Removable Partial Denture Wearers Research Articles

Tooth loss in treated periodontitis patients responsible for their supportive care arrangements

To identify risk indicators associated with tooth loss and periodontitis in treated patients responsible for arranging supportive periodontal care (SPC). Ninety-seven Chinese subjects (34-77 years) who showed favourable responses to periodontal therapy provided in a teaching hospital 5-12 years previously were recalled. They were advised to seek regular SPC on discharge. Background information, general health status, smoking, oral hygiene habits, follow-up dental care, tooth loss, and periodontal parameters were investigated. Multiple regression analysis was performed. Two hundred and fifty-six teeth had been lost, 195 because of self-reported periodontal reasons. Up to 26.8% sites were with pockets > or =6 mm. Positive correlations were found between total/periodontal tooth loss and (i) smoking pack-years, (ii) time spent on oral hygiene, (iii) years since therapy's conclusion, (iv) age, and negative correlations with (v) inter-dental brush use, and (vi) education levels. Tooth loss by arch was correlated with wearing of removable partial denture in that arch. Percentage sites with pockets > or =6 mm were significantly negatively correlated with percentage sites without bleeding on probing. Smokers, more elderly patients, removable partial denture wearers, and patients with lower education levels or not using inter-dental brushes ought to be targeted for clinic-based SPC.

Frequency of Temporomandibular Disorders in Asymptomatic Removable Partial and Complete Denture Wearers

A dogmatic view on occlusion as the main aetiological factor for temporomandibular disorder (TMD) has been present in the literature for a long time, but a direct scientific correlation between occlusal disorders and TMD has never been proven. The purpose of this study was to determine the frequency of TMD signs and tissue-specific diagnoses in a population of 164 asymptomatic participants, 70 removable partial denture wearers and 94 complete denture wearers of an average age of 61.3 years, by means of clinical manual functional analysis. TMD was found in 42.1% of the participants. No statistically significant difference in the occurrence of TMD was found between removable partial and complete denture wearers and between genders (P > 0.05). The most frequent tissue-specific diagnoses were osteoarthrosis (11%), total anterior disc displacement (9.1%) and partial anterolateral disc displacement (8.5%). The frequency of tissue-specific diagnoses was also not influenced by the type of prosthetic replacements.

Frequency of temporomandibular disorders in asymptomatic removable partial and complete denture wearers

Abstract A dogmatic view on occlusion as the main aetiological factor for temporomandibular disorder (TMD) has been present in the literature for a long time, but a direct scientific correlation between occlusal disorders and TMD has never been proven. The purpose of this study was to determine the frequency of TMD signs and tissue-specific diagnoses in a population of 164 asymptomatic participants, 70 removable partial denture wearers and 94 complete denture wearers of an average age of 61.3 years, by means of clinical manual functional analysis. TMD was found in 42.1% of the participants. No statistically significant difference in the occurrence of TMD was found between removable partial and complete denture wearers and between genders (P > 0.05). The most frequent tissue-specific diagnoses were osteoarthrosis (11%), total anterior disc displacement (9.1%) and partial anterolateral disc displacement (8.5%). The frequency of tissue-specific diagnoses was also not influenced by the type of prosthetic replacements.

Frequency of Temporomandibular Disorders in Asymptomatic Removable Partial and Complete Denture Wearers

A dogmatic view on occlusion as the main aetiological factor for temporomandibular disorder TMD has been present in the literature for a long time, but a direct scientific correlation between occlusal disorders and TMD has never been proven. The purpose of this study was to determine the frequency of TMD signs and tissue-specific diagnoses in a population of 164 asymptomatic participants, 70 removable partial denture wearers and 94 complete denture wearers of an average age of 61.3 years, by means of clinical manual functional analysis. TMD was found in 42.1% of the participants. No statistically significant difference in the occurrence of TMD was found between removable partial and complete denture wearers and between genders P > 0.05. The most frequent tissue-specific diagnoses were osteoarthrosis 11%, total anterior disc displacement 9.1% and partial anterolateral disc displacement 8.5%. The frequency of tissue-specific diagnoses was also not influenced by the type of prosthetic replacements.

