Development of Smart Dental Impression Trays on Operator Satisfaction During Dental Impression in Healthcare Services

Background: Crown and bridge prosthodontics needs an accurate and precise impression (positive replica) of the abutment teeth and the edentulous region to be rehabilitated for the dental technician to be able to construct the high quality and well adapted fixed dental restoration without mistakes. The aim of the current survey was to assess any visible mistakes commonly observed in fixed dental prosthesis impressions received at five commercial dental laboratories, frequency errors determination, and to determine any possible association between the preparation finish line errors and other assessed factors. Materials and methods: 150 fixed prosthodontic impressions were collected from five commercial dental laboratories located at Aljabal-Alakhdar region, Libya. All the fixed prosthodontic impressions which had been received by the visited commercial dental laboratories were assessed for many factors in relation to the accuracy such as the dental arch involved, prepared abutment teeth, dental impression materials used, and final techniques and viscosity of the impression, the type of impression tray, full-arch or segmental impression tray, the impression tray size, type of fixed dental restoration requested, mistakes in impression material or tray used, gingival tissue dilation errors, closed-mouth impression technique errors, and finish line errors. No attempts were made to determine the reason of the detected errors in each fixed prosthodontic impression assessed. Association between dental practitioner years of experience and gender and impression errors was evaluated. The association between categorical variables and the outcomes were examined by the use of Chi square and Fisher exact tests. Results: Condensation silicone was the most impression material used. Of the impressions evaluated 121(80.6%), 97% have at least one detectable error, 103(68.6%) had finish line errors, 53.9% had tooth preparation area errors. Visible contamination of impression with blood was seen in about 79(52.2%) of the assessed impressions. There was significant association between the type of dental impression material and errors in the preparation cervical finish line and tooth preparation area. Conclusion: In the present study, it has been found that a high frequency of recognizable errors was detected in crown and bridge impressions received by the five commercial dental laboratories. This can result in poorly fitted fixed restorations cemented for the fixed prosthodontic patients.

Many patients avoid dental appointments because of severe gagging when they have work performed, such as taking impressions. There are several methods known to alleviate gagging, and some studies have suggested that acupuncture may be effective in reducing gag reflex. The aim of the present study therefore was to evaluate whether acupuncture can produce a reduction of the gag reflex. A total of 20 patients, aged between 19 and 80 years, with history of gag reflex on taking dental impressions, were recruited. All patients fulfilling the inclusion criteria had an upper and lower dental alginate impression taken without acupuncture, and a second upper and lower alginate impression taken immediately after acupuncture based on traditional Chinese medicine. After each impression, the patients recorded their emetic sensation using a visual analogue scale (VAS). The results showed a significant (p<0.05) reduction in the gag reflex scores after acupuncture. For upper impressions, they fell from 6.8 (1.1) to 1.1 (1.1); and for lower impressions, from 5.45 (1.0) to 0.4 (0.7) (mean (SD)). The findings from our study suggest that acupuncture may be useful for preventing and treating gag reflex, and justifies further study.

Background A pronounced gag reflex (GR) can be a problem to both the acceptance and delivery of dental treatment. Despite a range of management strategies, some patients cannot accept even simple dental treatment. The aim of this study was to evaluate the use of acupuncture point CV-24 in controlling a profound gag reflex during dental treatment requiring an upper alginate impression. Method Members of the British Dental Acupuncture Society were invited to take part in an audit of the role of acupuncture point CV-24 in controlling the gag reflex. They were issued with patient inclusion criteria, a standardised procedure instruction sheet and a recording form. All patients fulfilling the inclusion criteria had an upper dental alginate impression taken (or an attempt made at it) before acupuncture, and a second upper alginate impression taken immediately after acupuncture of point CV-24. The GR assessment was undertaken prior to insertion of the acupuncture needle using the Gagging Severity Index (GSI); and after the acupuncture and impression taking using the Gagging Prevention Index (GPI). Both the GSI and GPI were recorded at three stages of the dental impression taking procedure, ie, when the empty impression tray was tried in the mouth, when the loaded tray was inserted into the mouth, and on completion of the impression taking. Results Twenty-one dentists submitted 64 case reports of which 37 fulfilled the inclusion criteria. Prior to acupuncture all 37 patients (20 females and 17 males with a mean age of 46.8 years) were unable to accept the impression taking. After acupuncture of point CV-24, an improvement of between 51-55% (mean 53%) for the three stages of impression taking was noticed. Thirty patients (81%) were able to accept the impression taking, whereas seven (19%) remained unable to tolerate the procedure. Assessed by the GSI and GPI, there was a significant decrease in GR scores at all three stages of the impression taking procedure (median 3 vs 1; 4 vs 2; 4 vs 2; p < 0.0001). Thus before acupuncture, the patients had moderate to severe GR and after acupuncture the GR had reduced to a level which only complicated dental treatment slightly. Conclusion Our results indicate that acupuncture of point CV-24 is an effective method of controlling severe GR during dental treatment including impression taking. However, the results of the current audit need to be tested in a randomised controlled study in order to substantiate the effectiveness of this method.

