Need For Complete Dentures Research Articles

Self-perception of oral health among tertiary-care users: quanti-qualitative analysis with chronic kidney disease patients

Chronic kidney disease (CKD) has become a global public health challenge. The objective of this study was to analyze the relationship between self-perception of oral health and clinical condition among patients with CKD. This is a quanti-qualitative survey conducted in a CKD specialized service. The sample consisted of 60 patients who underwent oral examinations to have their severity of caries (DMFT) and need for dental prosthesis checked. Age, sex, time on dialysis, marital status, skin color, education and pre-existing diseases were also analyzed. Among the kidney patients who agreed to undergo the clinical examinations and showed communication skills, some were selected, and three focus groups were created, with the participation of a moderator and six to 10 kidney patients in each group. Their speeches were processed in the IRAMUTEQ software and analyzed through the similarity analysis and word cloud techniques. As for profile, the patients were aged 60.23 ± 10.87 years old; were male (73.33%); were on dialysis for 41.90 ± 56.57 months; were married (61.67%); were white (76.67%); had incomplete primary education (41.66%); had arterial hypertension (76.67%); had a DMFT index of 22.55 ± 8.39; 43.33% needed an upper complete denture; and 30.00% needed a lower complete denture. The similarity analysis revealed many doubts and uncertainties about current health services, which can be proven by the words ‘no’ and ‘treatment’. The quanti-qualitative analysis showed a high rate of dental loss and the need for complete dentures and suggests inequities in oral health care for chronic kidney disease patients, especially in tertiary care. There was a positive representation regarding oral health, but the lexicographical analyses of the textual corpus confirmed the self-perception of lack of dental care.

Oral health-related quality of life of athletes with disabilities: a cross sectional study

Several studies have suggested that athletes with disabilities experience more difficulties having access to oral health care than the population in general. The aim of this study was to estimate the impact of socio-demographic/socio-economic factors, oral hygiene habits and clinical oral health conditions on the OHRQoL – Oral Health-Related Quality of Life (assessed with the Oral Health Impact Profile 14 – OHIP-14) on a sample of athletes with heterogeneous types of disabilities. Altogether, 105 athletes with disabilities were evaluated. Cross-sectional data was collected including interviews to obtain socio-demographic/socio-economic data, the OHIP-14 and clinical oral examinations parameters. The outcome variable was the OHIP-14 severity score. The explanatory variables were sex, age, monthly household income, level of schooling, frequency of toothbrushing and flossing, gingival bleeding, periodontal disease, trauma in incisors, prosthesis wearing and needs, number of sound teeth, DFMT (decayed, filled and missing teeth) index and its isolate components. Mann-Whitney, Kruskall-Wallis and Spearman tests used to compare OHIP-14 severity scores associated with the explanatory variables. The mean OHIP-14 severity score for the sample was 9.32 (SD 8.99) and the most affected domain was Physical Pain (mean 2.63; SD 1.97), followed by Psychological Discomfort (mean 1.81; SD 2.02). Significant differences in mean OHIP-14 scores were found for periodontal disease, need for complete dentures, number of sound teeth, DFMT index and its components. These results suggest that these clinical parameters can be related to impaired OHRQoL for this population.

Factors associated with the need for a complete denture in one arch or both arches among the elderly population.

This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04-2.29), with fewer household goods (OR = 2.25; CI95%:1.50-3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27-9.35), R$1501-2500 (OR = 4.11; CI95%:1.50-11.27), R$2501-4500 (OR = 2.76; CI95%:1.10-6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08-7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06-3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06-3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06-1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71-11.60), R$501-1500 (OR = 4.01; CI95%:2.14-7.51), R$1501-2500 (OR = 2.95; CI95%:1.64-5.32), < 3 years of education (OR = 1.45; CI95%:1.13-1.85), feeling unhappy (OR = 2.74; CI95%:1.35-5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75-12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64-3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85-6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85-6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.

Teaching Complete Denture Procedures to Dental Students by Conventional or Simplified Methods: A Randomized Clinical Trial.

