Lower Dentures Research Articles

Complications and Patient Satisfaction in Fully Edentulous Patients Treated with a Digital and Conventional Complete Denture, A Cross-Over Clinical Study.

The objective of this clinical study was to evaluate comfort, satisfaction, chewing ability and complications with digital complete dentures (DCD) and conventional complete dentures (CCD). For 16 edentulous patients, two sets of upper and lower dentures were fabricated by students in a university dental clinic. The impression for the DCD was done using indirect scanning of the cast. When the patients were pain free, each set of dentures was worn for four weeks. OHIP-14 and a DSI (Denture Satisfaction Index)were used to measure patient satisfaction and chewing ability respectively. Both questionnaires were administered before fabrication and after wearing each set. Adjustments made during the follow up period were included. At the end of the study, patients could express which set of dentures they preferred. The 25 dental students involved in fabricating the dentures, were questioned in terms of discomfort, preference and future use for both techniques. OHIP-14 showed significantly higher scores for the DCD for the domain concerning psychological discomfort. DSI showed no significant difference for both sets of dentures. In terms of complications, a significant difference was found for occlusion. The DCD required more occlusal adjustments. A minority of the patients (37.5%) chose the DCD as their favourite set. The students preferred the wax try-in and workflow of the CCD. The CCD and DCD showed differences in patient satisfaction. Chewing ability was comparable for both sets of dentures. More occlusal complications were seen in the DCD. Both students and patients preferred the CCD.

Comparison of Clinical and Radiographic Outcomes Between Single Symphyseal and Parasymphyseal Implants Versus Two Implant-Assisted Complete Mandibular Overdentures.

This study aimed to compare the efficacy of single implants in the symphyseal and parasymphyseal regions with that of two implants in complete mandibular overdentures. Fifteen completely edentulous male patients (50-65 years) were chosen and randomly grouped into three equal groups (five patients in each) according to the position and number of the received implants to assist mandibular complete overdentures: group I: single median implant; group II: single parasymphyseal implant; and group III: two implants were inserted in the canine area bilaterally. After three months of osseointegration, the lower denture was transformed into an implant-assisted complete mandibular overdenture. Clinical observations were documented on the day of loading, and three, six, and nine months later for each implant. Follow-up cone beam computed tomography scans were performed to assess marginal bone loss on the day of loading, and six and twelve months later. The masticatory efficiency evaluation was conducted one and three months after loading. The obtained results demonstrated insignificant differences between the three groups concerning marginal bone loss, plaque index, pocket depth, and bleeding index. Regarding the masticatory efficiency, the results revealed a significantly higher masticatory efficiency in group III than in groups I and II. Using two implants to retain mandibular overdentures is the first choice due to their higher masticatory efficiency than a single implant. However, a single implant may be a viable treatment alternative, especially in cases where there are any limitations that restrict the use of additional implants.

Oral Health Policy Framing For Thirumazhisai Town Panchayat, Thiruvallur District, Tamilnadu

Introduction Oral health is an integral part of general health and no individual can be considered fully healthy while there is active disease in the mouth as “Health is a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity. Aim of the study was to assess the prevalence of oral diseases and treatment needs among 5 years, 12 years, 15 years, 35–44 years, and 65–74 years age group population residing in Thirumazhisai town panchayat, India. Materials and methods It is a Cross- sectional study conducted in Thirumazhisai town panchayat. Permanent residents with the index age group -5, 12, 15, 35- 44, 65-74 years were included. A systematic random sampling methodology is used to carry out a cross sectional study in Thirumazhisai. Sample size, N= 207. Data collection to be done using a pre-tested questionnaire and clinical examination of study participant. The first part involved collection of demographic information of participant. The dentition status, oral mucosal lesions and treatment needs were assessed based on WHO proforma. All the subjects were examined under adequate illumination using plane mouth mirror and CPITN probe. Results In this study, among 35 to 44 years age group 27%(56) were females and 19.4%(40) were males. Prevalence of dental caries was found to be high about 42% among 35-44 years age group. Prevalene of partial denture wearers ( lower denture about 5.3% and upper denture about 4.8%) among 35-44 years old age group population. Prevalence of complete denture (about 2.4% )was found to be more among 65-74 years age group of study population Conclusion In the present study, Preventive treatment was highly required among 12 years age group of study subjects.. Urgent treatment was highly required among 35-44 years old study population. Prevalence of dental caries and partial denture wearers was found to be high among 35-44 years old age group of study population.

