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Prevalence of oral mucosal lesions associated with wearing removable dentures in Finish adults
Abstract
Of a representative sample of 8000 persons aged 30 and over living in Finland, 3875 users of removable dentures were examined. The condition of the oral mucosa was recorded during clinical examinations. The prevalence of oral mucosal lesions associated with removable dentures was analyzed according to age, sex, place of residence, geographical region of living, and type and location of prosthesis. Lesions were found in about 50% of the denture wearers. Women were affected more often than men. The prevalence of lesions decreased with age and differed slightly according to region of living and place of residence. Compared with the wearing of partial dentures, wearing complete dentures increased the risk of lesions. Only one of the 72 denture users who wore a denture with metallic base plate had oral mucosal lesions associated with wearing a denture.
... Denture-related stomatitis (DRS) is a common inflammatory process that mainly involves the palatal mucosa when it is covered by complete dentures [10,33,36,46]. The etiology appears to be multifactorial; old age and the associated decline of the immune defense, systemic diseases, continuous denture wearing, increased age of denture, and lack of denture cleanliness resulting in the accumulation of plaque on the denture have all been proposed as predisposing factors [10,12,21,33,36,43,45,46]. ...
... Denture-related stomatitis (DRS) is a common inflammatory process that mainly involves the palatal mucosa when it is covered by complete dentures [10,33,36,46]. The etiology appears to be multifactorial; old age and the associated decline of the immune defense, systemic diseases, continuous denture wearing, increased age of denture, and lack of denture cleanliness resulting in the accumulation of plaque on the denture have all been proposed as predisposing factors [10,12,21,33,36,43,45,46]. ...
... In addition to the duration dentures are worn, it was suggested that DRS is associated with the amount of tissue covered by a denture. DRS prevalence was found to be higher in complete maxillary denture cases [37,33,36,40,46,51]. Reduced salivary flow and dependant simultaneous changes in protein content, electrolyte content, buffering capacity, antibodies, and nonspecific antimicrobials of whole saliva are considered to be the main causes of the frequently detected rapid development of post-radiation caries and the quantitative and qualitative shifts in oral microflora. ...
Denture-related stomatitis (DRS) is still a dilemma in removable prosthodontics. The aim of this study was to investigate the relationship of DRS with the presence of Candida albicans hyphae and Lactobacillus. A total of 91 patients wearing maxillary and mandibular complete dentures were included in the present study and tested mycologically as well as bacteriologically. A statistically significant association of DRS was found with denture age (p = 0.003) and continuous denture wearing (p = 0.015). Presence of C. albicans hyphae was shown to be significantly higher in DRS cases (p < 0.01), and there was a statistically significant positive correlation between presence of hyphae and C. albicans (p < 0.01). Another interesting finding was that DRS patients showed higher Lactobacillus counts in their saliva (p = 0.04), as well as in the palate (p = 0.028). C. albicans is an important factor in the development of DRS. Hyphae seem to facilitate the rise of C. albicans counts and be related to the inflammatory response of the tissues. Lactobacillus seems to play an important role in the presence of DRS, as well. In agreement with many other studies, the results of this study confirm the importance of denture age and continuous denture wearing in the development of DRS.
... 13,[16][17][18] Many studies have reported higher prevalence of prosthesis stomatitis, in complete removable denture wearers 9,13,16,17,[19][20][21][22][23] than in partial removable denture wearers. 24 This is due to predisposing factors such as Candida infection, mechanical issues, and long-term prosthesis wearing as well as the larger area of oral mucosa covered by a complete removable denture. 7 In addition, premalignancies and malignancies were also reported to increase as the population ages. ...
... 25 Earlier studies showed varying prevalence of OMLs in adult and elderly populations. 2,4,5,8,9,24,[26][27][28][29][30][31][32] Yet, the data on the presence of OMLs as a function of prosthesis age and prosthesis use in such populations are limited. 16,18,33 Thus, information is needed to assess the requirements of the PW population. ...
PurposeThis prospective study evaluated the influence of self-reported prosthesis hygiene regimens and prosthesis usage habits on the presence of oral mucosal lesions (OMLs) in complete removable and/or partial removable dental (CRDP/PRDP) prosthesis wearers (PWs).Materials and Methods
Between January 2009 and January 2011, the conventional oral mucosa of 400 consecutive PWs (252 women; 148 men), aged between 29 and 86 years, were examined clinically. Information was derived considering the type and age of the prosthesis, hygiene level, frequency and style of prosthesis cleaning, overnight prosthesis use, storage conditions, and systemic diseases. Non-prosthesis- and prosthesis-related OMLs were identified. The data were analyzed using univariate (Chi-square) and multivariate (logistic regression) tests to assess the development of OMLs as a function of the selected variables. Odds ratios (OR) were calculated at 95% confidence intervals (CI; α = 0.05).ResultsOf the 400 PWs, 21.5% had CRDP, 52.5% PRDP, and 25.8% CRD/PRD prostheses. Thirty-two percent of the PWs cleaned their prosthesis once a day. Brushing the prosthesis with toothbrush and soap/toothpaste was the most commonly practiced cleaning regimen (85.8%). More than half (64.5%) of the PWs used their prosthesis overnight. Among all PWs, 37.8% had a prosthesis-related OML. Stomatitis Newton Type II (46%) and Type III (38%) were the most common OMLs. OML frequency was higher in PWs having CRDPs than those having PRDPs (p < 0.05). Overnight prosthesis use (p = 0.003, OR: 13.65; 95% CI: 1.7–109.3), denture age ≥11 years (p = 0.017, OR: 1.72; 95% CI: 1.1–2.7), and immersion in water and solution (p = 0.023, OR: 1.13; 95% CI: 0.02–1.02) affected the incidence of OML significantly. Hypertension was the most common systemic disease (31.5%).Conclusion
Overnight use, denture age, and storage conditions of CRDP or PRDPs demonstrated a more significant impact on OML incidence than frequency of cleaning. Oral healthcare programs for removable PWs should specifically provide education on prosthesis usage instructions.
... Çok sayıda çalışmada, tam veya bölümlü hareketli protez kullanan hastalarda oral mukoza lezyonlarının görülme sıklığının, protez kullanmayan hastalardan daha yüksek olduğu ortaya konmuştur (Freitas vd., 2008;MacEntee, Glick, & Stolar, 1998;Mikkonen, Nyyssönen, Paunio, & Rajala, 1984). Ayrıca, tam protezlerin daha geniş bir mukoza alanını kapsaması ve stabilitenin sağlanmasının daha problemli olması nedeniyle, tam protez kullanan hastalarda oral mukoza lezyonlarının görülme sıklığının, bölümlü protez kullanan hastalardan daha yüksek olduğu da gösterilmiştir (Coelho, Sousa, & Daré, 2004;Jainkittivong vd., 2010;Mubarak, Hmud, Chandrasekharan, & Ali, 2015;Ogunrinde & Olawale, 2020;Vigild, 1987). ...
... 24 In the present study, subjects of age 60 years and constant denture wearers were found to be the risk factors in females which was in accordance with the findings reported by Kovac-Kavcic and Skaleric, 39 whereas, in a study by MacEntee et al., 40 reported a higher incidence in men. Our results showed the frequency of denture-related conditions in complete denture wearers is higher than that in partial denture wearers which corresponds with the findings reported by Mikkonen et al. 41 The present study has provided information about the epidemiological aspects of oral mucosal lesions in geriatric people living in and around Bhimavaram, Andhra Pradesh, India. Most lesions were frequently associated with deleterious habits. ...
... They were about four times more common in the group of centenarians than in younger German seniors, aged 75-100 years, examined in the Fifth German Oral Health Study (DMS V) [20]. It must be noted, however, that studies in other countries have found a similar or increased prevalence compared to our results, even among younger age groups [42][43][44]. Prosthesis-related changes to the oral mucosa are not necessarily associated with age [45]. Since older adults, especially centenarians, are often reduced in their mobility, access to dental care is limited [46]. ...
