Complete Denture Patients Research Articles

A comparative study of masticatory performance in complete denture patients before and after application of soft liner

BackgroundTo compare the masticatory performance in complete denture patients before and after application of soft liner and to assess the effect of aging of soft liner on masticatory performance at different intervals of time. MethodsA total of 30 complete denture wearers between age of 64 and 80 years, were selected from both the sex (20 men, 10 women). This study evaluated the effect of before and after application of chair-side soft liner on masticatory performance of complete denture wearers by using raw carrots and roasted peanut as the test food. This study further evaluated the cushioning effect of chair-side soft liner material at the interval period of 1week, 4 weeks, 8 weeks, 12 weeks and 16 weeks. ResultsThere were significant differences in masticatory performance without soft liner as compared to with soft liner at different intervals of time. The performance was found to be significantly higher for raw carrot as compared to roasted peanut (p<0.001). For both the materials peak performance was recorded at 4th week. ConclusionThe use of soft liner helps in increasing the masticatory performance among complete denture wearers.

The effect of denture adhesive on the efficiency of complete denture in patients with different alveolar ridges

Background: Denture adhesives are used to improve retention, stability, and efficiency of complete dentures. Proper use of denture adhesives has benefits for patients. Evaluating the effect of denture adhesives on efficiency of complete dentures in patients with different alveolar ridges was the purpose of this study. Materials and Methods: This cross‑over randomized clinical trials study was conducted on 90 patients who were wearing well fitted complete dentures. The patients were categorized into three groups based on clinical and radiographic situations of residual ridges. Group I with mild resorption, group II with moderate resorption, and group III with severe resorption. The patients who had recently received their dentures and the primary complications had been resolved were asked to use denture adhesive according to the instructions. The patients answered two different questioners in 1 week and 2 months of using denture adhesive. The answers were analyzed by means of variance and Chi‑squared tests (P 0.05). Increased retention and adaptation made 64.4% of these patients willing to continue using the adhesive after the study. Forty‑three percent of patients reported moderate satisfaction of using this adhesive. Conclusion: Using denture adhesive in well‑fitted complete dentures resulted in an improvement in retention, talking, chewing, ease of use, self‑confidence, and efficiency of dentures. The use of denture adhesive is, therefore, recommended to patients wearing dentures with some problems. Key Words: Alveolar ridge, complete denture, denture adhesive, denture retention

Comparison of effectiveness of silver zeolite as an antimicrobial agent in acrylic and silicone soft liners in complete denture patients: An in vivo study

BACKGROUND: Soft liners (SLs) are easily colonized and infected by Candida species and bacteria, leading to denture-induced stomatitis. Hence, it is essential that the SLs be taken care of. To serve such a purpose, antimicrobial zeolites have been incorporated. Limited in vitro evidence suggests that silver zeolite (SZ) is a potentially effective antimicrobial agent. Hence, this study aims to analyze and compare the antimicrobial effectiveness of SZ when added to two different types of SLs in vivo for 28 days in complete denture patients. MATERIALS AND METHODS: This study was undertaken to determine the efficacy of SZ as an antimicrobial agent when incorporated in acrylic soft liners (ASLs) and silicone soft liners (SSLs). A total of 32 edentulous patients were selected and were divided into two groups. Group 1 consisted of 16 patients, wherein SSL was used, and Group 2 consisted of 16 patients with ASL. The reduction of colony-forming units (CFUs) was seen in both the groups after an interval of 28 days. RESULTS: There was a greater reduction noted when SZ was incorporated in SSLs after 28 days. Group 1 showed a mean reduction of CFU from 4.60 to 1.98, whereas Group 2 showed a mean reduction from 4.73 to 3.39. Thus, SZ was effective in both the SLs. CONCLUSION: SZ showed a significant reduction in CFU in both the SLs. Hence, this in vivo study concluded that incorporation of SZ is effective as an antimicrobial agent when added to SLs.