Oral Health Status and Treatment Needs of School Teachers in Kathmandu District

Introduction: Oral health is an integral part of general health. The high prevalence of dental diseases and conditions like dental caries, periodontitis, and malocclusion may lead to absenteeism from work as well as economic loss.
 Objective: To assess the oral health status and treatment needs of school teachers in Kathmandu district.
 Methods: An analytical cross-sectional study was conducted from January-June 2022 among the school teachers of Kathmandu after getting approval from the institutional review board of Kantipur Dental College. Informed consent was also obtained before the study. Data was entered in Microsoft Excel and analyzed using SPSS version 20. P value˂ 0.05 was considered statistically significant.
 Results: A total of 165 teachers participated in the study out of which 125 (75.80%) were females and 40 (24.20%) were males with a mean age of 36.29±10 were there. The prevalence of dental caries was 98 (59.40%), gingivitis138 (83.60%), periodontal pocket 40 (24.20%), and 39 (23.60%) had 4-5 mm pocket but only 1 (0.60%) had more than 6mm pocket, 2 (1.20%) had upper and 14 (8.50%) had lower dentures. There was no significant difference in dental caries and periodontal status among the government and private school teachers (p=0.081), (p=0.101) respectively but a significant difference in gingivitis status (p=0.001)
 Conclusion: The oral health status of the teachers was not satisfactory since there was a high prevalence of dental diseases. So, it can be improved by periodically conducting oral health education programs at schools and motivating them

Risk factors and immunological biomarkers in denture stomatitis: An observational cross-sectional study

ObjectiveAssess risk factors, local and systemic immunological biomarkers in healthy individuals and with Denture Stomatitis (DS). DesignFor this observational transversal study, 27 participants without DS (Group 0), 24 with moderate DS (Group 1), and 25 with severe DS (Group 2) were assessed for sociodemographic, behavioral, and clinical parameters, microbial load of Candida spp., Staphylococcus spp., Streptococcus mutans, Pseudomonas spp., and enterobacteria, and cytokine and C-reactive protein levels. ANOVA, Fisher's exact, Kruskal-Wallis, Mann-Whitney, Wilcoxon and Pearson's chi-square tests were used for data analysis (α = 0.05). ResultsGroup 1 had a significantly higher mean age compared to the other groups (P = 0.018), but no correlation was identified between age and DS (P = 0.830; r = 0.025). No significant differences were found among the groups for other sociodemographic and behavioral characteristics. Group 1 had significantly older upper and lower dentures; however, no correlation was identified between age of upper (P = 0.522; r = 0.075) and lower (P = 0.143; r = 0.195) dentures and DS. The microbial load of Candida albicans on the dentures (P = 0.035) and Candida spp. on the palate (P = 0.008) of the groups 1 and 2 was higher than group 0. Group 1 and 2 had higher Candida spp. counts on denture (P = 0.003) than group 0. There was no difference among groups for bacterial analyzed. Group 1 showed higher and Group 2 intermediate salivary levels of IL-6 compared to Group 0. There was no difference in the C-reactive protein levels among groups. ConclusionsMicrobial load of Candida spp. is the factor with the strongest relationship with DS, with capacity for local signaling through IL-6.

Patient satisfaction levels for complete dentures (F/F) delivered by undergraduate dental students

One important aspect of acceptance of full denture treatment is that of patient’s perceived outcome. A teaching environment is the best place for future clinicians to understand this aspect of treatment. The aim of this study was to assess the satisfaction levels of patients who received complete dentures delivered by undergraduate dental students at the University of Otago. Participants’ attitude toward dentures was measured via a 16-item questionnaire based on Patient’s Denture Assessment (PDA) questionnaire. It comprises of items that assessed factors related to dentures and was quantified on a four-point scale. A total of 60 edentulous patients wearing maxillary and mandibular dentures were recruited then contacted using a list of patients whose treatment were carried out and completed in the undergraduate clinic from 2010-2018 and were sent an explanatory letter, an informed consent form, and a self-administered questionnaire in a return envelope to the University of Otago Faculty of Dentistry. Bivariate analysis was then carried out on the responses. 55% of the invited participants responded to the survey. The mean extent of PDA impacts was 0.15 (range 0.0-0.71). There were no significant differences in the experience of the prevalence and extent of PDA impacts by gender and age. 81.8% reported their denture to be very important to them and 91% found it “very easy” or “easy” to eat and swallow. 88% enjoyed their meals “well” or “very well”. Bivariate analysis showed those aged 70 years old or younger were less likely to report issues with the denture, while there was no statically significant difference between genders. Overall, the participants expressed satisfaction with the treatment received at the faculty over the sub-groups of function, speech/aesthetics, upper denture, lower denture, and considered the denture to be of high importance.

