Article

Food selection and perceptions of chewing ability following provision of implant and conventional prostheses complete denture wearers

July 2002
Clinical Oral Implants Research 13(3):320-6

DOI:10.1034/j.1600-0501.2002.130313.x

Source
PubMed

Authors:

University College Cork

The loss of natural teeth compromises chewing efficiency, and edentulous patients often have a diet that is deficient in fibre and vitamins. Prostheses that are retained on implants offer the possibility of overcoming some of the limitations of conventional dentures in terms of chewing efficiency. The aim of this study was to test the hypothesis that improvement in satisfaction with oral prostheses would result in improved food selection in edentulous patients. This prospective study involved three groups, namely (i) subjects who requested and received implants to stabilise a complete fixed or removable prosthesis (IG, n = 26), (ii) edentulous subjects who requested implant prostheses, but received conventional dentures (CDG1, n = 22), and (iii) edentulous subjects who requested and received conventional dentures (CDG2, n = 35). Data were collected using validated questionnaires pre- and postoperatively. Prior to treatment, all subjects were asked whether they ate a variety of hard and soft foods, to indicate the degree of difficulty they experienced when chewing these foods, and to rate their satisfaction with various aspects of their maxillary and mandibular complete dentures. Following the completion of treatment, subjects completed the questionnaires again. Pre- and postoperative data were compared. Subjects who received implant prostheses reported significant improvement in chewing hard and soft foods. CDG2 subjects also reported improvement, but CDG1 subjects reported no change or even deterioration following treatment. Despite reported improvement in satisfaction with comfort and ability to chew food, 30-50% of IG and CDG2 subjects still avoided eating foods such as carrot and apple. This suggests that, in the absence of tailored dietary advice, apparently successful prosthetic rehabilitation does not necessarily result in a satisfactory diet.

Influence of Age on Factors associated with Peri-implant Bone Loss after Prosthetic Rehabilitation over Osseointegrated Implants

Article

Full-text available

Jan 2017
J Contemp Dent Pract

Introduction: To verify the influence of age on factors associated with peri-implant bone loss after prosthetic rehabilitation over osseointegrated implants. Materials and methods: This is an analytical, observational, and longitudinal study with initial 23 participants. Patients presenting with osseointegrated implants with their respective prostheses installed were included, and they could be carriers of chronic and degenerative diseases, such as diabetes, osteoporosis, hypothyroidism, cardiovascular disease (CVD), and systemic arterial hypertension. Thus, 18 participants with 57 implants were selected and followed up from 2009 to 2013. For statistical analysis, chi-square or Fisher's exact test was used for the association of systemic conditions and bone loss. Student's t-test was used for mean comparisons of age and number of total upper and lower implants. Results: The average age of the sample studied was 71.05 years (65-80). The average implant per person was 3.2. Smoking had an influence on both mesial and distal bone loss, and the latter was significant (p = 0.0370). The association between bone loss and gender was also significant (p < 0.05). Moreover, male gender and upper implants were factors significantly associated with bone loss. The systemic conditions, when isolated, did not have significant influence on implant survival. Conclusion: Age is not a factor that, alone, contraindicates implant-rehabilitating therapy. On the contrary, smoking has a significant influence on dental implant survival. Systemic diseases, such as osteoporosis, hypothyroidism, diabetes, hypertension, and heart diseases, when controlled, are not contraindication factors. Clinical significance: This study is relevant for assessing peri-implant bone loss in elderly patients, right after implant installation and over time. Therefore, it was possible to verify that age is not a limiting factor for this procedure. Controlled systemic diseases do not contraindicate implant installation, but smoking is a factor that affects implant survival.

Investigating the Impact of Perceived Masticatory Difficulty with Previous Dentures on Subsequent Food Intake with New Dentures: A Prospective Study

Article

Mar 2024

This study investigated changes in chewing satisfaction from old to new dentures, exploring how perceived masticatory difficulty with the old denture influenced food intake with the new dentures. Additionally, factors influencing overall masticatory satisfaction with the new dentures were examined. Consecutive sampling involved edentulous individuals seeking replacements for both maxillary and mandibular complete dentures. A total of 103 edentulous individuals（49 males, 54 females; age range: 39-87 years; mean age: 71.6±8.6 years）participated. At the baseline visit, patients provided general satisfaction ratings for their dentures in terms of subjective mastication. A 12- item questionnaire, using a 100mm visual analog scale（VAS）, assessed their ability to chew specific foods（tofu, fish cake, bean sprouts, cubic rice crackers, rice crackers, and squid jerky）with existing maxillary and mandibular dentures. The study revealed a significant increase in VAS for overall masticatory satisfaction and the intake of six Japanese foods with diverse textures. Notably, perceived masticatory difficulty with previous dentures exerted a substantial impact on subsequent food intake with new dentures. Factors influencing perceived mastication with the new dentures included crunchy foods（cubic rice crackers and rice crackers）and elastic foods（fish cake）. These findings highlight the considerable influence of old denture-related masticatory difficulty on overall masticatory satisfaction and subsequent food intake with new dentures. The study suggests valuable insights for treatment planning and denture design, emphasizing the necessity of considering these factors when fabricating new dentures and providing guidance to patients post-insertion.

Are UK graduates equipped with the skill set required to meet the demands of the UK's edentulous population?

Article

Jul 2018

As the UK witnesses a decline in the number of edentulous adults, there is a simultaneous reduction in the number of cases available to undergraduate dental students for the teaching of complete dentures. When edentulous adults are unable to function with conventional complete dentures, particularly pertaining to the mandibular denture, an implant-supported mandibular overdenture has been evidenced as the gold standard for edentulous patients. The evidence in favour of mandibular implant-supported overdentures is one of the most robust evidence bases for any clinical treatment and similarly it has been shown that undergraduate students are equally as capable in the provision of implant-supported overdentures as experienced prosthodontists. Yet there appears to be a disparity in the General Dental Council's undergraduate learning outcomes pertaining to care for edentulous adults. Furthermore, the UK seems to be falling behind in this respect in comparison to our European, American and Australian colleagues. This review looks at the evidence for the provision of implant-supported overdentures in the setting of the undergraduate dental curriculum, the potential barriers within this teaching forum and how well prepared UK undergraduates are for the clinical management of edentulous patients in the future.

Single Mandibular Midline-Implant supported Overdentures: Fifteen-Year Clinical Outcome

Article

Apr 2025
J DENT

Evaluation of the dietary outcomes among middle-aged Libyan edentulous male subjects treated with complete dentures; Part 1: The perceived ability to chew.

Article

Full-text available

Feb 2025

Statement of problem: The implant-retained or supported overdentures have been indicated as the primary treatment of edentulousness. However, for obvious reasons fewer patients will afford this type of treatment. Therefore, it is desirable to investigate and re-establish the effectiveness of the provision of complete dentures on patients’ essential oral functions. Aim of the study: To assess the perceived chewing ability of edentulous Libyan patients rehabilitated with traditional complete dentures. Materials and methods: Thirty-five edentulous adult male patients were carefully selected for this clinical trial. The researchers interviewed all subjects and assisted them in filling accurately the visual analogue scale questionnaire (VAS). The VAS questionnaire contained efficiency-rating questions assessing the effectiveness of wearing complete dentures on the ability to chew seven locally favourite meals. The answer for each question was ranked from zero to 100. Then, a standard treatment procedure was performed to provide each subject with a conventional complete denture. At the recall visit scheduled after six months of post-insertion of all prostheses, the same researchers helped subjects to indicate again their satisfaction level with their complete dentures using the same practice VAS questionnaire. The VAS scores recorded pre-treatment were compared to those scores recorded post-treatment using Wilcoxon signed-rank tests. Results: All subjects verbally expressed their contentment and enjoyment when eating meals using their dentures. The perceived ability to chew was significantly improved for almost all food tested except for those, which require slicing before chewing. The conventional complete dentures still provide edentulous patients with an improved chewing ability when consuming traditional Libyan meals. Conclusion: An optimistic improvement of chewing ability with complete dentures is achieved as shown by the validated practice VAS questionnaire. Consequently, the treatment with traditional complete dentures can be generalized and used for wider edentulous patients seeking treatment in the Libyan general dental practice.

Dental Functional Status as a Possible Risk Factor of Sarcopenia: A Computed Tomography‐Based Study

Article

Full-text available

Nov 2024
J ORAL REHABIL

Background Functional dentition may be associated with sarcopenia by affecting chewing activity. Objectives The objective of this study is to determine the sarcopenia status of participants using computed tomography (CT)‐based data and to investigate the association of sarcopenia with functional dentition, as well as denture condition. Methods The study included 309 patients. The number of teeth was recorded. Functional dentition was evaluated based on the following parameters: (1) ≥ 1 tooth in the maxilla and mandible; (2) ≥ 10 teeth in each arch; (3) the presence of 12 anterior teeth; (4) 3–4 premolar posterior occlusal pairs (POPs) and (5) ≥ 1 molar POP bilaterally. The denture condition was also evaluated. CT‐based assessment of sarcopenia was performed via measurement of the psoas muscle area at the level of the L3 vertebra and its hounsfield unit (HU) radiodensity on non‐contrast‐enhanced images. HU average calculation (HUAC), which is an imaging marker of sarcopenia, was performed. Gender‐specific quartiles were then generated, and the lowest quartile of HUAC scores within each gender group was set as the cut‐off point. Results A total of 76 (24.5%) of the patients had sarcopenia, and 233 (75.5%) did not have sarcopenia. The mean number of teeth in the sarcopenia group was 17.12 ± 8.39, compared to 22.24 ± 6.72 in those without sarcopenia ( p < 0.001). The relationship between functional dentition and sarcopenia was also significant. There was a positive relationship between ill‐fitting dentures and sarcopenia ( p < 0.001). Conclusions This unique perspective of the study contributes to the existing knowledge regarding the role of tooth loss in sarcopenia, highlighting the importance of functional occlusion.

