Association between food intake and oral health in elderly: SEPAHAN systematic review no. 8

Dental status may influence food intake. The aim of this review was to summarize the earlier investigations on the association between food intake and dental status. We searched the electronic databases of PubMed and the Cochrane library for articles published until 30 February, 2012. To reach the related published articles, Medical Subject Heading (MeSH) terms of 'oral health,' 'masticatory performance,' 'dental status,' and 'eating' or 'food intake' were used. We included all research articles in the English language that (1) had used the random sampling method, and (2) had investigated the association between dental status and nutrient intake in elderly, non-denture wearer individuals, with no systemic illness. The findings of the seven original research articles had a great variation. Four of them supported a strong association between dietary intake and dental status and three of them found that there was no association between these variables. Most investigations found a significant relationship between the oral health status and nutrient intake; however, longitudinal studies were required for a better understanding of the diet-oral health relations.

Retention of implant-supported zirconium oxide ceramic restorations using different luting agents

OBJECTIVE

The aim of this study was to evaluate the retention value of implant-supported zirconium oxide ceramic copings using different luting agents.

METHOD AND MATERIALS

Twenty ITI solid abutments of 5.5 mm height and ITI implant analogs were mounted vertically into autopolymerizing acrylic resin blocks. Ninety zirconium oxide copings (Cercon, Degudent) with a loop on the occlusal portion were made. All samples were airborne particle abraded with 110 μm Al₂O₃ and luted using different types of luting agents: resin cements (Clearfil SA, Panavia F2.0, Fuji Plus), conventional cements (Fleck's, Poly F, Fuji I), and temporary cements (Temp Bond, GC free eugenol, TempSpan) with a load of 5 Kg. (N = 10) All copings were incubated at 37°C for 24 h and conditioned in artificial saliva for 1 week, and thermal cycled for 5000 cycles 5-55°C with a 30-s dwell time. The dislodging force of the copings along the long axis of the implant-abutment complex was recorded using universal testing machine with 5 mm/min crosshead speed. Data were subjected to Kruskal-Wallis (α = 0.05) and Mann-Whitney tests with Bonferroni step down correction (α = 0.001).

RESULTS

There was significant difference between the mean rank retention values of different luting agents (P < 0.001). The resin cements showed the highest retention (Clearfil SA, 203.49 ± 52.86; Fuji Plus, 190.61 ± 48.00; Panavia F 2.0, 172.16 ± 70.76 N). The conventional cements had more retention than the temporary cements and glass ionomer cement (P < 0.001).

CONCLUSION

The retention of zircona ceramic restorations, over ITI solid abutments may be influenced by the type of cement. The application of an MDP-containing resin and resin-modified glass ionomer luting agents increase the retentive value of implant-supported zirconium oxide restorations.

Retention of implant-supported overdenture with bar/clip and stud attachment designs

The degree of retention for overdenture attachments depends on design, location, and alignment of supporting dental implants and the type of attachments. The aim of this study was to evaluate the retention of an implant-supported overdenture with different attachment designs. An overdenture was made on an edentulous mandibular model with 2 ITI implants (4.1 × 10 mm) in the symphyseal region. Five specimens of 8 attachment designs with corresponding abutments and superstructures were used: ITI regular Dolder bar with 1 metal clip, ITI regular Dolder bar with cantilever and 3 metal clips, Hader bar with 1 plastic clip, Hader bar with cantilever and 3 plastic clips, Sphero block abutment with Rhein plastic caps (green, white, and pink), and retentive anchor with ITI elliptical matrix. The attachments' housings were interchangeable and fixed into the overdenture through nut and screw. The overdenture attachments were subjected to 8 consecutive pulls on a universal testing machine with a crosshead speed of 50.8 mm/min in the vertical and posteroanterior directions. Analysis of variance and Duncan tests were used to determine differences between mean retention values (α = .05). The highest average value retention was recorded for the ITI Dolder bar with cantilever and 3 metal clips in both the vertical and posteroanterior directions, respectively (P < .05). The Rhein pink caps had the lowest retention in the posteroanterior direction (P < .05). Retention decreased over the course of consecutive pulls for all attachments in both directions. The type, number, and placement of attachments affect the retention of implant-supported mandibular overdentures.