Prediction accuracy of incisal points in determining occlusal plane of digital complete dentures.

This study aimed to predict the positional coordinates of incisor points from the scan data of conventional complete dentures and verify their accuracy. The standard triangulated language (STL) data of the scanned 100 pairs of complete upper and lower dentures were imported into the computer-aided design software from which the position coordinates of the points corresponding to each landmark of the jaw were obtained. The x, y, and z coordinates of the incisor point (XP, YP, and ZP) were obtained from the maxillary and mandibular landmark coordinates using regression or calculation formulas, and the accuracy was verified to determine the deviation between the measured and predicted coordinate values. YP was obtained in two ways using the hamular-incisive-papilla plane (HIP) and facial measurements. Multiple regression analysis was used to predict ZP. The root mean squared error (RMSE) values were used to verify the accuracy of the XP and YP. The RMSE value was obtained after cross-validation using the remaining 30 cases of denture STL data to verify the accuracy of ZP. The RMSE was 2.22 for predicting XP. When predicting YP, the RMSE of the method using the HIP plane and facial measurements was 3.18 and 0.73, respectively. Cross-validation revealed the RMSE to be 1.53. YP and ZP could be predicted from anatomical landmarks of the maxillary and mandibular edentulous jaw, suggesting that YP could be predicted with better accuracy with the addition of the position of the lower border of the upper lip.

Prosthodontic management of Atwood's order V and VI mandibular ridge with cocktail impression technique

Residual ridge resorption is the reduction in size of the bony ridge under the mucoperiosteum. The resorption occurs faster in the mandibular arch as compared to the maxillary arch. Fabrication of any dental prosthesis over a compromised residual alveolar ridge is really a challenge for prosthodontists. The pattern of bone resorption observed in Atwood's Orders V and VI causes difficulty in providing successful dentures, especially lower denture where stability of denture may get compromised. This clinical case report elicits a combination of different impression techniques to improve mandibular denture stability in severely resorbed ridges preventing their further resorption.

Condição de saúde bucal das pessoas idosas institucionalizadas da cidade de Manaus-AM

Studies show a worse oral health condition in institutionalized aged, when compared to non-institutionalized aged. Most of older people who residing in Long-Term Institutions for the aged (ILPI) have poorer oral hygiene, periodontal impairment and, therefore, greater tooth loss. This study aimed to investigate the oral health of institutionalized older people in the city of Manaus-AM, through secondary data from the medical records of an ILPI. A total of 117 medical records were investigated, with a predominance of male individuals (58.11%), whose age ranged from 60 to 107 years, who studied, on average, for 3.83 (± 3.85) years. There was a predominance of single individuals (77.7%) and those receiving retirement (55.5%). Regarding oral health, 69.3% of the individuals were edentulous. The mean DMFT-d was 29.3 (± 5.11). Upper and lower denture needs were observed in 77.7% and 82.5% of the sample, respectively. The retirement variable was the only one to present a limit of statistical significance in the association with the CPO-D, indicating that individuals who receive retirement have a lower average of the CPO-D index (p = 0.05).

A Comparison of Lower Dental Arch Changes Using Two Types of Space Regainers: A Removable Appliance with a Distalizing Screw and a Fixed Double-Banded Appliance.

