Functional oral status and oral health-related quality of life in community-dwelling older adults in Singapore

OBJECTIVES

The objectives were to investigate the association between oral functional status (defined by the number of functional teeth and functional occluding units [FOUs]) on oral health-related quality of life (OHRQoL). It also aimed to determine if dentures could compensate for the loss of FOUs in terms of OHRQoL in community-dwelling older adults in Singapore.

METHODS

Community-dwelling older adults, aged 60 years and above, were recruited from a community-based oral health functional screening programme from 1 May 2018 to 31 December 2019. During the screening, an Oral Health Impact Profile-14 (OHIP-14) questionnaire and oral examination were administered. Statistical analysis was performed using the chi-square test, univariate logistic regression and multivariate predictive modelling.

RESULTS

Data from 1037 participants were analysed (52% female; mean age 71.5 (SD 7.15)). The mean OHIP-14 score was 4.5 ± 7.2. The OHIP-14 scores were significantly associated with the number of functional teeth and the number of FOUs (p < .001). Having at least 20 functional teeth or 10 FOUs was associated with a significantly lower OHIP-14 score. Those with no FOUs had higher OHIP-14 scores compared to those with at least 10 FOUs, even in the presence of a satisfactory denture.

CONCLUSION

Maintaining at least 20 functional teeth or 10 FOUs was associated with better OHRQoL among community-dwelling older adults in Singapore. Dentures may have limited compensatory ability in terms of replacing natural functional occlusal units and maintaining OHRQoL.

Unveiling denture-induced oral lesions: A comprehensive study on classification and pain assessment

BACKGROUND

Denture-induced oral Lesions (DIOLs) often manifests shortly after the placement or adjustment of new or realigned dentures, frequently resulting in severe pain and discomfort.

OBJECTIVES

This study aimed to classify DIOLs placing a particular emphasis on assessing the associated pain.

METHODS

A prospective case study was conducted involving 126 patients who were fitted with a total of 193 dentures of various types at the Hadassah School of Dental Medicine. All patients underwent comprehensive intra-oral examinations within 1-8 weeks following denture delivery, completed symptom questionnaires and had their medical records reviewed. Key variables documented included age, gender, overall health status, denture type, and a detailed description of the DIOLs. The description encompassed factors such as lesion location, shape, colour, size, border characteristics, ulcerative appearance, membrane coverage, 3D morphology (elevated, immersed and flat) and patient-reported Verbal Pain Score (VPS) when touching the DIOLs, when wearing the denture, and when not wearing the denture.

RESULTS

Notably, 25.4% of denture wearers required no adjustments, while 14.4% necessitated more than three revisions. A majority (71.8%) of DIOLs cases were associated with mandibular complete dentures, primarily situated on the alveolar ridge. The mean VPS indicated a pain intensity of 7 ± 2.1, with temporary dentures in both jaws causing the most discomfort. Implant-supported overdentures were particularly painful when placed in the mandible. Additionally, VPS scores were higher among older individuals and those with prior prosthetic experiences. A significant correlation was observed between pain intensity and presence of chronic health condition (0.036).

CONCLUSIONS

This study revealed distinct characteristics of DIOLs and highlighted the multifactorial nature of pain experienced following the development of DIOLs. Insights into the influence of patient and denture characteristics on DIOLs and pain intensity can guide healthcare professionals in optimising patient comfort and satisfaction.

Clinical evaluation on the use of a new accessory device for Fox plane

OBJECTIVE

Evaluate the assimilation capacity and ease of handling of the Fox plane accessory by dentistry students, through a questionnaire about the experience in using this device compared to the conventional one. Its intention is to minimize possible interpretation errors and challenges that the traditional method determines.

METHODS

After approval by the Research Ethics Committee, registration at Sistema Nacional de Informações sobre Ética em Pesquisa/National Information System on Research Ethics (SISNEP) and signing of the free and informed consent form, 51 undergraduate students treating patients in need of complete dentures at Instituto de Ciência e Tecnologia/Institute of Science and Technology (ICT) Unesp in São José dos Campos completed a questionnaire to evaluate the technical ease of use and provider acceptance. The obtained data were submitted to statistical analysis, evaluating technical ease and acceptance by operators.

RESULTS

The results were analyzed using descriptive and inferential statistics using the Jamovi 2.2.5 software. From the responses, the frequency was obtained for each question in the questionnaire, then the weighted mean was calculated, average rating and percentage. With the results of these analyses it was possible to measure the level of satisfaction of the participants in relation to the use of the device.

CONCLUSION

It was concluded that most students have difficulty using the conventional Fox plane and that the accessory facilitated the process of determining the superior orientation plane, and its ease of use.

Appointments Needed for Complete Denture for Frail Older Adults Residing in Long-Term Care Facilities: A Cross-Sectional Study

Frail older adults who reside in long-term care (LTC) facilities face multiple barriers in receiving dental care. In edentulous LTC patients, the fabrication of complete dentures (CDs) can present challenges, leading to an increase in procedural or post-insertion appointments. The aim of this cross-sectional study was to document the number of fabrication and post-insertion follow-up appointments for CDs in frail older adults residing in LTC facilities. Data were collected from electronic patient records (AxiUm) and the Index of Clinical Oral Disorder in Elders (CODE) software utilized by the University of British Columbia Geriatric Dentistry Program from 2002 to 2018. A total of 362 CDs were fabricated between 2002 and 2018 in 272 patients. The mean number of visits required was 4.13 and 4.32, with standard deviations (Std) of 1.45 and 1.25 needed to fabricate maxillary CDs and mandibular CDs, respectively. The mean number of follow-up visits was 1.04 for maxillary dentures and 1.09 for mandibular dentures, with an Std of 1.25 for both, similar to the results obtained for adult patients in community dental clinics. Several factors were found to be associated with an increased number of CD fabrication and follow-up visits. Pre-operative assessment of the patient's cognitive/physical status and intra-oral condition may indicate the estimated time needed to fabricate CDs.

The Effect of Exposure to Candida Albicans Suspension on the Properties of Silicone Dental Soft Lining Material

While functioning in the oral cavity, denture soft linings (SL) are exposed to contact with the microbiota. Dentures can offer perfect conditions for the multiplication of pathogenic yeast-like fungi, resulting in rapid colonisation of the surface of the materials used. In vitro experiments have also shown that yeast may penetrate SL. This may lead to changes in their initially beneficial functional properties. The aim of this work was to investigate the effect of three months of exposure to a Candida albicans suspension on the mechanical properties of SL material and its bond strength to the denture base polymer, and to additionally verify previous reports of penetration using a different methodology. Specimens of the SL material used were incubated for 30, 60 and 90 days in a suspension of Candida albicans strain (ATCC 10231). Their shore A hardness, tensile strength, and bond strength to acrylic resin were tested. The colonization of the surface and penetration on fractured specimens were analysed with scanning electron and inverted fluorescence microscopes. Exposure to yeast did not affect the mechanical properties. The surfaces of the samples were colonised, especially in crystallized structures of the medium; however, the penetration of hyphae and blastospores into the material was not observed.

Exploring experiences of living with removable dentures-A scoping review of qualitative literature

OBJECTIVE

Examine the literature on the experiences of living with removable dentures (complete or partial) to identify any gaps and provide a map for future research.

BACKGROUND

Increasing proportions of society are living partially dentate with some form of restoration, including removable dentures. Previous studies have reported on the location, materials and usage of these prostheses, along with effects on oral-health-related quality of life (OHRQoL). However, less is known about experiences with removable dentures from a patient-centred perspective.

METHODS

A scoping review of the qualitative literature was undertaken using the framework of Arksey and O'Malley, updated by Levac et al. Literature searches were carried out using Medline and Web of Science. Papers were screened by title and abstract using inclusion and exclusion criteria. Remaining papers were read in full and excluded if they did not meet the required criteria. Nine papers were included in the final review.

FINDINGS

Key themes from these papers were: impact of tooth loss and living without teeth, and its impacts in relation to social position, appearance, confidence and function (chewing and speaking); social norms and tooth loss, including attitudes to tooth retention and treatment costs, and changes in intergenerational norms towards dentures; expectations of treatment, including patients being more involved in decision making, viewing the denture as a "gift" and dentures helping to achieve "an ideal"; living with a removable denture (complete or partial), including patient preparedness for a denture, adaptation and impacts on activities and participation; and the dentist-patient relationship, including issues with information and communication, and differing priorities between patients and dentists.

CONCLUSION

Little qualitative research exists on experiences of living with a removable denture. Existing literature demonstrates the importance of dispersed activities in differing social, spatial and temporal contexts when wearing removable dentures. Focusing on processes of positive adaptation to dentures and OHRQoL, rather than deficits, is also required to fully understand patients' experiences. Additionally, more complex technological advances may not always be in the best interest of every patient.