With populations aging around the world, the need for complete dentures is likely to increase in Brazil and other developing countries, as well among low-income populations globally, making the teaching of cost-efficient techniques to dental students essential. The aim of this study was to evaluate the effectiveness of complete dentures fabricated by the simplified method in comparison to the conventional method regarding patients' oral health-related quality of life (OHRQoL) and satisfaction, dentures' functional quality, and masticatory performance of patients who were rehabilitated by dental students. From February 2016 to April 2017, final-year dental students at the Federal University of Alfenas, Brazil, were instructed to fabricate new complete dentures for 36 edentulous patients, who were randomly divided into two groups according to denture manufacturing method: simplified method or conventional method. Patients' OHRQoL and satisfaction and the prostheses quality were evaluated at one, three, and six months. Masticatory performance was evaluated at three months. The results showed there was no significant difference between the two methods regarding OHRQoL, patient satisfaction, prostheses quality, or masticatory performance (p>0.05). All aspects evaluated also remained constant for the same group (simplified method or conventional method) in all periods of evaluation (p>0.05). The study concluded that the simplified method for complete denture fabrication was able to produce protheses with functional quality and patient satisfaction comparable to those produced with the conventional method, even when made by dental students.

Effect of different denture adhesives on retention of complete dentures: an in vivo study

The increase in prevalence of tooth loss with the effect of population aging produces the growing need for complete dentures. The success and acceptance of complete dentures by the patient depends on sufficient retention and stability. Therefore, denture adhesives are regularly used by denture wearers to improve the function of complete denture. We evaluated the effect of three different denture adhesives (Corega, Protefix, Fittydent) on the retention of maxillary complete denture (MCD) using with digital dynamometer (DD). For this purpose, denture adhesives were applied on MCDs of 30 participants. After chewing procedure, the force was applied at 45° to the palatal surface of denture by DD. Dislodgement force was recorded by means of Newton. There were four measurements on each patient including; group of control: Group C; Group CR: Corega; Group F: Fittydent; Group P: Protefix. The result of the study was statistically evaluated by using analysis of variance (ANOVA) and Tukey HSD test. Statistics of ANOVA showed a significant difference among all the four groups (p = 0.00, <0.05). Tukey HSD test indicated that there was a statistical difference between Group F and the other groups, but there was not a significant difference between the other groups. The highest adhesive strength value was observed in group F, the lowest in group C. Use of denture adhesives improved the retentive strength of complete denture.

The need for, and allocation of, regional prosthodontics laboratories in Brazil: an exploratory study

The scope of this study was to compare epidemiological indicators of the need for prosthetic rehabilitation in 2003 with the number of regional prosthodontic laboratories (LRPD) and technicians in prosthodontics (TPD) in the five Brazilian regions between 2012 and 2013. Data regarding health services were obtained from DATASUS and epidemiological data were obtained from SBBrasil 2003. The rates of dental prostheses produced and LRPD and TPD were calculated per 100,000 people. The Kruskal-Wallis and chi-square test were used for analysis. The results show that the sex/age adjusted prevalence of edentulism varied between regions (p < 0.01), being higher in the Southeast (13.9%). The highest mean number of missing teeth was found in the North (10.3 teeth). The highest availability of LRPD (1.16 per 100,000) and TPD (1.05 per 100,000) occurred in the Northeast region. The highest need for complete dentures (7.2%) was reported in the North, but was the lowest in delivery of dentures (9.71 per 100,000). There were statistically significant differences (p < 0.01) among regions for both LRPD, TPD rates for prostheses. It is considered that criteria other than epidemiological aspects influenced the opening of LRPD in the country.

Patients’ satisfaction with complete dentures: an update.

Population aging is a worldwide phenomenon and, even though there is a downward trend in edentulism, the need for complete dentures is not likely to decrease in the near future. Furthermore, patients’ satisfaction with their dentures is fundamental to improving oral health-related quality of life among edentulous individuals. Considering this, a search was performed for literature since 2001 on the factors that may influence patient satisfaction with complete dentures. Many factors were reported that related to technique, patient, and dentist, as well as their likelihood of influencing patient satisfaction. The factors presenting reasonable evidence of influencing patient satisfaction are the kind of therapy chosen (implant-retained overdentures rated more favorably than conventional dentures); patient personality and psychological factors; patient oral conditions; patient perception of the dentist and dental care; and patient-dentist communication issues. Several other factors that may influence patient satisfaction were not addressed in the recent literature or presented contradicting results, highlighting the need for more research in this topic.

