JOURNAL OF PROSTHODONTICS, Issue 7 2009
Won-suk Oh DDS
Abstract Precision attachment-retained removable partial dentures eliminate the use of visible clasps and improve the esthetic appearance of the smile; however, terminal abutment teeth may be subject to unfavorable stresses under function when misused. A provisional prosthetic management technique that incorporates an orthodontic wire to assist cross-arch support and stability of the periodontally weakened abutment teeth is described. This technique is simple, reversible, does not alter the esthetic appearance of the smile, and controls the mobility of the abutment teeth until a definitive treatment plan is established. [source]

Inhibition of biofilms associated with dentures and toothbrushes by tetrasodium EDTA

JOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2007
D.A. Devine
Abstract Aims:, We examined the efficacy of tetrasodium EDTA in eradicating biofilms derived from salivary inocula or pure cultures of Candida albicans on discs of polymethyl methacrylate (PMMA) denture base or on toothbrushes that had been used normally for 4,8 weeks. Its efficiency in virus neutralization was also determined. Methods and Results:, Overnight (16 h) treatment with 4% (w/v) tetrasodium EDTA solution reduced salivary and C. albicans biofilm viable counts by ,99%. Biofilm removal was confirmed using confocal laser scanning microscopy. Presence/absence of sucrose during biofilm formation had no effect on killing efficacy. Prolonged treatment of PMMA with tetrasodium EDTA did not influence subsequent formation of C. albicans biofilms or affect surface roughness of the PMMA, but it reduced subsequent biofilm formation from a salivary inoculum. Infectivities of herpes simplex virus and polio virus suspensions were reduced by >99·99% by treatment for 1 and 2 h, respectively. Conclusions:, Tetrasodium EDTA solution efficiently disinfected toothbrushes and PMMA discs, with the detachment of biofilms, and rapidly neutralized both nonenveloped and enveloped viruses. Significance and Impact of the Study:, Dentures and toothbrushes become contaminated by bacterial biofilms and by viruses. There is a need for disinfection methods that are rapidly effective, cost-effective, nontoxic and easily implemented. These studies indicate that tetrasodium EDTA solution has disinfection applications in the oral care field. [source]

Influence of Matrix Type on Surface Roughness of Three Resins for Provisional Crowns and Fixed Partial Dentures

JOURNAL OF PROSTHODONTICS, Issue 2 2009
Raul Ayuso-Montero DDS
Abstract Purpose: This study evaluated the effect of matrix type on the surface roughness of resins for provisional crowns and fixed partial dentures. Materials and Methods: Ninety specimens of two acrylic resins (Trim II, Tab2000) and one bis-acryl composite (Protemp II Garant) were fabricated using one of three matrices: irreversible hydrocolloid (Cavex CA37), poly(vinyl siloxane) (Aquasil) or vacuum-formed matrix (Bio-flow Hard). The sample size for each resin-matrix combination was 10. The vestibular face of one natural maxillary central incisor was used as a model to fabricate all the specimens, following the custom fabrication technique. The average roughness measurements, Ra (,m), were obtained using a profilometer, and the data were analyzed using Kruskal-Wallis and Mann-Whitney U- tests. The results were contrasted against the surface roughness of the tooth using a one-sample t- test. Results: Aquasil and vacuum-formed matrix had a smoother surface than Cavex CA37 regardless of the resin tested (p < 0.05). Protemp II Garant had the smoothest surface regardless of the matrix used, with no significant differences when polymerized against the three different matrices. Trim II polymerized against Cavex CA37 had a rougher (p < 0.05) surface than Aquasil or vacuum-formed matrix. Tab2000 had the smoothest surface (p < 0.05) when polymerized against a vacuum-formed matrix. Conclusions: There is no universal matrix that produces the smoothest surface: this depends on the compatibility between the resin and the matrix. Protemp II Garant polymerized against Cavex CA37 matrix yields a surface that is smooth enough not to require polishing unless this surface is adjusted. [source]

Fracture Resistance of Fiber-Reinforced PMMA Interim Fixed Partial Dentures

JOURNAL OF PROSTHODONTICS, Issue 4 2006
Tamer A. Hamza BDS
Purpose: To compare different fiber reinforcements on fracture toughness of interim polymethyl methacrylate materials and then use the best combination to determine the optimal position for fiber placement in an interim 3-unit fixed partial denture (FPD). Materials and Methods: In the first stage of the study, five groups of notched fracture toughness specimens were fabricated and loaded to failure (Instron): (1) unreinforced (control); (2) reinforced with pre-impregnated silanized E-glass fibers (Fibrestick); (3) cold plasma-treated woven polyethylene fibers (Ribbond triaxial); (4) pre-impregnated silanized plasma-treated woven polyethylene fibers (Construct); and (5) 1.0-mm-diameter stainless steel wire. In the second stage, the optimal position (occlusal, middle, or cervical third of pontic) for reinforcement with glass fibers (regimen 2) was tested by loading a 3-unit FPD to failure. All groups were compared with analysis of variance (, < 0.05). Results: The fracture toughness (in MPam1/2) for each reinforced group (Fibrestick 2.74 ± 0.12, Construct fibers 2.59 ± 0.28, Ribbond triaxial 2.13 ± 0.20, and orthodontic wire 1.66 ± 0.09) was statistically greater (p< 0.05) than for the unreinforced group (control = 1.25 ± 0.006). Fracture loads for FPDs were greatest when the fiber reinforcements were placed in the cervical third (cervical = 1165 N). Conclusions: The use of fiber and, to a lesser extent, orthodontic wire is an effective method to reinforce interim restoration resins. [source]

Communication Between the Dental Laboratory Technician and Dentist: Work Authorization for Fixed Partial Dentures

JOURNAL OF PROSTHODONTICS, Issue 2 2006
Zahra Afsharzand DMD
Purpose: A questionnaire was sent to laboratory technicians to determine the level of communication between dentists and dental laboratories in specific areas of the work authorization forms for the fabrication of fixed partial dentures. Materials and Methods: A select number of dental laboratories were randomly chosen from the National Association of Dental Laboratories (NADL) for each of the 50 states. The questionnaire was mailed to the laboratory directors for a total of 199 dental laboratories. The survey asked questions pertaining to the following areas of work authorization: legibility and thoroughness of prescriptions, patient information, choice of materials for the prosthesis, design of the prosthesis, and shade description. For each question, the number of responses received was tabulated and converted to a percentage. Results: Of the 199 laboratories surveyed, 114 (57%) responded to the questionnaire. Results from this survey suggest that there is lack of communication between dentists and dental laboratories through work authorization forms regarding choice of metal alloy, type of porcelain to be used, and choice of margin and pontic design for the prosthesis. Conclusions: Information obtained from the responding laboratories included effectiveness of work authorization forms. There were some similar trends indicated by the large percentage of dental laboratories agreeing on lack of communication by the dentists as reflected by the work authorization forms. [source]

