically significant difference in the levels of dysfunction, discomfort, and disability associated with oral problems between moderate and high expectation group at any time point., Conclusion: Elderly edentulous patients had an improved overall OHRQoL after complete denture therapy, and female patients had appreciably better OHRQoL than their male counterparts. A patient's initial expectation did not have significant influence on overall OHRQoL., (© 2014 by the American College of Prosthodontists.)

Background: Edentulism affects the quality of life and general health of an individual. But in ageing individuals, it has been observed to have greater impact, manifesting in functional, psychological and social limitations. With an increasing older adult population in Ghana, its burden is likely to increase. This study was thus carried out to explore the association between edentulism and quality of life among older Ghanaian adults., Methods: Secondary analysis of WHO's Study on global AGEing and adult health (SAGE) Wave 1 in Ghana was conducted using self-reported edentulism as the dependent variable. Participants included a nationally representative sample of adult's aged 50 years and older living in Ghana. Quality of life was measured using the 8 item WHOQOL measure and a single item measure which was a question "How would you rate your overall quality of life?". To assess the association between edentulism and the independent variables, a bivariate analysis was carried out. A Poisson regression model was then performed, adjusting for age, sex, income, education and the diagnosis of a chronic disease condition. A Spearman's correlation analysis was also carried out between the single and multi item measure of quality of life to assess how well they correlate., Results: Edentulism was observed to be associated with significantly lower levels of SWB among older adults using both the single-item and multiple-item measure (WHOQOL). It, however, showed no association with happiness. Among edentulous respondents, females and those with no formal education reported significantly lower quality of life. The WHOQOL correlated positively and strongly with the single-item measure., Conclusion: Edentulism may not be life threatening and yet it has been shown to have a negative effect on the quality of life of older adult Ghanaians. More emphasis may thus need to be placed on the oral health of the aging population in Ghana to avoid it.

Objectives: The aim of this study was to evaluate the reliability and validity of the Chinese version of the Oral Health Impact Profile for edentulous subjects (OHIP-EDENT-C)., Methods: After translation and cross-cultural adaptation following international guidelines, 162 complete denture wearers were recruited to complete the questionnaire. The reliability of the OHIP-EDENT-C was evaluated using internal consistency and test-retest methods. The validity of the OHIP-EDENT-C was analyzed by construct validity and convergent validity. Construct validity was determined based on factor analysis and convergent validity by analyzing the correlation between OHIP-EDENT-C subscale scores and the global question., Results: Cronbach's alpha value (internal reliability) for the total OHIP-EDENT-C score was 0.972, and the intraclass correlation coefficient value (test-retest reliability) was 0.763 (similar to the original OHIP-EDENT). Construct validity was determined by factor analysis, extracting five factors, accounting for 74.31 % of the variance. All items had factor loadings above 0.40. In terms of convergent validity, the OHIP-EDENT-C subscale was significantly highly correlated to the global question., Conclusion: The results suggest that the OHIP-EDENT-C is a reliable and valid measure to evaluate OHRQoL for edentulous subjects in China.

Background/aim: Tooth loss affects oral health-related life quality. More than a third of edentulous patients are not fully satisfied with their complete dentures and mainly complain of insufficient stability, retention, and pain during mastication. Solving the problem may include relining by materials that are based on silicone or acrylic. The aim of this study was to determine the level of patients' satisfaction before and after relining upper dentures with soft and rigid liners., Methods: The patients (n=24) were divided into two study groups. Maxillary denture relining of the first group of patients was performed with hard acrylic based resins while in the second group of patients complete denture was relined with a silicone-based soft liner. They were asked the questions from the specifically adapted the Oral Health Impact Profile Questionnaire for edentulous patients before and three months after relining dentures., Results: After relining the patients showed a higher degree of satisfaction with their dentures in all the tested domains (masticatory function, psychological discomfort, social disability and retention and hygiene). The padents with soft denture relines were more satisfied., Conclusion: Refining of maxillary complete dentures significantly positively impacts the quality of life of patients in all the tested domains (masticatory function, psychological discomfort, social disability, pain and oral hygiene). Better results were achieved using a silicone-based soft liner, which recommends it as the material of choice for relining dentures.

Purpose: The aim of this study was to investigate the effect of case severity on clinical outcomes when fabricating new complete dentures., Materials and Methods: Participants were separated into severe and moderate groups using the index of case difficulty for edentulous patients developed by the Japan Prosthodontic Society. Before and after treatment, self-assessed masticatory ability and oral health-related quality of life (OHRQoL) were examined, and the authors compared them according to case severity using the Mann-Whitney U test. To compare findings before and after treatment, the authors used the Wilcoxon signed rank test., Results: In the severe group, both scores were significantly improved after treatment (P < .01). However, in the moderate group, there was no significant difference in self-assessed masticatory ability as measured by the food acceptance score before and after treatment (P = .11). Before treatment, OHRQoL as measured by the Oral Health Impact Profile score was significantly higher in the severe group than in the moderate group (P < .01). However, after treatment, there was no significant difference between the two groups (P = .92)., Conclusions: The authors concluded that case severity makes a difference in the edentulous patient's OHRQoL and self-assessed masticatory ability during complete denture treatment. Evaluating case severity with the index before treatment is a useful tool for patients and clinicians to predict clinical outcomes.