A pronounced gag reflex (GR) can be a problem to both the acceptance and delivery of dental treatment. Despite a range of management strategies, some patients cannot accept even simple dental treatment. The aim of this study was to evaluate the use of acupuncture point CV-24 in controlling a profound gag reflex during dental treatment requiring an upper alginate impression. Members of the British Dental Acupuncture Society were invited to take part in an audit of the role of acupuncture point CV-24 in controlling the gag reflex. They were issued with patient inclusion criteria, a standardised procedure instruction sheet and a recording form. All patients fulfilling the inclusion criteria had an upper dental alginate impression taken (or an attempt made at it) before acupuncture, and a second upper alginate impression taken immediately after acupuncture of point CV-24. The GR assessment was undertaken prior to insertion of the acupuncture needle using the Gagging Severity Index (GSI); and after the acupuncture and impression taking using the Gagging Prevention Index (GPI). Both the GSI and GPI were recorded at three stages of the dental impression taking procedure, ie, when the empty impression tray was tried in the mouth, when the loaded tray was inserted into the mouth, and on completion of the impression taking. Twenty-one dentists submitted 64 case reports of which 37 fulfilled the inclusion criteria. Prior to acupuncture all 37 patients (20 females and 17 males with a mean age of 46.8 years) were unable to accept the impression taking. After acupuncture of point CV-24, an improvement of between 51-55% (mean 53%) for the three stages of impression taking was noticed. Thirty patients (81%) were able to accept the impression taking, whereas seven (19%) remained unable to tolerate the procedure. Assessed by the GSI and GPI, there was a significant decrease in GR scores at all three stages of the impression taking procedure (median 3 vs 1; 4 vs 2; 4 vs 2; p < 0.0001). Thus before acupuncture, the patients had moderate to severe GR and after acupuncture the GR had reduced to a level which only complicated dental treatment slightly. Our results indicate that acupuncture of point CV-24 is an effective method of controlling severe GR during dental treatment including impression taking. However, the results of the current audit need to be tested in a randomised controlled study in order to substantiate the effectiveness of this method.

Teeth with a poor prognosis are often extracted prior to radiotherapy for head and neck cancer (HNC) in order to help prevent the need for dental treatment after radiotherapy that might in turn lead to the development of osteoradionecrosis. However, the details and impact of replacing missing teeth after radiotherapy for HNC have received little attention, especially from the patients' perspective. This study aimed to assess the use, satisfaction, and impact of denture use following radiotherapy for HNC. The study also sought to determine patients' satisfaction with information about replacing their missing teeth postradiotherapy. Finally, this study also aimed to assess interest in replacing missing teeth for those who had not done so. A structured, validated, and reliable questionnaire was sent to HNC patients who had received radiotherapy and had missing teeth at the time of discharge. In addition to demographic details and self-reported oral hygiene, the questionnaire included questions on use of (or interest in) dentures, satisfaction with dentures, satisfaction with information about replacing missing teeth, QoL as measured by two questions from the short version of WHOQoL-BREF, and oral functioning as measured by BCSQ-H&N. Demographic details and clinical details were extracted from the hospital records. N=80 (24%) returned a completed questionnaire. Participants had an average of 12 missing teeth (SD=8.05). Most (n=60, 75%) had not replaced their missing teeth. Of these, 35 (58%) were very or extremely interested in doing so. For HNC survivors who wore dentures, there was variable satisfaction and a number of side-effects of wearing dentures. Satisfaction with information about replacing missing teeth was low. There was no statistical difference in QoL or oral functioning between participants who wore dentures and participants who did not wear dentures. However, those with dentures reported fewer problems with carrying out daily routines as measured by the oral functioning tool. QoL and oral functioning were similar regardless of denture use, highlighting reduced oral function in both those with and without dentures. In those who had not replaced their missing teeth, there was substantial interest in doing so and thus may be an unmet need. The dental team could offer HNC survivors more support after radiotherapy and following denture provision to improve information about denture use and increase satisfaction with dentures.