Aim The aim of this study was to compare lower dental arch changes using two types of space regainers, including a removable appliance with a distalizing screw and a fixed double-banded appliance. Methods and Materials In this case-control study, the study sample was comprised of thirty-eight children with mixed dentitions, all of whom had unilateral space deficiency due to premature loss of the second deciduous molar in the mandibular arch. Patients were treated with either a removable appliance with a distalizing screw or a fixed double-banded space regainer (DBSR) (n = 19). Pre- and posttreatment dental casts and lateral cephalograms of patients were evaluated to compare the effects of the two space-regaining devices on the mandibular dental arch. The data were analyzed using paired and independent t-tests. Results Available space, molar angle, IMPA, and the first molar distance to the mandibular plane and symphysis increased significantly in both groups (P < 0.001). The mean amount of IMPA changes was significantly greater in the distalizing screw group than in the DBSR group (P < 0.05). But, there were no statistically significant differences between the mean changes of available space, molar angle, and the first molar distance to the mandibular plane and symphysis in the distalizing screw and the DBSR group (P < 0.05). The DBSR group's treatment time was significantly shorter (P < 0.001). Conclusion The removable device with a distalizing screw and the DBSR were both able to regain mild-to-moderate unilateral space loss, achieving an increase in molar angle, IMPA, and molar extrusion. However, treatment time with the DBSR was shorter and with less incisor tipping as a side effect.

Edentulous Patient Satisfaction with Conventional Complete Dentures

Background and Objectives: Edentulism is considered to be an impediment impacting both patients’ quality of life and their nutrition. Conventional complete dentures are still a preferred treatment. However, there is no consensus on the most important factors which could substantially reduce the risk of patient dissatisfaction. This study evaluated the following determinants concerning patient satisfaction with complete maxillary and mandibular dentures: sex, denture-related functional and aesthetic aspects, and the degree of bone resorption. Materials and Methods: This study included 70 patients aged 34–81 years of age. All complete dentures were made by following the same technology. Visual analogue scales were used to assess patients’ overall satisfaction with dentures, comfort, ability to speak and chew, denture aesthetics, stability, and ease of prosthesis cleaning. Satisfaction with upper and lower dentures was rated separately. The degree of bone resorption was classified by using the Kalk and de Baat (1989) method. Results: The mean (SD) age of the study participants was 67.3 (10.4) years; 65.7% (n = 46) were females and 34.3% (n = 24) were males. There were no significant sex-based differences in resorption of the maxilla or mandibula. There were significant differences between maxillary and mandibular dentures, with lower mean satisfaction scores concerning chewing and maxillary complete dentures, and in regard to stability and comfort for mandibular complete dentures. There was a non-significant overall lower satisfaction with increased age. In multivariate analysis for mandibular complete dentures, aesthetics and stability significantly predicted the patient’s comfort levels, and the patient’s comfort significantly predicted overall satisfaction. For maxillary complete dentures, patient comfort and aesthetics significantly predicted overall patient satisfaction. Conclusions: Age, sex, and degree of resorption were not associated with patient satisfaction with complete dentures. Overall, patient satisfaction with both maxillary and mandibular complete dentures was related to their comfort level and denture aesthetics, and patient comfort itself was associated with stability of the mandibular denture.

The Physiological Basis Of The Oral Surgical Management Of A Patient With Polycythemia Rubra Vera: A Pathway For The Development Of A Protocol

Various oral surgical procedures are currently performed under local anaesthesia and conscious sedation as a day surgery procedure. Both oral and intravenous conscious sedation are available as a choice. Oral sedation with Alprazolam and Codeine is very effective for most oral surgical procedures especially the removal of impacted third molars and surgical placement of implants. It is this sedation regimen that comprises the synergistic use of both aprazolam and codeine to effect sedation with amnesia that is the standard procedure at the Faculty of Dentistry of the International Postgraduate Medical College. The purpose of this case report is to appraise the possible negative effect of Alprazolam and Codeine sedation mentioned above on a patient who presented with polycythaemia rubra vera (a very rare haematological condition). This is because the codeine component of this combination will depress the respiratory centre in the medulla oblongata putting the patient at risk. The case study is that of a 70-Year-old male patient who had been a regular patient for approximately 10 years ago at the Faculty of Dentistry, International Postgraduate Medical College (IPMC), where a total upper denture and a partial lower denture were placed. The patient returned in 2019 with the chief complaint of halitosis and pain in the mandibular posterior right region. The patient gave past medical history of PRV, epilepsy and hypertension and history of being on multiple medications for these conditions. The treatment plan advised was total extraction of the remaining mandibular dentition and excisional biopsy of the suspicious lesion mesial to the mandibular right first molar, together with a complete lower denture replacement. The procedure was done without sedation and at no time was the patient considered to be in danger as it relates to oxygen saturation, carbon dioxide drive to the brain and bleeding. Every hematologist managing patients with PRV will be very concerned as to how these patients are managed by dentists, particularly as it relates to oxygen saturation, carbon dioxide drive to the brain and hemostasis. Similarly, most dental practitioners that are managing such patients may not be familiar with the technicalities surrounding the clinical and operative management of these patients. It is for this reason that this case report focusing on oral surgical management of a patient with PRV is of significance to the dental literature, particularly as it aims to develop a working group for the development of the protocol for the management of PRV.