Introduction: Health is the main component of the quality of life, while oral health is component of the general health. The socio-demographic characteristics are one of the important factors for perception of the oral health and the quality of life. The main purpose of this study was to perform an evaluation of the quality of life of geriatric patients (older than 65) with built-in oral prosthetic dentures depending on the ethnic affiliation, level of education and place of living, as socio-demographic characteristics., Materials and Methods: The survey was a prospective transversal (cross-sectional) study conducted among 165 institutionally sheltered patients at the Gerontology Institute (inspected group - IG) and 170 patients from the dental specialist clinics (control group CG) at the age of 65 and older. The statistical program SPSS for Windows ver. 13.0 was used for statistical processing., Results and Discussion: Patients with upper and lower total dentures dominated (43.6% vs. 26.5%). The highest GOHAI score had the other ethnicities of IC (32.08) and Roma of IG (31.00), while the lowest was in the Albanians of CG (25.91). The highest value of 30.15 had the IG of patients living in urban areas., Conclusion: The quality of life and oral health of the geriatric patients are at unsatisfactory level, with significant influence of the place of living and insignificant influence of the ethnic affiliation and level of education.

Studies in industrialized nations suggest that severe edentulism correlates with cognitive impairment, but there is little information on this association in underserved populations. We conducted a community-based study to assess whether edentulism associates with cognitive impairment in elders living in rural Ecuador. Atahualpa residents aged ≥60 years were identified during a door-to-door census and evaluated using the Montreal Cognitive Assessment (MoCA). Persons were classified into two groups according to whether they have severe edentulism (<10 remaining teeth) or not. In addition, a questionnaire allowed self-rating of oral health. A total of 274 persons (mean age 69.6 ± 7.7 years; 59% women) were included. Persons with <10 remaining teeth (n = 116) have significantly lower MoCA scores than those with ≥10 teeth (n =158), after adjusting for demographics, cardiovascular risk factors, depression and dementia (β = -1.06, p = 0.03). Self-rated poor oral health was more prevalent among persons with <10 teeth (p < 0.0001), but did not correlate with MoCA scores (good vs. poor, β = -0.89, p = 0.89). Severe edentulism is associated with poor cognitive performance in elders living in rural Ecuador. Public health campaigns directed to improve oral health may facilitate early recognition of persons with cognitive impairment in underserved populations.

Purpose: The aim of this study was to assess patients' perceptions of benefits and risks concerning complete denture therapy. A secondary objective was to assess the influence of clinical and sociodemographic variables on patients' perceptions., Materials and Methods: The sample was composed of 104 volunteers who presented themselves for complete denture treatment at a dental school. The average age of the volunteers was 69.2 years (±) 9.3. Patient opinions concerning the benefits of complete denture therapy were recorded using a previously reported questionnaire. The answers were evaluated in three domains: (1) benefits (positive perceptions); (2) risks (negative perceptions); and (3) consequences of no treatment., Results: The average time of use of the previous dentures was 20 years (SD ±12.9). Risk factors (negative perceptions) received lower scores by the patients, while the consequences of no treatment received higher scores. No association was found among evaluations of the previous dentures and educational level, marital status, and gender; however, patients' evaluation about their previous dentures was significantly different depending on age (p = 0.001) and previous dentures' time of use (p = 0.038)., Conclusions: Patients presented a positive perception of complete denture therapy, and the risk factors (negative perceptions) received the lowest scores. Patient perception regarding complete denture therapy was not influenced by educational level, evaluation of the previous dentures, or marital status., (© 2014 by the American College of Prosthodontists.)

The purpose of this study was to evaluate the impact of psychological intervention on edentulous patients' satisfaction with complete clinically satisfactory complete dentures. The survey was conducted in China Medical University involving 84 individuals receiving complete dentures at this institution from August 2013 to March 2014. Participants were randomly allocated to intervention and control groups consisting of 42 subjects, respectively. In the intervention group, individuals received oral health education and psychological intervention before and after the whole process. In the control group, 42 cases received doctor's regular advice after treatment. Satisfaction regarding aesthetic, speech, mastication, retention and comfort was rated in the first and third month after prosthesis treatment. Patients overall aesthetic, speech, mastication and retention were significantly improved in both intervention and control groups in 3 months later after prosthesis treatment when compared with the first month (P < 0·05). No significant difference existed for comfort in control group. Patient scores on aesthetic, speech, mastication and retention at both first and third month evaluations (P < 0·05) differed between the control and intervention groups. However, there was no difference for their scores related to comfort (P > 0·05) in first and third month. The study concludes that psychological intervention plays a significant role in improving patient satisfaction with complete dentures., (© 2014 John Wiley & Sons Ltd.)

