Ill-fitting Dentures Research Articles

Inflammatory papillary hyperplasia: A systematic review.

IntroductionInflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use.ObjetivesThe aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated.Material and MethodsA search was carried out in PubMed (January 2005 to October 2015) with the key words “inflammatory papillary hyperplasia”, “denture stomatitis”, “granular stomatitis” and “Newton’s type III” The inclusion criteria were studies including at least a sample of 50 apparently healthy patients, articles published from 2005 to 2015 written in English. The exclusion criteria were reviews and non-human studies.ResultsOut of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH.ConclusionsIPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among non-denture-wearers is extremely unusual. Key words:Inflammatory papillary hyperplasia, denture stomatitis, prevalence, granular stomatitis, Newton’s type III stomatitis.

Shortcomings of prosthodontic rehabilitation of patients living in long-term care facilities.

Removable dentures are a non-invasive, cost-effective prosthodontic solution for the reduced dentition. Their intended purpose is the rehabilitation of harmonious oral function and aesthetics on a long-term basis. The prevalence of removable dentures among patients of advanced age is high and the quality of the dentures is often poor. The aim of this study was to find the most important shortcomings of removable dentures and address the main targets for improving the quality of prosthodontic rehabilitation. The records from dental check-ups in Austrian residential homes were analysed retrospectively. Dental anamnesis questionnaires and data from the clinical examinations of 105 denture wearers were analysed. The functional condition and retention of 192 dentures had been assessed, as well as the impact of the dentures on the intra-oral tissues. Insufficient denture retention was very common, particularly in the lower jaw (56·0%). Problems with the masticatory function were reported by 26.7% of the denture wearers, 11·4% were dissatisfied with the denture aesthetics, and 4·8% had difficulties with phonetics. Traumatic ulcers were found in 18·1%. Cracks, broken pieces (6·3%) or missing denture teeth (2·1%) were rare. It may be assumed that the findings of the present study also apply to a great percentage of community-dwelling seniors. The most important issues in prosthodontic rehabilitation with removable dentures are denture retention and masticatory function. Regular dental check-ups, denture adjustment and, when necessary, relining can maintain the primary denture quality and prevent damages of the oral tissues caused by ill-fitting dentures.

Effect of home reliner on occlusal relationships and oral mucosa: viscoelastic analyses by smoothed particle hydrodynamics simulation

BackgroundFor decades, many reports have expressed negative opinions about home reliner (HR), because it may result in residual ridge resorption. Recently, some clinical studies evaluated HR. However, the effect of HR on occlusal relationships and the oral mucosa remains unclear. Here, we dynamically analyzed the situation in which a patient applies HR to an upper complete denture. MethodsWe numerically simulated the effect of HR on occlusal relationships and the oral mucosa. In the simulation, the thickness of HR was set to 2mm as a proper amount and 4mm as an excessive amount. The loading points were set at the center of the right and left occlusal surfaces of the denture. ResultsCompared with the case without using HR, at proper amounts (2mm on the right and left sides), HR suppressed the depression of the ill-fitting denture, and stress on the oral mucosa was decreased. In the excessive HR model (4mm on the right and left sides), the vertical occlusal dimension was increased, and stress on the oral mucosa originally fitted with the denture base was increased. When the denture was modeled in an inclined position (2mm on the left side and 4mm on the right side), stress on the oral mucosa on the left buccal side was markedly increased. ConclusionIt was found that when an improper amount of HR was applied, the occlusal vertical dimension increased and the oral mucosa was pressured more than that under non-HR conditions.

The impact of oral health on the quality of life of nursing home residents.

BackgroundGood oral health in older residents of nursing homes is important for general health and quality of life. Very few studies have assessed how oral symptoms affect residents’ quality of life.ObjectiveTo assess the clinical and subjective oral health, including oral health related quality of life (OHRQoL), and the association of oral symptoms with OHRQoL in older people residing in nursing homes in Islington, London.MethodOverall, 325 residents from nine nursing homes were clinically examined and 180 residents were interviewed to assess their oral symptoms and their OHRQoL using the OIDP measure. Managers and carers working in the homes were also interviewed.ResultsAlmost two thirds of the sample were dentate (64.5 %). 61.3 % of dentate and 50.9 % of edentate residents reported problems such as dry mouth, sore cracked lips, broken teeth and toothache and ill-fitting dentures. Oral health impacted considerably upon resident’s OHRQoL; 20.2 % of dentate and 30.9 % of edentate reported at least one oral impact in the past 6 months. Sensitive teeth, toothache, bleeding gums, dry mouth and loose natural teeth among the dentate and loose or ill-fitting dentures among the edentate were strongly associated with higher prevalence of oral impacts even after adjusting for demographic and socio-economic factors, and for the number of teeth (dentate only).ConclusionThe burden of oral conditions was considerable. Oral symptoms were very common and were strongly associated with residents’ worse OHRQoL. Health promotion programmes are important to help residents maintain an acceptable level of oral health and function.