Comparison of general satisfaction, oral health-related quality of life, and patient's self-assessment between mandibular single-implant overdentures and experimental removable complete dentures: A randomized crossover clinical trial

Objective Patient satisfaction with single-implant overdentures (1-IODs) is unclear. This randomized crossover trial aimed to compare the general satisfaction, oral health-related quality of life, and patients’ self-assessment between mandibular 1-IODs and experimental removable complete dentures (eRCDs).Methods New mandibular RCDs were fabricated for 22 patients with edentulous mandibles. After adapting to the RCDs, one implant was inserted in the mandibular midline. The participants were then randomly classified into groups 1 and 2. Group 1 received IODs for the first 2 months, while group 2 used eRCDs with a non-loaded implant in the midline. After 2 months, the treatment was switched. Four validated, patient-reported dental outcome measures were assessed: general satisfaction, Japanese version of the Oral Health Impact Profile for edentulous subjects (OHIP EDENT-J), General Oral Health Assessment Index (GOHAI), and Patient's Denture Assessment (PDA). The assessments were performed at the end of the IOD- and eRCD- use periods.Results General satisfaction was significantly higher during the IOD period (p = 0.002). Significant differences were observed in all domains of the OHIP, except orofacial pain (p = 0.084). Further, the total score (p<0.001) and the scores of the physical (p<0.001) and psychosocial functioning (p = 0.001) domains of the GOHAI differed significantly. The total PDA score (p = 0.001) and the scores of the function (p = 0.004), lower denture (p = 0.002), esthetics and speech (p = 0.026), and importance (p = 0.009) domains were significantly higher during the IOD period than during the eRCD period.Conclusion General satisfaction, oral health-related quality of life, and patient self-assessment scores were significantly higher for 1-IODs than for eRCDs.Clinical significance Within the limitations of this study, we found that mandibular single-implant overdentures may be an efficient alternative to mandibular experimental removable complete dentures due to higher general satisfaction, oral health-related quality of life, and patient self-assessment scores of dentures.

Effect of flask closure method on occlusal vertical dimension of complete upper and lower dentures

The movement of teeth during processing of complete dentures disturbs the harmonious occlusal scheme established at the final wax try-in stage. Aims and objectives: to investigate the effect of RS flask closure on occlusal vertical dimensions of complete dentures. The mean occlusal vertical dimension of complete maxillary and mandibular dentures fabricated by the conventional flask closure were measured and compared with that of dentures fabricated by RS flask closure. Design: A pre-test post-test control group experimental design. Methods: Thirty sets of complete maxillary and mandibular wax trial dentures were randomly assigned to experimental groups. Fifteen sets were assigned to conventional flask closure and the remainder to RS flask closure. Compression molding with a long curing cycle was performed for the processing of the dentures. Pre-processing and post-processing occlusal vertical dimensions were determined. Results: The mean occlusal vertical dimensions of wax trial dentures assigned to either group were similar. The data produced substantial evidence to reject the null hypothesis that the post-processing mean occlusal vertical dimensions of both groups were equal. Conclusion: The occlusal vertical dimensions produced by dentures clamped by the RS flask closure were significantly less than those produced by dentures clamped by the conventional flask closure.

Patient-reported outcomes for the immediate loading of mandibular overdentures supported by two implants soon after implant surgery

Background/purposeNo studies have comprehensively assessed short-term patient-reported outcomes after the provision of overdentures supported by two immediate implants. The purpose of this study was to evaluate short-term patient-reported outcomes for mandibular overdentures retained by ball attachments on two immediately loaded implants. Materials and methodsNineteen participants with mandibular edentulism were provided with overdentures retained by ball attachments on two immediately loaded, unsplinted implants. The participants' self-assessment of their dentures and oral health-related quality of life were evaluated with the 22-item Patient's Denture Assessment (PDA), and the 19-item Japanese version of the Oral Health Impact Profile (OHIP-EDENT), respectively. Patient satisfaction was measured on a 100 mm visual analogue scale. Assessments were conducted at baseline, and at 1 and 6 months after implant surgery. ResultsThere were significant increases in the PDA “Lower denture” (P = 0.009) at 1 month, as well as “Function” (P = 0.002) and “Lower denture” (P = 0.009) scores at 6 months. Patient satisfaction was also significantly increased at 1 month (P = 0.007) and 6 months (P ≤ 0.000). Significant decreases were observed in the OHIP-EDENT “Physical pain” (P = 0.046) score at 1 month, as well as the summary score (P = 0.033), “Functional limitation” (P = 0.020) and “Psychological discomfort” (P = 0.019) scores at 6 months. ConclusionThe use of two immediately loaded implants for lower mandibular complete overdentures is associated with improvements in patient's self-assessment of dentures, satisfaction, and oral health-related quality of life, up to 6 months after implant surgery.

