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Complete Dentures (complete + denture)
Kinds of Complete Dentures Terms modified by Complete Dentures Selected AbstractsClinical quality of removable dentures provided by dentists, denturists and laboratory techniciansJOURNAL OF ORAL REHABILITATION, Issue 4 2003R. Tuominen summary, The aim of this study was to evaluate the clinical quality of removable dentures of elderly Finnish men, which had been prepared either by dentists, denturists or dental laboratory technicians. The participants comprised 242 denture-wearing subjects, with 231 maxillary and 177 mandibular removable dentures which had been prepared either by dentists, denturists or dental laboratory technicians. Clinical examinations were carried out without the examining dentist knowing who had provided the dentures. Complete dentures which had been illegally provided by laboratory technicians had significantly poorer retention and fitted less well in tuber and alveolar areas than those provided by either dentists or denturists. Complete maxillary dentures which had been provided illegally by laboratory technicians had significantly (P < 0·01) higher occurrence (90%) of some unacceptable characteristics than those (43%) provided by dentists or denturists. The difference between complete mandibular dentures was also obvious, 86% versus 59%, although statistically non-significant. Of those partial maxillary dentures provided by dentists 53% had some unacceptable characteristics, compared with 80% of those illegally provided by denturists or laboratory technicians (NS). In the case of partial mandibular dentures, 36% of those provided by dentists and 32% of those by denturists or laboratory technicians had some unacceptable characteristic (NS). Illegal provision of removable dentures seemed to be related to decreased clinical quality. [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 IndexGERODONTOLOGY, Issue 3 2010Kamal 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] Relative effectiveness of powered and manual toothbrushes in elderly patients with implant-supported mandibular overdenturesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2002A. 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] Removable prosthodontic services, including implant-supported overdentures, provided by dentists and denturistsJOURNAL OF ORAL REHABILITATION, Issue 4 2008J. 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 Validation of video versus electromyography for chewing evaluation of the elderly wearing a complete dentureJOURNAL OF ORAL REHABILITATION, Issue 8 2007E. 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] Quality of life and masticatory function in denture wearersJOURNAL OF ORAL REHABILITATION, Issue 5 2006H. 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 wearersJOURNAL OF ORAL REHABILITATION, Issue 12 2005M. 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] Finite element analysis of the effect of the bucco-lingual position of artificial posterior teeth under occlusal force on the denture supporting bone of the edentulous patientJOURNAL OF ORAL REHABILITATION, Issue 6 2003G. Nishigawa summary, To improve the quality of the complete denture prosthesis, the bucco-lingual position of the artificial posterior teeth must be determined with consideration of the shape of the maxillary and mandibular residual ridge and the relationship between them. The arrangement of posterior artificial teeth should be considered not only for the denture stability but also for the avoidance of high pressure on the supporting structures. A two-dimensional finite element method program to investigate the statics for the contour of the complete denture and the residual ridge was developed. With this program, the effect of the bucco-lingual position of the artificial posterior teeth under occlusal force on the denture supporting bone could be investigated. [source] Maximum bite force after the replacement of complete denturesJOURNAL OF ORAL REHABILITATION, Issue 9 2002F. MÜLLER In complete denture wearers the maximum bite force (MBF) is known to be considerably lower than in dentate people. Low MBF might therefore be an indication of poor denture fit but there is limited evidence on this. Therefore, the aim of the present study was to investigate whether MBF can be improved by the replacement of complete dentures for elderly people. Nine edentulous volunteers, average age 74·2 ± 5·5 years and average denture experience 19·4 ± 19·5 years (1,50 years), had replacement dentures made. Functional impressions were taken after border moulding using zinc oxide eugenol paste. After a rehearsal session, MBF was recorded with the old dentures, and with the new dentures immediately at insertion, at 3, 8 days, 2,3 weeks, 1, 2, 3 and 6,10 months post-insertion (p.i.). The MBF