English

The aim of this cross-sectional study was to investigate the relationship of dentition status, defined by the number of occluding pairs of natural teeth (OPNT) and removable denture fit, to food diversity among older Japanese adults. The study participants were 268 Japanese (mean age: 81.7 years) classified into four groups: (i) good dentition (n = 91; ≥5 OPNT), (ii) compromised dentition (n = 43; <5 OPNT), (iii) well-fitting dentures (n = 104; self-reported), and (iv) ill-fitting denture (n = 30; self-reported). Food diversity was assessed as a measure of dietary quality using the 11-item Food Diversity Score Kyoto (FDSK-11), which evaluates frequency of consumption of 11 main food groups (grains, potatoes, beans and soybean products, meat, fish and shellfish, eggs, milk and dairy products, vegetables, seaweed, nuts and fruits). Multivariable analysis of the differences in FDSK-11 score ranging from 0 to 11, with a higher score indicating greater food diversity, among the four groups was conducted using linear regression models with robust standard errors. The compromised dentition and self-perceived ill-fitting denture groups had significantly lower FDSK-11 scores than the good dentition group after adjusting for confounders (P < 0.05). A less-varied diet, as indicated by low FDSK-11 score, was observed in participants with fewer OPNT or ill-fitting dentures. Impaired dentition was associated with poor diet quality among older Japanese. Key words: Epidemiology, elderly, diet, dental health.

Dental Implant Therapy in Patients Affected by Oral Mucosal Diseases

have exacerbated the patient’s type 4 maxillary bone, compromised the healing capability, and consequently made implant surgery a challenge [12]. Ill-fitting dentures can cause vesiculobullous and ulcerative lesions. Prosthetic rehabilitation with implant-retained prostheses improves stabilization of the prosthesis in patients with PV and prevents formation of such lesions. We previously reported that this treatment choice could be considered as a good alternative for removable complete dentures in PV patients [13].

Greffes osseuses mandibulaires antérieures par voie sous-mentonnière

Some cases of totally edentulous mandibles are associated with extreme osseous resorption which do not allow the placement of dental implants, even in the symphysis area. We present a bone graft technique performed by mean of a submental approach. The reconstruction is performed under general anesthesia by mean of calvarial bone bone grafts affixed on the superior face and occasionally on the inferior face of the mandibular symphysis, between the mental foramens. The approach is a conventional sub-mental approach that exposes the entire symphysal region. Four patients (aged 61 to 81) have been operated according to this technic. There was no postoperative complication. Mean bone increase was 9.3mm. Nineteen implants were inserted (4.75implants per patient). No implant have been lost. The scare was inconspicuous. This technique is indicated for cases with extreme bone resorption. It allows the reconstruction of the mandibular symphysis, without an intraoral approach and thus with minimized risk of bone graft exposure. Postoperative courses are uneventful. This technique is therefore indicated for elderly patients who complain about ill-fitting dentures.

Denture Stomatitis: A Literature Review

Denture stomatitis is a denture-associated mucosal condition characterized by inflammation and erythema of the denture-bearing surfaces. The etiology is multifactorial, although, Candida albicans is the commonly associated pathogenic organism. Predisposing factors include poor oral and denture hygiene, ill-fitting dentures, nocturnal denture wearing, allergic reactions to denture base material and underlying systemic conditions. Usually, the patients are asymptomatic, although some patients may complain of burning sensations, bleeding from mucosal surfaces, bad smell and impaired taste sensations. Denture stomatitis can be managed by elimination of predisposing factors, placement of dentures in antiseptic solutions, and the use of antifungal agents. Surgical interventions may be required in severe inflammatory states.

Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus.

