Type Of Dental Prosthesis Research Articles

Association between the type of dental prosthesis and the masticatory performance of institutionalized patients: A cross-sectional study.

This cross-sectional study aimed to determine the chewing ability of 97 institutionalized older adults and its relevance to their status of dentition and type of prosthetic rehabilitation. The participants were categorized according to their dental status. The chewing ability was determined by semi-quantitative evaluation of a colour-changeable chewing gum and by recording the personal perception of the participants on a similar scale. The colorimetric means of the participants was significantly lower than the perception means. One-third of the participants had at least one jaw restored with complete dentures, while 17% were restored with tooth-supported or implant-supported fixed partial dentures. Based on the colorimetric method, edentulous participants displayed significantly lower chewing performance compared to all other groups. Additionally, participants with at least one complete denture exhibited weaker chewing function than those with natural teeth or fixed partial dentures. The age and sex of the participants had no further impact on the results. As the institutionalized elderly seem to overestimate their chewing efficiency, the colour changeable chewing gum could be used in nursing homes, as a simple method to determine their real masticatory function status and improve their dental care.

Elderly oral health condition in palliative care at public hospitals from Recife-PE, Brazil

This research aimed to evaluate the oral health condition of elderly people undergoing palliative care in public hospitals in the city of Recife-PE, Brazil. A sociodemographic questionnaire and the DMFT index were applied, as well as clinically evaluating the number of teeth, oral manifestations, use and types of dental prostheses. A descriptive analysis of the data was carried out and Fisher´s Exact Test was used with a significance level of p=0.05. 130 elderly people in palliative care participated, 55% were male and 70% were aged between 60 and 79 years. Regarding the number of teeth present in the mouth, 76% had between 0 and 10 teeth and 55% used dental prostheses, the most prevalent being the upper complete denture at 86%. The most prevalent oral manifestation was tongue coating and xerostomia with 58%. DMFT-d had a mean value of 27.3, which is considered very high, and was associated with the number of teeth with p=0.05. It is concluded that the DMFT index of elderly people receiving palliative care was considered very high, which makes it important to install prevention and intervention programs to improve the oral health condition of these people.

An assessment of the impact of L.Salvadora persica and G.Tea on the surface roughness and hardness of heat-cured acrylic-based denture soft liners.

Background: Soft denture liners are a type of dental prosthesis that functions as a cushioning material, alleviating the stress induced by the act of chewing. They offer relief to persons who encounter discomfort when wearing complete or partial dentures, particularly when these dentures are situated on rigid surfaces that support the denture. The objective of this study: is to assess the effects of including L.Salvadora persica. and green tea (G.Tea) extract powders on the surface roughness and hardness characteristics of acrylic-based soft liners. Materials & Procedures: 30 specimens were constructed using wax molds and acrylic-based heat-cured denture soft lining material. The standard curing procedure was used. The samples were separated into three equal groups: group A, the control group, with no additives in the soft-liner material; group B, with 5.12% weight percept L.salvadora persica extract powder; and group C, with 5.12% weight present green tea (G.Tea) extract powder. The samples were then prepared for surface hardness and roughness testing. Results: The results revealed that there was a non-significant rise in the mean values of surface roughness for both group B and group C, group B having the highest mean values followed by group C. When compared to the control group, the results showed a considerable rise in the mean values of surface hardness in group (B), which had the highest mean value for surface hardness, followed by group (C). Conclusion: The results of this study indicate that the incorporation of L.salvadora persica at a concentration of 1.024g and green tea (G.Tea) extract powders at a concentration of 1.024g shown a positive impact on the surface hardness of denture soft lining materials

Evaluation of Problems Related to Complete Denture in Patients Referred to Prosthodontics Department of Birjand Dental College in Years 2018-2020

Introduction: Complete denture is a type of dental prosthesis that is used to restore function and beauty in patients with complete edentulousness. Problems after denture delivery are common and involve the patient and the dentist, and post-delivery care is often overlooked by most students and dentists. The aim of this study was to investigate the common problems of the patients with complete dentures referred to the Prosthesis Department of Birjand Dental School and their relationship with variables such as sex, age, etc.
 Methods: In this descriptive analytical study 46 patients participated, 26 patients were male and 20 were female. The patients ranged in age from 33 to 90 years. These patients had previously been treated in the ward by students with complete prosthetics. Patients were asked the questions in the questionnaire. After collecting the data, the data were entered into SPSS software version 16 and reported as a percentage of relative frequency. Then, Chi-square or Fisher test was used to examine the relationship between qualitative variables. (P≤0.05).
 Results: The results showed that 3 of the most common problems included food retention (52%), lack of retention (50%), and pain (34.8%). But in most cases, there was no significant difference was seen among gender, age, patient motivation to refer, etc.
 Conclusion: According to the results, the most common problems after denture delivery are food retention and lack of retention, which need to be reduced to identify the etiology and their causes.