Two-body wear resistance of some indirect composite resins

The aim of this study was to evaluate two-body wear of five indirect composites and compare them with enamel. Signum, belleGlass HP, SR Adoro, Dialog, GC Gradia and enamel were formed into cylinders (n = 10). Two-body abrasive wear rates were determined using a porcelain disk and a pin on disk apparatus. The height and weight loss of the specimens were measured by stereomicroscope and digital scale. The data were subjected to analysis of variance and Tukey HSD tests to determine significant differences (alpha = 0.05). GC Gradia showed significantly less wear resistance than the other materials. Enamel was more resistant than any of the tested composites. Within the limitations of this study it can be concluded that the type of resin, filler size and method of polymerization could have affect the two-body abrasion resistance of indirect composites.

Comparative evaluation of ketoconazole tablet and topical ketoconazole 2% in orabase in treatment of Candida-infected denture stomatitis

AIM

Denture stomatitis is a common and recurring problem of denture wearers. Ketoconazole tablet is one of the antimycotic drugs that often has been used to treat this condition, but systemic use of this drug has some adverse effects that frequently lead to unfavorable compliance and treatment failure. This study was designed to compare the efficacy of topical ketoconazole 2% in orabase and ketoconazole tablet.

METHODS AND MATERIALS

Thirty patients with denture stomatitis (positive culture) were divided into two groups. The first group received ketoconazole tablet (orally used 200 mg per day) for 14 days and the second group received 2% topical ketoconazole in orabase applied twice daily on the mucosal denture surface. Candida cultures were taken from the palatal mucosa before and on days 7 and 14 after commencement of the therapy. The mean of colonies before and 7 and 14 days after medication were calculated. One-way ANOVA and paired t-test were used for data analysis (alpha=0.05).

RESULTS

The mean of colonies number before receiving medication in the tablet and topical application groups were 454 and 441 respectively. The mean of colonies number after receiving medication in tablet and topical application group were 137 and 176 (on the seventh day) and 122 and 96 (on the 14th day), respectively; there was no significant difference between the two groups after medication (p=0.18).

CONCLUSION

Topical ketoconazole 2% in orabase can be useful in managing denture stomatitis. This topical medication has fewer side effects, whereas systemic administration of ketoconazole tablet is associated with some complications.

CLINICAL SIGNIFICANCE

The application of topical ketoconazole 2% in orabase ointment can be considered in the treatment of denture stomatitis and has comparable efficacy with the ketoconazole tablet.

A method for making the implant-supported record bases

A method for fabrication of record bases which is used in implant dentistry has been described. This method is cost effective because it does not need extra equipment for making the maxillomandibular relations. This technique involves the application of plastic sprues that fit on the top of implants to hold the record bases and allows for easy recording of maxillomandibular relations with an implant-supported record base.

Effect of labial frenum notch size and palatal vault depth on stress concentration in a maxillary complete denture: a finite element study

AIM

Fracture is a common cause of acrylic resin denture failure due to crack development in a site of excessive concentration of stress in the denture. The purpose of this study was to evaluate the effect of labial frenum notch size and palatal depth on stress concentration in maxillary complete dentures.

METHODS AND MATERIALS

Three-dimensional finite element models of maxillary complete dentures with different palatal vault depths (shallow, medium, and deep) and different frenum notch sizes (small, medium, and large) were constructed. The stress concentration was analyzed using Nastran software and displayed in terms of von Mises stress generated under two conditions: dropping on a hard flat surface from a standard distance and applying vertical load to the occlusal surface.

RESULTS

The greatest stress concentration was observed in the labial frenum notch. Stress increased with an increase in the size of the labial frenum notch and a decrease in the depth of the palatal vault. The stress concentration in maxillary denture bases was greater when a vertical load was applied compared with dropping the denture on a hard surface from a standard distance.