Electomyographic analysis of the oral phase of swallowing in subjects rehabilitated with mandibular implant retained overdenture.

Objective: The purpose of this study was to detect the impact of mandibular implant retained overdenture on electromyographic activity of submental muscles during swallowing in edentulous subjects. Materials and methods: Fifteen completely edentulous subjects with problematic lower complete dentures were participated in this study. All subjects received a newly carefully constructed complete dentures and then the lower dentures were changed into mandibular implant retained overdentures by placing two implants on the mandibular canine regions and using ball attachments to retain the overdentures. All the subjects were submitted to surface electromyographic evaluation for the submental muscles without dentures, with complete dentures and with mandibular implant overdenture during swallowing of 10ml of water. Results: There was a statistically significant increase in swallowing duration and electromyographic amplitude of submental muscles after complete dentures insertion and also after insertion of mandibular implant overdenture. Moreover, there was a statistically significant reduction in both swallowing duration and electromyographic amplitude of submental muscles for mandibular implant overdenture when compared to complete dentures. Percentage Overlapping Coefficient showed a non-significant differences between different oral conditions. Conclusion: Rehabilitation of completely edentulous patient with mandibular implant retained overdenture revealed a reduction in swallowing duration and reduction in electromyographic amplitude of the submental muscles during swallowing.

Patient-reported outcomes with immediate-loaded two-implant-supported mandibular overdentures: Results of a 5-year prospective study

Background/purposeFew studies have comprehensively assessed long-term patient-reported outcomes for overdentures supported by two immediate implants. The purpose of the study was to evaluate patient-reported outcomes of immediately loaded two-implant-supported overdentures retained by ball attachments over a 5-year evaluation period. Material and methodsNineteen participants with edentulous mandibles were provided with immediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments. The participants completed the Japanese version of the Oral Health Impact Profile (OHIP)-EDENT-19 and the Patient's Denture Assessment (PDA). Additionally, patient satisfaction was measured by a 100-mm visual analog scale (VAS). Measurements were performed at baseline, and at 1 and 5 years following implant surgery. ResultsSeventeen participants and 14 participants were evaluated at the 1-year and 5-year assessment, respectively. Considering the OHIP-EDENT-19, there was a significant decrease in the total (p = 0.046), “functional limitation” (p = 0.021), and “physical disability” (p = 0.034) scores at 1 year and the total (p = 0.045) and “physical disability” (p = 0.024) scores at 5 years following surgery, compared to the baseline scores. Considering the PDA, there was a significant increase in the “function” (p = 0.038) and “lower denture” (p = 0.003) scores at 1 year and the “function” (p = 0.032), “lower denture” (p = 0.008), and “esthetic and speech” (p = 0.043) scores at 5 years following surgery, compared to the baseline scores. Patient satisfaction at 1 year following surgery was significantly greater than that at baseline (p = 0.005). ConclusionImmediately loaded two-unsplinted-implant-supported overdentures retained by ball attachments improved the oral health-related quality of life and self-assessment of dentures by the patients up to 5 years following implant surgery.

Subjective Assessment of Satisfaction Degree and Psychosocial Status of Patients with Highly Atrophic Mandible Treated by Implant-retained Over-denture

This study aimed at assessing patient’s satisfaction with new optimized conventional complete upper andlower dentures as compared to their previous problematic conventional dentures. A random sample ofpatients was selected (group 1). Each patient was provided with new optimized conventional upper and lowerdentures (group 2), then a subset who were not satisfied with the optimized lower prostheses were providedwith two implant-retained lower over-dentures (group 3). Self-assessment questionnaires were voluntarilyfilled by the participants. Male-female differences were assessed using the two independent samples t-test.Inter-group differences were evaluated using the two dependent samples t-test. Significant differences werefound between sexes in group 2, but not in group 3, in the direction of females being less satisfied than malesespecially with the lower denture, and between the groups in a number of variables in the direction of moresatisfaction with the lower dentures among group 3 as compared to group 2. Meanwhile, group 2 and 3 werefound to be equally satisfied with the upper denture.