Severe periodontal damage by an ultrasonic endodontic device: a case report

DENTAL TRAUMATOLOGY, Issue 2 2007
John D. Walters
Abstract,,, Heat produced within a root canal during use of an ultrasonic instrument can be conducted through the dentin into periodontal ligament, bone and soft tissue. If severe in intensity or long in duration, it can induce damage to these tissues. This report describes a case in which an ultrasonic endodontic instrument apparently induced severe damage to alveolar bone, gingiva and nasal mucosa in a 42-year-old female. Overheating of a maxillary central incisor caused necrosis of soft tissue and bone on the facial and mesial aspects and triggered a protracted inflammatory response in the adjacent nasal cavity. To relieve the severe discomfort associated with this damage, the patient chose to have her maxillary incisors extracted and replaced by a removable partial denture. A defect in the soft tissue and bone was present at a follow-up visit 10 months after the extractions. While morbidity of this nature is rare, this case reinforces the need to maintain adequate cooling of ultrasonic instruments. [source]

A missing denture's misadventure!

DISEASES OF THE ESOPHAGUS, Issue 1 2006
I. Samarasam
SUMMARY.,. We report a late onset, benign, tracheoesophageal fistula in a 51-year-old man, due to an accidentally swallowed denture. In view of the extensive peri-esophageal sepsis and fibrosis, he was managed by a subtotal esophagectomy and a cervical esophagogastric anastomosis. The tracheal defect was closed with the help of an intercostal muscle flap. This report also highlights the difficulty in identifying swallowed prosthetic dental material radiologically, when no metallic component is present. This fact was also responsible for the delay in diagnosis, eventually leading to the rare complication of a tracheoesophageal fistula. [source]

Original article: Assessment of changes in oral health-related quality of life among patients with complete denture before and 1 month post-insertion using Geriatric Oral Health Assessment Index

GERODONTOLOGY, Issue 3 2010
Kamal Shigli
doi:10.1111/j.1741-2358.2009.00323.x Assessment of changes in oral health-related quality of life among patients with complete denture before and 1 month post-insertion using Geriatric Oral Health Assessment Index Objective:, Geriatric Oral Health Assessment Index (GOHAI) is a 12-item measure of "patient-reported oral functional problems" intended for use in the assessment of the effectiveness of dental treatment. Design and Setting:, As there is scanty literature available on GOHAI in the Indian population, the present study was undertaken to assess the changes in GOHAI before and 1 month after placement of dentures in completely edentulous patients reporting to a dental hospital at Indore, India. Measurements:, The GOHAI questionnaire was completed by the examiner who interviewed the patients (n = 35) before placement of complete dentures and 1 month later. Mean, median values were calculated and the data were analysed using Wilcoxon signed-rank test. Results:, When overall mean was considered, the GOHAI scores increased from 27.48 to 30.19 (p = 0.002; highly significant). Conclusion:, Patients reported improvement in functional changes after placement of complete dentures. [source]

Implant overdentures for edentulous elders: study of patient preference

GERODONTOLOGY, Issue 1 2009
Shahrokh Esfandiari
Background:, Studies show that elders wearing implant overdentures have improved nutrition and quality of life. However, upfront costs of this therapy are high, and the income of elderly edentulous populations is low. Objectives:, This study was designed (i) to measure the preferences of edentulous patients for mandibular two-implant overdentures using Willingness-To-Pay (WTP) and Willingness-To-Accept (WTA), (ii) to assess the effect of long-term financing on WTP and (iii) to assess the desired role of health care plans in financing dental prostheses. Methods:, Edentulous elders (68,79 years; n = 36) wearing maxillary dentures and either a mandibular conventional denture (CD, n = 13) or a two-implant overdenture with ball attachments (IOD, n = 23) participated in this study. All had received their prostheses 2 years previously, as part of a randomised clinical trial. A three-part questionnaire was completed during a 20-min interview with a trained researcher. Results:, Forty-six per cent (6/13) of the CD wearers and 70% (16/23) of the IOD wearers were willing to pay three times more than the current cost of conventional dentures for implant prostheses. These percentages were increased to 77% (CD) and 96% (IOD) if participants could pay for implant overdentures in monthly instalments. Eighty-six per cent (31/36) of all participants in both groups (21/23 IOD; 10/13 CD) thought that the government should cover at least some of the cost of implant overdentures. Conclusions:, This study shows that, the majority of elderly edentate individuals who have not experienced mandibular two-implant overdenture therapy are willing to pay the cost, particularly when payment can be made in monthly instalments. [source]

Accelerated rehabilitation of an edentulous patient with an implant retained dental prosthesis: a case report

GERODONTOLOGY, Issue 3 2007
Gerald McKenna
This case report details the successful rehabilitation of an edentulous patient using a complete upper prosthesis and a lower implant retained overdenture. The provision of care was split between a specialist centre and a primary care setting. This approach reduced inconvenience to the patient. Modern surgical and prosthodontic techniques also reduced the total delivery time. After initial consultation a new set of complete dentures was prescribed with changes in design to the originals. The patient was also planned for placement of two mandibular implants to stabilise and retain the mandibular denture. The first line of treatment involved provision of a new set of dentures constructed by the patient's general dental practitioner. Dental implants were then placed in a specialist centre and the patient returned to the dental practice for attachment of the lower denture to the dental implants. The benefits and success of mandibular implant retained dentures are well documented. With delivery of the overdenture, the patient reported increased satisfaction with his prostheses which allowed him to eat a greater range of foods and enabled him to feel confident when speaking and socialising. [source]

Effects of 11-month interventions on oral cleanliness among the long-term hospitalised elderly

GERODONTOLOGY, Issue 1 2007
Petteri Peltola
Objectives:, This trial studied the effects of interventions on the oral cleanliness of the long-term hospitalised elderly. Background:, Oral cleanliness is mostly poor in long-term facilities. While many agree on the importance of oral hygiene education for nursing personnel, little information and agreement exists on how to organise this education in geriatric institutions. Materials and methods:, This is a longitudinal study with interventions. After a baseline clinical examination, the patient wards were divided into three groups (A, B and C) and the type of intervention was randomly assigned. In group A, dental hygienists provided oral hygiene measures for the subjects once every 3 weeks. In group B, the nursing staff first received hands-on instructions after which they assumed responsibility for the subjects' daily oral hygiene. Group C served as a control. Denture hygiene and dental hygiene were recorded at baseline and in the end of the 11-month study period. In total, 130 subjects completed the interventions; their mean age was 82.9 years. Results:, The best outcome in both denture and dental hygiene occurred when nursing staff at the wards took care of hygiene (group B). The increase in the proportion of those with good denture hygiene was the most prominent in group B (from 11% to 56%). The proportion of subjects with poor overall dental hygiene decreased from 61% at baseline to 57% in the end, for group B from 80% to 48%. Conclusions:, Organised oral health education of the nursing staff should receive more attention. [source]