Effects of various disinfectants on surface roughness and color stability of thermoset and 3D-printed acrylic resin

Denture cleansers are extensively utilized to inhibit the colonization of various Candida species. Currently, additive technology in denture fabrication has become more prevalent. This study aims to assess the impact of disinfectants on the surface roughness and color stability of distinct denture bases. Disc-shaped samples (N=66) were exposed to three different disinfectants: 0.5% sodium hypochlorite, 1% hydrogen peroxide, and 2% chlorhexidine. The samples underwent evaluation via spectrophotometry and profilometry, respectively. Data analysis was conducted utilizing analysis of variance (ANOVA) (p < 0.05). Within the heat-cured group, sodium hypochlorite resulted in the most notable change in surface roughness (0.2 μm), while chlorhexidine exhibited the least impact (0.001 μm), showing a significant difference (p <0.008). The color change (ΔE) for 3D-printed samples immersed in all disinfectants was higher compared to heat-cured samples. Among the heat-cured samples, chlorhexidine induced the highest ΔE (2.76), while sodium hypochlorite resulted in the lowest (ΔE = 1.44), and this difference was statistically significant (p <0.008). Chlorhexidine caused the most significant color alteration among the solutions, while sodium hypochlorite induced the most considerable changes in surface roughness.

Exploring Oral Function, Protein Intake, and Risk of Sarcopenia: A Scoping Review

INTRODUCTION

Sarcopenia is loss of both muscle mass and function with age and is associated with inadequate protein intake. However, evidence to suggest an association with oral health is less clear.

OBJECTIVE

To scope peer-reviewed published evidence (2000-2022) pertaining to oral function in relation to sarcopenia and/or protein intake in older people.

METHODS

CINAHL, Embase, PubMed, and Scopus were searched. Included were peer-reviewed studies measuring oral function (e.g., tooth loss, salivary flow masticatory function, strength of muscles of mastication, and tongue pressure) and a measure of protein intake and/or a measure of sarcopenia (appendicular muscle mass and function). Full article screening was conducted by 1 reviewer with a random 10% screened in duplicate by a second reviewer. Relevant content pertaining to study type, country of origin, measures of exposure, and outcomes and key findings was mapped and the balance of data showing a positive versus null association of oral health with outcomes charted.

RESULTS

Of 376 studies identified, 126 were screened in full, yielding 32 included texts, of which 29 were original articles. Seven reported intake of protein and 22 reported measures of sarcopenia. Nine distinct oral health exposures were identified, with ≤4 studies relating to any one of these measures. Most data were cross-sectional in nature (27 studies) and from Japan (20 studies). The balance of data showed associations between tooth loss and measures of sarcopenia and protein intake. However, the balance of data pertaining to any association between chewing function, tongue pressure, or indices of oral hypofunction and sarcopenia was mixed.

CONCLUSION

A broad range of oral health measures have been studied in relation to sarcopenia. The balance of data suggests that tooth loss is associated with risk, but data pertaining to the oral musculature and indices of oral hypofunction are mixed.

KNOWLEDGE TRANSFER STATEMENT

The findings of this research will increase awareness among clinicians of the amount and nature of evidence pertaining to the relationship between oral health and risk of compromised muscle mass and function, including data showing that loss of teeth is associated with increased risk of sarcopenia in older people. The findings highlight to researchers the gaps in the evidence and where further research and clarification of the relationship between oral health and risk of sarcopenia is warranted.

Mini-implant mandibular overdentures under a two-step immediate loading protocol: A 4-6-year retrospective study

OBJECTIVES

This retrospective study to evaluate the treatment outcomes of mandibular mini-implant overdentures (MIODs) placed under a two-step immediate loading protocol.

BACKGROUND

The mini-implant overdenture emphasises the advantages of simplicity using flapless surgery and immediate loading. However, some mini-implant have lowe initial stability.

MATERIALS AND METHODS

A total of 30 participants who used mandibular MIODs and maxillary removable complete dentures (RCDs) over 4 years were included. Four one-piece mini-implants (<3 mm in diameter) were placed by a flapless surgical approach after fabrication of new RCDs, and the O-ring attachment was attached at least 8 weeks after implant placement.

RESULTS

The average observation period was 58.9 ± 9.2 months after mini-implant loading. The survival rate of the implants was 100.0%, and the overall change in mean marginal bone level (ΔMBL) was -0.9 ± 1.1 mm. The implant success rate was 83.3% at the implant level, and 66.7% at the patient level. The mean initial Periotest value was 0.9 ± 3.1, and it was positively associated with ΔMBL and implant success (P < .05). Patient satisfaction improved after conversion from RCDs to MIODs (P < .05), and mastication and pain showed greater satisfaction with longer loading time (P < .05).

CONCLUSIONS

The mandibular MIODs could be chosen as an alternative treatment under a two-step immediate-loading protocol in edentulous patients with limited alveolar bone volume. To ensure superior treatment outcomes of MIODs, initial stability of implant must be obtained using as wide a diameter as possible within the anatomically allowable limits.

CPP-ACP paste's effect on salivary conditions in patients with removable dentures

PURPOSE

Older adults with removable dentures experience high rates of both caries (when the natural dentition remains) and salivary gland dysfunction. While many commercial dental therapeutic agents target these two interrelated problems, none have been labeled for use on the fitting surface of removable dentures. Off-label use of MI Paste (GC America, Alsip, IL), a dental therapeutic containing casein-phosphopeptide-amorphous-calcium-phosphate (CPP-ACP), was investigated following its application to the fitting surface of complete denture(s) with subsequent effects on salivary conditions measured.

MATERIALS AND METHODS

Salivary flow rate and pH were recorded at baseline and 15 min following the application of 1 mL of CPP-ACP paste to the fitting surface of each participant's denture through whole saliva collection. To assess buffering capacity, equivalent volumes of 0.01 M lactic acid were added to the collected saliva samples, and pH reduction was measured. Comparisons of salivary parameters between baseline and post-CPP-ACP paste application and between subjects with and without self-reported xerostomia were conducted using a paired-sample t-test, Wilcoxon signed-rank test, or two-sample t-test as appropriate.

RESULTS

Of the 28 participants (mean age = 70.3 ± 13.7 years, 17 males), 11 reported xerostomia. CPP-ACP-paste application was associated with decreased pH reduction during acid challenge compared to baseline (0.95 ± 0.24 vs. 1.54 ± 0.53, p < 0.001), and a higher final pH following acid challenge (5.93 ± 0.34 vs. 5.40 ± 0.66, p < 0.001). While the flow rates observed at post-CPP-ACP paste application were greater than those at baseline, the difference was not statistically significant (0.67 ± 0.44 mL/min vs. 0.55 ± 0.34 mL/min, p = 0.053). No significant differences were found in any salivary parameters between participants with or without self-reports of xerostomia.

CONCLUSIONS

The findings highlight potential positive effects on salivary conditions following the application of the CPP-ACP-containing product, MI Paste, to the fitting surface of a removable complete denture as a potential caries-risk-management tool when natural dentition remains. Determining the caries-preventive clinical significance will require longer-term trials.

Dental prosthesis use is associated with higher protein intake among older adults with tooth loss

BACKGROUND

Tooth loss is associated with reduced protein intake, which leads to sarcopenia and frailty in older adults.

OBJECTIVE

To evaluate the protective effect of dental prostheses on decreased protein intake in older adults with tooth loss.

METHODS

This cross-sectional study was based on a self-reported questionnaire targeting older adults. Data were obtained from the Iwanuma Survey of the Japan Gerontological Evaluation Study. We used % energy intake (%E) of total protein as the outcome and the use of dental prostheses and number of remaining teeth as explanatory variables. We estimated the controlled direct effects of tooth loss by fixing the use/non-use of dental prostheses based on a causal mediation analysis, including possible confounders.

RESULTS

Among 2095 participants, the mean age was 81.1 years (1SD = 5.1), and 43.9% were men. The average protein intake was 17.4%E (1SD = 3.4) of the total energy intake. Among participants with ≥20, 10-19 and 0-9 remaining teeth, the average protein intake was 17.7%E, 17.2%E/17.4%E and 17.0%E/15.4%E (with/without a dental prosthesis), respectively. Compared to participants with ≥20 remaining teeth, those with 10-19 remaining teeth without a dental prosthesis did not have a significantly different total protein intake (p > .05). Among those with 0-9 remaining teeth without a dental prosthesis, total protein intake was significantly low (-2.31%, p < .001); however, the use of dental prostheses mitigated the association by 79.4% (p < .001).

CONCLUSION

Our results suggest that prosthodontic treatment could contribute to maintaining protein intake in older adults with severe tooth loss.

Air-polishing technology is an effective alternative chairside method for cleaning dentures

AIMS

To investigate the efficiency and abrasiveness of air-polishing on different types of denture base acrylic resins and whether air-polishing can be an effective technique to clean dentures chairside.

MATERIALS AND METHODS

A total of 60 specimens were prepared (n = 20/group); heat-polymerized polymethyl methacrylate (PMMA) (G1), subtractive manufacturing (SM) (G2) and additive manufacturing (AM) denture base resins (G3). Equal number of specimens in each group were stained with permanent marker or nail polish and pumice mixture to mimic calcified biofilm. All specimens were treated using EMS Airflow® Prophylaxis Master with two different powders; erythritol or sodium bicarbonate powder, following manufacturer instructions. Efficacy of the powders and surface roughness of the specimens were measured. Scanning electron microscopy imaging was captured for qualitative observation.