A comparison of patient's satisfaction between complete and partial removable denture wearers

Abstract Objectives . The aim of this study was to compare satisfaction between complete denture (CD) and Kennedy Class I removable partial denture (RPD) wearers. Materials and methods . A total of 156 CD and 112 RPD wearers took a part in this study. From the primary group of the examined patients, only those whose RPDs and CDs were assessed as excellent or very good by the dentist, took a part in this study. Patients graded satisfaction of their dentures by using an analogue scale from 1 to 5 (1=unsatisfactory; 5=excellent). Results . Both CD and RPD wearers were mostly satisfied with their dentures (the distribution of the scores of the patients' assessments was skewed towards the highest scores; more than half of the patients scored all the examined variables to the best score category). Complete Denture wearers were significantly more satisfied with chewing, speech and retention of maxillary denture than RPD wearers ( P P P >0.05; N.S.). Conclusions . A majority of CD and RPD wearers were satisfied with the dentures. CD wearers were more satisfied with speech, chewing and retention of maxillary denture, while RPD wearers were more satisfied with the retention and the comfort of wearing mandibular denture. Different groups of denture wearers have to make significant, but different adjustments to wear their dentures successfully.

A comparison of patient's satisfaction between complete and partial removable denture wearers

Objectives. The aim of this study was to compare satisfaction between complete denture (CD) and Kennedy Class I removable partial denture (RPD) wearers. Materials and methods. A total of 156 CD and 112 RPD wearers took a part in this study. From the primary group of the examined patients, only those whose RPDs and CDs were assessed as excellent or very good by the dentist, took a part in this study. Patients graded satisfaction of their dentures by using an analogue scale from 1 to 5 (1=unsatisfactory; 5=excellent). Results. Both CD and RPD wearers were mostly satisfied with their dentures (the distribution of the scores of the patients' assessments was skewed towards the highest scores; more than half of the patients scored all the examined variables to the best score category). Complete Denture wearers were significantly more satisfied with chewing, speech and retention of maxillary denture than RPD wearers ( P<0.05). Removable partial denture wearers were significantly more satisfied with the retention and the comfort of wearing mandibular denture ( P<0.05). There was no significant difference between CD and RPD wearers for general satisfaction with their dentures, aesthetics and comfort of wearing maxillary denture ( P>0.05; N.S.). Conclusions. A majority of CD and RPD wearers were satisfied with the dentures. CD wearers were more satisfied with speech, chewing and retention of maxillary denture, while RPD wearers were more satisfied with the retention and the comfort of wearing mandibular denture. Different groups of denture wearers have to make significant, but different adjustments to wear their dentures successfully.

Clinical bone densitometric evaluation of the mandible in removable denture wearers dependent on the morphology of the mandibular cortex

Statement of problem Wide normal variations have been found in the structure and density of the human skeleton, as well as of the mandible. Purpose The objective of this study was to determine whether the mandibular bone mineral density is correlated with the classification of the structure of the inferior cortex on panoramic radiographs in complete and removable partial denture wearers. Material and methods The mandibular cortical index of 136 randomly selected complete and removable partial denture wearers was evaluated via panoramic radiographs. The criteria for the mandibular cortical index were as follow: category 1, sharp endosteal margin of the inferior cortex; category 2, semilunar defects; and category 3, thick cortical residues on endosteal margin. Forty male patients (mean age 72.7; range 56 to 84 years) and 96 female patients (mean age 69.7; range 48 to 86 years) participated. With a copper stepwedge and DenEx 2001 computer program, the mandibular bone mineral density was investigated densitometrically on dental panoramic radiographs. Four experienced observers and 6 general dental practitioners made the observations on all panoramic radiographs. All bone mineral density values were expressed in equivalents of the actual stepwedge thickness. An independent t test (α = .05) was used. Results The severity of changes in the mandibular cortex was significantly related to all measured mandibular bone mineral density values ( t test: P<.01). Mandibular cortical index category 3 had significantly lower bone mineral density values in all measured regions of interest. Interobserver and intraobserver agreement in mandibular cortical index assessment was excellent. Conclusion Patients having lower bone mineral density values in the mandible have much more porous cortical layer of the inferior border of the mandible.