Oral hygiene of elderly people in long-term care institutions , a cross-sectional study

GERODONTOLOGY, Issue 4 2006
Luc M. De Visschere
Objective:, The aim of this cross-sectional study was to assess the level of oral hygiene in elderly people living in long-term care institutions and to investigate the relationship between institutional and individual characteristics, and the observed oral cleanliness. Materials and methods:, Clinical outcome variables, denture plaque and dental plaque were gathered from 359 older people (14%) living in 19 nursing homes. Additional data were collected by a questionnaire filled out by all health care workers employed in the nursing homes. Results:, Only 128 (36%) residents had teeth present in one or both dental arches. About half of the residents (47%) wore complete dentures. The mean dental plaque score was 2.17 (maximum possible score = 3) and the mean denture plaque score was 2.13 (maximum possible score = 4). Significantly more plaque was observed on the mucosal surface of the denture with a mean plaque score of 2.33 vs. 1.93 on the buccal surface (p < 0.001). In the multiple analyses only the degree of dependency on an individual level was found to be significantly correlated with the outcome dental plaque (odds ratio: 3.09) and only the management of the institution with denture plaque (odds ratio: 0.43). Conclusion:, Oral hygiene was poor, both for dentures and remaining teeth in residents in long-term care institutions and only the degree of dependency of the residents and the management of the institutions was associated with the presence of dental plaque and denture plaque respectively. [source]

Oral hygiene and the need for treatment of the dependent institutionalised elderly

GERODONTOLOGY, Issue 2 2006
Sylvie Montal
Objective:, To assessing the oral hygiene and treatment needs of a geriatric institution in southern France. Background:, For various reasons, the care demand from elderly people is low and difficult to determine, whereas their oral status would need long and complicated treatments. Materials and methods:, From 2003 to 2004, a cross-sectional study of 321 elderly patients was conducted at several geriatric services of Montpellier, France. The clinical evaluation of dental status was recorded together with medical information. Dental and prosthetic hygiene, status of dentures, caries experience, dependence conditions and treatment needs were evaluated. Results:, The prevalence of edentulism was 27%, with no gender difference (23% of the men and 29% of the women). Among them, 16.7% (upper jaw) and 18.1% (lower jaw) were totally edentulous with no denture. The mean number of decayed and missing teeth was 3.7 for men and 2.8 for women and 21.5 for men and 21.0 for women, respectively. The mean number of filled teeth was 0.8 for men and 1.3 for women, with no statistical difference according to gender for the three indexes. Most of the subjects needed prostheses (53%), 45.1% extractions and 30.6% conservative treatments. Only 2.4% did not need any treatment. Conclusion:, The prevalence of edentulism was relatively low, while the need for prosthodontic rehabilitation, especially for men, was still very high. The dental hygiene was globally inadequate. This evaluation emphasises the care demand and the need for help in oral hygiene procedures for the dependent institutionalised elderly. [source]

Patients' experiences with partial dentures: a qualitative study

GERODONTOLOGY, Issue 4 2005
Patricia A. Smith
Objective:, The aim of the study was to gain insight into people's experiences of being given and using partial dentures. Methods:, In-depth semi-structured interviews were carried out with 23 people of varied age, social background and denture wearing experience in Tayside, Scotland. Participants were encouraged to discuss how they came to have partial dentures, their day-to-day denture use and their interactions with dentists. The interview data were systematically coded using key theme headings, and summary charts were constructed to facilitate analysis. Results:, The initial decision that a partial denture was needed was generally difficult to accept. People perceived the main benefits of partial dentures to be improved appearance and confidence, but experienced a variety of difficulties with their dentures and often coped with these by only wearing them on social occasions. Participants had not always told their dentists about the difficulties they experienced. Barriers to seeking help with denture problems included financial constraints, previous experience of rushed appointments or poor communication from dentists and a perceived lack of entitlement to help when partial dentures were issued free. Conclusions:, Partial dentures can be difficult to cope with. People experience a range of difficulties in wearing them, not all of which have been discussed with dentists. Informative and supportive communication when partial dentures are first needed, and subsequently, can improve the quality of patients' experiences and may help promote effective use and appropriate help-seeking by partial denture wearers. [source]

Cast titanium overlay denture for a geriatric patient with a reduced vertical dimension

GERODONTOLOGY, Issue 4 2005
Satyabodh Guttal
An older patient reporting to the dental surgery for his/her dental treatment is becoming a common occurrence. Improved oral hygiene has meant that teeth are retained for a longer time, along with the potential problems of attrition, decreased vertical dimension, temporomandibular joint discomfort/strain, and poor aesthetics. The case in question is that of a 65-year-old male patient who had severe attrition in the lower arch, temporomandibular joint pain and reduced vertical dimension. The maxillary arch had previously been restored with a fixed partial prosthesis. For restoration of the lower teeth, a removable cast titanium overlay denture was fabricated incorporating an increased vertical dimension. Porcelain facings were placed to restore the aesthetics of the anterior teeth. The titanium was cast in a semi-automatic electric arc, pressure type casting machine. A titanium overlay denture with porcelain facing on the anterior teeth may provide a means of restoring a patient's concerns regarding aesthetics and function. [source]

Impact of new prostheses on the oral health related quality of life of edentulous patients

GERODONTOLOGY, Issue 1 2005
J. L. Veyrune
Objective:, A study was conducted to evaluate the impact of the placement of complete dentures by using the Global Oral Health Assessment Index (GOHAI). Background:, Oral health quality of life indicators can be used to evaluate the effects of dental treatments. Material and methods:, The 26 participants were treated in a French University Clinic during 2002. They were randomly divided into two groups. Each group received new prostheses, but evaluation of the quality of life was made at different periods [baseline, denture placement (group 1), 6 and 12 weeks (group 2) after placement]. A questionnaire was used to collect information on patient's satisfaction with the previous and new prostheses. Nonparametric tests were used to test the relationships between patients' satisfaction or baseline data and GOHAI variations with time as well as to compare mean values of GOHAI within each group. Results:, At baseline, the impact of oral health problems was apparent; the mean GOHAI-Add score was 45.8 (10.2). Six weeks after placement of the new denture, there was no difference in GOHAI scores compared with the initial assessment. An improvement in GOHAI score was observed 12 weeks after the participants received their new dentures (p < 0.05). Change in GOHAI-Add scores was negatively correlated with the initial GOHAI-Add score. Patients who preferred the new prosthesis enjoyed a positive change in GOHAI scores (p < 0.001). There was a relationship between participants' satisfaction with the new dentures and change in GOHAI scores (p < 0.05). Conclusion:, The GOHAI can be used to evaluate needs for and effect of the making of new complete dentures. [source]