Introduction: It is a well-known fact that during a dental impression, some patients suffer from the gag reflexes. Aim of the study: Even if the main tendency is to use medication, our goal is to find a way to combat it. Material and methods: With the help of our 155 volunteering students, from UMFST Târgu Mureș, who agreed on having their dental impression taken, using alginate material, we tried to combat the gag reflex, using the following techniques: the high-leg method, salt crystals, as well as using a special impression tray. Results: When we applied all of these methods, great attention was payed, as we diligently wrote everything down. After all the work was done, we obtained the following results: 130 did not show any vomiting signs, 17 of them presented moderate vomiting reflex and only 8 of them have shown extreme vomiting reflex, leading to the point where the impression could not be performed. Conclusions: On the one hand, for the less informed people, these techniques present a better outcome; on the other hand, however, we wish to highlight one thing: the skills of the doctor are of utmost importance.

Introduction: The gag reflex (GR) is an innate healthy defense mechanism that helps prevent foreign bodies from entering the trachea. Psychological, anatomic, iatrogenic, local, and systemic factors influence the GR. The pharyngeal reflex that prevents choking involves five triggering zones in the oral cavity: the palatoglossal and palatopharyngeal folds, the post-pharyngeal wall, the uvula, the palate, and the base of the tongue. So, this study is undertaken to determine gag reflux using the Intellectual Colored game distraction technique during the dental impression. Aim: The aim of this study is to determine the effect of distraction using the intellectual colored game (ICG) on the severity of GR and anxiety in children during the dental impression. Methodology: 50 children aged between 5 to 11 years, needing upper alginate impressions will be selected for the study and will be divided into 2 groups of 25 each. Children’s baseline anxiety will be evaluated according to the Buchanan’s Facial Image Scale (FIS) before any impression attempt. In Group 1 the upper alginate impression will be taken without playing ICG and group 2 upper alginate impressions will be taken while playing ICG. Result: Statistical analysis showed that 28% and 76% of children from the control and treatment groups respectively had a higher level of anxiety before the use of the distraction technique. However, 12% and 4% of children had higher anxiety after the use of distraction technique and a statistically significant change in anxiety in the treatment group with existing anxiety level (Z = -3.412, p = 0.001) was observed. Conclusion: Intellectual distraction is a safe, successful & cost-effective method for gag reflux management in pediatric dentistry. The Intellectual coloured game diverted the child’s attention during the stressful alginate impression, henceforth it should be considered to further advance behaviour management techniques.

Dental impressions are crucial in pediatric dentistry, but exaggerated gagging can obstruct this process. Various methods have been proposed to manage the gag reflex (GR). This study aimed to evaluate and compare the effectiveness of laser acupuncture and electroacupuncture in controlling children's GR. A three-armed randomized controlled trial was conducted with 63 patients aged 6-9, with excessive GR, scheduled for dental impressions. Participants were assigned to one of three groups: low-level laser (n = 21), microcurrent stimulation with a Meridian pen (n = 21), and a control group with a deactivated pen (n = 21). Gag preventive index (GPI) was taken, and dental anxiety was assessed using the Facial Image Scale (FIS), pulse rate (PR), and blood oxygen saturation (SaO2). Significance was set at p < 0.05. All interventions influenced GPI scores. The Meridian pen and laser groups achieved better GPI scores (p < 0.001) than the control group. FIS scores between the Meridian pen and laser groups were comparable, differing significantly from the control group (p < 0.001). The Meridian pen and laser groups showed greater reductions in PR (p < 0.001) and higher SaO2 post-intervention (p < 0.001). The Meridian pen and laser outperformed the control group, demonstrating effectiveness in enhancing physiological and subjective measures. ClinicalTrials.gov identifier: NCT06422286.