Evaluation of suitability and stability in a skeletal Class III complete denture patient with flabby tissue: A case report

Evaluation of suitability and stability in a skeletal Class III complete denture patient with flabby tissue: A case report

Learner Reactions and Responses to Individualized Coaching on Communication Skills for Treating Completely Edentulous Patients

Purpose: Communication skills (CS) of each doctor vary as individual approach is unique. Assessment of particular skills they apply and what they lack in, permits us to individualize CS training i.e.dentist specific communication skill (DSCS). This study was designed to assess individual prosthodontic resident’s skills while treating real patients and to subsequently plan individualized coaching to strengthen the deficiencies identified. Methods: Videorecordings were done during treatment for 50 complete denture patients treated by six prosthodontic residents in a dental institution. The videointeractions were analyzed to identify their individual strengths and weakness and an individualized coaching was planned .Post training the residents were observed while treating another set of 50 edentulous patients. Results: It was found that each resident had an ‘individual pattern’ (IP) in practicing some skills as showing care and concern, empathy etc and were lacking in certain other skills e.g. consideration of psychosocial aspects etc. Conclusion: Individual feedback and personalized coaching were very well appreciated by the prosthodontic residents and a change in their attitude and patient-centered approach were apparent.

Developing Prosthodontic Residents' Communication Strategies with Edentulous Patients: A Pilot Study.

The aim of this study was to investigate whether prosthodontic residents' attitudes toward provider-client communication would be shaped by a tailor-made communications skills course. In 2016, the pre-intervention attitudes of all six second- and third-year prosthodontic residents in a three-year residency at an academic dental institution in India were assessed using the Communication Skills Attitude Scale (CSAS). The residents' performance was then video-recorded while they treated complete denture patients and was analyzed using the Kalamazoo scale, a validated scale for communication skills assessment. The residents' weaknesses were identified, and a custom-made generic module was designed along with individual guidance counseling for addressing aspects relevant to complete denture patients. The residents' attitudes were again assessed immediately after they completed the training using CSAS, as well as after two and four months using Balint sessions. Analysis of the recordings showed that few of the deficiencies during intraoral procedures were contextual, and the Kalamazoo scale did not address them: these were noted as being "beyond Kalamazoo." After the training, the residents reported awareness of their weaknesses and feeling motivated to practice their newly acquired skills. The Balint sessions showed that they had started valuing patients' agendas and the rapport-building process, and they reported transfer of skills when treating other types of prosthodontic patients. In this study, a customized communication skills module brought about a positive change in residents' attitudes, which was sustained over four months. Similar training could be implemented in other dental specialties.

Evaluation of Oral Stereognosis in Relation to Tactile Ability and Patient Satisfaction.

We investigated the oral stereognostic ability (OSA) of dentate individuals, conventional complete denture patients, and maxillary implant-supported denture patients with bar attachments. Stereognosis tests were carried out, and the relationship between OSA and patient satisfaction was assessed with a satisfaction survey: the Turkish version of the oral health impact profile-14 (OHIP-TR-14). To compare differences in oral sensory function among individuals with natural dentition, complete denture wearers, and maxillary implant-supported denture wearers, tactile awareness (thickness perception threshold) and pressure awareness (threshold of lateral loading) were assessed. According to the results, the oral perception level of natural dentate patients was higher than that of the complete denture group and maxillary implant-supported complete denture group at the end of the study. There was no statistically significant difference in OHIP-TR-14 scores between the maxillary implant-supported complete denture group and the complete denture group ( P < .05). The control group perceived the applied lateral and vertical forces statistically earlier than the other groups ( P < .001). There was no statistically significant difference between the complete denture and maxillary implant-supported denture groups in terms of the lateral pressure threshold or thickness tactile threshold ( P > .05). At the end of the study it was concluded that there was no correlation between oral perception levels and satisfaction in patients with complete dentures and patients with maxillary implant-supported complete dentures. The control group, compared with the complete denture and maxillary implant-supported complete denture groups, perceived the lateral and vertical forces statistically earlier than the other groups.