Five years of radiographic evaluation for the peri-implant bone changes of all-on-four implant prostheses constructed from different framework materials using different digital construction techniques

Article

Full-text available

Aug 2024
BMC Oral Health

Background There is insufficient evidence recommending a framework material and a CAD/CAM manufacturing technique for mandibular implant-supported prostheses. The study objective was to evaluate the clinical application of different materials and construction techniques used for mandibular All-on-4 prosthesis on circumferential peri-implant bony changes after 5 years. Methods Thirty-six male patients with all-on-4 mandibular implant-supported prostheses were recalled and divided into three groups. Group PK (patients with frameworks milled from PEEK blocks), Group PSM (patients with frameworks milled from soft metal blocks), and Group SLM (patients with frameworks constructed with additive manufacturing; selective laser melting). The circumferential bone level on all implant faces was assessed with a CBCT. Two-way repeated measures ANOVA was used to compare vertical bone loss (VBL) and horizontal bone loss (HBL) between different groups, implant positions, and observation times followed by Tukey’s multiple comparisons. Results For all observation times, there was a significant difference in VBL between groups for both anterior and posterior implants (P < .001). For anterior implants, group PSM showed the lowest VBL while group PK showed the highest for anterior and posterior implants. For all groups, HBL significantly increased after 5 years for both anterior and posterior implants (P < .001). For anterior implants, group PSM showed the highest HBL. For posterior implants, group PK and SLM showed the highest. Conclusion Within the study’s limitations, mandibular implant-supported fixed frameworks fabricated with either milling from PEEK or soft metal blocks, or additive manufacturing (laser melting technology) exhibited significant vertical and horizontal bone height changes after 5 years. Clinical Trial Registry Number (NCT06071689) (11/10/2023).

Comparison Between Two Treatment options for screw retained Mandibular Dentures Regarding Implant Stability

Article

Jan 2024

mohammed saud

The effect of computer guided occlusal adjustment versus articulating paper on implant retained mandibular complete over denture on masticatory efficiency and patient's satisfaction Introduction

Article

Full-text available

Nov 2023

Objective: The aim of this study was to evaluate the effect of computer guided occlusal adjustment versus articulating paper on implant retained mandibular complete over denture on masticatory efficiency and patient's satisfaction Patients and Methods: From the removable prosthodontics department clinic, Faculty of Dental Medicine, (Boys, Cairo, Egypt), Al-Azhar University, 10 completely edentulous patients were randomly chosen. The patients were divided into two groups, Group I received dentures adjusted by articulating papers. Group II received dentures adjusted by t-scan. Statistical analysis was done using student t-test, the data distribution of normality was done by using the Kolmogorov Smirnov test. Results: It was found that group I recorded a significant increase in masticatory efficiency and patient satisfaction for 1 week after insertion and there was no significant difference between the two groups for 3& 6 months after insertion. Conclusion: T-scan could be used for occlusal adjustment in complete denture.

Teeth Rehabilitation and Nutritional Influence on Diabetic Patients: A Review

Article

Full-text available

Sep 2023

Dalea M. Bukhary

Diabetes mellitus (DM) is a globally prevalent endocrine and metabolic disorder characterized by hyperglycemia. Its complications significantly impact both the quality and longevity of the patient’s life with a substantial burden on the healthcare system. Missing teeth make individuals more susceptible to malnutrition compared to those with functional teeth. This is especially true for people with diabetes, as the condition is closely linked to both oral health and food intake. Natural teeth loss can significantly reduce an individual's ability to chew food, leading to a decrease in the quality and quantity of their nutrition. Prosthodontics is a dental specialty that replaces missing teeth with artificial ones. Replacing missing teeth may prevent the risk of malnutrition due to decreased ability to chew. Good oral health is important for overall health, especially for those with conditions such as diabetes. Artificial teeth replacement may improve nutrition intake by improving chewing ability. Therefore, the ultimate objective of rehabilitating a patient's oral cavity is to replace the shape and function in terms of chewing performance to a degree that is as close to normal as feasible. The purpose of this review is to explore the literature showing the link between natural teeth loss and nutrition in individuals with DM, with a special focus on prosthodontic management. Several oral complications occur in diabetic patients specifically teeth loss, which in turn affects mastication function. This in turn cause malnutrition and affect glucose level. It is imperative for healthcare providers to take an interdisciplinary approach in order to improve the dental and nutritional status and overall well-being of DM patients.

The Single Midline Implant in the Edentulous Mandible—Current Status of Clinical Trials

Article

Full-text available

May 2023

The single midline implant in the edentulous mandible is a treatment concept that has often been controversially discussed. Nearly 30 years ago, the first available clinical results revealed high implant survival rates and remarkable improvements in oral comfort, function, patient satisfaction and oral health-related quality of life for edentulous patients compared to the situation with no implant. However, the clinical trials were predominantly conducted with a small number of patients over a short to medium follow-up period. Today, numerous clinical investigations on the single midline implant in the edentulous mandible, which increasingly include longer-term observation periods, are available. It is the aim of this overview to present the current literature and to highlight the clinical problems. This article is a 2023 update of a review published by the authors in the German language in 2021 in the German journal Implantologie. In total, 19 prospective clinical trials with a follow-up period of 0.5–10 years were analyzed. Over this observation period, single implants with modern rough implant surfaces in the edentulous mandible reveal high implant survival rates of between 90.9 and 100% when a conventional delayed loading protocol was applied.

Relevant domains, core outcome sets and measurements for implant dentistry clinical trials: The Implant Dentistry Core Outcome Set and Measurement (ID-COSM) international consensus report

Article

May 2023
J CLIN PERIODONTOL

Aim: Lack of consistently reported outcomes limits progress in evidence-based implant dentistry and quality of care. The objective of this initiative was to develop a core outcome set (COS) and measurements for implant dentistry clinical trials (ID-COSM). Materials and methods: This Core Outcome Measures in Effectiveness Trials (COMET)-registered international initiative comprised six steps over 24 months: (i) systematic reviews of outcomes reported in the last 10 years; (ii) international patient focus groups; (iii) a Delphi project with a broad range of stakeholders (care providers, clinical researchers, methodologists, patients and industry representatives); (iv) expert group discussions organizing the outcomes in domains using a theoretical framework and identifying the COSs; (v) identification of valid measurement systems to capture the different domains and (vi) final consensus and formal approval involving experts and patients. The methods were modified from the best practice approach following the Outcome Measures in Rheumatoid Arthritis Clinical Trial and COMET manuals. Results: The systematic reviews and patient focus groups identified 754 (665 + 89, respectively) relevant outcome measures. After elimination of redundancies and duplicates, 111 were formally assessed in the Delphi project. By applying pre-specified filters, the Delphi process identified 22 essential outcomes. These were reduced to 13 after aggregating alternative assessments of the same features. The expert committee organized them into four core outcome areas: (i) pathophysiology, (ii) implant/prosthesis lifespan, (iii) life impact and (iv) access to care. In each area, core outcomes were identified to capture both the benefits and harms of therapy. Mandatory outcome domains included assessment of surgical morbidity and complications, peri-implant tissue health status, intervention-related adverse events, complication-free survival and overall patient satisfaction and comfort. Outcomes deemed mandatory in specific circumstances comprised function (mastication, speech, aesthetics and denture retention), quality of life, effort for treatment and maintenance and cost effectiveness. Specialized COSs were identified for bone and soft-tissue augmentation procedures. The validity of measurement instruments ranged from international consensus (peri-implant tissue health status) to early identification of important outcomes (patient-reported outcomes identified by the focus groups). Conclusions: The ID-COSM initiative reached a consensus on a core set of mandatory outcomes for clinical trials in implant dentistry and/or soft tissue/bone augmentation. Adoption in future protocols and reporting on the respective domain areas by currently ongoing trials will contribute to improving evidence-informed implant dentistry and quality of care.

Patient Satisfaction and Maintenance Requirements of Classical Implant Locators versus Customized Attachments in Mandibular Implant-Retained Overdentures

Article

Full-text available

Jan 2022

Objectives: This study was performed to compare implant locators versus customized mandibular implant-retained overdentures considering patient satisfaction and prosthesis maintenance. Materials and methods: 12 completely edentulous patients from the prosthodontic department-Cairo university outpatient clinic were selected according to specific inclusion criteria. The patients were then allocated randomly into two groups using closed envelopes. For both groups, each patient received dental implants in the planned position. The patients were left for 3 months for implant healing. For group (A) the patients received two locator attachments. The attachment collar height was selected based on the soft tissue thickness keeping the retentive part 1 mm above the soft tissue level. The denture was relieved opposite the locator housing and the attachment was picked up using cold-cured resin. For group B, the implants were exposed, and healing collars were placed. After 2 weeks, the implants were scanned using an intraoral scanner. The denture was readapted using a light body closed mouth impression. The relined denture was scanned from both the fitting and the occlusal side. The scanned fitting surface was used to create an inverted virtual model and preceded till creating custom locator attachments. The generated custom attachment abutment was milled from grade V titanium blanks using a 5-axis milling machine. The abutments were anodized into gold color using an electric anodizer. The attachments were then sterilized and placed in the patient mouth as set before in the design. The pick-up of the housing was done in the same manner as group A. For both groups, the patients were given instructions for using and maintaining the overdenture. Initial denture corrections were made in the first 2 weeks if any complaint existed. The patients were recalled periodically at 3 months, 6 months, 9 months & 12 months respectively. Results: Likert scale out of 5 was followed for patient denture satisfaction along 3, 6, 9, and 12 months for groups A & B. Applying an Independent t-test for significance evaluation between group A and group B, precluded the higher significance of group B than group A for all follow up as P-value <0.05.For prosthetic maintenance along twelve months follow-up, group B revealed a lower insignificant different incidence of prosthetic complications than group A using the Chi-square test for significance testing between proportions as P-value >0.05. Conclusions: Customized locator attachments are highly recommended to retain mandibular overdentures, as they exhibited better maintenance values and more wear resistance with minimal loss of retention. Moreover, can be utilized by any presented implant system in the market, in addition, Patients were completely satisfied with their customized locators retaining their implant-supported overdentures.