was recorded with the central bearing point method using a full-bridge strain gauge with a confirmed linearity from 1 to 1000 N and an accuracy of ±1 N. Data were analysed off-line using the mean of two peak readings per patient per session. The results indicate that MBF tended to be impaired when replacement dentures were first fitted (n.s.). However, this trend reversed during the first month p.i. for patients with a ,moderate' lower ridge resorption of Atwood (1963) grade 3 or 4 (n=5). Patients with more severe lower ridge resorption (Atwood grade 5 or 6; n=4) showed a significantly lower MBF over the entire observation period (P=0·05) and took longer to regain bite strength. Only patients with moderate bone resorption exceeded their pre-insertion level of MBF within the observation period of 6,10 months p.i. In contrast to one report of immediate improvement of MBF at insertion of a new or relined denture (Leyka et al., 2000), the present study suggests that, at least for elderly patients with severe bone resorption, delayed improvement of MBF should be expected. [source] Comparison of oral sensory function in complete denture and implant-supported prosthesis wearersJOURNAL OF ORAL REHABILITATION, Issue 3 2001Kyung-Soo Jang In order to compare the differences of part of the oral sensory functions among natural dentition, complete denture wearers and implant-supported prostheses wearers, tactile and pressure awareness was measured. Tactile sense was estimated by the thickness perception threshold between upper and lower dentition. Sensibility of pressure feeling was evaluated by threshold of lateral loading on tooth. Within this limited experiment, it could be concluded that an osseointegrated root form implant helped towards restoration of oral sensory functions. [source] Acellular dermal allograft for vestibuloplasty,an alternative to autogenous soft tissue grafts in preprosthetic surgical procedures: A clinical reportJOURNAL OF PROSTHODONTICS, Issue 2 2003Monish Bhola DDS Various vestibular extension procedures have been described in the literature over the past 6 decades, including the use of free gingival grafts. An acellular dermal allograft has been used as a substitute for autogenous soft tissue grafts in root coverage procedures. This clinical report describes the use of such an allograft as a substitute for palatal donor tissue in the vestibular extension of an edentulous maxillary arch with multiple frenum attachments before fabrication of a complete denture. In this patient, healing was uneventful, and 6-month clinical observations demonstrated an apical positioning of the mucogingival junction with an increase in vestibular depth, and the absence of multiple frenae. The acellular dermal allograft appears to be a useful substitute for autogenous palatal grafts in preprosthetic surgery. This approach has many advantages over the free gingival graft, including no donor site morbidity, unlimited availability, and better color match. [source] Differential diagnosis of denture-induced stomatitis, Candida, and their variations in patients using complete denture: a clinical and mycological studyMYCOSES, Issue 3 2009Saadettin Da, istan Summary Denture-induced stomatitis usually occurs in persons who wear a complete or a partial denture. Among the many aetiological and predisposing factors, Candida spp. are believed to play an important role in the initiation and progression of the infection. Seventy cases who attended the clinics of the Dental Faculty, University of Atatürk, Turkey were investigated from the viewpoint of denture-induced stomatitis. After questioning the patients for their personal information, they were examined clinically and smears were obtained from lesions of the palatal mucosa and the contiguous denture surface by calcium aliginate swabs, and inoculated onto Sabouraud dextrose agar supplemented with 1% chloramphenicol, and CHROMagar Candida. Individual yeast species were identified by a germ tube test, development of blastospores, chlamydospores and pseudohyphae and assimilation tests employing the commercial kit API 20C AUX system. According to the results obtained, 70% of the cases had denture-induced stomatitis, and in 68% of them mycological culture results were positive. Candida albicans was the most frequently isolated fungus (68.75%). On the other hand, fungal growth was much more pronounced in the cultures made from the inner surface of the dentures. In conclusion, this study showed that candidal infections are not the predisposing factor in the occurrence of denture-induced stomatitis, but they play a major role, as also some other factors, especially those related with dentures. [source] Immediate Loading of Two Implants Supporting a Ball Attachment-Retained Mandibular Overdenture: A Prospective Clinical StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2007Riccardo