Communication Skills Teaching Learning In Prosthodontics

Background and Objective: To carry out an in-depth training on communication skills for Prosthodontic postgraduates for dealing with complete denture patients and analysis using Kalamazoo scale. The effectiveness of the training was evaluated based on Kirkpatrick’s model. Material and Methods: Videorecording of doctor patient interactions was done during complete denture treatment procedures for 27 completely edentulous patients in the Department of Prosthodontics, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Pondicherry.The videorecordings were analysed using Kalamazoo scale for assessment of communication skills and strength and weakness of postgraduates were identified. Based on the findings a need based customized training program involving general and individualized sessions were planned.Post training the same process of videorecording and analysis was done for another set of 18 patients to see the difference in attitude of postgraduates. The outcomes of the program were evaluated using Kirk Patrick model. Results: “Remarkable” improvements were identified in various aspects of communication skills and development of the skills of reflective practice which was evident from their change in attitude at all four levels in the post training videoanalysis based on Kalamazoo scale and self reflection of postgraduates. Conclusion: Such customised training and evaluation for dealing with complete denture patients based on Kirkpatrick’s framework helps in achieving a targeted outcome and brings change in attitude at all the four levels thereby contributing towards effective patient centered practice.

Fenestrated Denture: A Grace Option To Edentulous Patient

Edentulism can lead directly to impairment, functional limitation, physical, psychological, and social disability, and handicap. Edentulism was found to have a significant effect on residual ridge resorption, which leads to a reduction in the height of alveolar bone and the size of the denture bearing area. Fenestrated denture is a concept which preserves remaining teeth. This case report discusses the advantages of exploitation few remaining teeth to minimize alveolar ridge resorption and improvement of retention and support through using fenestrated denture which overcomes many problems encountered by complete denture and removable partial denture patients.

Correlation of masticatory muscle activity with masticatory ability in complete denture patients with canine guidance and balanced occlusion

Balanced occlusion is commonly used in complete denture occlusion scheme; however, canine guidance offers a simpler process and reduces alveolar ridge resorption. Correlative research of these two occlusion schemes is required. This study was done to analyze the correlation between masticatory muscle activity and masticatory ability of the subjects with canine guidance and balanced occlusion complete dentures. Ten denture wearers participated in this cross-over clinical trial, and five subjects were randomly selected to wear balanced occlusion followed by canine guidance complete dentures and vice versa. Electromyogram (EMG) activities of superficial masseter and anterior temporal muscles were measured and masticatory ability questionnaires were collected 30 days after the subjects wore each occlusal scheme. There were significant differences between the EMG activities of masticatory muscles in subjects who were given canine guidance and balanced occlusion complete dentures (p < 0.05). Subjects rated their masticatory ability as being significantly better when using canine guidance dentures (p = 0.046). There was a significant and strong correlation (p = 0.045; r = 0.642) between the EMG activity of anterior temporal muscles and masticatory ability when the subjects wore balanced occlusion dentures and between the EMG activity of superficial masseter muscles and masticatory ability (p = 0.043; r = 0.648) when wearing canine guidance dentures. Masticatory ability is better when using canine guidance dentures. There is a significant and strong correlation between masticatory muscle activity and masticatory ability.

Determination of occlusal vertical dimension for complete dentures patients: an updated review.

Determination of the occlusal vertical dimension (OVD) is an integral part of complete dentures fabrication. Due to the lack of teeth, the clinician faces the challenge of how to accurately establish the OVD of the new denture. Therefore, the purpose of this review article was to present, discuss and critique the available methods used in determining the OVD for complete dentures patients. This review identified two main streams to determine the OVD: (i) pre-extraction methods and (ii) post-extraction methods. For the pre-extraction methods, the OVD of the natural dentition is transferred to the new dentures mainly by intra-oral measurements, profile tracing and cephalometric analysis. The post-extraction methods rely on mandibular rest position, facial aesthetic appearance, swallowing pattern, craniofacial landmarks measurements, cephalometric analysis, phonetics and existing dentures. In general, all the available techniques have merits and are helpful for routine clinical use. However, they are empirical in nature, controversial and lack the scientific support. Further, there is no single accurate method for OVD determination. To overcome the limitations of the techniques, the clinician will benefit from applying combination of techniques to approximate the OVD.

