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Journal of Prosthodontics : Official... Aug 2022To assess the nutritional profile of denture wearers through a retrospective cohort study using nutritional biomarkers from matched electronic dental and health record...
PURPOSE
To assess the nutritional profile of denture wearers through a retrospective cohort study using nutritional biomarkers from matched electronic dental and health record (EDR-EHR) data.
MATERIALS AND METHODS
The case group (denture wearers) included matched EDR-EHR data of patients who received removable partial, complete, and implant-supported prosthodontic treatments between January 1, 2010 and December 31, 2018, study time. The control (nondenture wearers) group did not have recorded denture treatments and included patient records within 1 year of the denture index date (first date of case patients' receiving complete or partial denture) of the matching cases. The qualified patients' EDR were matched with their EHR based on the availability of laboratory reports within 2 years of receiving the dentures (index date). Nutritional biomarkers were selected from laboratory reports for complete blood count, comprehensive and basic metabolic profile, lipid, and thyroid panels. Summary statistics were performed, and general linear mixed effect models were used to evaluate the rate of change over time (slope) of nutritional biomarkers before and after the index date. Likelihood ratio tests were performed to determine the differences between dentures and controls.
RESULTS
The final cohort included 10,481 matched EDR-EHR data with 3,519 denture wearers and 6,962 controls that contained laboratory results within the study time. The denture wearers' mean age was 57 ±10 years and the control group was 56 ±10 years with 55% females in both groups. Pre-post analysis among denture wearers revealed decreased serum albumin (p = 0.002), calcium (p = 0.039), creatinine (p < 0.001) during the post-index time. Hemoglobin (Hb) was higher pre-index, and was decreasing during the time period but did not change post-index (p < 0.001). Among denture wearers, completely edentulous patients had a significant decrease in serum albumin, creatinine, blood urea nitrogen (BUN), but increased estimated glomerular filtration rate (eGFR). In partially edentulous patients, total cholesterol decreased (p = 0.018) and TSH (p = 0.004), BUN (p < 0.001) increased post-index. Patients edentulous in either upper or lower arch had decreased BUN and eGFR during post-index. Compared to controls, denture wearers showed decreased serum albumin and protein (p = 0.008), serum calcium (p = 0.001), and controls showed increased Hb (p = 0.035) during post-index.
CONCLUSIONS
The study results indicate nutritional biomarker variations among denture wearers suggesting a risk for undernutrition and the potential of using selected nutritional biomarkers to monitor nutritional profile.
Topics: Aged; Calcium; Creatinine; Denture, Complete; Dentures; Electronics; Female; Humans; Male; Middle Aged; Mouth, Edentulous; Nutrition Assessment; Retrospective Studies; Serum Albumin
PubMed: 35322481
DOI: 10.1111/jopr.13505 -
Community Dentistry and Oral... Apr 2023To examine the differences in treatment outcomes for patients who received subsidized complete dentures in private dental clinics and in public dental clinics over...
Differences in complete denture longevity and replacement in public and private dental services: A propensity score-matched analysis of subsidised dentures in adult Australians across 20 years.
OBJECTIVES
To examine the differences in treatment outcomes for patients who received subsidized complete dentures in private dental clinics and in public dental clinics over 20 years in Victoria, Australia.
METHODS
Between 2000 and 2019, 187 227 complete dentures were provided to eligible public patients by the Victorian public dental system. Of these, approximately 52% were provided to public patients in private clinics through the voucher system. Of the 97 107 participants who received denture care in private clinics, 70 818 were matched 1:1 by propensity score (PS) quantiles with participants who received denture care in public clinics. The PS matching balanced the characteristics between these two groups. Subsequently, a conditional logistic regression model investigated the binary outcome of denture replacement whilst a conditional Poisson regression modelled the number of years to denture replacement. A frailty Cox regression after PS matching investigated denture survival over time.
RESULTS
Dentures provided in public clinics had a mean time to replacement of 5.5 years (SD: 34.0) and 25.9% were replaced during the observation period. In the first year of denture service, incidence rate per person year (IR) for complete denture replacement in public clinics was 0.04 (95% CI: 0.04-0.04). Dentures provided in private clinics had a mean time to replacement of 6.5 years (SD: 3.8) with 29.4% replaced during the observation period. In the first year of denture service, the IR for complete denture replacement in private clinics was 0.02 (95% CI: 0.02-0.02), which was less than half that of the public IR. Multivariate analyses found that although private dentures were more likely to be replaced during the observation period than those provided in the public sector (odds ratio [OR]: 1.31, 95% CI: 1.28-1.35, p < .001), they had greater longevity (incidence rate ratio [IRR]: 1.23, 95% CI: 1.23-1.24, p < .001). Longer longevity of private dentures was also supported by the frailty Cox regression showing that private dentures had a reduced hazard of denture replacement over time (better survival) in comparison to public dentures (hazard ratio [HR]: 0.94, 95% CI: 0.92-0.97, p < .001). Probabilistic sensitivity analysis supported the study findings.