To date, there is little evidence on centenarians’ dental and prosthetic status or their oral-health-related quality of life (OHRQoL). Therefore, the aim of this study was to assess possible associations between sociodemographic and oral health factors, including prosthetic needs in this special age group and their potential influence on OHRQoL. Persons born before 1920 were recruited from population registries in south-western Germany. Fifty-five centenarians participated and underwent a comprehensive oral examination. Cognitive capacity was evaluated using the short Mini-Mental State Examination (S-MMSE, max. 21 points). At an S-MMSE > 10, an analysis of OHRQoL by means of the Geriatric Oral Health Assessment Index (max. ADD-GOHAI score 60 points) was performed (n = 43). Bivariate statistics and a linear regression model were used after variable selection to analyze data. Centenarians presented with a mean (SD) of 22 (7.2) missing teeth. Complete (65.5%) or partial dentures (21.8%) in at least one jaw were most common. One-third of the dentures needed repair/replacement; 16% of the centenarians presented with denture sores. In 60% of cases, OHRQoL was rated unsatisfactory (ADD-GOHAI < 57). Trouble biting or chewing resulted in the lowest levels of OHRQoL. Fewer remaining teeth, reduced functional capacity and removable prostheses correlated with an impaired OHRQoL (rs = −0.36, p = 0.01; rs = −0.34, p = 0.01; rs = −0.29, p = 0.03, respectively). After variable selection, the final linear regression model included only the number of missing teeth, the associated ADD-GOHAI score decreasing by 0.3 points per missing tooth. In conclusion, tooth loss and removable prostheses in need of repair or replacement are highly prevalent in centenarians. These factors seem to modulate OHRQoL negatively, assumedly due to impaired chewing function. Larger confirmatory studies are needed to validate these first results.
... Literatüre bakıldığında, POML görülme sıklığı %40-50 arasında değişmektedir. 7,8,26 Çalışmalarda elde edilen farklı sonuçlar, örneklemler arasındaki demografik farklılıklar, araştırmacıların kullandığı diagnostik kriterler ve metodolojik farklılıklardan kaynaklanabilir. 27 Örneklem grubunun büyüklüğü, cinsiyet dağılımı ve yaş aralıklarındaki değişkenlikler de bir diğer etkili faktör olarak düşünülebilir. ...
Aim: The aim of this study was to determine the frequency and
types of prosthetic associated oral mucosal lesions (POML)
in patients using removable prostheses; and to establish the
relationship between POML and age, sex, educational status,
systemic disease, smoking, prosthesis type, usage of prosthesis at night and oral hygiene status.
Materials and Method: This study consists of two stages: questionnaire and clinical examination. Age, gender, systemic
disease, education level, smoking, frequency of dental visit,
the habit of using prosthesis at night, daily prosthesis care
habits, and duration of prosthesis use were asked in the questionnaire form. The presence of POML (epulis fissuratum,
prosthetic stomatitis, unrestrained crest, angular chelitis, traumatic fibroma, pseudomembranous candidiasis, frictional keratosis, traumatic ulcer) and localization were recorded at the
time of clinical examination. Descriptive statistics were calculated for all parameters in the study. Chi-square test was used
to determine the relationships between categorical variables and significance was considered at p<0.05.
Results: The mean age of 133 individuals was 62.41 (41-
88) years. POML was detected in 95 of 227 prosthetic areas evaluated (41.8%). Among all patients, denture stomatitis was the most common form of POML type (%50.5). The
frequency of POML increased significantly with denture
age, frequency of prosthesis cleaning, usage of dentures
at night, and smoking habit (p<0.05). Educational status,
systemic disease, dentures type and localization, prosthesis hygiene regimen and POML were not found to be
related (p>0.05).
Conclusion: Prosthesis-related oral lesions can be decreased by routine prosthesis hygiene regimen and regulate
the duration of prosthesis usage.
... Use of a calibration process which requires replicate examinations is difficult and has not been used widely since most oral mucosal pathologies are rare. However there have been some instances where inter-examiner reliability has been measured, for example in smokers palate (Saietz, 1975) and denture associated lesions (Mikkonen et al, 1984). Zakzrewska et al (1993) recommended that for any professional group intending to undertake oral screening, training and education should be mandatory. ...
Evidence suggests that early detection of oral cancer or precancer decreases both mortality and morbidity. Screening for oral cancer may be an effective health care intervention in view of the annual increase in new registrations of oral cancer and rising mortality rates. Oral cancer meets many of the criteria for a disease suitable for screening, however a need exists for research into the design of a screening programme and the validity of a screening test. Visual examination of the oral mucosa would appear to be a valid instrument for detecting oral cancer and precancer; in this study a selection of qualified dentists achieved this with a sensitivity and specificity of 0.74 and 0.99 respectively. Compliance from an invitational screening programme was disappointingly low (25.7%) compared to other similar programmes suggesting that targeting of high risk individuals may be more effective in detecting lesions. Data from the screened population was modified and used to train a computerised neural network, this was shown to be a useful tool for the identification of people at high risk from oral cancer and could detect lesions with sensitivity (0.80) and specificity (0.77), values comparable to dentists. Health care interventions such as screening programmes are assessed in terms of costs and benefits to the patient and public. Quality of life was compared in terms of utility values between patients treated for small oral cancers and those treated for more major cancers. Utility values for various stages of oral cancer were also obtained from a sample of the public since it is argued that they should play a part in health care decision making. Finally, the potential value of screening was determined using a decision model based on the results obtained from this study.
... Although denture-related traumatic ulcers can affect up to 92% of those with ill-fitting dentures (291,364), none of our study participants reported any traumatic ulcers or soreness due to their dentures, and I confirmed this from their oral health statuses that we collected for the parent study. ...
Individuals with advance-stage illnesses frequently face illness or treatment-related adverse effects in the mouth. These adverse effects can have serious local and systemic consequences. Despite that, the importance of oral care in this population is often overlooked and there are no definitive guidelines as to what kind of oral care should be provided to these individuals. Given that, our study aims were to explore and better understand the oral health-related concerns, perceived oral care needs of palliative care patients and the berries that face in accessing dental care services. We conducted a qualitative description study by recruiting 11 participants with advanced stage health
conditions from the outpatient palliative care services of the University of Iowa Hospitals and Clinics. We conducted in-depth, semi-structured interviews and audiotaped all the interviews. All interviews were fully transcribed verbatim. All participants had oral concerns although they varied widely from person to person and their illness statuses. The most significant concerns were related to dry mouth, loose dentures, and eating difficulties. Among those who stated that they would seek dental care if required, they were not planning on seeking dental care even though they had treatable oral problems. Also, some of them faced significant barriers to accessing dental care. The frequently observed barriers were their illness and illness-related priorities, finances, feeling discriminated against by the dentist, and a dislike towards the dentist. Providing oral health-related information to the palliative care clinicians about the significance of oral health and its impact, incorporating a dental care provider in palliative care team, and providing timely information to individuals with advanced health conditions may enhance the understanding of their oral health problems and help them better manage their oral health and also, may help them in seeking the needed oral care.
... de si los sujetos han vivido independientemente o en una institución(Mikkonen et al., 1984; MacEntee y Scully 1988;Jorge et al., 1991;Espinoza et al., 2003) Se ha asumido que la salud bucal de los ancianos que viven independientemente sería mejor que la salud bucal de los ancianos que viven en las instituciones.Vigild (1987)mostró que aproximadamente la mitad de los sujetos institucionalizados tenían una o más lesiones patológicas en la mucosa oral. ...
Recibido: 25 de abril de 2019Aprobado: 26 de mayo de 2019El objetivo de este artículo es realizar una revisión bibliográfica a la luz de la evidencia actual de la salud bucal y el estado de los implantes orales en de pacientes con prótesis dental total. Considerando que el edentulismo es una desventaja que afecta la calidad de vida y la nutrición. La pérdida de dientes conduce a un deterioro funcional a nivel del sistema orofacial, lo que interfiere significativamente con la masticación, la deglución y el habla, así como con disfunción de la articulación temporomandibular, trastornos de la relación intermaxilar y fisionomía facial. La rehabilitación oral ideal de pacientes desdentados puede requerir la instalación de implantes endóseos para soportar una prótesis fija o removible. Se han demostrado buenos resultados clínicos a largo plazo en este grupo de pacientes, particularmente en casos en los que el tratamiento prostodóntico convencional ha fallado o es inaceptable para el paciente. Por otra parte, estudios indican que la terapia de implante oral puede considerarse como el tratamiento de elección en pacientes de edad avanzada, incluso cuando la higiene oral no es óptima.
... Sharry has advised four recall appointments after 10 days, 3 weeks, 6 weeks, and 3 months consequently from denture. [2][3][4][5][6] The present study provided such consistent care for patients till their comfort and satisfaction. ...