Marzola DDS ABSTRACT Background:, A prospective clinical study was conducted to evaluate clinically and radiographically the performance of two implants immediately loaded supporting a ball attachment-retained mandibular overdenture. Materials and Methods:, Seventeen completely edentulous patients were included in the study. Each patient received two implants inserted after a minimal flap reflection and no vestibular extension in order to reduce the postoperative swelling and facilitate immediate prosthesis connection. After implant placement, a mandibular complete denture was connected to the implants using ball attachments of appropriate height according to the depth of the peri-implant tissue. Patients were asked not to remove the denture for 1 week. No limitations to chewing function were given. At implant placement, the maximum value of insertion torque was recorded. Patients were examined at 1, 2, 4, 12, and 52 weeks postsurgery. At postoperative visit, occlusion was checked and the need for any prosthesis maintenance was recorded. The radiographic bone level (RBL) change was measured on periapical radiographs at baseline and 12 months after loading. Results:, After 12 months of loading, no implant failure was reported and the survival rate was 100%. Average RBL change was 0.7 mm ± 0.5 mm. Of the 17 cases, two had major prosthetic complications and five patients required minor extra maintenance appointments. Conclusions:, The immediate loading of two implants by means of ball attachment-retained mandibular complete denture may be a predictable treatment option. This clinical approach offers increased stability and comfort, while keeping a high implant success rate. [source] The Marius Implant Bridge: Surgical and Prosthetic Rehabilitation for the Completely Edentulous Upper Jaw with Moderate to Severe Resorption: A 5-Year Retrospective Clinical StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2002Yvan Fortin DDS ABSTRACT Background: Patients seeking replacement of their upper denture with an implant-supported restoration are most interested in a fixed restoration. Accompanying the loss of supporting alveolar structure due to resorption is the necessity for lip support, often provided by a denture flange. Attempts to provide a fixed restoration can result in compromises to oral hygiene based on designs with ridge laps. An alternative has been an overdenture prosthesis, which provides lip support but has extensions on to the palate and considerations of patient acceptance. The Marius bridge was developed as a fixed bridge alternative offering lip support that is removable by the patient for hygiene purposes, with no palatal extension beyond normal crown-alveolar contours. Purpose: Implant-supported restorative treatment of completely edentulous upper jaws, as an alternative to a complete denture, is frequently an elective preference, and it requires significant patient acceptance beyond the functional improvement of chewing. Patients with moderate to severe bone resorption and thin ridges present additional challenges for adequate bone volume and soft-tissue contours. The purpose of this investigation was to develop a surgical and prosthetic implant treatment protocol for completely edentulous maxillae in which optimal lip support and phonetics is achieved in combination with substantial implant anchorage without bone grafting. Materials and Methods: The Marius bridge is a complete-arch, double-structure prosthesis for maxillae that is removable by the patient for oral hygiene. The first 45 consecutive patients treated by one person (YF) in one center with this concept are reported, with 245 implants followed for up to 5 years after prostheses connection. Results: The cumulative fixture survival rate for this 5-year retrospective clinical study was 97%. Five fixtures failed before loading, in five different patients, and two fixtures in the same patient failed at the 3-year follow-up visit. None of the bridges failed, giving a prostheses survival rate of 100%. The complications were few and mainly prosthetic: nine incidences of attachment component complications, one mesobar fracture, and three reports of gingivitis. All complications were solved or repaired immediately, with minimal or no interruption of prostheses use. Conclusions: Satisfactory medium-term results of survival and patient satisfaction show that the Marius bridge can be recommended for implant dentistry. The technique may reduce the need for grafting, because it allows for longer implants to be placed with improved bone anchorage and prostheses support. [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 IndexGERODONTOLOGY, Issue 3 2010Kamal 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] Should edentulous patients be constrained to removable complete