CONCLUSIONS
Increased denture longevity, higher rates of denture replacement and lower rates of early denture replacement were associated with receiving denture care in private clinics as compared with dentures provided in the public sector.
Topics: Humans; Adult; Frailty; Propensity Score; Australia; Denture, Complete; Dental Care
PubMed: 35338502
DOI: 10.1111/cdoe.12744 -
PloS One 2022The study objectives were: 1) to develop a masticatory index for evaluating masticatory ability in patients wearing a dental prosthesis, including complete dentures...
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.
Topics: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Denture, Complete; Denture, Partial, Removable; Female; Humans; Male; Mastication; Middle Aged; Quality of Life
PubMed: 35081155
DOI: 10.1371/journal.pone.0263048 -
Journal of Indian Prosthodontic Society 2023Dementia in Alzheimer's disease complicates the caregivers in tracking the patients. Many options are discussed in the literature. A novel technique is essential to...
Dementia in Alzheimer's disease complicates the caregivers in tracking the patients. Many options are discussed in the literature. A novel technique is essential to improve the quality of life and to assist in locating the patients. The Global Position System (GPS) trackers are attached to dentures and the movements are observed through a mobile application. This technique discusses on a simple method of tracking Alzheimer's edentulous patients with the support of removable dentures. Denture tracking devices are a secured form of tracking patients. A GPS device in dentures assists in locating the patient's movement and supports the caretakers.
Topics: Humans; Alzheimer Disease; Quality of Life; Mouth, Edentulous; Denture, Partial; Caregivers
PubMed: 36588382
DOI: 10.4103/jips.jips_223_22 -
Journal of Prosthodontics : Official... Mar 2023This in vitro study compared the adaptation of denture bases fabricated by injection molding (IM), compression molding (CM), liquid crystal display (LCD), and digital...
PURPOSE
This in vitro study compared the adaptation of denture bases fabricated by injection molding (IM), compression molding (CM), liquid crystal display (LCD), and digital light processing (DLP) techniques.
MATERIAL AND METHODS
A definitive maxillary cast was duplicated using a silicone mold to create 40 gypsum casts that were laser scanned before any fabrication procedures were initiated. For the DLP and LCD groups, 20 denture bases (10 in each group) were virtually designed and manufactured referring to the digitalized data. For the CM and IM groups, 20 denture bases (10 in each group) were molded using gypsum models. A total of 40 gypsum models and their corresponding denture bases were scanned. The scanned intaglio surface of each denture base was superimposed on the scanned reference cast to compare the degree of tissue surface adaptation. The three-dimensional surface deviations of the total intaglio surface, denture border apex, palatal vault, and crest of the ridge were evaluated on the basis of the best fit algorithm technique using inspection software. The data were statistically analyzed using one-way ANOVA and Tukey's multiple comparison test (α = 0.05).
RESULTS
According to the superimposing results, for the total intaglio surface, the lowest deviation was present on the injection-molded group and the highest deviation occurred on the LCD group. For the palatal vault, the lowest deviation was present on the DLP group and the highest deviation occurred in the compression molded group. For the crest of the ridge, the lowest deviation was present in the injection-molded group and the highest deviation occurred in the LCD group. For the denture border apex, the lowest deviation was present in the DLP group and the highest deviation occurred in the LCD group.
CONCLUSIONS
Maxillary denture bases fabricated using DLP and IM techniques showed higher surface adaptation than the bases fabricated using LCD and CM techniques. Among the conventional techniques, higher compatible dentures can be produced with IM; among the additive techniques, higher compatible dentures can be produced with DLP.
Topics: Computer-Aided Design; Denture Bases; Calcium Sulfate; Denture Design; Maxilla
PubMed: 36495146
DOI: 10.1111/jopr.13623 -
International Journal of Dental Hygiene Feb 2021The aim of this systematic review was to evaluate the effectiveness of removable complete denture disinfection using microwaves for the treatment of denture stomatitis. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of this systematic review was to evaluate the effectiveness of removable complete denture disinfection using microwaves for the treatment of denture stomatitis.
