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The Journal of Prosthetic Dentistry Sep 2023The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for... (Review)
Review
STATEMENT OF PROBLEM
The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for complete denture users is lacking. As a result, many dentists choose the scheme based on their preferences and clinical experience.
PURPOSE
The purpose of this review was to assess the methodological quality and summarize the scientific evidence from secondary studies about the influence of occlusal schemes on the clinical performance of and patient satisfaction with complete dentures.
MATERIAL AND METHODS
Ten sources were surveyed according to the patient, intervention, comparison, outcome (PICO) strategy. Systematic reviews that evaluated the clinical performance and patient satisfaction (O) of rehabilitated edentulous patients with conventional complete dentures (P) under different occlusal schemes (I/C) were included. Methodological quality was assessed by using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool by 2 authors independently. The effect of each occlusal scheme in comparison with others was summarized and classified as positive, neutral, negative, or inconclusive based on the conclusions of the systematic review concerning clinical performance and patient satisfaction outcomes.
RESULTS
The search led to the inclusion of 10 systematic reviews. Seven were classified as of critically low, 2 as low, and 1 as moderate methodological quality. The following occlusal designs were included and analyzed: bilateral balanced occlusion, lingualized occlusion, canine guidance, group function, and monoplane occlusion. Bilateral balanced occlusion and canine guidance obtained satisfactory results for both outcomes. Lingualized occlusion showed a trend toward better results than other occlusal schemes for normal and resorbed ridges. Group function presented mainly inconclusive results, and monoplane occlusion did not deliver satisfactory outcomes.
CONCLUSIONS
The present overview concluded that occlusal schemes might interfere with the clinical performance of and patient satisfaction with complete dentures. Lingualized, bilateral balanced, and canine guidance are preferred compared with monoplane occlusion, but lingualized occlusion tends to show better results in some reviews. However, the results should be carefully considered because of the low quality of the systematic reviews included.
Topics: Humans; Patient Satisfaction; Denture Design; Systematic Reviews as Topic; Denture, Complete; Dental Occlusion; Dental Occlusion, Balanced; Mastication
PubMed: 34991859
DOI: 10.1016/j.prosdent.2021.10.018 -
The Journal of Prosthetic Dentistry Sep 2023Denture adhesives improve the mastication of complete denture wearers. However, the impact of denture adhesives with different presentations on mastication remains... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Denture adhesives improve the mastication of complete denture wearers. However, the impact of denture adhesives with different presentations on mastication remains unclear.
PURPOSE
The purpose of this systematic review was to answer the focused question, "Do different presentations of denture adhesives affect the masticatory function of complete denture wearers?".
MATERIAL AND METHODS
This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and the non-peer-reviewed literature were searched up to July 2021. Only clinical studies (randomized clinical trials and nonrandomized clinical trials) comparing the use of different denture adhesive presentations (cream, powder, or strips) were included, without language or follow-up restrictions. The risk of bias was assessed by using the Cochrane tools (RoB 2.0 and ROBINS-I). Masticatory performance, by using single and multiple sieves, masticatory performance with color-changing chewing gum (mixing ability), swallowing threshold (particle size and number of cycles), jaw kinematics, and occlusal force were considered. Meta-analyses were conducted to evaluate masticatory performance (single sieve) and occlusal force outcomes (α=.05), and the certainty of the evidence was determined with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) evaluations.
RESULTS
Nine studies (6 randomized and 3 nonrandomized clinical trials) were included. The risk of bias was considered moderate. Meta-analyses showed no differences between cream and powder denture adhesives for masticatory performance (standard mean difference=0.02; 95% CI=-0.46 to 0.50, P=.93) or between cream and strip denture adhesives for occlusal force (mean difference=14.35; 95% CI=-11.14 to 39.84, P=.27). Similarly, in qualitative analysis, cream and powder denture adhesives' performances were similar regarding masticatory performance with color-changing chewing gum (mixing ability), occlusal force, swallowing threshold (particle size and number of cycles), and jaw kinematics (P>.05). However, for resorbed ridges, cream denture adhesive resulted in a higher masticatory performance than strip (P<.05). When comparing powder to strip denture adhesives, the occlusal force was higher in the powder group (P<.05). The certainty of evidence was very low for all evaluated outcomes.
CONCLUSIONS
Different presentations of denture adhesives seem to improve the masticatory function of complete denture wearers in a similar way. However, the qualitative analysis showed that, in patients with a resorbed ridge, a cream denture adhesive may be better than strips to improve mastication, although the certainty of evidence was very low.
Topics: Humans; Powders; Chewing Gum; Denture, Complete; Bite Force; Mastication; Adhesives
PubMed: 34772484
DOI: 10.1016/j.prosdent.2021.09.026