dentures?GERODONTOLOGY, Issue 1 2010The use of dental implants to improve the quality of life for edentulous patients doi:10.1111/j.1741-2358.2009.00294.x Should edentulous patients be constrained to removable complete dentures? The use of dental implants to improve the quality of life for edentulous patients Background:, Nowadays, there is some speculation among dental educators that the need for complete dentures will significantly decrease in the future and that training in their provision should be removed from the dental curriculum. Objective:, To sensitise the reader to the functional shortcomings of complete denture therapy in the edentulous patient and present restorative options including implants to improve edentulous quality of life in these patients. Methods:, Information retrieval followed a systematic approach using PubMed. English articles published from 1964 to 2008, in which the masticatory performance of patients with implant-supported dentures was assessed by objective methods and compared with performance with conventional dentures, were included. Results:, National epidemiological survey data suggested that the adult population in need of one or two complete dentures will increase from 35.4 million adults in 2000 to 37.9 million adults in 2020. Clinical studies have showed that the ratings of general satisfaction were significantly better in the patients treated with implant overdentures post-delivery compared with the complete denture users. In addition, the implant group gave significantly higher ratings on comfort, stability and ability to chew. Furthermore, patients who received mandibular implant overdentures had significantly fewer oral health-related quality of life problems than did the conventional group. Conclusion:, Implant-supported dentures including either complete overdentures or a hybrid prosthesis significantly improve the quality of life for edentulous patients compared with conventional removable complete dentures. Therefore, the contemporary dental practitioner should consider other options as well as conventional removable complete dentures to restore edentulous patients. [source] Accelerated rehabilitation of an edentulous patient with an implant retained dental prosthesis: a case reportGERODONTOLOGY, Issue 3 2007Gerald 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] Oral hygiene of elderly people in long-term care institutions , a cross-sectional studyGERODONTOLOGY, Issue 4 2006Luc 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] Bonding acrylic teeth to acrylic resin denture bases: a reviewGERODONTOLOGY, Issue 3 2006S. B. Patil Partial or complete dentures are more commonly constructed for the elderly group of the population. Teeth debonding from the dentures can be frustrating to the patients as well as the dentist. Research has been carried out and is continuing to study the issue of bonding acrylic teeth to the denture base resin. The present review takes into account the majority of research papers published in the last five decades for determining the bond strength. Selection of more compatible combinations of denture base resins and acrylic teeth may reduce the number of prosthesis fractures and the resultant repairs. [source] Impact of new prostheses on the oral health related quality of life of edentulous patientsGERODONTOLOGY, Issue 1 2005J. 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] Responses of jawbone to pressure,GERODONTOLOGY, Issue 2 2004Gunnar E. Carlsson Objective:, To provide a literature review of bone resorption of edentulous jaws focusing on responses to pressure. Background:, After the extraction of all teeth in a jaw there is a continuous reduction of the residual ridge. The individual variation of bone resorption is great, and the aetiology is complex and not yet well understood. Materials and methods:, A search of the literature published up to May 2003 on bone resorption and pressure was performed using PubMed/Medline. Results:, Animal studies have demonstrated that excessive and constant pressure induces bone resorption. Recent experimental research has indicated that bone resorption is a pressure-regulated phenomenon with a lower threshold for continuous than for intermittent pressure. Clinical studies have suggested that residual ridge resorption is due more to the effects of denture wearing than to disuse atrophy. However, the results of leaving out dentures at night are not conclusive. Nor does the literature offer any strong evidence for the so-called combination syndrome, which has been described as a result of unfavourable loading. Clinical studies using multivariate analyses indicate that female gender and systemic factors may be of greater importance than oral and denture factors. Implant-supported prostheses have a bone preserving effect rather than the continuing resorption under