Oral mucosal lesions and the need for dentures in a brazilian elderly population

Objective: Verify the presence of oral mucosal lesions (OMLs) and the need for complete dentures in elderly people during the Campaign for Prevention and Early Diagnosis of Oral Cancer for a period of five years in Piracicaba, Brazil. Methods: Oral clinical examinations were performed by dental surgeons previously trained according to the variables during the period of five years (2007-2011) in the 41 Basics Units of Health distributed in six areas: north, south, east, west, central and contryside. Statistical analysis was performed using the Chi-Square test for trend. Results: The Campaign reached 3,452 elderly in 2007; 2,508 in 2008; 2,756 in 2009; 3,041 in 2010 and 2,217 in 2011. The need for doble complete dentures ranged from 9.9% to 18.3% being 16.8%, 12.3%, 18.3%, 13.7% and 9.9% from 2007 to 2011, respectively. And the presence of OMLs ranged from 7.3% to 1.,9% being 8.9%, 11.0%, 13.9%, 9.6% and 7.3% from 2007 to 2011, respectively. Just need for complete dentures tended to decrease over the period. Conclusion: The results revealed that the elderly still have unmet needs prostheses, despite a slight decrease over time and the importance of monitoring of oral lesions, still prevalent in all regions, with no downward trend.

Prevalence of temporomandibular disorders in a population of complete denture wearers

Complete tooth loss among the elderly is still frequent in developing countries and the incidence of temporomandibular disorders (TMD) is a common finding in complete denture wearers. The aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) in a population of complete denture wearers. The data were collected by four examiners for the diagnosis of use and need for complete dentures followed by the World Health Organization standards and interviews for TMD signs and symptoms evaluation. Exploratory variables included demographic, socio-economic status and TMD prevalence. The prevalence of TMD among denture wearers was 55.12%. Chi-squared test showed no statistical difference between subjects with or without TMD for gender, geographical location and skin colour (p < 0.05). The number of subjects with TMD increased as the period of complete denture wear increased, although no statistical difference between groups were found (p < 0.05). There is a need of educational programmes aiming at the importance of health care and periodical change of a complete denture, and strategies with a preventive approach to quality general dental care.

Should edentulous patients be constrained to removable complete dentures? The use of dental implants to improve the quality of life for edentulous patients

Nowadays, there is some speculation among dental educators that the need for complete dentures will significantly decrease in the future and that training in their provision should be removed from the dental curriculum. To sensitise the reader to the functional shortcomings of complete denture therapy in the edentulous patient and present restorative options including implants to improve edentulous quality of life in these patients. Information retrieval followed a systematic approach using PubMed. English articles published from 1964 to 2008, in which the masticatory performance of patients with implant-supported dentures was assessed by objective methods and compared with performance with conventional dentures, were included. National epidemiological survey data suggested that the adult population in need of one or two complete dentures will increase from 35.4 million adults in 2000 to 37.9 million adults in 2020. Clinical studies have showed that the ratings of general satisfaction were significantly better in the patients treated with implant overdentures post-delivery compared with the complete denture users. In addition, the implant group gave significantly higher ratings on comfort, stability and ability to chew. Furthermore, patients who received mandibular implant overdentures had significantly fewer oral health-related quality of life problems than did the conventional group. Implant-supported dentures including either complete overdentures or a hybrid prosthesis significantly improve the quality of life for edentulous patients compared with conventional removable complete dentures. Therefore, the contemporary dental practitioner should consider other options as well as conventional removable complete dentures to restore edentulous patients.

The future of complete dentures in oral rehabilitation. A critical review

Based on available investigations and current trends in oral rehabilitation published in the dental literature, an attempt is made to describe the possible future role of complete dentures. For edentulous patients, complete dentures have for long been the only prosthodontic treatment option. Whereas a large number of edentulous patients report satisfaction with denture usage, a smaller number are unable to adapt; for such patients, sophistication of clinical and technical processes or quality of denture-supporting tissues, appear to have little influence on patient-perceived outcomes. Since the 1980s, osseointegrated dental implants have dramatically improved the therapeutic possibilities, especially so for maladaptive patients. Those able to access such treatment can expect significant improvements in oral functional status and quality of life. While there is a downward trend in edentulism in several countries, it is region-specific, confirming the overriding influence of socio-economic factors on health status. In most societies, despite ageing populations, the need for complete dentures is not likely to reduce in the near future. Whereas a two- or even a one-implant overdenture for the edentulous mandible is increasingly regarded as a minimum standard of care in many developed countries, its routine prescription for the majority in the world who are disadvantaged is unrealistic; for them, even 'low-tech' therapies like conventional dentures are beyond their reach. Improving the conventional management of edentulous patients is a necessity and requires a keener focus by researchers, educators and clinicians in the developed world on the needs of populations with fewer resources.