RESULTS

The highest efficacy for stain removal was found in erythritol powder on G1 (98.06% ± 1.304%). The lowest was found in the erythritol powder on G3 (91.83% ± 3.611%). The highest efficacy for biofilm removal was found in sodium bicarbonate powder on G3 (71.49% ± 8.607%), and the lowest was found in erythritol powder on G2 (11.64% ± 4.68%). Only AM resins had statistically significant increases in surface roughness with the use of erythritol powder (p < 0.001). The use of sodium bicarbonate powder significantly increases surface roughness of heat-polymerized (p < 0.025) and AM resins (p < 0.724).

CONCLUSIONS

Air-polishing technology has shown to be effective and suitable for cleaning dentures. The sodium bicarbonate powder showed superior efficacy in cleaning dentures compared to the erythritol powder. Both powders show varyingly increase roughness depending on denture resin.

Could oral hygiene prevent cases of at-home-acquired Legionnaires' disease? - Results of a comprehensive case-control study on infection sources, risk, and protective behaviors

Introduction

The "LeTriWa study" on community-acquired cases of Legionnaires' disease (LD) found that most cases likely acquired their infection at home (AHALD). However, which sources confer the infection is largely unknown. We therefore analyzed the data set from the LeTriWa study to find out if individual sources were associated with AHALD and if specific behavioral habits may increase or lower the risk for AHALD.

Methods

During the study we had used two comparison groups: (i) controls matched for age group and hospital ("controls"), (ii) household members of cases with AHALD ("AHALD-HHM"). We inquired about exposure to water sources, such as showering or wearing dentures, as well as behavioral factors and habits related to oral hygiene. We took standardized household bathroom water and biofilm samples of both cases with AHALD and controls, and in addition from households of cases with AHALD only samples from suspect residential (non-)drinking water sources. We first conducted bivariate analyses for infection sources and behaviors, followed by multivariable analyses.

Results

There were 124 cases with AHALD, 217 controls and 59 AHALD-HHM. In bivariate analyses using controls for comparison, wearing dentures was the only variable significantly positively associated (odds ratio (OR) = 1.7, 95% confidence interval (CI) = 1.1-2.7, p-value = 0.02). Behavioral factors such as showering, letting water run before use and not being alcohol abstinent were significantly negatively associated, smoking was significantly positively associated. In a multivariable analysis, we identified good oral hygiene as a preventive factor for both denture wearers (OR = 0.33, 95% CI = 0.13-0.83, p-value = 0.02) and non-denture wearers (OR = 0.32, 95% CI = 0.10-1.04, p-value = 0.06). Analyses of comparisons with AHALD-HHM showed similar effects but lacked statistical power. We identified Legionella in 16 residential (non-)drinking water sources, one of which was a PCR-positive scratch sample of dentures.

Discussion

Wearing (inadequately cleaned) dentures or poor oral hygiene might confer an increased risk for AHALD, and oral hygiene may prevent AHALD. The hypothesis that Legionella in oral biofilm or dental plaque may be the cause of cases with AHALD should be examined further. If confirmed this may open new and simple avenues for the prevention of LD.

Association between Oral Hygiene Information Sources and Daily Dental and Denture Care Practices in Urban Community-Dwelling Older Adults

The purpose of this cross-sectional study was to explore the sources of daily oral hygiene information among urban community-dwelling older adults in Athens, Greece and associate them with their dental and denture care habits. One hundred and fifty-four older adults (aged 71.7 ± 9.2 years) participated in the study, and their dental status, denture use, daily oral care habits according to current gerodontology recommendations, and oral care information sources were investigated. Daily oral hygiene practices were poor, and a small number of individuals recalled having received oral hygiene advice from a dentist. Only 41.7% of the 139 dentate participants performed toothbrushing with fluoride-based toothpaste at least twice a day, and 35.9% completed regular interdental cleaning. Among 54 denture wearers, 68.5% removed their denture(s) at night, and 54% cleaned them at least twice a day. Oral hygiene information sources included dentists (for approximately half of the participants), media, friends/relatives, non-dental health care providers and dental technicians. Dentate participants who had received oral hygiene information from dentists had a greater probability of brushing their teeth with fluoride toothpaste at least twice a day (p = 0.049, OR = 2.15) and performing regular interdental cleaning (p < 0.001, OR = 29.26). Denture wearers who had received instructions about denture hygiene from dentists were more likely to use a brush and mild soap (p = 0.016, OR = 14.67) and remove their denture(s) at night (p = 0.003, OR = 8.75). Dentists should improve their oral health prevention and promotion strategies for their older patients.

Did Dental Insurance Expansion Improve Dental Care Needs Among Korean Adults? Difference in Difference Analysis

BACKGROUND

In 2012, the Korean government expanded dental insurance for the elderly to promote improved access to dental care. We examined the causal effect of this policy on dental care needs, focusing on low-income older adults.

METHODS

We compared data before and after policy implementation using double difference (DD) and triple difference (DDD) analyses. We used the nationally representative data from the Korea National Health and Nutrition Examination Survey from 2010 and 2016-2018. Individuals aged ≥65 years were included in the treatment group, and individuals aged <65 years were included in the control group.

RESULTS

Dental insurance expansion was associated with a paradoxical increase in perceived unmet dental needs among elderly individuals (8.8 percentage points increase, 95% CI: 4.7 to 13.0). However, there were improvements in dental prosthetics outcomes (denture wearing [4.0 percentage points, 95% CI: 0.2 to 7.9] and dental implants [5.0 percentage points, 95% CI: 2.1 to 7.9]; P < 0.01). Upon analyzing low-income elderly individuals using DDD analysis, we found that the insurance expansion led to a 21.6% smaller increase in unmet dental needs among low-income adults, compared to high-income adults (95% CI, -35.0 to -8.5; P < 0.01).

CONCLUSION

Dental insurance expansion in South Korea resulted in improvements in access to dental prosthetic services overall. It also led to a smaller increase in unmet dental needs among low-income older adults, compared to high-income adults.

Association of the number of natural teeth with dietary diversity and nutritional status in older adults: A cross-sectional study in China

AIM

To investigate the association of the number of natural teeth with overall dietary diversity and nutritional status in a nationally representative study among older adults in China.

MATERIALS AND METHODS

A cross-sectional analysis was conducted among community-dwelling adults aged 65 years or older from the Chinese Longitudinal Healthy Longevity Study. According to the self-reported number of natural teeth, participants were categorized into ≥20, 10-19, 1-9 natural teeth, and edentulous. Dietary diversity score (DDS) was constructed based on intake frequencies of 10 food groups assessed by a simplified food frequency questionnaire. The geriatric nutritional risk index was used to measure the malnutrition status (i.e., normal, mild malnutrition, and moderate-to-severe malnutrition) among a subgroup of participants. Linear and multinomial logistic regression models were used to examine the corresponding associations.

RESULTS

Among 54,796 study participants, the mean (SD) age was 87.86 (11.45) years, 82.7% had poor dentition (<20 natural teeth), and 27.3% wore dentures. After multivariable adjustment, participants with poor dentition had lower DDSs (β_edentulous  = -0.39, 95% confidence interval [CI], -0.48, -0.30; β_{1-9 teeth}  = -0.46, 95% CI, -0.55, -0.37; β_{10-19 teeth}  = -0.36, 95% CI, -0.46, -0.26) than those with 20 natural teeth or more. For individual food items, edentulous, 1-9 and 10-19 natural teeth were associated with lower odds of regular intake of fresh fruits, fresh vegetables, meat, fish and aquatic products, eggs, legumes, preserved vegetables, tea, and garlic, but higher odds of regular intake of sugar and sweets. Among participants with poor dentition, individuals without dentures had lower intake frequencies of most food groups than those wearing dentures. In addition, poor dentition was related to lower odds of normal nutritional status (odds ratio = 0.49, 95% CI, 0.27, 0.89).

CONCLUSIONS

Older adults with poor dentition had significantly lower dietary diversity and worse nutritional status. Future studies are warranted to identify effective interventions to improve the dietary quality and nutrition status among partially and fully edentulous individuals, including those with Stage IV periodontitis.

Effects of Different Surface Treatments of Woven Glass Fibers on Mechanical Properties of an Acrylic Denture Base Material

Silanized glass fibers are popular reinforcements of acrylic denture base materials. To increase the number of surface hydroxyl groups and to improve interfacial adhesion between the matrix and reinforcements, acid or base treatments of glass fibers are commonly performed before the silanization. However, limited data are available on the effect of these treatments on the mechanical properties of acrylic matrix composite materials used for denture base applications. In this work, before the silanization of a woven glass fiber fabric (GF) with 3-(trimethoxysilyl) propyl methacrylate, activation pretreatments using HCl and NH₄OH aqueous solutions have been performed. To characterize the glass surface, FTIR spectroscopy was used. Specimens of cured acrylic denture base resin and composites were divided into five groups: (1) cured acrylic denture base resin-control group; (2) composite with non-silanized GF; (3) composite with silanized GF; (4) composite with NH₄OH activated and silanized GF; (5) composite with HCl activated and silanized GF. The flexural and impact properties of specimens were evaluated by means of three-point-bending tests and Charpy impact testing, respectively. The residual reactivity of the samples was analyzed using differential scanning calorimetry. The results of mechanical testing showed that acid and base pretreatments of the glass fabric had a positive effect on the flexural modulus of prepared composites but a negative effect on their impact strength. Possible interfacial adhesion mechanisms and the diffusion control of isothermal cure reactions due to vitrification have been discussed.