Residual dentition, prosthesis type and oral health-related quality of life in Uruguayan adults.

To investigate the association between different types of dental prostheses (and residual dentition) and oral health-related quality of life (OHRQoL). A population-based study with a representative sample of adults and older adults in Uruguay (2010-2011). The dependent variable was the score on the oral impact on daily performance (OIDP), and the main predictor was the pattern of tooth loss and prosthesis use. Covariates included sex, age, socioeconomic status, education, missing teeth, pain and decayed teeth. Negative binomial regression was used. The sample comprised 762 participants. Those participants not wearing a prosthesis and with extensive tooth loss had a mean OIDP of 3.1 (95% CI=1.6-6.2), while those wearing removable partial dentures (RPD) and having <12 missing teeth had a mean OIDP of 3.6 (95% CI=1.3-10.0). Participants with a free-end saddle had the highest mean OIDP, at 4.9 (95% CI=2.0-12.1). For participants with ≤12 missing teeth, any additional missing tooth was associated with an 11% higher OIDP score. Participants who wore RDPs reported fewer impacts on OHRQoL if they had extensive tooth loss or anterior tooth loss than those with a free-end saddle, or who had lost fewer teeth. The use of RPDs is associated with better OHRQoL. These findings may be valuable in clinical practice and prosthetic planning.

Peri-Implant Diseases

AbstractOsseointegrated dental implants have become an increasingly popular modality of treatment for the replacement of absent or lost teeth because of its high rates of long-term survival when used to support various types of dental prostheses. However, complications and implant failure can still occur and are considered by many clinicians as a major obstacle for implant treatment. Biological complications mainly refer to inflammatory conditions of the soft tissues and bone surrounding implants and their restorative components, which are induced by the accumulation of bacterial biofilm. Two clinical varieties may be distinguished: peri-implant mucositis and peri-implantitis. Peri-implant mucositis is a reversible, plaque-induced inflammatory lesion confined to the peri-implant soft tissue unit, whereas peri-implantitis is an extension of peri-implant mucositis to involve the bone supporting the implant. Diagnosing and managing these biological complications is of utmost importance for the implant surgeon and dental practitioner. This review encompasses the etiology, diagnostic aspects, prevention, and management of biological complications.

Evaluation of quality of life and oral hygiene attitudes of individuals using dental prostheses during the COVID-19 pandemic

Statement of problemThe COVID-19 pandemic impacted every area of our lives, including delaying urgent dental care. However, studies evaluating how patients using dental prostheses have been affected by the pandemic are lacking. PurposeThe purpose of this study was to investigate how patients using different types of dental prostheses were being affected by the COVID-19 pandemic. Material and methodsA total of 129 randomly selected individuals from among those who had been examined in the same clinic before the COVID-19 outbreak were included in the study. The study participants were divided into 4 groups according to their type of prosthesis: complete dentures, implant-retained removable dentures, tooth-supported fixed partial dentures, and implant-supported fixed partial dentures. The Oral Health Impact Profile (OHIP-14) questionnaire was implemented by telephone interviews with the study participants, who were also asked about their concerns and steps made regarding prosthetic hygiene during the COVID-19 pandemic. Data were evaluated by the Kruskal-Wallis and post hoc Dunn tests, and multivariate logistic regression analysis with forward selection was carried out to identify predictors of the oral health-related quality of life (OHRQoL) status (α=.05). ResultsOHIP-14 total scores did not vary significantly among the groups (P>.05). When the domain scores of OHIP-14 were considered separately, the analysis revealed that the implant-retained removable denture group had significantly poorer functional limitations when compared with the tooth-supported fixed partial denture (P=.005) and implant-supported fixed partial denture (P=.031) groups. The results of the multivariate logistic regression analysis indicated a statistically significant association between OHRQoL during the COVID-19 pandemic and the frequency of tooth or denture cleaning (1 time a day versus less than 1 time a day: P=.011; 2-3 times a day versus less than 1 time a day: P=.032). ConclusionsAll prosthesis users exhibited increased interest in dental hygiene and an increase in the frequency of prosthesis cleaning during the pandemic. Furthermore, the study determined that the frequency of tooth or denture cleaning was associated with significantly improved OHRQoL during the time of the COVID-19 pandemic. Among the denture groups, those treated with implant-retained removable dentures had the poorest functional limitation in terms of OHRQoL, which can be linked to postponement of routine maintenance appointments. Therefore, providing all patients with scientifically sound information on prosthetic care during a pandemic would be highly beneficial.