METHODS
This review identified studies comparing the efficacy of microwave prosthesis disinfection (I) to topical antifungal therapy (C) in the treatment of denture stomatitis (O), which included only individuals who used complete dentures and presented with denture stomatitis (P). The search was performed in six databases and identified 1524 records; after the removal of duplicates, 816 articles remained. Three articles were selected for qualitative synthesis and two for meta-analysis. Random-effects meta-analysis estimated the polled effects of microwave disinfection and antifungal therapy on the Candida counts and clinical manifestation of denture stomatitis. The GRADE approach was used to estimate the certainty of evidence.
RESULTS
All included studies reported significant reductions in Candida counts and the frequency of denture stomatitis of groups subjected to microwave disinfection of dentures and topical antifungal therapy with nystatin. Significative differences between treatments were only detected for Candida quantification in the palate, within 90 days follow-up period (SMD = 0.47, 95% CI = 0.02-0.91). Meta-analyses did not show any further differences between treatments (p > .05), considering the Candida quantification in dentures and the frequency of clinical signs of denture stomatitis. The certainty of the evidence was considered as low, according to GRADE approach.
CONCLUSION
Microwave disinfection of complete dentures can be considered as efficient as antifungal therapy for the treatment of denture stomatitis. However, further well-designed studies are necessary to confirm such evidence.
Topics: Candida; Denture, Complete; Disinfection; Humans; Microwaves; Stomatitis, Denture
PubMed: 33022878
DOI: 10.1111/idh.12477 -
Journal of Prosthodontics : Official... Oct 2022To compare the outcomes of prosthodontic treatment for subjects wearing a complete maxillary denture opposing a root-supported mandibular overdenture (RSO) or an... (Review)
Review
PURPOSE
To compare the outcomes of prosthodontic treatment for subjects wearing a complete maxillary denture opposing a root-supported mandibular overdenture (RSO) or an implant-supported mandibular overdenture (ISO).
METHODS
A literature search was performed in seven electronic databases: MEDLINE via PubMed interface, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, and AgeLine. The search terms were developed by the primary investigators and the health sciences librarian, who then started with PubMed and adapted the original search strategy for the other databases. Included articles were those that compared the outcomes for mandibular RSOs and those with ISOs, for persons wearing a maxillary complete denture.
RESULTS
Seven articles were included in the review. There were limitations in this review because of small sample sizes, short study durations, and different methodologies. Also, no comparative studies were identified for clinically important outcomes, such as survival rates of abutments, prosthodontics/maintenance problems, and longitudinal cost of care. For prosthodontic complications, patient satisfaction, and ability to clean, no differences were reported. For oral tactile sensibility, RSOs presented significantly improved sensibility, whereas ISOs had higher maximum bite force capability, but the difference was not statistically significant, except when subjects had a cross-bite or a lingualized occlusion.
CONCLUSIONS
The results of this scoping review were not conclusive, except for maximum bite force, where ISOs seem to perform better than RSOs by the measured criteria. ISOs had higher survival rates than RSOs, and required less maintenance, but were more expensive. It was disappointing to find so few studies comparing these clinical treatment modalities, which suggests that either treatment may be clinically acceptable and depends upon a shared decision between patients and their dentists.
Topics: Humans; Denture, Overlay; Dental Prosthesis, Implant-Supported; Dental Implants; Denture, Complete; Bite Force; Mandible; Patient Satisfaction; Denture Retention
PubMed: 35187751
DOI: 10.1111/jopr.13498 -
The International Journal of... Dec 2023To compare the accuracy of milled versus 3D-printed complete denture bases and teeth and to assess the position of the teeth in relation to the corresponding denture...
PURPOSE
To compare the accuracy of milled versus 3D-printed complete denture bases and teeth and to assess the position of the teeth in relation to the corresponding denture bases.
MATERIALS AND METHODS
Two different manufacturing techniques were used in this study. In Group A, 10 complete dentures were digitally designed and fabricated by milling prepolymerized blocks of polymethyl methacrylate (PMMA). In Group B, 10 complete dentures were digitally designed and fabricated using a 3D-printing technique. The accuracy of the maxillary and mandibular denture bases and teeth and the positions of the teeth in relation to the corresponding denture bases were evaluated using Geomagic Control X software (Oqton). Data were presented as mean and SD values. Statistical analysis of the resultant data was performed using Student t test. The significance level was set at P ≤ .05.