The Relationships of Dentition, Use of Dental Prothesis and Oral Health Problems with Frailty, Disability and Diet Quality: Results from Population-Based Studies of Older Adults from the UK and USA

OBJECTIVES

This study examined the relationships of dental status, use and types of dental prothesis and oral health problems, individually and combined, with diet quality, frailty and disability in two population-based studies of older adults.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

Men form the British Regional Heart Study (BRHS) (aged 85±4 years in 2018; n=1013) and Men and Women from the Health, Aging, and Body Composition (HABC) Study (aged 75±3 years in 1998-99; n=1975).

MEASUREMENTS

Physical and dental examinations and questionnaires were collected with data available for dental status, oral problems related to eating, diet quality, Fried frailty phenotype, disability based on mobility limitations, and activities of daily living (ADL). The associations of dental status and oral health problems, individually and combined, with risk of frailty and disability were quantified. The relationship with diet quality was also assessed.

RESULTS

In the BRHS, but not HABC Study, impaired natural dentition without the use of dentures was associated with frailty independently. This relationship was only established in the same group in those with oral problems (OR=3.24; 95% CI: 1.30-8.03). In the HABC Study, functional dentition with oral health problems was associated with greater risk of frailty (OR=2.21; 95% CI: 1.18-4.15). In both studies those who wore a full or partial denture in one or more jaw who reported oral problems were more likely to have disability. There was no association with diet quality in these groups.

CONCLUSION

Older adults with impaired dentition even who use dentures who experience self-report oral problems related to eating may be at increased risk of frailty and disability. Further research is needed to establish whether improving oral problems could potentially reduce the occurrence of frailty and disability.

A randomized clinical study to assess the performance of a marketed denture adhesive in a model of food infiltration in healthy, edentulous adults

OBJECTIVES

An optimized food infiltration methodology was utilized to assess the objective and subjective efficacy of a marketed denture adhesive regarding denture dislodgment and infiltration and perception of food particles under maxillary and mandibular dentures. A pilot study helped optimize methodologies before the efficacy study.

MATERIALS AND METHODS

Participants were healthy adults (n =48 for both studies) with fair- to well-fitting and well-made full maxillary and mandibular dentures. In the pilot, groups were a denture adhesive applied in a conventional dabbed-on pattern, a denture adhesive applied in continuous strips, or no adhesive. In the efficacy study, groups were the Test denture adhesive (continuous strips pattern application) or no adhesive, employed in a crossover design. Food infiltration was investigated through measurement of peanut particle mass retrieved from under each denture (30-32 g chewed). No formal statistical testing was performed in the pilot. Statistical analysis in the efficacy study was performed using analysis of variance. Primary efficacy evaluation was combined peanut particle mass from both dentures. Secondary efficacy evaluations included peanut particle mass under separate dentures, participant-reported denture dislodgements, and awareness/rates of how bothersome peanut particles under dentures were.

RESULTS

In the pilot, the median peanut particle mass was lower with either pattern application compared with no adhesive. In the efficacy study, peanut particle mass under combined dentures was lower with than without adhesive (geometric mean [product of values]: 5.56 vs. 29.13 mg) with a between-group geometric mean ratio (adhesive over no adhesive) of 0.19 (95% confidence interval: 0.12, 0.30) favoring the Test adhesive (p < .0001). Similar Test adhesive beneficial outcomes in both studies included significantly fewer denture dislodgements and awareness and how bothersome peanut particles under dentures were. Treatments were generally well-tolerated.

CONCLUSIONS

These findings, including reduced peanut particle infiltration, fewer denture dislodgments, and lower ratings of bothersomeness, corroborate those studies investigating the benefits of denture adhesive in preventing food infiltration.

Changes in the Surface Texture of Thermoplastic (Monomer-Free) Dental Materials Due to Some Minor Alterations in the Laboratory Protocol-Preliminary Study

Contemporary thermoplastic monomer-free prosthetic materials are widely used nowadays, and there are a great variety available on the market. These materials are of interest in terms of the improvement of the quality features of the removable dentures. The aim of this study is to establish how minimal changes in the laboratory protocol of polyamide prosthetic base materials influence the surface texture. Two polyamide materials intended for the fabrication of removable dentures bases were used-Perflex Biosens (BS) and VertexTM ThermoSens (TS). A total number of 20 coin-shaped samples were prepared. They were injected under two different modes-regular, as provided by the manufacturer, and modified, proposed by the authors of this study. Scanning electronic microscopy (SEM) under four magnifications-×1000, ×3000, ×5000, and ×10,000-was conducted. With minimal alterations to the melting temperature (5 °C) and the pressure (0.5 Bar), in Biosens, no changes in terms of surface improvement were found, whereas in ThermoSens, the surface roughness of the material significantly changed in terms of roughness reduction. By modifying the technological mode during injection molding, a smoother surface was achieved in one of the studied materials.

Influence of Filler Metal on Electrochemical Characteristics of a Laser-Welded CoCrMoW Alloy Used in Prosthodontics

This paper sought to determine corrosion resistance changes in the artificial saliva of a CoCrMoW-based alloy used for dental prostheses under Nd:YAG laser welding with CoCr alloy and stainless steel wire filler metals. The paper presents the corrosion characteristics of such joints, including the next stage of porcelain-fused-to-metal (PFM) firing. Corrosion tests were performed by electrochemical methods registering anodic polarization curves and electrochemical impedance spectroscopy (EIS). The microstructures were assessed by scanning microscopy (SEM) and chemical composition analysis (EDS) at the connection and heat-affected zones. Welding CoCrMoW alloy with and without a filler material increased the open circuit potential of the samples by 40-100 mV compared to unwelded base alloy. At the same time, a potentiodynamic test showed a polarization resistance R_pol reduction in welded samples, both for CoCr and stainless steel wires, as compared to the base CoCrMoW material. On the other hand, when comparing the current density and polarization resistance between materials welded with two different filler metals, better results were obtained for samples welded with stainless steel wire. The polarization resistance R_pol for the base alloy was 402 kΩ·cm², for the CoCr wire weld it was 436 kΩ·cm², and the value was 452 kΩ·cm² for stainless steel wire welds. Comparing polarization resistance R_pol from the Tafel analysis and the total charge transfer resistance from Rp_(EIS) from EIS, the CoCrMoW alloy welded with a stainless steel wire after heat treatment equaled or even slightly exceeded the corrosion resistance of the base alloy and alloy welded with dedicated CoCr wire after heat treatment. These results indicated the possibility of using stainless steel wire for the laser welding of CoCrMoW alloys dental prostheses, including the next stage of PFM, without sacrificing the corrosion resistance of such connections, and this was confirmed by most electrochemical parameters.

Effect of different mouthwashes on the shear bond strength and surface roughness of intraoral and heat-cured soft liners

Background

The present study aimed to determine the effect of mouthwashes on the shear bond strength (SBS) and surface roughness (SR) of soft liners.

Materials and Methods

In this in vitro study, a total of 72 samples were prepared to evaluate the SBS (n = 36 for each liner). An autopolymerized (Mollosil Plus) and a heat-polymerized liner (Molloplast B) were injected in between two blocks of heat-processed acrylic resin (Triplex). The samples in each liner group were subdivided into three subgroups. Control group samples were totally stored in distilled water. In test groups, samples were immersed in chlorhexidine (CHX) or mouthwash containing ginger extract for 30 min daily. After 20 days, the SBSs were evaluated using a universal testing machine. To evaluate the SR, 30 disk-shaped samples (15mm*10mm) were prepared for each type of liners and stored in the similar solutions; distilled water, CHX and ginger mouthwash (n=10). SR was measured at 1 day and after 90 days with a profilometer. One-way ANOVA, independent t-test, and paired t-test were used to analyze data. P < 0.05 was considered statistically significant.

Results

The SBS in Molloplast B liner was significantly higher than Mollosil regardless of type of solution (P < 0.001). In both liners, the mean SBS was not statistically different between the three groups of solutions. Changes in SR were not statistically significant after 90 days, except for the Mollosil group, immersed in ginger extract solution which was increased (P = 0.04).

Conclusion

SBS of either group of liners did not change in both mouthwashes; However, SBS of heat-polymerized liner was higher than autopolymerized in all groups. Ginger extract-containing mouthwash increased SR of autopolymerized liner used in this study; whereas, there were no significant changes in the heat-cured liner. According to this study, CHX can be used for the disinfection of prosthesis lined with either type of liners.

