Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population. Part 4: Patient-Centered Analysis

Quantifying the facial proportions in edentulous individuals before and after rehabilitation with complete dentures compared with dentate individuals: A 3D stereophotogrammetry study

STATEMENT OF PROBLEM

Facial collapse is associated with edentulism, and while the provision of complete dentures promotes masticatory function and esthetics, whether complete dentures restore facial proportions to the natural appearance found in dental individuals is unclear.

PURPOSE

The purpose of this clinical study was to assess the facial profiles of edentulous individuals before and after treatment with complete dentures and compare these profiles with those of dentate individuals matched by age as the control.

MATERIAL AND METHODS

Sixty White participants were recruited as 2 groups: 30 edentulous participants provided with complete dentures in both arches and 30 participants with natural teeth and normal occlusion. Facial analysis was performed through 3D stereophotogrammetry. Linear, angular, surface, and perimeter facial measurements were made and statistically analyzed with paired and independent t tests (α=.05).

RESULTS

The mean age ±standard deviation was 63.16 ±7.33 years for the edentulous participants and 60.43 ±5.34 years for the dentate controls, without statistical differences between ages (P=.105). The facial profiles of the edentulous group with and without complete dentures were statistically different (P<.05) in 6 linear and 5 angular measurements. After quantifying the facial collapse by comparing edentulous individuals without complete dentures and the control dentate group, the results showed that the majority of differences occurred in the middle and lower third of the face, evidencing shortening in these areas with differences in facial measures of around 2 to 5 mm less in the edentulous group. However, statistically significant differences between the participants with complete dentures and the control dentate group were found in only 2 linear measurements (the distance between the right and the left exocanthion to cheilion), in the sealed lip angle and the left gonial angle, and in the surface and perimeter (P<.05).

CONCLUSIONS

Tooth loss affected the facial proportions in the lower third of the face. The provision of complete dentures restored their facial appearance but not precisely to the facial proportions of individuals with a natural dentition, as considerable differences were detected in surface and perimeter measurements.

3D assessment of facial contours of patients wearing either complete denture or implant-supported fixed dentures

Background

Total edentulousness leads to soft tissue changes causing esthetic problems. Being aware of the significant effects of different treatment approaches on facial soft tissue can help to obtain more satisfying esthetic results.

Aim

The current study's objective was to evaluate three-dimensional facial soft tissue changes in edentulous patients rehabilitated with a complete denture (CD) and implant-supported fixed partial denture (FPD).

Material and Methods

Fourteen edentulous patients, mean age of 47.6 years (42-63), were assessed before prosthetic treatments (T0), after CD (T1), and after FPD (T2). 3dMDface System (3dMD LLC) obtained the images and transferred them to 3dMD Vultus software (3dMD Vultus software Version 2.3.0.2). Nine linear, five angular, and one topographical measurement were performed for facial soft tissue analysis. For statistical analysis of facial soft tissue, ANOVA was used with a level of significance set at 5% (p <.05).

Results

Significant differences were observed in lower lip height (Sto-Sl) and nasolabial angle (Prn Sn Ls) with CD. There is no significant difference with the implant-supported fixed partial dentures in these measurements when compared with pretreatment. Significant differences were observed in the lower lip angle (Chr Li Chl) with the implant-supported fixed partial dentures. There is no significant difference with CD in this measurement when compared with pretreatment. According to the paired comparisons, a significant difference was observed in philtrum height (Ls-Sn) between the treatment approaches.

Conclusion

CD and implant-supported fixed partial dentures, both treatment approaches, cause facial soft tissue changes, which may help to improve the facial esthetic. The effects of these treatment methods on facial soft tissues are not significantly different, except the philtrum height.

Evaluation of Satisfaction Perceived by Prosthetic Patients Compared to Clinical and Technical Variables

Objectives:

The purpose of this study is to relate the clinical quality of the complete denture and specific anamnestic factors to the level of satisfaction perceived by patients. Also identifying possible prognostic parameters that could be predictive of future satisfaction.

Materials and Methods:

On the basis of a substantial existing literature, the most appropriate parameters to determine the prosthetic quality have been determined to evaluate the satisfaction perceived by patients about their denture; a completely new questionnaire has been drawn up. Ninety-eight patients have been included in the research, they have undergone a clinical examination, and they have filled out the questionnaire anonymously. The ANOVA test and Pearson correlation test have been employed to relate clinical and anamnestic factors to the overall satisfaction score.

Results:

The average level of patients’ satisfaction was between “quite satisfied” and “very satisfied.” There is no significant variability of satisfaction related to the type of prosthesis. The ANOVA test did not verify relationships between the overall satisfaction score and the anamnestic data examined. Pearson linear correlation coefficient between the overall prosthetic quality and the general satisfaction perceived by patients is 0.493 (P < 0.01). Extension of the prosthetic body (r = 0.478; P < 0.01) and retention (r = 0305; P < 0.05) are in correlation with the overall patients’ satisfaction.

Conclusion:

there is a moderately strong relationship between the overall prosthetic quality and the general satisfaction perceived by patients. Particularly, the retention and the adequate extension of the prosthetic body appear to be factors that are most associated with satisfaction. Instead, the anamnestic factors are not related to overall satisfaction score.