Removable dental prosthesis use and low handgrip strength in Korean adults: a nationwide cross-sectional study.

To evaluate the association between low handgrip strength and type of dental prosthesis used in Korean adults in a cross-sectional study of nationally representative big data. This study included 7,681 participants aged ≥ 19 years who were classified into the following four groups: NP (not using a dental prosthesis); FDP (using tooth-supported or implant-supported fixed dental prostheses); RPD (using removable partial dentures); and CD (using removable complete dentures). Low handgrip strength was defined as the lowest quartile of handgrip strength in each sex. The relationship between handgrip strength and dental prosthesis use was analyzed with adjustment for potential confounders. Multivariate logistic regression analyses were performed to examine the association between the use of dental prostheses and low handgrip strength (α = .05). The handgrip strength level of RPD users was significantly lower than those not using removable dentures (P < .0001). The respective adjusted odds ratios (with 95% CI) for low handgrip strength in the NP, FDP, RPD, and CD groups were 1 (reference), 0.90 (0.77, 1.05), 1.44 (1.13, 1.83), and 1.70 (1.29, 2.23) after adjustment for confounding factors. Using removable partial and/or complete dentures was associated with a 1.64-fold higher risk of low handgrip strength compared to not using removable dental prostheses. The use of removable dentures was associated with low handgrip strength and may be considered a potential risk indicator for functional decline in Korean adults.

Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses.

The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III (p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.

Impact of different types of dental prostheses on oral-health-related quality of life: a prospective bicenter study of definitive and interim restorations.

To assess the impact of different types of dental prostheses, including definitive and interim restorations, on oral health-related quality of life (OHRQoL) before and after prosthetic treatment. A total of 151 patients received prosthetic treatment at one of two German departments of prosthetic dentistry. The patients' OHRQoL was assessed using the German version of the Oral Health Impact Profile (OHIP-G53) at baseline (T0) and at 1 week (T1) and 3 months (T2) after treatment. Patients were divided into 10 subgroups according to their pre- and posttreatment status. The effect of the type (no prosthesis; fixed prosthesis; removable prosthesis) and duration of wear (definitive; interim) of the restorations was evaluated. Results were analyzed using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests with a significance level of P = .05. The highest OHRQoL was recorded for patients with fixed restorations, as indicated by the fact that their OHIP scores were lowest. A significant improvement in OHRQoL (P ≤ .034) was observed for patients who needed prostheses and were then treated with removable or fixed restorations. The OHIP score was affected by a change in restoration type. Rehabilitation with definitive prostheses had a significant effect on posttreatment OHRQoL (P ≤ .006). In general, prosthetic rehabilitation by use of fixed or removable prostheses resulted in an improvement in OHRQoL. The use of the same type of restoration before and after treatment had a positive effect on OHRQoL. If possible, a change of restoration type should be avoided. For patients who require permanent prostheses, the use of fixed and removable restorations is recommended. For oral rehabilitation, fixed restorations should be preferred in order to achieve best possible improvement of OHIP score.

Chewing Discomfort According to Dental Prosthesis Type in 12,802 Adults: A Cross-Sectional Study

This study examined the prevalence of self-perceived chewing discomfort depending on the type of dental prosthesis used in South Korean adults. The subjects were 12,802 people over 20 years of age who participated in a health interview and dental examination. Chewing discomfort was examined using a self-assessed report with a structured questionnaire. Using multivariable logistic regression analysis, adjusted odds ratios were evaluated along with their 95% confidence intervals (α = 0.05). After adjusting for covariates, including age, gender, smoking, drinking, hypertension, diabetes, body mass index, education, income, and toothbrushing frequency, the odds ratios (95% confidence intervals) for chewing discomfort in groups without a dental prosthesis, with fixed dental prostheses, with removable partial dentures, and with removable complete dentures were 1 (reference), 1.363 (1.213–1.532), 2.275 (1.879–2.753), and 2.483 (1.929–3.197), respectively. The association between the prevalence of chewing discomfort and the type of dental prosthesis used was statistically significant even after adjusting for various confounders (p < 0.0001). The type of dental prosthesis was related to chewing discomfort among South Korean adults.