Effect of Candida albicans Suspension on the Mechanical Properties of Denture Base Acrylic Resin

Yeast-like fungi such as Candida albicans (C. albicans) are the primary pathogenic microorganism in the oral cavity of denture wearers. The research available so far, conducted according to a protocol based on the exposure of specimens to a C. albicans suspension and their cutting with water cooling, shows that hard polymethyl methacrylate (PMMA) prosthetic materials are not only surface colonized, but also penetrated by microorganisms in a short time. This justifies the hypothesis that exposure to a suspension of the C. albicans strain causes the changes in mechanical properties due to surface colonization and/or penetration of the samples. In the current study, the chosen mechanical properties (flexural strength, flexural modulus, tensile strength, impact strength, ball indentation hardness, and surface Vickers hardness at 300 g load) of the PMMA denture base material Vertex RS (Vertex-Dental, The Netherlands) exposed for 30, 60, and 90 days to a suspension of C. albicans were investigated. The potential penetration of yeast was examined on the fractured surfaces (interior of specimens) to eliminate the risk of the contamination of samples during cutting. There was no influence on the flexural strength, flexural modulus, tensile strength, impact strength, or ball indentation hardness, but a significant decrease in surface hardness was registered. Microscopic observations did not confirm the penetration of C. albicans. On the surface, blastospores and pseudohyphae were observed in crystallized structures and in traces after grinding, which indicates that in clinical conditions, it is not penetration but the deterioration of surface quality, which may lead to the formation of microareas that are difficult to disinfect, causing rapid recolonization.

Difference of income inequalities of denture use by co-payment rates: A JAGES cross-sectional study

OBJECTIVES

Studies suggest that wearing dentures to restore missing teeth can have a positive impact on health status. However, income inequalities in denture wearing exist. The aim of this study was to investigate how differing co-payment rates under the current Japanese Universal Health Insurance Coverage System affect income inequalities in denture non-use among older adults with severe tooth loss.

METHODS

This cross-sectional study used data from the 2019 Japan Gerontological Evaluation Study (JAGES). Self-administered questionnaires were mailed to 345 356 independent people who did not receive long-term care insurance benefits and were aged ≥65 years. The dependent variable was denture non-use, and the independent variable was the equivalent annual household income. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were used with regression-based approaches to determine both absolute and relative inequalities in denture non-use by co-payment rates. The covariates were sex, age, years of education, number of teeth and comorbidities.

RESULTS

Of the 240 889 responses received (response rate =69.9%), we analysed 21 594 participants who fulfilled the inclusion criteria. The mean age was 72.8 years (standard deviation =4.1), and 57.6% were men. For 30 per cent, 20 per cent and 10 per cent co-payment rates, the percentages of people who did not use dentures and had severe tooth loss (≤9 teeth) were 18.3%, 13.3%, and 8.5%, respectively. All analyses confirmed significant inequalities in denture non-use. The lower the co-payment rate, the smaller the inequalities. SIIs for each co-payment rate were as follows: 30 per cent =13.35% (95% confidence interval [CI] = 9.61-17.09); 20 per cent =7.85% (95% CI = 4.88-10.81); and 10 per cent =4.85% (95% CI = 2.55-7.16). Inclusion of interaction term between income and co-payment rate significantly lowered the inequalities by co-payment rate in logistic regression analysis and SII. For RII, although the interaction was not statistically significant, a similar trend was observed.

CONCLUSIONS

Income inequalities in denture use existed among older adults with severe tooth loss in Japan, and the inequalities appeared to be greater when the co-payment rate was higher.

A Denture Use Model Associated with Candida spp. in Immunocompetent Male and Female Rats

Denture stomatitis (DS) is a common infection in denture wearers, especially women. This study evaluated the induction of DS using acrylic devices attached to the palate of rats combined with inoculation of Candida spp. Immunocompetent male and female rats received a carbohydrate-rich diet. Impressions were taken from the rats’ palate to individually fabricate acrylic devices. Mono- and multispecies biofilms of C. albicans, C. glabrata, and C. tropicalis were grown on the devices, which were then cemented on posterior teeth and kept in the rats’ palate for four weeks. Microbial samples from the palate and the device were quantified. Oral microbiome of rats inoculated with C. albicans was analyzed by 16S rRNA gene sequencing. Log10(CFU/mL) were analyzed by mixed or two-way MANOVA (α = 0.05). Candida spp. and acrylic device did not induce palatal inflammation macroscopically nor microscopically. Although there was an increase (p < 0.001) of the total microbiota and female rats demonstrated higher (p = 0.007) recovery of Candida spp. from the palate, the gender differences were not biologically relevant. The microbiome results indicate an increase in inflammatory microbiota and reduction in health-associated micro-organisms. Although Candida spp. and acrylic device did not induce DS in immunocompetent rats, the shift in microbiota may precede manifestation of inflammation.

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.

Effect of physical and psychological status on oral health quality of life of geriatric patients undergoing complete denture treatment

Aim

The present study was conducted to evaluate differences in Oral Health-Related Quality of Life (OHRQoL) in denture wearers based on psychological classification and patient satisfaction.

Settings and Design

A prospective study.

Materials and Methods

284 patients, aged 30 years and above who fulfilled the eligibility criteria were recruited. Participants answered the OHIP - EDENT questionnaire at the time of denture insertion and 6 months later. Psychological categorization was based on MM House classification. Patient satisfaction was graded from totally satisfied to not very satisfied.

Statistical Analysis Used

SPSS 23 version was used for analyzing descriptive and inferential statistics. ANOVA was used to find significant differences for OHRQoL based on psychological classification and patient satisfaction. Before and after intervention analysis was assessed using student 't' test.

Results

Philosophical and exacting patients had better adaptation to dentures than the hysterical and indifferent class of denture wearers. Totally satisfied and very satisfied patients with dentures had lesser mean scores as against the other categories which was significant in all domains suggesting better. Overall, OHIP - EDENT score decreased from 20.253 ± 12.466 to 17.168 ± 14.143, which were significant at P =0.043, thus showing an improvement after a 6 month follow up.

Conclusions

Psychological attitude of denture wearers must be considered by the prosthetic specialist for effective adaptation and acceptance by the edentulous patient.

In vitro performance of CAD/CAM and conventional removable dentures

AIM

Innovations in CAD/CAM technology and materials science offer new methodologies for removable prosthodontics. As clinical data are still rare, in vitro performance of both CAD/CAM and comparable conventional materials may help to estimate the clinical outcome.

MATERIALS AND METHODS

Specimens (n = 8 per group) from teeth (CediTEC, SR VivodentCAD, Vitapan), base materials (V-Print dentbase, IvoBase CAD, Paladur), adhesives (CediTEC Primer/Adhesive, IvoBase CAD Bond), and a fully printed specimen (Try-In) were created. All specimens underwent thermal cycling and mechanical loading (TCML): 1,200,000 × 50 N; 2x3000 x 5°C/55°C; H2O. Surviving specimens were loaded to fracture. Statistical tests used were the Shapiro-Wilk test and the Kaplan-Meier survival, with the level of significance set to α = 0.05.

RESULTS

Mean loading cycles until failure varied between 100 and 621,667 cycles. Up to five specimens per group failed during TCML. With one exception, all specimens of the entirely CAD/CAM-fabricated group survived TCML. The log-rank (Mantel-Cox) test showed significantly different (P = 0.000) loading cycles between the systems (chi-square test: 28,247; degree of freedom: 8). Failure of the dentures during TCML was characterized by failure of the denture base (2x), denture tooth (13x), mixed base/tooth (3x) or adhesive between base and tooth (1x).

CONCLUSION

TCML and fracture testing showed different aspects of denture tooth restoration. The results indicated no correlation between fracture force, fracture pattern, and survival cycles. Denture teeth (milled, heat-pressed), bases (milled, printed, pressed), and primer should be matched up to optimize the performance of dentures.

The Influence of Decontamination Procedures on the Surface of Two Polymeric Liners Used in Prosthodontics

Polymeric liners are materials commonly used in prosthodontics to reshape denture surfaces contacting the soft tissues of the oral cavity. The aim of the study was to determine the impact of different cleaning methods on two polymeric materials used in prosthodontics as non-adhesive permanent liners. The material for the research consisted of samples made from Mollosil Plus (Detax, Ettlingen, Germany)-direct polysiloxan liner; and Plastitanium (Pressing Dental, San Marino, Republic of San Marino)-an injection-molded liner. A total of 198 samples were made, 99 of each assessed material. They were exposed to different cleaning methods-a toothbrush, a toothbrush and soap, a toothbrush and toothpaste (BlendaMed, Procter&Gamble, Cincinnati, OH, USA), a toothpaste and denture cleaning paste (Protefix Hygiene Denture Paste, Queisser Pharma, Germany), denture cleansing tablets (Protefix Hygiene Cleaning Tablets, Queisse Pharma, Germany), and a disinfecting spray (Aftermat, Port Jefferson Station, New York City, NY, USA)-for 1 min, 5 min, 10 min, and 15 min. The image acquisition was performed with scanning electron microscopy and samples were analyzed for the homogeneity of their surfaces-the presence of holes, grooves, precipitate, and small and large separating pieces of the material marking departures from this homogeneity. For each type of damage, one point was given. Continuous data from two groups were compared with Mann-Whitney U testing. Due to a small sample size and distribution of variables other than normal, to compare more than two groups, Kruskal-Wallis testing with post hoc analysis (Dunn test with Bonferroni correction) was used. Categorical data were compared with the chi-square test and the Fisher's exact test. The Mollosil Plus material should be decontaminated with the use of a toothbrush or toothbrush with soap, while Plastitanium material should be disinfected. Plastitanium samples are more susceptible to damage during the decontamination procedures than Mollosil Plus.