Evaluation of retention and stability of locator and ball attachment mandibular overdenture retained on a single median implant - An invitro study

Conference Paper

May 2022

Aim: The purpose of this study was to evaluate and compare the retentive and stability values of locator and ball attachments retained on mandible with single median implant overdenture. Methods and Material: In this experimental study, an edentulous mandibular acrylic model was fabricated for testing the test dentures and two gypsum stone models of the same was made for fabricating the test dentures. A total of twenty test dentures, ten each for Group A [Locators] and Group B [Ball and O Ring attachment] were made. Later the retention and stability values of Group A and Group B test dentures were recorded by subjecting them to vertical, oblique and posterior dislodgement tensile forces on a Universal testing machine. Statistical analysis used: Statistical analysis data were tested for normality using Shapiro wilks test. Unpaired Student t test were used to compare retentive and stability values of locator and ball attachments retained on single implant retained over denture. Results: When the results of all the three tests were compared, it was clearly seen that the resistance to vertical dislodging forces were higher followed by the anteroposterior horizontal rotational forces and the oblique horizontal rotational forces. Conclusions: On evaluation and comparison of ball attachment and locator supported mandibular overdenture retained on a single median implant,ball abutment provides better retention by its bracing effect whereas locator offers ideal retention and stability with adequate freedom of rotation along the three dimensional aspects thereby providing necessary retention and stability to mandibular dentures.

A Comparison of the Time Efficiency and the Economics of Bone Graft Surgery vs. Computer-Aided Implant Surgery for Implant Placement in the Sinus Region: A Randomized Prospective Clinical Trial Study

Article

Full-text available

May 2021

Objective: To compare the time efficiency and the economics of Bone Graft Surgery (BGS) and Computer-Aided Implant Surgery (CAIS) for implant placement in patients with maxillary atrophy as well as the comparison of planned, placed, and loaded implants. Materials and Methods: Patients with extremely atrophic maxilla in need of implant placement were selected for a randomized controlled study clinical trial. The patients were divided randomly into two treatment groups: one group treated by using sinus grafting before implant placement and the group treated by using residual bone to place the implant by computer-aided implant surgery. Thirty Patients were assigned for each treatment group. The study provided a comparison of the time efficiency and economics of the two treatment groups. Results: The results revealed a significant difference in terms of total surgical time duration and cost of treatment without prosthesis: p= 0.000. The time efficiency of time was 53.33 min for one implant while that of the CAIS group was 29 min for one implant; there was no significant difference in implant surgery duration p= 0.928; implant 2 surgery duration, p= 0.227 The Economic efficiency of the two groups was as follows: 1346.41 € for one implant in the BGS group versus 945.36 € for one implant in the CAIS group. While there was no significant difference in consultation fees p= 0.131and second implant surgery costs p= 0.584. And there was significant difference in assistant costs p= 0.000; treatment planning costs p= 0.000, implant surgery costs p= 0.006, and implant loading costs p= 0.048. In addition, there was no significant difference in the number of missing teeth p= 0.695; loaded implant p= 0.057 versus there was a significant difference in number planned implants p= 0.0074; implants p= 0.034 between the groups. Conclusion: This study shows that Computer-Aided Implant Surgery seems to be more economical and time-efficient than the established conventional surgery by sinus lift and bone graft in dental implant placement, and the cost of treatment has increased for the sinus grafting procedures in Bone Graft Surgery. Also, the number of placed implants and planned implants was affected by the technique of implant placement. All planned implants were placed by Computer-Aided Implant Surgery while 81.5% of patients have placed their planned implants by bone grafting surgery.

Biting Force and chewing efficiency of Conventional and CAD/CAM complete dentures. A Cross-over Study

Article

Oct 2021

Number of teeth and masticatory function are associated with sarcopenia and diabetes mellitus status among community-dwelling older adults: A Shimane CoHRE study

Article

Full-text available

Jun 2021
PLOS ONE

Objectives We aimed to examine the number of teeth and masticatory function as oral health indices and clarify their roles in the pathogenesis of sarcopenia and diabetes mellitus in community-dwelling older adults. Subjects and methods This cross-sectional study was conducted with 635 older adults in Ohnan, Shimane Prefecture, in rural Japan. The number of teeth and masticatory function (measured by the number of gummy jelly pieces collected after chewing) were evaluated by dental hygienists. Sarcopenia status was assessed using handgrip strength, skeletal muscle index, calf circumference, and a possible sarcopenia diagnosis based on the Asian Working Group for Sarcopenia 2019. Diabetes mellitus status was defined as a hemoglobin A1c level ≥6.5% or self-reported diabetes. A multivariable logistic regression model was used to analyze the association between oral health, sarcopenia, and diabetes mellitus after adjusting for confounders. Results After adjusting for all confounders, logistic regression analysis showed that the number of remaining teeth was negatively associated with a low level of handgrip strength (odds ratio [OR], 0.961; 95% confidence interval [CI], 0.932–0.992) and possible sarcopenia (OR, 0.949; 95% CI, 0.907–0.992). Higher levels of masticatory function were also negatively associated with a low level of handgrip strength (OR, 0.965; 95% CI, 0.941–0.990) and possible sarcopenia (OR, 0.941; 95% CI, 0.904–0.979). Logistic regression analysis showed that the number of remaining teeth and a higher level of masticatory function were negatively associated with diabetes mellitus (OR, 0.978; 95% CI, 0.957–0.999; OR, 0.976; 95% CI, 0.960–0.992, respectively). Conclusion Our findings suggest that improvement in oral health, including the maintenance of masticatory function and remaining teeth, may contribute to the prevention of sarcopenia and diabetes mellitus in older adults.

Mandibular two‐implant overdentures with CAD‐CAM milled bars with distal extensions or retentive anchors: A randomized controlled trial

Article

Sep 2020
CLIN ORAL IMPLAN RES

Objective: This randomized controlled trial (RCT) aimed to demonstrate the noninferiority of mandibular 2-implant overdentures (IODs) on a CAD-CAM milled bar with long distal extensions against conventional IODs on retentive anchors. Methods: Forty edentulous participants already rehabilitated with a maxillary conventional denture and a mandibular 2-IOD participated in this trial. They were randomized into two trial groups [Control group (CG): retentive anchors + gold matrices; Experimental group (EG): CAD-CAM milled titanium bar with long distal extensions + gold clip]. The outcomes included implant survival rate (ISR), chewing efficiency [quantitative (VoH) and subjective (SA) assessments], peri-implant marginal bone level (PI-MBL), maximum bite-force (MBF), and patient-reported outcomes [oral health impact profile (OHIP-EDENT) and denture satisfaction index (DSI)]. Outcomes were recorded at baseline (BL), two weeks (T0), 6-months (T1) and at 1-year (T2) after the intervention. Intra- and inter-group analyses were performed using regression models with ⍺=0.05. Results: 38 participants completed the T2 visit (CG: n=19, age=74.7±7.8y; EG: n=19, age=70.3±10.7y). At T2, there was no implant loss in either of the groups (ISR=100%). There were no significant differences between the groups for the PI-MBL changes (p=0.754). Improvements occurred faster in the EG than in the CG, but over the observation time, there were no differences between the trial groups for VoH, MBF, OHIP-EDENT, and the DSI, except for SA being significantly better in the EG group (p=0.022). Conclusions: The results of this RCT confirm that mandibular 2-IODs with a CAD-CAM milled bar with long distal extensions are not an inferior treatment to the conventional IODs on retentive anchors.

Milled bar versus rigid telescopic attachment for mandibular implant supported overdentures. A study of patient satisfaction and oral health quality of life.

Article

Full-text available

Apr 2020

Mandibular Implant Overdentures Retained by Bars with Long Distal Extensions

Conference Paper

Mar 2020

Objectives: This randomized controlled trial (RCT) tested the hypothesis that mandibular overdentures with CAD/CAM-milled titanium bars with long distal extensions on two implants are not an inferior treatment to conventional overdentures on two ball attachments. Methods: This RCT received ethics approval (CCER#: 11-173/Psy 11-20). Forty completely edentulous patients with conventional maxillary complete dentures and mandibular overdentures on 2 implants were bloc- randomized into the two study groups [Control group (CG): n=20, intervention: ball attachments with Dalbo- Plus; Experimental group (EG): n=20, intervention: CAD/CAM-milled titanium bars with 15 mm long distal extensions and gold clip]. Endpoints included plaque (PI) and bleeding (BI) indices, radiographically-evaluated peri-implant bone loss (PIBL), chewing efficiency (CE): Subjective assessment (SA) and variance of hue (VoH), maximum bite-force (MBF), OHIP20 and patient denture satisfaction (DSI). Endpoints were measured at baseline (BL), two weeks (T0), 6-months (T1) and at 1-year (T2) after the intervention. ANOVA and post-hoc tests were applied for statistical analyses (alpha=0.05). Results: 38 participants completed the T2 follow up visit (one dropout in each group). At baseline, there was a significant difference between EG and CG in the DSI (p=0.038) but no differences in the other parameters. Within EG, at T2, there was increased PI (p=0.027) and BI (p=0.019) along with improvements in SA (p=0.0002), and DSI (p=0.023). No other changes were observed. At T2, there was no change within subjects for any of the investigated outcome measures in CG. Between the study groups, at T2, participants of EG demonstrated better CE (SA: p<0.0001; VoH: p=0.008) and higher MBF (p=0.0002). Conclusions: The preliminary results of this RCT confirm that mandibular overdentures on two implants retained by bars with long distal extensions are not an inferior treatment concept to conventional overdentures on ball attachments and may in the short term (1-year) provide functional advantages in terms of CE and MBF. KEYWORDS: Implant overdentures, CAD/CAM milled titanium bars, long extension bar, randomized controlled trial, complete dentures.

Descripción del estado de salud de los tratamientos rehabilitadores en base a implantes oseointegrados

Article

Full-text available

Apr 2020

Objetivo: Describir los factores asociados al estado de salud de la rehabilitación sobre implantes oseointegrados (IOI) en los pacientes atendidos en la Central Odontológica de la Primera Zona Naval de la Armada de Chile entre los años 1995 y 2015.Materiales y métodos: Estudio descriptivo de corte transversal a partir de la recolección de datos obtenidos a través de la evaluación clínica de los pacientes atendidos en la Central Odontológica de la Primera Zona Naval de la Armada de Chile, fichas clínicas y radiografías. Para la clasificación según escala de salud de los implantes se utilizaron los parámetros presentados en el Congreso Internacional de Implantología Oral de Pisa (2007). Resultados: 65 IOI, correspondientes a 30 pacientes, fueron analizados. 63 se encontraron en boca, con un tiempo promedio de 6.9 años de permanencia. El 50,76% se consideró exitoso, 38,46% con supervivencia satisfactoria, 3,07% con supervivencia comprometida y fracasados 7,69%. La asociación entre los cigarrillos diarios y el estado de salud de los IOI presentó un p valor de 0.040. Conclusiones: El fracaso de los implantes tiene un origen multifactorial. La rehabilitación en base a IOI sigue siendo una opción exitosa, predecible y segura para los pacientes.