complete dentures. Conclusions:, The best way to reduce bone resorption is to avoid total extraction, preserve a few teeth and fabricate overdentures. In edentulous jaws, placement of implant-supported prostheses will lead to less bone loss and may even promote bone growth. To increase our knowledge of residual ridge resorption extended experimental, clinical and statistical methods will be needed, preferably including collaboration between dental and medical researchers. [source] Bronchopneumonia and oral health in hospitalized older patients.GERODONTOLOGY, Issue 2 2002A pilot study Abstract Aims: To correlate microbial findings obtained by bronchoalveolar lavage in pneumonia patients with the clinical situation of the oral cavity. Method: Quantitative aerobic and anaerobic cultures were carried out in 150 ml samples of bronchoalveolar lavage (BAL) obtained by means of an endoscope (Video Endoscope Pentax®) inserted per as in the infected bronchus. Material: Twenty consecutive patients with a tentative clinical diagnosis of bronchopneumonia in whom BAL was carried out for diagnostic purposes. A clinical evaluation of the oral health status (oral hygiene, caries, periodontal diseases) was subsequently carried out. Results: In seven edentulous subjects wearing complete dentures the culture of anaerobic microorganisms was negative or yielding less than 100 cfu/ml BAL. Two patients yielded high counts of S. aureus and one high counts of P. aeruginosa. In the 13 subjects with natural teeth left one showed high counts of Veillonella spp. (anaerobic)+P. aeruginosa, one high counts of Veillonella spp. +S. aureus, one high counts of P. aeruginosa + S. aureus and one high counts of E. coli. These four subjects showed poor oral hygiene, periodontal pockets and a BAL microflora consistent with periodontal pathology. Conclusion: The results of this pilot study suggest that microorganisms of denture plaque or associated with periodontal diseases may give rise to aspiration pneumonia in susceptible individuals. [source] The influence of age and dental status on elevator and depressor muscle activityJOURNAL OF ORAL REHABILITATION, Issue 2 2006I. Z. ALAJBEG summary, The objective of this study was to determine whether the muscle activity at various mandibular positions is affected by age and dental status. Thirty edentulous subjects (E), 20 young dentate individuals (G1) and 20 older dentate individuals (G2) participated in this study. Surface electromyographic (EMG) recordings were obtained from the anterior temporal (T), masseter (M) and depressor muscles (D). Muscle activity was recorded during maximal voluntary contraction (MVC), maximal opening (Omax) and in six different mandibular positions. One way anova and the Bonferroni tests were used to determine the differences between groups. Significant differences between the three tested groups were found at MVC and Omax for all examined muscles (P < 0·001). The differences in muscle activity in dentate subjects of different age were found in protrusion for depressor muscles (P < 0·05) and in lateral excursive positions for the working side temporal (P < 0·05) and non-working side masseter and depressor muscle (P < 0·05). There was a significant effect regarding the presence of natural teeth or complete dentures in protrusion and maximal protrusion for all muscles (P < 0·05) and in lateral excursive positions for non-working side temporal (P < 0·05) and working side masseter muscle (P < 0·05). Muscle activity at various mandibular positions depends greatly on the presence of the prosthetic appliance, as edentulous subjects had to use higher muscle activity levels (percentages of maximal EMG value) than age matched dentate subjects in order to perform same mandibular movement. Different elevator muscles were preferentially activated in the edentulous subjects when compared with dentate group in lateral excursive positions of the mandible. The pattern of relative muscle activity was not changed because of ageing. [source] Chewing side preference as a type of hemispheric lateralityJOURNAL OF ORAL REHABILITATION, Issue 5 2004J. Nissan summary, Chewing side preference is a factor that could effect prosthodontic treatment. The purpose of this study was to determine whether chewing side was another type of hemispheric lateralization comparable with footedness, handedness, eyedness and earedness. Chewing side preference was tested in 189 subjects of whom 84 were partially edentulous, 98 had a full compliment of dental units (81 included implant-supported restoration restoring the missing teeth and 17 with fully intact dentitions), and seven were fully edentulous, restored with complete dentures. Laterality tests were carried out for the first cycle of mastication, handedness, footedness, earedness and eyedness and patient questionnaire. Most patients