Assessment of Oral Hygiene in Patients Using Fixed and Removable Dentures Treated at the University Dental Clinic in Krakow

Apart from local lesions, the presence of dental plaque may also have an effect on health, especially in people with general diseases. The aim of this project was to assess the oral hygiene of patients prosthetically treated at the Dental Prosthetics Clinic of the University Dental Clinic in Krakow (Poland) using fixed and removable dentures and to determine the demographic relationships and data related to the education of the respondents. The research material consisted of 120 patients who used fixed (group I) and removable (group II) restorations. Basic dental examinations and oral hygiene examinations were carried out with the use of the API (Approximal Plaque Index) and PI (Plaque Index) plaque indices. This study presents the percentage of respondents in terms of sex, place of residence, and education. The mean PI (Plaque Index) values were 46.73% (Group I) and 50.05% (Group II). (p = 0.4839). The mean values of API (Approximal Plaque Index) amounted to 65.14% (Group I) and 68.94% (Group II) (p = 0.4695). Patients using dentures showed insufficient oral hygiene, and the hygiene status of patients did not depend on the type of dentures used. The group that is most often treated with prosthetics is women with secondary education. The most numerous group of patients at the Dental Prosthetics Clinic are people living in large cities which results from easier access to health care.

Analysis of Changes in the Tensile Bond Strenght of Soft Relining Material with Acrylic Denture Material

Abrasions and pressure ulcers on the oral mucosa are most often caused by excessive pressure or incorrect fitting of the denture. The use of soft relining materials can eliminate pain sensations and improve patient comfort. The main functional feature of soft elastomeric materials is the ability to discharge loads from the tissues of the mucosa. (1) Background: The aim of the work was a comparative laboratory study of ten materials used for the soft lining of acrylic dentures. (2) Methods: There were materials based on acrylates (Vertex Soft, Villacryl Soft, Flexacryl Soft) and silicones (Sofreliner Tough Medium, Sofreliner Tough Medium, Ufi Gel SC, GC Reline Soft, Elite Soft Relining, Molloplast). Laboratory tests include the analysis of the tensile bond strength between the relining material and the acrylic plate of the prosthesis. The tests were conducted taking into account 90-day term aging in the distilled water environment based on the methodology presented in the European Standard ISO 10139-2. (3) Results: After three months of observation, the highest strength of the joint was characterized by Flexacryl Soft acrylic, for which the average value was 2.5 MPa. The lowest average value of 0.89 MPa was recorded for the GC Reline Soft silicone material. Over time, an increase in the value of the strength of the combination of acrylic materials and a decrease in these values in the case of silicone materials was observed. (4) Conclusion: Each of the tested silicone materials showed all three types of damage, from adhesive to mixed to cohesive. All acrylic-based materials showed an adhesive type of failure. Time did not affect the type of destruction.

Tooth loss, dental prostheses use and cognitive performance in older Brazilian adults: The SABE cohort study

AIM

To investigate the within- and between-person longitudinal effects of tooth loss and the use of dentures, clinically assessed by dentists, on cognitive decline in a representative sample of community-dwelling older Brazilian adults.

METHODS

Data came from 1265, 1112 and 1021 individuals aged ≥60 years who participated in the second (2006), third (2010) and fourth (2015) waves, respectively, of the Health, Well-being and Aging study (SABE). Cognitive performance was evaluated with the abbreviated version of the Mini-Mental State Examination (MMSE). The number of natural teeth was classified according to three categories: none, 1-19 and ≥20 teeth. The presence of removable full or partial dentures in each dental arch (yes/no) was recorded. Hybrid regression models, adjusted for sociodemographic, behavior and health-related covariates, were used to estimate the between- and within-person effects of the longitudinal association between cognitive performance and oral health.

RESULTS

Participants with 1-19 and no teeth had, respectively, 1.15 (95% CI 0.65-1.66) and 1.54 (95% CI 0.99-2.09) units lower MMSE score than those with ≥20 teeth. Denture wearers had 1.54 (95% CI 1.13-1.95) units greater MMSE score than non-denture wearers, and those who started wearing dentures during the follow up had 0.83 (95% CI 0.21-1.45) units greater MMSE score after the transition.

CONCLUSION

Our main findings showed that the use of dental prostheses might be a protective factor for cognitive decline. Geriatr Gerontol Int 2021; 21: 1093-1098.

Psychodiagnostics as a Mandatory Element of Patient Protocols in Dentistry

Objectives:

This study aims at performing psychodiagnostics of the patients` condition with removable and fixed dentures both before and after dental treatment.

Materials and Methods:

The first group included 200 patients with fixed-type dentures, and the second group consisted of 200 patients with removable dental devices. The control group included 200 patients with healthy teeth. All patients were subjected to Fere’s skin-galvanic reaction procedure. Patients also filled out the Dental Status Questionnaire and were then tested following the Spielberger-Hanin Scale. For a comparison of differences, a two-sample t-test for independent samples was used. The Pearson correlation between features was calculated considering their distribution as normal.

Results:

In the control group, the hemispheric activity index increased 1.1 times after treatment. In Group 2, following the dental status questionnaire, the index of hemispheric activity increased 1.3 times in males with a positive emotional mood (P ≤ 0.01). A 2.2-fold and 2.1-fold (P ≤ 0.01) increase was observed among female and male patients with a negative emotional mood in Group 2, respectively. After the treatment, the hemispheric activity index in Group 1 increased by 1.1 times for males with a positive mood (P ≤ 0.01) and by 1.2 times for male and female patients with a negative mood (P ≤ 0.05). Direct correlation was recorded between the increase in the number of scores and emotional mood among males and females from Group 1 (0.72 and 0.73, respectively). After the survey, a correlation was established between the values of the hemispheric activity index and the increase in scores among males (0.82) and females (0.81). There was also a connection between the increase in scores and the level of personal anxiety in both male (0.57) and female (0.66) patients, as well as between the increase in scores and the level of reactive anxiety (0.56 and 0.57, respectively).

Conclusions:

Changes in the hemispheric activity index were shown to be related to the patient’s dental condition questionnaire. Besides, there is a relationship with the type of dental service. The practical application of this study implies that more reliable information about the patient’s satisfaction with the quality of dental care provided can be obtained using not only standard psychodiagnostic methods but also questionnaires on the patient’s dental status. Once the survey is completed and the data obtained analyzed, it is possible to define the correct strategy to restore the patient’s physical and mental health after dental treatment.

Antiadhesive Properties of Imidazolium Ionic Liquids Based on (-)-Menthol Against Candida spp

Infections with Candida spp. are commonly found in long-time denture wearers, and when under immunosuppression can lead to stomatitis. Imidazolium ionic liquids with an alkyl or alkyloxymethyl chain and a natural (1R,2S,5R)-(-)-menthol substituent possess high antifungal and antiadhesive properties towards C. albicans, C. parapsilosis, C. glabrata and C. krusei. We tested three compounds and found they disturbed fungal plasma membranes, with no significant hemolytic properties. In the smallest hemolytic concentrations, all compounds inhibited C. albicans biofilm formation on acrylic, and partially on porcelain and alloy dentures. Biofilm eradication may result from hyphae inhibition (for alkyl derivatives) or cell wall lysis and reduction of adhesins level (for alkyloxymethyl derivative). Thus, we propose the compounds presented herein as potential anti-fungal denture cleaners or denture fixatives, especially due to their low toxicity towards mammalian erythrocytes after short-term exposure.

Factors Affecting Masticatory Satisfaction in Patients with Removable Partial Dentures

(1) Background: The degree of satisfaction with dental treatment varies among patients, and the discrepancy may exist between the patient's subjective evaluation and the objective assessment. Further, the optimal methods for increasing patient satisfaction with mastication remain unclear. This study aimed to identify factors affecting masticatory satisfaction in patients with removable partial dentures. (2) Methods: A total of 132 participants (71.0 ± 9.0 years) were included. Masticatory satisfaction was assessed on a visual analog scale. An oral health survey was conducted to assess the number of functional teeth, missing tooth classification: Kennedy classification, occlusal support: Eichner classification, and removable partial dentures wearing jaw. Objective masticatory performance was assessed using gummy jelly, while subjective masticatory ability was assessed using food acceptance status and oral health-related quality of life. The associations of these factors with masticatory satisfaction were assessed. (3) Results: Masticatory satisfaction among removable partial denture wearers was not significantly associated with gender, age, denture wearing jaw, Kennedy classification, and occlusal support. The degree of masticatory satisfaction was significantly greater with higher levels of masticatory function: masticatory performance, food acceptance score, and OHIP-14 score. The OHIP-14 score was the only significant explanatory variable for masticatory satisfaction in the multiple regression analysis; the strongest associations were with the "psychological discomfort" and "physical disability" subscales (p = 0.02 and p = 0.005, respectively). (4) Conclusions: Masticatory satisfaction among removable partial denture wearers was strongly associated with oral health-related quality of life, in which the ability to eat meals comfortably with removable partial dentures is the most important determinant of masticatory satisfaction.