Changes of blood flow in the mucosa underlying a mandibular denture following pressure assumed as a result of light clenching.

The aim of this study was to investigate the influence of the continuous compression assumed as a result of light clenching on the blood flow of the denture underlying mucosa in tissue-supported or tooth-tissue-supported denture wearers. Measurements were carried out on eight removable partial denture wearers (three males and five females, from 50 to 72 years, mean age: 61.5 years). The blood flow in the denture underlying mucosa was measured at the unilateral mandibular first molar region using an experimental denture base equipped with a laser Doppler flowmeter. The area of the experimental denture base was 2 cm2, and the loading force was 1 kgf. The loading time was set at 5, 10, 20, 30 and 60 s. The blood flow after 20 s loading was <15% in rest. The times from release of loading to the maximum blood flow and from release of loading to recovery up to 110% of the blood flow at pre-loading were significantly prolonged by an increase in the loading time. Even if it is light, a continuous clenching results in ischaemia and delays the recovery of blood flow in the mucosa underlying the denture after release of compression.

Rehabilitation of biting abilities in patients with different types of dental prostheses

This study investigated the masticatory rehabilitation of subjects wearing different types of prostheses. Biting abilities per person (biting force, biting pressure and occlusal contact area) were assessed with a pressure detecting sheet (Prescale®). Five hundred and ninety volunteers were divided into four groups according to the type of posterior dentition: complete denture, removable partial denture, fixed partial denture, and full natural dentition groups. The biting forces of the fixed partial, removable partial and complete denture wearers were 80, 35 and 11% respectively, when expressed as a percentage of the subjects with a natural dentition. The complete denture wearers showed the highest biting pressure among the four groups, followed by the removable partial denture wearers. In a clinical intra‐individual study, the biting abilities of 85 subjects, without (before insertion of) and with (after insertion of) renewed prostheses, were compared. No significant differences were found between biting before and immediately after insertion of the prostheses. However, the biting force and occlusal contact area increased 2 months after insertion of the prostheses. This study confirmed past clinical studies indicating an impaired masticatory function of denture wearers. The functional adaptation to new prostheses had improved at evaluation 2 months after insertion.

Relationship between oral function and occlusal support in denture wearers

Patients with removable partial dentures or complete dentures do not demonstrate masticatory function to the same level as patients with a full set of natural teeth. The purpose of this study was to characterize the relationship between reduction of masticatory function, in terms of masticatory performance and bite force, and the existence of remaining natural occlusal supports as assessed by the Eichner index. One hundred and eighteen removable partial denture and complete denture wearers were selected for analyses. These subjects were divided into four groups depending upon the number of occlusal supports. Seventy dentate subjects with full occlusal support were designated as a comparison group. Bilateral bite force was measured at the first molar region in all subjects. Masticatory performance was assessed using the modified Masticatory Performance Index. Peanuts were used as the test food. Both bite force and masticatory performance were significantly associated with group classification. Moreover, both bite force and masticatory performance of the four denture groups were significantly reduced compared to the comparison group and this tendency was remarkable for the denture groups without occlusal support. These results suggest that the existence of functional tooth units may be a key factor in preservation of masticatory function.

Relationship between oral function and occlusal support in denture wearers

Patients with removable partial dentures or complete dentures do not demonstrate masticatory function to the same level as patients with a full set of natural teeth. The purpose of this study was to characterize the relationship between reduction of masticatory function, in terms of masticatory performance and bite force, and the existence of remaining natural occlusal supports as assessed by the Eichner index. One hundred and eighteen removable partial denture and complete denture wearers were selected for analyses. These subjects were divided into four groups depending upon the number of occlusal supports. Seventy dentate subjects with full occlusal support were designated as a comparison group. Bilateral bite force was measured at the first molar region in all subjects. Masticatory performance was assessed using the modified Masticatory Performance Index. Peanuts were used as the test food. Both bite force and masticatory performance were significantly associated with group classification. Moreover, both bite force and masticatory performance of the four denture groups were significantly reduced compared to the comparison group and this tendency was remarkable for the denture groups without occlusal support. These results suggest that the existence of functional tooth units may be a key factor in preservation of masticatory function.