... This help Section: Dentistry in identifying high risk sub-population and guidance in carrying out preventive and curative services. [5] There have been less studies that inform about the prevalence of tobacco habits and associated oral changes in north India population. The purpose of this study was to investigate the prevalence of oral mucosal variants in individuals having habit of smoking and chewing tobacco and to assess the relative risk of oral mucosal lesions resulting from these habits in north Indian population. ...
... 24 In a Finnish study, it was noted that denture wearing was more common in women and that 50% of the participants wearing dentures had oral lesions. 25 Sores caused by ill-fitting partial or total dentures have been associated with an increased risk of tongue cancer. [26][27][28] We observed no statistically significant association between Candida-related and tongue lesions and gastric cancer overall. ...
... 7,15,25 Literatürde hareketli protez kullanan hastaların %40-50'sinde POML'ye rastlandığı bildirilmiştir. 10,33 Mevcut çalışmada da bu oran %48.2 olup, önceki çalışmalarla uyumluluk göstermektedir. Önceki çalışmalarda olduğu gibi, cinsiyet ile POML arasında ilişki bulunmamıştır. ...
Objective: The aim of this study was to investigate whether there was a relationship between removable denture-related oral mucosal lesions and denture type, and demographic characteristics.
Materials and Method: The age, sex, denture type, systemic condition and medication use, presence of denture-related oral mucosal lesions (DROML), their locations and patients’ awareness of above mentioned lesions were recorded for 199 patients. Pearson chi-square test was used to analyse the relationship between the DROML and denture type, and demographic characteristics of the patients.
Results: Among the patients included to the study, 122 (61.3%) were female and 77 (38.7%) were male. Ninety-six patients (48.2%) exhibited DROML, whereas 103 patients (51.8%) had no DROML. No relationship was detected between DROML and age, and sex (p>0.05). The most commonly detected DROML was denture stomatitis (34.7%). Denture stomatitis was significantly more frequently seen in partial denture wearers (p
... Mikkonen et al. [3] studied the dentures according to age, sex, geographical region of living and discussed its importance with oral mucosal lesions occurring due to dentures. About 50% of denture wearers have lesions at some point of time; females were affected more than males. ...
Background and Aims: Removable complete denture is one of the most common treatment modalities for completely edentulous patients. After denture insertion, patient very often faces problems with the denture even after complete care is taken during fabrication procedure. Most common complaint is traumatic ulcers. The present study aimed to locate the most common areas of ulcerations due to complete dentures, how frequently they occur and how many times patient visits for adjustment after insertion of complete denture. Materials and Methods: Two hundred and twenty-one patients were selected and were delivered complete dentures. Dentures were fabricated for all the patients. Each step of denture fabrication was controlled and guided by a prosthodontist. After placement of dentures, patients were evaluated at every recall visit and their dentures were adjusted. All the details of each visit (area of ulceration) and number of visits were recorded in a self-designed format. Descriptive statistical analysis was done using SPSS version 13 software. Chi-squared test was used to evaluate the correlation between mucosal injuries and postinsertion day and the relationship between lesions, patient age, and patient gender. Results: All the 221 patients required denture adjustment due to mucosal injuries. No significant difference was found between denture-related injuries between males and females. Injuries related to mandibular dentures were significantly higher than those related to maxillary dentures. In mandible, the most common area of mucosal injury is posterior one-third of alveololingual sulcus; while in maxilla, the most common area of mucosal injury is labial frenum. Conclusion: Postinsertion adjustments are an important aspect of rehabilitating patient with complete dentures. Most of the denture-related injuries were in limiting areas. Proper border molding techniques, accurate secondary impressions, and use of pressure indicating paste during denture insertion are main requisites for decreasing denture-related mucosal injuries.
... However some studies do not identify smoking as a risk factor for oral lesions [10]. The use of dentures in the elderly has also been known to act as a potential risk factor for oral lesions and the development of oral cancer as well as other characteristic lesions such as denture stomatitis and hyperplasia [11,12]. Traumatic ulcers are the most frequently seen oral lesion in users of dentures [13]. ...
... With regard to factors associated with an increased risk of OPLs, many studies have reported that smoking, drinking alcohol, wearing dentures, and chewing betel nut can be risk factors (for example : Mikkonen et al., 1984;Shiu et al., 2000;Garcia et al., 2002;Thomas et al., 2003;Coelho et al., 2004;Chung et al., 2005;Tovosia et al., 2007;Thomas et al., 2008;Carrard et al., 2011). In addition, various demographic factors including age, gender, occupation, education level, and socioeconomic status have been associated with OPLs (Hashibe et al., 2003;Lim et al., 2003;Thomas et al., 2003;Carrard et al., 2011). ...
Background: Oral cavity cancer (OCC) is one of the most common cancers worldwide. No studies have reported on the prevalence and epidemiologic risk factors of oral premalignant lesions (OPLs) in Thailand. The purposes of this study were to investigate the prevalence of OPLs and the factors associated with OPLs in Roi Et Province, Thailand.
Materials and Methods: To investigate the prevalence of OPLs, a cross-sectional descriptive study was conducted in which 2,300 recruited subjects over 40 years of age were screened for the prevalence of OPLs. To identify factors associated with OPLs, a matched case-control study was used in which the subjects were 102 cases with OPL and 102 matched controls without OPLs. The studies were conducted in Roi Et Province during the period 1 February, 2014, to 30 April, 2014, and the data were collected by the use of a structured interview questionnaire and by the extraction of information from medical records. Data analyses involved the use of descriptive statistics, McNemar’s test, and conditional logistic regression.
Results: The overall prevalence of OPLs was 3.8%, and no-one was diagnosed with more than one type of OPL. The factors found to be associated with a statistically significant higher risk of an OPL were betel nut chewing, smoking, and alcohol consumption. The associations with these factors were strong, especially for betel nut chewing and smoking.
Conclusions: The habits of betel nut chewing, smoking, and alcohol use are confirmed as factors associated with OPLs in a population of Roi Et Province, Thailand. Campaigns to reduce these risk healthy behaviours are needed, but whether any decrease in these behaviours will prevent the eventual transformation of an OPL into an OCC remains an open question.
... Souvent, les dentistes recommandent aux personnes édentées de retirer leurs prothèses la nuit, afin d'éviter certaines affections de la muqueuse buccale qui sont associées au port de prothèses dentaires amovibles. Nous en citons la stomatite prothétique, la chéilite angulaire, les ulcères traumatiques, l'hyperplasie d'irritation prothétique et les carcinomes oraux (64)(65)(66)(67). Cependant, de nombreux patients préfèrent porter leurs prothèses la nuit en raison de l'impact sur leur vie personnelle (58,68). ...