This work provides a systematic review of the literature from January 2003 to April 2014 pertaining to the incidence, pathophysiology, diagnosis, and treatment of osteonecrosis of the jaw (ONJ), and offers recommendations for its management based on multidisciplinary international consensus. ONJ is associated with oncology-dose parenteral antiresorptive therapy of bisphosphonates (BP) and denosumab (Dmab). The incidence of ONJ is greatest in the oncology patient population (1% to 15%), where high doses of these medications are used at frequent intervals. In the osteoporosis patient population, the incidence of ONJ is estimated at 0.001% to 0.01%, marginally higher than the incidence in the general population (<0.001%). New insights into the pathophysiology of ONJ include antiresorptive effects of BPs and Dmab, effects of BPs on gamma delta T-cells and on monocyte and macrophage function, as well as the role of local bacterial infection, inflammation, and necrosis. Advances in imaging include the use of cone beam computerized tomography assessing cortical and cancellous architecture with lower radiation exposure, magnetic resonance imaging, bone scanning, and positron emission tomography, although plain films often suffice. Other risk factors for ONJ include glucocorticoid use, maxillary or mandibular bone surgery, poor oral hygiene, chronic inflammation, diabetes mellitus, ill-fitting dentures, as well as other drugs, including antiangiogenic agents. Prevention strategies for ONJ include elimination or stabilization of oral disease prior to initiation of antiresorptive agents, as well as maintenance of good oral hygiene. In those patients at high risk for the development of ONJ, including cancer patients receiving high-dose BP or Dmab therapy, consideration should be given to withholding antiresorptive therapy following extensive oral surgery until the surgical site heals with mature mucosal coverage. Management of ONJ is based on the stage of the disease, size of the lesions, and the presence of contributing drug therapy and comorbidity. Conservative therapy includes topical antibiotic oral rinses and systemic antibiotic therapy. Localized surgical debridement is indicated in advanced nonresponsive disease and has been successful. Early data have suggested enhanced osseous wound healing with teriparatide in those without contraindications for its use. Experimental therapy includes bone marrow stem cell intralesional transplantation, low-level laser therapy, local platelet-derived growth factor application, hyperbaric oxygen, and tissue grafting.

Gingival necrosis due to the ill-fitting denture.

We present a case of an 80-year-old male who was referred to the Department of Oral Medicine, School of Dental Medicine University of Zagreb, Croatia due to gingival ulcer which was present for eight days. Clinical examination has revealed exposed bone on the toothless alveolar ridge in the lower molar region on the right side of 0.8 cm in diameter. Otherwise, the patient was taking doxazosin due to urinary problems and ipatropium bromide due to respiratory problems. The patient wore a 6-year-old partial lower denture. He was initially treated with periodontal bandage (Resopack, HagenWerken, Germany) for the first three days and was instructed not to wear the denture; however, no benefit could be seen. Therefore, we added a local corticosteroid (betamethasone) and am oral antiseptic (chlorhexidine digluconate) applied three times a day. After 3 weeks the lesion healed. A list of possible causative factors regarding gingival ulcers is included.

Ill-fitting dentures and oral cancer: A meta-analysis

Several studies have investigated the relationship between the use of dentures and the duration of denture use and cancer development. Of particular interest is whether ill-fitting dentures increase the likelihood of the development of oral cancer. We conducted a meta-analysis to determine the relationship between dentures and the development of cancer. We searched several databases (PubMed, Medline, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews) to find published papers on the topic. In particular, the duration of denture use and the comfort and fit of the dentures were investigated. The use of dentures by itself is associated with an increased risk of developing cancer (OR: 1.42, 95% CI: 1.01-1.99). In addition, ill-fitting dentures appears to substantially increase the risk of developing cancer (OR: 3.90, 95% CI: 2.48-6.13). In addition, there was no link between the duration of denture use and cancer development. This might be due to the arbitrary nature of what we defined as short and long term denture use and may have been affected by the inconsistency in time categorization between different studies. Ill-fitting dentures are a risk factor for the development of oral cancer, greater patient education and regular checking of dentures by dentists should be undertaken as a prevention measure.

OI0413 Chronic inflammation, trauma, and oral cancer

Chronic inflammation has been associated with tumorigenesis, increased cell proliferation, angiogenesis, survival, invasion, and metastasis. Repetitive oral mucosal trauma from malpositioned or sharp teeth, ill-fitting dentures, or parafunctional habits may lead to chronic inflammation and therefore increase the risk of cancer development. We conducted a retrospective review of patients with oral cancer to identify individuals with a history of chronic mucosal trauma before development of cancer.

Oral health status: relationship to nutrient and food intake among 80-year-old Japanese adults.