Estimation of Vertical Dimension of Occlusion in Edentuleous Patients Using Cephalometric Analysis

Abstract“The best of friends fall out with time and so do teeth.”Thus, there is a need to replace the lost teeth and the supporting structures for the patient's social demands and functional rehabilitation. Prosthetic treatment with complete dentures is a very common treatment modality; the biggest challenge in its fabrication is to duplicate the normal vertical dimension. Failure can be avoided by completing the treatment without changing the vertical dimension and obtaining an optimal facial proportion. There are many methods to record VD. Radiographic cephalometry has been used as a diagnostic tool in Prosthodontics for over five decades and numerous authors, like Ricketts (1981), McNamara (1984) and Slavicek (1984) developed and computerized these techniques to co-relate and record VD in patients. However cephalometric analysis can help to visualize skeletal and facial proportion relation. The present study was done to use the lateral radiographs with cephalometric analysis, as it could be a simple, non-technique sensitive, non-invasive and atraumatic way to determine VD for complete denture patients and also to compare physiologic methods (swallowing/phonetics) with cephalometric method to record lower facial height.

Case-based learning: A study to ascertain the effectiveness in enhancing the knowledge among interns of an Indian dental institute.

Objective:Time and again, it has been shown that active learning promotes critical thinking, and this environment has to be fostered in dental education too. Therefore, the present study was carried out with an aim to know the effectiveness of case-based learning (CBL) in enhancing the knowledge of dental interns of a dental institute in India.Materials and Methods:This pre-post single-blinded, experimental study was conducted in two sessions on a purposive sample of 45 dental interns who gave informed consent. The interns answered a pretest questionnaire comprising questions related to their knowledge of hyperplastic tissue in complete denture patients. The interns were randomly allocated into three subgroups for thorough discussion. Each group viewed all three parts of a case related to hyperplastic tissue and presented the case in the presence of a facilitator. The facilitator discussed the subject with the three subgroups. A post-test was conducted immediately, and the results were compared with the pretest. The facilitator explained about hyperplastic tissue with an audio-visual aid after the post-test was administered. The perception of interns toward CBL was assessed by a standard questionnaire.Results:On analysis, the comparison of the overall knowledge scores pre- and post-CBL showed a statistically significant increase from 9.8 ± 2.14 to 12.6 ± 1.37 (P < 0.001).Conclusion:CBL proved to be effective in enhancing the knowledge of dental interns.

A study to evaluate the location and frequency of denture-related ulcerations and postinsertion adjustments in complete denture patients

Background and Aims: Removable complete denture is one of the most common treatment modalities for completely edentulous patients. After denture insertion, patient very often faces problems with the denture even after complete care is taken during fabrication procedure. Most common complaint is traumatic ulcers. The present study aimed to locate the most common areas of ulcerations due to complete dentures, how frequently they occur and how many times patient visits for adjustment after insertion of complete denture. Materials and Methods: Two hundred and twenty-one patients were selected and were delivered complete dentures. Dentures were fabricated for all the patients. Each step of denture fabrication was controlled and guided by a prosthodontist. After placement of dentures, patients were evaluated at every recall visit and their dentures were adjusted. All the details of each visit (area of ulceration) and number of visits were recorded in a self-designed format. Descriptive statistical analysis was done using SPSS version 13 software. Chi-squared test was used to evaluate the correlation between mucosal injuries and postinsertion day and the relationship between lesions, patient age, and patient gender. Results: All the 221 patients required denture adjustment due to mucosal injuries. No significant difference was found between denture-related injuries between males and females. Injuries related to mandibular dentures were significantly higher than those related to maxillary dentures. In mandible, the most common area of mucosal injury is posterior one-third of alveololingual sulcus; while in maxilla, the most common area of mucosal injury is labial frenum. Conclusion: Postinsertion adjustments are an important aspect of rehabilitating patient with complete dentures. Most of the denture-related injuries were in limiting areas. Proper border molding techniques, accurate secondary impressions, and use of pressure indicating paste during denture insertion are main requisites for decreasing denture-related mucosal injuries.