Abstract(s)
Problématique : L’édentement et les troubles du sommeil sont des affections chroniques fréquentes chez les personnes âgées et qui peuvent avoir des conséquences défavorables sur le bien-être de ces personnes, ainsi que sur leur qualité de vie. L’édentement pourrait perturber le sommeil par la modification de la structure crânio-faciale et des tissus mous environnants. Cependant, cette relation n'est pas suffisamment documenté. Objectifs : Le but de cette étude pilote était de préparer la mise en œuvre d’une étude clinique randomisée contrôlée concernant l’effet du port nocturne des prothèses complètes sur la qualité du sommeil. Méthodologie : Treize aînés édentés ont participé à cette étude clinique randomisée contrôlée de type croisé. L’intervention consistait à dormir avec ou sans les prothèses durant la nuit. Les participants à l'étude ont été assignés à porter et ne pas porter leurs prothèses dans des ordres alternatifs pour des périodes de 30 jours. La qualité du sommeil a été évaluée par la polysomnographie portable et le questionnaire Pittburgh Sleep Quality Index (PSQI). Les données supplémentaires incluent la somnolence diurne, évaluée par le questionnaire Epworth Sleepiness Scale (ESS), et la qualité de vie liée à la santé buccodentaire, évaluée par le questionnaire Oral Health Impact Profile 20 (OHIP-20). De plus, à travers les examens cliniques et radiologiques, les données des caractéristiques sociodémographiques, de la morphologie oropharyngée, des caractéristiques buccodentaires et des prothèses ont été recueillies. Les modèles de régression linéaire pour les mesures répétées ont été utilisés pour analyser les résultats. Résultats : L’étude de faisabilité a atteint un taux de recrutement à l’étude de 59,1% et un taux de suivi de 100%. Le port nocturne des prothèses dentaires augmentait l’index d'apnée-hypopnée (IAH) et le score PSQI par rapport au non port nocturne des prothèses : (IAH : Médiane = 20,9 (1,3 - 84,7) versus 11,2 (1,9 - 69,6), p = 0,237; le score PSQI : Médiane = 6,0 (3,0 - 11,0) versus 5,0 (1,0 - 11,0), p = 0,248). Cependant, ces différences n'étaient pas statistiquement significatives, sauf que pour le temps moyen d’apnée (plus long avec des prothèses) (p < 0,005) et le temps de ronflement relatif (moins élevé avec des prothèses) (p < 0,05). La somnolence diurne excessive et la qualité de vie liée à la santé buccodentaire étaient semblables pour les deux interventions (le score ESS : Médiane = 4,0 (3,0-10,0) versus 5,0 (2,0-10,0), p = 0,746; le score OHIP-20: Médiane = 31,0 (20,0-64,0) versus 27,0 (20,0-49,0), p = 0,670). L’impact néfaste du port nocturne des prothèses complètes sur le sommeil a été statistiquement significatif chez les personnes souffrant de l’apnée-hypopnée moyenne à sévère (p < 0,005). Conclusion : L’essai clinique pilote a montré que le port nocturne des prothèses complètes a un impact négatif sur la qualité du sommeil des gens âgés édentés, surtout chez les personnes avec l’apnée obstructive du sommeil modérée à sévère. Les résultats doivent être confirmés par l’étude clinique randomisée contrôlée de phase II.
Problem: Edentulism and sleep disturbance are common chronic conditions in older people and may have adverse consequences on well-being of these persons, as well as their quality of life. Indeed, edentulism can modify the craniofacial structure and surrounding soft tissue, and lead to sleep disturbance in edentate individuals. However, this relationship is not sufficiently documented. Objectives: The aim of this study was to prepare a pilot randomized controlled trial on the effect of nocturnal complete denture wear on sleep quality. Methods: Thirteen edentate elders participated in this randomized cross-over clinical trial. The intervention consisted of sleeping with or without dentures at night. The study participants were assigned to wear and not wear their denture in alternate orders for periods of 30 days. Sleep quality was assessed by portable polysomnography and the Pittsburgh Sleep Quality Index (PSQI). Additional data included: daytime sleepiness assessed by the Epworth Sleepiness Scale (ESS) and oral-health-related quality of life assessed by the Oral Health Impact Profile 20 (OHIP-20). Furthermore, through the clinical and radiographic examinations, data on sociodemographic, oropharyngeal morphology, and oral and prosthesis characteristics were gathered. Linear regression models for repeated measures were used to analyze the data. Results: The recruitment rate for this study was 59.1% and the follow-up rate was 100%. Sleeping with dentures resulted in higher apnea-hypopnea index (AHI) and higher PSQI score when compared with sleeping without dentures (AHI: Median = 20.9 (1.3-84.7) vs. 11.2 (1.9-69.6), p = 0.237; PSQI score: Median = 6.0 (3.0-11.0) vs. 5.0 (1.0-11.0), p = 0.248). However, these differences were not statistically significant, except for the mean apnea time (more with dentures) (p < 0.005) and the relative snoring time (less with dentures) (p < 0.05). Excessive daytime sleepiness and the oral-health-related quality of life were similar for two interventions (ESS score: Median = 4.0 (3.0-10.0) vs. 5.0 (2.0-10.0), p = 0.746; OHIP-20 score: Median = 31.0 (20.0-64.0) vs. 27.0 (20.0-49.0), p = 0.670). The negative impact of sleeping with complete dentures wear was statistically significant in individuals suffering from moderate and severe apnea-hypopnea index (p < 0.005). Conclusion: The pilot clinical trial showed that wearing complete dentures at night has negative effects on the sleep quality of edentate elders, especially in individuals with moderate and severe obstructive apnea sleep. The results need to be confirmed with phase-II randomized clinical trial.
... In our study, the prevalence of oro-mucosal lesions was found to be 11.4%, which was very less as reported by Malaovalla et al. [13] and more as reported by Jahanbani. [14] The prevalence of lesion increased with age in our study which is same as that reported by Malaovalla et al. [13] but contrary with the study done by Mikkonen et al. [15] Furthermore, the most common oro-mucosal lesion in our study was tobacco pouch whereas in other studies leukoplakia is the most common lesion. Tobacco pouch was found to be 3.2%, which was high as reported by Ikeda et al. [16] The most common site affected by the lesions was buccal mucosa, which was same reported by Ikeda et al. [16] and García-Pola Vallejo et al. [17] The prevalence of oral submucous fibrosis was found to be 1.5%, which was less as reported by study carried out by Tang et al. [18] The mean number of teeth lost per worker showed a significant increasing trend with age in our study and it was same as that reported by Hayashi [19] and mean number of teeth loss were significantly greater in the age group of 55-63 years which was also same in both studies. ...
... [10] The use of dentures in the elderly has also been known to act as a potential risk factor for oral lesions and the development of oral cancer as well as other characteristic lesions such as denture stomatitis and hyperplasia. [11,12] Traumatic ulcers are the most frequently seen oral lesion in users of dentures. [13] The present study was carried out to verify the association between the use of tobacco and dentures and the development of oral mucosal lesions and to find the prevalence of oral lesions in a North Indian population. ...
The aim of the present study was to determine the prevalence and the relationship of oral mucosal lesions in tobacco users and denture wearers in a North Indian population.
The study comprised 3,749 patients attending the Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital between September 2008 and December 2012, for the treatment of dental problems other than oral mucosal lesions. The ages ranged from 28 years to 83 years, with a mean age of 49.7 years. The results were evaluated using the Pearson Chi-square test, with Yate's correction and ANOVA tests.
A total of 2,318 patients were diagnosed with lesions associated with the use tobacco and the wearing of dentures. The most frequently seen lesion was melanin pigmentation (29.9%) followed by linea alba (22.2%) and frictional keratosis (19.9%). Ulcers (6.1%) were the most common oral lesion seen in patients who wore dentures, followed by hyperplasia (4.8%). A statistically significant relation (P < 0.05) was established between tobacco and melanin pigmentation, frictional keratosis, traumatic ulcerations and leukoplakia. In those who wore dentures a statistically significant relation (P < 0.05) was found between candidiasis, traumatic ulceration and frictional keratosis.
The results of the present study indicate that the association of frictional keratosis with tobacco users and wearers of dentures can help in determining the diagnosis and treatment plan for oral cancer. Wearers of dentures should also be recalled for periodic checks at regular intervals and optimum preventive measures implemented.
... [6] Carcinomas are common in buccal mucosa, mucoceles are more commonly seen on lower lip, while minor salivary gland tumors are seen most commonly on upper lip. [7] Knowledge of site predilection for different diseases will be useful in acknowledging the factors responsible for the same. [8] The present retrospective study was carried out to assess the patterns of various oral cavity lesions among already existing data of 119 patients whose biopsy specimens were received in the department of pathology at Regional Institute of Medical Sciences (RIMS), Imphal during a period of 5 years (2006-2011). ...
Objective: To study the pattern of various oral cavity lesions in a tertiary care hospital in Manipur, India. Materials and Methods: This is a 5 year retrospective study from January 2006 to December 2011. All the oral cavity specimens received in the Department of Pathology, Regional Institute of Medical Sciences (RIMS) during the study period was included for the study. Data such as age, sex, and site of the lesion was collected and restaining of the slides with hematoxylin and eosin (H and E) was performed whenever required. Data's collected were analyzed. Results: A total of 119 cases was analyzed during the study period. Age ranged from 3 to 90 years in the study. Overall females were affected more than the male with male:female (M:F) ratio of 1:1.5. Buccal mucosa (26.9%) was the commonest site involved followed by tongue (26%). Neoplastic lesions accounted for 61.4% cases and nonneoplastic accounted for 38.6% cases. Among the neoplastic lesion, squamous cell carcinoma (SCC) was seen in 82% cases; verrucous carcinoma and ameloblastic carcinoma in 5.1% cases each; and mucoepidermoid carcinoma, adenosquamous carcinoma, and small cell carcinoma in 2.6% cases each. Most of the neoplastic lesions were located in the tongue (30.8%), followed by buccal mucosa (28.2%), alveolus (5.1%), floor of mouth (10.3%), and palate and lips (12.8%) each. The M:F ratio of the neoplastic lesion was 1:1.2. Chronic inflammatory lesions accounted for the maximum number of nonneoplastic lesions (26.1%), followed by fibrosis (23.9%), and fibrous hyperplasia and cystic changes, 17.4% each. Epulis accounted for 10.8% and ranula and hamartoma accounting for 2.2% each. The commonest site of involvement was gingiva and buccal mucosa with 32.6% each. Conclusion: A variety of lesions were encountered in the study with predominance of malignant lesions. SCC was the commonest malignant lesion. A larger epidemiopathological study in this region needs to be carried out.