Evaluation of the cost-effectiveness of root canal treatment using conventional approaches versus replacement with an implant

INTERNATIONAL ENDODONTIC JOURNAL, Issue 10 2009
M. W. Pennington
Abstract Aim, To evaluate the cost-effectiveness of root canal treatment for a maxillary incisor tooth with a pulp infection, in comparison with extraction and replacement with a bridge, denture or implant supported restoration. Methodology, A Markov model was built to simulate the lifetime path of restorations placed on the maxillary incisor following the initial treatment decision. It was assumed that the goal of treatment was the preservation of a fixed platform support for a crown without involving the adjacent teeth. Consequently, the model estimates the lifetime costs and the total longevity of tooth and implant supported crowns at the maxillary incisor site. The model considers the initial treatment decisions, and the various subsequent treatment decisions that might be taken if initial restorations fail. Results, Root canal treatment extended the life of the tooth at an additional cost of £5,8 per year of tooth life. Provision of orthograde re-treatment, if the root canal treatment fails returns further extension of the expected life of the tooth at a cost of £12,15 per year. Surgical re-treatment is not cost-effective; it is cheaper, per year, to extend the life of the crown by replacement with a single implant restoration if orthograde endodontic treatment fails. Conclusion, Modelling the available clinical and cost data indicates that, root canal treatment is highly cost-effective as a first line intervention. Orthograde re-treatment is also cost-effective, if a root treatment subsequently fails, but surgical re-treatment is not. Implants may have a role as a third line intervention if re-treatment fails. [source]

Tooth-related risk factors for periodontal disease in community-dwelling elderly people

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010
Toshinobu Hirotomi
Hirotomi T, Yoshihara A, Ogawa H, Miyazaki H. Tooth-related risk factors for periodontal disease in community-dwelling elderly people. J Clin Periodontol 2010; 37: 494,500. doi: 10.1111/j.1600-051X.2010.01565.x. Abstract Objective: While most previous epidemiological studies have focused on subject-level risk factors for periodontal destruction, tooth-related factors have not been fully explored. The purpose of this study was to evaluate both tooth-related and subject-related factors affecting periodontal disease progression using a two-level multilevel model. Material and Methods: A longitudinal survey over a period of 10 years was carried out on 286 community-dwelling elderly subjects aged 70 years at baseline. Clinical attachment level (CAL) was measured at six sites per tooth on all teeth present and periodontal disease progression was defined as CAL3 mm. Results: Periodontal disease progression was found in 79% of the subjects and most frequently in maxillary molars. Multilevel logistic regressions revealed that subjects wearing removable dentures were significantly at risk for periodontal disease progression. Abutment teeth for removable/fixed dentures were also significantly more likely to suffer periodontal breakdown. Furthermore, the following tooth-related variables were found to be possible risk factors for periodontal disease progression: maxillary and multirooted teeth. Conclusion: Multirooted teeth and abutments for a fixed denture were possible risk factors for periodontal disease progression. [source]

Relative effectiveness of powered and manual toothbrushes in elderly patients with implant-supported mandibular overdentures

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2002
A. Tawse-Smith
Abstract Aim: The aim of this study was to compare the clinical effectiveness of a powered toothbrush (Braun Oral-B Plaque Remover 3-D) and a manual soft toothbrush (Oral-B Squish-grip brush) for the control of supragingival plaque and soft tissue inflammation around implants supporting mandibular overdentures. Material and methods: The study sample involved 40 edentulous subjects, aged 55,80 years, having 2 unsplinted mandibular implants supporting a complete removable overdenture opposed by a maxillary complete denture. In this single-blinded, randomised, cross-over clinical trial, two 6-week experimental phases were separated by a 2-week wash-out period. 2 weeks prior to each experimental phase (pre-entry visits), implant abutments were polished to remove all plaque and a standardised instruction in the use of the toothbrush was given. Modified plaque and bleeding indices were recorded at the start and end of each experimental period. Mean index scores at each phase were analysed using paired t -test, and the mean number of sites showing a change in plaque or mucositis were compared using the Mann-Whitney U -test. Combined data from 2 different implant systems were considered after controlling for implant type. Results: Only minor changes in plaque and bleeding scores were observed following the two test periods. There were no statistically significant differences between the manual and powered toothbrushes. Conclusion: Manual and powered brushes were found to be of comparable efficacy with regard to improvement in peri-implant bleeding and plaque indices. Zusammenfassung Zielsetzung: Untersuchung der klinischen Effektivität einer elektrischen Zahnbürste (Braun Oral-B Plaque Remover 3-D) im Vergleich zu einer weichen Handzahnbürste (Oral-B Squish-grip brush) zur Kontrolle supragingivaler Plaque und Weichgewebsentzündung an Implantaten, die Unterkiefer-Totalprothesen tragen. Material und Methoden: Das Untersuchungskollektiv bestand aus 40 zahnlosen Patienten im Alter zwischen 55 und 80 Jahren, die 2 unverblockte Unterkiefer-Implantate zur Unterstützung einer Totalprothese aufwiesen. Der Oberkiefer war jeweils mit einer total schleimhautgetragenen Prothese versorgt. In dieser einfach verblindeten, randomisierten klinischen Cross-over-Studie wurden 2 6-wöchige experimentelle Phasen von einer 2-wöchigen Auswaschperiode unterbrochen. 2 Wochen vor jeder experimentellen Phase wurden die supragingivalen Implantatflächen von sämtlicher Plaque gereinigt und die Patienten erhielten eine Instruktion im Gebrauch der Zahnbürsten. Modifizierte Plaque- und Blutungsindizes wurden zu Beginn und am Ende jeder experimentellen Phase erhoben. Die Mittelwerte für die Indizes wurden mittels des paarigen t -Tests und die Zahl der Stellen, die eine Veränderung in Plaque und Mucositis aufwiesen, wurden durch den Mann-Whitney U -Test verglichen. Die Daten für 2 Implantatsysteme wurden zusammengefasst, nachdem der Einfluss des Implantatsystems überprüft worden war. Ergebnisse: Es wurden nur geringe Veränderungen der Plaque- und Blutungsindizes am Ende beider Testphasen beobachtet. Ein statistisch signifikanter Unterschied zwischen elektrischer und Handzahnbürste konnte nicht gezeigt werden. Schlussfolgerungen: Hand- und elektrische Zahnbürsten erwiesen sich als gleich effektiv für die Verbesserung periimplantärer Plaque- und Blutungsindizes. Résumé But: Le but de cette étude était de comparer l'efficacité clinique d'une brosse à dent électrique (Plaque remover 3D de Braun Oral B) et une brosse souple manuelle (squish grip d'oral B) pour le contrôle de la plaque supra-gingivale et l'inflammation des tissus mous autour d'implants supportant des overdentures mandibulaires. Matériaux et méthodes: L'échantillon étudié comprenait 40 sujets édentés, âgés de 55 à 80 ans, ayant 2 implants mandibulaires non reliés supportant une overdenture amovible complète et une prothèse maxillaire antagoniste complète. Dans cet essai clinique croisé en aveugle simple, randomisée, 2 phases expérimentales de 6 semaines encadraient une période d'arrêt de 2 semaines. 2 semaines avant chaque phase expérimentale, (visite de pré-entrée), les piliers implantaires étaient polis afin d'éliminer toute la plaque et des instructions standardisées d'utilisation de la brosse étaient données. On notait les indices, de saignement et de plaque modifié, au début et à la fin de chaque période expérimentale. Les notes d'indices moyens à chaque phase étaient analysées par le test t apparié et le nombre moyen de sites présentant une modification de la plaque ou de la mucosite était comparé par le test U de Mann Whitney. Les données combinées des 2 systèmes implantaires étaient considérées après cotrôle pour chaque type d'implant Résultats: De minimes modifications des notes de plaque et de saignement étaient observées après les deux périodes de test. Il n'y avait pas de différences statistiques significatives entre les brosses manuelles et électriques. Conclusion: Les brosses manuelles et électriques ont une efficacité comparable du point de vue de l'amélioration des indices de saignement et de plaque peri-implantaires. [source]