Karakteristik Durasi Konsonan Linguopalatal Bahasa Indonesia sebagai Nilai Dasar Obyektif dalam Evaluasi Kejelasan Ucapan

An observational research was done to find out the standard value, that could be used in a further research in phonetic problems. The descriptive study was done in 400 respondents, and the correlation with gender, education backgroud and ethnic group. An objective standard value of the duration of linguopalatal consonant bahasa Indonesia which was found in this research used a computer program CSL-50. One of the problems mostly faced in prosthodontic was difficulties in pronouncing linguopalatal consonants by upper removable partial denture wearers with palatal plate.

Further aspects of design for distal extension removable partial dentures based on the Kennedy classification.

A supplement to the Kennedy classification of partially edentulous arches for restoration with removable partial dentures has been suggested. Factors affecting denture design relating to the position of the abutment teeth, the symmetry of the edentulous distal extensions, the arch form and the cross-sectional shape of the residual ridges have been discussed and classified. An understanding of the movement of the denture bases in relation to the influence of these factors makes for a rational approach to removable partial denture design and the treatment of complications observed clinically in removable partial denture wearers.

そしゃくにおける片側遊離端義歯装着の意義

In some studies, the insertion of unilateral free-end removable partial dentures (RPDs) is regarded as overtreatment because mastication is not improved. However, most studies on masticatory efficiency have assessed only the degree of crushing and have disregarded the influence of RPDs on the intraoral flow of food, which is an essential factor for deglutition. In this study, two new parameters were devised to evaluate, at the same time, the degree of crushing and flow of the food, 10-mesh remaining ratio and lingual transport ratio, respectively.It was considered that patients who remove their RPDs chew unilaterally.Unilateral chewing was examined in seven fully dentate subjects (FDT group) first, and then in nine unilateral free-end RPD wearers (RPD group).In the FDT group, the degree of crushing and the accumulation of food particles in the lingual zone was significantly lower in unilateral chewing than in free chewing. In the RPD group, accumulation of food particles in the lingual zone was significantly lower without denture insertion than with the RPD inserted, but the degree of crushing was not significantly different.The results indicated that RPDs are useful for the accumulation of food particles in the lingual zone, which could facilitate deglutition.

PRESENÇA DE LEVEDURAS DO GÊNERO CANDIDA NA SALIVA DE PACIENTES COM DIFERENTES FATORES PREDISPONENTES E DE INDIVÍDUOS CONTROLE

Os microrganismos do gênero Candida são, em geral, comensais da cavidade bucal, mas, em determinados indivíduos e em situações específicas, podem transformar-se na forma parasitária, produzindo candidoses bucais. O objetivo deste trabalho foi analisar a presença das espécies do gênero Candida na saliva de indivíduos controle, comparando com pacientes que apresentavam diferentes fatores predisponentes. Foram avaliados 493 pacientes, divididos em 7 grupos: prótese total, prótese parcial removível, periodontite crônica de adulto, respiração bucal, aparelho ortodôntico fixo, aparelho ortodôntico removível e aparelho extrabucal. O grupo controle consistiu de 570 indivíduos que não apresentavam nenhum desses fatores, divididos em 2 grupos: infantil e adulto. Foram realizados o isolamento e a identificação das espécies do gênero Candida. Os resultados mostraram maior porcentagem de pacientes positivos para Candida nos grupos com fatores predisponentes em relação aos controles. Houve predominância de isolamento de C. albicans em todos os grupos, porém, os pacientes com fatores predisponentes apresentaram diversidade maior de espécies

Periodontal status of teeth in contact with denture in removable partial denture wearers.