The aim of this cross-sectional study was to investigate the relationship of oral health status defined on the basis of presence of posterior occluding pairs (POPs) and adequacy of removable denture fit as determined by self-report to nutrient and food intake among older Japanese. The subjects were 353 Japanese aged 80 years in 2008 and were classified into four groups according to the number of POPs, defined as pairs of occluding natural, restored, or fixed prosthetic postcanine teeth (range: 0-8) and removable denture status. The groups were: (i) good dentition (n = 56; 8 POPs and no removable prosthesis), (ii) well-fitting dentures (n = 158; <8 POPs with self-reported good-fitting dentures), (iii) ill-fitting dentures (n = 70; <8 POPs with self-reported ill-fitting dentures), and (iv) compromised dentition (n = 69; <8 POPs and no removable prosthesis). Multivariable analysis of the differences in nutrient and food intake outcome variables which were collected via validated food frequency questionnaire among the four oral health status groups was conducted using general linear models. Results: Intake of multiple nutrients was significantly (P < 0.05) lower in the group with ill-fitting dentures or compromised dentition than in the good dentition group. Vegetable, fish, and shellfish consumption was significantly lower in the ill-fitting dentures or compromised dentition groups. No significant differences were seen in dietary intake between the well-fitting dentures and good dentition groups. Conclusions: Dietary intake was poorer in those with self-perceived ill-fitting dentures or fewer POPs than among those having all POPs. Regular dental care to maintain intact dentition, as well as dental treatment to replace missing teeth and ensure adequate denture fit and function, may be important to the diet intake and subsequent nutritional status of older Japanese.

Peripheral cemento-ossifying fibroma: Report of a case in an elderly patient

The peripheral cemento-ossifying fibroma (PCOF) is an osteogenic neoplasm and is believed to arise from the periodontal ligament. It accounts for 3.1% of all oral tumors and 9.6% of all gingival lesions. It frequently occurs in the maxillary anterior region in teenagers and young adults, and has a female predilection. Trauma, local irritation due to calculus, ill-fitting dentures and faulty restorations, and hormonal disturbances are the known predisposing factors. An early diagnosis and surgical excision is required to prevent its recurrence. Here we present a case of PCOF with a history of just two months, occurring in an elderly female involving the edentulous mandibular posterior region.

The Association between Complete Denture Wearing and Denture Quality with Oral Health Related Quality Of Life in an Elderly Gujarati Population

Aim: This study aims to determine whether complete dentures improve the quality of life of an edentulous patient, and will also assess the roles of socioeconomic and demographic factors. The study will further assess the association between psychosocial, socioeconomic and demographic factors and patients' level of denture satisfaction.Material & Method : A final sample of 630 patients was then included in the study. Eighty-one percent (n=510) of the sample was female. The age ranged from 34 years to 80 years old with a mean age of 58 years.Result: Generally, all the patients were satisfied with the maxillary denture received during their treatment. A higher rate of dissatisfaction was recorded for the mandibular denture (36%) than the maxillary denture (10%). More than two thirds (68%) of the sample experienced great difficulty eating with their previous dentures and only 42% experienced pain in their mouth in the last month. Patients recorded higher impacts related to functional limitations. This could be due to ill-fitting dentures, inadequate retention and the resulting discomfort experienced by edentulous patients. Conclusion: The findings of this study could also serve as motivation for a more vigorous national plan with regards to oral health. The high prevalence of edentulism clearly suggests that the levels of tooth loss are not decreasing. The results of this study and future research could be used to motivate for more appropriate resource allocation.

Biological effects of soft denture reline materials on L929 cells in vitro

Soft denture reline materials have been developed to help patients when their oral mucosa is damaged or affected due to ill-fitting dentures or post-implant surgery. Although reports have indicated that these materials leach monomers and other components that do affect their biocompatibility, there is little information on what cell molecules may be implicated in these material/tissue interactions. The biocompatibility of six soft liners (Ufi Gel P, Sofreliner S, Durabase Soft, Trusoft, Softone and Coe Comfort) was evaluated using a mouse fibroblast cell line, L929. Within 2 h of material disc preparation, each of the materials was exposed by direct contact to L929 cells for periods of 24 and 48 h. The effect of this interaction was assessed by alamarBlue assay (for cell survival). The expression of integrin α5β1 and transforming growth factor β1 was also assessed using plate assays such as enzyme-linked immunosorbent assay. Trusoft, Softone and Coe Comfort showed significantly reduced cell survival compared with the other soft lining materials at each incubation period. Furthermore, there were significant differences with these same materials in the expression of both integrin α5β1 and transforming growth factor β1. Soft liner materials may affect cell viability and cellular proteins that have important roles in wound healing and the preservation of cell viability and function in the presence of environmental challenges and stresses.