... Denture-related lesions may represent acute or chronic reactions to microbial denture plaque, a reaction to constituents of the denture base material, or a mechanical denture injury 12 . With regard to denture type, denture-related mucosal lesions have been observed more frequently in complete denture wearers than in partial denture wearers 13 . This can be explained by the greater area of the oral mucosa covered by a complete denture than by a partial denture 14 . ...
The efficacy of a topical gel with triester glycerol oxide for treating ulcerations related to new complete dentures was studied and compared with a placebo gel.
Fifty edentulous patients were enrolled in this double-blind clinical study. All subjects received new maxillary and mandibular complete dentures and were recalled 1, 3 and 7 days after denture placement. Twenty-five subjects received topical gel with triester glycerol oxide (TGO), and 25 subjects received topical gel without TGO. At each visit, pain and discomfort with the new dentures was assessed, and at the last visit, healing of ulcerations was also graded by a clinician. Subjects also graded the gel's taste, smell and ease of use.
Specifically, there was no statistically significant difference in ulcer healing (p > 0.05), ratings of smell, taste and ease of use (p > 0.05) or pain and discomfort scores (p > 0.05). However, within-group differences were observed in pain and discomfort scores between follow-up sessions (p = 0.01 for all comparisons).
Clinically, TGO gel is not effective in the treatment of mucosal injuries occurring following placement of complete dentures.
... Most common denture-related problems were traumatic ulcer, denture stomatitis and angular cheilitis. Compared with the wearing of partial dentures, wearing complete dentures increased the risk of mucosal lesions (Jainkittivong et al., 2002;Mikkonen et al., 1984). Among the elders of the Helsinki Aging Study, 46% were edentulous and more than half (51%) of the edentulous subjects with complete dentures had mucosal lesions (Nevalainen et al., 1997). ...
Diss. -- Helsingin yliopisto.
... The prevalence of oral mucosal lesions varies between 52-59% depending on whether the subjects have lived independently or in an institution (Mikkonen et al., 1984;MacEntee & Scully 1988;Jorge et al., 1991;Espinoza et al., 2003). It has been assumed that the oral health of the independently living elderly would be better than the oral health of the elderly living in the institutions. ...
Diss. -- Helsingin yliopisto.
... Calibration of examiners for some types of conditions may not be possible, since many mucosal pathologies are rare. However, attempts at the measurement of inter-examiner reliability have been made for some of the more common conditions (Axell, 1976; Saietz, 1975; Mikkonen et al, 1984). For comparisons to be made among studies, standard methods of data collection and recording are needed. ...
Trend data on oral mucosal lesions are limited. The literature is comprised of a large number of studies documenting the prevalence of various lesions in different populations. Trend data on cancers of the oral cavity and pharynx are the exception. An overview of the international epidemiologic studies of these cancers is provided. General conclusions across studies and countries for trend data of these cancers cannot easily be drawn, since variations exist in data collection methods, risk factors, and other characteristics of the study populations. This paper also reviewed the available prevalence data for oral mucosal lesions in general as well as data on leukoplakia, recurrent herpes labialis, and recurrent aphthous ulcers. A few studies of the incidence of leukoplakia are described. In order to explore the potential for future trend data on oral mucosal lesions, this paper discusses issues related to the feasibility and structure of monitoring these lesions. Criteria that could be used to identify which conditions should be monitored in the future were discussed, such as, those that present a public health problem, those that are sentinel events for serious conditions, and infectious lesions. Once lesions are identified, it is clear that international consensus for diagnostic criteria of these lesions is needed in order to permit comparisons to be made among studies. Finally, strategies for monitoring these conditions and factors that may affect future trends are reviewed.
Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.
The aim of this paper is to review our understanding of the mechanisms and clinical significance of adhesion of C. albicans to denture-base materials in relation to denture plaque and denture-related stomatitis. Earlier reports in the literature of a 65% prevalence level of denture-related stomatitis seem to be exaggerated. More recent studies indicate that denture-related stomatitis is considerably less common, particularly in normal healthy subjects. The etiology of the condition is discussed in this review, and although much of the literature supports the view that the condition is strongly associated with C. albicans, this is not always so. In some subjects, the cause appears to be related to a non-specific plaque. This review also considers the role of denture plaque in the pathogenesis of denture-related stomatitis, the sequential development of denture plaque, and its colonization by Candida organisms. Designing controlled in vivo studies is difficult, and as a consequence, many investigators have had to resort to in vitro studies. The majority of these studies have attempted to investigate the hydrophobicity of C. albicans, relating the surface free-energy of denture-base materials, particularly acrylic resin, to that of the organism Surprisingly little work has been directed at surface roughness and how it affects retention of organisms. Further, no attention has been paid to the properties and character of the surface, other than average surface roughness, as it affects adhesion. A comparison of results from in vitro studies on the effect on adhesion of pre-coating the surfaces of denture-base materials with saliva has produced equivocal conclusions. This is largely due to little standardization of experimental protocols between studies, particularly in the collection and handling of the saliva used. In conclusion, the review strongly supports the suggestion that adherence of C. albicans to denture-base materials in vitro is related to the hydrophobicity of the organism. The clinical significance of the observation and the mechanisms for the development and maturation of denture plaque are yet to be understood. There is a clear need for further investigation of other factors that may moderate the adhesion of organisms and subsequent colonization of denture-base materials.
Objective: To determine the distribution of oro-mucosal lesions in patients of Maharishi Markendeshwer College of Dental Sciences and Research, (MMCDSR), Mullana. Further to identify sex predilection and different sites which are more susceptible to different oro-mucosal lesions. Materials and methods: A hospital based retrospective study was carried out from 1st January 2007 till 31st December 2009 at (MMCDSR), Mullana. A total of 451 biopsy reports were studied. Distribution and prevalence of oro-mucosal lesions among the data were analyzed using SPSS software package version 13. Results: There was no mention of habits in the biopsy reports of 85.4 % (385 patients) of the subjects. Out of the 66 subjects whose habits were mentioned, 71.2 % (47 patients) used to smoke tobacco in one form or the other. 21.2 % (14 patients) used to chew tobacco, 4.5 % (3 patients) of the subjects were in the habit of both smoking and chewing tobacco. More percentage of females 53.1 % were present in the age-group of 11-20 years as compared to males 46.9 % whereas in all other age-groups males were more in number. Regarding the distribution of oral lesions in the oral cavity, buccal mucosa was the common site for the presence of potentially malignant disorders in 16.8 % of the subjects and it was also the most common site for all the lesions. Conclusion: Lesion prevalence differed significantly by age, sex, and tobacco use. Individual demographic details such as age, gender, occupation, food habits, other deleterious oral habits, religion and oral hygiene measures should have a provision in biopsy request sheet and should be duly filled which will help in identifying risk-groups. Community programmes should be taken for public health to get them screened for any oral-mucosal lesions by availing pathological lab facilities.
Pacientes portadores de próteses totais, apresentam, com freqüência a chamada estomatite protética, com a qual associa-se Candida albicans determinando a chamada candidíase eritematosa. Assim, procuramos avaliar a suscetibilidade dessa levedura a agentes antifúngicos. A suscetibilidade de dezenove cepas de Candida albicans isoladas de pacientes apresentando estomatite protética foi estudada frente a: um derivado poliênico representado, pela anfotericina B (AnB), e dois derivados azóicos, cetoconazol e miconazol. A atividade antifúngica foi estudada a partir da determinação da concentração inibitória mínima (CIM) e da concentração fungicida mínima (CFM), pela técnica de diluição em ágar. Os resultados obtidos, mostraram baixos valores de CIMs e CFMs (< 0,15 m g/ml) para a AnB frente a todas as leveduras. Para o miconazol e o cetoconazol, foram observadas CIMs invariavelmente £ 4,00 m g/ml; para as CFMs, foram obtidos valores ³ 16,00 m g/ml frente a maioria das cepas. Conclui-se que a AnB apresentou maior ação fungicida in vitro enquanto os azóis demonstraram ação fungistática mas não fungicida. Acreditamos que a pesquisa de novas drogas, principalmente de uso tópico ainda é necessária, a fim de se tratar, com sucesso, a candidíase eritematosa, comumente observada nas chamadas estomatites protéticas.