A comparative evaluation of chewing efficiency, masticatory bite force, and patient satisfaction between conventional denture and implant-supported mandibular overdenture: An in vivo study.

Purpose:The purpose of this within-subject crossover clinical trial was to compare and evaluate the chewing efficiency, masticatory bite force, and patient satisfaction with conventional dentures and two implant-retained mandible overdentures after 4 weeks of usage.Method:This within-subject crossover clinical trial was carried out in the Department of Prosthodontics in K.D Dental College and Hospital. A total 15 patients were selected for the study. To report the changes in chewing efficiency by chewing 6gms of peanuts with 40 chewing strokes and comparing the particle size of the chewed material between two implant retained mandibular overdenture with that of conventional denture using micro vu excel gantry type visual measurement machine. To report changes in masticatory bite force after transition of conventional complete denture patient to implant retained overdenture after using the prosthesis for four weeks each and recorded by digital transducer. To assess the patient satisfaction after transition of conventional complete denture patient to implant retained mandibular overdenture with help of OHIP edent patient satisfaction questionnaire.Results:The chewing efficiency for implant retained overdenture increased significantly than that of conventional denture. The particle size decreased to 76.34% for implant supported overdenture than that of conventional denture. The chewing strokes required by conventional denture was 69 strokes and that by implant supported overdenture which was 40 strokes to get the same mean particle size. The patients satisfaction after receiving the implant retained overdenture was significantly higher than that of complete denture.Conclusion:The provision of two mandibular implants significantly improves measures of oral function and better quality of life for edentulous patients.

Assessment of Awareness and Knowledge about Geriatric Nutrition in Complete Denture Patients of Western Maharashtra (Karad), India: A Clinical Survey

Assessment of Awareness and Knowledge about Geriatric Nutrition in Complete Denture Patients of Western Maharashtra (Karad), India: A Clinical Survey

Denture Hygiene Knowledge and Practices among Complete Denture Wearers attending a Postgraduate Dental Institute.

The aim of this study was to assess the denture hygiene knowledge and practices among patients using complete dentures attending a postgraduate dental hospital in Jabalpur city. The objective of this study was to assess the relationship between hygiene knowledge and practices to the denture wearer's gender, education, and income. A descriptive, cross-sectional survey was conducted using a self-administered questionnaire involving the complete denture patients attending the Department of Prosthodontics. The study subjects were randomly selected by recruiting old dentures wearers visiting the Department of Prosthodontics for a recall visit or for new dentures on the odd dates of the month. All subjects signed an informed consent before filling the questionnaire. The institutional review committee approved the study. Descriptive statistics included computation of frequencies and percentages. Nonparametric test, namely, chi-square test, was used for further data analysis; p-value <0.05 was considered statistically significant. A total of 530 individuals were approached for participation in our survey, 30 (5.66%) subjects declined to participate. The results showed that 195 (39%) subjects were wearing the same dentures for more than 5 years. In this study, 51 (10.2%) subjects reported never having been advised by their dentists as to how to clean their dentures. Among all the subjects interviewed, 264 (52.8%) reported to clean the oral tissues daily. This study disclosed that 66 (13.2%) of the subjects usually slept with their dentures. Maximum subjects in illiterate group had experienced bad breath sometimes when compared with subjects in postgraduate group (χ2 = 47.452, p < 0.001). There was a significant difference for method of denture cleaning according to gender (χ2 = 101.076, p < 0.001). The majority of the denture wearers have limited knowledge of denture cleansing and oral hygiene practices. Hygiene habits and practices may not always present a positive correlation with the gender, educational level, and income of the subjects. Periodic recall for evaluation of denture and mucosal surfaces along with reinforcement of denture hygiene instructions will go a long way in helping the patients reap maximum benefits out of their prostheses.