preferred chewing on the right side (78,3%) and were right sided. Chewing side preference correlated with other tested hemispherical lateralities. Missing teeth, occlusion type, lateral guidance, gender, implant-supported restorations and complete dentures do not affect the side preference for chewing. This presents a strong argument that chewing side preference is centrally controlled and provides food for thought regarding its significance in prosthodontics. [source] Denture stomatitis and salivary Candida in Brazilian edentulous patientsJOURNAL OF ORAL REHABILITATION, Issue 11 2002F. R. Pires SUMMARY, Denture stomatitis (DS) is frequently associated with high levels of Candida in saliva and deficient denture hygiene. In order to analyse the incidence of DS and its pre-disposing factors, we evaluated 77 edentulous patients before and 6 months after the placement of new complete dentures. Denture stomatitis was observed in 50·6 and 18·2% of the patients at the first and second evaluation, respectively. Salivary flow, Candida counts in saliva and Candida species were similar in both evaluations. Denture stomatitis and Candida in saliva were more common in females. Our results showed that denture replacement and denture hygiene improvement were useful for DS resolution, particularly types I and II. However, oral and denture hygiene must be continuous, inasmuch as salivary Candida counts remained high and it is considered an important pre-disposing factor for DS. [source] Maximum bite force after the replacement of complete denturesJOURNAL OF ORAL REHABILITATION, Issue 9 2002F. MÜLLER In complete denture wearers the maximum bite force (MBF) is known to be considerably lower than in dentate people. Low MBF might therefore be an indication of poor denture fit but there is limited evidence on this. Therefore, the aim of the present study was to investigate whether MBF can be improved by the replacement of complete dentures for elderly people. Nine edentulous volunteers, average age 74·2 ± 5·5 years and average denture experience 19·4 ± 19·5 years (1,50 years), had replacement dentures made. Functional impressions were taken after border moulding using zinc oxide eugenol paste. After a rehearsal session, MBF was recorded with the old dentures, and with the new dentures immediately at insertion, at 3, 8 days, 2,3 weeks, 1, 2, 3 and 6,10 months post-insertion (p.i.). The MBF was recorded with the central bearing point method using a full-bridge strain gauge with a confirmed linearity from 1 to 1000 N and an accuracy of ±1 N. Data were analysed off-line using the mean of two peak readings per patient per session. The results indicate that MBF tended to be impaired when replacement dentures were first fitted (n.s.). However, this trend reversed during the first month p.i. for patients with a ,moderate' lower ridge resorption of Atwood (1963) grade 3 or 4 (n=5). Patients with more severe lower ridge resorption (Atwood grade 5 or 6; n=4) showed a significantly lower MBF over the entire observation period (P=0·05) and took longer to regain bite strength. Only patients with moderate bone resorption exceeded their pre-insertion level of MBF within the observation period of 6,10 months p.i. In contrast to one report of immediate improvement of MBF at insertion of a new or relined denture (Leyka et al., 2000), the present study suggests that, at least for elderly patients with severe bone resorption, delayed improvement of MBF should be expected. [source] Influence of the thickness of the resin palatal vault on the closest speaking space with complete denturesJOURNAL OF ORAL REHABILITATION, Issue 10 2001G. Schierano The closest speaking space (CSS) has been considered stable over time, and therefore useful to determine the vertical dimension of occlusion (VDO) in edentulous patients. Clemençon affirms that, in complete denture wearers, CSS is not constant but depends on the thickness of the resin palatal vault, and that is the air volume needed to pronounce words to remain constant. The aim of this study was to evaluate Clemençon hypothesis in a group of edentulous patients rehabilitated with traditional maxillary denture and mandibular implant anchored overdenture. The CSS was determined by means of a kinematics method using the Elite System® at 30, 60, 90, 180, 360 days from delivery. The CSS was assessed twice at each stage: with the unmodified denture and a second time after thickening the resin palatal vault by 2 mm with a calibrated wax layer. The CSS after thickening the resin palatal vault was wider. The wider CSS observed can be because of oro-sensory feedback excited by contact between tongue and palatal vault. As hypothesized by Clemençon thickening the resin palatal vault could be a useful procedure to increase the VDO, in cases in which it is too low from the aesthetic stand point. [source] A