Distribution of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia in an Australian population

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2001
S. M. Hamlet
Abstract Background, aim: The present study describes (i) the natural distribution of the three putative periodontopathogens Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actinomycetemcomitans in an Australian population and (ii) the relationship between these organisms, pocket depths and supragingival plaque scores. Methods: Subgingival plaque was collected from the shallowest and deepest probing site in each sextant of the dentition. In total, 6030 subgingival plaque samples were collected from 504 subjects. An ELISA utilising pathogen-specific monoclonal antibodies was used to quantitate bacterial numbers. Results::A. actinomycetemcomitans was the most frequently detected organism (22.8% of subjects) followed by P. gingivalis and P. intermedia (14.7% and 9.5% of subjects respectively). The majority of infected subjects (83%) were colonised by a single species of organism. A. actinomycetemcomitans presence was over-represented in the youngest age group but under-represented in the older age groups. Conversely, P. gingivalis and P. intermedia presence was under-represented in the youngest age group but over-represented in the older age groups. Differing trends in the distribution of these bacteria were observed between subjects depending upon the site of the infection or whether a single or mixed infection was present; however, these differences did not reach significance. Bacterial presence was strongly associated with pocket depth for both A. actinomycetemcomitans and P. gingivalis. For A. actinomycetemcomitans, the odds of a site containing this bacterium decrease with deeper pockets. In contrast, for P. gingivalis the odds of a site being positive are almost six times greater for pockets >3 mm than for pockets 3 mm. These odds increase further to 15.3 for pockets deeper than 5 mm. The odds of a site being P. intermedia positive were marginally greater (1.16) for pockets deeper than 3 mm. Conclusions: This cross-sectional study in a volunteer Australian population, demonstrated recognised periodontal pathogens occur as part of the flora of the subgingival plaque. Prospective longitudinal studies are needed to examine the positive relationship between pocket depth and pathogen presence with periodontal disease initiation and/or progression. Zusammenfassung Hintergrund: Die vorliegende Studie beschreibt: 1.) die natürliche Verteilung der 3 vermutlichen Parodontalpathogene Porphyromonas gingivalis und Prevotella intermedia und Actinobacillus actinomycetemcomitans in einer Australischen Population und 2.) das Verhältnis zwischen diesen Organismen, der Taschentiefe und den supragingivalen Plaquewerten. Methoden: In jedem Sextanten des Gebisses wurde subgingivale Plaque von der flachsten und tiefsten Stelle entnommen. Insgesamt wurden 6030 subgingivalen Plaqueproben bei 504 Personen entnommen. Um die Anzahl der Bakterien zu quantifizieren wurde ein ELISA, welcher mit pathogen-spezifische monoklonale Antikörper arbeitet, verwendet. Ergebnisse:A. actinomycetemcomitans war der Keim, der am häufigsten nachgewiesen wurde (22.8% der Personen), gefolgt von P. gingivalis und P. intermedia (14.7% bzw. 9.5% der Personen). Die Mehrheit der Personen (83%) wurde von einer einzigen Spezies eines Organismus kolonisiert. Das Vorkommen von A. actinomycetemcomitans war in der jüngsten Altersgruppe überrepräsentiert, aber in der älteren Altersgruppen unterrepräsentiert. Im Gegensatz dazu war das Vorkommen von P. gingivalis und P. intermedia in der jüngsten Altersgruppe unterepräsentiert, aber in der älteren Altersgruppen überrepräsentiert. Zwischen der Personen wurden unterschiedliche Trends in der Verteilung dieser Bakterien beobachtet. Diese waren abhängig von der Stelle der Infektion oder ob eine Monoinfektion oder Mischinfektion vorhanden war. Jedoch erreichten diese Unterschiede nicht den Bereich der Signifikanz. Sowohl für A. actinomycetemcomitans als auch P. gingivalis war das Vorkommen von Bakterien stark mit der Taschentiefe assoziiert. Für A. actinomycetemcomitans nimmt die Odds einer Stelle welche das Bakterium enthält mit der Tiefe der Tasche ab. Im Gegensatz dazu ist die Odds einer Stelle die positiv für P. gingivalis ist fast sechsmal größer für Taschen >3 mm als für Taschen 3 mm. Diese Odds erhöht sich weiter auf 15.3 für Taschen die tiefer als 5 mm sind. Die Odds einer Stelle die positive für P. intermedia ist war nur etwas größer (1.16) für Taschen, die tiefer als 3 mm sind. Schlussfolgerung: Diese Querschnittsstudie einer Australischen Population von Freiwillingen zeigte, dass die erkannten Parodontalpathogene ein Bestandteil der Flora der subgingivalen Plaque sind. Prospektive Langzeitstudien sind notwendig, um die positive Beziehung zwischen der Taschentiefe und dem Vorkommen von Pathogenen mit dem Beginn und der Progression einer Parodontalerkrankung zu untersuchen. Résumé Origine: Cette étude décrit (i) la distribution naturelle des 3 parodontopathogènes présume,Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis et Prevotella intermedia dans une population australienne et (ii) la relation entre ces organismes, les profondeurs de poche et les scores de plaque supragingivale. Méthodes: La plaque sous-gingivale a été prélevée sur le site le moins profond et sur le site le plus profond de chaque sextant de la denture. Au total, 6030 échantillons de plaque sous-gingivale ont été prélevés chez 504 sujets. Un test ELISA par anticorps monoclonaux spécifiques des pathogènes a permis de quantifier les nombres de bactéries. Résultats:Actinobacillus actinomycetemcomitans était l'organisme le plus fréquement détecté (22.8%) des sujets) suivi de Porphyromonas gingivalis et Prevotella intermedia (14.7% et 9.5% des sujets, respectivement). La majorité des sujets infectés (83%) étaient colonisés par une unique espèce d'organisme. La présence d'Actinobacillus actinomycetemcomitansétait surreprésentée dans le groupe des plus jeunes mais sous-représentée dans les groupes plus agés. Des tendances différentes de la distribution de ces bactéries étaient observées entre les sujets selon le site d'infection ou la présence d'une infection unique ou mixte. Cependant, ces différences n'étaient pas significatives. La présence bactérienne était fortement associée avec la profondeur de poche pour Actinobacillus actinomycetemcomitans et Porphyromonas gingivalis, pour Actinobacillus actinomycetemcomitans, les chances d'un site de contenir cette bactérie diminuant avec la profondeur de poche, alors que pour Porphyromonas gingivalis, les chances d'un site d'être positif étaient 6× plus grande pour des poches >3 mm que pour les poches 3 mm. Ces chances augmentaient en plus à 15.3 pour les poches >5 mm. Les chances d'un site d'être positif pour P. intermediaétaient légèrement plus importantes pour les poches de plus de 3 mm. Conclusions: Cette étude croisée dans une population volontaire australienne a démontré que des pathogènes parodontaux reconnus font partie de leur plaque sous-gingivale. Des études prospectives longitudinales sont nécessaires pour examiner les relations positives entre la profondeur de poche et la présence de pathogènes et l'initiation et/ou la progression de la maladie. [source]