Comparative evaluation of the lateral throat form and the border extension of mandibular complete denture in the distolingual region in gandhinagar district: An In-vivo study

Introduction: Lateral throat form plays an important role in the success of lower complete denture as it affects its retention and stability. The length and thickness of lower dentures should be properly established in this region. Aim of this study is to evaluate the difference in the extension of lateral throat form between the patient's mouth and lower dentures. Materials and Methods: The lateral throat form was classified according to Neil's classification into Class I, Class II and Class III. The length of the lateral throat form was measured in the patient's mouth and in lower dentures with the help of UNC periodontal probe, and a comparison was made between them. Results: Among all the patients in this study, Neil's Class I lateral throat form was 53%, Class II was 37% and Class III was 10%. The average variation between the extent of lateral throat form intraorally and in lower denture at the anterior edge of the retromolar pad was 1.7 ± 1.75 mm in the right side and 2.5 ± 2.00 mm in the left side, whereas at the posterior edge of retromolar pad, it was 2.23 ± 1.92 mm in the right side and 3.06 ± 2.25 mm in the left side. Conclusions: The proportion of Neil's Class I was the highest followed by Class II and Class III was the lowest. The difference between the length of lateral throat form in the patient's mouth and in lower denture was statistically significant (P < 0.05).

Correlation of Implant Stability Between Two Noninvasive Methods Using Submerged and Nonsubmerged Healing Protocols: A Randomized Clinical Trial.

Various invasive and noninvasive methods have been used for measuring primary implant stability. Periotest damping device and resonance frequency analysis with the Osstell device have been classified as noninvasive methods. Primary and secondary implant stability measurements using both devices have given reproducible quantitative values. In this clinical randomized trial, a general correlation was evaluated between the implant stability recorded using both Osstell and Periotest devices on the day of implant installation and 3 months after healing for the submerged and nonsubmerged loading protocols. The present study also investigated whether the difference in gender of the included patients would have an effect on the correlation between the two devices. Eighty completely edentulous patients were recruited, and all patients ranged from 50 to 69 years of age. Overall, 56 men and 24 women were included, with a mean age of 62.5 years for men and 59.6 years for women. A single implant was installed in the midline of the completely edentulous mandible to improve retention of the patient's lower denture. After implant installation, one implant stability quotient (ISQ) value at the buccal surface was recorded, and then the Periotest M device was used to measure the damping effect (Periotest value [PTV]) of the installed implant using the smart peg screwed to the implant. Patients were then randomized into 2 groups using sealed envelopes: the submerged and nonsubmerged groups. For both groups, all ISQ and Periotest readings were recorded in the patient's case report file on the day of implant installation and 3 months after healing. When the ISQ of the buccal surface was correlated to the PTV, there was a moderate negative statistically significant correlation between the 2 readings (correlation coefficient = -.466, P = .000). There tended to be a weak negative correlation between the 2 devices in the male group (correlation coefficient = .395, P = .046) during implant installation, although there tended to be no correlation between the 2 devices in the female group (correlation coefficient = -.367, P = .342). After 3 months of healing, when correlating the readings of the buccal surface of the Osstell with that of the Periotest within each group (submerged and nonsubmerged), there was no statistically significant correlation between the readings within each group (correlation coefficient = -.014, -.430, P = .942, P = .052, respectively). However, there was a strong negative statistically significant correlation between the 2 devices for the female group for both the nonsubmerged group (correlation coefficient = -.823, P = .003) and submerged group (correlation coefficient = -.857, P = .014), whereas there was no statistically significant correlation within the male group for both the nonsubmerged group (correlation coefficient = -.377, P = .123) and submerged group (correlation coefficient = -.022, P = .940). The correlation between the Osstel and Periotest device remains controversial. The present study concluded that there is a significant negative correlation between the 2 devices when recording primary implant stability, although this significance is lost after 3 months of loading when recording secondary implant stability. Gender also affects the implant stability recording, which is mainly due to the difference in bone density between men and women.