clinical diagnosis of diurnal (non-sleep) bruxism in denture wearersJOURNAL OF ORAL REHABILITATION, Issue 6 2000K. Piquero The purpose of this study was to establish a clinical method for diagnosing diurnal bruxism in denture wearers by recording masseter and anterior temporal electromygraph (EMG) activity. Seven suspected bruxists and five normal patients who wore complete dentures and/or distal extension base removable partial dentures were selected for participation. EMG activity in both the masseter and the anterior temporal muscles was recorded bilaterally during silent reading (10 min), maximal voluntary clenching (MVC), tapping in centric occlusion, lateral movements, chewing and swallowing. No significant differences of EMG activity were found between the groups during tapping, lateral movement, chewing and swallowing (P>0·05). However, during 10 min of silent reading, a significant difference was found between the groups when comparing masseter muscle activity (P<0·05). A threshold of 10% of MVC of at least 3-s duration was used to define an individual bruxism event. When the muscle activity recorded during silent reading was further analysed using these criteria, the control group displayed no bruxing activity while the suspected bruxist group displayed a mean frequency of six bruxism events (range 2,10). It was concluded that: (a) masseter muscle activity recorded during 10 min of silent reading showed significant difference between the groups; (b) the criteria selected in this study for the detection of sleep bruxism can also be used to assess diurnal bruxism; and (c) it is possible to diagnose diurnal bruxism in denture wearers by measuring the masseter EMG activity during 10 min of silent reading. [source] Tooth loss and the condition of the prosthodontic appliances in a group of elderly home residentsJOURNAL OF ORAL REHABILITATION, Issue 3 2000atovi The study assessed the number of missing teeth, the state of the existing prosthodontic appliances and the need for their replacement. Dental status and anamnesis were taken on a group of 120 elderly home residents by trained examiners. Prosthodontic appliances were evaluated according to the Karlsson's index for the crowns and bridges, and according to the modified Nevalainen et al. index for the evaluation of the complete dentures, as well as the need for prosthetic treatment. The most persistent teeth in both jaws were lower canines, while the most commonly missing teeth were lower first molars. On average, the crowns were older and in poorer condition than the bridges. Lower complete dentures had better stability but were also less retentive in comparison with the upper complete dentures. More than 82% of the subjects were in need of either fixed, removable or combined prosthodontic treatment. The high prevalence of needs for prosthodontic treatment pointed to the requirement for frequent dental check ups within elderly home residents in order to better identify and meet their dental needs. [source] Efficient Resource Use in Simplified Complete Denture FabricationJOURNAL OF PROSTHODONTICS, Issue 7 2010MMedSci, Yasuhiko Kawai DDS Abstract Purpose: Conventional dentures will remain the only treatment available to most edentulous people for the foreseeable future. In this study, we compared the efficiency of two methods of making complete conventional dentures,the traditional academic standard (T) and a simplified technique (S) used in private practice. We have previously shown that they produce similar levels of patient satisfaction and denture quality. Materials and Methods: Data were gathered during a randomized controlled clinical trial of 122 subjects from initial examination until 6-month follow-up. For this report, the direct costs of providing one set of conventional complete dentures by T or S techniques were estimated. All materials used were recorded and their cost was calculated in Canadian dollars (CAN$). The costs of fabrication in an outside laboratory were added. Clinician's labor time was recorded for every procedure. Between-group comparisons for each clinical procedure were carried out with independent t -tests. The number of patients in each group who needed postdelivery treatment was compared with Chi-square tests. The effect of group assignment and of treatment difficulty on outcomes was analyzed with multiple regression analysis. Results: The mean total cost of the T method was significantly greater than S (CAN$166.3; p < 0.001), and clinicians spent 90 minutes longer (p < 0.001) on clinical care. The difficulty of the case had no significant influence on outcomes. Conclusions: The results indicate that the S method is the more cost-efficient method and that there are no negative consequences that detract from the cost savings. [source]
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