RESULTS
With regard to denture bases, lower surface deviation values were found in the maxillary and mandibular milled denture bases (Group A), with values of 0.158 ± 0.024 and 0.117 ± 0.022, respectively. However, regarding the denture teeth, lower surface deviation values were found for printed teeth (Group B), with values of 0.18 ± 0.016 for the maxillary teeth and 0.153 ± 0.02 for the mandibular teeth. For positioning of the teeth in relation to the corresponding denture bases, the values were 0.4 ± 0.08 for the maxillary teeth and 1.003 ± 0.027 for the mandibular teeth.
CONCLUSIONS
The milling technique yields complete denture bases with superior accuracy, whereas printing technology produces denture teeth with better accuracy and positioning in the corresponding denture bases.
Topics: Computer-Aided Design; Denture, Complete; Printing, Three-Dimensional; Software; Maxilla; Denture Bases
PubMed: 38109400
DOI: 10.11607/ijp.7984 -
Journal of Esthetic and Restorative... Oct 2023This technique aims to construct a virtual, well-adapted maxillary denture from an existing, ill-fitting denture in completely edentulous patients.
OBJECTIVE
This technique aims to construct a virtual, well-adapted maxillary denture from an existing, ill-fitting denture in completely edentulous patients.
CLINICAL CONSIDERATIONS
A functional impression is made using the loose maxillary denture, and a cone beam computed tomography (CBCT) of the entire old denture is carried out. The obtained digital imaging and communication in medicine (DICOM) file was segmented using an image computing platform software (3D slicer). The resultant Standard Tessellation Language (STL) file was 3D printed in porcelain white-like resin, then colored and characterized.
CONCLUSIONS
The technique introduces a high-quality digital denture replicate with good retention, that can replace the traditional duplication technique. It can also be used as a relining method for old dentures. This proposed digital technique reduces the number of clinical appointments while also providing a digital library for future denture manufacture.
CLINICAL SIGNIFICANCE
The proposed technique offers a high-quality digital denture replicate that can replace the traditional duplication technique. This digital technique also reduces the number of clinical appointments required for denture duplication.
Topics: Humans; Denture Design; Computer-Aided Design; Denture, Complete; Mouth, Edentulous; Dental Porcelain
PubMed: 37078539
DOI: 10.1111/jerd.13055 -
BMC Oral Health Jul 2022Recently, a denture adhesive that is easy to clean and contain moisturizing ingredients have been developed for patients with dry mouth. Although the retentive force...
BACKGROUND
Recently, a denture adhesive that is easy to clean and contain moisturizing ingredients have been developed for patients with dry mouth. Although the retentive force produced by conventional denture adhesives and oral moisturizers have been compared on models, no study has reported their comparison in the oral cavity. In this study, we aimed to clarify the effects of different directions of traction and loads at the time of pressure contact on the retentive force on a palatal plate made from a dentulous jaw model.
METHODS
A palatal plate was fabricated with thermoplastic resin on a dentulous jaw model, and a loop-shaped traction device was attached to the centre of the palate. The test samples were a cream-type denture adhesive, a denture adhesive for dry mouth, an oral moisturizer, and a denture moisturizer. The specimens were applied to the inner surface of the plate, which was then mounted under vertical pressure. Then, the retentive force was measured, using a digital force gauge, while the plate was pulled in different directions and with different loads.
RESULTS
No significant difference in retentive force was observed in any of the test samples when the direction of traction was between 45° and 60°. The retentive force of the denture adhesive for dry mouth was significantly higher with a direction of traction of 90° than that of 45° or 60°. The retentive force when oral moisturizer was used was significantly higher in the 90° traction direction than in the 45° direction. There was no significant difference between a force of 4.0 kgf or 5.5 kgf when using a denture adhesive for dry mouth. Comparing the four load size conditions, the larger the load, the higher was the retentive force. Similar results were obtained for the cream-type denture adhesive and denture moisturizer. Significantly higher retentive force was observed for larger loads when oral moisturizer was used.
CONCLUSIONS
The results suggest that the direction of traction and the pressure load affect the retentive force on a palatal plate.
Topics: Dental Cements; Denture Retention; Humans; Palate; Traction; Xerostomia
PubMed: 35842648
DOI: 10.1186/s12903-022-02313-z