The effectivenes of ozonized oil in the treatment of degree I and II denture stomatitis was evaluated. 64 patients patients from the Dental Prosthesis Service of the Faculty of Stomatology that required new prosthetic treatment and had denture stomatitis were selected. Oleozón was applied to 32 patients, whereas nystatin cream was used in the other 32 considered as controls. Both groups (study and control) were subdivided into 2 subgroups, according to degree I and II stomatitis, with 16 patients each. Tables showing the general results attained in accordance with the number of daily applications were included. We can conclude that the treatment with both drugs has been effective, but with the application of oleozón the results obtained in the curve of denture stomatitis were faster and less applications were needed.
100 total maxillary edentelous patients and carriers of maladjusted dentures that received attention at the Prosthesis Service of the Faculty of Stomatology of the Higher Institute of Medical Sciences of Havana City were studied. The patients were examined and the palatal mucosa was directly observed in order to find macroscopic signs of denture stomatitis. Denture stomatitis was classified according to Newton's criteria. The zone of location of the injury was determined and information about the denture-wearing habit was obtained by interviewing the patients. 70% of the studied patients had an altered mucosa with a predominance of degree II denture stomatitis in 44.3 % and degree III, with less frequency, in 21.4 %. The injury was preferably located in the middle and posterior zone of the palatine vault, for 44.3 and 34.3 %, respectively. 31 patients had the injury in the middle zone for 44.4 %. Degree II denture stomatitis prevailed in this zone for 58 %, followed by 24 patients with injury in the posterior zone (34.2 %), where the degree I predominated (58.3 %). As to the denture-wearing habit, 70 of the 100 studied patients wore thew denture continuously, whereas 25 wore it discontinuously. 62 of those who wore the prosthesis all the time had altered mucosa and among them there was a predominance of degree II stomatitis (96.8 %) and the injuries were more frequent in the middle and posterior zones, for 80.6 and 91.6 %, respectively. On relating the continuous denture-wearing habit, the zone of location of the injuries and the degreee of denture stomatitis, it was observed that in the middle zone the frequency of appareance of the injury was higher (35.8 %) and much lower in the anterior zone (8.5 %). The degree II injury prevailed in the middle zone, for 38.8 %, while the degree I injury predominated in the posterior zone, for 50 %.
Purpose:
To assess and compare the oral manifestations of HIV-infected paediatric patients undergoing ART (anti-retroviral therapy) and those not undergoing ART.
Methods:
A cross-sectional study was conducted amongst the 5-12 years old, HIV positive children (receiving and not receiving ART) registered at Nireekshana ART centre, Hyderabad and HIV negative children enrolled in a nearby school. HIV-related oral lesions were diagnosed according to WHO criteria. Information on age, gender, place of residence (urban/rural), socio-economic status, duration of HIV infection, duration of ART therapy, use of traditional medicine, presence of HIV-related systemic disease was recorded. CD4+ cell count was also determined for each subject. Chi-square test, stepwise multiple linear and logistic regression were used for statistical analysis. For all tests, confidence interval and p value were set at 95 % and p ≤ 0.05, respectively.
Results:
Twelve percent and 21.3 % of the study participants were on short-term and long-term ART (Group I), respectively. A greater proportion of HIV patients receiving treatment had CD4+ cell counts of more than 750 cells/mm(3). Nearly 81.3 % of HIV patients receiving long-term therapy did not have any oral lesions. Around half of the participants not receiving treatment suffered from HIV-related oral lesions. The best predictors for presence of oral lesions were socio-economic status, group (ART treatment), duration of HIV infection and CD4+ cell count.
Conclusion:
The results of the present study demonstrated that ART proved to be effective in reducing the prevalence of HIV-related oral lesions.
Purpose:
To compare the frequency of denture stomatitis (DS) under maxillary complete dentures (CDs) in patients with opposing mandibular distal extension removable partial dentures (RPDs) and CDs.
Materials and methods:
Participants included 365 maxillary CD wearers (241 women, mean age 70.5 ± 13.2 years; 124 men, mean age 71.5 ± 10.4 years) from 7 rest homes in Istanbul. A total of 268 had mandibular CDs; 97 had mandibular distal extension RPDs. Two independent, calibrated examiners performed oral examinations. Presence of maxillary denture-related stomatitis and the effect of risk factors on DS were evaluated and recorded.
Results:
The frequency of palatal DS (Newton I-III) was 45.1% (n = 121) in the mandibular CD group and 49.5% (n = 48) in the mandibular distal extension RPD group, a statistically insignificant difference (p= 0.4). Factors significantly associated with palatal DS were maxillary denture age (p= 0.02), reduced occlusal vertical dimension (p= 0.04), and nocturnal denture wear (p= 0.03).
Conclusion:
In this study, DS beneath maxillary CDs did not differ between mandibular distal extension RPD and CD wearers. The presence of mandibular anterior teeth did not influence the occurrence of palatal DS.
There is scant information in the literature on the local delivery of antifungal agents within the mouth. Research, therefore, is warranted to evaluate the optimal vehicle for the delivery of the agents to the oral mucosa. A major difficulty for the successful eradication of fungal infections appears to be the dilution and rapid elimination of the drugs from the oral cavity due to the flushing action of saliva. This problem may partly be circumvented by the discovery of the newer triazoles which appear to be effective for most oral candidoses, with only a single dose administration per day and the drug delivered via the systemic route. Nonetheless, whether such newer drugs, with a wide spectrum of activity and minimal toxicity, should be used routinely for oral candidoses merits consideration as emergence of resistant organisms to the triazoles have been now been reported. Accordingly, topical delivery of antifungals remains the most widely accepted approach, with techniques aimed at prolonging drug inhibitory concentrations in the oral cavity. Since most antifungals do not possess inherent ability to bind to oral mucosa, this goal may best be achieved through improved formulations.
The efficacy of fluconazole and amphotericin in the management of denture stomatitis was investigated in a comparative trial. Patients were assessed clinically, hematologically, and mycologically at the time of entry into the study and at 1, 4, and 12 weeks thereafter. A total of 29 patients were selected at random to receive 50 mg of fluconazole daily for 14 days; 30 patients were selected to receive amphotericin lozenges and cream for 28 days. Clinical response rates were similar in both treatment groups throughout the study. The best mycologic response was noted after 1 week whereas the best clinical response was observed after 4 weeks. Clinical evidence of relapse and recurrence at 12 weeks was a common finding irrespective of treatment. Side effects were uncommon in both groups.
The aim of this systematic review was to analyze the evidence on the occurrence of denture stomatitis (DS) and potential risk factors in patients wearing partial removable dental prostheses (RDPs).
MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews were searched and complemented by manual searching. Outcome measures were the presence of DS in patients wearing partial RDPs and an assessment of associated risk factors. All types of experimental and observational studies investigating an association between DS and the wearing of partial RDPs were included. Methodologic quality and level of evidence were assessed using valid scales. Two authors performed study selection, data extraction, and quality assessment independently.
A total of eight studies met the inclusion criteria. The prevalence of DS in partial RDP wearers ranged from 1.1% to 36.7%. Data on the potential risk factors were not consistent. Despite the heterogeneity and methodologic quality of included studies, an association between DS and the wearing of partial RDPs was found.
There is some evidence that the presence of DS is associated with the wearing of partial RDPs. However, because of methodologic limitations and cross-sectional designs of research studies, no cause-effect relationship could be inferred. Future research should provide higher levels of evidence to confirm the etiology of DS in partial RDP wearers.
Denture induced stomatitis (DIS) affects a large number of denture wearer patients, particularly elderly people. The purpose of this study was to determine the prevalence of DIS among a sample of denture wearers attending a teaching hospital, in relation to denture hygiene level and method, age, gender, objective and subjective severity of the lesion.