Santé orale chez le sujet âgé édenté : enjeux et perspectives en prothèse odontologique

Thesis

Dec 2019

Cindy Batisse

Ce travail s’intéresse aux liens existants entre la santé bucco-dentaire de la personne âgée édentée et son alimentation. En effet, chez la personne âgée, une prise alimentaire régulière et diversifiée est à rechercher pour éviter une dénutrition protéino-énergétique. Cependant, la réhabilitation de l’édentement par prothèses amovibles n’optimise pas ou peu la diversification de l’alimentation. La mise en place d’implants par prothèse implanto-retenue ou portée reste restreinte au sein de cette population. A ce titre, une des solutions thérapeutiques envisageables est la transformation de la prothèse amovible en prothèse implanto-retenue par mini implants. L’impact de cette nouvelle procédure sur la fonction masticatoire et la qualité de vie orale des patients a été évaluée par une étude de suivi. Cette évaluation a montré que la prothèse implanto-retenue permet d’améliorer la capacité masticatoire du sujet et sa qualité de vie orale mais l’efficacité masticatoire reste bien en deçà de celle observée chez un sujet âgé denté.Consécutivement, de nouvelles procédures thérapeutiques utilisant la CFAO (Conception et la Fabrication Assistée par Ordinateur) ont été développées et évaluées chez des sujets réhabilités au sein du service d’Odontologie du CHU Estaing. Les avantages qu’apporte la CFAO dans le maintien de la santé bucco-dentaire de la personne âgée ont ainsi été objectivés. Dans la continuité de ce travail, de nouvelles procédures CFAO de réhabilitation orale du sujet édenté sont actuellement en cours d’évaluation.Par ailleurs une prise alimentaire de qualité implique la mise en jeu des différentes perceptions orales. Les interactions existantes entre l’altération de la santé bucco-dentaire chez la personne âgée, la mastication et les perceptions orosensorielles sont donc mises en évidence par une revue de littérature. Des facteurs impactant la prise alimentaire de la personne âgée sont également identifié. L’objectif à terme est de travailler sur les caractéristiques de l’aliment consommé (nature et texture) pour faciliter sa mastication, modifier sa perception orosensorielle et donc certainement favoriser sa consommation.

Assessment of clinical and radiographic outcomes of mandibular implant supported Overdenture with regular and mini dental implants

Article

Full-text available

Feb 2020

Purpose: this prospective study was done to evaluate the clinical and radiographic outcomes of mandibular implant supported over denture using two regular implants and two mini-implants. Methods: Sixteen patients were selected for the study and divided to Group I (control) who received a two conventional implants and group II (test) that received a two mini implants. Retention force of dentures, Bite force and Masticatory efficiency tests were. Evaluation for ridge loss was done using CBCT. The results were statistically analyzed by one-way ANOVA test. Results: the control group had a statistically significant increment of the clinical features and a statistically significant decrement of ridge resorption than the test group. Conclusions: Mandibular implant supported overdenture by two mini implant has lower retention, biting force, and masticatory efficacy than the overdenture supported by two conventional implants. Also, it is associated with more radiographic ridge loss than overdenture supported by two conventional implants.

Article

Jan 2020

Background: Impaired oral conditions are described as influencing food intake behavior and contributing to poor nutritional status in elderly persons. Objectives and methods: In order to evaluate the influence of age and oral factors on food choice among independently living elderly, we investigated food selectivity and oral health status in elders (aged over 65 years) and in younger people (aged between 35-64 years). Food selective behavior was appraised by using a food selectivity questionnaire based on traditional French dishes. A stepwise binary logistic regression analysis was done to sequentially identify age and oral conditions associated with oral discomfort-related food avoidance. Results: Occlusal status and oral-health related quality of life contributed to food choice. Risk of oral discomfort-related food avoidance was significantly increased in people with fewer than 7 Occlusal Functional Units (OFUs), and with Geriatric Oral Health Assessment Index summary scores (GOHAI-ADD) indicating poor and average oral-health related quality of life (p<0.05). Age was never a significant factor of food selective behavior. Conclusion: Present data support the impact of occlusal status and oral health-related quality of life on food behavior. Specific attention should be given in maintaining or restoring good oral conditions throughout the lifespan, especially occluding teeth.

The Impact of Eating Rate on Energy Intake, Body Composition and Health

Chapter

Nov 2019

The modern food environment is often characterised by an increasingly assessable diet of inexpensive, energy-dense and highly palatable foods. Extensive evidence indicates the eating rate of foods (g/min or kcal/min) is associated with energy intake, body composition and the associated risk of food based non-communicable diseases. Moderating eating rate during food intake offers a simple but effective strategy to regulate energy consumption and body weight. Research evidence from population and experimental studies demonstrate that eating at a slower rate can produce sustained changes in ad-libitum energy intake, influence body composition and moderate our metabolic response to ingested nutrients. Understanding which factors combine to influence eating rates affords new opportunities to design ‘slower’ foods that can reduce the risk of over-consumption and support better long-term energy control. This chapter summarises the role of eating rate in energy intake and body composition, provides an overview of development of eating behaviours in infancy and childhood and describes the individual and food-based factors that can influence eating rate and its metabolic impact. The chapter provides a summary of research that has intervened to slow eating rate and demonstrates opportunities to support energy intake reductions using texture led changes to eating rate.

Patient satisfaction and oral health related quality of life (OHRQoL) of conventional denture, fixed prosthesis and milled bar overdenture for Allon-4 implant rehabilitation. A cross over study

Article

Full-text available

Aug 2019

Abstract Objectives: This study aimed to evaluate patient satisfaction and oral health related quality of life (OHRQoL) of conventional denture, fixed prosthesis and milled bar overdenture for All-on-4 implant rehabilitation. Materials and methods: Sixteen completely edentulous patients with ill-fitted mandibular dentures received new mandibular dentures (CD). After 3 months, 4 implants were installed according to the “All-on-4 concept” and immediately loaded with mandibular dentures. Three months after osseointegration, patients received either fixed prosthesis (FP) or milled bar overdenture (MB) in a crossover design. Patient satisfaction was evaluated using a visual analogue scale (VAS). OHRQoL was evaluated using the OHIP-14. Questionnaires of VAS and OHIP-14 were measured 3 months after wearing each of the following prostheses: CD, FP, and MB Results: For all questions of VAS and OHIP-14, CD showed significant lower satisfaction compared to FP and MB (p<.00025). FP recorded significant higher VAS scores than MB regarding retention and stability (p<.00007). MB recorded significant higher scores than FP regarding general satisfaction, comfort, ease of cleaning and handling (p<.00008). Regarding OHIP-14, no significant differences in OHIP scores between FP and MB were observed for all domains of OHIP Accepted Article This article is protected by copyright. All rights reserved. Conclusion: “All-on-4” implant rehabilitation of edentulous mandible with FP and MB achieves high patient satisfaction and OHRQoL compared to CD. No significant difference in OHRQoL between FP and MB was observed. Regarding VAS, FP rated greater satisfaction with retention, stability and chewing compared to MB. However, MB rated greater satisfaction with ease of cleaning and handling compared to FP.

Etude de la digestion et du confort en bouche de produits fromagers développés pour répondre aux besoins sensoriels et nutritionnels de la population senior.

Thesis

May 2018

Lorieau Lucie

Lors du vieillissement, les capacités sensorielles et l’efficacité masticatoire diminuent, affectant négativement l'alimentation des séniors. Ainsi, la formulation d’aliments adaptés aux besoins nutritionnels et sensoriels des seniors est un enjeu pour les années à venir. L'objectif principal de cette thèse, intégrée au projet AlimaSSenS, est d’étudier l’impact de la texture de produits fromagers sur le confort en bouche et la biodisponibilité des acides aminés et du calcium. Les fromages modèles développés ont la même composition mais des textures variables. Des analyses sensorielles réalisées sur un panel de séniors, ainsi que des études de digestion in vitro et in vivo (sur modèle porcin) ont été réalisées. Les résultats des digestions soulignent la pertinence d’intégrer les protéines sériques en tant que source protéique majeure dans les produits fromagers, afin de maximiser l’apport plasmatique en acides aminés essentiels. Cependant, la texture des fromages modèles n’a pas influencé la bioaccessibilité des acides aminés et du calcium. De plus, la bioaccessibilité du calcium est majoritairement liée aux pH intra-gastrique et -intestinal, plutôt qu’à sa forme chimique initiale. Enfin, l’étude sensorielle a mis en évidence que seules les textures perçues comme « sèches » étaient liées à une baisse importante du confort en bouche des séniors. Ce travail souligne l'opportunité de développer des produits fromagers destinés aux séniors. Il serait intéressant de poursuivre ces travaux avec des études cliniques pour connaître l'impact physiologique de ces produits

Clinical and Radiographic Evaluation of Implant Ball Retained Mandibular Complete Overdentures with Lingualized Balanced Occlusion•

Article

Jul 2018

The relationship between masticatory ability, age, and dental and prosthodontic status in an institutionalized elderly dentate population in Qingdao, China

Article

Full-text available

Feb 2019
CLIN ORAL INVEST

Objectives To identify relationships between masticatory ability and age, and dental and prosthodontic status amongst an institutionalized elderly dentate population in China. Materials and methodsA sample of 512 elders living in eight nursing homes in Qingdao was categorized based on a hierarchical dental functional classification system with and without tooth replacements. Masticatory disability scores (MDSs) were analyzed using multiple regression models with only age, and age and dentition variables for participants having ≥ 10 natural and those having < 10 natural teeth in each jaw. ResultsOverall, associations between MDS and age, number of teeth, and number of teeth replaced by dental prostheses were identified. For participants having ≥ 10 natural teeth in each jaw, no significant associations between MDS and age and dental and prosthodontic status were found. Participants having < 10 natural teeth in each jaw had higher MDS (increasing chewing difficulties) at higher ages. However, when “premolar region sufficient” and “molar region sufficient” were included, MDS was not associated with age, but with these dentition variables. For participants having ≥ 10 teeth including prosthodontically replaced teeth in each jaw, age was the only variable associated with MDS. For participants having < 10 teeth including teeth replaced in each jaw, the significant factor was “premolar region sufficient.” Overall, lower MDS was associated with increasing number of teeth, as well as with increasing number of teeth replaced by dental prostheses. Conclusions In this population of institutionalized dentate elderly, masticatory ability was significantly associated with dental and prosthodontic status. Clinical relevanceFor institutionalized elderly, having less than ten natural teeth in each jaw is associated with chewing problems. Most important dentition factor is the presence of three to four premolar pairs. Teeth added by partial removable dental prostheses compensate impaired masticatory ability due to tooth loss for 50% compared to natural teeth.

