Effects of complete dentures on respiratory performance: spirometric evaluation

Assessment of the Oropharyngeal Space Using CBCT and Its Impact on Volume of Airway Prior and after Denture Placement: In Vivo Study

AIM

The current study aimed to assess the oropharyngeal space using cone-beam computed tomography (CBCT) and its effect on airway volume both before and after denture placement.

MATERIALS AND METHODS

For this investigation, a total of 15 individuals with fully edentulous upper and lower ridges, ranging in age from 40 to 70, were taken into consideration. A recording of the pulmonary function test was made both prior to and following full denture recovery. Prior to finishing denture therapy, the patient underwent a CBCT scan while standing erect and wearing a cephalostat. For one patient, two tomographs were recorded. The initial skull tomography was obtained prior to the rehabilitation of prosthetic limbs. After receiving prosthetic rehabilitation, the second tomograph was taken. On Demand 3D and CS 3D imaging software were used to take the measurements. The maxillary and mandibular complete dentures were fabricated using standardized techniques. Following prosthesis insertion, a CBCT scan of the skull was performed, and the results were recorded and analyzed.

RESULTS

The mean oropharyngeal space measurement before and after complete denture rehabilitation was 9.18 mm and 10.20 mm, respectively. It was discovered that there was a statistically significant difference (p = 0.001). The oropharynx's mean volume before complete denture rehabilitation was 5533.50 mm3, and it was 6562.39 mm3 after denture rehabilitation was finished. A statistically significant difference was discovered (p = 0.028).

CONCLUSION

On conclusion, a statistically significant difference was found between the airway volume and oropharyngeal space prior to and following denture rehabilitation. Reducing apnea-hypopnea episodes can be achieved by minimizing pharyngeal collapsibility in patients by providing complete dentures that are created with acceptable and potentially improved vertical dimension of occlusion within the limits of permissible tissues.

CLINICAL SIGNIFICANCE

The CBCT image enables it to be simple to distinguish between empty space and soft tissues. One benefit of wearing a denture while sleeping for edentulous patients with obstructive sleep apnea is that it helps decrease apnea-hypopnea episodes. This happens because wearing a denture causes changes to the soft tissue, pharyngeal airway space, jaw, and tongue positions. How to cite this article: Raj K, Soni M, Hatila S, et al. Assessment of the Oropharyngeal Space Using CBCT and Its Impact on Volume of Airway Prior and after Denture Placement: In Vivo Study. J Contemp Dent Pract 2024;25(10):936-940.

Assessment of the Effect of Complete Dentures on Respiratory Performance: A Spirometric Analysis

Background

Among the vital functions, respiration can be claimed to be one of the most important. A thorough understanding of the patient should be an important aspect a prosthodontist should dwell into so as to predispose patients to acknowledge the kind of prosthesis they require. Hence, the present study was conducted for assessing the effect of complete dentures on respiratory performance.

Materials and Methods

Fifty patients with the presence of complete edentulous arch and who had a history of complete denture usage for at least 5 years were enrolled. All the spirometric procedures were performed by trained technicians. A diagnostic spirometer was employed for performing the spirometric test. Testing was carried out in the following steps: Stage 1: testing in the absence of denture, Stage 2: testing in the presence of both dentures, Stage 3: testing in the presence of maxillary denture only, and Stage 4: testing in the presence of mandibular dentures only. Forced vital capacity (FVC) value, peak expiratory flow (PEF) value, forced expiratory volume in 1 s (FEV1) value, and forced expiratory flow 25%-75% (FEF_25-75) value were recorded with the spirometric test. Analysis of all the results was done by SPSS software.

Results

The spirometric value of FVC, PEF, FEV1, and FEF_25-75 in the absence of both maxillary and mandibular dentures (Stage 1) was found to be 3.18, 5.83, 2.44, and 2.80, respectively. The spirometric value of FVC, PEF, FEV1, and FEF_25-75 in the presence of both maxillary and mandibular dentures (Stage 2) was found to be 3.09, 5.67, 2.41, and 2.67, respectively. While analyzing statistically, it was seen that there was a significant decrease in the value of spirometric variables in the presence of dentures.

Conclusion

Chronic denture wearer edentulous patients are subjected to the risk of development of spirometric alterations. Hence, these patients should be given timely instructions about the various respiratory exercise protocols.

Effects of nocturnal complete denture usage on cardiorespiratory parameters: A pilot study

STATEMENT OF PROBLEM

Sleeping without conventional complete dentures (CCDs) has been stated by some to induce negative effects on the cardiorespiratory functions of edentulous patients with obstructive sleep apnea (OSA), although others have reported the exact opposite. Therefore, a consensus on nocturnal CCD usage is lacking.