Perfil dos pacientes atendidos nas disciplinas de Prótese Dentária de uma Clínica Escola de Odontologia

Tendo em vista o aumento da expectativa de vida e a busca cada vez mais frequente da melhoria em sua qualidade, faz-se necessário observar as constantes mudanças no perfil dos pacientes que necessitam de reabilitação protética. O objetivo desse trabalho foi avaliar o perfil dos pacientes atendidos nas disciplinas de prótese dentária, da Clínica-Escola de Odontologia da UFCG, Patos/PB. Sendo realizado um estudo observacional, descritivo, através de uma análise retrospectiva em 195 prontuários dos pacientes atendidos no período letivo de 2013.1 a 2015.1. Por motivos de exclusão, a amostra final do estudo foi de 131 prontuários. Assim sendo, foram verificados os seguintes dados; a maioria foram pacientes do gênero feminino (72,5%); a idade média geral dos pacientes foi de 49,7 anos, variando entre 20 e 85 anos; o tipo de edentulismo mais encontrado foi o parcial (77,1%); e quanto ao tipo de prótese dentária, a mais utilizada foi a PPR bimaxilar com 29,8%, seguida pela PT bimaxilar e PPF. Os resultados obtidos permitiram concluir que os pacientes são em sua maioria adultos, do gênero feminino e parcialmente edêntulos, com a higiene bucal regular, onde apresentavam a condição dos remanescentes dentários favoráveis para o tratamento reabilitador.

EFFECT OF METAL-CERAMIC PROSTHESIS ON GINGIVAL MUCOSA

The fixed dental prosthesis is one of the most commonly used prosthesis in dental clinical practice for restoring function and health of oral tissues. This type of dental prosthesis is not without complications, as these restorations often extend into the gingival sulcus, and gingival epithelial cells come into contact with them. Unfortunately, they also alter and modify oral microbial flora. The aim of the present study is to identify the dynamics of changes of mucosa in the region of metallo-ceramic prosthesis. We have examined three groups of patients, according to the length of wearing time of metallo-ceramic prosthesis: I group - 1year, II group – 1-5 years and III group – 6-10 years. Each group includes two subgroup, where was studied influence of supportive and intermediate parts of Metal-Ceramic prosthesis on gingival mucosa. The gingival mucosa was examined by Papanicolaou staining and cytomorphometric indexes. A review of the literature and the results of our study demonstrated the effect of metallo-ceramic prosthesis on the dynamics of changes in the surrounding gingival mucosa. At the same time, the literature searches around the present study also showed possible reasons for the changes mentioned above. It was shown that the success of fixed dental prosthesis depends on many factors which should be considered during treatment planning. Therefore, a detailed analysis of the changes in the gingival mucosa surrounding the fixed ceramic-metal prosthesis and their possible causes are necessary prerequisites for successful prosthetics. Keywords: Fixed Metal-Ceramic prosthesis; Gingival Mucosa; Cytomorphometric Indexes;

Association between oral health status and handgrip strength in older Korean adults.

Poor oral conditions in older adults are not limited to oral problems, which lead to physical problems. Prior research insufficiently has probed the relationship between oral health and physical function. This study investigated the relationship between oral health status and grip strength in older adults living in the community. This study used data from the 2014-2018 Korean National Health and Nutrition Survey. Oral health status was assessed by the type of dental prosthesis, the number of teeth. Grip strength was determined as the highest value among the three consecutive measurements of the dominant hand. The covariates included age, income, education, alcohol drinking, smoking, body mass index, sedentary time, comorbidity and number of caries teeth. Multiple logistic regression analysis was performed to examine the association between oral health status and grip strength. Data on 6,437 older adults (men 2766; women 3671) were analyzed. The mean age was 72.9 ± 0.1years. In the crude model of logistic regression analysis, both men and women had an association between full denture use and low grip strength compared to high grip strength. After controlling for covariates, the remaining 0-9 teeth was associated with low grip strength compared to high grip strength in men [odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.03-1.88]. The use of full dentures was also associated with low grip strength compared to high grip strength in men (OR = 1.47, 95% CI = 1.09-1.98). No significant associations were found in women. Low handgrip strength was associated with using full dentures and remaining 0-9 teeth in older men. Low grip strength, one of the key characteristics of sarcopenia and frailty, may serve as an important indicator of poor oral health, especially among men in late life.