The intra-oral translocation of periodontopathogens jeopardises the outcome of periodontal therapy

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2001
A review of the literature
Abstract Background: Although periodontitis has a multi-factorial aetiology, the success of its therapy mainly focuses on the eradication/reduction of the exogenous/endogenous periodontopathogens. Most of the species colonise several niches within the oral cavity (e.g. the mucosae, the tongue, the saliva, the periodontal pockets and all intra-oral hard surfaces) and even in the oro-pharyngeal area (e.g., the sinus and the tonsils). Methods: This review article discusses the intra-oral transmission of periodontopathogens between these niches and analyses clinical studies that support the idea and importance of such an intra-oral translocation. Results and conclusions: Based on the literature, the oro-pharyngeal area should indeed be considered as a microbiological entity. Because untreated pockets jeopardise the healing of recently instrumented sites, the treatment of periodontitis should involve "a one stage approach" of all pathologic pockets (1-stage full-mouth disinfection) or should at least consider the use of antiseptics during the intervals between consecutive instrumentations, in order to prevent a microbial translocation of periodontopathogens during the healing period. For the same reason, regeneration procedures or the local application of antibiotics should be postponed until a maximal improvement has been obtained in the remaining dentition. This more global approach offers significant additional clinical and microbiological benefits. Zusammenfassung Grundlagen: Obwohl die Parodontitis eine multifaktorielle Ätiologie hat, konzentriert sich der Erfolg ihrer Therapie hauptsächlich auf die Eliminierung/Reduktion der exogenen/endogenen Parodontalpathogene. Die meisten dieser Spezies kolonisieren verschiedene Nischen innerhalb der Mundhöhle (z.B. die Schleimhäute, die Zunge, den Speichel, die parodontalen Taschen und alle intraoralen Hartgewebe) und sogar den oro-pharyngealen Bereich (z.B. die Nebenhöhlen und die Tonsillen). Methoden: Dieser Übersichtartikel diskutiert die intraorale Übertragung von Parodontalpathogenen zwischen diesen Nischen und analysiert klinische Studien, die die Idee und Wichtigkeit dieser intraoralen Übertragung unterstützen. Ergebnisse und Schlussfolgerung: Auf der Grundlage der Literatur sollte der oro-pharyngeale Bereich in der Tat als eine mikrobiologische Einheit angesehen werden. Weil unbehandelte Taschen die Heilung von kürzlich instrumentierten Stellen gefährden, sollte die Behandlung der Parodontitis ein einzeitiges Vorgehen bei allen pathogenen Taschen beinhalten (einzeitige vollständige Mundhöhlen-Desinfektion). Oder es sollten wenigsten die Verwendung von antiseptischen Mitteln während der Intervalle zwischen aufeinanderfolgenden Instrumentierungen erwogen werden, um die mikrobielle Übertragung von Parodontalpathogenen während der Heilungsphase zu verhindern. Aus dem gleichen Grunde sollten regenerative Maßnahmen oder die lokale Applikation von Antibiotika so lange verschoben werden, bis eine maximale Verbesserung im restlichen Gebiss erzielt wurde. Dieser globalere Ansatz liefert zusätzliche signifikante klinische und mikrobiologische Vorteile. Résumé Origine: Bien que la parodontite ait une étiologie multifactorielle, le succès de son traitement repose principalement sur l'éradication/réduction des bactéries parodontopathogènes exogènes/endogènes. La plupart des espèces colonisent plusieurs niches au sein de la cavité buccale (par exemple, les muqueuses, la langue la salive, les poches parodontales et toutes les surfaces dures intraorales), et même dans la zone oro-pharyngée (par example, les sinus et les amygdales). Méthodes: Cette revue critique discute la transmission intra-buccale des pathogènes parodontaux entre ces niches et analyse les études clinique qui soutiennent l'idée et l'importance d'une telle translocation intra-buccale. Résultats et conclusions: D'après la littérature, la zone oro-pharyngée peut vraiment être considérée comme une entité microbiologique. Puisque les poches non traitées compromettent la cicatrisation des sites récemment instrumentés, le traitement de la parodontite devrait impliquer une approche en une étape de toutes les poches pathologiques (désinfection de toute la bouche en une étape) ou devrait au moins considérer l'utilisation d'antiseptiques pendant les intervals entre deux instrumentations successives, de façon à prévenir une translocation bactérienne des pathogènes parodontaux pendant la période de cicatrisation. Pour la même raison, les procédures de régénération ou les applications locales d'antibiotiques devraient être remises jusqu'à ce qu'une amélioration maximale ait été obtenue sur le reste de la denture. Cette approche plus globale donne des bénéfices cliniques et microbiologiques supplémentaires significatifs. [source]