Clinical presentation, diagnosis and management of aerodigestive tract foreign bodies in the adult population: Part 1

In the adult population, foreign bodies may be accidentally or intentionally ingested or even inserted into a body cavity. The majority of accidentally ingested foreign bodies pass through the alimentary tract without any complications and rarely require intervention. Accidentally ingested foreign bodies are usually fish bones, bones of other animals, and dentures. Oesophageal food impaction is the commonest cause of oesophageal foreign bodies in the Western hemisphere. Intentionally ingested foreign bodies may be organic or inorganic, and often require intervention; these patients have either underlying psychological or mental disease or are involved in illegal activities such as body packing, which involves trafficking narcotics. Imaging plays a crucial role in not only identifying the type, number and location of the foreign body but also in excluding any complications. In this comprehensive pictorial review, we provide an overview of the spectrum of foreign bodies ingested in adults, emphasising the role of various imaging modalities, their limitations and common foreign body mimickers on imaging.

Medical Device Regulation: Requirements for Dental Professionals Who Prescribe and Manufacture Custom-Made Devices

A custom-made device (CMD) is a medical device intended for the sole use of a particular patient. In a dental setting, CMDs include prosthodontic devices, orthodontic appliances, bruxism splints, speech prostheses and devices for the treatment of obstructive sleep apnoea, trauma prevention and orthognathic surgery facilitation (arch bars and interocclusal wafers). Since 1993, the production and provision of CMDs have been subject to European Union (EU) Directive 93/42/EEC (Medical Device Directive, MDD) given effect in the UK by The Medical Devices Regulations 2002 (Statutory Instrument 2002/618), and its subsequent amendments. Regulation (EU) 2017/745 (Medical Device Regulation, EU MDR) replaces the MDD and the other EU Directive pertaining to Medical Devices, Council Directive 90/385/EEC (Active Implantable Medical Device Directive, AIMDD). The EU MDR was published on 5 April 2017, came into force on 25 May 2017 and, following a three-year transition period was due to be fully implemented and repeal the MDD on 26 May 2020, but was deferred until 26 May 2021 due to the coronavirus disease 2019 (COVID-19) pandemic.In the UK, in preparation for the country's planned departure from the EU, the EU MDR, with necessary amendments, was transposed into UK law (Medical Devices (Amendment etc.) (EU Exit) Regulations 2019, UK MDR). The UK left the Union on 31 January 2020 and entered a transition period that ended on 31 December 2020, meaning that, from 1 January 2021, dental professionals in Great Britain who prescribe and manufacture CMDs are mandated to do so in accordance with the new legislation while Northern Ireland remains in line with the EU legislation and implementation date. This paper sets out the requirements that relate to the production and provision of CMDs in a UK dental setting.

Can masticatory performance be predicted by using food acceptance questionnaire in elderly patients with removable dentures?

BACKGROUND

Although a food acceptance questionnaire is useful for subjective masticatory function assessments, its characteristics and limitations when applied to patients with removable dentures have been unclear. We therefore assessed the relationship between the subjective and objective masticatory function and explored whether or not a decreased masticatory function could be evaluated by food acceptance questionnaire.

METHODS

One hundred and nineteen patients >60 years old with removable partial and/or complete dentures participated. Food acceptance score (FAS) was calculated by using Sato's questionnaire with 20 food items. Masticatory performance (MP) was assessed by a visual scoring method using a test gummy jelly (UHA Mikakuto). Simple/multiple regression analyses were performed to explain the objective masticatory function. The cut-off value of FAS was determined to predict a decreased masticatory function by sensitivity, specificity and receiver operating characteristics curve.

RESULTS

No significant gender differences in MP or FAS were noted. Although both MP and FAS increased with the number of functional teeth, FAS was not significantly affected by age. The number of functional teeth, FAS and age had significant correlations with MP, with the number of functional teeth showing the strongest correlation. Multiple linear regression analyses identified the FAS as a significant explanatory variable for MP, and 70 was the optimal cut-off value for detecting a decreased masticatory function (MP score ≤ 2) in the diagnosis of 'oral hypofunction'.

CONCLUSIONS

Using FAS to assess the MP was deemed appropriate, and a score of 70 was the optimal cut-off value for detecting a decreased masticatory function.

Relationship between taste perception and use of upper complete dentures

AIMS

The aim of the present study was to evaluate the taste perception in patients with upper complete dentures.

METHODS AND RESULTS

One hundred seventy male and female patients (45-83 years old) upper denture wearers were evaluated for their gustatory function by the paper strips technique in relation to the four basic tastes. The taste test was performed with and without the presence of the denture on the palate. Through Shapiro-Wilk and Kolmogorov-Smirnov tests, the results were analyzed by their normal distribution. The t-test for paired samples was used to evaluate if there was a statistical difference on the taste perception and itself revealed that there is a significant difference (p < 0.01) when the taste perception was analyzed for the absence and presence of the prosthesis (alone and compared) (p < 0.01). The results revealed that patients with dentures had great difficulty to recognize the bitter taste, followed by the salty, sweet, and sour.

CONCLUSION

The presence of the denture was able to modify the perception of taste when compared to its absence, especially for the bitter taste.

Effect of Denture Base Fabrication Technique on Candida albicans Adhesion In Vitro

Denture stomatitis is a common manifestation of oral candidiasis affecting some 65% of denture wearers. This condition is initiated by the adherence of Candida albicans to denture base acrylic resin. The present study aimed to test the in vitro effect of traditional and novel fabrication methods on Candida albicans adhesion to denture base samples. Denture based acrylic discs were fabricated using: (i) computerized milling, (ii) 3D printing, (iii) heat curing, and (iv) cold curing. Discs were tested for surface roughness (Ra), hydrophobicity (contact angle), mucin adsorption (Bradford assay), and Candida albicans adhesion. 3D printing significantly increased microbial cell adhesion as compared with heat curing, and computerized milling significantly decreased it. These results were associated with mucin adsorption levels rather than surface roughness. Results suggest that 3D printing may increase the risk for developing denture stomatitis, whereas computerized milling may decrease it as compared with traditional heat curing denture base fabrication.

Association between dental factors and mortality

AIM

To study whether oral parameters such as endodontic infections, root canal fillings, number of teeth or wearing removable dentures at baseline are associated with cardiovascular- and all-cause mortality in a follow-up of approximately 8 years.

METHODOLOGY

The Finnish Parogene cohort consists of 508 Finnish adults (mean age 63.3 years, SD 9.1) with cardiac symptoms, all of whom had undergone coronary angiography for accurate baseline coronary status. Extensive clinical and radiographic oral examinations were performed, and additional data were acquired from medical records and questionnaires. Root canal fillings and endodontic lesions, as well as their co-occurrence, were determined from panoramic radiographs. The mortality data were assessed via record linkage with the Finnish Causes of Death register (mean follow-up time 7.81 years, SD 1.45 years). A total of n = 471 dentate patients were included in the statistical analyses.

RESULTS

A total of n = 69 deaths were recorded, of which n = 41 were due to cardiovascular diseases (CVDs, ICD-10 I00-I99). The deceased had fewer root canal fillings (mean 1.57; SD 1.64 vs. mean 2.30; SD 2.34, P = 0.03) than the survivors. The number of missing teeth was associated with smoking, occluded coronary arteries and diabetes. Cox regression with Firth's penalized maximum-likelihood method using age as timescale revealed an inverse association (HR; 95%CI) between mortality and number of teeth (all-cause 0.91; 0.86-0.96, CVD mortality 0.89; 0.83-0.96), use of removable dentures (all-cause 0.24; 0.09-0.62, CVD mortality 0.20; 0.06-0.72), root canal fillings (all-cause 0.82; 0.70-0.94, CVD mortality 0.79; 0.63-0.96) and having root canal fillings in all teeth with apical rarefactions (all-cause 0.27; 0.06-0.79, CVD mortality 0.09; 0.01-0.63), when gender, smoking, occluded coronary arteries, periodontal inflammatory burden index and the number of teeth were adjusted for.

CONCLUSIONS

The number of missing teeth appeared to be the strongest predictor of mortality in this study, whereas endodontic infections per se had no independent association. Nevertheless, signs of professional intervention in these problems, such as root canal fillings and removable dentures, appeared to be associated with improved survival, which might partly be explained by the utilization of healthcare services.

Chewing Discomfort According to Dental Prosthesis Type in 12,802 Adults: A Cross-Sectional Study

This study examined the prevalence of self-perceived chewing discomfort depending on the type of dental prosthesis used in South Korean adults. The subjects were 12,802 people over 20 years of age who participated in a health interview and dental examination. Chewing discomfort was examined using a self-assessed report with a structured questionnaire. Using multivariable logistic regression analysis, adjusted odds ratios were evaluated along with their 95% confidence intervals (α = 0.05). After adjusting for covariates, including age, gender, smoking, drinking, hypertension, diabetes, body mass index, education, income, and toothbrushing frequency, the odds ratios (95% confidence intervals) for chewing discomfort in groups without a dental prosthesis, with fixed dental prostheses, with removable partial dentures, and with removable complete dentures were 1 (reference), 1.363 (1.213-1.532), 2.275 (1.879-2.753), and 2.483 (1.929-3.197), respectively. The association between the prevalence of chewing discomfort and the type of dental prosthesis used was statistically significant even after adjusting for various confounders (p < 0.0001). The type of dental prosthesis was related to chewing discomfort among South Korean adults.