Single mandibular implant study (SMIS) − masticatory performance − results from a randomized clinical trial using two different loading protocols

Article

Jul 2017

Objectives: This multi-centre randomized controlled trial was conducted to investigate, whether the masticatory performance of elderly edentulous patients is improved by placement of a single implant in the midline of the edentulous mandible, and whether improvements differ with respect to the loading protocol, i.e., implant is loaded either directly or three months later after second stage surgery. Methods: Edentulous seniors aged 60-89 years were screened according to inclusion and exclusion criteria and 163 underwent implant placement. Of those, 158 were randomly assigned either to the direct loading group A (n=81) or the conventional loading group B (n=77). Chewing efficacy was obtained before treatment, one month after implant placement during the submerged healing phase (only group B) and 1 and 4 months after implant loading. Results: The masticatory performance increased over time in both groups. Four months after loading, a significant increase was observed for both groups compared to the baseline data without implant (p≤0.05). However, between the two groups, chewing efficiency did not differ significantly at any point in time (p>0.05). Conclusions: A single midline implant in the edentulous mandible increases masticatory performance significantly, independently from the loading protocol. Clinical significance: A single midline implant in the edentulous mandible increases masticatory performance. The loading protocol has no influence.

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

Article

Full-text available

Jan 2010

SUMMARY 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. KEYWORDS: decision-making, dental implants, edentulism, epidemiology, implant overdentures, prevalence, quality of life, treatment choice Accepted for publication 14 November 2009

Presence of Serum Ferritin before and after Bariatric Surgery: Analysis in Dentate and Edentulous Patients

Article

Full-text available

Oct 2016
PLOS ONE

Society has changed its own lifestyle, specially its eating habits and physical activities, leading to excessive weight and a sedentary behavior, which has contributed to obesity increase. Bariatric surgery is the most effective treatment to obesity, allowing weight loss and its maintenance. However, it has been related high levels of iron deficiency after surgery. A person’s nutritional status might be affected by total or partial tooth loss. The aim of this longitudinal prospective cohort study was to evaluate the levels of serum ferritin before and after bariatric surgery and to identify if there is a relation with tooth loss. The sample was composed of 50 patients selected and assisted at Amaral Carvalho Hospital, located in Jaú city, Brazil. The use and necessity of prosthesis, dental absence or presence, and serum ferritin dosage were evaluated. Student’s t test, Univariate analysis, Chi-square and Odds Ratio were adopted (p<0.05). There was no significant difference regarding the serum ferritin levels between dentate and edentulous patients prior to surgery (p = 0.436). After surgery, the serum ferritin levels were higher in edentulous patients (prosthesis users) when compared to the pre-surgical levels, and the post-surgical levels presented significant difference regarding the dentate patients (p = 0.024). It can be concluded that rehabilitated patients in postoperative period showed better levels of serum ferritin after surgical intervention.

Stabilization of mandibular complete dentures by four mini implants: Impact on masticatory function

Article

May 2016

Objectives: The frequent instability of mandibular removable complete dentures causes an alteration of mastication. An innovative therapeutic strategy involves placing four symphyseal mini implants. This study aimed at assessing the development of masticatory parameters and the impact on quality of life in subjects that underwent this procedure. Methods: Eleven edentulous subjects (mean age 72±11years) with unstable mandibular complete dentures were followed-up before (T0) and two - three months after (T1) mini implant setting. Physiological parameters (number of cycles, duration of sequence and frequency of mastication) during the mastication of food models and the bolus median particle size (d50) of carrot were evaluated at each time. Quality of life was assessed at T0 and T1 using the Global Oral Health Assessment Index (GOHAI). Parametric tests were used to test relationships between mastication, quality of life variations and mini implant setting, and to compare each parameter mean value at times T0 and T1. Results: More subjects were able to chew carrot after setting the mini implants (8 subjects compared to 4 at T0). This improvement was accompanied by changes in kinematic parameters when chewing carrots, soft and hard model food, and by an improvement of their quality of life. However, the particle size values observed in the bolus remained higher than for normal dentate subjects (9.2±2.8mm). Conclusions: These results indicated that the placement of mini implants as retentive elements for mandibular full dentures had a positive impact on patients' masticatory function and quality of life. Clinical significance: The placement of mini implants has a positive impact on the masticatory function and oral health quality of life. The results suggest that this alternative procedure can be used as a treatment option for patients unable to receive conventional implants.

Short Term Effects of Prosthodontic Rehabilitation on Dietary Intake and Body Mass Index in Edentulous Patients in Malaysia

Article

Jan 2024

Background: Edentulism in the elderly population has been related to changes in food intake and nutritional deficiency, as it has a measurable impact on mastication. Providing dentures helps in enhancing the chewing ability and improving the dietary intake of the elderly, thus improving their physical status. Aim: The objectives of this study were to identify the preliminary changes in physical status of edentulous patients, to identify the changes in calorie intake, and to examine the association between calorie intake and the physical status of edentulous individuals before and after prosthodontic rehabilitation. Materials and Methods: This cross-sectional study involved 39 patients. The parameters used to conduct the study for evaluating and comparing the dietary intake with physical status were clinical extra oral and intra oral examination of the patients, anthropometric records including body-mass-index (BMI) and 24-hour dietary recall method. First level of analysis was done using descriptive statistics and second level of analysis was done using Pearson’s chi-square test. Results: There was an increase in calorie intake in 51.3% of the patients after prosthodontic rehabilitation. Meanwhile, 28.2% had a decrease in calorie intake and 20.5% showed no difference in their calorie intake. For the association between calorie intake with physical status, 33.3% showed an increase in calorie intake and normal BMI. While 25.6% showed a decrease in calorie intake with normal BMI after rehabilitation, 15.4% had no changes in their calorie intake with normal BMI. Conclusion: The majority of edentulous patients both before and after prosthodontic rehabilitation had a lower calorie intake than recommended. There was no significant difference between calorie intake and physical status of patients after prosthodontic rehabilitation.

Are Patient-Reported Outcomes Improved by Implant-Assisted Maxillary Prostheses Compared to Conventional Maxillary Dentures? A Systematic Review

Article

Nov 2024
J DENT

The Impact of Eating Rate on Energy Intake, Body Composition, and Health

Chapter

May 2020

The impact of wearing complete denture in one or both arches, on eating-related quality of life and patients' perceived need for advice to support eating well: Results from a qualitative study

Article

Full-text available

Jun 2024
J ORAL REHABIL

Background Wearing complete denture in one or both arches can impact enjoyment of eating and affect quality of life compared with being dentate. Clinicians focus on issuing technically sound dentures but ignore the impact of wearing dentures on the eating‐related quality of life which affects the success of treatment. Objectives The aim of this research was to qualitatively explore ERQoL in Australian adults wearing complete dentures using a validated questionnaire and through focus groups. Methods Complete denture wearers ( n = 44) were recruited from dental clinics and invited to complete the self‐administered Emotional and Social Issues Related to Eating questionnaire. Responses were categorised under the six questionnaire domains. A subsample of 20 participants who completed the questionnaire were invited to participate in focus groups to identify emerging themes. Results Twenty‐three participants (52.3%) completed the questionnaire. Most participants expressed a decline in enjoyment of eating due to reduced ability to eat, longer chewing times and the need to frequently clean dentures while eating. Focus groups ( n = 2 × 4 participants) indicated educational materials on eating with dentures would increase recognition of eating problems with dentures and reduce trial and error approaches to dealing with these. Conclusion ERQoL is adversely affected by wearing complete dentures due to functional limitations, restricted food choices and adaptive eating behaviours. Patient support for eating well with a complete denture/s wearers is required.

Validation of maintenance requirements and patient satisfaction of classical implant locators versus customized attachments in mandibular implant-retained overdentures

Article

Apr 2023

Influence of wearing complete denture on the glycemic control, serum lipid, and proteins in patients with diabetes

Article

Full-text available

Jul 2023

Aims The aim of this study was to assess the impact of prosthodontic rehabilitation on glycemic and lipid control in functionally and completely edentulous patients with diabetes. Setting and Design An in vivo study conducted with the intention of studying the potential link between edentulism and impaired masticatory efficiency with the nutritional status in diabetic patients. Materials and Methods A total of 20 diabetic patients based on the inclusion criteria were selected. They were rehabilitated using a removable prosthesis, and observations were made across three parameters – glycosylated hemoglobin (HbA1C), serum cholesterol (S col), and serum protein (SP) at three stages – baseline, 3 months, and 6 months posttreatment. This was done to gauge the impact of the prosthetic rehabilitation on their health due to an increased masticatory efficiency potentially causing changes in dietary patterns. Statistical Analysis Used •Inter group comparison (>2 groups) was done using one way ANOVA followed by pair wise comparison using post hoc test. •Intra group comparison was done using repeated measures ANOVA (for>2 observations) followed by post Hoc test. For all the statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and β error ati20%, thus giving a power to the study as 80%. Results Hba1c at the baseline had a mean value of 8.04%, which reduced to 7.87% at the 3-month stage and 7.38% at the 6-month stage. S col at the baseline had a mean of 151.6 mg/dL; at the 3-month follow-up, it was 166.5 mg/dL, and at the 6-month follow-up, it was 173.95 mg/dL. SP had a mean baseline value of 6.38 mg/dL, which progressed to 6.67 mg/dL at the 3-month stage and 6.97 at the 6-month stage. Conclusion Within the limitations of this study, it can be concluded that after 6 months of prosthetic rehabilitation in edentulous/functionally edentulous patients: There was a reduction in HbA1c (8.04%-7.38%); however, it was found to be statistically insignificant at that stage There was an increase in S col (151.6 mg/dL–173.95 mg/dL); it was found to be statistically significant There was an increase in SP (6.38 mg/dL–6.97 mg/dL); however, it was found to be statistically insignificant at that stage.