A comparative study for plaque removing efficacy between commonly used denture cleansers in India.

Aim:A comparative study for plaque removing efficacy between toothpaste, liquid handwashing soap, and two chemical-soak denture cleansers (clinsodent denture cleansing powder and fittydent denture cleansing tablet).Materials and Methods:A total of 140 healthy complete denture patients were selected and checked for denture cleansing using toothpaste, liquid handwashing soap, and two chemical denture cleansers: Clinsodent powder and fittydent tablets. Cleansing with plain water was kept as control for twenty patients.Results:The data were analyzed using Wilcoxon signed ranks test for checking the efficacy. The Kruskal–Wallis test was used for comparing the plaque removing efficacies of each denture cleanser used in the study. All four denture cleansers were significantly effective in removing plaque when compared with plain water, but there was no significant difference among them.Conclusions:There was no significant difference among action of four denture cleansers used in this study. Thus we can infer that patients can use liquid handwashing soap or commercial products to overcome disadvantages of toothpastes. Recommendation from the results of this study is the use of liquid handwashing soap for cleansing after every meal and soaking of the denture in commercial denture cleanser during the night.

Fabrication of complete dentures in three visits using existing prosthesis-a simplified technique for geriatric patients.

Complete edentulism often limits patients' ability to masticate and perform other oral functions, resulting in a reduction of oral-health-related quality of life. Although the two-implant mandibular overdenture may be considered as a minimum standard of treatment of complete edentulism, patients often prefer conventional complete dentures due to cost and surgical procedures related to implant supported dentures. Many complete denture patients may have limited access to dental care due to socioeconomic or health issues, hence there is a need in simplification of complete denture fabrication. Researchers have proposed "simplified" techniques to fabricate complete dentures by eliminating two stage impression procedures facebow transfer, and articulator programming, with impressive initial results. However, long-term clinical data of these techniques is unavailable. A novel technique for fabricating simplified complete dentures in three visits, using patient's existing dentures is presented here. Unlike previously described techniques on "simplified" dentures, this technique does not eliminate vital steps such as border-molded impressions, facebow transfer, verification of centric relations during try-in, programming of the articulator, and balancing procedures.

Clinical Evaluation of Post Insertion Problems among Newly Wearers of Complete Denture Patients in Sulaimani City

Growth of the aging population will presumably increase the edentulous population in need of care with complete denture prostheses. The objective was to examine complete dentures in patients experiencing difficulties with their new prostheses, determine the most frequent complaints and their possible relation to age and gender. A total number of 200 complete denture wearer patients 126 females and 74 males participated in this study. A questionnaire was used to record the information which was taken directly from the patient when they attend the dental hospital. The information includes; age, gender, and types of the complaint. The study result revealed that; female number 126 ( 63%) was more than male 74 (37%), the number of the patients within the age group of above 60 years was 158( 79%), more than patients within the age group of 60 years, 42 (21%). The significant difference was found between gender and age groups (P &lt; 0.05). Pain 54 (27%) was the most common complaint of most of the patients in both genders, 23 (6.5%) for male and 31 (15.5%) for females. Loose Denture complaint had the lowest number among male 10 (5%), while complaint relating to mastication and eating had the lowest number of Females 18 (9%). No significant difference was found between gender and type of complaints (P&gt; 0. 05). Speech problem had the highest incidence among patients within the age group of up to 60 years 11 (5.5%), while the highest incidence among patients within the age group of above 60 years, were pain complaint 45 (22.5%). Complaint relating to eating and mastication had the lowest incidence among both age groups in total 34 (17%). No significant difference was found between age group and type of complain. Pain during insertion, removing, and wearing a complete denture had the highest prevalence, alongside speech problem in one age group only. A significant difference was found between gender and age group. No statistically significant difference was found between gender and type of complaints.