CONCLUSION

Using finite element analysis, the presence of a large labial frenum notch and a shallow palatal vault increased the concentration of stress in maxillary complete dentures. Stress concentration in a maxillary denture base is much greater during the application of a vertical load than when dropping the denture on a hard flat surface.

CLINICAL SIGNIFICANCE

The concentration of stress at the tip of a large frenum notch and in a shallow palatal vault could have a weakening effect on the maxillary complete acrylic resin denture base making it more vulnerable to fracture. In this scenario alternative denture base strengthening strategies, such as using a metal framework, should be considered in the fabrication of maxillary complete dentures.

Effect of occlusal splints on the electromyographic activities of masseter and temporal muscles during maximum clenching

OBJECTIVES

Despite the broad use of occlusal splints in the treatment of temporomandibular disorders, the efficacy of splints is a source of controversy. In this study, the effectiveness of occlusal splints on the electromyographic activity of the masseter and temporal muscles in healthy individuals was investigated.

METHOD AND MATERIALS

An occlusal splint was made for 25 healthy individuals. Surface electromyographic recordings were done during maximum clenching without the splint and immediately after application of the splint. The relative level of activity in the masseter and temporal muscles was quantified by means of activity index. Paired t test and Wilcoxon signed-rank tests were used for data analysis.

RESULTS

The mean electromyographic activities of masseter and temporal muscles (in mV/s) were 0.7712 and 1.0488 without the splint and 0.8396 and 0.9276 immediately after application of the splint. There was no significant difference between the electromyographic activities of both muscles before and after insertion of the splints. The activity index increased after application of the occlusal splints. This increase was also insignificant.

CONCLUSION

Immediate application of occlusal splints has no significant effect on the activity of masseter and temporal muscles. It could decrease the relative activity of the temporal to the masseter muscle (increasing the activity index).

Marginal accuracy of interim restorations fabricated from four interim autopolymerizing resins

STATEMENT OF PROBLEM

One of the most important requirements for interim restorations is good marginal adaptation. Polymerization shrinkage of interim restorative materials can jeopardize the marginal integrity of interim restorations.

PURPOSE

The purpose of this study was to compare the marginal accuracy of interim restorations made with 4 interim materials.

MATERIAL AND METHODS

A direct technique was used to fabricate 44 interim restorations with 4 materials: Protemp 3 Garant, Trim II, Tempron, and Acropars (n=11). The interim restorations were made on a prepared molar-shaped metal die with a vinyl polysiloxane impression as a matrix. Marginal discrepancy of interim restorations was measured at the midpoint of buccal, palatal, mesial, and distal surfaces of metal die finish line with a microscope at x100 magnification. Comparisons were made with 1-way analysis of variance and the Duncan multiple range test (alpha=.05).

RESULTS

The mean marginal discrepancies of Protemp 3 Garant, Trim II, Tempron, and Acropars were 0.059, 0.063, 0.068, and 0.102 mm, respectively. Acropars exhibited the most marginal discrepancies and was significantly different from the other materials tested (P<.001). However, there were no statistical differences between the other 3 materials tested.

CONCLUSIONS

Interim restorations made from the Bis-GMA and conventional acrylic resins tested produced comparable marginal fit. Acropars demonstrated significant increases in marginal gap size.

Model of age estimation based on dental factors of unknown cadavers among Iranians

Two hundred and ten cadavers ranging in age from 25 to 60 were studied. Thirty subjects from each five-year interval were selected, and data were collected using the mandibular anterior and premolar teeth after extraction. Sections ranging from 0.5 to 1.0 mm were measured by a stereo microscope with a precision of 0.1 mm. The following factors were determined: attrition, periodontosis, root resorption, secondary dentine apposition, cementum apposition, and translucency of the root. Statistical analysis used the sum of ranks of the dental factors as an independent variable in a linear regression model to estimate the age of the cadaver. Among the different mandibular teeth, the sum of ranks of the first premolar factors had the best correlation coefficient with age. The sum of the dental factors presented a better model than each of the factors alone. The first premolar is recommended as the first step in the estimation of age.