Correlation between the Individual and the Combined Width of the Six Maxillary Anterior Teeth

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 3 2009
LUIZ CARLOS GONÇALVES DMD
ABSTRACT Purpose:, There is a consensus in the community of dental research that the selection of undersized artificial maxillary anterior teeth offers an unnatural appearance to the denture. Several methods to select the adequate width of these teeth are of questionable validity, and many dentures have an obviously artificial appearance. This article assessed the relationship between the individual and the combined width of maxillary anterior teeth. Materials and Methods:, Impressions were made of the anterior dentition of 69 dentate undergraduate students with rubber impression silicon, and casts were formed. The individual widths of the maxillary anterior teeth were measured by using a digital caliper (SC-6 digital caliper, Mitutoyo Corporation, Tokyo, Japan), and the combined width was registered by both adding the individual width and using a flexible millimeter ruler. Results:, Student's t -test showed significant differences between the analogous teeth and different sides of the maxillary dental arch (p = 0.001), with the exception of the central incisor (p = 0.984). Pearson's product moment correlation coefficient showed significant positive correlation between all the measurements compared (p = 0.000). Linear regression analysis concluded three mathematical equations to obtain the individual tooth width after measuring the combined width of the six maxillary anterior teeth by using a flexible millimeter ruler. Conclusions:, The individual tooth width can be determined if the combined width of the maxillary anterior teeth is obtained by using a flexible millimeter ruler. CLINICAL SIGNIFICANCE The adequate selection of each maxillary anterior tooth width can offer variance and individuality to the denture, particularly for partially dentate patients. By offering an adequate tooth-to-tooth relationship, the esthetic result of the oral rehabilitation treatment can be improved. [source]

The Teaching of Denture Marking Methods in Dental Schools in the United Kingdom and the United States,

JOURNAL OF FORENSIC SCIENCES, Issue 6 2009
M.Phil, Raymond Richmond B.Sc.
Abstract:, Forensic organizations worldwide have recommended that dental prostheses should be marked with, at a minimum, the patient's name and preferably with further unique identifiers such as a social security number. The current study aimed to assess the denture marking practice of dental schools within the United States and the United Kingdom. A questionnaire-based survey was employed to gain both quantitative and qualitative data on the methods, practices, and ethos behind denture marking in 14 U.K. and 32 U.S. dental schools. One hundred percent of U.K. and 87.5% of U.S. schools returned surveys and the results suggest that, for dental schools where there is no legal or legislative need for denture marking, the practice is inconsistently taught and appears to be reliant on internal forces within the school to increase awareness. Among those schools practicing marking, only 18% employ a technique likely to withstand common postmortem assaults; this is a concern. [source]

Mode of HIV transmission associated with risk of oral lesions in HIV-infected subjects in Thailand

JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 2 2010
W. Nittayananta
J Oral Pathol Med (2010) 39 195,200 Background:, The aim of this study was to determine if route of human immunodeficiency virus (HIV) transmission is associated with the risk of oral lesions in HIV-infected subjects in Thailand. Methods:, A cross-sectional study was performed in 186 HIV-infected heterosexuals (aged 21,65 years, mean 32 years), and 82 HIV-infected intravenous drug users (IVDUs) (aged 16,50 years, mean 30 years). The following information was recorded: route of HIV transmission, total lymphocyte cell counts, weight, smoking habit, alcohol consumption, medications, presence of denture, plaque index, and presence of oral lesions. The association between mode of HIV transmission and the risk of oral lesions among the subjects was determined by multiple logistic regression analysis. Results:, Oral lesions were found in 138 HIV-infected heterosexuals (75%) and in 37 HIV-infected IVDUs (46%). Oral candidiasis (OC) was the most common lesion among both groups (44% vs. 28%), followed by hairy leukoplakia (HL) (33% vs. 10%). Multiple logistic regression analysis showed a significant association between mode of HIV transmission and the risk of oral lesions after controlling for the total lymphocyte cell counts and other confounding factors [OR 3.1; 95% CI 1.5,6.4; P = 0.002]. OC was significantly associated with heterosexual route of HIV transmission [OR 2.4; 95% CI 1.2,4.7; P = 0.014]. Similar association was also observed with HL [OR 3.7; 95% CI 1.5,9.1; P = 0.004]. Conclusions:, Mode of HIV transmission is associated with the risk of oral lesions in HIV-infected subjects in Thailand. Further studies should be performed to determine if the risk of oral lesions is associated with differences in HIV-subtypes. [source]

Effect of direct retainer and major connector designs on RPD and abutment tooth movement dynamics

JOURNAL OF ORAL REHABILITATION, Issue 11 2008
H. ITOH
Summary, Designs of removable partial dentures are suggested to affect the mobility of abutment teeth and removable partial denture (RPD) during oral functions. This study aimed to examine the effect of direct retainer and major connector designs on RPD dynamics under simulated loading. Six different Kennedy class II maxillary RPDs were fabricated on a maxillary model. These dentures involved 3 different direct retainers (wrought-wire clasp, RPA clasp, and conical crown telescopic retainer) and 2 different major connectors (Co-Cr major connector and heat-cured acrylic resin with a metal strengthener). Using an experimental model with simulated periodontal ligaments and mucosa that were fabricated using silicone impression material, three-dimensional displacements of the RPDs were measured under a simulated 30-N loading with a displacement transducer type M-3. Significant effects of "direct retainer design" on bucco-palatal displacements and "major connector" on mesio-distal displacements were revealed by 2 × 3 two-way analysis of variance of abutment teeth movements (P < 0·001 and P = 0·002, respectively). Additionally, analysis of variance of RPD displacements revealed significant effects of "direct retainer design" on corono-apical displacements and "major connector" on mesio-distal displacements (P = 0·001 and P = 0·028, respectively). Rigid direct retainers and rigid major connectors decrease the movements of both abutment tooth and RPD. [source]

Removable prosthodontic services, including implant-supported overdentures, provided by dentists and denturists