Are recurrent denture-related sores associated with the risk of oral cancer? A case control study.

This study aimed to assess the hypothesis that recurrent denture-related sores association may be associated with the risk of oral cancer. We conducted a hospital-based case-control study comprising 71 new cases of oral cancer in two hospitals in São Paulo, Brazil, and 240 controls without cancer, recruited from outpatient units of the same hospitals. All cases had histologically confirmed squamous cell carcinoma in anatomic sites of the mouth that may be specifically consi-dered at risk of sores by ill-fitting dentures. Denture-related sores were assessed by the self-report of recurrent oral sores due to the use of ill-fitting complete removable dental prosthesis. Associations were assessed by multivariate logistic regression conditioned on socio-demographic and behavioral characteristics. The association between ill-fitting dentures and oral cancer was statistically significant in the multivariate model: odds ratio 3.98; 95% confidence interval 1.06 - 14.96. The specific assessment of association between tumors in the lower jaw and sores by mandibular dentures confirmed this result: odds ratio 6.39; 95% confidence interval 1.49 - 29.52. The potential contribution of denture-related sores to oral carcinogenesis still fuels controversies. This study reinfor-ces the hypothesis that recurrent denture-related sores may be associated with the risk of oral cancer. Results reported here also suggest that an appropriate application and monitoring of dental prosthesis represent a non-negligible scope for cancer prevention.

Complication of a columellar strut in an edentulous patient

The cartilaginous columellar strut is a well established, commonly used graft in rhinoplasty which provides support and stability to the nasal base. The risk of such a graft is related to grafts designs, whereby the posterior aspect can cause clicking with movement across the anterior nasal spine. We present an additional unusual complication of ill-fitting maxillary dentures in an edentulous patient, previously not reported in the literature. This unique complication should alert facial plastic surgeons to use additional caution when sculpting columellar grafts in edentulous patients in order to avoid potential post-operative complications in this specific patient population.

Diode laser assisted management of denture induced fibrous hyperplasia

Epulis fissuratum is an overgrowth of intraoral tissues resulting from chronic irritation by ill-fitted dentures. The etiology is persistent mucosal irritation and trauma, mostly seen over alveolar ridges or in vestibular sulcus. This report describes a case of 58-year-old female with soft tissue hyperplastic growth in labial vestibule of upper anterior region. This lesion was removed by using diode laser. The healing was uneventful and no suture, periodontal pack or analgesics were required. The histopathological report confirmed the presurgical diagnosis. The follow-up did demonstrate any relapse of the growth.

Surgical Elevation of Bilateral Maxillary Sinus Floor with a Combination of Autogenous Bone and Lyophilized Bovine Bone

Realize the surgery of sinus lifting floor to allow the installation of osseointegrated implants for oral rehabilitation, with the combination of different biomaterials, autogenous bone and lyophilized bovine bone. Oral rehabilitation using the installation of osseointegrated implants is an alternative surgical approach that results in the satisfactory form, function and esthetics of the dental units. After clinical, dental and laboratory assessment, a 47-year-old female patient underwent full maxillary oral rehabilitation involving the installation of osseointegrated implants to allow her to meet the physiological demands of occlusion and mastication. It was found that the patient had fully pneumatized maxillary sinuses with insufficient height to anchor implants, with a loss of the vertical dimension of the occlusal and masticatory functions due to general dental loss, compounded by the use of ill-fitting dentures; hence, the choice was made to take autogenous bone from the patient's chin area and supplement it with lyophilized bovine bone as collateral for larger areas to be grafted. It was also decided to avulse the remaining tooth units due to their impairment by periodontal disease. Bone grafts do not constitute suitable alternatives in the cosmetic and functional rehabilitation of the maxilla in patients requiring bilateral sinus elevation. The chin region provides bone tissue that, when complemented by lyophilized bovine bone grafts, ensures greater volume and less invasive surgery. In the case described here, a height gain of approximately 550% was obtained, making it possible to anchor seven implants. In this study, the surgical procedures used for grafting a combination of autogenous and lyophilized bovine bone, aimed to elevate the maxillary sinus floor to allow the installation of osseointegrated implants for oral rehabilitation.