Dentition status and 10-year higher-level functional capacity trajectories in older adults

AIM

The effect of dentition status on higher-level functional capacity patterns over time remains unclear. We aimed to identify distinct higher-level functional capacity trajectories in individuals aged 70-80 years, and examine whether dentition status at 70 years predicted the trajectory.

METHODS

The study included 551 community-dwelling adults aged 70 years at baseline. Higher-level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) up to the age of 80 years. A higher TMIG-IC score indicated a higher level of competence. Group-based trajectory modeling was used to identify distinct TMIG-IC trajectories. The number of teeth, use of dentures, sex and education were added as baseline group membership predictors. Dental visits, health behaviors, body mass index and comorbidities during observation were added as time-varying covariates.

RESULTS

Three TMIG-IC trajectories were identified: "high/stable" (65.3%), "middle/decline" (24.5%) and "low/decline" (10.2%). A lower number of teeth and non-denture use were associated with increased odds of a low/decline trajectory relative to a high/stable trajectory (odds ratio 1.09, 95% confidence interval 1.04-1.14 [per one decrease] and odds ratio 3.96, 95% confidence interval 1.54-10.16, respectively).

CONCLUSIONS

Older adults with fewer teeth and those without dentures at the age of 70 years were more likely to follow a trajectory toward functional decline with low baseline TMIG-IC scores, which further declines by the age of 80 years. These findings suggest that preserving natural teeth later in life, as well as using dentures, could contribute toward maintaining a higher-level functional competence. Geriatr Gerontol Int 2021; 21: 48-53.

Effectiveness of denture microwave disinfection for treatment of denture stomatitis: A systematic review and 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.

Oral Factors Associated with Swallowing Function in Independent Elders

PURPOSE

This study clarified the oral factors related to swallowing function using the results of dental check-ups among community-dwelling independent elders.

MATERIALS AND METHODS

Data on oral and medical health check-ups from 4,676 participants aged 75 and 80 years were analysed. Swallowing function was evaluated using the repetitive saliva swallowing test (RSST), which assesses the ability to swallow saliva. Swallowing three or more times during a 30 s period was recorded as normal, while swallowing twice or less in 30 s was considered to indicate swallowing difficulty. Multivariate logistic regression analyses were performed to examine the relationship between oral factors and swallowing function.

RESULTS

In all participants, the odds ratio (OR) for swallowing difficulty was 3.42 (95% confidence interval (CI): 1.78-6.55) and 6.68 (95% CI: 1.97-22.64) among those who had 10-19 teeth without dentures and those who had 0-9 teeth without dentures, respectively, compared to individuals with ≥ 20 teeth without dentures. Those with moderate or severe dry mouth had a statistically significantly higher OR (8.01, 95% CI: 4.84-13.27) for swallowing difficulty than those without dry mouth. Among dentate participants, in addition to statistically significant variables in the analysis among all participants, those with abundant dental plaque showed a significantly higher OR (2.58, 95% CI: 1.54-4.32) for swallowing difficulty compared to those with no or slight dental plaque.

CONCLUSION

These results suggest that oral factors such as having few teeth without dentures, dry mouth, and poor oral hygiene are related to swallowing function in elders.

Use of dentures, receipt of information, quality of life, and oral function following radiotherapy for head and neck cancer

BACKGROUND

Teeth with a poor prognosis are often extracted prior to radiotherapy for head and neck cancer (HNC) in order to help prevent the need for dental treatment after radiotherapy that might in turn lead to the development of osteoradionecrosis. However, the details and impact of replacing missing teeth after radiotherapy for HNC have received little attention, especially from the patients' perspective.

AIMS

This study aimed to assess the use, satisfaction, and impact of denture use following radiotherapy for HNC. The study also sought to determine patients' satisfaction with information about replacing their missing teeth postradiotherapy. Finally, this study also aimed to assess interest in replacing missing teeth for those who had not done so.

METHODS

A structured, validated, and reliable questionnaire was sent to HNC patients who had received radiotherapy and had missing teeth at the time of discharge. In addition to demographic details and self-reported oral hygiene, the questionnaire included questions on use of (or interest in) dentures, satisfaction with dentures, satisfaction with information about replacing missing teeth, QoL as measured by two questions from the short version of WHOQoL-BREF, and oral functioning as measured by BCSQ-H&N. Demographic details and clinical details were extracted from the hospital records.

RESULTS

N = 80 (24%) returned a completed questionnaire. Participants had an average of 12 missing teeth (SD = 8.05). Most (n = 60, 75%) had not replaced their missing teeth. Of these, 35 (58%) were very or extremely interested in doing so. For HNC survivors who wore dentures, there was variable satisfaction and a number of side-effects of wearing dentures. Satisfaction with information about replacing missing teeth was low. There was no statistical difference in QoL or oral functioning between participants who wore dentures and participants who did not wear dentures. However, those with dentures reported fewer problems with carrying out daily routines as measured by the oral functioning tool.

CONCLUSIONS

QoL and oral functioning were similar regardless of denture use, highlighting reduced oral function in both those with and without dentures. In those who had not replaced their missing teeth, there was substantial interest in doing so and thus may be an unmet need. The dental team could offer HNC survivors more support after radiotherapy and following denture provision to improve information about denture use and increase satisfaction with dentures.

Biological and Chemo-Physical Features of Denture Resins

In the dental field, the study of materials has always been the basis of the clinical practice. Over the years, with the evolution of materials, it has been possible to produce safe and predictable prosthetic devices, with ever better aesthetic features, biocompatibility and patient satisfaction. This review briefly analyzes the features of dental resin materials to underline the biological, microbiological and chemo-physical characteristics. The main aim of prosthodontics is to rehabilitate patients and therefore improve their quality of life. Dental resins are the main materials used for the production of dentures. Once solidified, these polymers have different mechanical or surface characteristics. The results of the literature on these characteristics were analyzed and some new brand dental resins, known as modern resin, were subsequently evaluated. The new materials are undoubtedly a step forward in the creation of dental prostheses, and also in all subsequent maintenance phases. This review shows how changing the chemical structure of the resins could have microbiological influences on the growth and management of the biofilm, and also physical influences in terms of its mechanical characteristics. The development of new materials is a constant goal in dentistry in order to obtain increasingly predictable rehabilitations.

Intraoral hemorrhage caused by dental calculus: two case reports

Intraoral hemorrhage is an undesirable and emergency condition, and it can also occur spontaneously. Clinicians sometimes face difficulty in identifying the hemorrhage points and the causes of hemorrhage, as well as difficulty in the hemostatic procedures. Here, the authors present two rare cases of spontaneous intraoral hemorrhage related to dental calculus. The hemorrhage points and causes of hemorrhage were determined after removing the removable intraoral components, including the dental calculus.

The association between mastication and mild cognitive impairment in Korean adults

Currently, a few of studies revealed that there is an association between mastication and cognitive impairment. There is no study of Korean adult representative samples in relation to mastication and cognitive decline. This study was to investigate the relationship between mastication and mild cognitive impairment in Korean adults.A population-based cross-sectional study was conducted in which a total of 7029 subjects (2987 men and 4042 women) over 45 years old were surveyed from the Korea Longitudinal Study on Aging (KLoSA), Round 5th survey. Logistic regression analysis was performed for the study data controlling for confounding factors such as age, gender, education, income, smoking, drinking, exercise, wearing denture, and the number of chronic diseases.Decreased chewing function is associated with mild cognitive impairment (odds ratio [OR] = 3.24, 95% confidence interval [CI] = 2.67-3.93) after controlling for confounding variables. In the participants who did not wear dentures, the reduction of chewing function was strongly correlated with mild cognitive impairment (OR = 3.97, 95% CI = 3.11-5.08).Mastication was associated with mild cognitive impairment. To prevent cognitive decline, health specialists should pay more attention to the decline of the mastication in people without dentures.

Denture use and osteoradionecrosis following radiotherapy for head and neck cancer: A systematic review

BACKGROUND

It is strongly recommended to extract teeth with poor prognosis in head and neck cancer (HaNC) patients prior starting treatment with radiotherapy to avoid need for extraction post-radiotherapy and prevent development of osteoradionecrosis (ORN). Dental extraction means that patients are often left with insufficient teeth leading to psychological problems and reducing their quality of life post-radiotherapy. Some clinicians do not advocate the use of dentures in HaNC patients claiming that dentures might lead to soft tissue irritation followed by ORN when constructed on irradiated jaws.

AIMS

This systematic review aimed to investigate the existing evidence regarding the impact of denture use on the development of ORN in HaNC patients post-radiotherapy.

METHODS

This systematic review followed the Preferred Reporting Item for Systematic Review and Meta-analyses (PRISMA) guideline. Three database systems were used: Ovid Medline, EMBASE and PsycINFO. PROSPERO was searched for ongoing or recently completed systematic reviews. The https://ClinicalTrials.gov was searched for ongoing or recently completed trials. The Joanna Briggs Institute critical appraisal tools were used to assess quality of studies being reviewed.

RESULTS

Only three retrospective case-control studies were included. Numbers of participants included in the three studies are limited with incomparable types of mucosal dentures. None of the studies described the method of measurement of the exposure (denture use) in a standard, validated and reliable way.

CONCLUSION

The three included studies suggested no link between denture use and development of ORN. However, very little evidence exists and the robustness of the studies is questionable. Well-powered studies are needed.