Relevant domains, core outcome sets and measurements for implant dentistry clinical trials: The Implant Dentistry Core Outcome Set and Measurement (ID-COSM) international consensus report

Article

May 2023
CLIN ORAL IMPLAN RES

Long-Term Prosthetic Aftercare of Mandibular Implant-Supported Overdenture

Article

Full-text available

Aug 2022

Background: Two of the most popular resilient attachment systems for mandibular implant-supported overdenture (MISOD) are locator and ball attachments. The purpose of the present retrospective cohort study was to assess the long-term prosthetic aftercare and oral hygiene status in edentulous patients rehabilitated with MISOD. Materials and Methods: Forty-five consecutive patients were included (22, group A- ball vs. 23, group B- locator attachments). Attachment incorporation into the MISOD was conducted in a direct (chair-side) intraoral technique at the time of denture insertion. Routine follow-up included yearly visits. The number of visits requiring prosthetic aftercare, either during the follow-up or during the additional visit, was recorded. Outcome parameters included—prosthetic aftercare—the number of aftercare (primary outcome parameter) visits, and dental treatment received (pressure sores relief, liner changes due to loss of retention, loss of retention due to debris accumulation, denture repair—secondary outcome parameters); oral hygiene—gingival index (primary outcome parameter). Results: The mean follow-up of the entire study population was 84 ± 21 months, range 39–120 months. Statistical analysis revealed a lower need for prosthetic aftercare interventions in group A (p < 0.001). The mean number of visits dedicated to pressure sores relief (6.09 ± 1.04 vs. 3.03 ± 0.77, p < 0.001) and liner exchange due to loss of retention (5.6 ± 1.03 vs. 2.09 ± 1.04, p < 0.001), were significantly lower in group A. Debris (food/calculus) accumulation inside the attachment was noted only for the locator’s group (p < 0.001). No statistically significant differences between the groups were noted for denture repair (p = 0.318). Oral hygiene also exhibited statistically significant differences in favor of group A (2.3 ± 0.3 vs. 1.03 ± 0.2, p < 0.001). Conclusions: It can be concluded that using ball attachments for MISOD yields less need for aftercare treatments and improved oral hygiene status over the years.

Сравнительная характеристика функциональной активности жевательных мышц на ранних этапах ортопедической реабилитации с опорой на имплантаты

Article

Jan 2021

Interrater reliability and concurrent validity of oral/dental items in the resident assessment instrument minimum data set 2.0

Article

Oct 2020

Objective To examine interrater reliability and concurrent validity of oral/dental items in the Resident Assessment Instrument Minimum Data Set (RAI‐MDS) 2.0. Background RAI‐MDS is a standardised instrument used in nursing to determine health status and nursing needs. The extent to which oral/dental items in the RAI‐MDS describe dental treatment needs concerning oral health has been questioned. Materials and Methods This study evaluated the interrater reliability (dentist vs. nurse) and validity of oral/dental items in the Swiss version of RAI‐MDS 2.0 (areas: K—nutritional status, L—oral/dental status) using professional oral examinations as a benchmark. Data of 168 residents of five long‐term care facilities in the canton of Zurich, Switzerland, were collected within 1 year between October 2017 and December 2018. The statistical evaluation used descriptive statistics and Cohen’s kappa (95% CI). Results RAI‐MDS items K1a, chewing (κ 0.098, 95% CI: 0.004‐0.19); K1c, pain (κ 0.039, 95% CI: −0.03 to 0.11); L1a, debris (κ 0.117, 95% CI: 0.02‐0.21); L1c, dental status (κ 0.229, 95% CI: 0.12‐0.34); L1d, dental disease (κ 0.129, 95% CI: 0.02‐0.24); L1e, periodontal diseases (κ −0.005, 95% CI: −0.07 to −0.03); and L1f, daily cleaning (κ −0.031, 95% CI: −0.05 to −0.01) showed weak or no agreement, whereas L1b, denture status (κ 0.634, 95% CI: 0.52‐0.75), showed substantial agreement. Conclusion Oral/dental items in RAI‐MDS lack reliability and validity. Recognition of oral health situation/treatment needs by nursing staff does not seem to be possible with the current version of this tool.

Interventions for replacing missing teeth: Attachment systems for implant overdentures in edentulous jaws

Article

Oct 2018

Background: Implant overdentures are one of the most common treatment options used to rehabilitate edentulous patients. Attachment systems are used to anchor the overdentures to implants. The plethora of attachment systems available dictates a need for clinicians to understand their prosthodontic and patient-related outcomes. Objectives: To compare different attachment systems for maxillary and mandibular implant overdentures by assessing prosthodontic success, prosthodontic maintenance, patient preference, patient satisfaction/quality of life and costs. Search methods: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 24 January 2018); Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 12) in the Cochrane Library (searched 24 January 2018); MEDLINE Ovid (1946 to 24 January 2018); and Embase Ovid (1980 to 24 January 2018). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials on 24 January 2018. No restrictions were placed on the language or date of publication when searching the electronic databases. Selection criteria: All randomised controlled trials (RCTs), including cross-over trials on maxillary or mandibular implant overdentures with different attachment systems with at least 1 year follow-up. Data collection and analysis: Four review authors extracted data independently and assessed risk of bias for each included trial. Several corresponding authors were subsequently contacted to obtain missing information. Fixed-effect meta-analysis was used to combine the outcomes with risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, with 95% confidence intervals (95% CI). We used the GRADE approach to assess the quality of evidence and create 'Summary of findings' tables. Main results: We identified six RCTs with a total of 294 mandibular overdentures (including one cross-over trial). No trials on maxillary overdentures were eligible. Due to the poor reporting of the outcomes across the included trials, only limited analyses between mandibular overdenture attachment systems were possible.Comparing ball and bar attachments, upon pooling the data regarding short-term prosthodontic success, we identified substantial heterogeneity (I2 = 97%) with inconsistency in the direction of effect, which was unexplained by clinical or methodological differences between the studies, and accordingly we did not perform meta-analyses for this outcome. Short-term re-treatment (repair of attachment system) was higher with ball attachments (RR 3.11, 95% CI 1.68 to 5.75; 130 participants; 2 studies; very low-quality evidence), and there was no difference between both attachment systems in short-term re-treatment (replacement of attachment system) (RR 1.18, 95% CI 0.38 to 3.71; 130 participants; 2 studies; very low-quality evidence). It is uncertain whether there is a difference in short-term prosthodontic success when ball attachments are compared with bar attachments.Comparing ball and magnet attachments, there was no difference between them in medium-term prosthodontic success (RR 0.84, 95% CI 0.64 to 1.10; 69 participants; 1 study; very low-quality evidence), or in medium-term re-treatment (repair of attachment system) (RR 1.75, 95% CI 0.65 to 4.72; 69 participants; 1 study; very low-quality evidence). However, after 5 years, prosthodontic maintenance costs were higher when magnet attachments were used (MD -247.37 EUR, 95% CI -346.32 to -148.42; 69 participants; 1 study; very low-quality evidence). It is uncertain whether there is a difference in medium-term prosthodontic success when ball attachments are compared with magnet attachments.One trial provided data for ball versus telescopic attachments and reported no difference in prosthodontic maintenance between the two systems in short-term patrix replacement (RR 6.00, 95% CI 0.86 to 41.96; 22 participants; 1 study; very low-quality evidence), matrix activation (RR 11.00, 95% CI 0.68 to 177.72; 22 participants; 1 study; very low-quality evidence), matrix replacement (RR 1.75, 95% CI 0.71 to 4.31; 22 participants; 1 study; very low-quality evidence), or in relining of the implant overdenture (RR 2.33, 95% CI 0.81 to 6.76; 22 participants; 1 study; very low-quality evidence). It is uncertain whether there is a difference in short-term prosthodontic maintenance when ball attachments are compared with telescopic attachments.In the only cross-over trial included, patient preference between different attachment systems was assessed after only 3 months and not for the entire trial period of 10 years. Authors' conclusions: For mandibular overdentures, there is insufficient evidence to determine the relative effectiveness of different attachment systems on prosthodontic success, prosthodontic maintenance, patient satisfaction, patient preference or costs. In the short term, there is some evidence that is insufficient to show a difference and where there was no evidence was reported. It was not possible to determine any preferred attachment system for mandibular overdentures.For maxillary overdentures, there is no evidence (with no trials identified) to determine the relative effectiveness of different attachment systems on prosthodontic success, prosthodontic maintenance, patient satisfaction, patient preference or costs.Further RCTs on edentulous cohorts must pay attention to trial design specifically using the same number of implants of the same implant system, but with different attachment systems clearly identified in control and test groups. Trials should also determine the longevity of different attachment systems and patient preferences. Trials on the current array of computer-aided designed/computer-assisted manufactured (CAD/CAM) bar attachment systems are encouraged.

Patients’ satisfaction of implant supported overdentures versus conventional dentures: A systematic review

Article

Jan 2018

Objectives To systematically review the patients’ satisfaction of implant supported mandibular dentures and conventional dentures. Methods PubMed, EMbase, The Cochrane Library, CNKI, WanFang and VIP databases were searched to collect randomized controlled trials (RCTs) on patients’ satisfaction of implant supported mandibular dentures (IODs) and conventional dentures (CDs) from inception to November 31st, 2016. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Then, meta-analysis was conducted using RevMan 5.3 software. Results Seven randomized-controlled trials were identified. The results of meta-analysis showed that compared with CDs group, IODs group had a relatively higher level of patients’ satisfaction (SMD=1.11, 95%CI 0.79 to 1.43, P<0.001) and oral health quality of life (MD=–12.41, 95%CI –18.96 to –5.86, P<0.001). Conclusions The current evidence suggests that IODs may be a better choice for mandibular edentulous patients than CDs. Due to the limitations of the quality and quantity of the included studies, the above conclusions still require larger sample and high quality research to verify. © 2018, West China University of Medical Science. All rights reserved.