A total of 71 denture wearers were systemically interviewed and clinically examined by the same operator of their oral mucosal health and the denture hygiene practice. A questionnaire, including 20 questions was used in this study.
The results showed an incidence of DIS in both arches of 62% with no difference between the maxillary and mandibular arches. Denture hygiene within patients was good by 21.1%, of the sample, fair by 43.6% and poor by 35.2%. Another finding proved the incidence of DIS to be higher (Rev-1 + Rev-2) in elderly patients and a significant association was found between the presence of DIS and denture hygiene habits and sleeping with dentures (P < 0.05), with no differences related to gender.
Results indicated that the predisposing factors to DIS are associated with the method of denture hygiene methods and use of denture while sleeping. Clinical significance: Dentists and dental hygienists should bear the responsibility by routinely providing post-placement denture hygiene instructions to educate and motivate the patient.
To determine the prevalence of oral mucosal lesions (OMLs) and denture-related mucosal lesions (DMLs) in denture wearers and to co-relate the prevalence with age, gender, type of denture and any systemic conditions.
Dental records of 380 denture wearers were retrospectively reviewed for OMLs and DMLs.
We found 45% of the denture wearers had DMLs and 60.8% had OMLs not related to denture wearing. Although the prevalence of DMLs was higher in complete denture wearers than in partial denture wearers (49% vs. 42.2%), this difference was not significant. The most common DMLs were traumatic ulcer (19.5%) and denture-induced stomatitis (18.1%). When analysed by type, traumatic ulcer, denture hyperplasia, frictional keratosis and candidiasis were more common in complete denture wearers, whereas denture-induced stomatitis was more common in partial denture wearers. Frictional keratosis was more common in men than in women. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers, and the most common OML was fissured tongue (27.6%). No association between DMLs and systemic conditions or xerostomic drugs was noted.
No differences in the prevalence of DMLs in association with denture type were found. The prevalence of OMLs not related to denture wearing was higher in complete denture wearers than in partial denture wearers. This difference was affected by age, and the data were similar to the findings observed in the elderly.
Pathology related to complete denture-wearing will remain an important issue because of an increase in the ageing population.
To investigate the prevalence and the risk factors for denture-related stomatitis in the edentulous maxilla of older patients with a maxillary complete denture.
One hundred and six patients treated in the Department of Prosthodontics of the Athens Dental School were interviewed and clinically examined. The results were analysed using chi-square tests and multiple logistic regression.
Denture stomatitis was recorded in 39.6% of the sample (pinpoint hyperaemia: 17%, diffuse erythema: 16%, papillary hyperplasia: 6.6%). Chi-square tests recorded significant associations between denture stomatitis and the continuous use of dentures (particularly the diffuse erythema type), the increased duration of denture experience and the poor retention of the maxillary denture. Other significant associations were recorded between the increased age of the current denture and pinpoint hyperaemia, and the reduced frequency of denture cleaning and papillary hyperplasia. Multiple logistic analysis revealed that the most important risk factor for denture stomatitis was the continuous use of the denture.
The prevalence of denture stomatitis was high in denture users. Although many predisposing conditions were recorded, the most important risk factor was the continuous use of the denture. Therefore, appropriate advice on denture maintenance should be provided.
The prevalence and microbiology of macrophotographically documented denture stomatitis were studied in denture wearers participating in an interdisciplinary health-monitoring project (Koster Health Project) on the Koster islands, Sweden. Upper dentures were used by 26.6% of the adult population, and 59.2% of the denture wearers had stomatitis. Denture stomatitis type I was identified as sialadenitis. The more severe forms of denture stomatitis (types II and III) demonstrated increased recovery of microorganisms in the palatal mucosa in addition to sialadenitis. Only one proband showed increased growth of fungi. Hemophilus spp. and Bacteroides spp. were the predominating microorganisms in stomatitis types II and III. Shifts in the normal oral flora are suggested to be an important factor for the development of denture stomatitis. It is concluded that bacterial colonization on the palatal mucosa may play an important role in denture stomatitis in this relatively healthy population.
The effect of inorganic acid fumes from the working environment on the occurrence of periodontal pockets and soft oral tissues was investigated in a cross-sectional, blind study. A sample of 186 workers was drawn from 4 factories. Of the 170 participants, 82 were working in departments containing acid fumes, and 88 controls had never worked under such conditions. Of the workers exposed to acid fumes 36.9% and of the controls 30.9% had periodontal pockets. The presence of periodontal pockets increased with age significantly more among the acid-exposed workers than among the controls (p less than 0.0001). Oral mucous membrane lesions were observed among 23.2% of the acid-exposed workers and 21.6% of the controls. The findings suggest that acid fumes in the workplace air do not increase the occurrence of oral mucous lesions but may lead to an increase in the prevalence of periodontal pockets.
During the last decade, many studies in Europe and North America have evaluated oral conditions and dental needs in the elderly. Similar information does not exist in Brazil. The aim of this study was to determine the prevalence of oral health and disease in elderly persons living in an institution in the city of Piracicaba, State of São Paulo, Brazil. Of 350 elderly persons, 134 males and 136 females were interviewed and clinically examined. Less than one half had healthy mouths. 58.9% of the examined individuals showed one or more lesions in the oral mucosa, the most frequent being denture-induced stomatitis (20.0%). Fibrous hyperplasias (11.8%) and angular cheilitis (9.3%) were fairly common. Gender, use and degree of hygiene of the denture were factors statistically significantly contributing to prevalence of denture stomatitis. Precancerous lesions such as leukoplakia (3.0%), actinic cheilitis (2.6%) were uncommon but three cases of squamous carcinoma (1.1%) were revealed. This study emphasizes the need for regular oral examinations of the elderly by personnel trained in oral diagnosis.
The methods used in the international English-language literature of epidemiologic investigations of oral mucosal conditions were reviewed. Methods used to study leukoplakia, lichen planus, recurrent herpes labialis, recurrent aphthous ulcers, geographic tongue and candidiasis are highlighted. In addition, studies of the full range of pathologies documented in a population were reviewed. The methodologic issues raised by the epidemiologic literature as well as those to be considered for future studies of oral mucosal conditions are presented. Emphasis is placed on study population selection, diagnostic criteria development, type and training of examiners, risk factor assessment and issues related to data collection, analysis and reporting.
Using a representative sample of 5028 dentulous Finnish adults the occurrence of periodontal pockets was studied separately for the maxillae and the mandibles among removable partial denture (RPD) wearers and non-wearers. RPD(s) were worn in 11.2% of the 3444 maxillae with at least four natural teeth remaining, and in 7.7% of the 4706 corresponding mandibles (P less than 0.001). Periodontal pockets were more frequently observed in maxillae than mandibles. Wearing of RPDs highly significantly (P less than 0.0001) increased the odds of having periodontal pockets in general (4 mm or more) as well as the odds of having deeper periodontal pockets (exceeding 6 mm). This phenomenon was observed both in the maxillae and in the mandibles. These results suggest that wearing of RPD is a threat to periodontal tissues and that dentists should take care to frequently recall their patients fitted with RPD(s). During the recall visits more attention should be paid to the periodontal conditions of patients wearing RPD(s).
The purpose of the study was to determine the prevalence of oral mucosal lesions among institutionalized elderly. The study population comprised 486 elderly from eight nursing homes, and 199 elderly from five hospital long-term care facilities in the eastern part of Denmark. Approximately half of the subjects exhibited one or more pathologic conditions of the oral mucosa. Denture related traumatic ulcerations were found in 3.9% of the nursing home residents, compared to 8.3% among the elderly in hospital long-term care. The most prevalent finding was denture stomatitis, which was manifest in about one third of the elderly. The prevalence was strongly influenced by the denture hygiene; 54% of the elderly with poor denture hygiene suffered from denture stomatitis, as compared to only 7% of those with clean dentures. The prevalence of denture stomatitis was also related to the usage of dentures at night and to the age of the dentures. The prevalence decreased significantly with increasing age, although the oldest age group did not have better denture hygiene, or more favorable wearing habits. It did not appear that sex, type of residency, degree of urbanization, denture conditions, or the use of anticholinergic drugs influenced the prevalence of denture stomatitis. The prevalence and severity of the disease can probably be reduced if the denture hygiene is improved and if the elderly only use their dentures during the daytime.(ABSTRACT TRUNCATED AT 250 WORDS)
Using a representative sample of 5028 dentulous Finnish adults the occurrence of dental caries was studied among removable partial denture (RPD) wearers and non-wearers. Of the subjects wearing no RPD(s) 61.4% had one or more carious teeth, among those wearing a single RPD the figure was 60.5% and among those wearing RPDs in both jaws 62.7%, respectively. When sociodemographic background, other oral status measures than caries and oral health care habits were simultaneously controlled, subjects wearing RPDs in both jaws had slightly increased (P less than 0.05) probability of having one or more carious teeth compared to those with no RPD(s). Subjects with a single RPD did not have a statistically significantly increased probability of having carious teeth. Among those 3075 subjects who had one or more carious teeth the wearing of one or two RPDs did not significantly increase the number of carious teeth. Because the subjects wearing RPDs in both jaws were seen to have a slightly increased risk of having caries, this confirms the view that dentists should emphasize good oral hygiene habits and regular dental attendance among RPD wearers.