Caracterização sociodemográfica de usuários de próteses dentarias no estado do Amapá

É crescente o número de pessoas sem nenhum dente no Brasil, 11% da população é desdentada total, o que corresponde a um montante de 16 milhões de pessoas e 33% da população faz uso de algum tipo de prótese dentária. Embasados nestes números relevantes, o objetivo deste estudo foi realizar a caracterização sociodemográfica de edêntulos totais usuários de prótese total mucossuportada e prótese total implantossuportada na cidade de Macapá, estado do Amapá, Brasil. Foram entrevistados 299 usuários de prótese total mucossuportada e 48 usuários de prótese total implantossuportada por meio de um questionário sociodemográfico estruturado já validado pela literatura médica. As variáveis do estudo foram caracterizadas por medidas estatísticas descritivas. Como avaliações descritivas foram empregados a média e o desvio padrão para a caracterização das variáveis quantitativas e frequências absolutas e relativas tanto para a caracterização de variáveis qualitativas quanto às quantitativas. A faixa etária mais prevalente foi de 61 a 70 anos, para ambos os grupos. Em relação ao gênero, apresentaram 50% de homens e mulheres, respectivamente; nos usuários de prótese implantossuportada, enquanto 56% dos usuários de prótese mucossuportada eram mulheres, 69% dos usuários de prótese implantossuportada se autodeclararam brancos (as); 44% possuíam ensino superior completo, com uma renda familiar de 7 a 10 salários mínimos, 65%. Dentre os usuários de prótese mucossuportada, 69% se autodeclararam brancos, a maioria com 1° grau completo, 62%, e renda familiar de 1 a 2 salários mínimos, 69%. Conclui-se que usuários de prótese implantossuportada apresentaram significativamente maior nível de escolaridade e maior renda familiar.

RELAÇÃO ENTRE TEMPO DE USO E QUALIDADE DE VIDA EM USUÁRIOS DE PRÓTESE TOTAL NO ESTADO DO AMAPÁ

&#x0D; &#x0D; &#x0D; &#x0D; Introduction: É crescente o número de pessoas sem nenhum dente no Brasil, 11% da população é desdentada total, o que corresponde a um montante de 16 milhões de pessoas e 33% da população faz uso de algum tipo de prótese dentária. O número de dentes presentes na cavidade bucal é pequeno, fazendo com que problemas sociais, físicos, psicológicos e nutricionais afetem diretamente a qualidade de vida dos edêntulos.&#x0D; Objetive: O objetivo deste artigo é relacionar o tempo de uso de próteses totais com a qualidade de vida destes usuários.&#x0D; Methodology: Foram entrevistados 299 usuários de prótese total mucossuportada e 48 usuários de prótese total implantossuportada por meio de dois questionários, o Oral Health Impact Profile-14Br (OHIP-14Br) e questionário sociodemográfico.&#x0D; Results: Ususarios de prótese total possuem melhor qualidade de vida em todas as variáveis comparadas com ussuarios de prótese mucossuportada e usuários de prótese total mucossuportada apresentam grande relação entre qualidade de vida e tempo de uso das próteses.&#x0D; &#x0D; &#x0D; &#x0D;

Sense of coherence and oral health in older adults in SouthernBrazil.

The aim of this study was to evaluate the association between sense of coherence and oral health among older adults treated at family health units in southern Brazil. The sample was composed of 164 individuals aged 60years old or older. Socio-demographic and oral health variables were collected using a standardised questionnaire. Sense of coherence (SOC) was measured with the questionnaire proposed by Antonovsky containing 29 closed-ended questions. Poisson regression analysis was employed to identify factors associated with SOC. Among the 164 older adults, 53.9% were edentate, 54.5% did not need any type of dental prosthesis, and 82.1% had good/adequate self-assessed oral health. The multivariate analysis revealed lower SOC scores among non-white individuals [Mean Ratio (MR)=0.94; 95% CI: 0.91-0.97; P<.001], with poor/very poor self-assessed oral health (MR=0.85; 95% CI: 0.78-0.91; P<.001) and with one or more teeth present in the oral cavity (MR=0.94; 95% CI: 0.91-0.97; P<.001). The present results show that older adults who are self-reported as non-white, with one or more teeth in the oral cavity and with poor/very poor self-assessed oral health have lower SOC scores.