Relationship Between Prosthodontic Treatment and Nutritional Status: A Review

Article

Full-text available

May 2018

p>Pertinent literature search about changes or eﬀects of prosthodontic treatment on nutritional status was performed. The articles were electronically and hand searched in all available journals including research works, reviews, randomized controlled trials and systematic reviews. The information were obtained to answer the question whether denture therapy has a role in altering nutritional intake or not. Most articles agreed that the risk of malnutrition is elevated by being edentulous. However, there were contrasting results about improvement of nutrition by providing prosthodontic treatment. Thus, many authors have emphasized the role of nutritional counseling along with denture therapy for the beneﬁts of geriatric patients who undergo the inevitable process of being edentulous. BJHS 2018;3(1)5 : 385 - 389</p

Article

Jun 2017

Objectives: The present study aimed at evaluating both the implant site-related and patient-based factors with the potential to affect the extent of patients' satisfaction and also their perceptions regarding dental implant treatment. Potential differences between the esthetic evaluations of dental patients and dental specialists were also considered. Materials and methods: Implant-supported fixed prosthesis (n = 164) in 264 anterior esthetic implant sites were included. Patients' satisfaction, esthetic considerations, and perceptions toward dental implants, were evaluated by both Oral Health Impact Profile-14 (OHIP-14) questionnaire and visual analog scale. Pink Esthetic Score/White Esthetic Score were used for the professional esthetic evaluations of dental specialists. Results: Overall patient satisfaction was high (87.42 ± 11.86). Compared with implant supported single-tooth restorations, patients with implant-supported bridges had lower OHIP scores (P = 0.001) and were relatively less satisfied with particular aspects of dental implant treatment (eg, cleanability, phonetics, surgical discomfort, and pretreatment information). Generally, type of prosthesis, history of soft/hard tissue augmentation, and reason for tooth loss had a clear impact on the extent of patients' satisfaction, esthetic considerations regarding treatment outcome, and their perceptions toward dental implant treatment (P < 0.05). Conclusions: Fixed implant-supported restorations generally provide with high levels of satisfaction and oral health-related quality of life.

Treatment of an Edentulous Patient with Two‐Implant–Retained Mandibular Overdenture

Chapter

Sep 2013

Facial Pain Associated With Fibromyalgia Can Be Marked by Abnormal Neuromuscular Control: A Cross-Sectional Study

Article

Full-text available

Aug 2013

Background: Temporomandibular disorder (TMD) development in fibromyalgia syndrome (FMS) is not yet fully understood, but altered neuromuscular control in FMS may play a role in triggering TMD. Objective: The purpose of this study was to verify the association between neuromuscular control and chronic facial pain in groups of patients with FMS and TMD. Design: A cross-sectional study was conducted. Methods: This study involved an analysis of facial pain and electromyographic activity of the masticatory muscles in patients with FMS (n=27) and TMD (n=28). All participants were evaluated according to Research Diagnostic Criteria for Temporomandibular Disorders and surface electromyography (SEMG). Myoelectric signal calculations were performed using the root mean square and median frequency of signals. Results: The data revealed premature interruption of masticatory muscle contraction in both patient groups, but a significant correlation also was found between higher median frequency values and increased facial pain. This correlation probably was related to FMS because it was not found in patients with TMD only. Facial pain and increased SEMG activity during mandibular rest also were positively correlated. Limitations: Temporal conclusions cannot be drawn from the study. Also, the study lacked a comparison group of patients with FMS without TMD as well as a control group of individuals who were healthy. Conclusions: Altered neuromuscular control in masticatory muscles may be correlated with perceived facial pain in patients with FMS.

A new occlusal surface design for artificial posterior teeth to achieve high masticatory performance

Article

Jun 2016

Purpose: The low masticatory efficiency of denture prostheses impairs the ability of wearers to consume high-fiber foods. Hence, artificial teeth with high masticatory efficiency are required. This study aimed to establish an occlusal surface design for posterior artificial teeth in denture prostheses that is compatible with the existing artificial teeth arrangement and that has high masticatory efficiency for the comminution of raw vegetables. Methods: A masticatory simulator for occluding complete dentures was used to evaluate the masticatory efficiency of four occlusal surface designs, i.e., with parallel grooves occluding at right angles to the opposing teeth, groove depths of 1 and 0.5mm, and inter-groove distances of 1, 2, and 3mm. Raw carrots, rice, raw lettuce, chicken breasts, and peanuts were used as test foods to evaluate food comminution. Results: Grooved occlusal surface designs with a 1-mm groove depth and a 2- or 3-mm inter-groove distance demonstrated significantly greater masticatory efficiency than the conventional occlusal form (p<0.05). Conclusions: The superiority of grooved designs over the conventional design was particularly evident for lettuce and raw carrots in this study, both of which are considered difficult foods to chew with complete dentures.

Prosthetic dentistryPatient expectations of oral implant-retained prostheses in a UK dental hospital

Article

Full-text available

Jan 1999

Statement of problem The loss of the natural dentition leads to severe functional impairment in many edentulous adults. A prosthesis retained and supported by osseointegrated dental implants may provide a satisfactory solution for people who have lost all their natural teeth. However, little information is available as to what patients requesting implants expect of implant-retained prostheses.Aim The aim of this study was to assess the expectations of a group of edentulous patients requesting implant therapy.Method The study included two groups: (1) a group of edentulous adults who requested implant therapy ('implant group'); and (2) an edentulous control group, of similar age and gender distribution as the implant group, receiving conventional complete dentures. Following a clinical and radiographic examination of the patients, data were collected using validated questionnaires. Both groups made a subjective assessment of current dentures. The implant group also completed a questionnaire which assessed expectations of implant-retained prostheses.Results Baseline satisfaction with current dentures was low in both groups, with the implant group being significantly less satisfied with comfort and stability of their mandibular dentures. Perceived ability of the implant group to chew hard foods was less than the control group. The implant group's expectations of an implant-retained prosthesis were significantly greater than for a conventional denture.Conclusion Careful assessment of patient expectation of implant therapy is essential to determine appropriate treatment need, and to highlight unrealistic expectations.

The effect of maximum biting force and bone loss upon masticatory function and dietary selection of the elderly

Article

Jan 1982

Heath

Relationship between dental state and dietary intake in 70-year-old males and females in Göteborg, Sweden: a population study

Article

Nov 1982
J ORAL REHABIL

A representative sample of 368 70-year-old males and females in Göteborg, Sweden, participated in an odontological examination and a dietary interview. The aim of the study was to relate dental state to dietary habits and, furthermore, to study the possible influence of some social factors on these relations. The degree of dental invalidity was measured with Eichner's index. There was a highly significant correlation between this index and the number of teeth and tooth contacts. Dietary interviews were performed by a dietitian according to the dietary history method. Intake of several food items was significantly inversely related to the degree of dental invalidity in males but less so in females. The proportion of probands with insufficient intake of nutrients was in one or more respects higher among the edentulous than in the dentate and highest in the female edentulous probands with only one or no denture. Insufficient intakes of some nutrients were significantly related to the degree of dental invalidity. These relations remained unchanged in males but not in females when some socio-economic factors were introduced as confounding factors in a multivariate relation analysis; which might be due to the fact that these social factors play a more important role in females than in males.

Masticatory performance and efficiency in denture wearers

Article

Jul 1964
J PROSTHET DENT

Masticatory ability, denture quality, and oral conditions in edentulous subjects

Article

Sep 1992
J PROSTHET DENT

This study investigated the relationships between the ability of 38 patients with complete dentures to comminute a tough artificial test food and their answers to questions about the chewing experience. Also, clinical assessments were made of denture quality and oral conditions. Significant but weak relationships were found between the ability to comminute the test food and the subjective chewing experience as well as the degree of resorption of the mandibular residual ridge. Masticatory ability is conceivably determined by many other factors as well. Results indicate that dentists cannot rely on asking denture wearers about chewing problems and clinical responses with respect to oral conditions and denture quality for predicting those patients' masticatory abilities. The ability of wearers of complete dentures to comminute tough foods should be determined individually by a series of chewing tests.

Demographical, odontological, and psychological variables in individuals referred for osseointegrated dental implants

Article

Sep 1992

Edentulism and/or the wearing of a removable denture always requires adaptation, not only on a functional, but also on an emotional, level. Four hundred and seventy-three patients referred for treatment with osseointegrated implants due to problems with removable prostheses entered the study and 315 (66.6%) completed it. The average age was close to 60 yr, and the majority of patients were women. The average time of edentulousness was 14.3 yr. Twelve percent experienced profound negative effects from wearing dentures, this to an extent that it led to overt psychological and social effects. Subjective ratings revealed that functional and/or intra-personal effects were of higher significance than social consequences. The group was found to be more depressed than average as well as having an external health locus of control orientation.

Dental status and intake of food items among adult Finnish population

Article

Mar 1988
Gerodontics

Inequalities in Nutrition

Article

Feb 1987

Arthur Wynn

Inequalities in nutrition are associated with inequalities in health. Many surveys, mainly American, show that there are large variations between individuals in the quality and quantity of food consumed. Variations depend upon up-bringing, education, income and availability of food. In the United Kingdom there is a steep social-class gradient in age-specific death-rates for heart disease and other diseases including cancer. Of all the many possible nutritional factors the strongest inverse correlates with death-rates within the United Kingdom and in other developed countries are the consumption of fresh vegetables and fruit. Among the individual nutrients a low consumption of vitamin A, or its precursor carotene is associated with an increased cancer risk. Whole milk is a major source of vitamin A and carotene in the British diet and is also reported to be protective against osteoporosis and some forms of hypertension including preeclampsia. School meals can set a pattern of life-long eating habits.

The effect of different prosthetic restorations on the dietary selection in edentulous patients: A longitudinal study of patients initially treated with optimal complete dentures and finally with tissue-integrated prostheses

Article

Jan 1988

The effect of prosthetic restoration of masticatory ability on dietary selection was evaluated in 23 edentulous patients with denture adaptation problems. The patients were first given optimal complete dentures and then a fixed prosthesis on tissue-integrated implants in the lower jaw. Changes in dietary selection were evaluated from 4-day records obtained before prosthetic treatment and on six occasions up to 78 months after treatment. With the method used, no significant changes in food selection were recorded during the rehabilitation period, except for a slight increase in intake of crisp bread and fresh fruit after treatment with fixed tissue-integrated prostheses in the mandibular jaw. It is concluded that an improved oral function will not in itself lead to a change in dietary selection and that dietary changes probably require professional and individually given dietary advice by a trained dietitian.