Purpose: The purpose of this study was to evaluate and compare Oral Health-Related Quality of Life (OHRQoL), denture satisfaction, and masticatory performance in edentulous patients provided with mandibular implant-supported overdentures (ISODs) retained with telescopic attachments and those of conventional complete dentures (CCDs). Peri-implant soft tissue changes were also evaluated at various intervals during a 1-year observation period., Materials and Methods: Participating patients received new CCDs and later received two mandibular interforaminal implants and had their mandibular CCDs converted into ISODs with telescopic attachments. Questionnaires were used to assess OHRQoL (Shortened Oral Health Impact Profile-14, Malaysian version) and denture satisfaction at different stages of treatment with CCDs and ISODs. Objective masticatory performance with the CCDs and ISODs was recorded with a mixing ability test. Evaluations were carried out at 3 months with the new CCDs, 3 months after mandibular ISOD provision, and 1 year after receiving the ISOD. Peri-implant parameters were additionally assessed at specific intervals during the treatment period. The data obtained were statistically analyzed and compared., Results: In the 17 patients who completed the protocol, significant improvements were observed in OHRQoL and patient satisfaction when CCDs were modified to ISODs, after 3 months, and at 1 year. Significantly better mixing ability with the ISOD was noted, with the highest values observed at 1 year. Statistically insignificant differences were observed for all the peri-implant parameters, except for gingival recession, for which significant changes were observed 6 months after ISOD delivery (values had stabilized by 1 year)., Conclusion: Telescopic crown attachment-retained mandibular ISODs improved OHRQoL, dental prosthesis satisfaction, and masticatory performance compared to CCDs. Peri-implant soft tissue response and implant stability were found to be favorable after 1 year.

Background: The OHIP-49 is widely used to assess oral health-related quality of life, but its length makes it time-consuming and difficult to use. An abbreviated version of the OHIP-49 with fourteen items has been validated for older adults, but not in Chile. The aim was to develop and validate the Spanish version of the OHIP-14 in an elderly Chilean population., Methods: Two studies were conducted; a cross sectional to develop and a retrospective study to validate the OHIP-14Sp. The OHIP-49Sp was applied to 490 older adults and the fourteen questions with the higher impact on oral health-related quality of life were selected through linear regression. These items were applied on a retrospective dataset of 85 older adults to test internal consistency (Cronbach's alpha). A discriminative validity analysis was performed along with the assessment of sociodemographic (age and gender, educational level) and clinical variables (number of teeth, caries lesions, CPITN, prosthetic needs and prosthetic functionality). Data were analyzed using Mann-Whitney U, Student's t and one-way ANOVA tests with a 95% confidence level and finally were analyzed by a Multivariate Logistic Regression Model., Results: High internal consistency values were obtained for the OHIP-14Sp instrument (0.91). There was an association between the OHIP-14Sp scores and the presence of caries (p = 0.003), need for complex periodontal treatment (p = 0.002), prosthetic needs (p < 0.0001) and age younger than 70 years-old (p < 0.0001). Subjects with periodontal treatment need were more likely to report reduced oral health-related quality of life (PR = 2.10)., Conclusions: The OHIP-14Sp proved to be a consistent and valid tool to assess oral health-related quality of life when tested in Chilean older adults.

Generalised aggressive periodontitis is characterised by "generalized interproximal attachment loss affecting at least three permanent teeth other than first molars and incisors." The management of generalised aggressive periodontitis is challenging as it involves an interdisciplinary approach. When the patient presents himself late to the clinician, the tooth and bone loss can be up to 60%. Natural teeth and alveolar bone contribute to the contour and aesthetics of the face. Loss of teeth in younger age may lead to attitude, behaviour changes and may cause psychological depression and withdrawal from society. The main distinguishing feature of this case report is the psychological counselling provided along with periodontal and prosthetic treatment., (2014 BMJ Publishing Group Ltd.)

Objective: Evaluate the validity, reliability, and factorial invariance of the complete Portuguese version of the Oral Health Impact Profile (OHIP) and its short version (OHIP-14)., Methods: A total of 1,162 adults enrolled in the Faculty of Dentistry of Araraquara/UNESP participated in the study; 73.1% were women; and the mean age was 40.7 ± 16.3 yr. We conducted a confirmatory factor analysis, where χ(2)/df, comparative fit index, goodness of fit index, and root mean square error of approximation were used as indices of goodness of fit. The convergent validity was judged from the average variance extracted and the composite reliability, and the internal consistency was estimated by Cronbach standardized alpha. The stability of the models was evaluated by multigroup analysis in independent samples (test and validation) and between users and nonusers of dental prosthesis., Results: We found best-fitting models for the OHIP-14 and among dental prosthesis users. The convergent validity was below adequate values for the factors "functional limitation" and "physical pain" for the complete version and for the factors "functional limitation" and "psychological discomfort" for the OHIP-14. Values of composite reliability and internal consistency were below adequate in the OHIP-14 for the factors "functional limitation" and "psychological discomfort." We detected strong invariance between test and validation samples of the full version and weak invariance for OHIP-14. The models for users and nonusers of dental prosthesis were not invariant for both versions., Conclusion: The reduced version of the OHIP was parsimonious, reliable, and valid to capture the construct "impact of oral health on quality of life," which was more pronounced in prosthesis users., (© International & American Associations for Dental Research.)