To investigate the associations among tooth loss, denture use and malnutrition in Chinese older adults, and to identify malnutrition risk factors by dentition status. Malnutrition affects 7.7% of older adults in China and is associated with tooth loss, which impairs chewing. Dentures are commonly used to mitigate this, but their influence on malnutrition remains unclear. A cross-sectional analysis of 13,234 individuals aged 60 and older from the 8th wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was conducted. Data on tooth loss, denture use, malnutrition and socio-demographic factors were collected. Modified Poisson regression was used to calculate prevalence ratios (PRs) and confidence intervals (CIs) adjusted. Malnutrition was more common among partially dentate older women without dentures (APR 1.75, 95% CI 1.29-2.37), and those with edentulism, both with dentures (APR 1.61, 95% CI 1.18-2.20) and without dentures (APR 1.93, 95% CI 1.41-2.64). Denture use was associated with a lower malnutrition risk in partially dentate (APR 0.80, 95% CI 0.70-0.91) and edentulous older adults (APR 0.79, 95% CI 0.70-0.80). Denture use is associated with a lower malnutrition risk, especially in women, though it may not fully restore nutritional status. Strategies to prevent tooth loss and promote denture use are vital for reducing malnutrition in older adults.

BackgroundsTooth loss, often considered as an inevitable result of ageing, is one of the most frequently stated problems with older adults worldwide, which entails a negative impact on physical and mental health, as well as quality of life. However, there is urban-rural gap among older adults in both oral health condition and dental service utilization. The study focused on the urban-rural gap in Chinese older population, aiming to describe their tooth loss and denture use status, and explore the associated factors, hoping to provide insights into improving the oral healthcare system in China and other developing countries.MethodsThis cross-sectional study used data collected from May to September in 2020. A stratified, multi-stage cluster sampling design was used to produce nationally representative samples of 2709 adults aged 60 years and older. The dependent variable was denture use of the participant. Determinants included demographic characteristics, health status, social support, oral health knowledge and health service utilization. Descriptive analysis was conducted to describe the sample characteristics, and Generalized Linear Mixed Model was used to identify independent factors associated with denture use among older adults in rural and urban China respectively.ResultsThere were significant urban-rural differences in tooth loss, denture use and health service utilization among Chinese older adults. Urban participants’ denture use was associated with oral health knowledge (OR = 1.29, 95%CI = 1.07–1.56). Rural participants’ denture use was associated with oral health knowledge (OR = 1.23, 95%CI = 1.02–1.47), dental checkup in the last six months (OR = 1.19, 95%CI = 1.00-1.40), and social support (OR = 1.22, 95%CI = 1.03–1.44).ConclusionsGreater efforts should be made to enhance oral health education and emphasize the importance of regular dental checkups among older population. Targeted focus on different aspects of oral health based on the characteristics of different populations is suggested. Policymakers should be aware of the urban-rural disparity in distribution and utilization of oral health services.

To assess the effectiveness of music therapy on the quality of life, anxiety, depression and pain of patients with cancer. Systematic review. Five electronic databases were searched in September 2018 for randomized controlled trials evaluating music therapy for patients with cancer. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook Version 5.1.0 and the Revman version 5.3 software was used to perform the meta-analysis. The outcomes were overall quality of life, anxiety, depression and pain. A total of 19 trials evaluating 1,548 patients were included in this study, of which 765 were in the control group and 783 in the experimental group. Compared with standard care, music therapy can significantly increase the score of the overall quality of life in patients with cancer. In addition, music therapy was found to be more effective for decreasing the score of anxiety, depression and pain. Music therapy can improve the overall quality of life of patients with cancer, with an observed optimal intervention duration of 1-2months. Meanwhile, anxiety, depression and pain are improved as well. Nevertheless, high-quality trials are still needed to further determine the effects of music intervention in supportive cancer care.