Changes in bite force and chewing efficiency after denture treatment in edentulous patients with denture adaptation difficulties

Article

Feb 1986

Masticatory function was studied by means of a chewing efficiency test and bite forces measurements in forty-nine edentulous patients who had applied for treatment with fixed protheses on osseointegrated dental implants. Registrations were performed with the original complete dentures and after treatment aiming at optimizing the dentures. The patients were divided into two groups and the post-treatment recordings were completed after adaptation periods of 2 and 6 months, respectively. The functional tests showed mainly small and non-significant changes after the denture treatment. Improvement was greater, however, in those with the poorest pre-treatment values. Chewing efficiency deteriorated after treatment in the older patients (more than 50 years) while it did not change in the younger ones. A longer adaptation period did not lead to better functional results. The findings are discussed in relation to the fact that the patients were waiting for implant treatment, with consequent psychological implications for interpretation.

The effect of new complete denture on mastication and diet intake

Article

Nov 1985

Masticatory efficiency, the subjective experience of masticatory performance, and dietary intake were measured for 43 subjects who were provided with new complete dentures. The subjects were tested on three occasions: with the old complete dentures, with the new complete dentures when free from symptoms, and with the new dentures about 4 months after insertion. Masticatory efficiency and the subjective experience of masticatory performance increased significantly when the subjects were provided with new dentures, but no changes were found in the dietary intake. With the new dentures the masticatory efficiency and the subjective experience of masticatory performance were correlated to each other.

Impact of Complete Dentures and Impaired Natural Dentition on Masticatory Performance and Food Choice in Healthy Ageing Man

Article

Apr 1983
J PROSTHET DENT

Shifts in food selection patterns result from impairments in masticatory ability, and the extent to which any dietary alterations occur appears to be influenced by the degree of impairment. Moreover, these shifts can be modified by a variety of physiologic, social, economic, and psychologic factors. The preference for softer, easier-to-chew foods in persons with complete dentures requires that the foods selected meet daily nutritional requirements. In view of the large proportion of individuals in the United States with complete dentures, an understanding of how these multiple factors affect the nutritional status of edentulous elderly persons may lead to more rational dietary approaches to the maintenance of health.

The effect of maximum bite force and bone loss on masticatory function and dietary selection of the elderly

Article

Jan 1983

M R Heath

Simple methods are described for measuring masticatory effectiveness--the percentage of sugar chewed out of chewing gum in 20 strokes--and the height of residual mandibular bone using callipers. Both are objective methods, they are acceptable to the elderly, appropriate for denture wearers and practicable for use in domiciliary surveys. Using these and other methods, the masticatory effectiveness of housebound pensioners is shown to relate to maximum biting force, denture quality, remaining mandibular bone and dietary selection. However, opinions on the difficulty of mastication are completely unrelated to any of these measures. The level of compensation for inadequate mastication is indicated by the percentage of difficult foods eaten by geriatric hospital inpatients: there was complete overlap of percentages in those endentulous patients using dentures and those without dentures. Presumably many of these patients had adapted to swallowing very poorly chewed food. The contrasts shown between hospital inpatients and old people still at home indicate the progressive consequences of physical and neurological deterioration.

Relationship between dental state and dietary intake in 70-year-old males and females in Goteborg, Sweden: A population study

Article

Dec 1982

Within-subject Comparisons of Implant-supported Mandibular Prostheses: Evaluation of Masticatory Function

Article

Nov 1994

In the past, fixed prostheses were believed to be more efficient implant-supported devices than removable types for edentulous patients. However, this hypothesis was never properly tested. Therefore, a within-subject crossover clinical trial was designed in which 145 completely edentulous subjects were tested wearing implant-supported mandibular fixed prostheses and long-bar overdentures. Eight subjects received the fixed appliance first and seven the removable type. The patients' perceptions of various characteristics of the implant-supported prostheses were measured after a minimum of two months' adaptation. Mandibular movements and jaw muscle electromyographic activity were recorded while the patients chewed five standard-sized test foods: bread, apple, hard cheese, sausage, and raw carrot. The prostheses were then changed, worn for the same period of adaptation, and the procedures repeated. There were three test sessions per prosthesis, and each included five trials per food. The measurements were repeated three times at one-week intervals. Mastication time was found to be shorter for three foods (bread, cheese, and sausage) when subjects wore the long-bar overdenture. The vertical amplitude of the masticatory strokes was significantly less with the overdenture for all foods except carrot. Cycle duration was significantly longer with the overdenture for sausage and carrot. Contrary to what might be expected, the long-bar overdenture appears to be no less efficient than the fixed prosthesis. Furthermore, these data suggest that patients are capable of adapting their masticatory movements to the characteristics of the two prostheses.

Nutritional adequacy of reported intake of edentulous subjects treated with conventional or implant supported mandibular dentures

Article

Oct 1995
J PROSTHET DENT

The nutrient content of the diet of edentulous patients who have various oral prostheses is of concern. This study compared baseline food records to those records kept semiannually for 3 years after treatment to ascertain whether nutrient intake of edentulous patients changed after they received new implant-supported mandibular dentures (n = 41) or new conventional dentures (n = 30). No significant differences in intake of calories or of 27 nutrients were noted between the two groups (p > 0.01). A decline in the percent of calories from fat with a corresponding increase in carbohydrate calories within both groups (p < 0.01) reflected a national trend; a slight decrease in calories was similarly observed (p < 0.02). More than 40% of patients in both groups were found to have inadequate intakes of dietary fiber, calcium, or both, and 25% to 50% had low intakes of vitamins A, E, D, B6 and/or magnesium. Intakes were similar to those reported for two age-matched populations.

Two-center clinical trial of implant-retained mandibular overdentures versus complete dentures - Chewing ability

Article

Feb 1996

This study is a two-center clinical trial with the aim to assess the treatment effects of implant-retained mandibular overdentures versus conventional complete dentures. Treatment had been assigned according to a balanced allocation method. The following criteria were used to enhance the comparability of the treatment groups: age, gender, the edentulous period of the mandible, the number of previously made mandibular dentures, the number of years having worn the present mandibular denture and the symphyseal bone height. 151 patients with severely resorbed mandibles participated in the study, they were treated at two centers. Ninety-one patients received an implant-retained mandibular overdenture (IRO) and 60 patients a conventional complete denture (CD). Since some patients refused the allocated treatment the "Intention To Treat" principle was applied. This implies that patients are evaluated in the originally allocated treatment group regardless of the actual treatment they received. Patient's experiences were evaluated before treatment and 1 yr after insertion of the new dentures. Results before treatment showed that both treatment groups were comparable: they were dissatisfied with their mandibular denture and they could hardly chew tough or hard foods. One year after insertion of the new dentures the IRO-group was satisfied with their mandibular denture, whereas only one third of the CD-group was satisfied. With respect to the chewing ability the IRO-group scored significantly better than the CD-group(P<0.0001).

In vivo measurements of some functional aspects with mandibular fixed prostheses supported by implants

Article

Jun 1996

Maximal occlusal force and oral tactile sensibility were recorded in 21 edentulous patients wearing maxillary complete dentures and mandibular fixed prostheses supported by Brånemark implants. Bite force was measured with a miniature force transducer between antagonistic molars and premolars, and the passive tactile sensibility of the fixtures was recorded in the horizontal and vertical directions with spring balances. The active tactile sensibility was tested using steel foils (100 to 10 microns). The range of maximal occlusal force recorded was from 35 to 330N with highest values observed on the second premolars (mean 143N). Significantly lower forces were found on molars and first premolars (p < 0.01). The detection threshold of minimal pressure was about 330 g in the horizontal, and 388 g in the vertical direction. This difference was not statistically significant. The average number of incorrect assessments when testing steel foils was 16.6 errors, out of 100 recordings. Similar results when using these 3 test modalities had been found on overdentures supported by two mandibular implants and occluding with maxillary complete dentures. The results of this study suggest that mandibular implants supporting fixed prostheses are not likely to improve oral tactile sensibility and maximal occlusal force in the presence of maxillary complete dentures.

Bite Forces with Mandibular Implant-retained Overdentures

Article

Nov 1998

Sensitivity or pain of the mucoperiosteum covering the mandibular edentulous ridge is often thought to limit bite forces in complete-denture wearers. Therefore, bite forces with mandibular implant-retained overdentures may depend on the degree of implant support. This study analyzed the effects of different degrees of support for the mandibular denture on bite forces measured four years after denture treatment as part of a randomized controlled clinical trial. All subjects had received new maxillary dentures and (1) mainly implant-borne overdentures on a transmandibular implant (TMI), (2) mucosa-borne overdentures on two cylindric permucosal IMZ implants, or (3) new conventional dentures in the mandible. Fifty-three women and 15 men (mean age, 59.1 yrs; range, 41 to 77) participated in this trial. Both unilateral and bilateral bite forces were recorded at different positions with a miniature strain gauge transducer and a mechanical bite fork, respectively. The subjects were asked to bite at three force levels. Results indicated that women had significantly lower maximum bite forces than men. Persons with mandibular implant-retained overdentures had significantly higher unilateral and bilateral maximum bite forces than complete-denture wearers. However, bite forces did not differ between the mainly implant-borne (TMI) and mucosa-implant-borne (IMZ) implant systems. Therefore, it appears that differences in support for the mandibular overdenture by dental implants are not reflected in bite force capabilities.

Patient expectations of implant supported prostheses in a UK dental hospital

Article

Feb 1999

The loss of the natural dentition leads to severe functional impairment in many edentulous adults. A prosthesis retained and supported by osseointegrated dental implants may provide a satisfactory solution for people who have lost all their natural teeth. However, little information is available as to what patients requesting implants expect of implant-retained prostheses. The aim of this study was to assess the expectations of a group of edentulous patients requesting implant therapy. The study included two groups: (1) a group of edentulous adults who requested implant therapy ('implant group'); and (2) an edentulous control group, of similar age and gender distribution as the implant group, receiving conventional complete dentures. Following a clinical and radiographic examination of the patients, data were collected using validated questionnaires. Both groups made a subjective assessment of current dentures. The implant group also completed a questionnaire which assessed expectations of implant-retained prostheses. Baseline satisfaction with current dentures was low in both groups, with the implant group being significantly less satisfied with comfort and stability of their mandibular dentures. Perceived ability of the implant group to chew hard foods was less than the control group. The implant group's expectations of an implant-retained prosthesis were significantly greater than for a conventional denture. Careful assessment of patient expectation of implant therapy is essential to determine appropriate treatment need, and to highlight unrealistic expectations.

Food selection and perceptions of chewing ability following provision of implant and conventional prostheses complete denture wearers

Abstract

No full-text available

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