The aims of the study were to determine the periodontal status of the teeth in contact with removable partial dentures (RPDs) and to compare them with other teeth in the opposing arch not related to any prosthesis. The periodontal status was also assessed in relation to the age of the dentures. Four hundred and twenty-seven patients treated with RPDs from 1981 to 1986 were recalled for examination. Prior to prosthetic treatment they were given periodontal treatment and fillings when required. Initially all were given oral hygiene instructions and motivation. They were reviewed regularly only on a short-term basis. Eighteen patients were suitable for the present study comprising of eight males and 10 females whose mean age was 41 years. The RPDs were in use from 1.5 to 8 years (mean 4.6 years). The following parameters were assessed: Plaque index (P1I), Gingival index (GI), loss of attachment (LA) and tooth mobility. The wearing of RPDs resulted in higher P1I, GI and LA compared to the controls and these differences were statistically significant. There was an increased frequency of higher P1I, GI and LA with the increase in denture age. Minor changes in tooth mobility were observed. It was concluded that the wearing of RPDs was detrimental to periodontal health in patients whose oral hygiene was less than adequate.

The oral status of elderly removable partial denture wearers

A random sample of 1019 elderly home dwelling persons participated in this study. There were 809 dentate respondents, 28.6% of whom wore removable partial dentures. They were examined for coronal and root caries, gingival recession, pocket depth and loss of gingival attachment. The removable partial dentures were also evaluated. Abutment teeth were found to be more likely to have caries and periodontal disease than all other teeth. Using a MANOVA statistical procedure, the analysis indicated that the partial denture itself, irrespective of any professionally determined problems with the denture, appears to affect coronal and root caries on the teeth of partial denture wearers. Partial dentures judged to need repair or adjustment were related to periodontal status. The data on adverse effects of partial dentures suggest a need for patient education by the dentist and through public health measures, and good oral self care and regular professional recall for people who wear removable partial dentures.

Patient use of removable partial dentures: Two- and four-year telephone interviews

Two telephone surveys requested patients to report on their use of removable partial dentures that were constructed by undergraduate dental students. In the first survey, of the 431 patients called, 290 were contacted and interviewed 24 to 33 months after their removable partial denture(s) had been inserted. Of these, 258 patients reported using their prostheses and 238 had no apparent problems. In the second survey, the 238 trouble-free removable partial denture wearers from the first survey were called and 169 were contacted and interviewed 48 to 57 months after the removable partial dentures had been inserted. Of these, 156 reported still using their prosthesis and 152 had no apparent problems. These data are provided, along with some interpretive caveats, for dentists to use in discussing treatment options with patients.

Wearing of removable partial dentures in relation to periodontal pockets.

Using a representative sample of 5028 dentulous Finnish adults the occurrence of periodontal pockets was studied separately for the maxillae and the mandibles among removable partial denture (RPD) wearers and non-wearers. RPD(s) were worn in 11.2% of the 3444 maxillae with at least four natural teeth remaining, and in 7.7% of the 4706 corresponding mandibles (P less than 0.001). Periodontal pockets were more frequently observed in maxillae than mandibles. Wearing of RPDs highly significantly (P less than 0.0001) increased the odds of having periodontal pockets in general (4 mm or more) as well as the odds of having deeper periodontal pockets (exceeding 6 mm). This phenomenon was observed both in the maxillae and in the mandibles. These results suggest that wearing of RPD is a threat to periodontal tissues and that dentists should take care to frequently recall their patients fitted with RPD(s). During the recall visits more attention should be paid to the periodontal conditions of patients wearing RPD(s).

Wearing of removable partial dentures in relation to dental caries.

Using a representative sample of 5028 dentulous Finnish adults the occurrence of dental caries was studied among removable partial denture (RPD) wearers and non-wearers. Of the subjects wearing no RPD(s) 61.4% had one or more carious teeth, among those wearing a single RPD the figure was 60.5% and among those wearing RPDs in both jaws 62.7%, respectively. When sociodemographic background, other oral status measures than caries and oral health care habits were simultaneously controlled, subjects wearing RPDs in both jaws had slightly increased (P less than 0.05) probability of having one or more carious teeth compared to those with no RPD(s). Subjects with a single RPD did not have a statistically significantly increased probability of having carious teeth. Among those 3075 subjects who had one or more carious teeth the wearing of one or two RPDs did not significantly increase the number of carious teeth. Because the subjects wearing RPDs in both jaws were seen to have a slightly increased risk of having caries, this confirms the view that dentists should emphasize good oral hygiene habits and regular dental attendance among RPD wearers.