The aim of this study was to investigate two different acupuncture approaches in the treatment of orthodontic patients with a gagging reflex (GR). Forty-five patients (mean age 10.1 + or - 2.6 years) had an upper dental alginate impression taken prior to receiving laser stimulation. GR assessment was evaluated by using the Gagging Severity Index (GSI). Fifteen patients in Group A underwent a red-light soft magnetic field laser stimulation of conception vessel 24 (CV 24) for 1 min. Fifteen other patients in Group B undertook a combination of laser stimulation of CV 24 and acupressure pericardium 6 (PC 6). Group C, which consisted of the remaining 15 patients, formed the placebo group. After the laser stimulation and acupressure, a second impression was taken. The Gagging Prevention Index (GPI) was used to evaluate gagging reflex after the laser stimulation and acupressure. Both GSI and GPI were recorded at three stages of the dental impression taking procedure, ie with an empty impression tray, with a loaded tray and the ability to keep the impression in the mouth until set. A significant decrease in GPI values compared to GSI values, was observed at the three stages of the impression taking process and after the laser stimulation in Group A and B (p <0.05). The average improvement between the GSI and GPI scores was 58.9% before and after the laser stimulation in Group B 37.9% in Group A and 11.2% in Group C. Both acupuncture points CV 24 and PC 6 were found to be effective in controlling GR in orthodontic patients.

BackgroundThe gag reflex is a common challenge in dental practice, often causing discomfort and leading to treatment avoidance, especially during procedures like taking dental impressions. Although both pharmacological and non-pharmacological treatments are utilized to manage the gag reflex, current evidence supporting the routine use of these interventions is limited, highlighting the need for further research. To optimize gag reflex management and identify future research trends through a bibliometric analysis.MethodsData from eligible studies were extracted through a comprehensive search and various analyses, including descriptive bibliometric, citation, keyword, and thematic analyses. Group comparisons were made between Asian and non-Asian groups to assess the differences and trends between the two regions.ResultsBetween 2000 and 2025, 47 studies were published, with an average annual increase of 4.68%. Japan, Iran, India, the USA, and Turkey each contributed at least 10 studies, and studies from Lebanon had the highest citation frequency. The majority of studies were randomized controlled trials (46.81%), followed by case reports (46.81%) and case series (6.38%). Most studies (80.85%) focused on adults undergoing extractions (38.30%), restorations (31.91%), and dental impressions (14.89%). Interventions primarily targeted nausea and vomiting (74.47%) using pharmacological treatments such as lidocaine, propofol, and midazolam and non-pharmacological methods such as acupuncture, acupressure, and Transcutaneous Electrical Nerve Stimulation. Significant differences were observed between Asian and non-Asian groups in publication years, study designs, demographics, treatments, and clinical outcomes.ConclusionsGag reflex management has advanced with pharmacological treatments for immediate relief and increased use of non-pharmacological methods such as acupuncture and laser stimulation, particularly in Japan, Turkey, and the USA. However, challenges such as small-scale studies, limited follow-ups, and underrepresentation of children and adolescents highlight the need for larger studies, standardized tools, and inclusive approaches for diverse patient groups.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420250650382, identifier (CRD420250650382).

Is laser acupuncture effective in controlling gag reflex while taking dental impressions? A randomized double-blinded sham-controlled clinical trial.

BackgroundThe associations between the number of natural teeth/denture use and all-cause mortality remain unclear due to lake of investigation for the potential interaction between tooth loss and denture use and for the potential changes in these exposures over time in older adults. We undertake this study to evaluate the associations of the number of natural teeth and/or denture use with mortality in Chinese elderly.MethodsThis is a prospective cohort study of 36,283 older adults (median age: 90). The number of natural teeth and denture use were collected with structured questionnaire. We evaluated hazard ratios (HRs) and confidence intervals (CIs) using a Cox proportional hazards model adjusting for demographic factors, education, income, lifestyle factors, and comorbidities.ResultsWe documented 25,857 deaths during 145,947 person-years of observation. Compared to those with 20+ teeth, tooth loss was associated with a gradual increase in mortality, with an adjusted HR of 1.14 (95% CI, 1.06 to 1.23) for those with 10–19 teeth, 1.23 (95% CI, 1.15 to 1.31) for those with 1–9 teeth, and 1.35 (95% CI, 1.26 to 1.44) for those without natural teeth. Denture use was associated with lower risk of mortality (adjusted HR 0.81; 95% CI, 0.77 to 0.84). Subgroup analyses indicated that the benefit of denture use was greater in men than in women (P = 0.02) and tended to decrease with age (P < 0.001). The effects of denture use did not differ among various degrees of tooth loss (P = 0.17).ConclusionsTooth loss was associated with an increased risk of mortality in older adults. Denture use provided a protective effect against death for all degrees of tooth loss however, this effect appeared to be modified by sex and age.