In a population of 629, 145 elderly subjects had at least one mucosal lesion; 27% of denture wearers had a denture-related lesion. Lesions were found most commonly on the palate, followed by the lips. Increasing age was the only significant factor in the risk of soft tissue enlargement.
A representative sample of Finnish denture wearers (n = 3875) aged 30 or over were examined clinically and interviewed about their oral hygiene habits, use of dental services and possible prosthetic treatment during last visit to a dentist. Of these denture wearers, over 80% brushed their dentures at least once a day, and 16% visited a dentist at least once in 2 yr. For denture stomatitis the age-standardized risk ratio decreased with brushing frequency in women and increased in men. For frequency of dental visits the prevalence of denture stomatitis increased in both men and women when visits were made over 2-yr intervals. The prevalence of denture stomatitis was higher in the group with dentures over 1 yr old. It seems that the oral hygiene measures as they are generally carried out and regular dental visits are not effective enough methods in preventing denture stomatitis.
Oral mucosal changes and associated factors were studied among male industrial workers in southern Finland. Two groups, with or without access to an employer-provided dental benefit scheme, were compared. A multiple-choice questionnaire followed by clinical examinations was completed by 325 (81%) subsidized workers and 174 (69%) controls. In both groups 52% of the subjects had some oral mucosal change, and there were no significant differences between the groups in the location distribution of the changes. Smoking was significantly associated with redness of the oral mucosa (p < 0.001), coating (p < 0.001), and leukoplakia (p < 0.01), whereas denture wearing was associated with ulcers (p < 0.05), hyperplasia (p < 0.001), and redness (p < 0.001). Among denture wearers non-acceptable dentures were significantly associated with hyperplasia (p < 0.001). The subsidized group had better dentures, although this did not significantly benefit their oral mucosal status.
Over the last century, the number and percentage of older adults has increased dramatically. In the last 30 years, the percentage of older edentulous adults has declined significantly but the total number is expected to remain constant at 9 million until the year 2020. The increasing number of and percentage of dentate adults will have more teeth at risk for caries and periodontal disease. Many of these adults will have multiple medical problems and be taking various pharmacotherapies which will complicate oral disease and its treatment. New concepts in prevention of oral disease will be required, as will more accurate diagnostic procedures, especially to identify the at-risk older adults.
2 statistics, kappa and weighted kappa, are available for measuring agreement between 2 raters on a nominal scale. Formulas for the standard errors of these 2 statistics are in error in the direction of overestimation, so that their use results in conservative significance tests and confidence intervals. Valid formulas for the approximate large-sample variances are given, and their calculation is illustrated using a numerical example. (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1969 American Psychological Association.
Abstract A representative sample (n= 8000) was drawn from the population aged 30 years and over, registered as living in Finland. Periodontal disease status was recorded according to the modified Periodontal Treatment Need System (PTNS). Plaque retentions were examined separately. Of the subjects with four or more teeth 3.4% had a healthy periodontal status, while 10.2% of the jaw quadrants were healthy Plaque retentions were found in 96.6% of the subjects and 90.9% of the jaw segments. Periodontal treatment need was calculated in three ways and was 195± 111 (S. D.) min when the calculation was based on WHO recommendations (1978). Number of teeth, age, sex, caries and filling scores, and education explained about 30% of the treatment need when tested by multiple linear regression analysis.
The prevalence of oral soft tissue lesions in elderly people was studied by examining 487 inmates of old people's homes, age range 65-101 years (117 men, 370 women). The prevalence figures were: fissured tongue 42.8%, varicosities on the ventral side of the tongue 42.8%, furred or coated tongue 28.7%, Fordyce spots 26.0%, atrophic buccal mucosa 20.3%, atrophic tongue surface 17.9%, other vascular changes 15.8%, hyperkeratotic lesions 14.4%, ulcerative changes 7.8%, benign tumours or tumourlike lesions 7.8%, cheilosis 7.3%, bullous or vesicular lesions 3.7%. The lesions were more common among men than women. The prevalence rates of denture-related lesions in 297 denture wearers were; denture stomatitis (localized or generalized) 54.7% in maxilla, 36.0% in mandible; angular stomatitis 24.9%; flabby ridges 20.4% in maxilla, 26.5% in mandible; periphery hyperplasias 12.8% in maxilla, 19.6 % in mandible; palatal papillary hyperplasias 17.6%; traumatic ulcers 19.1% in maxilla, 35.4% in mandible; suction cup or relief chamber lesions 15.6%. Maxillary denture stomatitis was more common among women than men (p<0.05), whereas for the mandible it was vice versa (p<0.05). Denture stomatitis was more common in the maxilla than mandible (p<0.001), while for periphery hyerplasias and ulcerations the opposite was true (p<0.05; p<0.001). Soft tissue pathology became more frequent as the dentures became older.
The reduction in the epithelial thickness under dentures did not reach the level of significance. The significant reduction in the epithelial morphology indicating a flatter basement membrane would suggest that the epithelium undergoes an adaptive change as a result of surface loading to produce a more uniform epithelium. The degree of keratinization was less and the stratum corneum was thinner in the epithelium under dentures. The complete dentures in these studies seemed to reduce the quantity and quality of the keratin layer. This study has shown that the presence of a denture produced a more regular epithelium with few rete ridges, and a thinner, less highly keratinized stratum corneum.
Lesions of the oral mucosa associated with wearing of removable dentures may represent acute or chronic reactions to microbial denture plaque, a reaction to constituents of the denture base material, or a mechanical denture injury. The lesions constitute a heterogeneous group with regard to pathogenesis. They include denture stomatitis, angular cheilitis, traumatic ulcers, denture irritation hyperplasia, flabby ridges, and oral carcinomas. Denture stomatitis is the most common condition which affects the palatal mucosa in about 50% of wearers of complete or partial removable dentures. Most of the lesions caused by chronic infection (Candida albicans) or mechanical injury whereas allergic reactions to the denture base materials are uncommon. Angular cheilitis (lesions of the angles of the mouth) is characterized by maceration, erythema and crust formation. The prevalence is about 15% among wearers of complete dentures. The lesions have an infectious origin but several local, including prosthetic, or systemic predisposing conditions are usually present. Traumatic ulcers caused by dentures with overextended or unbalanced occlusion are seen in about 5% of denture wearers. Denture irritation hyperplasia, which is caused by chronic injury of the tissue in contact with the denture border, is present in about 12% of denture wearers. Flabby ridge, which is replacement of alveolar bone by fibrous tissue, is present in 10-20%. Finally, there is evidence that chronic injury of the oral mucosa by dentures in rare instances may predispose to development of carcinomas. Most types of lesions are benign and quite symptomless. However, diagnosis may be difficult and the more severe and dramatic tissue reactions to dentures may indicate underlying systemic diseases. In order to prevent or minimize the extent of the lesions, denture wearers should be recalled regularly for an examination of the oral cavity and the dentures. It is important that the examination is carried out by a person who has adequate medical knowledge.
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Clinical aspects, pathology and patho-genesis. Thesis Oral mueosa and eomplete dentures
- Bertram U Xerostomia Watson Ib
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Primary oral status and adaptation to complete dentures Oral health among the inmates of old people's homes. IV. Soft tissue pathology
- A Makti
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Primary oral status and adaptation to complete dentures
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The effect of ageing upon oral mucosa
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