Dental prosthesis use and/or need impacting the oral health-related quality of life in Brazilian adults and elders: Results from a National Survey

ObjectivesThis study aimed to assess the impact of use of and need for dental prosthesis (DP) on oral health related quality of life (OHRQoL) among Brazilian adults and elders. MethodsThis cross-sectional, population-based study, used data from the Brazilian Oral Health National Survey performed in 2010. The sample was representative of adults (35–44 years of age) and elders (65–74 years) at national level. Oral Impact on Daily Performance (OIDP) questionnaire was used to assess the individuals’ OHRQoL. Interest variables included use of and need for DP and location of tooth losses. Covariates included socioeconomic, behavioral and clinical characteristics. Associations were performed using Negative Binomial regression models, estimating the rate ratios (RR) and respective 95% confidence intervals. ResultsFrom the total of 17,398 individuals evaluated, 68.3% needed some type of DP, while the prevalence of DP usage was 49.2%. After adjustments, those needing prosthesis, regardless of already using prosthesis presented an impact more than 50% higher on OHRQoL, and those needing a greater the number of teeth to be replaced and those presenting losses on anterior and posterior regions had higher impact on OHRQoL. ConclusionsThese findings suggest that improvement of strategies focused on oral rehabilitation of adults and elders are crucial to promote population oral health. Clinical significanceThe high prevalence of normative need for prosthetic rehabilitation in adult and elder Brazilian population impacts significantly on oral health-related quality of life highlighting the importance of providing prosthetic oral rehabilitation in this population.

Prothetische vervanging van afwezige gebitselementen. Indicaties voor vaste en uitneembare prothetische constructies

Prosthetic replacement of missing teeth aims to improve health. This can be achieved by improving the patient's well-being and quality of life and by restoring the biological balance in terms ofocclusal and mandibular stability in the occlusal and the orofacial system. In occlusal systems with a complete anterior region and 'satisfactory' premolar and molar regions, prosthetic replacement of missing teeth is not indicated generally. In case ofa restricted number of missing teeth in the anterior region and/or a not 'satisfactory' premolar region, fixed dental prostheses may be indicated. In case of an incomplete anterior region and no 'satisfactory'premolar as well as molar regions, removable dental prostheses are usually indicated. These guidelines are presented in the absence of sufficient scientific evidence. Therefore, in clinical decision making, the question whether prosthetic replacement of missing teeth is sensible, and if so, by which type of dental prosthesis, can only be answered after a dialogue with mutual respect between care provider and patient.

Removable dental prostheses and cardiovascular survival: A 15-year follow-up study

ObjectivesIn previous studies, increasing number of teeth predicted better survival and the acute needs for dental treatment predicted mortality. We sought to investigate whether restored dentitions by various removable dental prostheses impact cardiovascular (CVD) longevity. MethodsKuopio Oral Health and Heart study was initiated as a cross-sectional investigation with 256 subjects with diagnosed coronary artery disease [CAD] and 250 age- and sex-matched controls without CAD in 1995–1996. The mean age of both groups was 61, 30% were females. We appended mortality follow-up records to the baseline data and formulated this 15-year follow-up study. We examined the relationship between various types of dental prostheses and cardiovascular mortality by proportional hazard regression analyses. We also explored their correlation to oral and systemic inflammatory markers such as asymptotic dental score and C-reactive protein. ResultsIn a model adjusted for age, sex and smoking, groups having only natural teeth (NT), removable partial denture(s) [PD] and NT, a PD and a full denture [FD], and FD/FD or FD/NT demonstrated the following hazard ratios for mortality (95% confidence interval). NT both arches: 1.00 [reference]; PD and NT: 0.75 [0.22–2.56]; PD and FD: 1.99 [1.05–3.81]; and FD opposed by FD or NT: 1.71 [0.93–3.13], respectively [p for trend=0.05]. Although statistically not significant, those with PD and NT with mean a number of teeth [Nteeth] of 15.4 had better survival compared with those who had all NT [Nteeth=22.5]; while those who had FD and PD [Nteeth=6.5] had shorter longevity than those with FD/FD or FD/NT [Nteeth=3.5]. ConclusionsAlthough not all subgroups of dental prostheses reached significant relationship with CVD mortality, our study suggests that not only the number [quantity] of remaining teeth but their maintenance [quality] removing potential inflammatory foci, such as pericoronitis or retained root tips, may positively impact on cardiovascular survival.