Will there be a need for complete dentures in the United States in 2020?

Currently, there is much speculation among dental educators that the need for complete dentures will decline markedly in the future and that complete denture training should be removed from the dental curriculum. Estimates based on national epidemiologic survey data indicate that edentulism has declined by 10% every decade and that only 90% of edentulous adults obtain and wear complete dentures. However, when the number of adults in each specific age group is multiplied by the percentage who need a complete maxillary or mandibular denture, the results suggest that the adult population in need of 1 or 2 complete dentures will increase from 33.6 million adults in 1991 to 37.9 million adults in 2020. The 10% decline in edentulism experienced each decade for the past 30 years will be more than offset by the 79% increase in the adult population older than 55 years. The clinical implications of these findings are twofold: First, practicing dentists will find that a sizable minority of the patient population will continue to need complete denture services; and second, if training in complete denture prostheses is eliminated from the dental education curriculum, millions of patients will be forced to seek denture services from alternative providers. (J Prosthet Dent 2002;87:5-8.)

The role of specialists and general practitioners in provision of prosthodontic services

The national situation regarding prosthodontic services is being shaped by the following factors: 1. There is an increasing number of people in the 60-, 70-, and 80-year-old age group. 24 2. There is less dental caries, which has resulted in more teeth in the adult population. 3. There is less gingivitis, but it is unclear whether this factor is significant. 4. There is an ongoing debate about the continued prevalence and severity of periodontitis, but with more teeth and more older adults there appears to be a great potential for an increase in the total amount of advanced periodontal disease. 5. There is somewhat less total edentulism. 6. There is a substantial unmet need for complete dentures as well as fixed and removable partial dentures. In summary, the stage is set for an increased demand for prosthodontic services.

The telescoped complete denture: A research report at the clinical level

1. The retention of a few natural teeth over which a complete denture may be telescoped provides better retention and stabilization than is possible with the usual complete dentures. 2. The reduction of the length of the crowns of the teeth being retained provides a more favorable crown-root proportion and frequently results in the elimination of periodontal disease. 3. Where lower natural anterior teeth exist, the retention of even two or three upper incisors provides the bony support in the anterior part of the upper ridge with protection against traumatic vertical and horizontal pressures from the lower teeth. Ridge resorption has become a national tragedy; any method of preventing it should be welcomed. 4. The retention of two or more lower natural teeth over which a full mandibular denture is telescoped provides a means of better retention and stabilization than is otherwise possible. 5. The psychologic impact of having all the teeth removed may be ameliorated and the patients may be conditioned to expect the eventual need for complete dentures. 6. Regardless of the theories stating that stabilization is all that is essential, both stabilization and retention are achieved in telescoped complete dentures. 7. The telescoped complete denture acts as a removable splinting device for the abutment teeth. 8. When individual teeth are joined together by a gold bar they provide greater stabilization and retention than if they were not splinted together, e.g., as with two lower cuspids. 9. With only a few lower teeth remaining to support a lower prosthesis, it is wise to consider the removal of the upper natural teeth in order to increase the longevity of the lower teeth. 10. While we advocate the use of metal secondary crowns in telescopes in fixed and removable partial dentures, acrylic resin seems more practical for use in telescoped full dentures. The exception occurs where there is no labial flange. In this situation gold telescoped veneer crowns are used. However, we consider these as removable partial dentures rather than telescoped complete dentures.

Immediate dentures and psychic trauma

Many people will cling to a mutilated and functionally hopeless dentition when confronted with the need for complete dentures because they fear that their dentures will not appear as their own teeth. A basis for communication between patient and dentist can develop during the course of the treatment. The patient can be made to realize that the dentist is cognizant of his fears and is prepared to meet his needs with the appropriate solution. Adequate provision must be made to acquaint the patient with the realities, some of them unpleasant, of the abrupt transition from natural teeth to immediate dentures.