JOURNAL OF ORAL REHABILITATION, Issue 4 2008
J. G. EGAN
Summary, The aim of this study was to evaluate the provision of removable prosthodontic services, including implant-supported overdentures, by dentists and denturists. A structured questionnaire was mailed to 474 randomly chosen dentists and 156 denturists registered to practise in New Zealand. Information was sought on the range of removable prosthodontic services provided (including implant-supported overdentures) and the professional fees charged for them. From 410 respondents, there was an overall response rate of 67.43%; 290 came from the dentists (males 78.6%, n = 228; females 21.48%, n = 62) and 120 from denturists (males 91.7%, n = 110; females 8.3%, n = 10). Most respondents were over 40 years of age, with one in three denturists (but only one in seven dentists) over 60 years of age. The extent of removable prosthodontic services varied. One-third of dentists referred complete denture patients and denturists referred a similar number of immediate denture cases. Denturists' complete denture, immediate denture and single reline prices were generally lower than those from dentists. Removable partial denture prices were similar. Implant-supported overdentures were recommended for edentulous patients by one-third of the dentists and three out of four denturists. Forty per cent of denturists (but only 10% of dentists) charged dentures. (1NZ$ = US$ 0.75; 1NZ$ = , 0.56; 1NZ$ = GBP 0.38) Implant-supported overdenture fees were predominantly in the range of NZ$1500,3000 for both groups, but one in four dentists and one in six denturists charged more than NZ$3000. Although both denturists and dentists both provide prosthodontic services, there is a professional fee differential between them. Denturists' lower fees provide a more economic option. Denturists are likely to steadily develop further inroads into the implant-supported overdenture market. [source]

Validation of video versus electromyography for chewing evaluation of the elderly wearing a complete denture

JOURNAL OF ORAL REHABILITATION, Issue 8 2007
E. NICOLAS
summary, Chewing efficiency may affect nutritional status in the elderly. Many elderly patients are complete denture wearers, and often present cognitive problems. Those two factors make evaluation of mastication difficult with experimental methods. Analysis of video recording may be a simple way to routinely assess chewing parameters. This study aimed at validating several parameters of video evaluation versus electromyography (EMG), which is considered the ,gold standard'. The design was a prospective randomized study, carried out at the Faculty of Dentistry, University of Auvergne, Clermont-Ferrand, France. Twelve complete denture wearers chewed four model foods differing in hardness. Sessions were videotaped and EMG recordings were registered. Mastication time, number of masticatory cycles and cleaning time were recorded simultaneously by video and EMG. Two investigators independently analyzed the videos twice, in random order. Evaluation of criterion validity: a positive video/EMG correlation was found for the parameters ,chewing time' (0·89, Pearson) and ,number of masticatory cycles' (0·94, Spearman), whereas no statistical difference was found between these two EMG and video variables (t -test). Inter and intra-rater reliability gave a positive intraclass coefficient (ICC) for duration of mastication (0·86,0·98), number of masticatory cycles (0·90,0·97) and cleaning time (0·90,0·98). Discriminatory ability was studied using anova (P = 0·01): variation was significant in masticatory duration (F = 10), number of masticatory cycles (F = 10) and cleaning time (F = 4). Video may be a useful assessment tool in prosthetic rehabilitation and can be applied to help choose the type of food (solid, semi-liquid or liquid) to administer to dependent persons, particularly those suffering from dementia. [source]

Effect of adding impression material to mandibular denture space in Piezography

JOURNAL OF ORAL REHABILITATION, Issue 6 2006
K. IKEBE
summary, The purpose of the study was to examine the effect of adding impression material on denture space using a piezographical record. Subjects were ten voluntary edentulous patients, aged from 61 to 84 years old. A maxillary trial denture with anterior artificial teeth and a mandibular base plate with a keel were inserted into the oral cavity. Three ml of tissue-conditioning materials was injected on the base plate for each trial. Afterwards, the patients were instructed to pronounce various phonemes, so that tongue, cheeks and lips conformed to the denture space. The impression complexes were cut at the level of the estimated occlusal plane. Occlusal analogues were made by duplicating the impression complexes. Measurements were performed for five analogues from the first to fifth additions for each subject. The data were compared using analysis of variance (ANOVA), and a Friedman's test followed by a Bonferroni test for multiple comparisons with a level of significance at 5%. At the molar and premolar positions, the bucco-lingual widths of the occlusal table increased significantly at incremental injection of impression materials from P1 to P4. The midpoints of the analogues were located at a distance of 1.5 mm buccally at the molar position and at a distance of 1.9 mm buccally at the premolar position from the top of the alveolar crest, independent of the addition of impression material. It was concluded that denture space was regulated by volume of material and was located slightly on the buccal side from the crest of the residual alveolar ridge. [source]

Quality of life and masticatory function in denture wearers

JOURNAL OF ORAL REHABILITATION, Issue 5 2006
H. KOSHINO
summary, Successful prosthodontic treatments for a patient with removable partial dentures including maxillofacial prostheses hopefully brings about psychological wellbeing as well as improved health. The purpose of this study was to investigate the relationship between quality of life (QOL) and the various aspects of denture function. At first, a questionnaire with a visual analog scale with 16 question items concerning denture and/or eating problems, the present state of health, psychological and physical wellbeing, life satisfaction, and QOL was developed. To discuss the validity and reliability of the questionnaire, 48 outpatients who wore a denture were asked to fill it out. Next, to discuss the difference in QOL of the patient with various kinds of dentures and conditions, 103 outpatients were asked to complete the newly developed questionnaire. The questionnaire which contained four factor areas with eight questions for denture patients was developed by factor analysis with Varimax rotation. The reliability of the QOL scale was confirmed by reliability analysis (Cronbach's ,=0·784). The QOL score of edentulous patients with a complete denture having some trouble chewing was significantly lower than that of other denture patients. It was suggested that the wearing of a denture significantly affected the QOL of elderly persons. [source]

Surface EMG of jaw-elevator muscles and chewing pattern in complete denture wearers

JOURNAL OF ORAL REHABILITATION, Issue 12 2005
M. G. PIANCINO
summary, The aim of this study was to investigate the adaptation process of masticatory patterns to a new complete denture in edentulous subjects. For this purpose, muscle activity and kinematic parameters of the chewing pattern were simultaneously assessed in seven patients with complete maxillary and mandibular denture. The patients were analysed (i) with the old denture, (ii) with the new denture at the delivery, (iii) after 1 month and (iv) after 3 months from the delivery of the new denture. Surface electromyographic (EMG) signals were recorded from the masseter and temporalis anterior muscles of both sides and jaw movements were tracked measuring the motion of a tiny magnet attached at the lower inter-incisor point. The subjects were asked to chew a bolus on the right and left side. At the delivery of the new denture, peak EMG amplitude of the masseter of the side of the bolus was lower than with the old denture and the masseters of the two sides showed the same intensity of EMG activity, contrary to the case with the old denture. EMG amplitude and asymmetry of the two masseter activities returned as with the old denture in 3 months. The EMG activity in the temporalis anterior was larger with the old denture than in the other conditions. The chewing cycle width and lateral excursion decreased at the delivery of the new denture and recovered after 3 months. [source]