PURPOSE

The purpose of this clinical study was to assess the effects of nocturnal denture usage on cardiorespiratory stability by using pulse oximetry (PO).

MATERIALS AND METHODS

Thirty CCD wearers were enrolled in the study. The first nocturnal pulse oximetry (FNPO) recordings were made on 3 different nights while the participants were sleeping without dentures (WOD). Oxygen desaturation index (ODI) and other PO parameters of the participants, including total respiratory event (TRE), basal SpO₂ (BSpO₂), time≤88 (T88), average low SpO₂ (ALSpO₂), total pulse event (TPE), average pulse rate (APR), and heart rate variability index (HRVI), were processed and the obtained data were recorded as WOD condition values. According to the ODI scores, the OSA status of the participants was grouped as normal (ODI<5), mild (5<ODI<15), moderate (15<ODI<30), or severe (ODI>30). Complete dentures were fabricated by an experienced prosthodontist and a dental laboratory technician by following conventional procedures. At the end of the first month of the follow-up period, the second nocturnal PO recordings (SNPO) were made on 3 different nights while the participants slept wearing dentures (WID), and the data obtained were recorded as WID condition values. The comparison of mean PO values obtained from WOD and WID were analyzed with the Wilcoxon signed- rank test (α=.05).

RESULTS

Significant differences were found between WOD and WID values in terms of TRE (P=.01), ODI (P=.001), ALSpO2 (P=.006), TPE (P=.001), and HRVI (P=.001) parameters. The significance of the improvements in the WID condition increased with the severity of OSA.

CONCLUSIONS

Improvements were observed in substantial cardiorespiratory parameters such as the ODI and HRVI of the participants wearing dentures nocturnally.

Joint Indian Chest Society-National College of Chest Physicians (India) guidelines for spirometry

Although a simple and useful pulmonary function test, spirometry remains underutilized in India. The Indian Chest Society and National College of Chest Physicians (India) jointly supported an expert group to provide recommendations for spirometry in India. Based on a scientific grading of available published evidence, as well as other international recommendations, we propose a consensus statement for planning, performing and interpreting spirometry in a systematic manner across all levels of healthcare in India. We stress the use of standard equipment, and the need for quality control, to optimize testing. Important technical requirements for patient selection, and proper conduct of the vital capacity maneuver, are outlined. A brief algorithm to interpret and report spirometric data using minimal and most important variables is presented. The use of statistically valid lower limits of normality during interpretation is emphasized, and a listing of Indian reference equations is provided for this purpose. Other important issues such as peak expiratory flow, bronchodilator reversibility testing, and technician training are also discussed. We hope that this document will improve use of spirometry in a standardized fashion across diverse settings in India.

Spirometric Assessment of Impact of Complete Dentures on Respiratory Performance: An in vitro Study

INTRODUCTION

Edentulism is one of the debilitating states affecting a significant portion of the geriatric population. It is often considered as the ultimate marker for predicting the pressure and burden on oral health. Respiration is also a routine vital function running continuously through the human body and most commonly assessed by a spirometer. Hence, we planned the present study to assess the impact of complete dentures on the functioning of the respiratory system.

MATERIALS AND METHODS

In the present study, a spirometric assessment of the effect of complete dentures on respiratory performance was done. A total of 100 subjects were included, and diagnostic spirometer was used for carrying out the spiro-metric test at different stages of each subject. The spirometric test was carried out at four different stages: In the absence of both the denture (AODs), with both the dentures (maxillary and mandibular) inserted in the patient's mouth (BDs), with only maxillary denture inserted in the oral cavity (UDs), and finally, by inserting only the mandibular dentures in the oral cavity (LDs). Forced vital capacity (FVC), peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), and forced expiratory flow between 25 and 75% (FEF_25-75) were evaluated. All the results were compiled and assessed using Statistical Package for the Social Sciences (SPSS) software.

RESULTS

Of the total 100 subjects included in the study, 42 were males and 58 were females. The mean FVC values of AOD, BD, LD, and UD group were 3.10, 3.02, 2.90, and 2.93 respectively. The mean PEF values of AOD, BD, LD, and UD group were 5.79, 5.60, 5.40, and 5.48 respectively; 2.39, 2.35, 2.33, and 2.32 were the mean FEV1 values observed in AOD, BD, LD, and UD group respectively. Statistically significant results were obtained while comparing AOD-FVC and BD-FVC and other oral conditions.

CONCLUSION

Spirometric values of respiratory functional tests in edentulous patients might be unfavorably affected by wearing complete dentures.

CLINICAL SIGNIFICANCE

Since subjects without complete dentures exhibited a maximum value of respiratory functional test, respiratory exercise protocols should also be carried in denture-wearing edentulous patients for increasing the performance of the respiratory system.